Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study

ObjectivesThis study aimed to investigate the relationship between disability and domain-specific cognitive function in older adults with chronic obstructive pulmonary disease (COPD).DesignCross-sectional analyses combined with retrospective longitudinal analyses.SettingWe included 450 communities in China.ParticipantsIn this study, 1022 (mean age: 68.6±6.3; 612 males) and 152 (mean age: 67.0±5.2; 83 males) older adults with COPD from the China Health and Retirement Longitudinal Study were included in a cross-sectional multivariate linear regression analysis and a longitudinal logistic regression analysis, respectively.Outcome measuresDisability was determined by the difficulty or inability to complete 1 of the 12 activity items in basic activities of daily living (ADL) and instrumental ADL. The cognitive dimensions of episodic memory, attention/numerical ability, orientation to time, and visuospatial ability were assessed via the immediate/delayed recall task, serial sevens task, naming the current date and pentagon-figure-drawing tasks, respectively.ResultsOf 1022 older respondents with COPD at wave-4, 48.5% had ADL disability. Declines in the global cognitive function (β (95% CI)=−0.627 (−1.214 to –0.040)), orientation to time (β (95% CI)=−0.207 (−0.364 to –0.050)) and visuospatial ability (β (95% CI)=−0.068 (−0.127 to –0.009)) were significantly associated with the presence of ADL disability, when demographic and health-related variables were adjusted. Of 152 older participants with COPD and without ADL disability in wave-2, 61 (40.1 %) developed disability over a 2-year follow-up. Relative to the participants without a decline in orientation to tine, those with the condition had greater odds of incidence of ADL disability increased by a factor of about 1.46 over a 2-year follow-up.ConclusionsIn older adults with COPD, orientation to time and visuospatial inability are vulnerable to the presence of a disability. Prevention of a decline in orientation to time might help prevent disability in older people with COPD.

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Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126271 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6271

Author(s):

Yee Mang Chan ◽

Norhafizah Sahril ◽

Ying Ying Chan ◽

Nor’ Ain Ab Wahab ◽

Norliza Shamsuddin ◽

...

Keyword(s):

Older Adults ◽

Gender Differences ◽

Activities Of Daily Living ◽

Hearing Impairment ◽

Daily Living ◽

Hearing Impairments ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Adl Disability

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults’ level of independence.

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Relationship Between Balance, Gait, and Activities of Daily Living in Older Adults With Dementia

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320929578 ◽

2020 ◽

Vol 11 ◽

pp. 215145932092957 ◽

Cited By ~ 1

Author(s):

Nam Gi Lee ◽

Tae Woo Kang ◽

Hyun Ju Park

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Activities Of Daily Living ◽

Daily Living ◽

Cross Sectional ◽

Double Support ◽

Targeted Interventions ◽

People With Dementia ◽

Gait Parameters ◽

Support Time

Introduction: Gait characteristics are closely associated with executive functions including basic and high-level cognitive processes such as attention, working memory, decision-making, and problem-solving. Impaired cognitive function resulting from dementia is associated with loss of balance and poor activities of daily living (ADLs). If associations between gait parameters, balance, and ADLs are observed, then quantitative gait analysis may be optimal for reinforcing balance and ADL assessments in people with dementia. This study aimed to determine the association between balance, gait, and ADLs in older adults with dementia. Materials and Methods: A cross-sectional study was conducted in 46 older adults who have been diagnosed with dementia. Measurements including the Mini-Mental Statement Examination-Korean version (MMSE-K), Berg Balance Scale (BBS), 10-meter walk test (10MWT), Modified Barthel index (MBI), and GAITRite were used to assess cognitive function, balance, walking speed, ADLs, and gait parameters, respectively. The Pearson product correlation coefficient ( r) was used for correlation analysis. Results and Discussion: Among the gait parameters, velocity was positively associated with the BBS, 10MWT, and MBI ( r = 0.341-0.516, P > .05). Step length ( r = 0.301-0.586, P > .05), stride length ( r = 0.329-0.580, P > .05), and walk ratio ( r = 0.324-0.556, P > .05) were positively associated with the MMSE-K, BBS, 10MWT, and MBI. A moderate positive association between single support time and MBI was observed ( r = 0.308, P = .039). Additionally, a moderate negative association between double support time and the MBI was observed ( r = −0.349, P = .019). This study presents the first empirical evidence on the association between balance, gait, and ADLs in older adults with dementia. Conclusions: This study identified important associations between balance, gait, and ADL assessments in people with dementia. Further studies involving targeted interventions addressing gait parameters and improving balance and functional performance in people with dementia are required in the future.

