Association between Ambulatory Status and Functional Disability in Elderly People with Dementia

Dementia is highly comorbid with gait disturbance, and both conditions negatively impact the ability of elderly people to conduct daily living activities. The ambulatory status of older adults with dementia may cause variable functional disability, which is crucial for the progression of dementia. The present study investigated the association between ambulatory status with functional disability in elderly people and dementia by using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). In total, 34,040 older adults with mild-to-advanced dementia were analyzed and categorized according to their ambulatory status into three groups: Nonambulatory, assisted ambulatory, and ambulatory. In general, poor ambulatory status was associated with both greater severity of dementia and functional disability. The study participants were further segregated according to their ages and dementia severity levels, which demonstrated that the WHODAS 2.0 domains of functioning for getting along, life activities, and participation (domains 4, 5–1, and 6) were all associated with ambulatory status. In addition, nonambulatory status was significantly associated with institution residency among older adults with dementia. In conclusion, the present study clearly demonstrated the role of ambulatory status in functional disability in older adults with dementia, and the association persisted among older adults of different ages and severities of dementia. This finding indicates the importance of maintaining walking ability in the management of dementia in older adults.

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World Health Organization Disability Health Assessment 2.0 for Health Monitoring: Examining the potential use of the WHODAS 2.0 as a health screening tool among older adults in rural North Carolina

American Journal of Recreation Therapy ◽

10.5055/ajrt.2016.0099 ◽

2017 ◽

Vol 15 (1) ◽

pp. 47

Author(s):

Amanda Warren, MS, CTRS ◽

Richard Williams, EdD, LRT/CTRS/FDRT

Keyword(s):

Older Adults ◽

Health Monitoring ◽

Assessment Tool ◽

Health Assessment ◽

Community Dwelling ◽

World Health ◽

Term Care ◽

Whodas 2.0 ◽

Financial Burdens ◽

Health Organization

Unless measures are taken, escalating healthcare costs and an aging population will increasingly contribute to financial burdens on federal and state healthcare budgets. With the help of appropriate supports, many older adults can remain in their homes and communities and delay expensive long-term care placements. An important aspect of aging in place is health monitoring so that health issues can be addressed before they escalate. The WHODAS 2.0 is a standardized assessment tool that may be valuable for recreational therapists and others to use to monitor health and functional status of community-dwelling older adults.

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Dementia-Related Functional Disability in Moderate to Advanced Parkinson’s Disease: Assessment Using the World Health Organization Disability Assessment Schedule 2.0

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16122230 ◽

2019 ◽

Vol 16 (12) ◽

pp. 2230 ◽

Cited By ~ 5

Author(s):

Jia-Hung Chen ◽

Chien-Tai Hong ◽

Dean Wu ◽

Wen-Chou Chi ◽

Chia-Feng Yen ◽

...

Keyword(s):

Activities Of Daily Living ◽

Functional Assessment ◽

Daily Living ◽

Functional Disability ◽

World Health ◽

Disability Assessment ◽

Advanced Parkinson’S Disease ◽

Whodas 2.0 ◽

The World ◽

Health Organization

Dementia is a common nonmotor condition among people with moderate or advanced Parkinson’s disease (PD). Undoubtedly, profound motor symptoms cause remarkable impairment in daily activities; however, dementia-related disabilities have not been thoroughly investigated, especially not with consideration of differences according to sex. The present study used the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to compare the functional disability between men and women with PD (PwP) with and without dementia. This study employed a registry of disability evaluation and functional assessment using the Taiwan Data Bank of Persons with Disability between July 2012 and October 2018. To investigate dementia-related disability in PwP, 1:1 matching by age and Hoehn-Yahr stage was conducted, which resulted in the inclusion of 1605 study participants in each group. The present study demonstrated that among the six major domains of WHODAS 2.0, the section of “Getting alone with others” was significantly worse in both genders of PwP with dementia; however, a greater disability in fulfilling activities of daily living was only noted in male PwP with dementia but not in their female counterparts. Neither the inability to provide self-care nor participation were significantly different between the sexes. Our findings suggested that deteriorating social relationships were a dementia-related disability in all PwP at the moderate and advanced disease stages. Regarding the performance of activities of daily living, deterioration was related to dementia only in male PwP. Such disabilities could indicate cognitive impairment in people with moderate or advanced PD and could be used as an indicator for the early detection of dementia in PwP by healthcare professionals through the easier functional assessment of the WHODAS 2.0.

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Anemia and functional disability in older adults with cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.9109 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 9109-9109

Author(s):

Cynthia Owusu ◽

William P. Tew ◽

Molly Hardt ◽

Supriya Gupta Mohile ◽

Heidi D. Klepin ◽

...

