Impact of treatment and frailty on elder-relevant physical function outcomes in older adults with metastatic castration-resistant prostate cancer (mCRPC).

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 76-76
Author(s):  
Helen Yang ◽  
Henriette Breunis ◽  
Narhari Timilshina ◽  
Seungyeon Kim ◽  
Shabbir M.H. Alibhai
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Grip Strength ◽  
Frailty Index ◽  
Well Being ◽  
Older Men ◽  
Frailty Status ◽  
Treatment Type ◽  
The Impact ◽  
Over Time

76 Background: Maintenance of physical function is a key consideration in treatment decision-making for older adults with metastatic cancer, many of whom are frail. However, physical function outcomes with treatment, and effects of frailty, have not been adequately explored in the mCRPC setting. We evaluated the effects of frailty status and treatment with docetaxel (CHEMO), abiraterone (ABI), enzalutamide (ENZA), and radium 223 (RAD) on elder-relevant physical function outcomes in older men with mCRPC. Methods: Men aged 65+ were enrolled in this multicenter prospective observational cohort study. Daily function was evaluated with the OARS instrumental activities of daily living (IADL). Objective physical function was assessed by grip strength and the Short Physical Performance Battery (SPPB). Falls were documented during interviews. We also collected FACT-G physical well-being (PWB) and functional well-being (FWB) subscales. Assessments were performed at baseline, 3 months, and 6 months. We identified frailty status with a validated frailty index. Mixed effects regression models were used to examine the difference in primary outcomes over time by treatment group or frailty status adjusted for baseline characteristics. Factors associated with falls within 6 months of treatment initiation were determined with logistic regression. Results: A total of 70, 38, 67, and 23 men starting CHEMO, ABI, ENZA, and RAD were included. Mean age, education, race, number of medications, and BMI were similar at baseline between treatment groups. In treatment-stratified analyses without considering frailty, no significant changes over time were reported for any physical function outcome. Frailty was significantly associated with lower IADL function (p < 0.0001), worse grip strength (p < 0.0001), worse SPPB score (p < 0.0001), worse PWB (p < 0.0001), and worse FWB (p < 0.0001) at baseline. In frailty-stratified analyses, grip strength (p = 0.0345) worsened, but SPPB (p = 0.0147) improved significantly over time. Also, changes in SPPB (p = 0.0394) and PWB scores (p = 0.0269) over time differed by frailty status, where frail cohorts had greater improvement over time in both scores. Frailty and treatment type were not predictors of falls whereas prior falls history (OR: 3.52, 95% CI: 1.40-8.86) and age (OR: 1.07, 95% CI: 1.01-1.14) were significant predictors. Conclusions: Frail older men receiving treatment for mCRPC have worse IADL function, grip strength, SPPB scores, PWB, and FWB at baseline. Although grip strength worsened over time, they had greater improvement in SPPB scores and PWB over time than fit patients. Contrary to our hypothesis, most older adults do not experience significant worsening in elder-relevant physical function outcomes over time regardless of treatment. The impact of frailty requires further study.

scholarly journals The psychosocial benefits of providing non-kin childcare in older adults: A longitudinal study with older New Zealanders

2020 ◽  
Author(s):  
Á Szabó ◽  
Eva Neely ◽  
C Stephens
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Longitudinal Study ◽  
Well Being ◽  
Grandparental Childcare ◽  
Psychosocial Benefits ◽  
The Impact ◽  
Over Time ◽  
New Zealanders

© The Author(s) 2019. Community grandparenting may promote the well-being of older adults. We examined the impact of non-kin and grandparental childcare on quality of life and loneliness using longitudinal data from 2653 older New Zealanders collected over 2 years. Providing both non-kin and grandparental childcare predicted greater self-realisation for women only and was associated with reduced levels of control and autonomy for men. Non-kin childcare was also associated with reduced social loneliness over time independent of gender. Findings suggest that non-kin grandparenting has psychosocial benefits for older adults. Surrogate grandparenting offers promising avenues for those without grandchildren to experience the benefits of grandparenting.

scholarly journals The psychosocial benefits of providing non-kin childcare in older adults: A longitudinal study with older New Zealanders

2021 ◽  
Author(s):  
Agnes Szabo ◽  
Eva Neely ◽  
C Stephens
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Longitudinal Study ◽  
Well Being ◽  
Grandparental Childcare ◽  
Psychosocial Benefits ◽  
The Impact ◽  
Over Time ◽  
New Zealanders

© The Author(s) 2019. Community grandparenting may promote the well-being of older adults. We examined the impact of non-kin and grandparental childcare on quality of life and loneliness using longitudinal data from 2653 older New Zealanders collected over 2 years. Providing both non-kin and grandparental childcare predicted greater self-realisation for women only and was associated with reduced levels of control and autonomy for men. Non-kin childcare was also associated with reduced social loneliness over time independent of gender. Findings suggest that non-kin grandparenting has psychosocial benefits for older adults. Surrogate grandparenting offers promising avenues for those without grandchildren to experience the benefits of grandparenting.

