scholarly journals PERCEIVED MENTAL FATIGABILITY: NOVEL INSIGHTS INTO SOCIOBEHAVIORAL CORRELATES AND HERITABILITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S232-S232
Author(s):  
Nancy W Glynn ◽  
Eleanor M Simonsick
Keyword(s):  
Older Adults ◽  
Coping Styles ◽  
Functional Decline ◽  
Patient Reported Outcome ◽  
Self Report ◽  
Future Directions ◽  
Brain Volumes ◽  
Diurnal Patterns ◽  
Patient Reported ◽  
And Coping

Abstract Fatigue, a common patient-reported outcome, is a unique risk factor associated with both cognitive and physical function. Perceived mental fatigability, a self-report measure of cognitive fatigue anchored to activities of fixed intensity and duration, eliminates self-pacing bias, and therefore is a more sensitive measure of the degree to which cognitive tiredness limits activity. Higher perceived mental fatigability has been associated with functional decline and lower grey matter brain volumes in older adults. We developed the Pittsburgh Fatigability Scale (PFS), a self-administered, 10-item tool to assess perceived physical and mental fatigability across a range of activities, which is widely used internationally. We previously validated the PFS physical subscale. Using a large multicenter international cohort, the Long Life Family Study, we will present the validation of the PFS mental subscale, examine its epidemiology, and explore genetic and socio-behavioral factors associated with perceived mental fatigability in older adults. Specifically, Ms. Renner will share the results of the validation of the PFS mental subscale; Ms. Meinhardt will present heritability and prevalence of higher perceived mental fatigability across age strata and sex; and Ms. Gmelin will consider the link between stress and coping styles on perceived mental fatigability. Further, using a smaller methodological study, the Developmental Epidemiologic Cohort Study, Ms. Graves will explore whether diurnal patterns of physical activity using accelerometry differ in older adults with higher versus lower perceived mental fatigability. Dr. Simonisick, our Discussant, will critically review the presentations and share future directions to inform potential interventions aimed at lowering perceived mental fatigability.

Standardised approach to measuring goal-based outcomes among older disabled adults: results from a multisite pilot

2020 ◽  
pp. bmjqs-2019-010742
Author(s):  
Erin R Giovannetti ◽  
Catherine A Clair ◽  
Lee A Jennings ◽  
Shana F Sandberg ◽  
Angelia Bowman ◽  
...  
Keyword(s):  
Older Adults ◽  
Goal Attainment ◽  
Health Management ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Goal Attainment Scaling ◽  
Care Needs ◽  
Trade Offs ◽  
Patient Reported ◽  
Specific Care

BackgroundOlder adults with complex care needs face trade-offs in determining the right course of treatment. The Centers for Medicare and Medicaid Services identified ‘Care is personalized and aligned with patient’s goals’ as a key meaningful measures category, yet existing quality measures typically assess disease-specific care and may not effectively evaluate what is most important to older adults and family members. Measures based on individualised goals and goal-based outcomes have been proposed as an alternative but are not routinely assessed or implemented.ObjectivesWe tested two approaches to assessing goal-based outcomes that allow individuals to set goals based on their own priorities and measure progress—(1) goal attainment scaling and (2) existing, validated patient-reported outcome measures (PROM).MethodsA prospective cohort study of feasibility in seven sites (33 clinicians) of the two approaches with 229 individuals. We calculated performance on a measure of achievement of individually identified goals.ResultsBoth approaches were successfully implemented in a non-randomly selected population, and a goal-based outcome could be calculated for 189 (82%) of participants. Most individuals met their goal-based outcome (73%) with no statistical difference between the goal attainment scaling approach (74%) and the patient-reported outcomes approach (70%). Goals were heterogeneous ranging from participating in activities, health management, independence and physical health. Clinicians chose to use goal attainment scaling (n=184, 80%) more often than PROMs (n=49, 20%) and rated the goal attainment scaling approach as useful for providing patient care.ConclusionGoal-based outcomes have the potential to both improve the way healthcare is provided and fill a critical gap in value-based payment.

