scholarly journals EFFECT OF CHAIR YOGA ON FRAILTY IN OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS: RANDOMIZED CLINICAL TRIAL

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S685-S685
Author(s):  
Juyoung Park ◽  
Zuyun Liu ◽  
Edgar R Vieira ◽  
Patricia Liehr
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Frailty Index ◽  
Secondary Analysis ◽  
Cohort Effect ◽  
Community Dwelling ◽  
Primary Analysis ◽  
Linear Mixed Effects ◽  
Random Intercept ◽  
Community Dwelling Older Adults

Abstract This study examined whether chair yoga (CY) could reduce severity of frailty in community-dwelling older adults with lower extremity osteoarthritis (OA). Participants were randomly assigned to CY or health education program (HEP) at each of two sites and attended twice-weekly 45-minute sessions for 8 weeks. Data were collected at baseline and 4 and 8 weeks. For primary analysis, followed by Rockwood’s suggesiton, 97 deficits/variables measuring OA symptoms, physical function, balance, fatigue, depression, social activities, and life satisfaction were used to construct a frailty index, ranging from 0 to 1. Fewer deficits/variables were used to construct three alternative versions of the index. Linear mixed-effects models with random intercept were used to analyze longitudinal repeated outcome measures. A total of 112 participants (n = 63 CY, n = 49 HEP; 75.3[7.5] years; 76% female, 46% Hispanic) completed the study. After adjusting for site, cohort effect, and baseline of frailty, there was no significantly greater decline in frailty in the CY group compared to the HEP group (between-group difference, -0.019; 95% CI, -0.063 to 0.025) or the trend of changes in the index (p for interaction = .489). Additional adjustment for baseline characteristics (age, gender, ethnicity, marital status, living alone, health status, pain medication) did not change results substantially. Secondary analysis of three alternative versions of the index indicated similar nonsignificant changes. Thus, an 8-week CY intervention did not reduce severity of frailty in older adults with lower extremity OA. A longer duration of CY with a larger sample size is needed.

scholarly journals Bedside Ultrasound Measures of Muscle Mass and Frailty Measures in Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 269-269
Author(s):  
Kenneth Madden ◽  
Boris Feldman ◽  
Shane Arishenkoff ◽  
Graydon Meneilly
Keyword(s):  
Older Adults ◽  
Muscle Mass ◽  
Frailty Index ◽  
Geriatric Medicine ◽  
Muscle Thickness ◽  
Vancouver General Hospital ◽  
Community Dwelling ◽  
Point Of Care Ultrasound ◽  
Clinical Frailty Scale ◽  
Community Dwelling Older Adults

Abstract The age-associated loss of muscle mass and strength in older adults is called sarcopenia, and it is associated with increased rates of falls, fractures, hospitalizations and death. Sarcopenia is one of the most common physical etiologies for increased frailty in older adults, and some recent work has suggested the use of Point-of care ultrasound (PoCUS) measures as a potential measure of muscle mass. The objective of this study was to examine the association of PoCUS measures of muscle thickness (MT) with measures of frailty in community-dwelling older adults. We recruited 150 older adults (age >= 65; mean age 80.0±0.5 years, 66 women, 84 men) sequentially from 5 geriatric medicine clinics (Vancouver General Hospital). We measured lean muscle mass (LMM, by bioimpedance assay) and an ultrasonic measure of muscle quantity (MT, vastus medialis muscle thickness) in all subjects, as well as two outcome measures of frailty (FFI, Fried Frailty Index; RCFS, Rockwood Clinical Frailty Scale). In our models, MT showed an inverse correlation with the FFI (Standardized β=-0.2320±0.107, p=0.032) but no significant correlation with the RCFS (Standardized β = -0.025±0.086, p=0.776). LMM showed no significant association with either FFI (Standardized β=-0.232±0.120, p=0.055) or RCFS (Standardized β = -0.043±0.119, p=0.719). Our findings indicate that PoCUS measures show potential as a way to screen for physical manifestations of frailty and might be superior to other bedside methods such as bioimpedance assay. However, PoCUS measures of muscle thickness will likely miss patients showing frailty in the much broader context captured by the RCFS.

scholarly journals Meaningful Change Estimates for the Late-Life Function and Disability Instrument in Older Adults

2018 ◽  
Vol 74 (4) ◽  
pp. 556-559 ◽  
Author(s):  
Marla K Beauchamp ◽  
Rachel E Ward ◽  
Alan M Jette ◽  
Jonathan F Bean
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Community Dwelling ◽  
Minimal Detectable Change ◽  
Global Rating ◽  
Mobility Limitations ◽  
Meaningful Change ◽  
Patient Reported ◽  
Community Dwelling Older Adults ◽  
Life Function

Abstract Background The Late-Life Function and Disability Instrument (LLFDI) is a well-validated and frequently used patient-reported outcome for older adults. The aim of this study was to estimate the minimal clinically important difference (MCID) of the LLFDI-Function Component (LLFDI-FC) and its subscales among community-dwelling older adults with mobility limitations. Methods We performed a secondary analysis of the Boston Rehabilitative Impairment Study of the Elderly, a longitudinal cohort study of older adults with mobility limitations residing in the community. The MCID for each LLFDI-FC scale over 1 year of follow-up was estimated using both anchor- and distribution-based methods, including mean change scores on a patient-reported global rating of change in function scale, the standard error of measurement (SEM), and the minimal detectable change with 90% confidence (MDC90). Results Data from 320 older adults were used in the analysis (mean age 76 years, 69% female, mean of four chronic conditions). Meaningful change estimates for “small change” based on the global rating of change and SEM were 2, 3, 4, and 4 points for the LLFDI-FC overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. Estimates for “substantial change” based on the global rating of change and minimal detectable change with 90% confidence were 5, 6, 9, and 10 points for the overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. Conclusion This study provides the first MCID estimates for the LLFDI-FC, a widely used patient-reported measure of function. These values can be used to interpret the outcomes of longitudinal investigations of functional status in similar populations of community-dwelling older adults.