Quality of life (QOL) and physical function in one-year adult and elderly survivors of acute myeloid leukemia (AML).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7071-7071
Author(s):  
Shabbir M.H. Alibhai ◽  
Henriette Breunis ◽  
Narhari Timilshina ◽  
Mark D. Minden ◽  
Vikas Gupta ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Grip Strength ◽  
Age Groups ◽  
Cell Transplant ◽  
Prospective Longitudinal Study ◽  
Younger Patients ◽  
Eortc Qlq ◽  
Prospective Longitudinal ◽  
Over Time

7071 Background: The treatment of AML with intensive chemotherapy (IC) is associated with significant short-term toxicities. We previously showed similar impairments in QOL and physical function among younger (age 18-59) and older (age 60+) patients with AML at diagnosis, with similar recovery over 3 cycles of IC. We now comprehensively describe QOL and physical function recovery over 1 year from diagnosis. Methods: Younger and older AML patients undergoing IC without stem cell transplant were enrolled in a prospective, longitudinal study. Assessments were done at baseline (pre-IC) and at 7 time points over the next year. At each visit, patients completed the EORTC QLQ-C30 and the FACT-Fatigue to measure QOL and fatigue, respectively, in addition to 3 physical function tests (grip strength, 2-minute walk test (2MWT), and timed chair stands). Analyses involved multivariable linear regression analyses stratified by age group. Results: 243 patients were recruited (147 younger and 96 older, 56% male). Attrition was greater in older adults due to death or disease progression/relapse. Among patients remaining in remission after IC, global QOL and fatigue improved significantly over time (p<0.001 for both); trends were similar between older and younger patients. All 5 QOL domains improved or remained stable over time; the greatest improvements were seen in social function and role function and were similar in both age groups. Grip strength increased slightly over time (p=0.04) whereas both timed chair stands (p<0.001) and the 2MWT (p<0.001) had moderate to large improvements, with trends toward greater improvement in younger patients (p=0.07 and 0.09, respectively). Results were similar when missing data were imputed. Conclusions: Survivors of AML after successful conventional chemotherapy achieve significant improvements in QOL, fatigue, and physical function over time. The course of recovery is remarkably similar in younger and older AML patients, although significant attrition in older adults is a noteworthy limitation. These data suggest that appropriately selected older patients do well following IC for AML.

The potential role of frailty in modifying quality-of-life related outcomes in metastatic castration-resistant prostate cancer (mCRPC) patients receiving docetaxel, abiraterone, enzalutamine, and radium 223.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 63-63
Author(s):  
Seungyeon Kim ◽  
Henriette Breunis ◽  
Narhari Timilshina ◽  
Helen Yang ◽  
Shabbir M.H. Alibhai
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Older Men ◽  
Frailty Status ◽  
Frail Patients ◽  
Radium 223 ◽  
Patient Reported ◽  
Decisional Regret ◽  
Over Time

