scholarly journals The Impact of a Submaximal Level of Exercise on Balance Performance in Older Persons

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Hani Asilah Alias ◽  
Maria Justine
Keyword(s):  
Sensory Integration ◽  
Older Persons ◽  
Community Dwelling ◽  
Rank Test ◽  
Clinical Test ◽  
Older Individuals ◽  
Balance Performance ◽  
Eyes Closed ◽  
Soft Surface ◽  
The Impact

Objective. The purpose of this study was to determine the impact of a submaximal level of exercise on balance performance under a variety of conditions.Material and Method. Thirteen community-dwelling older persons with intact foot sensation (age = 66.69 ± 8.17 years, BMI = 24.65 ± 4.08 kg/m2, female,n=6) volunteered to participate. Subjects’ balance performances were measured using the Modified Clinical Test of Sensory Integration of Balance (mCTSIB) at baseline and after test, under four conditions of stance: (1) eyes-opened firm-surface (EOF), (2) eyes-closed firm-surface (ECF), (3) eyes-opened soft-surface (EOS), and (4) eyes-closed soft-surface (ECS). The 6-minute walk test (6MWT) protocol was used to induce the submaximal level of exercise. Data was analyzed using the Wilcoxon Signed-Rank Test.Results. Balance changes during EOF (z=0.00,P=1.00) and ECF (z=-1.342,P=0.180) were not significant. However, balance changes during EOS (z=-2.314,P=0.021) and ECS (z=-3.089,P=0.02) were significantly dropped after the 6MWT.Conclusion. A submaximal level of exercise may influence sensory integration that in turn affects balance performance, particularly on an unstable surface. Rehabilitation should focus on designing intervention that may improve sensory integration among older individuals with balance deterioration in order to encourage functional activities.

scholarly journals 40 The Association between Apathy, Decline in Physcal Performance, and Falls

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Marieke Henstra ◽  
Didi Rhebergen ◽  
Lisette De Groot ◽  
Natasja Van Schoor ◽  
Nathalie Van der Velde
Keyword(s):  
Physical Performance ◽  
Fall Risk ◽  
Older Persons ◽  
Osteoporotic Fractures ◽  
Community Dwelling ◽  
Older Individuals ◽  
Negative Effects ◽  
Age And Gender ◽  
And Gender ◽  
The Impact

Abstract Background Symptoms of apathy are common in older persons. Negative effects on physical performance and fall risk are plausible, considering the pathophysiology of apathy. However, literature is scarce. Aim To longitudinally assess the association between apathy and 1) decline of physical performance and 2) the number of falls in older community-dwelling persons. Methods The ‘B-vitamins for the PRevention Of Osteoporotic Fractures’ study (B-PROOF) provided data on 2919 older persons over a period of two years. Apathy was assessed using the Geriatric Depression Scale3. A physical performance score (PPS) was calculated using three performance tests. Falls were registered prospectively. We calculated adjusted odds ratios (ORs), Incidence Rate Ratios (IRRs) their 95% confidence intervals (CI). Effect-modification by age and gender was investigated. We also investigated mediation by baseline PPS for the association between apathy and the number of falls. Results Apathy and decline of PPS were independently associated. After stratification, the effect only remained in men. Age was an effect modifier; higher ORs for decreasing age. Apathy was also independently associated with the number of falls. After stratification, women had higher IRRs than men. Age modified the association in the opposite direction: higher IRRs for increasing age. Baseline PPS was a mediator in the association. Conclusion The impact of apathy on physical performance and fall-incidents varied with age and gender. Potentially, in older individuals with apathy, fall risk is preceded by a decline in physical performance. In clinical practice, identifying apathy in older persons might be useful to target mobility preserving interventions.

