scholarly journals Impact of functional capacity on change in self-rated health among older adults in a nine-year longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Flávia Silva Arbex Borim ◽  
Daniela de Assumpção ◽  
Anita Liberalesso Neri ◽  
Samila Sathler Tavares Batistoni ◽  
Priscila Maria Stolses Bergamo Francisco ◽  
...  
Keyword(s):  
Older Adults ◽  
Relative Risk ◽  
Emotional Health ◽  
Multinomial Logistic Regression ◽  
Community Dwelling ◽  
Relative Risk Ratio ◽  
Chi Square ◽  
Multinomial Logistic Regression Analysis ◽  
Self Rated Health ◽  
Chi Square Test

AbstractThe aims of the present study were to estimate the frequency of change in self-rated health (SRH) among community-dwelling older adults, between two measures taken at a 9-year interval; and determine factors associated with a decline and an improvement in SRH, in relation to aspects of physical/emotional health and subjective wellbeing. Data were derived from a community-based study on frailty among Brazilian elderly. Associations were investigated using Pearson’s chi-square test and relative risk ratios were estimated using multinomial logistic regression analysis. 39.3% of participants did not change their SRH at both assessment times, 21.7% rated it as worse and 39.0% rated it as better. The relative risk ratio of an improvement in SRH for individuals with disability in basic activities of daily living (ADLs) was lower than for individuals with independence in basic ADLs (IRR=0.22; IC95%: 0.08-0.63). Understanding the complex interactions between self-rated health and the dimensions that influence the improvement of health perception may shed light on key determinants of the wellbeing among older adults.

scholarly journals Clinical and sonohysterography evaluation of infertile women

2020 ◽  
Vol 10 (1) ◽  
pp. 58-63
Author(s):  
Upendra Pandit ◽  
Lekhnath Baral
Keyword(s):  
Multinomial Logistic Regression ◽  
Polycystic Ovaries ◽  
Chi Square ◽  
Endometrial Polyps ◽  
Multinomial Logistic Regression Analysis ◽  
Tubal Patency ◽  
Infertile Women ◽  
Modern Technique ◽  
Combined Test ◽  
Chi Square Test

Background: Hysterosalpingography (HSG) is an integral part of the Conventional clinical evalu­ation of infertile women. Now a day, Sonohysterography is a modern technique widely used in the clinical evaluation. The objective of this study was to identify pelvic pathology; compare the effect and findings of tubal patency test between Sonohysterosalpingography and single film HSG radiograph. Methods: This is a prospective evaluation of infertile women who attended the infertility unit of the gynecology department from 2017 March to 2018 October. Women 220 clients were subjected to clinical including SHSG evaluation followed by a single film HSG radiograph on the single sitting. The Chi-square test, multinomial logistic regression analysis was done using IBM SPSS statistics version 20. Results: Women had bilateral tubal patency 181(82.2%) in SHSG and conformed the same number later by HSG. SHSG showed bilateral tubal occlusion in 33 (15%) whereas HSG conformed only in 22(10%) and block was seen in 18(8.18%) only by HSG. The pathological findings were polycystic ovaries in 33 (15%), Fibroid uterus 11 (5%), ovarian cysts 5(2%), endometrial polyps in 2 cases, en­dometriotic cyst with hydrosalpinx 8(4%). Procedural side effects were no pain in 69(31.1%), mild pain 125(56.3%), Moderate pain 21(9.5%), vasovagal symptoms 7(3.1%). Conclusions: The outcome of the Sonohysterosalpingraphy (SHSG) test for tubal patency is sig­nificantly synergized by concurrent HSG in the same sitting. The combined test is best indicated if SHSG alone is not able to demonstrate the sign of tubal patency.

scholarly journals Favorite Activity Patterns Among Older Adults With and Without Dementia: Findings From the NHATS

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 293-293
Author(s):  
Tianxue Hou ◽  
Minhui Liu ◽  
Christina E Miyawaki ◽  
Yuxiao Li ◽  
Xiaocao Sun ◽  
...  
Keyword(s):  
Older Adults ◽  
Multinomial Logistic Regression ◽  
Activity Patterns ◽  
Community Dwelling ◽  
Relative Risk Ratio ◽  
Logistic Regression Models ◽  
Dementia Screening ◽  
Screening Interview ◽  
Watching Tv ◽  
Community Dwelling Older Adults