Keyword(s):

Older Adults ◽

Functional Status ◽

Functional Disability ◽

Secondary Analysis ◽

Stage Iv ◽

World Health ◽

Bivariate Analysis ◽

Factors Associated ◽

Pre Treatment ◽

Health Organization

9109 Background: While anemia is associated with functional disability in older adults in general, this relationship has not been well characterized in older adults with cancer. We sought to examine the association between anemia and functional disability and to identify other factors associated with functional disability in patients (pts) age ≥65 with cancer. Methods: We conducted a secondary analysis of a multi-center prospective study of 500 pts ≥ age 65 that identified predictors of chemotherapy (chemo) toxicity (Hurria et al, JCO, 2011). The primary outcome of this analysis was functional disability, defined as need for assistance with ≥1 instrumental activities of daily living. Data collected prior to initiation of a new chemo regimen included: age, tumor/treatment variables, labs [including hemoglobin (Hb)], and geriatric assessment (functional status, comorbidity, social support, psychological, cognitive, and nutritional status). Anemia (World Health Organization criteria) was defined as Hb <12g/dl (women) and Hb <13g/dl (men). Bivariate analysis and logistic regression were used to examine the association between functional disability, anemia, and other pre-treatment variables. Results: Among 500 pts [median age 72 years (range 65-91), 56% female, 61% stage IV], the prevalence of functional disability and anemia was 43% and 51%, respectively. The mean Hb was 11.7g/dl and 12.6g/dl among pts with and without functional disability. Pts with anemia were more likely to report functional disability (53% vs. 46%, p<0.01). On multivariate analysis, factors associated with functional disability included anemia [Odds Ratio (OR)= 2.06, 95% confidence interval (CI)= 1.39-3.05], increased age (OR= 1.04, 95% CI = 1.00-1.07), increased comorbidity (OR= 1.23, 95% CI = 1.09-1.39), advanced stage (OR= 1.85, 95% CI = 1.22-2.80), and unintentional weight loss (OR= 2.02, 95% CI = 1.37-3.00). Conclusions: Anemia was highly prevalent and was associated with functional disability. Prospective studies that further examine the relationship between anemia and functional disability and randomized-controlled trials that evaluate the correction of anemia as a modifiable strategy to improve functional status in older pts with cancer are warranted.

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Disability, Frailty and Depression in the community-dwelling older adults with Osteosarcopenia

BMC Geriatrics ◽

10.1186/s12877-021-02022-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ki-Soo Park ◽

Gyeong-Ye Lee ◽

Young-Mi Seo ◽

Sung-Hyo Seo ◽

Jun-Il Yoo

Keyword(s):

Older Adults ◽

Short Form ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

Normal Group ◽

World Health ◽

Common Disease ◽

Using Data ◽

Health Organization

Abstract Background The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. Methods This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values according to Osteosarcopenia were large, and GDSSF (0.096) was medium Conclusions Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.

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Functional difficulties and toileting among older adults in Ghana: evidence from the World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 1

Ageing and Society ◽

10.1017/s0144686x21000453 ◽

2021 ◽

pp. 1-23

Author(s):

Kofi Awuviry-Newton ◽

Kylie Wales ◽

Meredith Tavener ◽

Paul Kowal ◽

Julie Byles

Keyword(s):

Older Adults ◽

Marital Status ◽

Conceptual Framework ◽

World Health ◽

Adult Health ◽

Care Needs ◽

Functional Difficulties ◽

The World ◽

Health Organization ◽

Global Ageing

Abstract Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.

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World Health Report on Vision: Aging Implications for Global Vision and Eye Health

Innovation in Aging ◽

10.1093/geroni/igaa057.2933 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 807-808

Author(s):

Bonnielin Swenor ◽

Varshini Varadaraj ◽

Moon Jeong Lee ◽

Heather Whitson ◽

Pradeep Ramulu

Keyword(s):

Older Adults ◽

Visual Impairment ◽

Vision Loss ◽

World Health ◽

World Health Report ◽

Global Public Health ◽

Eye Care ◽

Health Report ◽

Public Health Challenges ◽

Health Organization

Abstract In 2019, the World Health Organization World Report on Vision estimated that that 2.2 billion people have a vision impairment, of which almost half could have been prevented or is yet to be addressed. As the global population ages and the prevalence of visual impairment increases, inequities in eye care and the downstream health and aging consequences of vision loss will become magnified. This session will: (1) provide key information regarding the burden of eye disease and visual impairment among older adults worldwide; (2) outline a framework created to conceptualize the aging and long-term health implications of vision loss, and (3) discuss the global public health challenges to eye care and to maximizing health for older adults with visual impairments.

