scholarly journals Number of chronic conditions and associated functional limitations among older adults: cross-sectional findings from the longitudinal aging study in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Palak Sharma ◽  
Priya Maurya ◽  
T. Muhammad
Keyword(s):  
Older Adults ◽  
Heart Disease ◽  
Activities Of Daily Living ◽  
Lung Disease ◽  
Chronic Conditions ◽  
Daily Living ◽  
Functional Limitations ◽  
Older Men ◽  
Psychiatric Disease ◽  
Related Disease

Abstract Background Chronic conditions reduce the likelihood of physical functioning among older adults. However, the contribution of most prevalent diseases and multimorbidity to different measures of functional limitations is relatively underexplored among Indian older adults. The present study explores the prospective association between number of chronic conditions and limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) among older adults in India. Methods This study utilized data from the nationally representative Longitudinal Ageing Study in India (LASI-2017-18). The effective sample size was 31,464 older adults aged 60 years and above. Descriptive statistics along with cross-tabulation were presented in the study. Additionally, binary logistic regression analysis was used to fulfil the objectives. The outcome variables were dichotomized; high representing no difficulty in ADL/IADL and low representing a difficulty in at least one ADL/IADL. The chronic conditions included hypertension, diabetes, neurological/psychiatric disease, lung disease, heart diseases, stroke, and bone-related disease. The number of chronic diseases was categorized into no disease, single, two and three plus based on number of reported disease. Results 26.36% of older women and 20.87% of older men had low ADL and the figures for low IADL were 56.86 and 38.84% for older men and women respectively. The likelihood of low ADL (AOR: 1.698, CI:1.544, 1.868) and low IADL (AOR: 1.197; CI: 1.064, 1.346) was higher among womenthan men. With increasing age, the prevalence of low ADL increased among older adults. Respondents with pre-existing chronic conditions had higher likelihood of low ADL and IADL. Older adults with hypertension, psychiatric disease, heart disease, stroke and bone-related disease had significantly higher odds of reporting low IADL. The chances of low ADL and IADL were 2.156 (CI: 1.709, 2.719) and 2.892 (CI: 2.067, 4.047) times respectively higher among older adults with more than three chronic conditions. After controlling for socio-economic and health-related covariates, it was found that men with more than three pre-existing chronic conditions had higher odds of low ADL than women. On the other hand, low IADL were found higher among women with more than three pre-existing chronic conditions. Conclusions The present study demonstrates a significant burden of functional limitations among older individuals and that there is a strong association between pre-existing chronic conditions and functional disability. Those with hypertension, diabetes, psychiatric disorders, heart disease, stroke, lung disease or bone-related diseases should be effectively monitored to predict future functional limitations, which may lead to worsening health.

scholarly journals Differences in Self-Rated Memory by Race/Ethnicity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 551-551
Author(s):  
Yujin Franco ◽  
Joseph Saenz ◽  
Yuri Jang ◽  
Jessica Ho
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Chronic Conditions ◽  
Daily Living ◽  
Functional Limitations ◽  
Religious Practice ◽  
Cultural Factors ◽  
Race Ethnicity ◽  
Social And Cultural Factors ◽  
Memory Status

Abstract Self-rated memory is an important dimension of well-being among older adults that has also been linked to cognitive impairment over the long term. However, few studies based on nationally-representative samples have examined differences in self-rated memory by race/ethnicity. This study explores differences in self-rated memory across non-Hispanic White, non-Hispanic Black, and Hispanic older adults in the United States. Data were drawn from the 2011 wave of the National Health and Aging Trends Study (NHATS). The sample consisted of older adults aged 65 and older (N=4,753 non-Hispanic Whites, N=1,442 non-Hispanic Blacks, and N=388 Hispanics). Logistic regression was used to examine the association between having poor/fair self-rated memory and race/ethnicity, controlling for socio-demographic characteristics (age, gender, education level, income, and marital status), chronic conditions (heart attack, hypertension, diabetes, stroke, and depressive symptoms), objective memory status, functional limitations (activities of daily living and instrumental activities of daily living), and other social and cultural factors (economic vulnerability, religious practice, and limited English proficiency). I find that non-Hispanic Blacks and Hispanics have significantly higher odds of reporting poor/fair self-rated memory than non-Hispanic Whites. Compared to non-Hispanic Whites, Blacks and Hispanics had 33% and 56% higher odds of reporting poor/fair self-rated memory, respectively, controlling for sociodemographic characteristics, chronic conditions, objective memory status, functional limitations, and social and cultural factors. These results provide evidence that understanding differences in self-rated memory across racial/ethnic groups may have important implications for health professionals, particularly in relation to conducting and interpreting cognitive screening assessments.

