scholarly journals Declining Cognition and Falls: Role of Risky Performance of Everyday Mobility Activities

2014 ◽  
Vol 94 (3) ◽  
pp. 355-362 ◽  
Author(s):  
Barbara L. Fischer ◽  
Carey E. Gleason ◽  
Ronald E. Gangnon ◽  
Jodi Janczewski ◽  
Terry Shea ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Clinical Judgment ◽  
Physical Therapists ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Prospective Data ◽  
Community Dwelling Older Adults ◽  
The Relationship

Background Declining cognition is a risk factor for falls among older adults. The extent to which impaired judgment in performance of daily activities increases fall risk is unclear. Objective The aim of this study was to determine whether engagement in mobility activities in a risky manner explains the association between declining cognition and rate of falls. Design This study was a secondary analysis of baseline and prospective data from older adults enrolled in the intervention arm of a randomized clinical trial. Methods Two hundred forty-five community-dwelling older adults (79% female; mean age=79 years, SD=8.0) who were at risk for falls received physical, cognitive, and functional evaluations. Cognition was assessed with the Short Portable Mental Status Questionnaire (SPMSQ). Using interview and in-home assessment data, physical therapists determined whether participants were at risk for falls when performing mobility-related activities of daily living (ADL) and instrumental ADL (IADL). Falls were measured prospectively for 1 year using monthly falls diaries. Results Declining cognition was associated with increased number of mobility activities designated as risky (1.5% of mobility activities performed in a risky manner per SPMSQ point) and with increased rate of falls (rate ratio=1.16 for each unit change in SPMSQ score). Risky performance of mobility activities mediated the relationship between cognition and rate of falls. Limitations Risk assessment was based on the clinical judgment of experienced physical therapists. Cognition was measured with a relatively insensitive instrument, and only selected mobility activities were evaluated. Conclusions Engagement in mobility ADL and IADL tasks in a risky manner emerged as a link between declining cognition and increased number of falls, suggesting a mechanism through which the rate of falls may increase. Specifically, declining cognition is associated with performance of mobility activities in an unsafe manner, thereby increasing the risk for falls.

scholarly journals The Effect Of Insomnia On Functional Status Of Community-Dwelling Older Adults

2021 ◽  
Author(s):  
Penney H. Deratnay
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
Secondary Data ◽  
Community Dwelling ◽  
Psychological Function ◽  
Moderate Severity ◽  
Mediating Role ◽  
Community Dwelling Older Adults ◽  
The Relationship

This secondary data analysis examined the extent to which fatigue mediates the relationship between insomnia and the physical, social, and psychological domains of functional status in community-dwelling older adults. Data were obtained from 209 older adults with insomnia. Regression analysis was used to test the proposed mediating role of fatigue. Findings identified insomnia of moderate severity in community-dwelling older adults. Insomnia was directly associated with social function and indirectly associated with physical and psychological function. Fatigue mediated the relationship between insomnia and all three domains of functional status. The findings highlight the importance of successfully managing insomnia and fatigue to promote functioning in older adults.

scholarly journals The Effect Of Insomnia On Functional Status Of Community-Dwelling Older Adults

2021 ◽  
Author(s):  
Penney H. Deratnay
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
Secondary Data ◽  
Community Dwelling ◽  
Psychological Function ◽  
Moderate Severity ◽  
Mediating Role ◽  
Community Dwelling Older Adults ◽  
The Relationship

This secondary data analysis examined the extent to which fatigue mediates the relationship between insomnia and the physical, social, and psychological domains of functional status in community-dwelling older adults. Data were obtained from 209 older adults with insomnia. Regression analysis was used to test the proposed mediating role of fatigue. Findings identified insomnia of moderate severity in community-dwelling older adults. Insomnia was directly associated with social function and indirectly associated with physical and psychological function. Fatigue mediated the relationship between insomnia and all three domains of functional status. The findings highlight the importance of successfully managing insomnia and fatigue to promote functioning in older adults.

scholarly journals Functional Status, Meanings of Life Activities, and COVID-19 Related Disruptions among Disabled Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 948-948
Author(s):  
Meng-Hsuan Yu ◽  
Shiau-Fang Chao
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
Well Being ◽  
Community Dwelling ◽  
Daily Routine ◽  
Older Individuals ◽  
Research Findings ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Participating in meaningful activities has been proven beneficial to the well-being of disabled older adults. However, social distancing policies and restrictions on public activities have been implemented since the outbreak of COVID-19 at the beginning of 2020 in Taiwan. These restrictions not only prevent older individuals from performing meaningful activities but also have actual impacts on their daily life. This study aims to elucidate the intervening role of meanings of life activities on the relationship between functional status and COVID-19 disruptions. Data were collected from a sample of 526 community-dwelling older adults with disabilities in Taiwan between April and July, 2020. Utilizing Multiple Regression Analysis, the research findings were as follows. First, participants with better functional status experienced more COVID-19 related disruptions to their daily routine. In the meantime, they also valued their life activities as more meaningful than those with worse functional status. Second, higher levels of meanings in performing life activities also positively related to COVID-19 disruptions. Third, meanings of life activities fully mediated the relationship between functional status and COVID-19 disruptions. That is, disabled older individuals with better functional status may experience more COVID-19 related disruptions because their accessibility to meaningful activities was limited. Since preventive approaches to control the spread are necessary during COVID-19 epidemic, efforts should be made to sustain meaningful life activities participation among disabled older adults. Based on the findings of this study, this would be especially critical to the well-being of more capable older individuals with disabilities during the pandemic.