scholarly journals THE MEDIATING ROLES OF HEALTH LOCUS OF CONTROL AND COPING ON THE PAIN-DEPRESSION PATHWAY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S162-S162
Author(s):  
Kyrsten Costlow ◽  
Patricia A Parmelee ◽  
Tina Harralson
Keyword(s):  
Older Adults ◽  
Locus Of Control ◽  
Coping Strategies ◽  
Health Locus Of Control ◽  
Self Report ◽  
Osteoarthritis Of The Knee ◽  
Osteoarthritis Pain ◽  
Serial Mediation ◽  
Negative Coping ◽  
And Coping

Abstract The literature on health locus of control (HLC) suggests that individuals who believe that their health is internally determined are more likely to use active coping strategies than those who believe their health is determined by chance or powerful others (Brosschot, Gebhardt, & Godaert, 1994; Gibson & Helme, 2000). Coping strategies (Klapow et al., 1995) and HLC (Campbell, Hope, & Dunn, 2017) have been found to influence the relation between chronic pain and depression. We hypothesized that the relation between osteoarthritis pain and depression would be serially mediated by HLC and coping. Self-report measures of osteoarthritis pain (Meenan, Mason, Anderson, Guccione, & Kazis, 1992; Parmelee, Katz, & Lawton), HLC (Wallston, Wallston, & DeVellis, 1978), coping strategies (Felton & Revenson, 1984; Rosenstiel & Keefe, 1983), and depression (Radloff, 1977) were examined in 367 older adults with osteoarthritis of the knee. Hayes’ (2013) PROCESS macro was used to test the hypothesized serial multiple mediation for three subscales of HLC: internality (IHLC), chance (CHLC), and powerful others (PHLC). After controlling for age, the hypothesized serial mediation was statistically significant for IHLC and CHLC but not PHLC. More specifically, osteoarthritis pain significantly increased CHLC, which increased negative coping and depression in turn. Osteoarthritis pain significantly decreased IHLC, which was associated with both positive and negative coping strategies in a complex serial mediation. These findings suggest that interventions targeting HLC and/or coping strategies may be able to alter the pain-depression pathway for older adults with chronic osteoarthritis pain. (Supported by R01-MH51800, P. Parmelee, PI).

scholarly journals ROLE OF COPING STYLES AND NEGATIVE LIFE EVENTS ON HIGHER PERCEIVED MENTAL FATIGABILITY IN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S233-S233
Author(s):  
Theresa Gmelin ◽  
Stacy L Andersen ◽  
Robert M Boudreau ◽  
Kaare Christensen ◽  
Mary K Wojczynski ◽  
...  
Keyword(s):  
Older Adults ◽  
Life Events ◽  
Perceived Stress ◽  
Family Study ◽  
Coping Styles ◽  
Stressful Events ◽  
Adaptive Coping ◽  
Attentional Resources ◽  
And Coping

Abstract Older adults are vulnerable to negative recent life events (RLE) which deplete attentional resources and leads to cognitive exhaustion. Adaptive coping styles reduce perceived stress severity but their role on cognitive tiredness is unknown. We examined RLE and coping styles on perceived mental fatigability (Pittsburgh Fatigability Scale (PFS), 0-50pts, higher=greater fatigability) in the Long Life Family Study (N=1464, age=74.7±12.6, female=57.7%, 43.9% ≥1 major RLE past 6 months, 27.8% higher mental fatigability≥13). All analyses adjusted for family structure, field center, age, and sex. PFS mental scores correlated with all NEO-FFI (60-item, 5-domain) personality traits representing maladaptive (neuroticism r=0.25 p<.0001) and adaptive (conscientiousness r=-0.18, extraversion r=-0.24, p<.00001) coping. Having ≥1RLE was associated with higher mental fatigability (OR=1.4, 95% CI:1.2,1.8, p=.0004); adjustment for neuroticism (OR=1.3, 95% CI:0.9,1.7, p=.06) attenuated the association. Education on adaptive coping may be a modifiable skill that allows older adults to maintain lower perceived mental fatigability despite stressful events.