scholarly journals 44 Association between Falls and Cognitive Frailty among Community Dwelling Older Adults: A Cross Sectional Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Resshaya Roobini Murukesu ◽  
Devinder Kaur Ajit Singh ◽  
Noor Izyani Mokhtar ◽  
Janet Bong May Ing ◽  
Ponnusamy Subramaniam ◽  
...  
Keyword(s):  
Older Adults ◽  
Rating Scale ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cognitive Frailty ◽  
Prospective Longitudinal ◽  
Community Dwelling Older Adults

Abstract Introduction The presence of either frailty or cognitive impairment have been determined as precursors of falls among older adults. However, the association between falls and cognitive frailty has yet to be established. Objective To investigate the association between falls and cognitive frailty among community dwelling older adults. Methods A total of 246 Malaysian community dwelling older adults aged 60 years and above residing in the state of Selangor participated in this cross-sectional study. Sociodemographic details and clinical characteristics including the history of falls were obtained via interview. The presence of cognitive frailty was identified using the Clinical Dementia Rating Scale and Fried Frailty Index. Data analysis was carried out via binary logistic regression. Results The prevalence of falls and cognitive frailty in this study were 21.2% and 21.9% respectively among community dwelling older adults (mean age 72.39±5.40). No significant relationship between falls and cognitive frailty [OR:1.187, 95% C.I: 0.493-2.856, p=0.702] was demonstrated. However, older women [OR:2.663, 95% C.I, 1.136-6.239, p=0.024] and the presence of multi-morbidities [OR: 1.431, 95% C.I, 1.026-1.997, p=0.035] were significantly associated with falls which corroborates with existing literature. Conclusion Cognitive frailty was not a significant risk factor of falls among community dwelling older adults in this study. Further research is required in prospective, longitudinal, population-based studies to confirm this result.

scholarly journals LO13: Characteristics of emergency department visits by community-dwelling older adults who screened positive for elder abuse during home care assessments

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S11 ◽  
Author(s):  
E. Mercier ◽  
A. Jones ◽  
A. Brousseau ◽  
J. Hirdes ◽  
F. Mowbray ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Reporting System ◽  
Elder Abuse ◽  
Frailty Index ◽  
Population Based ◽  
Community Dwelling ◽  
Care Assessment ◽  
Ed Visits ◽  
Community Dwelling Older Adults

Introduction: Elder abuse is infrequently detected in the emergency department (ED) and less than 2% are reported to proper law authorities by ED physicians. This study aims to examine the characteristics of community-dwelling older adults who screened positive for elder abuse during home care assessments and the epidemiology of ED visits by these patients relative to other home care patients. Methods: This study utilized a population-based retrospective cohort study of home care patients in Canada between April 1, 2007 and March 31, 2015. Standardized, comprehensive home care assessments were extracted from the Home Care Reporting System. A positive screen for elder abuse was defined as at least one these criteria: fearful of a caregiver; unusually poor hygiene; unexplained injuries; or neglected, abused, or mistreated. Home care assessments were linked to the National Ambulatory Care Reporting System in the regions and time periods in which population-based estimates could be obtained to identify all ED visits within 6 months of the home care assessment. Results: A total of 30,413 from the 2,401,492 patients (1.3%) screened positive for elder abuse during a home care assessment. They were more likely to be male (40.5% versus 35.3%, p < 0.001), to have a cognitive impairment (82.9% versus 65.3%, p < 0.001), a higher frailty index (0.27 versus 0.22, p < 0.001) and to exhibit more depressive symptoms (depression rating scale 1 or more: 68.7% versus 42.7%, p < 0.001). Patient who screened positive for elder abuse were less likely to be independent in activities of daily living (41.9% versus 52.7%, p < 0.001) and reported having fallen more frequently (44.2% versus 35.5%, p < 0.001). Caregiver expressing distress was associated with elder abuse (35.3% versus 18.3%, p < 0.001) but not a higher number of hours caring for the patient. Victims of elder abuse were more likely to attend the ED for low acuity conditions (Canadian triage and acuity scale (CTAS) 4 or 5). Diagnosis at discharge from ED were similar with the exception of acute intoxication that was more frequent in patients who are victims of abuse. Conclusion: Elder abuse is infrequently detected during home care assessments in community-dwelling older adults. Higher frailty index, cognitive impairment, depressive symptoms were associated with elder abuse during homecare assessments. Patients who are victims of elder abuse are attending EDs more frequently for low acuity conditions but ED diagnosis at discharge, except for acute intoxication, are similar.

scholarly journals Time-restricted feeding and lower-extremity functioning in community-dwelling older adults

2020 ◽  
Vol 40 ◽  
pp. 684
Author(s):  
D.B. Estrada-deLeón ◽  
E.A. Struijk ◽  
F.F. Caballero ◽  
M. Sotos Prieto ◽  
F. Rodríguez-Artalejo ◽  
...  
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Community Dwelling ◽  
Restricted Feeding ◽  
Community Dwelling Older Adults
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