scholarly journals Loss of Ambulatory Level and Activities of Daily Living at 1 Year Following Hip Fracture: Can We Identify Patients at Risk?

2021 ◽  
Vol 12 ◽  
pp. 215145932110021
Author(s):  
Sanjit R. Konda ◽  
Nicket Dedhia ◽  
Rachel A. Ranson ◽  
Yixuan Tong ◽  
Abhishek Ganta ◽  
...  
Keyword(s):  
At Risk ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Injury Severity ◽  
Risk Groups ◽  
Assistive Device ◽  
Loss Of Function ◽  
Ambulatory Status

Introduction: Operative hip fractures are known to cause a loss in functional status in the elderly. While several studies exist demonstrating the association between age, pre-injury functioning, and comorbidities related to this loss of function, no studies have predicted this using a validated risk stratification tool. We attempt to use the Score for Trauma Triage for Geriatric and Middle-Aged (STTGMA) tool to predict loss of ambulatory function and need for assistive device use. Materials and Methods: Five hundred and fifty-six patients ≥55 years of age who underwent operative hip fracture fixation were enrolled in a trauma registry. Demographics, functional status, injury severity, and hospital course were used to determine a STTGMA score and patients were stratified into risk quartiles. At least 1 year after hospitalization, patients completed the EQ-5D questionnaire for functional outcomes. Results: Two hundred and sixty-eight (48.2%) patients or their family members responded to the questionnaire. Of the 184 patients alive, 65 (35.3%) reported a return to baseline function. Eighty-nine (48.4%) patients reported a loss in ambulatory status. Patients with higher STTGMA scores were older, had more comorbidities, reported greater need for help with daily activities, increased difficulty with self-care, and a reduction in return to activities of daily living (all p ≤ 0.001). Patients with lower STTGMA scores were more likely to never require an assistive device while those with higher scores were more likely to continue needing one (p = 0.004 and p < 0.001). Patients in the highest STTGMA risk groups were 1.5x more likely to have an impairment in ambulatory status (need for ambulatory assistive device or decreased ambulatory capacity) (p = 0.004). Discussion: Patients in higher STTGMA risk quartiles were more likely to experience impairment after hip fracture surgery. The STTGMA tool can predict loss of ambulatory independence following hip fracture. At-risk populations can be targeted for enhanced physiotherapy and rehabilitation services for optimal return to prior functioning.

scholarly journals Prevalence of malnutrition and its determinants in an elderly people in South India

2018 ◽  
Vol 5 (8) ◽  
pp. 3570 ◽  
Author(s):  
Satyanarayana Konda ◽  
Ravi Kumar B. P. ◽  
Purushottam A Giri
Keyword(s):  
At Risk ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Elderly People ◽  
Low Income ◽  
Daily Living ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Nutrition Status

Background: The population of elderly people aged ≥60 years is increasing worldwide and is projected to reach 1.5 billion by 2050. In India, the elderly people constitute 8.1% of the total population. Malnutrition is highly prevalent in the elderly population due to various diseases and impairments.Methods: A cross-sectional study was carried out amongst 209 elderly people from February 2018 to April 2018. A questionnaire was used to collect data related to socio-demographic characteristics, Mini Nutritional Assessment (MNA) and regarding medication use, comorbidity, use of a walking aid, smoking and alcohol consumption. The MNA tool was used for the assessment of nutrition status. For an assessment of functional status, the activities of daily living scale and instrumental activities of daily living scale were used. Descriptive analysis and Chi-square test were used to present the data.Results: The average MNA score was 23.5 (SD=4.3, range: 7-30) and that of BMI was 23.8 (SD=3.9, range: 15.6-38.9). Of 209 study participants, 9.1% were malnourished, 32.5% were at risk of malnutrition and remaining 58.4% were having normal nutritional status. The possible predictors of malnutrition were older age, lower education level, staying single, unemployed, low income and less than three meals daily.Conclusions: The overall prevalence of malnutrition was found to be 9.1% but the proportion of elderly people at risk of malnutrition was relatively high. Diagnosis and treatment of elderly people at high risk for malnutrition based on the findings of this study may improve functional status and prognosis of elderly people.

scholarly journals Falls in Older Patients with Cancer Undergoing Surgery: Prevalence and Association with Geriatric Syndromes and Levels of Disability Assessed in Preoperative Evaluation

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Somayeh Fahimnia ◽  
Hadi Mirhedayati Roudsari ◽  
John Doucette ◽  
Armin Shahrokni
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Older Patients ◽  
Preoperative Evaluation ◽  
Assistive Device ◽  
Geriatric Syndromes ◽  
Patients With Cancer ◽  
Time Fall

