scholarly journals The Validation of a Pocket Worn Activity Tracker for Step Count and Physical Behavior in Older Adults during Simulated Activities of Daily Living

2020 ◽  
Vol 6 ◽  
pp. 233372142095173
Author(s):  
Darcy Ummels ◽  
Wouter Bijnens ◽  
Jos Aarts ◽  
Kenneth Meijer ◽  
Anna J. Beurskens ◽  
...  

Purpose: The purpose of this study was to validate optimized algorithm parameter settings for step count and physical behavior for a pocket worn activity tracker in older adults during ADL. Secondly, for a more relevant interpretation of the results, the performance of the optimized algorithm was compared to three reference applications Methods: In a cross-sectional validation study, 20 older adults performed an activity protocol based on ADL with MOXMissActivity versus MOXAnnegarn, activPAL, and Fitbit. The protocol was video recorded and analyzed for step count and dynamic, standing, and sedentary time. Validity was assessed by percentage error (PE), absolute percentage error (APE), Bland-Altman plots and correlation coefficients. Results: For step count, the optimized algorithm had a mean APE of 9.3% and a correlation coefficient of 0.88. The mean APE values of dynamic, standing, and sedentary time were 15.9%, 19.9%, and 9.6%, respectively. The correlation coefficients were 0.55, 0.91, and 0.92, respectively. Three reference applications showed higher errors and lower correlations for all outcome variables. Conclusion: This study showed that the optimized algorithm parameter settings can more validly estimate step count and physical behavior in older adults wearing an activity tracker in the trouser pocket during ADL compared to reference applications.

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 291
Author(s):  
Tatsuro Inoue ◽  
Keisuke Maeda ◽  
Ayano Nagano ◽  
Akio Shimizu ◽  
Junko Ueshima ◽  
...  

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.


Author(s):  
Yee Mang Chan ◽  
Norhafizah Sahril ◽  
Ying Ying Chan ◽  
Nor’ Ain Ab Wahab ◽  
Norliza Shamsuddin ◽  
...  

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.


2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Angel G Hilerio Lopez

Malnutrition in the older adult is an ongoing situation in Mexico and is most apparent in individuals that reside in hospitals, nursing homes, and retirement homes. For that reason, it is necessary to evaluate the nutritional status of these adults by means of the Mini Nutritional Assessment (MNA) and levels of three serum indicators that are commonly ordered when making malnutrition diagnosis. An analytical cross-sectional study was carried out on 100 older adults residing in eldercare facilities. Nutritional status was evaluated by means of the MNA and three serum indicators (albumin, ferritin, and hemoglobin). Descriptive statistics were used to analyze sociodemographic characteristics, and a Student’s t test, based on gender and reference values, was used to compare mean values of the three serum indicators.  A Chi-square test was used to compare proportions in individuals, based on gender, who had normal nutritional status or were malnourished, and who were at-risk of malnutrition.  A One-way ANOVA with Scheffé post hoc test was used to identify the association between serum indicators and nutritional status of older adults. Of the 100 older adults studied, 53% were men and 47% were women. The mean age was 85±0.7 years. According to the MNA, 20% had normal nutritional status, 55% were at-risk of malnutrition, and 25% were malnourished. The mean indicator values were: albumin 4.7±0.04 g/dL, ferritin 74.2±8.7 ng/mL, and hemoglobin 13.0±0.1 g/dL. No significant association was found between serum indicators and each MNA classification; however, when the same indicators were compared between the sexes, hemoglobin showed a significant difference (P=0.037). Women had lower values but those values did not extend beyond the established physiological range for this population. There was a 55% prevalence of risk of malnutrition in the nutritional status of older adults living in Mexican eldercare facilities in a Mexican province and it was even more frequent in women. 


2021 ◽  
Vol 8 ◽  
Author(s):  
Yunru Liao ◽  
Zhenlan Yang ◽  
Zijing Li ◽  
Rui Zeng ◽  
Jing Wang ◽  
...  