The impact of functional limitations on disability and the moderating effects of psychological attributes in community-dwelling older persons

1998 ◽  
Author(s):  
G. I. J. M. Kempen ◽  
M. J. G. van Heuvelen ◽  
E. van Sonderen ◽  
R. H. S. van den Brink ◽  
A. C. Kooijman ◽  
...  
Keyword(s):  
Older Persons ◽  
Functional Limitations ◽  
Community Dwelling ◽  
Moderating Effects ◽  
Psychological Attributes ◽  
The Impact

scholarly journals Impact of an integrated community-based model of care for older people with complex conditions on hospital emergency presentations and admissions: a step-wedged cluster randomized trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jennifer Mann ◽  
Fintan Thompson ◽  
Robyn McDermott ◽  
A. Esterman ◽  
Edward Strivens
Keyword(s):  
Older People ◽  
Older Persons ◽  
Hospital Admissions ◽  
Community Dwelling ◽  
Trial Registration ◽  
Significant Finding ◽  
Complex Needs ◽  
Primary Practice ◽  
The Impact ◽  
Open Arch

Abstract Background Health systems must reorient towards preventative and co-ordinated care to reduce hospital demand and achieve positive and fiscally responsible outcomes for older persons with complex needs. Integrated care models can improve outcomes by aligning primary practice with the specialist health and social services required to manage complex needs. This paper describes the impact of a community-facing program that integrates care at the primary-secondary interface on the rate of Emergency Department (ED) presentation and hospital admissions among older people with complex needs. Methods The Older Persons Enablement and Rehabilitation for Complex Health Conditions (OPEN ARCH) study is a multicentre randomised controlled trial with a stepped wedge cluster design. General practitioners (GPs; n = 14) in primary practice within the Cairns region are considered ‘clusters’ each comprising a mixed number of participants. 80 community-dwelling persons over 70 years of age if non-Indigenous and over 50 years of age if Indigenous were included at baseline with no new participants added during the study. Clusters were randomly assigned to one of three steps that represent the time at which they would commence the OPEN ARCH intervention, and the subsequent intervention duration (3, 6, or 9 months). Each participant was its own control. GPs and participants were not blinded. The primary outcomes were ED presentations and hospital admissions. Data were collected from Queensland Health Casemix data and analysed with multilevel mixed-effects Poisson regression modelling to estimate the effectiveness of the OPEN ARCH intervention. Data were analysed at the cluster and participant levels. Results Five clusters were randomised to steps 1 and 2, and 4 clusters randomised to step 3. All clusters (n = 14) completed the trial accounting for 80 participants. An effect size of 9% in service use (95% CI) was expected. The OPEN ARCH intervention was found to not make a statistically significant difference to ED presentations or admissions. However, a stabilising of ED presentations and a trend toward lower hospitalisation rates over time was observed. Conclusions While this study detected no statistically significant change in ED presentations or hospital admissions, a plateauing of ED presentation and admission rates is a clinically significant finding for older persons with complex needs. Multi-sectoral integrated programs of care require an adequate preparation period and sufficient duration of intervention for effectiveness to be measured. Trial registration The OPEN ARCH study received ethical approval from the Far North Queensland Human Research Ethics Committee, HREC/17/QCH/104–1174 and is registered on the Australian and New Zealand Trials Registry, ACTRN12617000198325p.

scholarly journals Influence of middle ear alterations on children's balance

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Joana Ferreira ◽  
Carla Matos Silva ◽  
Inês Araújo
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Postural Balance ◽  
Sensory Integration ◽  
Type A ◽  
Clinical Test ◽  
Type B ◽  
Balance Performance ◽  
Balance Disorders

Abstract Background Postural instability is a possible symptom in children with otitis media, which often occurs in this population. The child with balance disorders usually has intolerance to sudden movements, difficulties in moving in the dark, nausea, vomiting and numerous fall events. To verify whether changes in the middle ear can influence the balance postural in children from 3 to 5 years. Methods The sample consisted of 31 children of both sexes, aged between 3 and 5 years. To collect data, a tympanogram was used to analyze the integrity of the tympanic membrane and the Modifid Clinical Test of Sensory Integration and Balance (MCTSIB), with four different sensory conditions, to assess static postural balance. Results Regarding the tympanogram, it was verified that the majority of the sample showed no changes, 45.2% of which were type A and 32.3% of type C1. Regarding the type B and C2 tympanogram, it was found that 12.9% of the sample had type B tympanogram and 9.7% type C2. When comparing these values with the MCTSIB results, there were no significant differences between the tympanogram with changes (B and C2) and the tympanogram without changes (A and C1), regarding the child's balance performance. Conclusions In this study, it was concluded that the alterations of the middle ear, proved through the tympanogram, did not influence the postural balance. However, it was found that the unilateral changes reported by the tympanogram, suggest higher values of postural oscillation, compared to bilateral changes.

