scholarly journals Disease-related disability burden: a comparison of seven chronic conditions in middle-aged and older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chieh-Ying Chou ◽  
Ching-Ju Chiu ◽  
Chia-Ming Chang ◽  
Chih-Hsing Wu ◽  
Feng-Hwa Lu ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Disability ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Disease Diagnosis ◽  
Rate Of Change ◽  
Middle Aged ◽  
Rates Of Change ◽  
Depression Status ◽  
Stage Disease

Abstract Background Although previous studies have explored the effect of chronic conditions on physical disability, little is known about the levels and rates of change in physical disability after a chronic condition diagnosis in middle-aged and older adults in the Asian population. The aim of this study is to ascertain the average levels and rates of change in the development of disability after disease diagnosis, as well as to determine the influences of sociodemographic and health-related correlates in the development of disability. Methods This is a retrospective cohort study analyzing data of nationally representative participants aged 50 and over with a chronic condition or having developed one during follow-ups based on data from the 1996–2011 Taiwan Longitudinal Study on Aging (TLSA) (n = 5131). Seven chronic conditions were examined. Covariates included age at initial diagnosis, gender, education level, number of comorbidities, and depression status. Physical disability was measured by combining self-reported ADL, IADL, and strength and mobility activities with 17 total possible points, further analyzed with multilevel modeling. Results The results showed that (1) physical disability was highest for stroke, followed by cancer and diabetes at the time of the initial disease diagnosis. (2) The linear rate of change was highest for stroke, followed by lung disease and heart disease, indicating that these diseases led to higher steady increases in physical disability after the disease diagnosis. (3) The quadratic rate of change was highest in diabetes, followed by cancer and hypertension, indicating that these diseases had led to higher increments of physical disability in later stage disease. After controlling for sociodemographic and comorbidity, depression status accounted for 39.9–73.6% and 37.9–100% of the variances in the physical disability intercept and change over time, respectively. Conclusions Despite the fact that a comparison across conditions was not statistically tested, an accelerated increase in physical disabilities was found as chronic conditions progressed. While stroke and cancer lead to disability immediately, conditions such as diabetes, cancer, and hypertension give rise to higher increments of physical disability in later stage disease. Mitigating depressive symptoms may be beneficial in terms of preventing disability development in this population.

scholarly journals Disability trajectories prior to death for ten leading causes of death among middle-aged and older adults in Taiwan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ching-Ju Chiu ◽  
Meng-Ling Li ◽  
Chia-Ming Chang ◽  
Chih-Hsing Wu ◽  
Maw Pin Tan
Keyword(s):  
Older Adults ◽  
Physical Disability ◽  
Causes Of Death ◽  
Middle Aged ◽  
Survival Status ◽  
Rates Of Change ◽  
Prediction Of Survival ◽  
Severe Deterioration ◽  
Death Data ◽  
Prolonged Life Expectancy

Abstract Background Prolonged life expectancy is associated with increased prevalence of chronic diseases. The aim of this study was to determine the different disability trajectories for the top ten leading causes of death in Taiwan . Methods A total of 2,431 participants aged 50–96 in 1996 from the Taiwan longitudinal study on aging (TLSA) who died from 1996 to 2016 were analyzed. Integration of Cause of Death Data and TLSA helped sort out participants who had died from the ten leading causes of death. The level of physical disability was evaluated with the Activities of Daily Living Scale (ADLs), ranging from 0 to 6 points, in 1996, 1999, 2003, 2007, and 2011. A multilevel model was used to investigate the levels and rates of change in disability development before death. Results The outcome of the research showed that the earliest group to experience physical limitation was individuals living with diabetes. The groups with the highest ADL scores were participants with diabetes, cerebrovascular disease, and hypertension-related diseases. Most groups reach ADL scores ≥ 1 (mild-level) during 4–6 years before death except chronic hepatitis and cirrhosis and injury. Conclusions People who had died from the ten leading causes of death experienced different disability trajectories before death. The trajectory of the participants who had died from diabetes showed a unique pattern with the earliest occurrence and more severe deterioration in terms of development of disabilities. Disability trajectories provide a prediction of survival status for middle-aged and older adults associated with the ten leading causes of death.

scholarly journals DOES ONSET OF CHRONIC CONDITIONS MODERATE THE IMPACT OF RELATIONAL LIFE EVENTS ON DEPRESSED MOOD?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S260-S260
Author(s):  
Aaron M Ogletree ◽  
Rosemary Blieszner ◽  
Rachel Pruchno ◽  
Jyoti Savla ◽  
Laura P Sands
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Life Events ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Process Model ◽  
Mixed Effect ◽  
The Impact ◽  
Over Time