Purpose: Purpose of this study is to evaluate the measuring consistency of central refraction between multispectral refraction topography (MRT) and autorefractometry.Methods: This was a descriptive cross-sectional study including subjects in Sun Yat-sen Memorial Hospital from September 1, 2020, to December 31, 2020, ages 20 to 35 years with a best corrected visual acuity of 20/20 or better. All patients underwent cycloplegia, and the refractive status was estimated with autorefractometer, experienced optometrist and MRT. We analyzed the central refraction of the autorefractometer and MRT. The repeatability and reproducibility of values measured using both devices were evaluated using intraclass correlation coefficients (ICCs).Results: A total of 145 subjects ages 20 to 35 (290 eyes) were enrolled. The mean central refraction of the autorefractometer was −4.69 ± 2.64 diopters (D) (range −9.50 to +4.75 D), while the mean central refraction of MRT was −4.49 ± 2.61 diopters (D) (range −8.79 to +5.02 D). Pearson correlation analysis revealed a high correlation between the two devices. The intraclass correlation coefficient (ICC) also showed high agreement. The intrarater and interrater ICC values of central refraction were more than 0.90 in both devices and conditions. At the same time, the mean central refraction of experienced optometrist was −4.74 ± 2.66 diopters (D) (range −9.50 to +4.75D). The intra-class correlation coefficient of central refraction measured by MRT and subjective refraction was 0.939.Conclusions: Results revealed that autorefractometry, experienced optometrist and MRT show high agreement in measuring central refraction. MRT could provide a potential objective method to assess peripheral refraction.


2021 ◽  
Author(s):  
Jacqueline Giovanna De Roza ◽  
David Wei Liang Ng ◽  
Blessy Koottappal Mathew ◽  
Teena Jose ◽  
Ling Jia Goh ◽  
...  

Abstract BackgroundFalls in older adults is a common problem worldwide. Fear of falling (FoF) is a consequence of falls which has far-reaching implications including activity restriction, functional decline and reduced quality of life. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. MethodsThis descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors and clinical factors including history of falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine predictors of high FoF.ResultsOut of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had three or more chronic conditions. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77 – 19.13), use of walking aids (OR = 3.67, 95% CI = 1.54 – 8.77) and increasing frailty were significant predictors for high FoF. The odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66 – 17.37), mildly frail older adults (OR =18.58, 95% CI = 4.88 – 70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86 – 1512.60).ConclusionsFoF is a prevalent and compelling issue in community-dwelling older adults, particularly those with frailty. The demographic and clinical factors identified in this study will be helpful to develop targeted and tailored interventions for FoF.


2020 ◽  
Author(s):  
Hongpeng Liu ◽  
Jing Jiao ◽  
Chen Zhu ◽  
Minglei Zhu ◽  
Xianxiu Wen ◽  
...  

Abstract Background: Older adults are vulnerable to a decline in physical functioning, including basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL). The causes of functional disability in older adults are multifactorial. A comprehensive understanding of these factors will contribute toward future health service planning. However, studies of ADL and IADL in Chinese older adults are insufficient. The aim of this study is to describe the level of ADL and IADL in different age groups and explore the factors associated with functional disability in Chinese older inpatients. Methods: We conducted a cross-sectional study consisted of 9,996 Chinese older inpatients aged 65 years and older. Participants were recruited from six provinces or municipality city in southwest (Sichuan province), northeast (Heilongjiang), south central (Hubei province), northern (Beijing municipality city), northwest (Qinghai province), and eastern China (Zhejiang province) from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale in consecutive intervals from 65 years of age. After controlling for the cluster effect of hospital wards, a mixed-effect generalized linear model was used to examine the association between functional disability and covariates. Results: The average ADL score was 27.68±4.59 and the mean IADL score 6.76±2.01 for all participants. A negative correlation between scores and age was observed, and there was a significant difference in ADL and IADL scores among different age groups. The top negatively influential factor in ADL and IADL was stair climbing and shopping, respectively. After controlling for the cluster effect of hospital wards, aging, emaciation, frailty, depression, falling accidents in past 12 months, hearing dysfunction, cognitive dysfunction, urinary dysfunction, and defecation dysfunction were associated with ADL and IADL. Patients transitioned from the emergency department and other hospitals were also affected by ADL disability. Former smoking was associated with lower IADL scores. Higher level of education, living in a building without elevators, and current alcohol consumption were correlated with better IADL performance. Conclusion: Decreased functional ability was associated with the increasing age. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care.


2009 ◽  
Vol 15 (2) ◽  
pp. 117 ◽  
Author(s):  
A. Foley ◽  
S. Hillier ◽  
R. Barnard