scholarly journals Multimorbidity: Constellations of Conditions across Subgroups of Midlife and Older Individuals, and Related Medicare Expenditures

2017 ◽  
Vol 7 (1) ◽  
pp. 33-43 ◽  
Author(s):  
Siran M. Koroukian ◽  
Nicholas K. Schiltz ◽  
David F. Warner ◽  
Jiayang Sun ◽  
Kurt C. Stange ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Chronic Conditions ◽  
Daily Living ◽  
Functional Limitations ◽  
Upper Body ◽  
Multiple Chronic Conditions ◽  
Fee For Service ◽  
Geriatric Syndromes ◽  
Older Individuals

Introduction: The Department of Health and Human Services’ 2010 Strategic Framework on Multiple Chronic Conditions called for the identification of common constellations of conditions in older adults. Objectives: To analyze patterns of conditions constituting multimorbidity (CCMM) and expenditures in a US representative sample of midlife and older adults (50–64 and ≥65 years of age, respectively). Design: A cross-sectional study of the 2010 Health and Retirement Study (HRS; n=17,912). The following measures were used: (1) count and combinations of CCMM, including (i) chronic conditions (hypertension, arthritis, heart disease, lung disease, stroke, diabetes, cancer, and psychiatric conditions), (ii) functional limitations (upper body limitations, lower body limitations, strength limitations, limitations in activities of daily living, and limitations in instrumental activities of daily living), and (iii) geriatric syndromes (cognitive impairment, depressive symptoms, incontinence, visual impairment, hearing impairment, severe pain, and dizziness); and (2) annualized 2011 Medicare expenditures for HRS participants who were Medicare fee-for-service beneficiaries ( n=5,677). Medicaid beneficiaries were also identified based on their self-reported insurance status. Results: No large representations of participants within specific CCMM categories were observed; however, functional limitations and geriatric syndromes were prominently present with higher CCMM counts. Among fee-for-service Medicare beneficiaries aged 50–64 years, 26.7% of the participants presented with ≥10 CCMM, but incurred 48% of the expenditure. In those aged ≥65 years, these percentages were 16.9% and 34.4%, respectively. Conclusion: Functional limitations and geriatric syndromes considerably add to the MM burden in midlife and older adults. This burden is much higher than previously reported.

Informal Caregivers of elderly people: an european review

1992 ◽  
Vol 12 (03) ◽  
pp. 369-380 ◽  
Author(s):  
Gilbert Dooghe
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Chronic Conditions ◽  
Daily Living ◽  
Functional Limitations ◽  
Good Health ◽  
Age Group ◽  
Mental Disabilities ◽  
Growing Age ◽  
European Review

Europe is experiencing a rapid increase in the numbers and proportions of the very old, and the number of older adults with chronic or longstanding diseases and functional limitations is rising. Between 1980 and 2025, the population aged 80 years and over is projected to increase 2·15 times, from in million in 1980 to 23·7 million. As those aged 80 years and over have been the most rapidly growing age-group, it is evident that the prevalence of physical and mental disabilities is of concern. Many suffer from chronic conditions which compromise daily living, although a substantial group are in good health and with little disability.203 Nevertheless as the average age increases, more people need some form of assistance with the activities of daily living, such as bathing, dressing, eating, preparing meals and errands (ADL). Reaching the age of 80 years does not necessarily mean losing one's independence; nevertheless the risk increases with age.