Abstract Favorite activities are usually meaningful and valuable to older adults. However, information on favorite activity patterns and their relationship with cognitive function from large samples is still limited. Using Round 1 data from the National Health and Aging Trends Study, we examined favorite activity patterns among community-dwelling older adults with and without dementia (N=6,565). Based on the 8-item Ascertain Dementia (AD8) dementia screening interview, participants were classified into no dementia, possible dementia, and probable dementia. Favorite activity was assessed by asking participants, “What their favorite activity they are currently able to do?” Multinomial logistic regression models were used to examine the association between each of the top three favorite activities and the cognitive impairment categories, controlling for demographics and general health. The sample was on average, 77±7.45 years old, non-Hispanic White (69.8%), female (57.3%), and 35.0% had high school education. The three most popular favorite activities among probable dementia participants were watching TV, walking, and outdoor maintenance. Participants who liked watching TV most were more likely associated with possible dementia (Relative Risk Ratio [RRR] = 1.49, p=0.044) compared to participants without favorite activities. Participants who liked walking most were less associated with possible dementia (RRR=0.58, p=0.003) and probable dementia (RRR=0.39, p<0.001) compared to those without favorite activities. Similarly, participants who liked outdoor maintenance most were less likely to develop possible dementia (RRR=0.48, p<0.001) and probable dementia (RRR=0.27, p<0.001) than participants without favorite activities. Researchers may use older adults’ “active” favorite activities to create tailored interventions to slow dementia progression.

Does Self-Rated Health Predict Dementia?

2013 ◽  
Vol 26 (1) ◽  
pp. 41-50 ◽  
Author(s):  
Philip John ◽  
Patrick Montgomery
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Memory Loss ◽  
Multinomial Regression ◽  
Subjective Memory ◽  
Chi Square ◽  
Self Rated Health ◽  
Gender Education ◽  
Chi Square Test ◽  
Cognitively Intact

Objectives: 1. To determine if Self-Rated Health (SRH) predicts dementia over a five period in cognitively intact older adults, and in older adults with Cognitive Impairment, No Dementia (CIND); and 2. To determine if different methods of eliciting SRH (age-referenced (AR) versus unreferenced) yield similar results. Design: Prospective cohort. Population: 1468 cognitively intact adults and 94 older adults with CIND aged 65+ living in the community, followed over five years. Measures: Age, gender, education, subjective memory loss, depressive symptoms, functional status, cognition, SRH and AR-SRH were all measured; dementia was diagnosed on clinical examination. Those with abnormal cognition not meeting criteria for dementia were diagnosed with CIND. Results: In those who were cognitively intact at time 1, and had good SRH: 69.4% were intact; 6.0% had CIND; 6.9% had dementia, and 17.7% had died at time 2, while in those with poor SRH: 44.9% were intact, 11.1% had CIND, 9.1% had dementia, and 34.8% had died (p<0.001, chi-square test). In multinomial regression models SRH predicted dementia and death. In those with CIND at time 1 and good SRH: 2.3% were intact: 18.6% had CIND; 34.9% had dementia and 44.2% had died at time 2, while in those with poor SRH: 4.8% were intact, 31.0% had CIND, 19.0% had dementia, and 43.6% had died (p=0.30, chi-square test). In multinomial regression models, this was not significant. AR-SRH analyses were similar. Conclusions: In cognitively intact older adults SRH predicts dementia. In older adults with CIND, SRH does not predict dementia.

scholarly journals Dual Decline in Gait and Cognition Is Associated With Future Dementia: Evidence for a Phenotype

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 264-264
Author(s):  
Manuel Montero Odasso ◽  
Mark Speechley ◽  
Richard Camicioli ◽  
Nellie Kamkar ◽  
Qu Tian ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Regression Models ◽  
Community Dwelling ◽  
Hierarchical Regression ◽  
Chi Square ◽  
Cox Models ◽  
Incident Dementia ◽  
Risk Of Progression ◽  
Community Dwelling Older Adults

Abstract BACKGROUND: The concurrent decline in gait speed and cognition are associated with future dementia. However, the clinical profile of those who present with dual-decline has not yet been described. We aimed to describe the phenotype and risk for incident dementia of individuals who present a dual-decline in comparison with non dual-decliners. METHODS: Prospective cohort of community-dwelling older adults free of dementia at baseline. We evaluated participants’ gait speed, cognition, medical status, functionality, incidence of adverse events, and dementia biannually over 7 years. Gait speed was assessed with a 6-meter electronic-walkway, and global cognition was assessed using the MoCA test. We compared characteristics between dual-decliners and non dual-decliners using t-test, Chi-square, and hierarchical regression models. We estimated incident dementia using Cox models. RESULTS: Among 144 participants (mean age 74.23 ± 6.72 years, 54% women), 17% progressed to dementia. Dual-decliners had a three-fold risk (HR: 3.12, 95%CI:1.23-7.93, p=0.017) of progression to dementia compared with non dual-decliners. Dual-decliners were significantly older with a higher prevalence of hypertension and dyslipidemia (p=0.002). Hierarchical regression models show that age and sex alone explained 3% of the variation in the dual-decliners group, while adding hypertension and dyslipidemia increased the explained variation to 8% and 10 %, respectively. The risk of becoming a dual-decliner was 4-fold if hypertension was present. CONCLUSION: Older adults with concurrent decline in gait speed and cognition represent a group at the highest risk of progression to dementia. These dual-decliners have a distinct phenotype with a higher prevalence of hypertension, a potentially treatable condition.