scholarly journals Characteristics Associated With Functional Changes During Systemic Cancer Treatments: A Systematic Review Focused on Older Adults

2021 ◽  
Vol 19 (9) ◽  
pp. 1055-1062
Author(s):  
Kah Poh Loh ◽  
Vivian Lam ◽  
Katey Webber ◽  
Simran Padam ◽  
Mina S. Sedrak ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
Older Adult ◽  
Functional Decline ◽  
Functional Change ◽  
Cancer Treatments ◽  
Functional Changes ◽  
Systemic Treatments ◽  
Wide Range ◽  
Patient Reported

Background: Maintaining functional status is important to older adults with cancer, but data are limited on how systemic treatments affect functional status. We systematically reviewed changes in functional status during systemic cancer treatments and identified characteristics associated with functional decline and improvement. Methods: We searched PubMed, Embase, Web of Science, and Cochrane Register of Controlled Trials for articles examining characteristics associated with functional changes in older adults during systemic cancer treatment published in English between database inception and January 11, 2019 (PROSPERO CRD42019123125). Findings were summarized with descriptive statistics. Study characteristics between older adult–specific and non–older adult–specific studies were compared using the Fisher exact test. Results: We screened 15,244 titles/abstracts and 519 full texts. The final analysis included 44 studies, which enrolled >8,400 patients; 39% of studies focused on older adults (1 study enrolled adults aged ≥60 years, 10 enrolled adults aged ≥65 years, and 6 enrolled adults aged ≥70 years). Almost all studies (98%) used patient-reported outcomes to measure functional status; only 20% used physical performance tests. Reporting of functional change was heterogeneous, with 48% reporting change scores. Older adult–specific studies were more likely to analyze functional change dichotomously (29% vs 4%; P=.008). Functional decline ranged widely, from 6% to 90%. The most common patient characteristics associated with functional decline were older age (n=7 studies), worse performance status (n=4), progressive disease status (n=4), pain (n=4), anemia (n=4), and worse nutritional status (n=4). Twelve studies examined functional improvement and identified 11 unique associated characteristics. Conclusions: Functional decline is increasingly recognized as an important outcome in older adults with cancer, but definitions and analyses are heterogeneous, leading to a wide range of prevalence. To identify patients at highest risk of functional decline during systemic cancer treatments, trials need to routinely analyze functional outcomes and measure characteristics associated with decline (eg, nutrition).

scholarly journals Age, gender, and residence differences in prevalence and patterns of multimorbidity among older Chinese: Evidence from Chinese Longitudinal Healthy Longevity Survey

2022 ◽  
Author(s):  
Siyue Han ◽  
Guangju Mo ◽  
Tianjing Gao ◽  
Qing Sun ◽  
Huaqing Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Functional Decline ◽  
Self Report ◽  
Care Utilization ◽  
Rule Mining ◽  
Demographic Differences ◽  
Healthy Longevity ◽  
Older Chinese ◽  
Multimorbid Patients

