Longitudinal Follow-Up Studies on the Bidirectional Association between ADL/IADL Disability and Multimorbidity: Results from Two National Sample Cohorts of Middle-Aged and Elderly Adults

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Yanan Qiao ◽  
Siyuan Liu ◽  
Guochen Li ◽  
Yanqiang Lu ◽  
Ying Wu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Multinomial Logistic Regression ◽  
Elderly Adults ◽  
Middle Aged ◽  
Bidirectional Association ◽  
Bidirectional Relationship ◽  
Iadl Disability

<b><i>Background and Objectives:</i></b> Few studies have investigated the bidirectional relationship between disability and multimorbidity, which are common conditions among the older population. Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) and the Survey of Health, Ageing and Retirement in Europe (SHARE), we aimed to investigate the bidirectional relationship between disability and multimorbidity. <b><i>Methods:</i></b> The activities of daily living (ADLs) and the instrumental activities of daily living (IADLs) scales were used to measure disability. In stage I, we used multinomial logistic regression to assess the longitudinal association between ADL/IADL disability and follow-up multimorbidity. In stage II, binary logistic regression was used to evaluate the multimorbidity effect on future disability. <b><i>Results:</i></b> Compared with those free of disability, people with disability possessed ascending risks for developing an increasing number of diseases. For ADL disability, the odds ratio (OR) (95% confidence interval [CI]) values of developing ≥4 diseases were 4.10 (2.58, 6.51) and 6.59 (4.54, 9.56) in CHARLS and SHARE; for IADL disability, the OR (95% CI) values were 2.55 (1.69, 3.84) and 4.85 (3.51, 6.70) in CHARLS and SHARE. Meanwhile, the number of diseases at baseline was associated, in a dose-response manner, with future disability. Compared with those without chronic diseases, participants carrying ≥4 diseases had OR (95% CI) values of 4.82 (3.73, 6.21)/4.66 (3.65, 5.95) in CHARLS and 3.19 (2.59, 3.94)/3.28 (2.71, 3.98) in SHARE for developing ADL/IADL disability. <b><i>Conclusion:</i></b> The consistent findings across 2 national longitudinal studies supported a strong bidirectional association between disability and multimorbidity among middle-aged and elderly adults. Thus, tailored interventions should be taken to prevent the mutual development of disability and multimorbidity.

Social isolation, loneliness and functional disability in Chinese older women and men: a longitudinal study

2020 ◽  
Author(s):  
Lizhi Guo ◽  
Li An ◽  
Fengping Luo ◽  
Bin Yu
Keyword(s):  
Longitudinal Study ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Social Isolation ◽  
Daily Living ◽  
Functional Disability ◽  
Iadl Disability ◽  
Older Populations ◽  
New Onset

Abstract Objective This study investigated whether loneliness or social isolation is associated with the onset of functional disability over 4 years among Chinese older populations. Setting and Subjects This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Analyses were conducted with data from two waves (2011 and 2015) and were restricted to those respondents aged 50 and older and free of functional disability at baseline [n = 5,154, mean age (SD) = 60.72 (7.51); male, 52.3%]. Method Social isolation, loneliness and covariates were measured at baseline. Follow-up measures of new-onset ADL and IADL disability were obtained 4 years later. We stratified the sample by gender, and then used binary logistic regressions to evaluate the associations between baseline isolation, loneliness and new-onset ADL and IADL disability. Results For women, baseline social isolation was significantly associated with new-onset ADL (OR = 1.18, 95% CI = 1.07–1.30) and IADL (OR = 1.11, 95% CI = 1.01–1.21) disability; no significant association between loneliness and ADL or IADL disability was found. For men, neither social isolation nor loneliness was found to be significantly associated with ADL or IADL disability. Conclusion This longitudinal study found that social isolation, rather than loneliness, was significantly associated with functional disability over 4 years among women (but not men) in China. These findings expand our knowledge about the association between social relationships and functional status among non-Western populations.

scholarly journals Association between psychological factors related to pain and instrumental activities of daily living disability in older adults with knee osteoarthritis

2021 ◽  
Author(s):  
Keigo Nanjo ◽  
Takashi Ikeda ◽  
Naoko Nagashio ◽  
Tomoko Sakai ◽  
Tetsuya Jinno
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Knee Osteoarthritis ◽  
Activities Of Daily Living ◽  
Psychological Factors ◽  
Daily Living ◽  
Short Form ◽  
Independent Variables ◽  
Knee Oa ◽  
Iadl Disability