scholarly journals Impact of COVID-19 Pandemic Exacerbation of Depressive Symptoms for Social Frailty from the ORANGE Registry

2022 ◽  
Vol 19 (2) ◽  
pp. 986
Author(s):  
Ayuto Kodama ◽  
Yu Kume ◽  
Sangyoon Lee ◽  
Hyuma Makizako ◽  
Hiroyuki Shimada ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Depressive Symptoms ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Older Individuals ◽  
State Of Emergency ◽  
Frailty Status ◽  
The Social ◽  
The Impact ◽  
At Home

Background: Recent longitudinal studies have reported proportion of frailty transition in older individuals during the COVID-19 pandemic. Our study aimed at clarifying the impact of social frailty in community-dwelling older adults during the COVID-19 pandemic and at identifying factors that can predict transition to social frailty. Methods: We performed this study from 2019 (before declaration of the state of emergency over the rising number of COVID-19 cases) to 2020 (after declaration of the emergency). We applied Makizako’s social frail index to our study subjects at the baseline and classified into robust, social prefrailty, and social frailty groups. Multiple logistic regression analysis was performed using robust, social prefrailty, or social frailty status as dependent variable. Results: Analysis by the Kruskal–Wallis test revealed significant differences in the score on the GDS-15 among the robust, social prefrailty, and social frailty groups (p < 0.05). Furthermore, multiple regression analysis identified a significant association between the social frailty status and the score on GDS-15 (odds ratio, 1.57; 95% confidence interval (95% CI), 1.15–2.13; p = 0.001). Conclusion: The increase in the rate of transition of elderly individuals to the social frailty group could have been related to the implementation of the stay-at-home order as part of the countermeasures for COVID-19. Furthermore, the increased prevalence of depressive symptoms associated with the stay-at-home order could also have influenced the increase in the prevalence of social frailty during the COVID-19 pandemic.

scholarly journals Childhood Cognition and Age-Related Change in Standing Balance Performance From Mid to Later Life: Findings From a British Birth Cohort

2018 ◽  
Vol 75 (1) ◽  
pp. 155-161 ◽  
Author(s):  
Joanna M Blodgett ◽  
Diana Kuh ◽  
Rebecca Hardy ◽  
Daniel H J Davis ◽  
Rachel Cooper
Keyword(s):  
Cognitive Processing ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Later Life ◽  
Standing Balance ◽  
Balance Performance ◽  
Standard Deviation Increase ◽  
Eyes Closed ◽  
Age Related ◽  
The Impact

Abstract Background Cognitive processing plays a crucial role in the integration of sensory input and motor output that facilitates balance. However, whether balance ability in adulthood is influenced by cognitive pathways established in childhood is unclear, especially as no study has examined if these relationships change with age. We aimed to investigate associations between childhood cognition and age-related change in standing balance between mid and later life. Methods Data on 2,380 participants from the MRC National Survey of Health and Development were included in analyses. Repeated measures multilevel models estimated the association between childhood cognition, assessed at age 15, and log-transformed balance time, assessed at ages 53, 60–64, and 69 using the one-legged stand with eyes closed. Adjustments were made for sex, death, attrition, anthropometric measures, health conditions, health behaviors, education, other indicators of socioeconomic position (SEP), and adult verbal memory. Results In a sex-adjusted model, 1 standard deviation increase in childhood cognition was associated with a 13% (95% confidence interval: 10, 16; p &lt; .001) increase in balance time at age 53, and this association got smaller with age (cognition × age interaction: p &lt; .001). Adjustments for education, adult verbal memory, and SEP largely explained these associations. Conclusions Higher childhood cognition was associated with better balance performance in midlife, with diminishing associations with increasing age. The impact of adjustment for education, cognition and other indicators of SEP suggested a common pathway through which cognition is associated with balance across life. Further research is needed to understand underlying mechanisms, which may have important implications for falls risk and maintenance of physical capability.

