Disparities in First Instrumental Activity of Daily Living Difficulty between Black and White Older Adults: Findings from the Advanced Cognitive Training in Independent and Vital Elderly Study

2021 ◽  
pp. 089826432110230
Author(s):  
Danielle M. Feger ◽  
Sherry L. Willis ◽  
Jennifer Deal ◽  
Lorraine T. Dean ◽  
Alden L. Gross
Keyword(s):  
Older Adults ◽  
Cognitive Training ◽  
Discrete Time ◽  
Daily Living ◽  
Age Of Onset ◽  
Absolute Risk ◽  
Activity Of Daily Living ◽  
Task Groups ◽  
Black And White ◽  
Multiple Group

Objectives: Few studies have examined differences in age of onset of first self-reported instrumental activities of daily living difficulty, much less differences by race. Our objective was to determine whether there are differences in the first reported difficulty with IADLs between Black and white older adults. Methods: We analyzed data from N = 1168 participants in the Advanced Cognitive Training in Independent and Vital Elderly (ACTIVE) study. A multiple group discrete-time multiple-event process survival mixture (MEPSUM) model was used to estimate the hazard of incident IADL difficulty in seven IADL task groups. Results: No statistically significant differences were identified in the first reported IADL task group difficulty between Black and white older adults. Discussion: Our findings indicate similar patterns of early IADL difficulty in Black and white older adults, suggesting that previously reported racial disparities in ability to perform IADLs may be attributable to differences in absolute risk, not timing.

scholarly journals I'd Rather Be . . . : Activities Older Adults Reported Leading to Decreased Engagement With Cognitive Training

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 325-325
Author(s):  
Erin Harrell ◽  
Nelson Roque
Keyword(s):  
Older Adults ◽  
Risk Factor ◽  
Form Factor ◽  
Activities Of Daily Living ◽  
Cognitive Ability ◽  
Cognitive Training ◽  
Daily Living ◽  
Training Programs ◽  
Qualitative Approach ◽  
Tablet Device

Abstract One modifiable risk factor of dementia is cognitive inactivity. Given cognitive ability is closely tied to continual performance of instrumental activities of daily living, cognitive training programs continue to be explored as a way to boost cognition and allow older adults to remain independent longer. While the efficacy of cognitive training is controversial, identifying activities older adults are willing to limit in exchange for cognitive training provides valuable information in relation to designing cognitive training programs that appeal to older adults. Using a qualitative approach, this study highlights activities older adults (ages 64+) noted as contributing to decreased gameplay of a cognitive training program on a tablet device. We found that respondents (61%) noted playing less as a result of entertainment activities (i.e., reading and playing games), social activities (31%) and travel (27%). Findings have implications for device form factor in administering cognitive training and other programs.

Integrating a touchscreen-based brief geriatric assessment in older adults with multiple myeloma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21703-e21703 ◽  
Author(s):  
Nitya Nathwani ◽  
Supriya Gupta Mohile ◽  
Brea Lipe ◽  
Karen Carig ◽  
Laura DiGiovanni ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Multiple Myeloma ◽  
Geriatric Assessment ◽  
Daily Living ◽  
Dose Intensity ◽  
Treatment Decision ◽  
Activity Of Daily Living ◽  
Treatment Decision Making ◽  
Frailty Score

e21703 Background: Multiple myeloma (MM) is a disease of older adults (OAs) with > 60% of diagnoses and nearly 75% of deaths occurring in patients > 65 years old (YO). Geriatric Assessment (GA) is associated with toxicity and survival in OAs with MM, but not routinely used in practice. This project pilot tests a tablet-based modified Geriatric Assessment (mGA) that presents compiled GA results, including (the Palumbo) frailty score, to clinicians at a treatment decision-making visit in a single screen dashboard. Methods: In this multisite ongoing study, 210 patients with MM ≥65 YO facing a decision point for care will complete a mGA that includes the Charlson Comorbidity Index (CCI), Katz Activity of Daily Living (ADL) Score, and Lawton Instrumental Activity of Daily Living (IADL) Score prior to meeting with a physician. mGA results, including composite frailty score, are provided to physicians at the start of a visit. Results: Thirty-six patients have been enrolled to date; enrollment continues. Participants are 69% (n = 25) white, 64% (n = 23) male, and mean age of 72 YO (range 65-87). Most (74%, n = 20) currently receive ≥1 therapy and have few co-morbidities (CCI median 1, SD 1.95, range 0-8); 57% require assistance with IADLs and 37% require assistance with ADLs. Based on Palumbo score, 36% of participants were frail (n = 13), 33% intermediate (n = 12), and 31% fit (n = 11). Providers report mGA results influenced treatment decision (54%, n = 28) and frailty score was the most frequently cited result to impact treatment decision-making (61%, n = 39). The most common way the mCGA influenced decision-making was to reduce dose/dose intensity (25%, N = 8). Clinicians on average spent 5 minutesreviewing the mGA results. Patients reported an average of 7 minutes to complete the survey, most independently (83%, n = 30), and were satisfied with the electronic program overall (80%, n = 29), including how easy it was to use (88%, n = 32). Conclusions: Preliminary data support feasibility, usability, and acceptability of the tablet-based mGA and that frailty score influences provider decision-making ≥50% of the time. Future analyses will explore the relationship of the mGA with toxicity, dose modification and/or treatment discontinuation in OAs with MM.