Objective To investigate the association between psychological factors related to pain and instrumental activities of daily living (IADL) disability in older adults with knee osteoarthritis (OA). Design A cross-sectional study. Setting Outpatients at a general hospital in Japan. Participants: One hundred seventy-nine (N=179) patients with knee OA and aged => 65years. Interventions Not applicable. Main Outcome Measure: Six-item short form of the pain catastrophizing scale (PCS-6) and four-item short form of the pain self-efficacy questionnaire (PSEQ-4) were used to assess the psychological status related to pain. IADL status was assessed using eight activity items. Participants selected able, need help, or unable depending on their abilities to perform these IADL activities. If they chose need help or unable to perform, for at least one item, we defined them as disabled. Results Of all participants, 88 (49.1%) showed disability in conducting IADL. Binary logistic regression analysis with the dependent variable as IADL disabled or not and PCS-6 and PSEQ-4 as independent variables were performed. Age, sex, pain intensity, depressive symptoms, usual gait speed (UGS), and isometric knee extension strength were included as covariates in the logistic regression model. Only PSEQ-4 (odds ratio (OR)=0.90, 95% confidence interval (95%CI)=0.82-0.99, p=0.02) was a significant independent variable for psychological factors related to pain. PCS-6 was not a significant variable (OR=1.06, 95%CI=0.94-1.19, p=0.13). Sex (OR=0.38, 95%CI=0.15-0.96, p=0.04) and UGS (OR=0.13, 95%CI=0.02-0.72, p=0.02) were significantly independent variables. Conclusion Our study showed the importance of assessing self-efficacy related to pain using the PSEQ-4 to determine the presence of IADL disability in older adults with knee OA.

scholarly journals Instrumental Activities of Daily Living Difficulties Predict Cognitive Decline in Older Puerto Rican Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 238-239
Author(s):  
Caitlin Pope ◽  
Tyler Bell ◽  
Brian Downer ◽  
Sadaf Milani ◽  
Lauren Roach ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Puerto Rican ◽  
Daily Living ◽  
The United States ◽  
Community Dwelling ◽  
Instrumental Activities ◽  
Bidirectional Association ◽  
Bidirectional Associations

Abstract Given the hypothesized bidirectional association between functional and cognitive decline, further characterization of the temporal association between the two is needed, especially in Latinx samples as they are the most rapidly growing demographic in the United States and at greater risk for Alzheimer’s disease. This study assessed bidirectional associations between instrumental activities of daily living (IADL) difficulty and cognition in older Puerto Rican adults. Participants included 2,840 community-dwelling adults (60+ years) without cognitive impairment who completed baseline and a four-year follow-up in the Puerto Rican Elderly: Health Conditions (PREHCO) project. At each wave, cognition (using the Mini-Mental Cabán) and self-reported IADL difficulty (a sum score of 10 everyday tasks) were measured. Covariates included age, gender, education, comorbidities, and depressive symptoms. Bidirectional associations were tested using a path model with concurrent and cross-lagged paths between cognition and IADL difficulty adjusting for covariates. Lower baseline cognition related to more baseline IADL difficulty (B=-0.08, SE=0.02, p&lt;.001). Cognitive decline at follow-up related to greater IADL difficulty at follow-up (B=-0.06, SE=0.02, p=.012). Looking at cross-lagged associations, greater baseline IADL difficulty associated with more cognitive decline at follow-up (B=-0.10, SE=0.04, p=.012). However, baseline cognition was not significantly associated with change in IADL difficulty at follow-up (B=-0.003, SE=0.02, p=.869). Findings support the growing body of literature that IADL difficulties can predict future cognitive decline in samples of community-dwelling older adults. More research into both functional and cognitive decline in Latinx samples will provide a more generalizable view of aging.

scholarly journals Factors associated with basic and instrumental activities of daily living in elderly participants of a population-based survey: the Nord-Trøndelag Health Study, Norway

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018942 ◽  
Author(s):  
Siri Høivik Storeng ◽  
Erik R Sund ◽  
Steinar Krokstad
Keyword(s):  
Risk Factors ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Population Based ◽  
Health Study ◽  
Factors Associated ◽  
Self Rated Health ◽  
Instrumental Activities ◽  
Iadl Disability