Abstract Background With the dramatic acceleration of ageing in China, multimorbidity among the older adults has become increasingly common，which are associated with more functional decline and higher health care utilization and mortality. Understanding demographic differences of patterns of multimorbidity is in favor of making targeted intervention strategies. The purpose of this study was to reveal age- specific, gender- specific, and residence- specific prevalence and patterns of multimorbidity among older adults in China. Methods The present analysis is based on the 2018 wave of Chinese Longitudinal Health Longevity Survey (CLHLS). We selected 13 chronic diseases from the CLHLS survey, and information was collected based on self-report. Multimorbidity was defined as the coexistence of two or more chronic diseases from 13 chronic diseases in the same individual. Descriptive statistical analysis was used to examine multimorbidity according to age, sex, and residence. Patterns and trends of chronic disease pairs and multimorbidity were explored using association rule mining. Results 9,660 individuals aged 65-117 years in the CLHLS were analyzed in this study. Overall, 74.4% of all participants had one or more morbidities, and 42.4% were multimorbid. The prevalence of individual chronic diseases ranged from 1.5% for cancer to 41.8% for hypertension, and each disease was often accompanied by one or more other chronic diseases. The prevalence of multimorbidity does not always increase with age. The subgroups with the highest prevalence of multimorbidity was 80-89 years old (48.2%), female (45.0%) and urban (47.2%) group. Prevalence of the hypertension- diabetes pattern decreases with age and is higher in women than in men. The prevalence of hypertension- depression pattern was at the highest among the 90-117 years and rural older adults, while the other groups were hypertension-heart disease. Moreover, it was noteworthy that the multimorbidity rate of dyslipidemia is the highest at 95.5% among the 13 chronic diseases. Conclusions The prevalence of multimorbidity among older Chinese was substantial, and patterns of multimorbidity differed in age, sex, and residence. Future efforts are needed to identify possible prevention strategies and guidelines targeted demographic differences of multimorbid patients to promote health in older adults.

scholarly journals Robot for health data acquisition among older adults: a pilot randomised controlled cross-over trial

2019 ◽  
Vol 28 (10) ◽  
pp. 793-799 ◽  
Author(s):  
Roel Boumans ◽  
Fokke van Meulen ◽  
Koen Hindriks ◽  
Mark Neerincx ◽  
Marcel G M Olde Rikkert
Keyword(s):  
Older Adults ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Well Being ◽  
Patient Reported Outcome ◽  
Outpatient Setting ◽  
Community Dwelling ◽  
Patient Reported ◽  
Randomised Controlled ◽  
Community Dwelling Older Adults

Background /ObjectivesHealthcare professionals (HCP) are confronted with an increased demand for assessments of important health status measures, such as patient-reported outcome measurements (PROM), and the time this requires. The aim of this study was to investigate the effectiveness and acceptability of using an HCP robot assistant, and to test the hypothesis that a robot can autonomously acquire PROM data from older adults.DesignA pilot randomised controlled cross-over study where a social robot and a nurse administered three PROM questionnaires with a total of 52 questions.SettingA clinical outpatient setting with community-dwelling older adults.ParticipantsForty-two community-dwelling older adults (mean age: 77.1 years, SD: 5.7 years, 45% female).MeasurementsThe primary outcome was the task time required for robot–patient and nurse–patient interactions. Secondary outcomes were the similarity of the data and the percentage of robot interactions completed autonomously. The questionnaires resulted in two values (robot and nurse) for three indexes of frailty, well-being and resilience. The data similarity was determined by comparing these index values using Bland-Altman plots, Cohen’s kappa (κ) and intraclass correlation coefficients (ICC). Acceptability was assessed using questionnaires.ResultsThe mean robot interview duration was 16.57 min (SD=1.53 min), which was not significantly longer than the nurse interviews (14.92 min, SD=8.47 min; p=0.19). The three Bland-Altman plots showed moderate to substantial agreement between the frailty, well-being and resilience scores (κ=0.61, 0.50 and 0.45, and ICC=0.79, 0.86 and 0.66, respectively). The robot autonomously completed 39 of 42 interviews (92.8%).ConclusionSocial robots may effectively and acceptably assist HCPs by interviewing older adults.