scholarly journals Prediction of Severe, Persistent Activity-of-Daily-Living Disability in Older Adults

2013 ◽  
Vol 178 (7) ◽  
pp. 1085-1093 ◽  
Author(s):  
Dae Hyun Kim ◽  
Anne B. Newman ◽  
Lewis A. Lipsitz
Keyword(s):  
Older Adults ◽  
Daily Living ◽  
Activity Of Daily Living ◽  
Persistent Activity

scholarly journals The impact of near visual impairment on instrumental activities of daily living among community-dwelling older adults in Selangor

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Qiu Ting Kee ◽  
Mohd Harimi Abd Rahman ◽  
Norliza Mohamad Fadzil ◽  
Zainora Mohammed ◽  
Suzana Shahar
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Visual Impairment ◽  
Daily Living ◽  
Visually Impaired ◽  
Community Dwelling ◽  
Activity Of Daily Living ◽  
Instrumental Activities ◽  
Iadl Disability ◽  
The Impact

Abstract Objective Near visual impairment (VI) is a common disability in an aging population. Near vision is crucial in activity of daily living including reading, smartphone and computer use and meal preparation. This study was conducted to determine the association between near visual acuity (VA) and contrast sensitivity (CS) with activity of daily living (ADL) among visually impaired older adults. Results A total of 208 participants aged  ≥  60 were recruited from the population-based longitudinal study on neuroprotective model for healthy longevity. Habitual near VA and CS were measured using Lighthouse near VA chart and Pelli-Robson CS chart, respectively. Lawton instrumental activities of daily living (IADL) was used to assess ADL. There are 41.8% participants with near visual impairment and 28.7% among them had IADL disability. Independent t test showed significant lower mean IADL score among visually impaired participants [t(206)  =  2.03, p  =  0.04]. IADL score significantly correlated with near VA (r  =   − 0.21, p  =  0.05) but not with CS (r  =   − 0.14, p = 0.21). Near VA (B  =   − 0.44, p  =  0.03) and age (B  =   − 0.07, p  =  0.01) significantly predicted IADL. The findings show poorer VA renders higher IADL disability, which may necessitate interventions to improve ADL among visually impaired older adults.

scholarly journals Psychosocial Well-Being Associated With Activity of Daily Living Stages Among Community-Dwelling Older Adults

2017 ◽  
Vol 3 ◽  
pp. 233372141770001 ◽  
Author(s):  
Ling Na ◽  
Joel E. Streim
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Social Life ◽  
Daily Living ◽  
Depression Scale ◽  
Well Being ◽  
Community Dwelling ◽  
Activity Of Daily Living ◽  
Cross Sectional ◽  
Latent Factor Models

Objectives: Activity of daily living (ADL) stages demonstrated ordered associations with risk of chronic conditions, hospitalization, nursing home use, and mortality among community-living elderly. This article explores the association of stages with psychosocial well-being. We hypothesized that higher ADL stages (greater ADL limitation) are associated with more restricted social networks, less perceived social support, greater social isolation, and poorer mental health. Methods: Cross-sectional data from the National Social Life, Health, and Aging Project ( N = 3,002) were analyzed in regression models and latent factor models. Results: Although ADL stages had a nearly monotonic relationship with most mental health measures (e.g., Center for Epidemiologic Studies Depression Scale [CES-D]), only the complete limitation stage (Stage IV) showed significant disadvantage in the majority of social network measures. Discussion: The study may aid clinicians and policy makers to better understand the social and mental health needs of older adults at different ADL stages and provide well-planned social and mental health care.

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