scholarly journals 74Relationship of higher-level functional capacity on long-term mortality in Japanese population: NIPPON DATA90

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Hideki Nagata ◽  
Katsuyuki Miura ◽  
Sachiko Tanaka ◽  
Aya Kadota ◽  
Takehito Hayakawa ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Functional Capacity ◽  
Daily Living ◽  
Social Role ◽  
Intellectual Activity ◽  
Risk Of Mortality ◽  
Japanese Adults ◽  
Japanese Elderly ◽  
Long Term Mortality

Abstract Background Little is known about the relationships between higher-level functional capacity (HLFC) and mortality, and its gender difference. Methods NIPPON DATA90 is the cohort study of the National Cardiovascular Survey of Japan in 1990. We followed up 1824 Japanese adults over 65 years who were independent in basic activities of daily living in 1995 until 2010. HLFC was measured in 1995 using the total score and 3 subscales (instrumental activities of daily living [IADL], intellectual activity, social role) by the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The association of HLFC to mortality was evaluated by adjusted hazard ratio (HR) and 95% confidence interval (CI) using the Cox proportional hazard model. Results During average 12.2-year follow-up, 836 participants (45.8%) died. Participants with impaired total TMIG-IC score showed significantly higher risk of mortality (adjusted HR 1.37; 95%CI 1.14-1.66) compared with normal participants, even after adjusting for other variables. The corresponding HR was significant only in women (HR 1.42; 95% CI 1.10-1.83). Among the 3 subscales, only impaired social role showed significantly higher risk of mortality (HR 1.37; 95%CI 1.12-1.67) in men. In contrast, IADL and intellectual activity showed significantly higher risk in women (HR 1.51; 95%CI 1.16-1.96) (HR 1.46; 95%CI 1.19-1.80). Conclusions Impaired HLFC was related to higher risk of long-term mortality in Japanese elderly at baseline. Especially among women, IADL and intellectual activity were important predictors, whereas social role was important in men. Key messages Impaired HLFC was related to long-term mortality in Japanese elderly.

Long-term mortality rates and associated risk factors following primary and revision knee arthroplasty

2022 ◽  
Vol 104-B (1) ◽  
pp. 45-52
Author(s):  
Liam Zen Yapp ◽  
Nick D. Clement ◽  
Matthew Moran ◽  
Jon V. Clarke ◽  
A. Hamish R. W. Simpson ◽  
...  
Keyword(s):  
General Population ◽  
Knee Arthroplasty ◽  
Mortality Rates ◽  
Factors Associated ◽  
Revision Knee Arthroplasty ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Male Sex ◽  
Long Term Mortality

Aims The aim of this study was to determine the long-term mortality rate, and to identify factors associated with this, following primary and revision knee arthroplasty (KA). Methods Data from the Scottish Arthroplasty Project (1998 to 2019) were retrospectively analyzed. Patient mortality data were linked from the National Records of Scotland. Analyses were performed separately for the primary and revised KA cohorts. The standardized mortality ratio (SMR) with 95% confidence intervals (CIs) was calculated for the population at risk. Multivariable Cox proportional hazards were used to identify predictors and estimate relative mortality risks. Results At a median 7.4 years (interquartile range (IQR) 4.0 to 11.6) follow-up, 27.8% of primary (n = 27,474/98,778) and 31.3% of revision (n = 2,611/8,343) KA patients had died. Both primary and revision cohorts had lower mortality rates than the general population (SMR 0.74 (95% CI 0.73 to 0.74); p < 0.001; SMR 0.83 (95% CI 0.80 to 0.86); p < 0.001, respectively), which persisted for 12 and eighteight years after surgery, respectively. Factors associated with increased risk of mortality after primary KA included male sex (hazard ratio (HR) 1.40 (95% CI 1.36 to 1.45)), increasing socioeconomic deprivation (HR 1.43 (95% CI 1.36 to 1.50)), inflammatory polyarthropathy (HR 1.79 (95% CI 1.68 to 1.90)), greater number of comorbidities (HR 1.59 (95% CI 1.51 to 1.68)), and periprosthetic joint infection (PJI) requiring revision (HR 1.92 (95% CI 1.57 to 2.36)) when adjusting for age. Similarly, male sex (HR 1.36 (95% CI 1.24 to 1.49)), increasing socioeconomic deprivation (HR 1.31 (95% CI 1.12 to 1.52)), inflammatory polyarthropathy (HR 1.24 (95% CI 1.12 to 1.37)), greater number of comorbidities (HR 1.64 (95% CI 1.33 to 2.01)), and revision for PJI (HR 1.35 (95% 1.18 to 1.55)) were independently associated with an increased risk of mortality following revision KA when adjusting for age. Conclusion The SMR of patients undergoing primary and revision KA was lower than that of the general population and remained so for several years post-surgery. However, approximately one in four patients undergoing primary and one in three patients undergoing revision KA died within tenten years of surgery. Several patient and surgical factors, including PJI, were associated with the risk of mortality within ten years of primary and revision surgery. Cite this article: Bone Joint J 2022;104-B(1):45–52.