Comparison of Self-Report of Dysphagia Using the Eating Assessment Tool and the Sydney Swallowing Questionnaire in Community Dwelling Older Adults

2021 ◽  
pp. 1-7
Author(s):  
Aarthi Madhavan ◽  
Nicole Shuman ◽  
Claire Snyder ◽  
Nicole Etter
Keyword(s):  
Older Adults ◽  
Assessment Tool ◽  
Community Dwelling ◽  
Self Report ◽  
Screening Tools ◽  
Medical Diagnoses ◽  
Age Related ◽  
Swallowing Problems ◽  
Patient Reported ◽  
Community Dwelling Older Adults

Purpose Patient-reported outcomes (PROs) are an important feature in clinical evaluation of swallowing. The Eating Assessment Tool (EAT-10) and the Sydney Swallow Questionnaire (SSQ) are two validated dysphagia PROs commonly used in healthy older adult populations as screening tools for swallowing problems. The purpose of this study is to compare the consistency of the EAT-10 and SSQ scores for self-reported swallowing difficulties in a group of community-dwelling older adults (CDOA) completing both questionnaires. Method A total of 316 individuals over the age of 60 years completed the EAT-10, SSQ, and provided demographic data, including a self-report of any medical diagnoses. Participants were excluded if they had any diagnoses known to cause dysphagia. Questionnaire responses were analyzed for frequencies of responses across all participants. Results Seventy-five participants were identified as having dysphagia by the EAT-10 (23.7%), while 30 participants were identified by the SSQ (9.49%). When comparing the results of the two assessments, the scales agreed on 289 out of 316 participants (91%). There was a disagreement on the results in 27 of the 316 participants, with 26 of these self-reporting dysphagia symptoms on the EAT-10 but not on the SSQ. Conclusions Two commonly used dysphagia PROs resulted in different prevalence rates of self-reported dysphagia in a group of CDOA. CDOAs may need questionnaires specifically validated for them with special consideration for specific age-related risk factors, to ensure accurate early identification.

Patient-reported Outcome Measures for Women with Vulvar Neoplasia – Current Situation and Future Directions

2013 ◽  
Vol 09 (02) ◽  
pp. 110
Author(s):  
Beate Senn ◽  
Manuela Eicher ◽  
Michael D Mueller ◽  
Sandra Engberg ◽  
Rebecca Spirig ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Intraepithelial Neoplasia ◽  
Patient Reported Outcome Measures ◽  
Evidence Base ◽  
Patient Reported Outcome ◽  
Self Report ◽  
Vulvar Intraepithelial Neoplasia ◽  
Research Project ◽  
Patient Reported

This article discusses concerns about women with vulvar neoplasia (vulvar intraepithelial neoplasia and vulvar cancer) and the available surgical treatment options. Given the gaps in the evidence base in terms of women with vulvar neoplasia and surgical treatment the women with vulvar Neoplasia-Patient Reported Outcome (WOMAN-PRO) research project focused on complications, symptoms and associated distress of women with surgically treated vulvar neoplasia. The main results of the research project are summarised, showing complications identified by clinicians, experiences reported by patients, the newly developed WOMAN-PRO instrument and symptom occurrence of each of 31 symptoms and the degree to which symptoms distressed women during the first seven days after discharge following surgical treatment for their vulvar neoplasia. Furthermore, based on the major findings of the project, suggestions for further research and clinical practice and conclusions are presented. We conclude that including patient self-report as a major element in follow-up care has the potential to enhance the quality of supportive care.

Patient-Reported Outcome Measures in Aphasia

2012 ◽  
Vol 22 (4) ◽  
pp. 160-166 ◽  
Author(s):  
Billy Irwin
Keyword(s):  
Patient Reported Outcomes ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Self Report ◽  
Future Application ◽  
Social Approach ◽  
The Social ◽  
Patient Reported ◽  
Primary Focus ◽  
Subjective Reports

Patient-reported outcomes (PROs) for persons with aphasia offer a new method of obtaining subjective reports of social and psychological wellbeing subsequent to stroke and/or aphasia. Several instruments designed to elicit self-report in stroke patients, including those who have aphasia, have adopted aphasia-friendly formats and have included persons with all levels of severity in the development of the instrument. A brief overview of currently available tools is provided with comments regarding the primary focus of the tools and some of the reported psychometric properties. In addition, this article includes a discussion of the rationale and forces that are driving the development and use of these tools, including systematic health-care changes and an increased prominence of the social approach to aphasia. Also, the author discusses an overview of the current and future application of PROs.

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