Multiple Physical Symptoms of Community-Dwelling Older People in Western China: Prevalence and Its Association with Frailty

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Shuli Jia ◽  
Wanyu Zhao ◽  
Yan Zhang ◽  
Lisha Hou ◽  
Xin Xia ◽  
...  
Keyword(s):  
Older Adults ◽  
Multinomial Logistic Regression ◽  
Physical Symptoms ◽  
Community Dwelling ◽  
Western China ◽  
Musculoskeletal Symptoms ◽  
Frailty Phenotype ◽  
The Past ◽  
Organ Systems ◽  
Multiple Symptoms

<b><i>Introduction:</i></b> Physical symptoms and frailty are common in older adults. A previous study has reported that multiple somatic symptoms are associated with frailty. In this study, we aimed to describe the picture of physical symptoms in older adults in western China and examine the relationship of multiple physical symptoms and frailty, as well as the sex difference of this relationship. <b><i>Methods:</i></b> Cross-sectional analyses were based on the West China Health and Aging Trend (WCHAT) study comprising 4,106 community-dwelling older adults (60–95 years). Frailty was assessed using the physical frailty phenotype (PFP). Participants’ experience of 28 different physical symptoms in the past 4 weeks was assessed. Physical symptoms were divided into several categories according to organ systems. Multinomial logistic regression analyses were performed to examine the association between frailty and multiple physical symptoms. <b><i>Results:</i></b> Nearly half of the subjects reported experiencing at least 1 physical symptom during the past 4 weeks. Musculoskeletal symptoms were the most prevalent symptoms. More than 5 physical symptoms were more likely to be frailty, even when all covariates were controlled. A significant association between multiple musculoskeletal symptoms and frailty also was found after adjusted for all covariates and multiple symptoms of other organ systems. Similar results were obtained for multiple cardiopulmonary symptoms. Furthermore, there were sex differences in these relationships. <b><i>Conclusion:</i></b> Multiple physical symptoms appear to have a detrimental impact on frailty in older adults. Compared with counting total symptoms, multiple symptoms of the same organ system may have a greater impact on frailty. Effective interventions and management of multiple physical symptoms are warranted to prevent frailty.

scholarly journals Engagement in Advance Care Planning: The Association With Cognitive Impairment and Care Preferences

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-418
Author(s):  
Hyo Jung Lee ◽  
Giyeon Kim
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Relative Risk ◽  
End Of Life ◽  
Advance Care Planning ◽  
Multinomial Logistic Regression ◽  
Quality Care ◽  
Care Planning ◽  
Advance Care ◽  
Four Levels

Abstract Although there has been growing evidence that Advance care planning (ACP) benefits people with cognitive impairment nearing death, our understanding about this issue is still limited. This study examines whether cognitive impairment is associated with ACP engagement and end-of-life care preferences among older adults in the U.S. Using data from the 2012 National Health and Trends Study (n=1798, aged 65 to 101), we identified four levels of ACP engagement: None (28%), Informal ACP conversation only (12%), Formal ACP only (14%), and Both informal and formal ACP (46%). Older adults with None showed the highest prevalence of having cognitive impairment (17%), followed by those with Formal ACP only (15%) and the other two (6%, 6%). The results of Multinomial Logistic Regression showed that, compared to those without, respondents with cognitive impairment had 143% increased relative risk of having None (RR = 2.43, CI: 1.58-3.73) and 81% increased relative risk of completing Formal ACP only (RR = 1.81, CI: 1.11-2.95) relative to completing Both informal and formal ACP. In addition, respondents with None were more likely to prefer to receive all treatments available nearing death than those with any ACP engagement. Achieving high quality care at the end of life can be more challenging for older adults with cognitive impairment and their family caregivers due to the limited capacity. Although encouraged, informal ACP conversation with loved ones does not necessarily occur before the formal ACP, especially, for those with cognitive impairment. Therefore, they may merit more attention such as early ACP engagement.

scholarly journals Orthostatic Hypotension and Falls in Hospitalized Older Adults

