Cardiac Rehabilitation in Very Old Adults: Effect of Baseline Functional Capacity on Treatment Effectiveness

2016 ◽  
Vol 64 (8) ◽  
pp. 1640-1645 ◽  
Author(s):  
Samuele Baldasseroni ◽  
Alessandra Pratesi ◽  
Sara Francini ◽  
Rachele Pallante ◽  
Riccardo Barucci ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Treatment Effectiveness ◽  
Very Old ◽  
Old Adults

Health Differences in Advanced Old Age

1993 ◽  
Vol 13 (4) ◽  
pp. 619-655 ◽  
Author(s):  
Elisabeth Steinhagen-Thiessen ◽  
Markus Borchelt
Keyword(s):  
Old Age ◽  
Functional Capacity ◽  
Functional Limitations ◽  
Laboratory Data ◽  
Predictive Ability ◽  
General Outline ◽  
Very Old ◽  
Old Adults ◽  
Health Differences ◽  
Organ Systems

AbstractThe first part of this paper provides a general outline of objectives and methods of the Internal Medicine and Geriatrics Unit of the Berlin Aging Study (BASE). Based on a multi-dimensional conceptualization of health, objective and laboratory data collected about different organ systems, e.g. cardiovascular and musculoskeletal, and functional capacity are complemented by qualitative clinical diagnoses and judgements as well as self-reported health problems and functional limitations. Some of the central questions that can be addressed using these data relate to understanding the nature and processes of differential ageing. The second part of the paper includes initial analyses of inter-individual health differences in advanced old age (70 to 105 years). Initial findings indicated that heterogeneity in somatic morbidity and functional capacity was at least as large in old adults (70 to 84 years) as in very old adults (85 to 105 years), even though higher rates of somatic morbidity and lower levels of functional capacity were observed in the very old. Chronological age and morbidity as well as psychosocial and demographic factors were found to be independent predictors of functional capacity in advanced old age. Additionally, the relative importance of psychosocial factors was found to be a function of age with lower predictive ability among the very old. In conclusion, these initial findings support the hypothesis of significant health differences in advanced old age due to differential ageing.

scholarly journals Vitamin D Status, Muscle Strength and Physical Performance Decline in Very Old Adults: A Prospective Study

Nutrients ◽  
2017 ◽  
Vol 9 (4) ◽  
pp. 379 ◽  
Author(s):  
Antoneta Granic ◽  
Tom Hill ◽  
Karen Davies ◽  
Carol Jagger ◽  
Ashley Adamson ◽  
...  
Keyword(s):  
Vitamin D ◽  
Muscle Strength ◽  
Prospective Study ◽  
Physical Performance ◽  
Vitamin D Status ◽  
Very Old ◽  
Old Adults ◽  
Performance Decline ◽  
A Prospective Study

scholarly journals Mortality is not increased with Diabetes in Hospitalised Very Old Adults: A multi-site review.

2020 ◽  
Author(s):  
Peter Smerdely
Keyword(s):  
Length Of Stay ◽  
Adverse Events ◽  
Negative Binomial ◽  
Negative Impact ◽  
Outcome Data ◽  
Teaching Hospitals ◽  
Very Old ◽  
Old Adults ◽  
Lengths Of Stay ◽  
Hospital Acquired

Abstract Background: Few data exist regarding hospital outcomes in people with diabetes aged beyond 75 years. This study aimed to explore the association of diabetes with hospital outcome in the very old patient.Methods: A retrospective review was conducted of all presentations of patients aged 65 years or more admitted to three Sydney teaching hospitals over six years (2012-2018), exploring primarily the outcomes of in-hospital mortality, and secondarily the outcomes of length of stay, the development of hospital-acquired adverse events and unplanned re-admission to hospital within 28 days of discharge. Demographic and outcome data, the presence of diabetes and comorbidities were determined from ICD10 coding within the hospital's electronic medical record. Logistic and negative binomial regression models were used to assess the association of diabetes with outcome. Results: A total of 139130 separations (mean age 80 years, range 65 to 107 years; 51% female) were included, with 49% having documented comorbidities and 26.1% a diagnosis of diabetes. When compared to people without diabetes, diabetes was not associated with increased odds of mortality (OR: 0.89 SE (0.02), p<0.001). Further, because of a significant interaction with age, diabetes was associated with decreased odds of mortality beyond 80 years of age. While people with diabetes overall had longer lengths of stay (10.2 days SD (13.4) v 9.4 days SD (12.3), p<0.001), increasing age was associated with shorter lengths of stay in people aged more than 90 years. Diabetes was associated with increased odds of hospital-acquired adverse events (OR: 1.09 SE (0.02), p<0.001) and but not 28-day re-admission (OR: 0.88 SE (0.18), p=0.523).Conclusion: Diabetes has not been shown to have a negative impact on mortality or length of stay in hospitalised very old adults from data derived from hospital administrative records. This may allow a more measured application of diabetic guidelines in the very old hospitalised patient.