scholarly journals Effect of successful aging on mortality in older individuals: The PALA study

2014 ◽  
Vol 8 (2) ◽  
pp. 182-186 ◽  
Author(s):  
Ana Luiza Camozzato ◽  
Claudia Godinho ◽  
Márcia Lorena Fagundes Chaves
Keyword(s):  
Mortality Rate ◽  
Successful Aging ◽  
Healthy Aging ◽  
Causes Of Death ◽  
Cox Regression ◽  
Normal Aging ◽  
Community Dwelling ◽  
Older Individuals ◽  
Increased Risk ◽  
The Impact

ABSTRACT The definition of successful aging and identification of predictors have been extensively reviewed, less attention however, has been given to the role of this condition on mortality. Objective: To evaluate the effect of aging status (normal or successful) on mortality in a South Brazilian population-based cohort, adjusted for sociodemographic and clinical variables, and to report the mortality rate and causes of death in this population. Methods: The baseline sample comprised 345 community-dwelling, independent and healthy Southern Brazilian older individuals who were followed for 12 years. Clinical, socio-demographic, functional and cognitive variables were assessed at baseline and during the follow-up. At baseline, 214 participants fulfilled criteria for successful aging, and 131 for normal aging. The main outcome was death. Results: The Cox regression model showed an increased risk for mortality in subjects with normal aging (HR=1.9; p=0.003) adjusted by age (HR=1.1; p<0.001) and by sex (HR=1.9; p=0.002). The overall mortality rate was 41% and the rate was significantly lower among successful than normal agers (p=0.001). The main causes of death were cardiovascular disease and cancer. Conclusion: Our main finding was an increased risk of mortality among normal in comparison with successful aging subjects, emphasizing the impact of the heterogeneity of the healthy aging process on mortality.

scholarly journals Influence of gender on static balance in healthy community dwelling elderly: a comparison using posturography

2020 ◽  
Vol 8 (8) ◽  
pp. 2950
Author(s):  
Atiya A. Shaikh ◽  
Rutuja D. Joshi
Keyword(s):  
Community Dwelling ◽  
P Value ◽  
Static Balance ◽  
Clinical Test ◽  
Sensory Interaction ◽  
Male And Female ◽  
Eyes Closed ◽  
Healthy Elderly ◽  
Significant Difference ◽  
Eyes Open

Background: Background and need of study- Influence of gender on balance is still controversial. Previous researchers have done studies using traditional methods. These methods may fail to detect subtle changes in balance difference. A tool like posturography which is highly specific may help to for accurate assessment and hence precise conclusion. Aim was to compare balance scores of male and female elderly using modified Clinical Test of Sensory Interaction on Balance (CTSIB).Methods: There were 56 healthy elderly ambulating without an assistive device and free from any neurological and orthopedic problems were assessed for their balance abilities using mCTSIB of balance master(standing on firm surface with eyes open, with eyes closed, standing on foam surface with eyes open and with eyes closed). Sway velocity was assessed using Unpaired t test.Results: There was a no significant difference in scores of modified CTSIB between male and female elderly ( p value>0.005).Conclusions: Gender has no effect on static balance abilities between male and female elderly while performing modified clinical test of sensory interaction on balance.

scholarly journals Responses and Interventions to Delusions Experienced by Community-Dwelling Older Persons With Dementia

2021 ◽  
pp. 089198872110429
Author(s):  
Jiska Cohen-Mansfield ◽  
Hava Golander
Keyword(s):  
Family Caregivers ◽  
Relative Frequency ◽  
Older Persons ◽  
Community Setting ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Guidance Programs ◽  
The Impact ◽  
Qualitative Analyses

