Predictors of difficulty in carrying out basic activities of daily living among the old-old: A 2-year community-based cohort study

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

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Lower Levels of Serum Albumin and Total Cholesterol Associated with Decline in Activities of Daily Living and Excess Mortality in a 12-Year Cohort Study of Elderly Japanese

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2007.01549.x ◽

2008 ◽

Vol 56 (3) ◽

pp. 529-535 ◽

Cited By ~ 62

Author(s):

Tomonori Okamura ◽

Takehito Hayakawa ◽

Atsushi Hozawa ◽

Takashi Kadowaki ◽

Yoshitaka Murakami ◽

...

Keyword(s):

Cohort Study ◽

Serum Albumin ◽

Activities Of Daily Living ◽

Total Cholesterol ◽

Daily Living ◽

Excess Mortality ◽

Elderly Japanese

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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

BMC Geriatrics ◽

10.1186/s12877-019-1289-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 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.

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Depressive symptoms, emotional support and activities of daily living disability onset: 15-year follow-up of the Bambuí (Brazil) Cohort Study of Aging

Cadernos de Saúde Pública ◽

10.1590/0102-311x00141917 ◽

2018 ◽

Vol 34 (7) ◽

Cited By ~ 4

Author(s):

Juliana Lustosa Torres ◽

Erico Castro-Costa ◽

Juliana Vaz de Melo Mambrini ◽

Sérgio William Viana Peixoto ◽

Breno Satler de Oliveira Diniz ◽

...

Keyword(s):

Cohort Study ◽

Social Network ◽

Depressive Symptoms ◽

Activities Of Daily Living ◽

Psychosocial Factors ◽

Emotional Support ◽

Daily Living ◽

Wide Range

Psychosocial factors appear to be associated with increased risk of disability in later life. However, there is a lack of evidence based on long-term longitudinal data from Western low-middle income countries. We investigated whether psychosocial factors at baseline predict new-onset disability in long term in a population-based cohort of older Brazilians adults. We used 15-year follow-up data from 1,014 participants aged 60 years and older of the Bambuí (Brazil) Cohort Study of Aging. Limitations on activities of daily living (ADL) were measured annually, comprising 9,252 measures. Psychosocial factors included depressive symptoms, social support and social network. Potential covariates included sociodemographic characteristics, lifestyle, cognitive function and a physical health score based on 10 self-reported and objectively measured medical conditions. Statistical analysis was based on competitive-risk framework, having death as the competing risk event. Baseline depressive symptoms and emotional support from the closest person were both associated with future ADL disability, independently of potential covariates wide range. The findings showed a clear graded association, in that the risk gradually increased from low emotional support alone (sub-hazard ratio - SHR = 1.11; 95%CI: 1.01; 1.45) to depressive symptoms alone (SHR = 1.52; 95%CI: 1.13; 2.01) and then to both factors combined (SHR = 1.61; 95%CI: 1.18; 2.18). Marital status and social network size were not associated with incident disability. In a population of older Brazilian adults, lower emotional support and depressive symptoms have independent predictive value for subsequent disability in very long term.

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Disabilities in activities of daily living and in instrumental activities of daily living among older adults in China, 2011–15: a longitudinal cohort study

The Lancet ◽

10.1016/s0140-6736(19)32418-3 ◽

2019 ◽

Vol 394 ◽

pp. S82 ◽

Cited By ~ 1

Author(s):

Mingming Yan ◽

Tingting Qin ◽

Ping Yin

Keyword(s):

Older Adults ◽

Cohort Study ◽

Activities Of Daily Living ◽

Daily Living ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort ◽

Instrumental Activities

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An 18-month prospective cohort study of functional outcome of delirium in elderly patients: activities of daily living

International Psychogeriatrics ◽

10.1017/s1041610206003310 ◽

2006 ◽

Vol 18 (4) ◽

pp. 681-700 ◽

Cited By ~ 25

Author(s):

Stephen Vida ◽

Guillaume Galbaud du Fort ◽

Ritsuko Kakuma ◽

Louise Arsenault ◽

Robert W. Platt ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cohort Study ◽

Elderly Patients ◽

Activities Of Daily Living ◽

Functional Outcome ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Daily Living ◽

Medical Problems

Objectives: To examine delirium, chronic medical problems and sociodemographic factors as predictors of activities of daily living (ADL), basic ADL (BADL) and instrumental ADL (IADL).Methods: A prospective cohort study of four groups of elderly patients examined in the emergency department (ED): those with delirium, dementia, neither, and both. All were aged 66 years or older and living at home. Delirium was assessed with the Confusion Assessment Method and dementia with the Informant Questionnaire on Cognitive Decline in the Elderly. Demographic variables and chronic medical problems were ascertained with questionnaires. Outcome was ADL at 6, 12 and 18 months, measured with the ADL subscale of the Older Americans Resources and Services instrument.Results: Univariate analyses suggested significantly poorer ADL, particularly IADL, at 18 months in the delirium versus the non-delirium group, in the absence of dementia only. Statistically significant independent predictors of poorer ADL at 18 months in the non-dementia groups were poorer initial ADL, stroke, Parkinson's disease, hypertension and female sex. Independent predictors of poorer BADL at 18 months in the non-dementia groups were poorer initial BADL, Parkinson's disease, stroke, cancer, colds/sinusitis/laryngitis, female sex and hypertension. Independent predictors of poorer IADL at 18 months in the non-dementia groups were poorer initial IADL, stroke, never-married status, colds/sinusitis/laryngitis, arthritis and hypertension, with Parkinson's disease showing a non-significant but numerically large regression coefficient.Conclusion: Rather than finding delirium to be a predictor of poorer functional outcome among survivors, we found an interaction between delirium and dementia and several plausible confounders, primarily chronic medical problems, although we cannot rule out the effect of misclassification or survivor bias.

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