63 Background: As the arsenal of therapeutic agents for mCRPC expands, frailty-informed care is emerging as a strategy for tailoring management decisions. Yet, data to guide this approach and to ascertain its impact on the mood, fatigue, pain, and quality of life (QoL) experienced by older men with mCRPC remain lacking. We examined patient-reported outcomes, stratified by a validated frailty index (FI), for mCRPC treatment with docetaxel chemotherapy (CHEMO), abiraterone (ABI), enzalutamide (ENZA), or radium 223 (RAD). Methods: Older (aged 65+) men starting one of four approved therapies for mCRPC were enrolled in a multicenter prospective cohort study. Assessing their mood, fatigue, pain, and QoL with PHQ-9, ESAS tiredness, ESAS pain, and FACT-G total as well as subscale scores, we used linear mixed effect models to determine change in each outcome over time (0, 3, 6 months). At end of treatment, we administered the Decisional Regret Scale. We then constructed a FI from 34 variables that span laboratory abnormalities, geriatric syndromes, instrumental activities of daily living, social support, as well as emotional, cognitive, and physical deficits. Following established cut-offs, we categorized patients as non-, pre-, and frail, then performed stratified linear mixed effects regression analyses to identify differences in outcomes by frailty status. Results: A total of 198 men (mean age 75.1) starting CHEMO (n = 70), ABI (n = 38), ENZA (n = 67), and RAD (n = 29) were included, of which 9.6%, 1.5%, 5.6%, and 2.5%, respectively, were determined frail. Frailty correlated only modestly with age (Pearson r = 0.27). Independent of frailty status, patients across treatment cohorts were similar in terms of baseline QoL-related measures, with the exceptions of mood (p = 0.033) and pain (p = 0.034). Over time, no significant change in QoL was reported, although all four therapies resulted in generally low levels of decisional regret and similar trends of improved pain but worsened mood (p = 0.006 and 0.02, respectively). At baseline, frailty status correlated with worse FACT-G total (p < 0.001) and functional well-being (p < 0.001), as well as worse depression scores (p < 0.001). According to FI-stratified analysis, frail patients experienced similar QoL-related outcomes to fit patients for all measures aside from mood (p < 0.001). Contrary to our hypotheses, frailty was not associated with significant worsening in emotional well-being or functional well-being in response to mCRPC treatment. Conclusions: Of the older men receiving care for mCRPC, frail patients may experience generally similar trends in QoL as fit patients. Interestingly, frailty status, rather than treatment modality, may play more of a contributory role to changes in QoL-related outcomes over time.

scholarly journals Loving Others: The Impact of Compassionate Love on Later-Life Psychological Well-being

2020 ◽  
Author(s):  
Eva Kahana ◽  
Tirth R Bhatta ◽  
Boaz Kahana ◽  
Nirmala Lekhak
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Later Life ◽  
Well Being ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Psychological Well Being ◽  
Compassionate Love ◽  
The Impact ◽  
Over Time

Abstract Objectives Existing scholarship in social gerontology has paid relatively little attention to broader loving emotions, such as compassionate and altruistic love, as potentially meaningful mechanisms for improving later-life psychological well-being outside a family framework. Method Drawing from a 3-wave longitudinal survey of community-dwelling older residents (n = 334) of Miami, Florida, we utilized generalized estimating equation models to examine the influence of changes in compassionate love (i.e., feeling love toward other persons and experiencing love from others) on depressive symptoms over time. We also explored cross-sectional relationship between compassionate love and positive and negative affects. Results An increase in the feeling of being loved (β = −0.77, p &lt; .001) and feeling love for others (β = −0.78, p &lt; .001) led to a decline in odds of reporting greater levels of depressive symptoms over time. The odds of reporting higher level of positive affect were significantly greater for older adults who reported feeling loved by others (β = .63, p &lt; .001) and expressed love for other people (β = 0.43, p &lt; .05). Older adults who felt loved and expressed love for other people, respectively, had 0.71 and 0.54-point lower ordered log odds of reporting higher negative affect than those who reported lower levels of love. The statistically significant impact of feeling loved on all well-being outcomes was maintained even after adjustment for altruistic attitudes and emotional support. Except for depressive symptoms, such adjustments explained the positive influence of love for others on well-being outcomes. Discussion Our findings underscore the powerful influence of both receiving and giving loving emotions for the maintenance of later-life psychological well-being.

scholarly journals The psychosocial benefits of providing non-kin childcare in older adults: A longitudinal study with older New Zealanders

2020 ◽  
Author(s):  
Á Szabó ◽  
Eva Neely ◽  
C Stephens
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Longitudinal Study ◽  
Well Being ◽  
Grandparental Childcare ◽  
Psychosocial Benefits ◽  
The Impact ◽  
Over Time ◽  
New Zealanders

© The Author(s) 2019. Community grandparenting may promote the well-being of older adults. We examined the impact of non-kin and grandparental childcare on quality of life and loneliness using longitudinal data from 2653 older New Zealanders collected over 2 years. Providing both non-kin and grandparental childcare predicted greater self-realisation for women only and was associated with reduced levels of control and autonomy for men. Non-kin childcare was also associated with reduced social loneliness over time independent of gender. Findings suggest that non-kin grandparenting has psychosocial benefits for older adults. Surrogate grandparenting offers promising avenues for those without grandchildren to experience the benefits of grandparenting.