scholarly journals Fresh and Lean Pork Intake in Relation to Functional Limitations Among U.S. Older Adults, 2005–2016 (P18-002-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ruopeng An ◽  
Sharon Nickols-Richardson ◽  
Reginald Alston ◽  
Sa Shen ◽  
Caitlin Clarke
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Measurement Errors ◽  
Daily Living ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Preliminary Evidence ◽  
Cross Sectional ◽  
Pork Consumption ◽  
Lean Pork

Abstract Objectives This study assessed fresh and lean pork intake in relation to functional limitations among U.S. older adults 65 years and older. Methods Nationally-representative sample (N = 27,117) from 2005–2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. Logistic regressions were performed to estimate the odds ratios of activities of daily living limitation (ADLs), instrumental activities of daily living limitation (IADLs), leisure and social activities limitation (LSAs), lower extremity mobility limitation (LEM), general physical activities limitation (GPAs), and any functional limitation with respect to daily pork, fresh pork, and fresh lean pork consumption, adjusting for individual charteristics including sex, age, race/ethnicity, education, marital status, obesity, smoking, self-rated health, chronic conditions, and survey wave. Results Approximately 21%, 18%, and 16% of older adults consumed pork, fresh pork, and fresh lean pork, respectively. The rates of ADL, IADLs, LSAs, LEM, GPAs, and any functional limitations were 22%, 32%, 23%, 22%, 66%, and 70% among NHANES older adults, respectively. A daily increase in pork consumption by 1 ounce-equivalent was associated with a reduction in the odds of ADLs by 12% (OR = 0.88; 95% CI = 0.78, 0.98), IADLs by 10% (OR = 0.90, 95% CI = 0.82, 0.99), and any functional limitation by 7% (OR = 0.93, 95% CI = 0.86, 0.99). A daily increase in fresh pork consumption by 1 ounce-equivalent was associated with a reduction in the odds of ADLs by 13% (OR = 0.87; 95% CI = 0.78, 0.97), IADLs by 10% (OR = 0.90, 95% CI = 0.82, 0.99), GPAs by 8% (OR = 0.92; 95% CI = 0.85, 0.99), and any functional limitation by 8% (OR = 0.92, 95% CI = 0.85, 0.99). Similar effects were found for fresh lean pork consumption on ADLs, IADLs, GPAs, and any functional limitation. No association between pork consumption and LSAs or LEM was identified. Conclusions This study found some preliminary evidence linking fresh and fresh lean pork consumption to reduced risk of functional limitations. This study has limitations pertaining to measurement errors and cross-sectional study design. Future studies with longitudinal/experimental designs are warranted to examine the influence of fresh and lean pork consumption on functional limitations among older adults. Funding Sources National Pork Board.

scholarly journals Gait Speed and Instrumental Activities of Daily Living in Older Adults After Hospitalization: A Longitudinal Population-Based Study

2021 ◽  
Author(s):  
Juraj Sprung ◽  
Mariana Laporta ◽  
David S Knopman ◽  
Ronald C Petersen ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Gait Speed ◽  
Daily Living ◽  
Functional Limitations ◽  
Parameter Estimate ◽  
Population Based ◽  
Instrumental Activities

Abstract Background Hospitalization can impair physical and functional status of older adults, but it is unclear whether these deficits are transient or chronic. This study determined the association between hospitalization of older adults and changes in long-term longitudinal trajectories of two measures of physical and functional status: gait speed (GS) and Instrumental Activities of Daily Living measured with Functional Activities Questionnaire (FAQ). Methods Linear mixed effects models assessed the association between hospitalization (non-elective vs. elective, and surgical vs. medical) and outcomes of GS and FAQ score in participants (>60 years old) enrolled in the Mayo Clinic Study of Aging who had longitudinal assessments. Results Of 4,902 participants, 1,879 had ≥1 hospital admission. Median GS at enrollment was 1.1 m/s. The slope of the annual decline in GS before hospitalization was -0.015 m/s. The parameter estimate [95%CI] for additional annual change in GS trajectory after hospitalization was -0.009 [-0.011 to -0.006] m/s, P<0.001. The accelerated GS decline was greater for medical vs. surgical hospitalizations (-0.010 vs. -0.003 m/s, P=0.005), and non-elective vs. elective hospitalizations (-0.011 vs -0.006 m/s, P=0.067). The odds of a worsening FAQ-score increased on average by 4% per year. Following hospitalization, odds of FAQ-score worsening further increased (multiplicative annual increase in odds ratio per year [95%C] following hospitalization was 1.05 [1.03, 1.07], P<0.001). Conclusions Hospitalization of older adults is associated with accelerated long-term decline in GS and functional limitations, especially after non-elective admissions and those for medical indications. However, for most well-functioning participants these changes have little clinical significance.