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Effect of Vitamin D on Cognitive Functions in Older Adults: 24-Week Follow-Up Study

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317518822274 ◽

2019 ◽

Vol 34 (2) ◽

pp. 112-117 ◽

Cited By ~ 1

Author(s):

Esra Ates Bulut ◽

Pinar Soysal ◽

Idil Yavuz ◽

Suleyman Emre Kocyigit ◽

Ahmet Turan Isik

Keyword(s):

Older Adults ◽

Vitamin D ◽

Cognitive Function ◽

Activities Of Daily Living ◽

Cognitive Functions ◽

Cognitive Assessment ◽

Daily Living ◽

Severe Deficiency ◽

Deficiency Group

The purpose of this study is to assess the effect of vitamin D replacement on cognitive function in older adults. A total of 560 patients who underwent comprehensive geriatric assessment including Global cognitive assessment, Basic Activities of Daily Living (BADL), and Instrumental Activities of Daily Living (IADL) twice in 6-month period were retrospectively reviewed. Oral cholecalciferol was replaced to patients with vitamin D deficiency routinely. In baseline cognitive scores, BADL-IADL scores were lower in the severe deficiency group than in the deficiency and adequate groups ( P < .05). With regard to the relation between changes in cognitive functions, BADL-IADL scores on the 6-month versus baseline, no difference was determined in patients with and without dementia ( P > .05). Vitamin D replacement may not improve cognitive performance in older adults, even if vitamin D is raised to adequate level, suggesting that longer term replacement therapy may be needed to improve cognitive function.

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Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

Psychological Medicine ◽

10.1017/s0033291720001026 ◽

2021 ◽

pp. 1-8

Author(s):

Bin Yu ◽

Andrew Steptoe ◽

Yongjie Chen ◽

Xiaohua Jia

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Cognitive Function ◽

Episodic Memory ◽

Cognitive Decline ◽

Social Isolation ◽

Mental Status ◽

Chinese Older Adults ◽

Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

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Multimorbidity, Disadvantage, and Trends in Disability-Free Life Expectancy: The CFAS Studies

Innovation in Aging ◽

10.1093/geroni/igaa057.2200 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 641-641

Author(s):

Andrew Kingston ◽

Holly Bennett ◽

Louise Robinson ◽

Lynne Corner ◽

Carol Brayne ◽

...

Keyword(s):

Cognitive Function ◽

Life Expectancy ◽

Longitudinal Data ◽

Activities Of Daily Living ◽

Daily Living ◽

Health Conditions ◽

Disadvantaged Groups ◽

Disability Free Life Expectancy ◽

Reported Health

Abstract The combined contribution of multi-morbidity and socio-economic position (SEP) to trends in disability free life expectancy (DFLE) is unknown. We use longitudinal data from the Cognitive Function and Ageing Studies (CFAS I: 1991; CFAS II: 2011), with two year follow up. Disability was defined as difficulty in activities of daily living, and SEP as area-level deprivation. Multi-morbidity was constructed from nine self-reported health conditions and categorised as 0-1, 2-3, 4+ diseases. In 1991 and 2011, shorter total and disability-free years were associated with greater multi-morbidity. Between 1991 and 2011, gains in life expectancy and DFLE were observed at all levels of multi-morbidity, the greatest gain in DFLE being 4 years for men with 0-1 diseases. As multi-morbidity is more prevalent in more disadvantaged groups, further analyses will investigate whether SEP differences remain at all levels of multi-morbidity.

