scholarly journals Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial

2019 ◽  
Author(s):  
Lynne Taylor ◽  
John Parsons ◽  
Denise Taylor ◽  
Elizabeth Binns ◽  
Sue Lord ◽  
...  
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Cost Effectiveness ◽  
Long Term Care ◽  
Controlled Trial ◽  
Exercise Program ◽  
Community Dwelling ◽  
Control Group ◽  
Term Care

Abstract BackgroundFalls are two to four times more frequent amongst long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesized that a progressive exercise program targeting balance and strength will reduce falls rates when compared to a seated exercise program and do so cost effectively.Methods/DesignThis is a single blind, parallel-group, randomized controlled trial with blinded assessment of outcome and intention-to-treat analysis. LTC residents (age ≥65 years) will be recruited from LTC facilities in New Zealand. Participants (n= 528 total; with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable to people with dementia, (intervention group) or a seated exercise program (control group). The intervention and control group classes will be delivered for 1 hour twice weekly over 1 year. The primary outcome is rate of falls (per 1000 person years) within the intervention period.Secondary outcomes will be risk of falling (the proportion of fallers per group), falls rate relative to activity exposure, hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and change in physical performance assessed at baseline, 6 and 12 months. Cost effectiveness will be examined using intervention and health service costs. The trial commenced recruitment on 31 November 2018.DiscussionThis study evaluates the efficacy and cost effectiveness of a progressive strength and balance exercise program for aged-care residents to reduce falls. The outcomes will aid development of evidenced-based exercise programs for this vulnerable population.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12618001827224. Registered on November 9 2018; Universal trial number U1111-1217-7148

scholarly journals Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial

2019 ◽  
Author(s):  
Lynne Taylor ◽  
John Parsons ◽  
Denise Taylor ◽  
Elizabeth Binns ◽  
Sue Lord ◽  
...  
Keyword(s):  
Older Adults ◽  
Cost Effectiveness ◽  
Long Term Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Community Dwelling ◽  
Control Group ◽  
Term Care

Abstract Background Falls are two to four times more frequent amongst long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesized that a progressive exercise program targeting balance and strength will reduce falls rates when compared to a seated exercise program and do so cost effectively. Methods/Design This is a single blind, parallel-group, randomized controlled trial with blinded assessment of outcome and intention-to-treat analysis. LTC residents (age ≥65 years) will be recruited from LTC facilities in New Zealand. Participants (n= 528 total; with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable to people with dementia, (intervention group) or a seated exercise program (control group). The intervention and control group classes will be delivered for 1 hour twice weekly over 1 year. The primary outcome is rate of falls (per 1000 person years) within the intervention period. Secondary outcomes will be risk of falling (the proportion of fallers per group), falls rate relative to activity exposure, hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and change in physical performance assessed at baseline, 6 and 12 months. Cost effectiveness will be examined using intervention and health service costs. The trial commenced recruitment on 31 November 2018. Discussion This study evaluates the efficacy and cost effectiveness of a progressive strength and balance exercise program for aged-care residents to reduce falls. The outcomes will aid development of evidenced-based exercise programs for this vulnerable population.

scholarly journals Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Lynne Taylor ◽  
John Parsons ◽  
Denise Taylor ◽  
Elizabeth Binns ◽  
Sue Lord ◽  
...  
Keyword(s):  
Older Adults ◽  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Long Term Care ◽  
Controlled Trial ◽  
Exercise Program ◽  
Control Group ◽  
Term Care ◽  
Randomised Controlled

Abstract Background Falls are two to four times more frequent amongst older adults living in long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesised that a progressive exercise program targeting balance and strength will reduce fall rates when compared to a seated exercise program and do so cost effectively. Methods/design This is a single blind, parallel-group, randomised controlled trial with blinded assessment of outcome and intention-to-treat analysis. LTC residents (age ≥ 65 years) will be recruited from LTC facilities in New Zealand. Participants (n = 528 total, with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable to people with dementia (intervention group), or a seated exercise program (control group). The intervention and control group classes will be delivered for 1 h twice weekly over 1 year. The primary outcome is rate of falls (per 1000 person years) within the intervention period. Secondary outcomes will be risk of falling (the proportion of fallers per group), fall rate relative to activity exposure, hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and change in physical performance assessed at baseline and after 6 and 12 months. Cost-effectiveness will be examined using intervention and health service costs. The trial commenced recruitment on 30 November 2018. Discussion This study evaluates the efficacy and cost-effectiveness of a progressive strength and balance exercise program for aged care residents to reduce falls. The outcomes will aid development of evidenced-based exercise programmes for this vulnerable population. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618001827224. Registered on 9 November 2018. Universal trial number U1111-1217-7148.

scholarly journals Effects of a 12-Week Exercise Training Program on Physical Function in Institutionalized Frail Elderly

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Cristiane Batisti Ferreira ◽  
Pâmela dos Santos Teixeira ◽  
Geiane Alves dos Santos ◽  
Athila Teles Dantas Maya ◽  
Paula Americano do Brasil ◽  
...  
Keyword(s):  
Exercise Training ◽  
Frail Elderly ◽  
Long Term Care ◽  
Controlled Trial ◽  
Exercise Program ◽  
Care Facility ◽  
Control Group ◽  
Anthropometric Parameters ◽  
Term Care

With the increase in life expectancy, the Brazilian elderly population has risen considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, frailty syndrome, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. This randomized controlled trial aimed to verify the effects of exercise training on biochemical, inflammatory, and anthropometric indices and functional performance in institutionalized frail elderly. The sample consisted of 37 elderly people of both genders, aged 76.1 ± 7.7 years, who were randomly allocated into 2 groups: 13 individuals in the exercise group (EG) and 24 in the control group (CG). Anthropometrics, clinical history, functional tests, and biochemical evaluation were measured before and after the completion of a physical exercise program, which lasted for 12 weeks. The 12-week exercise program for frail elderly residents in a long-term care facility was efficient in improving muscle strength, speed, agility, and biochemical variables, with reversal of the frailty condition in a considerable number. However, no effects in anthropometric and inflammatory parameters were noted.

