scholarly journals Complexity of care of hospitalized older adults and its relationship with sociodemographic characteristics and functional independence

2019 ◽  
Vol 22 (6) ◽  
Author(s):  
Beatriz Aparecida Ozello Gutierrez ◽  
Henrique Salmazo da Silva ◽  
Rosa Yuka Sato Chubaci ◽  
Caroline Ribeiro Borja-Oliveira
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Daily Living ◽  
Functional Independence ◽  
Sao Paulo ◽  
São Paulo ◽  
Term Care ◽  
Female Sex ◽  
Hospitalized Older Adults

Abstract Objectives: To investigate the relationship between the complexity of care of hospitalized older adults and sociodemographic and functional independence characteristics. Method: A quantitative cross-sectional and descriptive study was carried out in the medical and surgical clinics of the University Hospital of the Universidade de São Paulo, in the state of São Paulo SP, Brazil. A total of 382 older adults were assessed through a socio-demographic inventory, the Mini Mental State Exam, the Katz Index of Independence in Activities of Daily Living and the Interdisciplinary Medicine Instrument Method. Results: The complexity of care of participants was associated with the female sex (p=0.003), not having a partner (p=0.003), having a lower income (p=0.022), cognitive decline (p<0.001) and dependence in basic activities of daily living (BADL) (p<0.001). In the multiple logistic regression model, variables such as the female sex (OR=1.76; p=0.018), dependence in one or more activities of daily living (OR=1.26; p<0.001) and cognitive decline (OR=3.31; p<0.001) remained associated with complexity of care. Conclusion: The complexity of care of hospitalized older adults, as it is associated with limitations in BADL and cognitive decline, requires actions by the interprofessional team to ensure the rehabilitation, integration of long-term care and planning of care resources for older patients. Thus, it is necessary to adopt integrated services that include home care and care networks for the elderly, in order to provide qualified post-hospital discharge care and promote the health of the hospitalized older population.

ASSESSMENT OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING IN OLDER ADULTS WITH SUBJECTIVE COGNITIVE DECLINE USING THE VIRTUAL REALITY FUNCTIONAL CAPACITY ASSESSMENT TOOL (VRFCAT)

2018 ◽  
pp. 1-9
Author(s):  
A.S. Atkins1 ◽  
A. Khan ◽  
D. Ulshen ◽  
A. Vaughan ◽  
D. Balentin ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Functional Capacity ◽  
Daily Living ◽  
Assessment Tool ◽  
Subjective Cognitive Decline ◽  
Capacity Assessment ◽  
Instrumental Activities

Background: Continuing advances in the understanding of Alzheimer’s disease progression have inspired development of disease-modifying therapeutics intended for use in preclinical populations. However, identification of clinically meaningful cognitive and functional outcomes for individuals who are, by definition, asymptomatic remains a significant challenge. Clinical trials for prevention and early intervention require measures with increased sensitivity to subtle deficits in instrumental activities of daily living (IADL) that comprise the first functional declines in prodromal disease. Validation of potential endpoints is required to ensure measure sensitivity and reliability in the populations of interest. Objectives: The present research validates use of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) for performance-based assessment of IADL functioning in older adults (age 55+) with subjective cognitive decline. Design: Cross-sectional validation study. Setting: All participants were evaluated on-site at NeuroCog Trials, Durham, NC, USA. Participants: Participants included 245 healthy younger adults ages 20-54 (131 female), 247 healthy older adults ages 55-91 (151 female) and 61 older adults with subjective cognitive decline (SCD) ages 56-97 (45 female). Measures: Virtual Reality Functional Capacity Assessment Tool; Brief Assessment of Cognition App; Alzheimer’s Disease Cooperative Study Prevention Instrument Project – Mail-In Cognitive Function Screening Instrument; Alzheimer’s Disease Cooperative Study Instrumental Activities of Daily Living – Prevention Instrument, University of California, San Diego Performance-Based Skills Assessment – Validation of Intermediate Measures; Montreal Cognitive Assessment; Trail Making Test- Part B. Results: Participants with SCD performed significantly worse than age-matched normative controls on all VRFCAT endpoints, including total completion time, errors and forced progressions (p≤0001 for all, after Bonferonni correction). Consistent with prior findings, both groups performed significantly worse than healthy younger adults (age 20-54). Participants with SCD also performed significantly worse than controls on objective cognitive measures. VRFCAT performance was strongly correlated with cognitive performance. In the SCD group, VRFCAT performance was strongly correlated with cognitive performance across nearly all tests with significant correlation coefficients ranging from 0.3 to 0.7; VRFCAT summary measures all had correlations greater than r=0.5 with MoCA performance and BAC App Verbal Memory (p<0.01 for all). Conclusions: Findings suggest the VRFCAT provides a sensitive tool for evaluation of IADL functioning in individuals with subjective cognitive decline. Strong correlations with cognition across groups suggest the VRFCAT may be uniquely suited for clinical trials in preclinical AD, as well as longitudinal investigations of the relationship between cognition and function.