2021 ◽  
pp. 105477382098668
Author(s):  
Kathleen Schell ◽  
Denise Lyons ◽  
Barry Bodt
Keyword(s):  
Older Adults ◽  
Orthostatic Hypotension ◽  
Electronic Medical Records ◽  
Fall Prevention ◽  
Medical Records ◽  
The Elderly ◽  
Chi Square ◽  
Convenience Sample ◽  
Chi Square Test ◽  
Hospitalized Older Adults

The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings ( n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance ( p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.

scholarly journals Patterns and predictive factors of loss of the independence trajectory among community-dwelling older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlotte Bimou ◽  
Michel Harel ◽  
Cécile Laubarie-Mouret ◽  
Noëlle Cardinaud ◽  
Marion Charenton-Blavignac ◽  
...  
Keyword(s):  
Older Adults ◽  
Predictive Factors ◽  
Multinomial Logistic Regression ◽  
Cognitive Disorder ◽  
Community Dwelling ◽  
Functional Autonomy ◽  
Process Loss ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Community Dwelling Older Adults

Abstract Background Independence is related to the aging process. Loss of independence is defined as the inability to make decisions and participate in activities of daily living (ADLs). Independence is related to physical, psychological, biological, and socioeconomic factors. An enhanced understanding of older people’s independence trajectories and associated risk factors would enable the develop early intervention strategies. Methods Independence trajectory analysis was performed on patients identified in the Unité de Prévention de Suivi et d’Analyse du Vieillissement (UPSAV) database. UPSAV cohort is a prospective observational study. Participants were 221 community-dwelling persons aged ≥75 years followed for 24 months between July 2011–November 2013 and benefits from a prevention strategy. Data were collected prospectively using a questionnaire. Independence was assessed using the “Functional Autonomy Measurement System (Système de Mesure de l’Autonomie Fonctionnelle (SMAF))”. Group-based trajectory modeling (GBTM) was performed to identify independence trajectories, and the results were compared with those of k-means and hierarchical ascending classifications. A multinomial logistic regression was performed to identify predictive factors of the independence trajectory. Results Three distinct trajectories of independence were identified including a “Stable functional autonomy (SFA) trajectory” (53% of patients), a “Stable then decline functional autonomy decline (SDFA) trajectory” (33% of patients) and a “Constantly functional autonomy decline (CFAD) trajectory” (14% of patients). Not being a member of an association, and previous fall were significantly associated of a SDFA trajectory (P < 0.01). Absence of financial and human assistance, no hobbies, and cognitive disorder were significantly associated with a CFAD trajectory (P < 0.01). Previous occupation and multiple pathologies were predictive factors of both declining trajectories SDFA and CFAD. Conclusions Community-living older persons exhibit distinct independence trajectories and the predictive factors. The evidence from this study suggests that the prevention and screening for the loss of independence of the older adults should be anticipated to maintaining autonomy.

scholarly journals Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7 years in community-dwelling older adults with hand pain

2019 ◽  
Author(s):  
Michelle Marshall ◽  
Helgi Jonsson ◽  
Gudrun Helgadottir ◽  
Elaine Nicholls ◽  
Helen L Myers ◽  
...  
Keyword(s):  
Older Adults ◽  
Construct Validity ◽  
Community Dwelling ◽  
Analysis Of Covariance ◽  
Hand Osteoarthritis ◽  
Clinical Progression ◽  
Chi Square ◽  
Term Change ◽  
Community Dwelling Older Adults ◽  
Longitudinal Construct Validity

Abstract Background: To determine the longitudinal construct validity of assessing hand OA progression on digital photographs over 7 years compared with progression determined from radiographs, clinical features and change in symptoms. Methods: Participants were community-dwelling older adults (≥50 years) in North Staffordshire, UK. Standardized digital hand photographs were taken at baseline and 7 years, and hand joints graded for OA severity using an established photographic atlas. Radiographic hand OA was assessed using the Kellgren and Lawrence grading system. Hand examination determined the presence of nodes, bony enlargement and deformity. Symptoms were reported in self-complete questionnaires. Radiographic and clinical progression and change in symptoms were compared to photographic progression. Differences were examined using analysis of covariance and Chi-Square tests. Results: Of 253 individuals (61% women, mean age 63 years) the proportion with photographic progression at the joint and joint group-level was higher, though not statistically significantly, in those with radiographic or clinical progression compared to those without. At the person-level, those with moderate photographic progression over 7 years had significantly higher summed radiographic and clinical scores after adjustment for baseline scores compared to those with no or mild photographic progression. Similar findings were observed for change in symptoms, although differences were small and not statistically significant. Conclusion: Assessing hand OA on photographs shows modest longitudinal construct validity over 7 years compared with change in radiographic and clinical hand OA at the person-level. Using hand photographs for determining long-term change may be a reasonable alternative when hand examinations and radiographs are not feasible.

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