Long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors—Impact of cognitive dysfunction, emotional problems and fatigue

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.

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1055 THE IMPACT OF SHORT SLEEP DURATION ON INSTRUMENTAL ACTIVITIES OF DAILY LIVING (IADL) AMONG STROKE SURVIVORS

SLEEP ◽

10.1093/sleepj/zsx050.1054 ◽

2017 ◽

Vol 40 (suppl_1) ◽

pp. A392-A392

Author(s):

D Chung ◽

A Seixas ◽

SL Richards ◽

G Casimir ◽

E Auguste ◽

...

Keyword(s):

Activities Of Daily Living ◽

Sleep Duration ◽

Daily Living ◽

Stroke Survivors ◽

Short Sleep Duration ◽

Short Sleep ◽

Instrumental Activities ◽

The Impact

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The impact of short and long sleep duration on instrumental activities of daily living among stroke survivors

Neuropsychiatric Disease and Treatment ◽

10.2147/ndt.s177527 ◽

2019 ◽

Vol Volume 15 ◽

pp. 177-182 ◽

Cited By ~ 2

Author(s):

Azizi A. Seixas ◽

Debbie P. Chung ◽

Shannique L. Richards ◽

Shreya Madhavaram ◽

Preeti Raghavan ◽

...

Keyword(s):

Activities Of Daily Living ◽

Sleep Duration ◽

Daily Living ◽

Stroke Survivors ◽

Instrumental Activities ◽

Long Sleep ◽

The Impact

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Effect of Instrumental Activities of Daily Living habituation due to routinising therapy in patients with frontotemporal dementia

BMJ Case Reports ◽

10.1136/bcr-2020-240167 ◽

2021 ◽

Vol 14 (2) ◽

pp. e240167

Author(s):

Kosuke Nakanishi ◽

Takayoshi Yamaga

Keyword(s):

Activities Of Daily Living ◽

Frontotemporal Dementia ◽

Daily Living ◽

Long Term Care ◽

Care Staff ◽

Term Care ◽

Household Chores ◽

Care Burden ◽

Instrumental Activities

We examined whether Instrumental Activities of Daily Living (IADL) improves with routinising therapy for a patient with frontotemporal dementia (FTD) living in a group home. The patient exhibited symptoms of agitation, apathy, disinhibition, irritability and stereotyped behaviour. The care staff experienced long-term care burden and the patient was spending time idly. An occupational therapist, in collaboration with care staff, evaluated the patient and routinised the household chores included in IADL. Consequently, a routine of household chores was established, reducing behavioural and psychological symptoms of dementia and long-term care burden, and the quality of life (QOL) of the patient improved. The results suggested that routinising IADL of the patient with FTD reduced long-term care burden and improved QOL of the patient.

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Memorial Sloan Kettering-Frailty Index (MSK-FI): Validation and its relationship with postoperative outcomes of older survivors of cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.34_suppl.172 ◽

2018 ◽

Vol 36 (34_suppl) ◽

pp. 172-172

Author(s):

Armin Shahrokni ◽

Amy Tin ◽

Koshy Alexander ◽

Saman Sarraf ◽

Anoushka Afonso ◽

...

Keyword(s):

Activities Of Daily Living ◽

Cancer Patients ◽

Daily Living ◽

Frailty Index ◽

Postoperative Outcomes ◽

Care Process ◽

Icu Admission ◽

Frail Patients ◽

Instrumental Activities

172 Background: Older cancer patients are at higher risk for poor postoperative outcomes. We tested the validity and utility of Memorial Sloan Kettering-Frailty Index (MSK-FI) in this setting. Methods: In a single institution, prospective cohort study, patients age 75+ received comprehensive geriatric assessment (CGA) by the Geriatrics service during preoperative evaluation. The MSK-FI was developed based on the modified Frailty Index, incorporating 10 comorbid conditions and one item related to basic and instrumental activities of daily living. With the total score ranging from 0 to 11, a score of ≥ 3 was considered frail. We validated the MSK-FI against the CGA, and assessed the relationship between MSK-FI frailty with short term (hospital length of stay (LOS), intensive care unit (ICU) admission) and long-term (overall survival) postoperative outcomes utilizing multivariable linear, logistic, and cox regression models, adjusting for age, duration of surgery, American Society of Anesthesiologists physical status classification, and preoperative albumin level. Results: In total, 1,137 cancer patients (median age 80) were included in the study. The prevalence of frailty based on MSK-FI was 41%. Frail patients were more likely to have poor Karnofsky Performance Status (56% vs. 29%), be dependent in basic and instrumental activities of daily living (72% vs. 40% and 64% vs. 34%), experienced a fall in the past year (30% vs. 18%), have slower gait speed (49% vs. 22%),be depressed (66% vs. 49%), have limited social activity (62% vs. 43%), take ≥ 5 medications (63% vs. 25%), experienced significant weight loss (24% vs. 16%), and suffer from polycomorbid conditions (87% vs. 26%). Frailty was associated with longer LOS in the hospital (1.9 days, p <0.0001) and higher odds of ICU admission (OR = 2.34, p = 0.005). With the median follow up of 12.1 months for survivors, frail patients were at higher risk for overall mortality (HR = 1.67, p < 0.001). Conclusions: MSK-FI is a valid instrument in predicting short and long-term postoperative outcomes of older adults with cancer. Future studies should assess the impact of administering MSK-FI on surgical decision-making, postoperative health care process, and outcomes.

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