scholarly journals Examining Consequences Related to Unmet Care Needs Across the Long-Term Care Continuum

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 90-90
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie Robert
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Residential Care ◽  
Informal Care ◽  
Daily Living ◽  
Long Term Care ◽  
Community Care ◽  
Term Care ◽  
Care Arrangement

Abstract At some point in our lives, approximately 70% of us will need support to help with daily care. Without adequate assistance we may experience unmet care need consequences (UCNC) – such as skipping meals, going without clean clothes, or taking the wrong medication. This study examines the likelihood of experiencing UCNC related to gaps in assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) across long-term care arrangements: informal community care, paid community care, residential care, and nursing homes. We examine a sample of older adults receiving assistance in a care arrangement (N=2,499) from the nationally representative 2015 National Health and Aging Trends Study. Cross-sectional and longitudinal regression models, adjusting for differences in demographic and health/functioning characteristics, examine if type of care arrangement in 2015 is associated with UCNC in 2015 and change in UCNC by 2017. Holding all else constant, there were no significant differences in UCNC related to ADLs in 2015 across care arrangements. However, those receiving paid community care were more likely to experience UCNC related to IADLs (going without clean clothes, groceries, or a hot meal and making medication errors) compared to those receiving only informal care (OR=1.64, p&lt;.05) or residential care (OR=2.19, p&lt;.01). By 2017, paid care was also significantly associated with continued UCNC, but older adults in informal care arrangements were most likely to experience a new UCNC. Results suggest improving/expanding assistance with IADLs among community-dwelling older adults, and promoting equitable access to residential care, to reduce UCNC.

scholarly journals IS THERE A RELATIONSHIP BETWEEN PAIN AND FEAR OF FALLING IN OLDER ADULTS LIVING IN LONG-TERM CARE FACILITIES?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S718-S719
Author(s):  
Edgar R Vieira ◽  
Diego Tavares ◽  
Particia Nobrega ◽  
Alvaro Maciel
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Long Term Care ◽  
Fear Of Falling ◽  
Term Care ◽  
Assessment Scores ◽  
Care Facilities ◽  
Geriatric Pain

Abstract Fear of falling is common in older adults and it is associated with multiple factors such as gait and balance issues, difficulties in activities of daily living, visual impairment, and frailty. Unfortunately, fear of falls increases the risk of falls as opposed to protect from falls. Pain can impair mobility, affects activities of daily living, and may also be associated with fear of falling but no studies have evaluated this potential association. The objectives of this study were to evaluate if there was an association between pain and fear of falling in older adults living in long-term care facilities. One hundred and eight older adults living in long-term care facilities participated in the study. The mean age was 79±7 years, and 65% of the participants were women. The participants completed the Geriatric Pain Measure (GPM) questionnaire for multidimensional pain assessment (scores range from 0 to 42), and the Falls Efficacy Scale International (FES-I) for fear of falling assessment (scores range from 16 to 64). The data was analyzed using multiple linear regression. Forty-five percent of the participants had chronic pain (≥3 months) and 18% had acute pain (&lt;3 months). Pain scores were 29±31. Pain was associated with an increase of 3 to 7 points (out of 64 max) in the FES-I. The prevalence of pain in long-term care residents was high, and pain was associated with increased fear of falling.