Determinants of long-term care insurance applications in South Korea

2020 ◽  
Author(s):  
Sunhee Park ◽  
Heejung Kim ◽  
Chang Gi Park
Keyword(s):  
Older Adults ◽  
South Korea ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Term Care ◽  
Factors Affecting ◽  
Long Term Care Insurance ◽  
The Government

Abstract Background South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Methods Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N = 523). Data were analyzed using multilevel modeling. Results Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one’s community. Conclusions Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers.

scholarly journals EAST MEETS WEST: IMPROVING HEALTH AND LONG-TERM CARE FOR OLDER ADULTS IN THE U.S. AND CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S243-S244
Author(s):  
Bei Wu ◽  
Jie Hua Lu
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Long Term Care ◽  
Panel Discussion ◽  
Community Dwelling ◽  
Term Care ◽  
Spousal Caregiving ◽  
Pragmatic Clinical Trials ◽  
The U.S

Abstract As the number of older adults in the U.S. and China continues to increase, promoting healthy aging is essential for individuals, family, and society. Both countries face many similar issues due to their aging populations, including prolonging healthy life expectancy and providing quality of care. However, the change in demographics brings with it unique challenges for both the U.S and China. This forum invites scholars and researchers from these two countries to share their knowledge and insights on promoting healthy aging and improving care for older adults. This forum includes five presentations and one-panel discussion. Two presentations will focus on long-term care (LTC) in China, one is to forecast the needs of LTC in the next five decades, and the other is to evaluate the current LTC needs and discuss LTC policy. Using the data from the Health and Retirement Study, the third presentation aims to re-conceptualize spousal caregiving as a dyad-level phenomenon and provides a dynamic view of the spousal caregiving experiences. The last two presentations will focus on promoting healthy aging through clinical interventions. The fourth one is to evaluate the effectiveness of adaptive computer-based cognitive training among community-dwelling older adults in China. The last presentation provides some examples of using pragmatic clinical trials to improve the care of older adults in skilled nursing facilities in the U.S. After the five presentations, the three panelists will provide feedback to the presentations and share their views on healthy aging with the audience.

Reminiscence intervention for community-dwelling older adults without dementia: a literature review

2020 ◽  
Vol 25 (1) ◽  
pp. 40-44 ◽  
Author(s):  
Michele Shropshire
Keyword(s):  
Older Adults ◽  
Literature Review ◽  
Cognitive Abilities ◽  
Social Engagement ◽  
Cognitive Skills ◽  
Long Term Care ◽  
Community Dwelling ◽  
Positive Health ◽  
Term Care

The aim of the present integrative literature review is to summarise empirical evidence supporting the positive health benefits of reminiscence intervention for older adults without dementia who reside in community and long-term care settings. Reminiscence intervention may be used to improve cognitive ability in older adults by prompting them to share life stories and recall past events. Using Garrard's matrix method, 15 studies were identified and included in this review, with a total of 815 participants. The health outcomes of reminiscence intervention for older adults residing in the community and long-term care settings were improvements in depressive symptoms; greater wellbeing, peace and life satisfaction; and improvements in quality of life, social engagement, anxiety and cognitive skills/memory. Non-pharmacological approaches such as reminiscence intervention may contribute to a rich base for reformulating cognitive interpretations, increasing cognitive abilities, and improving social skills among older adults.

scholarly journals Clinical features and risk factors for mortality among long-term care facility residents hospitalized due to COVID-19 in Spain

2021 ◽  
Author(s):  
José-Manuel Ramos-Rincón ◽  
Máximo Bernabeu-Whittel ◽  
Isabel Fiteni-Mera ◽  
Almudena López-Sampalo ◽  
Carmen López-Ríos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Long Term Care ◽  
Functional Dependence ◽  
Care Facility ◽  
Community Dwelling ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Abstract Background COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. Methods This is a cross-sectional analysis within a retrospective cohort of hospitalized patients≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. Results Of 6,189 patients≥75 years, 1,185 (19.1%) were LTCF residents and 4,548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs. 82.1 years), mostly female (61.6% vs. 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs. 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p<.001). Mortality risk factors in LTCF residents were severe functional dependence (aOR:1.79;95%CI:1.13-2.83;p=.012), dyspnea (1.66;1.16-2.39;p=.004), SatO2<94% (1.73;1.27-2.37;p=.001), temperature≥37.8ºC (1.62;1.11-2.38; p=.013); qSOFA index≥2 (1.62;1.11-2.38;p=.013), bilateral infiltrates (1.98;1.24-2.98;p<.001), and high C-reactive protein (1.005;1.003-1.007;p<.001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR:0.74,95%CI:0.62-0.87;p<.001). Conclusion Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.

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