Hypertension prevalence and control among community‐dwelling lebanese older adults

Abstract Background This study evaluated the effect of attentional focus instructions on movement efficiency during a level-ground walking task in older adults with and without a history of falls. Methods One hundred and thirty-four community-dwelling older adults were categorised into older fallers (OF) (n = 37) and older non-fallers (ONF) (n = 97). Each participant was instructed to walk at a self-selected pace along a 6 m walkway under three attentional focus conditions (i.e. internal, goal-directed and control) for a total of nine trials. Average muscle activity indices of lower limb co-contractions were measured using surface electromyography. Results Both shank and thigh muscle co-contractions were higher in OF than in ONF in all three conditions. OF also demonstrated higher shank muscle co-contraction under the internal relative to the goal-directed condition, with no such change observed in ONF. Conclusion Despite no significant between-group differences in functional balance and balance confidence, relative walking inefficiencies were observed in OF compared with ONF. This finding demonstrates the debilitating consequences of falling that can occur with relative independence from various physiological or psychological factors that are commonly associated with falling and used to rationalise behavioural change. We also provide evidence that OF are more susceptible to conditions that provoke them to allocate attention internally. Therefore, in clinical contexts (e.g. gait rehabilitation), verbal instructions that refer to body movements (internal focus) might serve to compromise movement efficiency in older adults with a history of falls. Such changes will, theoretically, lessen the ability to react efficiently to changing environments experienced in daily life.

Download Full-text

Association Between Neighborhood Disadvantage and Hypertension Prevalence, Awareness, Treatment, and Control in Older Adults: Results From the University of Alabama at Birmingham Study of Aging

American Journal of Public Health ◽

10.2105/ajph.2014.302048 ◽

2015 ◽

Vol 105 (6) ◽

pp. 1181-1188 ◽

Cited By ~ 13

Author(s):

David R. Buys ◽

Virginia J. Howard ◽

Leslie A. McClure ◽

Katie Crawford Buys ◽

Patricia Sawyer ◽

...

Keyword(s):

Older Adults ◽

Neighborhood Disadvantage ◽

University Of Alabama ◽

Hypertension Prevalence ◽

The University ◽

And Control

Download Full-text

Self-management program versus usual care for community-dwelling older adults with multimorbidity: A pragmatic randomized controlled trial in Ontario, Canada

Journal of Comorbidity ◽

10.1177/2235042x20963390 ◽

2020 ◽

Vol 10 ◽

pp. 2235042X2096339

Author(s):

Kathryn Fisher ◽

Maureen Markle-Reid ◽

Jenny Ploeg ◽

Amy Bartholomew ◽

Lauren E Griffith ◽

...

Keyword(s):