Naturally Occurring Expressive Suppression is Associated with Lapses in Instrumental Activities of Daily Living Among Community-Dwelling Older Adults

2019 ◽  
Vol 25 (7) ◽  
pp. 718-728 ◽  
Author(s):  
Yana Suchy ◽  
Madison A. Niermeyer ◽  
Emilie I. Franchow ◽  
Rosemary E. Ziemnik
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Independence ◽  
Community Dwelling ◽  
Self Report ◽  
Expressive Suppression ◽  
Instrumental Activities ◽  
Lower Accuracy ◽  
Community Dwelling Older Adults

AbstractObjectives: Expressive suppression (i.e., effortful regulation of overt affect) has a deleterious impact on executive functioning (EF). This relationship has potential ramifications for daily functioning, especially among older adults, because a close relationship exists between EF and functional independence. However, past research has not directly examined whether expressive suppression impacts instrumental activities of daily living (IADL). The present study examined this association among older adults. Methods: One hundred ten community-dwelling older adults completed a self-report measure of acute (past 24 hr) and chronic (past 2 weeks) expressive suppression, a timed test of IADL, and the Behavioral Dyscontrol Scale as a measure of EF. Results: High chronic expressive suppression was related to slow IADL performance beyond covariates (age, IQ, depression), but only for individuals with low EF. High acute expressive suppression was associated with lower accuracy on IADL tasks beyond covariates (IQ, depression), but this association was fully explained by EF. Conclusions: The current results suggest that expressive suppression is associated with less efficient and more error-prone IADL performance. EF fully accounted for the relationship between acute expressive suppression and IADL performance, showing that suppression is a risk factor for both poorer EF performance and functional lapses in daily life. Furthermore, individuals with weaker EF may be particularly vulnerable to the effect of chronic expressive suppression. (JINS, 2019, 25, 718–728)

scholarly journals Validating a test battery of activities of daily living for physically independent elderly

1999 ◽  
Vol 13 (1) ◽  
pp. 46 ◽  
Author(s):  
Rosana Aparecida Andreotti ◽  
Silene Sumire Okuma
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Sao Paulo ◽  
Test Battery ◽  
São Paulo ◽  
Independent Elderly

Dados de pesquisas mostram que 25% da população idosa mundial é dependente de outros para realizar suas tarefas cotidianas. Entretanto, a grande maioria, apesar de apresentar alguma dificuldade na realização dessas atividades, é independente. Não obstante esses dados, continuam a predominar medidas de avaliação voltadas para a população fisicamente dependente ou fragilizada, dificultando a análise e compreensão do desempenho motor e das atividades da vida diária (AVD) da maioria dos idosos, que não são fisicamente dependentes. Assim, o objetivo desse estudo foi criar e validar uma bateria de testes motores relacionados às AVD, voltados para a população fisicamente independente. Participaram da validação da bateria de testes 30 idosos fisicamente independentes, com idade média de 68,7 anos, participantes do PAAF (Programa Autonomia para Atividade Física), da Escola de Educação Física e Esporte da Universidade de São Paulo. Levando em consideração as atividades mais freqüentemente desempenhadas por esses idosos, em seu dia-a-dia, bem como as de maior dificuldade de realização, foi elaborada uma bateria de testes com as atividades: caminhar 800 metros, sentar e levantar-se de uma cadeira e locomover-se pela casa, subir degraus, subir escadas, levantar-se do solo, habilidades manuais e calçar meias. Os resultados apontaram que os testes criados nesse estudo têm descrição clara, relacionam-se com AVD e possuem aplicabilidade, o que corrobora a validade de seu conteúdo. Além disso, todos eles mostraram alto grau de objetividade e fidedignidade, respectivamente: caminhar 800 metros (r = 0,99; r = 0,97); sentar e levantar-se da cadeira e locomover-se pela casa (r = 0,99; r = 0,96); subir degraus (r = 1,00; r = 0,94); subir escadas (r = 0,98; r = 0,92); habilidades manuais (r = 0,97; r = 0,74); calçar meias (r = 0,99; r = 0,87). Testes relacionados à capacidade funcional de idosos fisicamente independentes devem enfocar as atividades de locomoção