Pre and post testing were conducted on community-dwelling older adults referred to a geriatric day rehabilitation centre (DRC). Consecutive DRC clients were screened for inclusion over a 16-month period and were eligible if: aged 60+ years; cognitively intact; and reason for referral involved spinal or lower limb musculoskeletal impairment, disability or surgery, and/or reduced functional mobility or falls. Clients were excluded if they had a neurological disorder, or did not complete the program. Outcome measures included: lower limb strength; balance; mobility; self-reported pain; activities of daily living; and quality of life. Data were summarised using descriptive statistics and analysed using paired t-tests. Of the 137 participants recruited, 110 were female and the mean age was 79.5 ± 7.3 years. In total, 106 participants completed the DRC program and were assessed at baseline and re-assessed at discharge. The mean length of stay was 12.4 ± 2.9 weeks, with 21.4 ± 5.4 attendances. From baseline to discharge, statistically significant differences were found for all objective measures of physical functioning, balance, and for all lower limb strength tests (P < 0.0001). Glasgow Pain Questionnaire scores demonstrated statistically significant improvements in all five domains of the scale (P < 0.0001). The Barthel Index and Multi-dimensional Functional Assessment Questionnaire both showed a statistically significant improvement in the level of independence in activities of daily living (ADL) (P < 0.05). The Assessment of Quality of Life Questionnaire showed a statistically significant improvement (P = 0.027). The Exercise Benefits/Barriers Scale also showed a statistically significant improvement over DRC attendance (P = 0.005). The Falls Efficacy Scale showed a positive change, but the improvement was not statistically significant (P = 0.80). The study’s results indicate that community-dwelling older adults with physical disabilities and multiple comorbidities who attended the interdisciplinary geriatric DRC, significantly improved their lower limb strength, balance and physical function, and also showed significant decreases in self-reported pain, and improvements in independence in ADL and quality of life. Given the limitations of the current study, further research, in the form of high quality studies with larger sample sizes that involve direct comparisons with other forms of care or against a control group, is needed to determine whether day rehabilitation centre programs provide the optimum mode of rehabilitation for this population in the most cost effective manner.


Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 692
Author(s):  
Muñoz-Bermejo ◽  
Villafaina ◽  
Collado-Mateo ◽  
Postigo-Mota ◽  
Adsuar

Background and objective: In an aging population, it is increasingly common for older adults to take care of other older adults. Caregiving tasks may be conditioned by the aging process. This study aims to analyze the perceived physical strength of older caregivers and its impact on the functional capacity to engage in caregiving activities. Methods: A discretionary sampling of caregivers (N = 107), ≥65 years old, in the rural health area of Badajoz (Spain) participated in this cross-sectional study. Measurements included questions about the caregiver’s role (experience, years, hours, difficulties, demands) and their perceived physical strength, ability to perform activities of daily living (ADL), need for help or difficulty for caring. Results: Older caregivers from rural areas perceived a lack of physical strength (71%). These caregivers need more help, have more difficulties, and show less ability to perform ADL. Furthermore, around 80% of the people who had a lack of strength were caring for people with severe or total dependence. There is a direct correlation between the perceived lack of physical strength and the ability to perform basic (r = 0.382, p < 0.01) and instrumental (r = 0.370, p < 0.01) activities. Conclusions: Therefore, the perception of strength and the characteristics of the cared for person may be crucial variables to successfully conduct caregiving tasks.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e040098
Author(s):  
Bingyan Gong ◽  
Shaomei Shang ◽  
Chao Wu

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.


2017 ◽  
Vol 33 (6) ◽  
pp. 219-224
Author(s):  
Kenya Ie ◽  
Maria Felton ◽  
Sydney Springer ◽  
Stephen A. Wilson ◽  
Steven M. Albert

Background: Prescription-related problems among older adults have been of great interest. However, few data are available regarding the prevalence of these problems in US family medicine residency practices (FMRPs). Objective: The aim of this research was to examine the prevalence of multimorbidity, polypharmacy, and potentially inappropriate medications (PIMs) use among older adults who visited 5 FMRPs more than once a year. Methods: A cross-sectional hospital record review for patients 65 years or older who visited 1 of the 5 university-affiliated FMRPs at least twice during January 1 to December 31, 2014, was conducted. The prevalence of multimorbidity (24 chronic index conditions), polypharmacy, and PIMs use was examined. Results: A total of 1084 patients were included in the analyses. The most common chronic conditions were hypertension (87.8%), hyperlipidemia (69.7%), and osteoarthritis (56.1%). The mean number of chronic conditions was 5.3 (SD 2.6). The prevalence of multimorbidity (≥2 chronic conditions) was 95.6%. Among these multimorbid older adults (N = 1036), the mean number of medication orders was 9.04 (SD 4.36) and 1.57 (SD 0.92) for PIMs, 86.1% met polypharmacy standards (≥5 medications), and 33.4% were prescribed one or more PIMs. The proportion of patients with fewer prescriptions at the last visit was 45.4% in the polypharmacy group and 38.0% in the PIMs group. Conclusion: Our results suggest a high level of morbidity and complexity among older adults receiving care in FMRPs. Improving the continuity of care as well as promoting interdisciplinary collaboration would have potential to reduce these prescription-related problems. Further research and education to address polypharmacy and PIMs among this population at FMRPs are required.


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