ObjectivesTo investigate factors associated with the need for assistance in basic and instrumental activities of daily living in Norwegian elderly.DesignProspective cohort study.SettingThe Nord-Trøndelag Health Study (HUNT), a large population-based health survey in Norway.Participants5050 individuals aged 60–69 years old at baseline in HUNT2 (1995–1997) who also participated in HUNT3 (2006–2008) were included in the study. 676/693 individuals were excluded in the analyses due to missing outcomes.OutcomesNeeding assistance in one or more basic or instrumental activities of daily living reported in HUNT3.ResultsIn adjusted multinomial logistic regression analyses, poor self-rated health and depression were the strongest risk factors for needing assistance in one or more basic activities of daily living in HUNT3, with ORs of 2.13 (1.35 to 3.38) and 1.58 (0.91 to 2.73). Poor self-rated health and poor life satisfaction were the strongest risk factors for needing assistance in one or more instrumental activities of daily living in HUNT3, with ORs of 2.30 (1.93 to 2.74) and 2.29 (1.86 to 2.81), respectively. Excessive sitting time, short or prolonged sleeping time, and physical inactivity seemed to be the most important lifestyle risk factors for basic/instrumental activities of daily living (ADL/IADL) disability. The studied factors were, in general, greater risk factors for mortality during follow-up than for ADL/IADL disability. Smoking was the strongest risk factor for mortality during follow-up and non-participation in HUNT3. Smoking and low social participation were the strongest risk factors for non-participation in HUNT3.ConclusionsSubjective health perception, life satisfaction and depression were the strongest risk factors for needing assistance in one or more basic/instrumental activities of daily living later in life. These factors could be possible targets for prevention purposes.

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

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.

scholarly journals The effect of a 24-week training focused on activities of daily living, muscle strengthening, and stability in idiopathic inflammatory myopathies: a monocentric controlled study with follow-up

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Maja Špiritović ◽  
Barbora Heřmánková ◽  
Sabína Oreská ◽  
Hana Štorkánová ◽  
Olga Růžičková ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Substantial Proportion ◽  
Controlled Study ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Local Inflammatory Response ◽  
Secondary Outcomes

Abstract Background The structural and functional changes of the skeletal muscles in idiopathic inflammatory myopathies (IIM) caused by inflammation and immune changes can be severely disabling. The objective of this study was to assess the effect of a 24-week program combining a supervised training of activities of daily living (ADL), resistance, and stability with home exercise for improving muscle function, compared to a daily home-based exercise representing the regular outpatient care. Methods Fifty-seven patients with IIM were consecutively and non-selectively enrolled in an intervention (IG, n = 30) or control (CG, n = 27) group. Both groups were provided a standard-of-care pharmacological treatment and follow-up. Only the IG underwent the supervised intervention twice a week for 1 h per session. At baseline, 12, 24, and 48 weeks, all patients were assessed by an assessor blinded to the intervention for primary outcomes: muscle strength (Manual Muscle Testing of eight muscle groups [MMT-8]) and endurance (Functional Index-2 [FI-2]), and secondary outcomes: stability and body composition. Secondary outcomes also included questionnaires evaluating disability (Health Assessment Questionnaire [HAQ]), quality of life (Short Form 36 [SF-36]), depression (Beck’s Depression Inventory-II [BDI-II]), and fatigue (Fatigue Impact Scale [FIS]), and analysis of the systemic and local inflammatory response and perceived exertion to assess the safety of the intervention. Results Twenty-seven patients in the IG and 23 in the CG completed the entire program and follow-up. At week 24, compared to deterioration in the CG, we found a significant improvement in the IG in muscle strength (mean % improvement compared to baseline by 26%), endurance (135%), disability (39%), depression (26%), stability (11%), and basal metabolism (2%) and a stabilization of fitness for physical exercise. The improvement was clinically meaningful (a 24-week change by >20%) in most outcomes in a substantial proportion of patients. Although the improvement was still present at 48 weeks, the effect was not sustained during follow-up. No significant increase in the systemic or local expression of inflammatory markers was found throughout the intervention. Conclusions This 24-week supervised intervention focused on ADL training proved to be safe and effective. It not only prevented the progressive deterioration, but also resulted in a significant improvement in muscle strength, endurance, stability, and disability, which was clinically meaningful in a substantial proportion of patients. Trial registration ISRCTN35925199 (retrospectively registered on 22 May 2020).

Sign in / Sign up

Export Citation Format

Share Document