Abstract More than 62% of adults aged 65+ have more than one chronic condition; this number increases to more than 82% for those 85+. Older adults simultaneously experience changes in their relationships due to negative relational life events, including illness, injury, or death of a loved one. Stressors occurring in tandem can overload psychological resources and increase risk for poor mental health. Informed by the stress process model, we assessed the influence of relational life events on depressive symptoms over time and evaluated the moderating effects of chronic condition onset. Self-reports of four stressful life events, five chronic conditions, and depressive symptoms as measured by the CES-D came from 2,948 older adults participating in the ORANJ BOWL panel. Using longitudinal multilevel mixed effect modeling, we examined trajectories of depressive symptoms across three waves. While depressive symptoms increased over time, they were greater for people who experienced more relational life events and the onset of more chronic conditions. Participants who reported experiencing all four relational life events but no chronic conditions had an average CES-D score of 5.28 (p<.0001); average CES-D score increased to 12.72 (p<.0001) for those who reported four life events and the onset of four or more new chronic conditions during the study period. In summary, chronic condition onset moderated the relationship between life events and depressive symptoms. Findings highlight the need for practitioner awareness of increased mental health risks for people experiencing stressors in multiple domains of life.

scholarly journals The Engagement in Physical Activity for Middle-Aged and Older Adults with Multiple Chronic Conditions: Findings from a Community Health Assessment

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Wei-Chen Lee ◽  
Marcia G. Ory
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Chronic Conditions ◽  
Health Assessment ◽  
The United States ◽  
Cross Sectional Study ◽  
Multiple Chronic Conditions ◽  
Middle Aged ◽  
Cross Sectional ◽  
Musculoskeletal Systems

The current aging trends accompanying the increasing prevalence of multiple chronic conditions (MCCs) and decreasing participation in physical activity (PA) have swept the United States. In light of the magnitude of this phenomenon, this study seeks to identify the most common MCC combinations and their relationships with PA level. A cross-sectional study,Brazos Valley Health Assessment, was conducted between October 2009 and July 2010. All data analyses were performed by STATA 12.0. The overall sample which met the inclusion criteria is 2,603. Among people older than 45 years, chronic conditions of cardiovascular, endocrine, and musculoskeletal systems were the most prevalent. Participants with three chronic conditions were less likely to meet the PA standard than those with only two chronic conditions. Younger age, women, rural residence, and unsafe environments were related to the lower PA level. After adjusting for seven covariates, all MCCs combinations adversely affect the level of PA (, ). People with MCCs were among the least active subgroups despite the health benefits of doing exercise. Given the well-documented benefits of physical activity for delaying the onset or progression of MCCs, public health efforts to enhance regular PA in middle-aged and older adults are recommended.

Chronic Conditions May Be More Important Than Race or Ethnicity in Relation to Health Information Seeking and Use

2017 ◽  
Vol 31 (4) ◽  
pp. 611-630 ◽  
Author(s):  
Ronica N. Rooks ◽  
Craig G. Kapral ◽  
Arlesia L. Mathis
Keyword(s):  
Older Adults ◽  
Health Information ◽  
Information Seeking ◽  
Chronic Conditions ◽  
Household Survey ◽  
Middle Aged ◽  
Logistic Regression Models ◽  
Survey Results ◽  
Nationally Representative ◽  
The Impact

Objective: This research examines health information (HI) seeking and use among middle-aged and older adults with chronic health conditions. Method: We used logistic regression models to analyze HI seeking ( N = 7,822) and use (N = 4,541-4,547) among participants (aged 45+ years) with chronic conditions from the nationally-representative Health Tracking Household Survey. Results: Adults aged 45+ years with chronic conditions were significantly more likely to seek and use HI; however, these results varied based on the age and education. Compared with Whites, Latinos were less likely to seek HI but more likely to use HI to treat illness, and African Americans were more likely to use HI to maintain health. Conclusion: Middle-aged and older adults with chronic conditions are prominent HI seekers and users. Proficient HI seeking and use may have the potential to enhance control over one’s own health, maintain independence in the community, and reduce the impact of negative health consequences on the health care system.

scholarly journals Occupational Therapy Interventions for Older Adults With Chronic Conditions and Their Care Partners

2021 ◽  
Vol 75 (6) ◽  
Author(s):  
Beth Fields
Keyword(s):  
Older Adults ◽  
Occupational Therapy ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Partners ◽  
Therapy Services ◽  
Therapy Interventions ◽  
Occupational Therapy Interventions

Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association’s Evidence-Based Practice Project. In this Evidence Connection article, I describe a clinical case report of an older adult with a chronic condition and his daughter who received home health occupational therapy services. I discuss the occupational therapy evaluation and intervention processes with these clients to support chronic condition self-management, coping skills, and problem solving, drawing on findings from the systematic review on the effectiveness of interventions for care partners of people with chronic conditions published in the July/August 2021 issue of the American Journal of Occupational Therapy. It is my hope that this Evidence Connection article can be used to inform and guide clinical decision making when working with older adults with chronic conditions and their care partners.

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