scholarly journals Environment in institutional care settings as a promoting factor for older individuals’ mobility: A systematic review

Author(s):  
Noora Narsakka ◽  
Riitta Suhonen ◽  
Minna Stolt
2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 182-182
Author(s):  
Kun Wang

Abstract Due to the fast pace of population aging and the “4-2-1” family structure, institutional care was proposed as “support” for the elderly care service system in China. The purpose of this systematic review paper was to identify factors that are associated with the well-being of older residents living at institutional care facilities in China. Studies were included if participants (1)aged 60 years or older, (2) were living at an institutional care facility in mainland China. Studies were excluded if participants (1) were Chinese Immigrants, or residents in Hong Kong, Macao, and Taiwan, (2) were cognitively impaired, or (3) at the end of their lives and need palliative care in institutional facilities. A total of 12 articles were selected in this review study based on PRISMA guidelines: 10 quantitative studies and 2 qualitative studies. Anderson healthcare utilization model was used in this study to categorize related factors into three dynamics: predisposing factors, enabling factors, and need factors. Among predisposing factors, older, more educated, widowed adults with higher income were more likely to have higher levels of well-being in institutional care facilities. Social supports, such as family visit, activity engagement and peer support, were very important enabling factors. The actual need, such as ADL, health status and depression, was another important dimension for the well-being of older Chinese living in institutional care facilities. Aiming at increasing older residents’ well-being, the present study suggested more tailored interventions should be designed and implemented to enhance their social support, activity engagement and peer support.


2020 ◽  
Vol 9 (10) ◽  
pp. 3150
Author(s):  
Jason Trieu ◽  
Daniel J. Gould ◽  
Chris Schilling ◽  
Tim Spelman ◽  
Michelle M. Dowsey ◽  
...  

An increasing number of total knee replacements (TKRs) are being performed in response to the growing burden of osteoarthritis. Patients <65 years of age represent the fastest growing group of TKR recipients and are expected to account for an increasing number of primary and revision procedures. Concerns have been raised about the outcomes that can be expected by this age demographic who are more active, physically demanding, and have longer life expectancies compared to older TKR recipients. This systematic review and meta-analysis evaluated the effectiveness of TKR for osteoarthritis in patients <65 years of age, compared to older individuals. A systematic search of Embase and Medline was conducted to identify studies which examined patient-reported outcomes measured using disease-specific and generic health-related quality of life instruments. Ten studies met our inclusion criteria and were included in this review. These studies comprised 1747 TKRs performed between 1977 and 2014. In the meta-analysis of two prospective studies (288 TKRs), patients <65 years of age were able to attain large and clinically meaningful improvements in pain, function, and quality of life. One of these studies (61 TKRs) suggested that patients <55 years of age attained a larger degree of improvement compared to older individuals. Results into the second postoperative decade were less certain, with some data suggesting a high prevalence of pain and patterns of functional decline. Further research is required to investigate longer-term outcomes following TKR for osteoarthritis in younger patients.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S455-S456
Author(s):  
Francesco Vailati Riboni ◽  
Francesco Pagnini

Abstract Age-based stereotype threat (ABST) occurs when older adults are influenced by negative stereotypes about age-related decline and functional losses and ironically behave in disengaging and self-defeating ways that confirm the stereotype (Steele & Aronson, 1995). Aging stereotypes are found to be strong predictors of health and illness outcomes in later life, and are associated with performance in specific areas, mainly in cognitive and physical domains. The current study reviewed the experimental methods and their reported effects previously published in the literature to determine if there were different ABST methods were associated with different types of age-related outcomes. We conducted a systematic review, screening the scientific literature for papers that included experimental manipulation of age-related stereotypes as an independent variable, focusing on samples of older adults (1113 articles, most published after 2003). Through a classification of the common and distinctive characteristics of the different stereotype manipulation techniques, we were able to identify three specific types of experimental methods: by instruction, tests, and interpersonal exposure. Although the mechanism by which stereotypes are associated with functional outcomes in older adults remains unclear, our review suggests it is possible to experimentally control the activation of the stereotype by manipulating its specific characteristics and the way older participants are exposed to it. Findings also highlight the possibility that specific experimental methods used to induce ABST in older individuals may lead to unique and different consequences on functional performance variation.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027349
Author(s):  
Banaz Al-khalidi ◽  
Joycelyne Efua Ewusie ◽  
Jemila Hamid ◽  
Samantha Kimball

IntroductionClinical trials and systematic reviews of trials involving vitamin D supplementation have mainly focused on defining the optimal amount of vitamin D dosage. However, the comparative effectiveness of different dosing schedules (ie, daily vs bolus dosing schedule) has been largely unexplored; and currently, there is no consensus regarding the optimal vitamin D dosing schedule. Our objective is to conduct a systematic review and network meta-analysis (NMA) to evaluate the comparative effectiveness and safety of steady (eg, daily, weekly) and intermittent high-dose (eg, monthly, yearly) vitamin D dosing schedules; and to determine the effectiveness of the various dosing schedules and combinations of treatments.Methods and analysisWe will conduct a systematic search and review of literature from major medical databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov) involving studies that compare vitamin D supplementation alone or in combination with calcium. Only randomised controlled trials (RCTs) will be considered. We will, however, consider various settings (eg, community, institutional care) and study designs (eg, cluster RCTs, cross-over trials). Our primary outcomes include falls and fractures including hip-fracture and non-vertebral fractures. Secondary outcomes will include muscle strength, physical performance, gait and mobility limitation. A Bayesian NMA will be conducted, and the results will be presented in the form of treatment effect estimates and ranking probabilities, with corresponding CIs. Pairwise meta-analysis will also be conducted for studies reporting head-to-head comparisons. Subgroup analysis will be performed with respect to pre-determined subgroups; including vitamin D status as measured by serum 25-hydroxyvitamin D levels, age and follow-up time. Sensitivity analysis will also be performed with respect to risk of bias.Ethics and disseminationThis study is a systematic review and meta-analysis of published RCTs; therefore, no ethical approval is required. Results will be disseminated through open access peer-reviewed publications.Systematic review registrationPROSPERO CRD42018112662.


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