Cardiac Rehabilitation after an Acute Coronary Syndrome: The Impact in Elderly Patients

Cardiology ◽  
2015 ◽  
Vol 131 (3) ◽  
pp. 177-185 ◽  
Author(s):  
Patrícia Rodrigues ◽  
Mário Santos ◽  
Maria João Sousa ◽  
Bruno Brochado ◽  
Diana Anjo ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Heart Rate Recovery ◽  
Real Life ◽  
The Elderly ◽  
Chronotropic Response ◽  
Coronary Syndrome ◽  
Supervised Exercise ◽  
The Impact

Introduction: Cardiac rehabilitation (CR) has been shown to decrease mortality and morbidity, improve the control of risk factors and the quality of life of patients with coronary artery disease. However, the elderly are underrepresented in most studies and in real-life CR programs. Our goal was to evaluate the impact of CR after an acute coronary syndrome in the elderly population. Methods: A cutoff of 65 years was used to dichotomize age. Our main focus was on the effects of ambulatory supervised exercise training on several surrogate markers, namely total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, body mass index, fasting glucose, glycated hemoglobin, probrain natriuretic peptide, International Physical Activity Questionnaire score, maximal exercise capacity, chronotropic response index and heart rate recovery. We evaluated those variables at the beginning and at the end of phase II of the CR program (after 3 months) and repeated the treadmill test at 12 months. Results: A total of 548 patients with a recent acute coronary syndrome were enrolled; 37% were 65 years old or older. Both age groups had a statistically significant improvement in all the evaluated parameters. Interestingly, at 12 months both groups maintained the improvement in functional capacity seen immediately after 3 months. Conclusions: The benefits of CR in terms of functional capacity, metabolic profile and other prognostic parameters were significant in both younger and older patients. Therefore, all eligible patients should be referred to CR programs, irrespective of age.

Efficacy of a Physician-Led Multiparametric Telemonitoring System in Very Old Adults with Heart Failure

2015 ◽  
Vol 63 (6) ◽  
pp. 1175-1180 ◽  
Author(s):  
Claudio Pedone ◽  
Francesca Flavia Rossi ◽  
Annagrazia Cecere ◽  
Luisa Costanzo ◽  
Raffaele Antonelli Incalzi
Keyword(s):  
Heart Failure ◽  
Very Old ◽  
Old Adults

Functional Capacity but Not Early Uptake of Cardiac Rehabilitation Predicts Readmission in Patients With Metabolic Syndrome

2018 ◽  
Vol 33 (4) ◽  
pp. 306-312
Author(s):  
Lee Anne Siegmund ◽  
Nancy M. Albert ◽  
Mark S. McClelland ◽  
James F. Bena ◽  
Shannon L. Morrison
Keyword(s):  
Metabolic Syndrome ◽  
Cardiac Rehabilitation ◽  
Functional Capacity

scholarly journals Protein intake and transitions between frailty states and to death in very old adults: the Newcastle 85+ study

2019 ◽  
Vol 49 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Nuno Mendonça ◽  
Andrew Kingston ◽  
Antoneta Granic ◽  
Carol Jagger
Keyword(s):  
Energy Intake ◽  
Sex Education ◽  
Protein Intake ◽  
Community Dwelling ◽  
Physical Endurance ◽  
Prospective Longitudinal Study ◽  
Very Old ◽  
Old Adults ◽  
State Models ◽  
Prospective Longitudinal

Abstract Objectives To examine the association of protein intake with frailty progression in very old adults. Design The Newcastle 85+ study, a prospective longitudinal study of people aged 85 years old in Northeast England and followed over 5 years. Setting and Participants 668 community-dwelling older adults (59% women) at baseline, with complete dietary assessment and Fried frailty status (FFS). Measures Dietary intake was estimated with 2 × 24-h multiple pass recalls at baseline. FFS was based on five criteria: shrinking, physical endurance/energy, low physical activity, weakness and slow walking speed and was available at baseline and 1.5, 3 and 5 years. The contribution of protein intake (g/kg adjusted body weight/day [g/kg aBW/d]) to transitions to and from FFS (robust, pre-frail and frail) and to death over 5 years was examined by multi-state models. Results Increase in one unit of protein intake (g/kg aBW/d) decreased the likelihood of transitioning from pre-frail to frail after adjusting for age, sex, education and multimorbidity (hazard ratios [HR]: 0.44, 95% confidence interval [CI]: 0.25–0.77) but not for the other transitions. Reductions in incident frailty were equally present in individuals with protein intake ≥0.8 (HR: 0.60, 95% CI: 0.43–0.84) and ≥1 g/kg aBW/d (HR: 0.63, 95% CI: 0.44–0.90) from 85 to 90 years. This relationship was attenuated after adjustment for energy intake, but the direction of the association remained the same (e.g. g/kg aBW/d model: HR: 0.71, 95% CI: 0.36–1.41). Conclusion High protein intake, partly mediated by energy intake, may delay incident frailty in very old adults. Frailty prevention strategies in this age group should consider adequate provision of protein and energy.

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