We examined how family caregivers react, and what interventions they use in response to delusions exhibited by relatives with dementia in a community setting. Structured interviews were conducted with 68 family caregivers whose relatives were described as experiencing delusions based on the BEHAVE-AD or the NPI. Quantitatively, we cross-tabulated the type of response to delusion by the type of person providing the response and by the type of delusion manifested. Qualitatively, we analyzed open-ended responses to understand the types of caregivers’ responses to delusions, the contextual circumstances, and the impact of the responses. Caregiver responses to delusions included “Explaining that the delusion was wrong” (34% of responses), “Trying to calm down” (27%), “Agreeing with the delusion” (13%), “Distracting” (12%), and “Ignoring” (10%). Responses including “Anger, yelling or scolding,” were rare. The vast majority of reactions were by family caregivers of the persons with dementia. The relative frequency of the type of reaction tended to be consistent across delusion types. The qualitative analyses added some categories of reactions, but mostly highlighted issues to be considered when examining responses and their efficacy, including the use of multiple responses, and the manner and mood in which responses are conveyed. To cope with delusions, family caregivers develop intuitive intervention techniques. Understanding those interventions and reactions by caregivers and their relative efficacy can inform guidance programs for family caregivers. Improved support for family caregivers has the potential to positively influence the behavior of caregivers and older adults with dementia and improve their respective quality of life.

scholarly journals Kidney function and other factors and their association with falls

2020 ◽  
Vol 20 (S1) ◽  
Author(s):  
Sabine Britting ◽  
◽  
Rada Artzi-Medvedik ◽  
Paolo Fabbietti ◽  
Lisanne Tap ◽  
...  
Keyword(s):  
Kidney Function ◽  
Older Persons ◽  
Community Dwelling ◽  
Health Concern ◽  
Cross Sectional ◽  
Link Type ◽  
Injurious Falls ◽  
Increased Risk ◽  
Risk Of Falls ◽  
The Impact

Abstract Background Reduced kidney function has become a major public health concern, especially among older people, as Chronic Kidney Disease (CKD) is associated with increased risk of end stage renal disease and mortality. Falls are a serious negative health outcome in older persons with one third of people aged 65 years experiencing a fall per year and increasing fall rates with increasing age. The impact of CKD on falls in older community-dwelling persons is not well investigated. Additionally, lower urinary tract symptoms (LUTS) may also increase the risk of falls. Therefore, our aim was to investigate the impact of CKD and LUTS on falls as well as on injurious falls. Methods The SCOPE study is an observational, multinational, multicenter, prospective cohort study involving community-dwelling older persons aged 75 years and more recruited from August 2016 to March 2018 in seven European countries. The main outcomes of the present study were any falls and any injurious falls during the 12 months before enrolment. The cross-sectional association of estimated glomerular filtration rate (eGFR) and LUTS with study outcomes was investigated by logistic regression analysis adjusted for baseline characteristics of enrolled subjects. Results Our series consisted of 2256 SCOPE participants (median age = 79.5 years, 55.7% female). Of them, 746 participants experienced a fall and 484 reported an injurious fall in the 12 months prior to baseline assessment. CKD was not significantly associated with falls (OR = 0.95, 95%CI = 0.79–1.14 for eGFR< 60; OR = 1.02, 95%CI = 0.81–1.28 for eGFR< 45; OR = 1.08, 95%CI = 0.74–1.57 for eGFR< 30) or injurious falls (OR = 0.91, 95%CI = 0.67–1.24 for eGFR< 60; OR = 0.93, 95%CI = 0.63–1.37 for eGFR< 45; OR = 1.19, 95%CI = 0.62–2.29 for eGFR< 30). LUTS were found significantly associated with both falls (OR = 1.56, 95%CI = 1.29–1.89) and injurious falls (OR = 1.58, 95%CI = 1.14–2.19), and such associations were confirmed in all multivariable models. Conclusions Cross-sectional data suggest that CKD may not be associated with history of falls or injurious falls, whereas LUTS is significantly associated with the outcomes. Trial registration This study was registered on 25th February 2016 at clinicaltrials.gov (NCT02691546).

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