Measuring Activity Limitations Within the National Health and Aging Trends Study (NHATS)

Abstract Background and Objectives To better understand the disablement process among older adults, improved measures of activity limitations are needed. Traditional population-level measures lack the ability to distinguish precise gradations of activity limitation and are unable to detect degrees of differences over a wide range of ability levels. Therefore, we used contemporary measurement methods to improve upon current methodologies for characterizing activity limitations within the National Health and Aging Trends Study (NHATS) . Research Design and Methods We used the NHATS Round 1 cohort to assess the feasibility of constructing an Activity Limitations scale using Rasch item response theory methods. Factor analysis was used to develop the scale from a set of existing items in the NHATS Mobility, Self-Care, and Household Activity domains. Psychometric properties of the scale were evaluated and the scale was used to examine change in activity limitations among the sample from 2011 to 2015. Results Results supported an 18-item scale (N = 7,609). Rasch infit and outfit statistics were within acceptable range for all items (Cronbach’s alpha = 0.95; sample score reliability = 0.83). From 2011 to 2015, 5.88% older adults demonstrated increase in function, 15% showed decrease in function, and 78% of the sample showed no change (did not exceed ± MDC90). Discussion and Implications Findings demonstrate that a unidimensional, interval scale of activity limitations can be constructed using traditional survey measures nested within the NHATS. Results revealed concerns regarding ceiling effects within the current self-report items of activity limitations suggesting future work is needed to expand the range of ability currently represented in the NHATS Activity Limitation items.

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Utility of the Late Life Function and Disability Instrument (LLFDI) in rehabilitation services for older adults

Innovation in Aging ◽

10.1093/geroni/igab046.3184 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 882-882

Author(s):

Pamela Toto ◽

Anne Stankiewicz

Keyword(s):

Older Adults ◽

Primary Care ◽

Skilled Nursing Facility ◽

Late Life ◽

Activity Limitation ◽

Self Report ◽

Rehabilitation Services ◽

Activity Limitations ◽

Participation Restriction ◽

Life Function

Abstract Introduction The Late Life Function and Disability Instrument (LLFDI) is a valid self-report tool that quantifies disability based on activity limitations and participation restrictions in everyday life. Both the original longer tool (LLFDI) and the shorter computer adaptive version (LLFDI-CAT) offer practitioners a method for measuring function independent or in conjunction with performance-based assessment. Objectives: Examine scores of the LLFDI and LLFDI-CAT for measuring disability in older adults who are receiving rehabilitation services in community and institution settings. Method: A secondary data analysis was conducted comparing scores from occupational therapy evaluations with older adults from 3 groups: 1) older adults in primary care using the LLFDI; 2) older adults in primary care using the LLFDI-CAT; older adults in a skilled nursing facility (SNF) using the LLFDI-CAT. Results Mean scores for Activity Limitation and Participation Restriction were lowest for older adults in a SNF indicating greater disability. A one-way Analysis of variance on ranks showed a main effect for Activity Limitation, χ2 (2) = 22.267, p < 0.001, and Participation Restriction, χ2 (2) = 60.372, p < 0.001. Post-hoc analyses revealed significant differences between groups based on tool (i.e. LLFDI vs. LLFDI-CAT) for Activity Limitations and setting (i.e. primary care vs. SNF) for Participation Restriction. Conclusion The LLFDI-CAT may be the preferred instrument to measure disability in older adults across treatment settings. Additional research is warranted to understand how personal and environmental factors influence LLFDI-CAT outcomes.

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Current Progress and Future Directions for Theory and Research on Savoring

Frontiers in Psychology ◽

10.3389/fpsyg.2021.771698 ◽

2021 ◽

Vol 12 ◽

Author(s):

Fred B. Bryant

Keyword(s):