Older Adults ◽

Home Care ◽

Service Use ◽

Primary Outcome ◽

Controlled Trial ◽

Home Care Services ◽

Community Dwelling ◽

Care Services ◽

And Control ◽

Community Dwelling Older Adults

Background: Multimorbidity, the co-existence of 2+ (or 3+) chronic diseases in an individual, is an increasingly common global phenomenon leading to reduced quality of life and functional status, and higher healthcare service use and mortality. There is an urgent need to develop and test new models of care that incorporate the components of multimorbidity interventions recommended by international organizations, including care coordination, interdisciplinary teams, and care plans developed with patients that are tailored to their needs and preferences. Purpose: To determine the effectiveness of a 6-month, community-based, multimorbidity intervention compared to usual home care services for community-dwelling older adults (age 65+ years) with multimorbidity (3+ chronic conditions) that were newly referred to and receiving home care services. Methods: A pragmatic, parallel, two-arm randomized controlled trial evaluated the intervention, which included in-home visits by an interdisciplinary team, personal support worker visits, and monthly case conferences. The study took place in two sites in central Ontario, Canada. Eligible and consenting participants were randomly allocated to the intervention and control group using a 1:1 ratio. The participants, statistician/analyst, and research assistants collecting assessment data were blinded. The primary outcome was the Physical Component Summary (PCS) score of the 12-Item Short-Form health survey (SF-12). Secondary outcomes included the SF-12 Mental Component Summary (MCS) score, Center for Epidemiological Studies of Depression (CESD-10), Generalized Anxiety Disorder (GAD-7), Self-Efficacy for Managing Chronic Disease, and service use and costs. Analysis of covariance (ANCOVA) tested group differences using multiple imputation to address missing data, and non-parametric methods explored service use and cost differences. Results: 59 older adults were randomized into the intervention (n = 30) and control (n = 29) groups. At baseline, groups were similar for the primary outcome and number of chronic conditions (mean of 8.6), but the intervention group had lower mental health status. The intervention was cost neutral and no significant group differences were observed for the primary outcome of PCS from SF-12 (mean difference: −4.94; 95% CI: −12.53 to 2.66; p = 0.20) or secondary outcomes. Conclusion: We evaluated a 6-month, self-management intervention for older adults with multimorbidity. While the intervention was cost neutral in comparison to usual care, it was not found to improve the PCS from SF-12 or secondary health outcomes. Recruitment and retention challenges were significant obstacles limiting our ability to assess intervention effectiveness. Yet, the intervention was grounded in internationally-endorsed recommendations and implemented in a practice setting (home care) viewed as a key upstream resource fostering independence in older adults. These features collectively support the identification of ways to recruit/retain older adults and test alternative implementation strategies for interventions that are based on sound principles of multimorbidity management.

Download Full-text

Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study

PLoS Medicine ◽

10.1371/journal.pmed.1003740 ◽

2021 ◽

Vol 18 (8) ◽

pp. e1003740

Author(s):

Sanjay K. Mohanty ◽

Sarang P. Pedgaonkar ◽

Ashish Kumar Upadhyay ◽

Fabrice Kämpfen ◽

Prashant Shekhar ◽

...

Keyword(s):

Older Adults ◽

Living Arrangement ◽

Diet Restriction ◽

Indian States ◽

Salt Diet ◽

Hypertension Prevalence ◽

Disadvantaged Groups ◽

Socially Disadvantaged ◽

Nationally Representative ◽

And Control

Background Lack of nationwide evidence on awareness, treatment, and control (ATC) of hypertension among older adults in India impeded targeted management of this condition. We aimed to estimate rates of hypertension ATC in the older population and to assess differences in these rates across sociodemographic groups and states in India. Methods and findings We used a nationally representative survey of individuals aged 45 years and over and their spouses in all Indian states (except one) in 2017 to 2018. We identified hypertension by blood pressure (BP) measurement ≥140/90 mm Hg or self-reported diagnosis if also taking medication or observing salt/diet restriction to control BP. We distinguished those who (i) reported diagnosis (“aware”); (ii) reported taking medication or being under salt/diet restriction to control BP (“treated”); and (iii) had measured systolic BP <140 and diastolic BP <90 (“controlled”). We estimated age–sex adjusted hypertension prevalence and rates of ATC by consumption quintile, education, age, sex, urban–rural, caste, religion, marital status, living arrangement, employment status, health insurance, and state. We used concentration indices to measure socioeconomic inequalities and multivariable logistic regression to estimate fully adjusted differences in these outcomes. Study limitations included reliance on BP measurement on a single occasion, missing measurements of BP for some participants, and lack of data on nonadherence to medication. The 64,427 participants in the analysis sample had a median age of 57 years: 58% were female, and 70% were rural dwellers. We estimated hypertension prevalence to be 41.9% (95% CI 41.0 to 42.9). Among those with hypertension, we estimated that 54.4% (95% CI 53.1 to 55.7), 50.8% (95% CI 49.5 to 52.0), and 28.8% (95% CI 27.4 to 30.1) were aware, treated, and controlled, respectively. Across states, adjusted rates of ATC ranged from 27.5% (95% CI 22.2 to 32.8) to 75.9% (95% CI 70.8 to 81.1), from 23.8% (95% CI 17.6 to 30.1) to 74.9% (95% CI 69.8 to 79.9), and from 4.6% (95% CI 1.1 to 8.1) to 41.9% (95% CI 36.8 to 46.9), respectively. Age–sex adjusted rates were lower (p < 0.001) in poorer, less educated, and socially disadvantaged groups, as well as for males, rural residents, and the employed. Among individuals with hypertension, the richest fifth were 8.5 percentage points (pp) (95% CI 5.3 to 11.7; p < 0.001), 8.9 pp (95% CI 5.7 to 12.0; p < 0.001), and 7.1 pp (95% CI 4.2 to 10.1; p < 0.001) more likely to be aware, treated, and controlled, respectively, than the poorest fifth. Conclusions Hypertension prevalence was high, and ATC of the condition were low among older adults in India. Inequalities in these indicators pointed to opportunities to target hypertension management more effectively and equitably on socially disadvantaged groups.