scholarly journals Aged: functional capacity for basic and instrumental activities of daily living

2014 ◽  
Vol 6 (2) ◽  
pp. 584-593
Author(s):  
Leticia Silveira Cardoso ◽  
Bárbara Tarouco da Silva ◽  
Daiane dos Santos Rodrigues ◽  
Cristiana Lopes Leal ◽  
Marcelo Clarete Seracini Penner
Keyword(s):  
Activities Of Daily Living ◽  
Functional Capacity ◽  
Daily Living ◽  
Instrumental Activities

OBJETIVO: Avaliar a capacidade funcional das pessoas idosas residentes em duas instituições de longa permanência de um município da região da campanha/RS. MÉTODO: Com abordagem exploratório-descritiva, aplicou-se a Escala de Katz e a de Lawton a 44 pessoas idosas para a coleta de dados, que foram analisados qualitativamente. RESULTADOS: As atividades básicas da vida diária, Escala de Katz, apresentaram maior grau de independência em relação às instrumentais, Escala de Lawton. As dependências das pessoas idosas que foram ressaltadas circunscrevem-se no atendimento as necessidades psciobilógicas de higiene corporal e eliminações para a realização das atividades básicas da vida diária. E nas necessidades psicossociais de comunicação e gregária para a realização das atividades instrumentais da vida diária. CONCLUSÃO: A capacidade funcional das pessoas idosas em investigação determina o planejamento e a organização do trabalho da Enfermagem. Determinando a qualidade dos serviços por indicar o quantitativo necessário para atender as exigências e a capacitação continua.     

scholarly journals Fatigue as a long-term risk factor for limitations in instrumental activities of daily living and/or mobility performance in older adults after 10 years

2016 ◽  
Vol Volume 11 ◽  
pp. 1579-1587 ◽  
Author(s):  
Sigrid Mueller-Schotte ◽  
Nienke Bleijenberg ◽  
Yvonne T. van der Schouw ◽  
Marieke J. Schuurmans
Keyword(s):  
Older Adults ◽  
Risk Factor ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Mobility Performance ◽  
Instrumental Activities

scholarly journals Anemia and functional capacity in elderly Brazilian hospitalized patients

2013 ◽  
Vol 29 (7) ◽  
pp. 1322-1332 ◽  
Author(s):  
Raquel de Macedo Bosco ◽  
Elisa Priscila Souza Assis ◽  
Renata Rosseti Pinheiro ◽  
Luiza Cristina Viana de Queiroz ◽  
Leani S. M. Pereira ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Functional Capacity ◽  
Daily Living ◽  
Strong Association ◽  
Population Based ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Cross Sectional ◽  
Belo Horizonte ◽  
The Impact

This study evaluated the association between anemia and physical functional capacity in a cross-sectional population-based sample of 709 hospitalized elderly patients aged 60 years and over admitted to the Madre Teresa Hospital, Belo Horizonte, State of Minas Gerais, Brazil. The Mann-Whitney or "t" test, and chi-square or Fisher exact test were used for quantitative and categorical variables, respectively, and hierarchical binary logistic regression was used to identify significant predictors. The presence of anemia was found in 30% of participants and was significantly associated with decreased functionality according to the two measures which were used - ADL (activities of daily living) and IADL (instrumental activities of daily living). Anemia was also independently associated with older age. The results of this study demonstrate a strong association between the presence of anemia and lower levels of functional capacity. Further investigations are needed to assess the impact of anemia treatment on the functionality and independence of older people.

scholarly journals Review on Pricing Models for Long-term Care Insurance

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Syakir Asrulsani ◽  
Mazlynda Md Yusuf
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Long Term Care ◽  
Financial Burden ◽  
Term Care ◽  
Protection Mechanism ◽  
Long Term Care Insurance ◽  
Risk Protection ◽  
Care Costs