Positive Emotions ◽

Past Research ◽

Attentional Focus ◽

Self Report ◽

Positive Experience ◽

Future Directions ◽

Wide Range ◽

The Moment ◽

Future Work ◽

Positive Stimuli

As research on savoring has increased dramatically since publication of the book Savoring: A New Model of Positive Experience (Bryant and Veroff, 2007), savoring has gradually become a core concept in positive psychology. I begin by reviewing the evolution of this concept, the development of instruments for assessing savoring ability and savoring strategies, and the wide range of applications of savoring in the psychosocial and health sciences. I then consider important directions for future theory and research. To advance our understanding of how naturalistic savoring unfolds over time, future work should integrate the perceptual judgments involved in not only the later stages of attending to and regulating positive experience (where past research has concentrated), but also the initial stages of searching for and noticing positive stimuli. Whereas most research has investigated reactive savoring, which occurs spontaneously in response to positive events or feelings, future work is also needed on proactive savoring, which begins with the deliberate act of seeking out or creating positive stimuli. To advance the measurement of savoring-related constructs, I recommend future work move beyond retrospective self-report methods toward the assessment of savoring as it occurs in real-time. The development of new methods of measuring meta-awareness and the regulation of attentional focus are crucial to advancing our understanding of savoring processes. I review recent research on the neurobiological correlates of savoring and suggest future directions in which to expand such work. I highlight the need for research aimed at unraveling the developmental processes through which savoring skills and deficits evolve and the role that savoring impairments play in the etiology and maintenance of psychopathology. Research is also needed to learn more about what enhances savoring, and to disentangle how people regulate the intensity versus duration of positive emotions. Finally, I encourage future researchers to integrate the study of anticipation, savoring the moment, and reminiscence within individuals across time.

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Psychometric Properties of NASA-TLX and Index of Cognitive Activity as Measures of Cognitive Workload in Older Adults

Brain Sciences ◽

10.3390/brainsci10120994 ◽

2020 ◽

Vol 10 (12) ◽

pp. 994

Author(s):

Hannes Devos ◽

Kathleen Gustafson ◽

Pedram Ahmadnezhad ◽

Ke Liao ◽

Jonathan D. Mahnken ◽

...

Keyword(s):

Older Adults ◽

Cognitive Activity ◽

Event Related Potentials ◽

Self Report ◽

Cognitive Workload ◽

Wide Range ◽

Related Potentials ◽

The Mean ◽

Nasa Tlx ◽

Index Of Cognitive Activity

Cognitive workload is increasingly recognized as an important determinant of performance in cognitive tests and daily life activities. Cognitive workload is a measure of physical and mental effort allocation to a task, which can be determined through self-report or physiological measures. However, the reliability and validity of these measures have not been established in older adults with a wide range of cognitive ability. The aim of this study was to establish the test–retest reliability of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Index of Cognitive Activity (ICA), extracted from pupillary size. The convergent validity of these measures against event-related potentials (ERPs) was also investigated. A total of 38 individuals with scores on the Montreal Cognitive Assessment ranging between 17 and 30 completed a working memory test (n-back) with three levels of difficulty at baseline and at a two-week follow-up. The intraclass correlation coefficients (ICC) values of the NASA-TLX ranged between 0.71 and 0.81, demonstrating good to excellent reliability. The mean ICA scores showed fair to good reliability, with ICCs ranging between 0.56 and 0.73. The mean ICA and NASA-TLX scores showed significant and moderate correlations (Pearson’s r ranging between 0.30 and 0.33) with the third positive peak of the ERP at the midline channels. We conclude that ICA and NASA-TLX are reliable measures of cognitive workload in older adults. Further research is needed in dissecting the subjective and objective constructs of cognitive workload.

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Older Adult Productive Activity Participation Using the National Health and Aging Trends Study

Gerontology and Geriatric Medicine ◽

10.1177/2333721420910657 ◽

2020 ◽

Vol 6 ◽

pp. 233372142091065

Author(s):

Elizabeth E. Marfeo ◽

Caroline Ward

Keyword(s):

Older Adults ◽

National Health ◽

The United States ◽

Community Dwelling ◽

Productive Aging ◽

Activity Participation ◽

Productive Activity ◽

Current Profile ◽

Wide Range ◽

Community Dwelling Older Adults

This study aims to characterize factors related to productive activity participation among community-dwelling older adults. Cross-sectional analyses using data from the National Health and Aging Trends Study were used to calculate weighted frequencies representative of the U.S. population of older adults. Multivariate logistic regression was used to explore factors related to participation outcomes (paid work, volunteering, caregiving). We found that 21% of community-dwelling older adults in the United States reported currently working. Older adults reported working in a wide range of occupations. Driving emerged as one of the most important factors related to increased odds of productive activity participation. Age, gender, and health factors were also significantly associated with increased odds of productive activity participation. By understanding the current profile of participation in activities including employment, caregiving, and volunteering among a national sample of community-dwelling older adults, we can effectively inform intervention programs and resource allocation to support productive aging.