Download Full-text

Effects of Resistance Training on Muscular Strength and Functional Abilities of Community-Dwelling Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.3.3.238 ◽

1995 ◽

Vol 3 (3) ◽

pp. 238-250 ◽

Cited By ~ 30

Author(s):

Jeanne F. Nichols ◽

Lori M. Hitzelberger ◽

Jennifer G. Sherman ◽

Patricia Patterson

Keyword(s):

Older Adults ◽

Exercise Program ◽

Community Dwelling ◽

Moderate Intensity ◽

Functional Abilities ◽

Positive Effects ◽

Weight Trainers ◽

Shoulder Strength ◽

And Control ◽

Community Dwelling Older Adults

This study examined the efficacy of a progressive resistance exercise program, using equal concentric/eccentric (CE) or greater eccentric/concentric (GE) workloads, for increasing strength and improving functional abilities of community-dwelling older adults. Sixty men and women were randomly assigned to one of three groups: CE, GE, or control. All strength testing and training took place on six Lifecircuit machines. Functional tests included a bas carry, weighted stair climb, shelf task 1-RM, and static balance. Significant interactions in strength tests were noted for the chest, back, and shoulder exercises. GE improved in shoulder strength more than CE and control For functional measures, all weight trainers were grouped and compared to controls. A significant interaction occurred for the stair climb and balance with the exercise groups decreasing stair climb time by 11% and increasing balance time by 26%. Relative improvements by weight trainers of 12% for the shelf task and 7% for the bag carry were not significant. These data indicate that a moderate intensity resistance program can have positive effects on tasks required for everyday function.

Download Full-text

Association Between Antidepressant Medication Use and Prevalence and Control of Cardiovascular Risk Factors in Community-Dwelling Older Adults: The Italian Health Examination Survey 2008–2012

Metabolic Syndrome and Related Disorders ◽

10.1089/met.2019.0088 ◽

2020 ◽

Vol 18 (2) ◽

pp. 73-78

Author(s):

Giovanni Viscogliosi ◽

Chiara Donfrancesco ◽

Cinzia Lo Noce ◽

Simona Giampaoli ◽

Diego Vanuzzo ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Medication Use ◽

Antidepressant Medication ◽

Community Dwelling ◽

Health Examination ◽

And Control ◽

Community Dwelling Older Adults

Download Full-text

The prevalence, awareness, treatment, and control of hypertension in older adults with an intellectual disability in Ireland: a cross sectional study

European Journal of Cardiovascular Nursing ◽

10.1093/eurjcn/zvaa019 ◽

2021 ◽

Author(s):

Frances O’Brien ◽

Philip McCallion ◽

Rachael Carroll ◽

Máire O’Dwyer ◽

Eilish Burke ◽

...

Keyword(s):

Older Adults ◽

Intellectual Disability ◽

Female Gender ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Hypertension Prevalence ◽