scholarly journals Cognitive complaints in age-related chronic conditions: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253795
Author(s):  
Nikki L. Hill ◽  
Sakshi Bhargava ◽  
Monique J. Brown ◽  
Hyejin Kim ◽  
Iris Bhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Heart Disease ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Chronic Conditions ◽  
Future Research ◽  
Cognitive Complaints ◽  
Age Related ◽  
Review Team

Introduction Cognitive complaints in older adults may be indicative of progressive cognitive decline including Alzheimer’s disease (AD), but also occur in other age-related chronic conditions, complicating identification of early AD symptoms. To better understand cognitive complaints in aging, we systematically reviewed the evidence to determine their prevalence and characterization among older adults with the most common age-related chronic conditions. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the review protocol was prospectively registered with PROSPERO (ID: CRD42020153147). Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and ProQuest Dissertations & Theses A&I in June 2020. Two members of the review team independently determined article eligibility for inclusion and conducted quality appraisal. A narrative synthesis of results was used to integrate findings across studies and draw conclusions regarding the strength of the evidence in each chronic condition category. Results Thirty-seven articles met eligibility criteria and were included in the review. Conditions represented were diabetes (n = 20), heart disease (n = 13), hypertension (n = 10), chronic lung disease (n = 5), arthritis (n = 4), heart failure (n = 2), and hyperlipidemia (n = 2). In addition, 16 studies included a measure of multimorbidity. Overall, there was a higher prevalence of cognitive complaints in individuals with higher multimorbidity, including a potential dose-dependent relationship. Findings for specific conditions were inconsistent, but there is evidence to suggest that cross-sectionally, older adults with diabetes, heart disease, chronic lung disease, and arthritis have more cognitive complaints than those without these conditions. Conclusion There is strong evidence demonstrating that cognitive complaints are more common in older adults with higher multimorbidity, but little research examining these associations over time. Improving our understanding of the longitudinal trajectory of cognitive complaints, multimorbidity, and objective cognition in older age is an important area for future research.

scholarly journals Dependency Change with Aging and Associated Factors in Uruguay: A Cohort Study

2021 ◽  
pp. 089826432110177
Author(s):  
Alejandra Marroig ◽  
Maximiliano Machado ◽  
Graciela Muniz-Terrera
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Chronic Conditions ◽  
Daily Living ◽  
Associated Factors ◽  
Social Care ◽  
Representative Study ◽  
Increased Risk ◽  
Using Data

Objectives: To assess the heterogeneity of transitions toward dependency in older adults and to explore the robustness of results to different operationalizations of dependency. Method: Using data from people aged 60 years and older from a national representative study in Uruguay ( Encuesta Longitudinal de Protección Social, N = 5071), we fitted multinomial regressions adjusted by sociodemographic and health characteristics to model transitions into dependency and death. We used a harder operationalization with basic activities of daily living (Katz-dependency) and Comprehensive-dependency with basic, instrumental, and advanced activities. Results: Increasing age (RRR = 1.08, CI = [1.05; 1.12], p < .001) and having comorbidities (RRR = 2.16, CI = [1.31; 3.57], p = .003) increased the risk of transition from nondependent to dependent using Katz-dependency. Women with at least two chronic conditions have increased risk of Comprehensive-dependency (RRR = 1.79, CI = [1.15; 2.80], p = .010). Discussion: Inconsistencies in findings emerged when evaluating transitions into dependency with the different measures, which may have social care implications.