scholarly journals Bidirectional Relationship Between Subjective Age and Frailty: Findings From the NHATS

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 271-271
Author(s):  
Yuxiao Li ◽  
Minhui Liu ◽  
Christina Miyawaki ◽  
Xiaocao Sun ◽  
Tianxue Hou ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Syndrome ◽  
Community Dwelling ◽  
Chronological Age ◽  
Subjective Age ◽  
Bidirectional Relationship ◽  
Study Participants ◽  
Community Dwelling Older Adults ◽  
The Relationship ◽  
Hispanic White

Abstract Frailty is a clinical syndrome that becomes increasingly common as people age. Subjective age refers to how young or old individuals experience themselves to be. It is associated with many risk factors of frailty, such as increased depression, worse cognitive function, and poorer psychological wellbeing. In this study, we examined the relationship between subjective age and frailty using the 2011-2015 waves of the National Health and Aging Trends Study. Participants were community-dwelling older adults without frailty in the initial wave (N=1,165). Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the Fried five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust=0, pre-frail=1 or 2; frail=3 or more criteria met. Participants were, on average, 74.1±6.5 years old, female (52%), and non-Hispanic White (81%). Eighty-five percent of the participants felt younger, and 3% felt older than their chronological age, but 41% of them were pre-frail/frail. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95%CI= 1.01, 1.01-1.02). In contrast, frailty predicted an “older” subjective age (OR, 95%CI= 2.97, 1.65-5.35) adjusting for demographics and health conditions. These findings suggest a bidirectional relationship between subjective age and frailty. Older people who feel younger than their chronological age are at reduced risk of becoming pre-frail/frail. Intervention programs to delay frailty progression should include strategies that may help older adults perceive a younger subjective age.

scholarly journals Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6666
Author(s):  
Yoshihiro Kugimiya ◽  
Masanori Iwasaki ◽  
Yuki Ohara ◽  
Keiko Motokawa ◽  
Ayako Edahiro ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cross Sectional Study ◽  
Albumin Level ◽  
Community Dwelling ◽  
Tongue Pressure ◽  
Swallowing Function ◽  
Cross Sectional ◽  
Community Dwelling Older Adults ◽  
The Relationship

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.

Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

2021 ◽  
Author(s):  
K Makino ◽  
S Lee ◽  
S Bae ◽  
I Chiba ◽  
K Harada ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Frailty Status ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

scholarly journals Association between objectively measured walking steps and sleep in community-dwelling older adults: A prospective cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243910
Author(s):  
Noriyuki Kimura ◽  
Yasuhiro Aso ◽  
Kenichi Yabuuchi ◽  
Etsuro Matsubara
Keyword(s):  
Older Adults ◽  
Sleep Disturbances ◽  
Linear Regression Analysis ◽  
Community Dwelling ◽  
Sleep Efficiency ◽  
Ageing Society ◽  
Sleep Parameters ◽  
Objectively Measured ◽  
Community Dwelling Older Adults ◽  
The Relationship

Physical inactivity and sleep disturbances are major problems in an ageing society. There is increasing evidence that physical activity is associated with sleep quality. However, the association between daily walking steps and sleep remain unclear. This prospective study examined the relationship between objectively measured daily walking steps and sleep parameters in Japanese community-dwelling older adults. In total, 855 community-dwelling individuals aged 65 and above, with an uninterrupted follow-up from August 2015 to March 2016, were enrolled. The participants wore a wristband sensor for an average of 7.8 days every three months. Multiple linear regression analysis was performed to examine the relationship between daily walking steps and sleep parameters, including the total sleep time, sleep efficiency, time awake after sleep onset (WASO), awakening time count during the night, and naptime. The median (interquartile range, IQR) age of the participants was 73 (69–78) years, with 317 (37.1%) men and 538 (62.9%) women. The median (IQR) educational level was 12 (11–12) years, and the median (IQR) Mini-Mental State Examination score was 29 (27–30) points. The number of daily walking steps showed a positive correlation with sleep efficiency and an inverse correlation with WASO, awakening time count, and naptime, after adjusting for covariates and correcting for the false discovery rate (β = 0.098, 95% confidence interval [CI]: 0.034 to 0.162, p = 0.003; β = −0.107, 95% CI: −0.172 to −0.043, p = 0.001; β = −0.105, 95% CI: −0.17 to −0.04, p = 0.002; and β = −0.31, 95% CI: −0.371 to −0.249, p < 0.001, respectively). Our results can help promote walking as an intervention for preventing sleep disturbances in community-dwelling older adults.

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