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Self-Report Hearing and Injury or Falls in Older Adults from the National Health and Information Survey

Seminars in Hearing ◽

10.1055/s-0041-1726016 ◽

2021 ◽

Vol 42 (01) ◽

pp. 066-074

Author(s):

Danielle S. Powell ◽

Emmanuel E. Garcia Morales ◽

Sasha Pletnikova ◽

Jennifer A. Deal ◽

Nicholas S. Reed

Keyword(s):

Older Adults ◽

National Health ◽

Secondary Analysis ◽

Self Report ◽

Cross Sectional ◽

Representative Study ◽

Hearing Aid Use ◽

Prevention Studies ◽

History Of ◽

Nationally Representative

AbstractThis article aims to investigate the association between hearing and nonfatal injury or falls in a nationally representative sample of adults from the National Health Interview Survey (NHIS) utilizing over 20 years of participant surveys. We conducted a pooled cross-sectional analysis of participant surveys (aged 50 years and older) from 1997 to 2017. Self-report hearing difficulty, history of injury over the last 3 months, reported injury from fall over the last 3 months, and reported reason for fall (including due to balance/dizziness) were collected. Using logistic regression, we investigated the odds of injury, injury from fall, and fall due to balance/dizziness by self-report hearing status. In secondary analysis, we investigated the odds of each outcome by reported hearing aid use. Models were adjusted for demographics, year of study, vision difficulty, diabetes, employment, and cardiovascular disease. Reported moderate or greater difficulty hearing demonstrated a significantly greater odds of injury (odds ratio [OR]: 1.29; 95% confidence interval [CI]: 1.18, 1.42) or fall due to balance/dizziness (OR: 1.26; 95% CI: 1.00, 1.60) compared with reported excellent/good hearing. A dose–response association was seen across levels of reported difficulty hearing for all outcomes. In this nationally representative study of adults aged 50 years and older, greater reported difficulty hearing was significantly associated with increased odds of injury and suggests greater odds of falls or fall due to balance/dizziness compared with reported good hearing. Results suggest hearing loss should be considered as a possible risk factor for both injury and fall prevention studies and programming in older adults.

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Association between Self-Reported and Accelerometer-Based Estimates of Physical Activity in Portuguese Older Adults

Sensors ◽

10.3390/s21072258 ◽

2021 ◽

Vol 21 (7) ◽

pp. 2258

Author(s):

Célia Domingos ◽

Nadine Correia Santos ◽

José Miguel Pêgo

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Outcomes ◽

Accurate Method ◽

Assessment Tools ◽

Self Report ◽

Wide Range ◽

Positive Correlations ◽

Objectively Measured ◽

Activity Survey

Accurate assessment of physical activity (PA) is crucial in interventions promoting it and in studies exploring its association with health status. Currently, there is a wide range of assessment tools available, including subjective and objective measures. This study compared accelerometer-based estimates of PA with self-report PA data in older adults. Additionally, the associations between PA and health outcomes and PA profiles were analyzed. Participants (n = 110) wore a Xiaomi Mi Band 2® for fifteen consecutive days. Self-reported PA was assessed using the International Physical Activity Questionnaire (IPAQ) and the Yale Physical Activity Survey (YPAS). The Spearman correlation coefficient was used to compare self-reported and accelerometer-measured PA and associations between PA and health. Bland–Altman plots were performed to assess the agreement between methods. Results highlight a large variation between self-reported and Xiaomi Mi Band 2® estimates, with poor general agreement. The highest difference was found for sedentary time. Low positive correlations were observed for IPAQ estimates (sedentary, vigorous, and total PA) and moderate for YPAS vigorous estimates. Finally, self-reported and objectively measured PA associated differently with health outcomes. Summarily, although accelerometry has the advantage of being an accurate method, self-report questionnaires could provide valuable information about the context of the activity.