scholarly journals FRESH AND LEAN BEEF INTAKE IN RELATION TO FUNCTIONAL LIMITATIONS AMONG U.S. OLDER ADULTS, 2005-2016

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S474-S474
Author(s):  
Ruopeng An ◽  
Sharon Nickols-Richardson ◽  
Reginald Alston ◽  
Sa Shen ◽  
Caitlin Clarke
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Measurement Errors ◽  
Daily Living ◽  
Sodium Intake ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Functional Health ◽  
Cross Sectional ◽  
Lean Beef

Abstract Beef is a key component in the American diet. This study assessed fresh and fresh lean beef intake in relation to functional limitations among U.S. older adults 65 years and older. Logistic regressions were performed on individual-level 24-hour dietary recall and health indicator data (N=6,135) retrieved from 2005–2016 National Health and Nutrition Examination Survey. Approximately 51%, 14%, and 9% of older adults consumed beef, fresh beef, and fresh lean beef, respectively. Daily increase in fresh beef consumption by 1 ounce-equivalent was associated with a reduction in the odds of lower extremity mobility limitation (LEM) by 16% (95% confidence interval=4%–27%), general physical activities limitation by 13% (1%–24%), and any functional limitation by 14% (2%–24%). Daily increase in fresh lean beef consumption by 1 ounce-equivalent was associated with a reduction in the odds of LEM by 22% (7%–34%) and any functional limitation by 15% (1%–28%). No association with activities of daily living, instrumental activities of daily living, or leisure and social activities limitations was identified. In conclusion, preliminary evidence links fresh and fresh lean beef consumption to reduced functional limitation risk. Older beef consumers are encouraged to modestly increase their intakes of fresh and lean beef, rather than total beef, to maximize attributes of functional health associated with beef consumption while concurrently avoiding additional saturated fat and sodium intake. Limitations of this study include measurement errors and cross-sectional study design. Future studies with longitudinal/experimental design are warranted to examine the influence of fresh/lean beef consumption on functional limitations among older adults.

Fresh- and lean-pork intake in relation to functional limitations among US older adults, 2005–2016

2020 ◽  
Vol 26 (4) ◽  
pp. 295-301
Author(s):  
Ruopeng An ◽  
Sharon M Nickols-Richardson ◽  
Reginald J Alston ◽  
Sa Shen ◽  
Caitlin Clarke
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Preliminary Evidence ◽  
Individual Level ◽  
General Physical ◽  
Pork Consumption ◽  
Lean Pork

Background: Pork consumption, in particular fresh/lean-pork consumption, provides protein and other essential micronutrients that older adults need daily and may hold the potential to prevent functional limitations resulting from sub-optimal nutrition. Aim: Assess fresh/lean-pork intake in relation to functional limitations among older adults in the USA. Methods: Individual-level data came from the National Health and Nutrition Examination Survey (NHANES) 2005–2016 waves. Nineteen validated questions assessed five functional limitation domains: activities of daily living (ADLs); instrumental activities of daily living (IADLs); leisure and social activities (LSAs); lower extremity mobility (LEM); and general physical activities (GPAs). Logistic regressions were performed to examine pork, fresh-pork and fresh lean-pork intake in relation to functional limitations among NHANES older adults ( n = 6135). Results: Approximately 21, 18 and 16% of older adults consumed pork, fresh pork and fresh lean pork, respectively. An increase in pork consumption by 1 oz-equivalent/day was associated with a reduced odds of ADLs by 12%, IADLs by 10% and any functional limitation by 7%. An increase in fresh-pork consumption by 1 oz-equivalent/day was associated with a reduced odds of ADLs by 13%, IADLs by 10%, GPAs by 8%, and any functional limitation by 8%. Similar effects were found for fresh lean-pork consumption on ADLs, IADLs, GPAs and any functional limitation. Conclusion: This study found some preliminary evidence linking fresh/lean-pork consumption to a reduced risk of functional limitations. Future studies with longitudinal/experimental designs are warranted to examine the influence of fresh/lean-pork consumption on functional limitations.

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