scholarly journals An investigation and analysis of the activities of daily living of older adults living at home in Ningxia Hui Autonomous Region of China: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaofeng Xu ◽  
Lina Yang ◽  
Xiaohui Miao ◽  
Xiuying Hu
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Low Income ◽  
Daily Living ◽  
Minority Population ◽  
Term Care ◽  
Autonomous Region ◽  
Ningxia Hui Autonomous Region ◽  
Adl Performance ◽  
At Home

Abstract Background To investigate the current situation regarding the activities of daily living (ADL) of older adults living at home in Ningxia Hui Autonomous Region of China and to analyze the associated factors of ADL performance so that we can provide references for the implementation of pension policies and long-term care insurance of older adults living at home. Methods We surveyed a total of 1040 older adults who live at home and receive home-based care in Ningxia Hui Autonomous Region by a face-to-face evaluation. A logistic regression model was used to analyze the factors associated with ADL performance. Results In the study, 82.79% of the older adults living at home can live independently. A total of 11.92% of the older adults have mild dysfunction, 4.33% have moderate dysfunction, and 0.96% have severe dysfunction. Multiple logistic analyses indicated that older adults with very difficult economic conditions (OR 3.212; 95% CI(1.209–8.534)) and without a spouse (OR 1.616; 95% CI(1.098–2.377)) were significantly associated with ADL limitations. In addition, the risks of ADL limitations in older adults aged 60–69 years and 70–79 years were 0.187 and 0.4307 times, respectively, that of older adults over 80 years old. The risk of ADL limitations in older adults of the Han nationality was 0.605 times that of the minority population. More highly educated and older adults without diseases have a lower risk of ADL limitations. Conclusions Compared with the national average in China, the number of ADL limitations of older adults in Ningxia is greater and is associated with advanced age, ethnic minority status, low education level, low income, lacking a spouse and having diseases. As the number of older adults increases, maintaining and improving their ability to perform ADL and providing comfortable pension services and health services urgently need to be solved.

scholarly journals Population with Long-Term Care Needs in Six Latin American Countries: Estimation of Older Adults Who Need Help Performing ADLs

2021 ◽  
Vol 18 (15) ◽  
pp. 7935
Author(s):  
Mauricio Matus-Lopez ◽  
Alexander Chaverri-Carvajal
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Latin American ◽  
Daily Living ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Latin American Countries

The population in Latin America is ageing, and there is an inevitable demand for long-term care services. However, there are no comparative analyses between Latin American countries of the dependency situation of older adults. This study aims to calculate and compare percentages of older adults who need help performing the activities of daily living in six Latin American nations. The study is observational, transversal, and cross-national and uses microdata drawn from national surveys conducted in Argentina (n = 3291), Brazil (n = 3903), Chile (n = 31,667), Colombia (n = 17,134), Mexico (n = 7909), and Uruguay (n = 4042). Comparable indicators of the need for help in performing the basic and instrumental activities of daily living were calculated. The percentages of older adults in need of help for basic activities of daily living ranged from 5.8% in Argentina to 11% in Brazil; for instrumental activities of daily living, from 13.8% in Mexico to 35.7% in Brazil; and combined, from 18.1% in Argentina to 37.1% in Brazil. Brazil thus has the highest indicators, followed by Colombia. The results warn of the frail physical condition of older people and the high potential demand for long-term care services. The information provided could be useful for further research on and planning for long-term care needs in Latin American and middle-income countries.

Sign in / Sign up

Export Citation Format

Share Document