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Reliability and Validity of Cognitive Workload in Older Adults

10.1101/2020.10.26.20219881 ◽

2020 ◽

Author(s):

Hannes Devos ◽

Kathleen Gustafson ◽

Pedram Ahmadnezhad ◽

Ke Liao ◽

Jonathan D. Mahnken ◽

...

Keyword(s):

Older Adults ◽

Intraclass Correlation ◽

Cognitive Activity ◽

Reliability And Validity ◽

Event Related Potentials ◽

Self Report ◽

Cognitive Workload ◽

Wide Range ◽

Related Potentials ◽

Nasa Tlx

AbstractCognitive workload (mental effort) is a measure of attention allocation to a task, which can be administered through self-report or physiological measures. Cognitive workload is increasingly recognized as an important determinant of performance in cognitive tests and daily life activities. However, the reliability and validity of these measures have not been established in older adults with a wide range of cognitive ability. The aim of this study was to establish the test-retest reliability of the NASA-Task Load Index (NASA-TLX) and Index of Cognitive Activity (ICA), extracted from pupillary size. The convergent validity of these measures against event-related potentials (ERPs) was also investigated. A total of 38 individuals with scores on the Montreal Cognitive Assessment ranging between 17 and 30 completed a working memory test (n-back) with three levels of difficulty at baseline and two-week follow-up. Intraclass correlation coefficients (ICC) values of the NASA-TLX ranged between 0.71 and 0.81, demonstrating good to excellent reliability. Mean ICA scores showed fair to good reliability, with ICC’s ranging between 0.56 and 0.73. Mean ICA and NASA-TLX scores showed significant and moderate correlations (Pearson r range between 0.30 and 0.33) with P3 ERP at the midline channels. We conclude that ICC and NASA-TLX are reliable measures of cognitive workload in older adults. Further research is needed in dissecting the subjective and objective constructs of cognitive workload.

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Older adults with obesity have higher risks of some micronutrient inadequacies and lower overall dietary quality compared to peers with a healthy weight, National Health and Nutrition Examination Surveys (NHANES), 2011–2014

Public Health Nutrition ◽

10.1017/s1368980020000257 ◽

2020 ◽

Vol 23 (13) ◽

pp. 2268-2279 ◽

Cited By ~ 1

Author(s):

Shinyoung Jun ◽

Alexandra E Cowan ◽

Anindya Bhadra ◽

Kevin W Dodd ◽

Johanna T Dwyer ◽

...

Keyword(s):

Older Adults ◽

Older Women ◽

National Health ◽

Weight Status ◽

Healthy Eating Index ◽

Small Sample ◽

Self Report ◽

Dietary Quality ◽

Healthy Weight ◽

Health And Nutrition

AbstractObjective:To evaluate total usual intakes and biomarkers of micronutrients, overall dietary quality and related health characteristics of US older adults who were overweight or obese compared with a healthy weight.Design:Cross-sectional study.Setting:Two 24-h dietary recalls, nutritional biomarkers and objective and subjective health characteristic data were analysed from the National Health and Nutrition Examination Survey 2011–2014. We used the National Cancer Institute method to estimate distributions of total usual intakes from foods and dietary supplements for eleven micronutrients of potential concern and the Healthy Eating Index (HEI)-2015 score.Participants:Older adults aged ≥60 years (n 2969) were categorised by sex and body weight status, using standard BMI categories. Underweight individuals (n 47) were excluded due to small sample size.Results:A greater percentage of obese older adults compared with their healthy-weight counterparts was at risk of inadequate Mg (both sexes), Ca, vitamin B6 and vitamin D (women only) intakes. The proportion of those with serum 25-hydroxyvitamin D < 40 nmol/l was higher in obese (12 %) than in healthy-weight older women (6 %). Mean overall HEI-2015 scores were 8·6 (men) and 7·1 (women) points lower in obese than in healthy-weight older adults. In addition, compared with healthy-weight counterparts, obese older adults were more likely to self-report fair/poor health, use ≥ 5 medications and have limitations in activities of daily living and cardio-metabolic risk factors; and obese older women were more likely to be food-insecure and have depression.Conclusions:Our findings suggest that obesity may coexist with micronutrient inadequacy in older adults, especially among women.