Falls are common among older adults. However, not much is known about the prevalence of falls among older patients with cancer. In 2015, older patients with cancer referred to Geriatrics service for preoperative evaluation were assessed for fall history, basic and instrumental activities of daily living (ADL and IADL), KPS, and use of assistive device. Of 806 patients, 215 (26.7%) patients reported fall. Incidence of last fall inside and outside home was 54.4% and 45.5%, respectively. Among patients with no falls, 33.6% had KPS ≤ 80 compared to 59.6% with one-time fall and 60.7% with multiple falls (p<0.001). Among IADL, 8.5% of patients with no falls were unable to do shopping compared with 14.7% in one-time fall and 18.8% in multiple fallers (p<0.001). In ADL items, the percentage of patients who were limited a lot in walking outside was 10.7% in no falls, 20.2% in one-time fall, and 27.1% in multiple fallers groups (p<0.001). Only 17.8% of patients with no falls were using canes while 27.7% of patients with one-time fall and 38.8% with multiple falls were using canes (p<0.001). Falls are prevalent among older patients with cancer. Fall history and number of falls are associated with functional status.

Inflammation, Functional Status, and Weight Loss During Recovery From Cardiac Surgery in Older Adults

2013 ◽  
Vol 16 (3) ◽  
pp. 344-352 ◽  
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Eileen M. Sullivan-Marx ◽  
Charlene Compher
Keyword(s):  
Weight Loss ◽  
Cardiac Surgery ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Grip Strength ◽  
Daily Living ◽  
Community Dwelling ◽  
Chair Stand ◽  
Prospective Longitudinal ◽  
Over Time

Objective: To determine the nutritional, inflammatory, and functional aspects of unintentional weight loss after cardiac surgery that warrant further investigation. Research Methods and Procedures: Twenty community-dwelling adults > 65 years old undergoing cardiac surgery (coronary artery bypass graft [CABG] or CABG + valve) were recruited for this prospective longitudinal (preoperative and 4–6 weeks postdischarge) pilot study. Anthropometrics (weight, standing height, and mid-arm and calf circumference), nutritional status (Mini-Nutritional Assessment™ [MNA]), appetite, physical performance (timed chair stand), muscle strength (hand grip) and functional status (basic and instrumental activities of daily living), and inflammatory markers (plasma leptin, ghrelin, interleukin [IL]-6, high-sensitivity[hs] C-reactive protein, and serum albumin and prealbumin) were measured. Results: Participants who completed the study ( n = 11 males, n = 3 females) had a mean age 70.21 ± 4.02 years. Of these, 12 lost 3.66 ± 1.44 kg over the study period. Weight, BMI, activities of daily living, and leptin decreased over time ( p < .05). IL-6 increased over time ( p < .05). Ghrelin, hs-CRP, and timed chair stand increased over time in those who underwent combined procedures ( p < .05). Grip strength decreased in those who developed complications ( p = .004). Complications, readmission status, and lowered grip strength were found in those with low preoperative MNA scores ( p < .05). Conclusion: After cardiac surgery, postdischarge weight loss occurs during a continued inflammatory response accompanied by decreased physical functioning and may not be a positive outcome. The impacts of weight loss, functional impairment, and inflammation during recovery on disability and frailty warrant further study.

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 Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: a retrospective, dual-center cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carl Neuerburg ◽  
Stefan Förch ◽  
Johannes Gleich ◽  
Wolfgang Böcker ◽  
Markus Gosch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Trauma Care ◽  
Daily Living ◽  
Aging Population ◽  
Readmission Rates ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Background Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC). Methods We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL). Results A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up. Conclusions Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards. Trial registration The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.

scholarly journals Associations among occupational roles, independence, assistive technology, and purchasing power of individuals with physical disabilities

2013 ◽  
Vol 21 (2) ◽  
pp. 484-491 ◽  
Author(s):  
Daniel Marinho Cezar da Cruz ◽  
Maria Luisa Guillaumon Emmel
Keyword(s):  
Activities Of Daily Living ◽  
Assistive Technology ◽  
Functional Status ◽  
Barthel Index ◽  
Daily Living ◽  
Physical Disabilities ◽  
Lower Number ◽  
Purchasing Power ◽  
Classification Criterion ◽  
Occupational Roles

OBJECTIVE: to verify whether there are associations among occupational roles, independence to perform Activities of Daily Living, purchasing power, and assistive technology for individuals with physical disabilities. METHOD: 91 individuals with physical disabilities participated in the study. The instruments used were: Role Checklist, Brazilian Economic Classification Criterion, Barthel Index, and a Questionnaire to characterize the subjects. RESULTS: an association with a greater number of roles was found among more independent individuals using a lower number of technological devices. Higher purchasing power was associated with a lower functional status of dependence. CONCLUSION: even though technology was not directly associated with independence, the latter was associated with a greater number of occupational roles, which requires reflection upon independence issues when considering the participation in occupational roles. These findings support interdisciplinary actions designed to promote occupational roles in individuals with physical disabilities.

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