scholarly journals OPERATIONALIZING THE FRAILTY INDEX BASED ON WEARABLE SENSOR TO ASSESS FUNCTIONAL PERFORMANCE IN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S680-S680
Author(s):  
Hung Nguyen ◽  
Jacqueline Yang ◽  
Mohsen Zahiri ◽  
Bijan Najafi
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Assessment Tool ◽  
Functional Performance ◽  
Frailty Index ◽  
Activity Level ◽  
Wearable Sensor ◽  
Frailty Status ◽  
Frailty Assessment ◽  
Flexion And Extension

Abstract Frailty status is a well-known predictor of adverse health outcomes and functional performance. An assessment tool based on a wearable sensor was developed to quickly assess frailty using an upper extremity flexion and extension test. However, the current tool has relied on conventional frailty assessment to classify the frailty status of the participant. The aim of this study is to operationalize the frailty index based on wearable sensor to classify frailty status of older adults. 104 older adults were recruited for the study (age=78.6 ±9.7 years old). Participants were asked to perform a quick 20-second upper flexion and extension task while wearing a gyroscope on the wrist. A sensor-based frailty index (FI) was derived using parameters extracted from the sensor. Participants were also assessed using the Fried Phenotype Criteria (FC) and were classified into three groups: robust, pre-frail, and frail. Mean-shift clustering algorithm was used to operationalize the FI by identifying the cut-off point for each group. Grip strength and physical activity level were used as functional outcome measures. Regression analysis (r) was used to compare the correlation of the FC and FI with the identified metrics. Bivariate analysis show that grip strength was highly associated with the sensor-based frailty classification (r=-0.547) and FC (r =-0.503). The sensor-based classification was significantly associated with walking activity (r=-0.355). The results showed that the sensor-based frailty assessment tool could be used to quickly classify frailty status in older adults and eliminated the need for subjective and time-consuming evaluation.

The impact of positive reappraisal on positive (and negative) emotion among older adults

2015 ◽  
Vol 28 (4) ◽  
pp. 681-693 ◽  
Author(s):  
Jamie S. Nowlan ◽  
Viviana M. Wuthrich ◽  
Ronald M. Rapee
Keyword(s):  
Older Adults ◽  
Positive Emotion ◽  
Negative Emotion ◽  
Well Being ◽  
Anxiety And Depression ◽  
Positive Reappraisal ◽  
Life Event ◽  
Adverse Life Event ◽  
The Impact ◽  
Over Time

ABSTRACTBackground:Positive reappraisal is an important cognitive strategy for older adults associated with wide-ranging improvements in psychological well-being. However, little is known about the relationship between positive reappraisal and positive and negative emotion, anxiety and depression, and whether positive reappraisal is associated with continued increases in positive emotion over time.Methods:In the first study, 61 participants aged 62 to 88 years (M = 72, SD = 5.8) completed current measures of cognitive emotion regulation, positive emotion, negative emotion, anxiety and depression regarding their most distressing aging-related adverse life event, and rated (retrospectively) positive reappraisal use at the time of the stressor. Utilizing a longitudinal design, in a second study 60 participants aged 62 to 88 years (M = 71.2, SD = 5.7) completed the same measures for a recent adverse life event and repeated the measures 3 and 6 months later.Results:In the first study, positive reappraisal reported for both time periods was significantly correlated with current positive emotion, but not negative emotion with mixed findings for anxiety and depression, and positive reappraisal use increased with time since stressor onset. In the second study, positive reappraisal was significantly correlated with positive emotion and significantly predicted positive emotion from 3-month to 6-month follow-up, and was related to anxiety and depression but not general negative emotion.Conclusions:These findings indicate that positive reappraisal is related to positive emotion but not consistently with negative emotion, and continues to be beneficial over time in older adults who have experienced a stressor.

The psychosocial benefits of providing non-kin childcare in older adults: A longitudinal study with older New Zealanders

2019 ◽  
pp. 135910531989301
Author(s):  
Ágnes Szabó ◽  
Eva Neely ◽  
Christine Stephens
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Longitudinal Study ◽  
Well Being ◽  
Grandparental Childcare ◽  
Psychosocial Benefits ◽  
The Impact ◽  
Over Time ◽  
New Zealanders

Community grandparenting may promote the well-being of older adults. We examined the impact of non-kin and grandparental childcare on quality of life and loneliness using longitudinal data from 2653 older New Zealanders collected over 2 years. Providing both non-kin and grandparental childcare predicted greater self-realisation for women only and was associated with reduced levels of control and autonomy for men. Non-kin childcare was also associated with reduced social loneliness over time independent of gender. Findings suggest that non-kin grandparenting has psychosocial benefits for older adults. Surrogate grandparenting offers promising avenues for those without grandchildren to experience the benefits of grandparenting.

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