Funding for long-term care costs among elderly people is a critical matter, especially due to high costs and an unexpected length of time. Placement for long-term care that is funded under Jabatan Kebajikan Masyarakat (JKM) is very limited, hence, the next option is through private nursing homes. However, the cost could be up to RM 2,000 a month for each person. Therefore, Long- Term Care Insurance is an alternative to fund for Long-Term Care costs as it is expected to reduce financial burden during old age. It is a risk protection mechanism for an insured that needs health and financial protection when an individual is unable to do activities of daily living (ADL) or supports in instrumental activities of daily living (IADL). This paper reviews three models that have been used in pricing long-term care insurance. All three models use the equivalent principle of premium to price the insurance policy. However, the probability and assumptions used for each model differ, depending on the insured's needs and profile.

scholarly journals Increased mortality in patients with corticosteroid-dependent asthma: a nationwide population-based study

2019 ◽  
Vol 54 (5) ◽  
pp. 1900804 ◽  
Author(s):  
Hyun Lee ◽  
Jiin Ryu ◽  
Eunwoo Nam ◽  
Sung Jun Chung ◽  
Yoomi Yeo ◽  
...  
Keyword(s):  
Baseline Period ◽  
Population Based ◽  
High Dose ◽  
Population Based Study ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Korean National Health Insurance ◽  
Independent Cohort ◽  
Long Term Mortality

IntroductionChronic systemic corticosteroid (CS) therapy is associated with an increased risk of mortality in patients with many chronic diseases. However, it has not been elucidated whether chronic systemic CS therapy is associated with increased mortality in patients with asthma. The aim of this study was to determine the effects of chronic systemic CS therapy on long-term mortality in adult patients with asthma.MethodsA population-based matched cohort study of males and females aged ≥18 years with asthma was performed using the Korean National Health Insurance Service database from 2005 to 2015. Hazard ratio (HR) with 95% confidence interval for all-cause mortality among patients in the CS-dependent cohort (CS use ≥6 months during baseline period) relative to those in the CS-independent cohort (CS use <6 months during baseline period) was evaluated.ResultsThe baseline cohort included 466 941 patients with asthma, of whom 8334 were CS-dependent and 458 607 were CS-independent. After 1:1 matching, 8334 subjects with CS-independent asthma were identified. The HR of mortality associated with CS-dependent asthma relative to CS-independent asthma was 2.17 (95% CI 2.04–2.31). In patients receiving low-dose CS, the HR was 1.84 (95% CI 1.69–2.00); in patients receiving high-dose CS, the HR was 2.56 (95% CI 2.35–2.80).ConclusionsIn this real-world, clinical practice, observational study, chronic use of systemic CS was associated with increased risk of mortality in patients with asthma, with a significant dose–response relationship between systemic CS use and long-term mortality.

scholarly journals Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: a retrospective, dual-center cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carl Neuerburg ◽  
Stefan Förch ◽  
Johannes Gleich ◽  
Wolfgang Böcker ◽  
Markus Gosch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Trauma Care ◽  
Daily Living ◽  
Aging Population ◽  
Readmission Rates ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Background Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC). Methods We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL). Results A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up. Conclusions Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards. Trial registration The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.

scholarly journals Functional capacity and reported morbidities: a comparative analysis in the elderly

2017 ◽  
Vol 20 (3) ◽  
pp. 398-408 ◽  
Author(s):  
William César Gavasso ◽  
Vilma Beltrame
Keyword(s):  
Activities Of Daily Living ◽  
Functional Capacity ◽  
Daily Living ◽  
Family Health ◽  
The Elderly ◽  
Gastrointestinal System ◽  
Elderly Persons ◽  
Santa Catarina ◽  
Cross Sectional ◽  
Percentage Difference

Abstract Objective: To evaluate the influence of chronic morbidities on the functional capacity of elderly persons living in the municipal region of Herval d’ Oeste, in the state of Santa Catarina, Brazil. Methods: An analytical cross-sectional study was carried out with a sample of 272 elderly people registered in the Family Health Strategy of the municipality of Herval d’ Oeste, Santa Catarina. A socio-demographic questionnaire, Katz’s Basic Activities of Daily Living Scale and Lawton’s Instrumental Activities of Daily Living Scale (IALD) were used as instruments to gather data. The socio-demographical variables were estimated in frequencies and percentages. The associations were analyzed through the chi-square test. Results: Significant statistical associations for dependence were only found in the IADL assessments. Hypertension and Diabetes Mellitus were not found to influence the dependence of the elderly. However, a greater number of elderly persons who reported pathologies of the gastrointestinal system were classified as dependent. While the number of morbidities did not influence dependence in IADL, there was a smaller percentage difference between dependent and independent individuals among those with more than three morbidities. Conclusion: No relationship was found between the number of morbidities and the functional and instrumental capacity of the elderly. However, diseases of the gastrointestinal system demonstrated an influence on the dependence of elderly persons of Herval d'Oeste, Santa Catarina.

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