Disease Mortality ◽

Nationally Representative ◽

And Control

Abstract Aims Hypertension is a leading risk factor for cardiovascular disease, accounting for almost 50% of ischaemic heart disease mortality. This study aims to identify the prevalence, awareness, treatment, and control of hypertension and their predictors in older adults with an intellectual disability (ID). Methods and results This cross-sectional study utilized data from the ID Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). Participants were drawn from the nationally representative sample and included those who completed the self/informant report measures, in addition to objective blood pressure (BP) measurement. From the 551 individuals with ID, aged ≥40 years, hypertension prevalence was 35.2% [95% confidence interval (CI) 31.2–39.2%]. Of those with hypertension, 44.3% (95% CI 37.1–51.5%) were aware of their hypertensive status, and 64.2% (95% CI 57.3–71.1) were taking antihypertensive medication. Among those on treatment, 70.8% (95% CI 61.8–78.2%) had their BP controlled to below 140/90 mmHg. Significant predictors of awareness were age (P = 0.036) and level of ID (P = 0.004), predictors of treatment were age (P = 0.002), level of ID (P = 0.019), and diabetes (P = 0.001). Both diabetes and female gender were predictors of control of hypertension (P = 0.013 and P = 0.037, respectively). Conclusion The prevalence of hypertension in older adults with ID was lower than reports for the general Irish population, with overall levels of treatment and control, when identified, higher in the ID population. There was under-treatment and lower levels of awareness among those with more severe ID, which requires addressing. The finding, that when diagnosed, people with ID respond well to treatment should encourage addressing the under-treatment found here.

Download Full-text

Preferences for collaborative and individual everyday problem solving in later adulthood

International Journal of Behavioral Development ◽

10.1080/01650250143000337 ◽

2002 ◽

Vol 26 (1) ◽

pp. 26-35 ◽

Cited By ~ 27

Author(s):

JoNell Strough ◽

Suling Cheng ◽

Lisa M. Swenson

Keyword(s):

Older Adults ◽

Problem Solving ◽

Social Comparisons ◽

Social Resources ◽

Community Dwelling ◽

Meal Preparation ◽

Everyday Problem ◽

And Control ◽

Everyday Problems ◽

Community Dwelling Older Adults

Individual and contextual predictors of preferences for solving everyday problems alone and in collaboration with others were investigated in a sample community-dwelling older adults ( M age = 71.80 years, SD = 5.78, range = 56–87, 51 men, 56 women). Gender differences in problem-solving preferences were found in gender-stereotyped domains (e.g., meal-preparation; house repair). In several problem domains, more positive social comparisons of problem-solving ability were related to greater preferences for solving problems alone and lesser preferences for solving problems with others. Marital status, temporal comparisons of ability, and perceived health and control were related to problem-solving preferences in some problem domains. Results are discussed from a contextual perspective that focuses on the fit between individuals’ personal and social resources and their preferred approaches to solving everyday problems.

Download Full-text

Resilience of Hmong Older Adults: Coping With Loneliness

Innovation in Aging ◽

10.1093/geroni/igaa057.1026 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 320-321

Author(s):

Cindy Vang ◽

Michael Sieng ◽

Mingyang Zheng

Keyword(s):

Older Adults ◽

Forced Migration ◽

Coping Mechanisms ◽

Community Dwelling ◽

Constructivist Grounded Theory ◽

Host Countries ◽

Individual Interviews ◽

Older Immigrants ◽

History Of ◽

And Control

Abstract Older refugees are especially susceptible to loneliness with their history of trauma, forced migration, and social isolation in host countries. Rates of loneliness among older immigrants range from 24% to 50%. Despite their heightened vulnerability to loneliness, coping mechanisms among this population remain understudied. The purpose of this study was to examine how community-dwelling Hmong older adults, an aging refugee group, cope with loneliness. The data was drawn from a larger constructivist grounded theory study aimed at understanding the loneliness experiences of community-dwelling Hmong older adults. Semi-structured individual interviews were conducted in the Hmong language with 17 Hmong age 65 and older residing in Northern California. Data was collected and analyzed in an iterative and comparative process using initial coding, focused coding, and connecting the focused codes to form categories and subcategories. Five coping mechanisms emerged from the data: (a) religious and spiritual beliefs; (b) social support; (c) wandering; (d) activity engagement; and (e) avoidance and control. Coping mechanisms utilized by Hmong older adults in this study highlighted the resilience of this aging population and the lack of culturally-relevant programs to prevent and address their persistent loneliness and emotional distress. Implications for research, practice, and policy suggests the need for greater culturally- and linguistically-competent services informed by Hmong older adults.

Download Full-text