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Frailty transitions and cognitive function among South Korean older adults

Scientific Reports ◽

10.1038/s41598-021-90125-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Fatima Nari ◽

Bich Na Jang ◽

Hin Moi Youn ◽

Wonjeong Jeong ◽

Sung-In Jang ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Daily Living ◽

Mini Mental State Examination ◽

Adult Population ◽

Geriatric Syndrome ◽

South Korean ◽

Adl Disability ◽

Older Adult Population ◽

State Examination

AbstractFrailty is considered a multidimensional geriatric syndrome, manifested by the accumulation of age-associated deficits. The consequences of frailty transitions are still understudied. This study evaluated the influence of frailty transitions on cognitive function in the older adult population. We used data derived from the Korean Longitudinal Study of Aging (KLoSA) (2008–2018) on older adults aged ≥ 65 years. Frailty was assessed using a validated Korean frailty measure known as the frailty instrument (FI), and cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE). Transitions in frailty and their relationship with cognitive function were investigated using lagged generalized estimating equations (GEE), t-tests, and ANOVA. Respondents who experienced frailty transitions (those with ameliorating frailty), those who developed frailty, and whose frailty remained constant, were more likely to have a lower cognitive function than those who were consistently non-frail. Older age, activities of daily living (ADL) disability, and instrumental ADL disability were more negatively associated with declining cognitive function, especially in the “frail → frail” group. Changes in all individual components of the frailty instrument were significantly associated with impaired cognitive function. The results suggest an association between frailty transitions and cognitive impairment. Over a 2-year span, the remaining frail individuals had the highest rate of cognitive decline in men, while the change from non-frail to frail state in women was significantly associated with the lowest cognitive function values. We recommend early interventions and prevention strategies in older adults to help ameliorate or slow down both frailty and cognitive function decline.

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The mediating and moderating effects of depressive symptoms on the prospective association between cognitive function and activities of daily living disability in older adults

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2021.104480 ◽

2021 ◽

pp. 104480

Author(s):

Chao Wu

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Cognitive Function ◽

Activities Of Daily Living ◽

Daily Living ◽

Moderating Effects ◽

Prospective Association

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Obesity, Apolipoprotein E ε4, and Difficulties in Activities of Daily Living Among Older Adults: a 6-Year Follow-up Study

Annals of Behavioral Medicine ◽

10.1007/s12160-016-9848-y ◽

2016 ◽

Vol 51 (2) ◽

pp. 251-260 ◽

Cited By ~ 2

Author(s):

Li-Jung Chen ◽

Andrew Steptoe ◽

Po-Wen Ku

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Apolipoprotein E ◽

Daily Living ◽

Follow Up Study

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Appendicular Lean Mass, Grip Strength, and the Development of Hospital-Associated Activities of Daily Living Disability among Older Adults in the Health ABC Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glab332 ◽

2021 ◽

Author(s):

James S Andrews ◽

Laura S Gold ◽

May J Reed ◽

Jose M Garcia ◽

Robyn L McClelland ◽

...

Keyword(s):

Older Adults ◽

Grip Strength ◽

Lean Mass ◽

Daily Living ◽

Adult Survivors ◽

Regression Analyses ◽

Appendicular Lean Mass ◽

Adl Disability ◽

Separate Regression

Abstract Background Half of all physical disability, including activity of daily living (ADL) disability, among older adults occurs in the setting of hospitalization. This study examines whether appendicular lean mass (ALM) and grip strength, which are commonly included in various definitions of sarcopenia, are associated with development of hospital-associated ADL disability in older adults in the Health ABC Study. Methods Individuals hospitalized during the first 5 years of follow-up (n=1,724) were analyzed. ALM to body mass index (BMI) ratio (ALMBMI), by dual energy x-ray absorptiometry (DXA), and grip strength, by hand-held dynamometery, were assessed annually. Development of new ADL disability was assessed at the time of the next annual assessment after hospitalization. Separate regression analyses modeled the association of pre-hospitalization ALMBMI or grip strength with death before the next scheduled annual assessment. Next, among those who survived to the next annual assessment, separate regression analyses modeled the association of ALMBMI or grip strength with development of ADL disability. Results Each standard deviation decrement in pre-hospitalization grip strength was associated with an adjusted 1.80 odds of new ADL disability at follow-up (95% CI: 1.18, 2.74). Low, compared to not low, grip strength (per FNIH definition) was associated with an adjusted 2.36 odds of ADL disability at follow-up (95% CI: 1.12, 4.97). ALM measures were not associated with development of hospital-associated ADL disability. ALM and grip strength measures were not associated with death. Conclusions Pre-hospitalization lower grip strength may be an important risk factor for ADL disability among older adult survivors of hospitalization.

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