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On the art of doing surveys among adolescents

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1066 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

P Due ◽

A M Arnarsson ◽

N Lyyra ◽

P Löfstedt ◽

K R Madsen ◽

...

Keyword(s):

Public Health ◽

Measurement Instrument ◽

Population Level ◽

Self Report ◽

Cross Sectional ◽

School Aged Children ◽

Wide Range ◽

Measurement Tools ◽

Cross Sectional Design ◽

Biased Reporting

Abstract The aim is to discuss methodological challenges for research on adolescent positive mental health. A first consideration is which questions should the measurement instrument answer. In the clinical context it should have the properties of giving enough information for making a diagnosis of high quality. In the public health context, its objective may be to give information that enables the researcher to describe trends at the population level and provide guidance on areas of intervention. The HBSC study is monitoring the health and health behaviour of school-aged children in a public health context. It is a population survey, defined by the form of data collection and the method of analysis. The data is collected by questionnaire from a representative sample of school-aged children. It tries to answer descriptive questions (What, who, when?), but also tries to explore causal associations (Why?), given the limitations of the cross-sectional design. Surveys have advantages: Good for gathering descriptive data; Can cover a wide range of topics. Are relatively inexpensive to use; Can include large number of respondents; and Can be analysed using a variety of existing software. Among the disadvantages can be mentioned: Self-report may lead to biased reporting; Data may provide a general picture but lack depth; Difficult to obtain adequate information on context; and Differences in understanding: it is difficult to formulate questions in such a way that it will mean exactly same thing to each respondent. The choice of measurement tools or indicators involves both theoretical and practical issues. Multidisciplinary research teams may include different theoretical traditions, which is an asset but also make it necessary to be explicit regarding overall aims of the study. Most often the theoretical issues focus one of three topics: the value of the types of data; the relative scientific rigor of the data; or basic, underlying philosophies of evaluation.

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Sedentary Behavior and Happiness: The Mediation Effects of Social Capital

Innovation in Aging ◽

10.1093/geroni/igab044 ◽

2021 ◽

Author(s):

Akitomo Yasunaga ◽

Mohammad Javad Koohsari ◽

Ai Shibata ◽

Kaori Ishii ◽

Rina Miyawaki ◽

...

Keyword(s):

Older Adults ◽

Social Capital ◽

Sedentary Behavior ◽

Television Viewing ◽

Leisure Activities ◽

Self Report ◽

Linear Regression Models ◽

Cross Sectional ◽

Mediation Effects ◽

Design And Methods

Abstract Background and Objectives This study aimed to examine the associations between time spent in six different domains of sedentary behavior and happiness and whether social capital mediated such associations among adults and older adults living in a rural area of Japan. Research Design and Methods Cross-sectional data from 3357 participants (mean age: 60±16 years) were used. Six domains of sedentary behavior, happiness, and social capital were assessed using a self-report questionnaire. Age-stratified multivariable linear regression models adjusted for covariates were used to examine the associations between six domains of sedentary behavior and happiness. For relationships where the direct effect was significant, we tested the mediating effects of two social capital measures. Results Among both adults and older adults, more time spent viewing television was significantly associated with lower happiness scores, and more time spent engaging in other leisure activities was significantly associated with higher happiness scores. In addition, more time spent using cell phones and computers was significantly associated with lower happiness scores among the adults. Engaging in activities with neighbors significantly mediated the relationship between other leisure activities and happiness in the adults and older adults and between television viewing and happiness in the older adults. Discussion and Implications Our findings indicated that less television viewing and more mentally active sedentary behavior (e.g., talking with others and engaging in hobbies) were associated with greater happiness. One aspect of social capital, engaging in activities with neighbors, acts as a potential mediator for relationships between sedentary behavior and happiness.

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