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Cross-cultural adaptation and validation to Brazil of the Obesity-related Problems Scale

Einstein (São Paulo) ◽

10.1590/s1679-45082017ao4004 ◽

2017 ◽

Vol 15 (3) ◽

pp. 327-333

Author(s):

Andreia Mara Brolezzi Brasil ◽

Fábio Brasil ◽

Angélica Aparecida Maurício ◽

Regina Maria Vilela

Keyword(s):

Cultural Adaptation ◽

Cross Cultural ◽

World Health ◽

Dimensional Structure ◽

Obese Patients ◽

Intra Class Correlation ◽

Cross Cultural Adaptation ◽

Whodas 2.0 ◽

The World ◽

Health Organization

ABSTRACT Objective To validate a reliable version of the Obesity-related Problems Scale in Portuguese to use it in Brazil. Methods The Obesity-related Problems Scale was translated and transculturally adapted. Later it was simultaneously self-applied with a 12-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), to 50 obese patients and 50 non-obese individuals, and applied again to half of them after 14 days. Results The Obesity-related Problems scale was able to differentiate obese from non-obese individuals with higher accuracy than WHODAS 2.0, correlating with this scale and with body mass index. The factor analysis determined a two-dimensional structure, which was confirmed with χ2/df=1.81, SRMR=0.05, and CFI=0.97. The general a coefficient was 0.90 and the inter-item intra-class correlation, in the reapplication, ranged from 0.75 to 0.87. Conclusion The scale proved to be valid and reliable for use in the Brazilian population, without the need to exclude items.

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Change of Functioning in Persons With Severe Musculoskeletal Injuries Over Time: A Multilevel Analysis

10.21203/rs.3.rs-842098/v1 ◽

2021 ◽

Author(s):

Jennifer Usinger ◽

Sandra Kus ◽

Stefan Simmel ◽

Michaela Coenen

Keyword(s):

Inpatient Rehabilitation ◽

Musculoskeletal Injuries ◽

Assessment Instrument ◽

World Health ◽

International Classification Of Functioning ◽

Whodas 2.0 ◽

Treatment Targets ◽

Registration Number ◽

Health Organization ◽

Over Time

Abstract Background: The World Health Organization (WHO) recommends the WHO Disability Assessment Schedule (WHODAS) 2.0 as a generic assessment instrument to collect data on functioning and disability. The questionnaire was developed specifically to capture the activities and participation domain as defined by the International Classification of Functioning, Disability and Health (ICF). Evidence on the most relevant factors predicting WHODAS 2.0 outcome in the context of musculoskeletal injuries are controversial. This study aims to assess change in functioning of patients with severe musculoskeletal injuries undergoing inpatient rehabilitation over time.Methods: A longitudinal multicentre study was conducted, following up 571 participants with severe musculoskeletal injuries over the course of a first inpatient rehabilitation stay until 3 months after discharge. At admission, data on sociodemographic, health-related aspects, functioning and contextual factors were collected. WHODAS 2.0 assessed functioning. Data were analysed using a multilevel model approach.Results: The mean WHODAS 2.0 declined from admission to discharge and 3-month follow-up, indicating an improvement in functioning. Multilevel analyses revealed age, duration of inpatient rehabilitation, severity of the injury, injury localizations, number of comorbidities, emotional functioning, pain, being informed about the injury, subjective prognosis on return to work and agreement on treatment targets as factors influencing change in functioning over time.Conclusions: In a rehabilitation setting, a healthcare professional can promote an increase in functioning, for example, by ensuring that there are treatment targets defined and agreed on with the patient and that the patient feels sufficiently informed about the injury. The identified factors could potentially be used for a short screening at admission to rehabilitation to estimate the patient’s change of functioning over time. Trial registration number and date of registration: DRKS00014857; July 04, 2018.

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Assessing Functional Disability Among Persons Experiencing Homelessness

American Journal of Occupational Therapy ◽

10.5014/ajot.2021.75s2-rp192 ◽

2021 ◽

Vol 75 (Supplement_2) ◽

pp. 7512505192p1-7512505192p1

Author(s):

John V. Rider ◽

Justina Selim ◽

Alexys Garcia

Keyword(s):

Functional Disability ◽

Cross Sectional Study ◽

World Health ◽

Daily Functioning ◽

Occupational Engagement ◽

Sectional Study ◽

Cross Sectional ◽

Health Related ◽

Health Organization

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This cross-sectional study provides a deeper understanding of how the experience of homelessness affects occupational engagement and quality of life. Health-related disparities among persons experiencing homelessness and their implications for functioning in daily life were analyzed through the World Health Organization Disability Assessment Schedule 2.0. Results indicate that the emotional burden of health conditions had the greatest impact on daily functioning. Highly affected domains included participation, mobility, and life activities. Primary Author and Speaker: John V. Rider Additional Authors and Speakers: Justina Selim, Alexys Garcia

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COVID-19 Pandemic: The Lived Experiences of Older Adults in Aged Care Homes

Millennial Asia ◽

10.1177/0976399620958326 ◽

2020 ◽

Vol 11 (3) ◽

pp. 299-317

Author(s):

Shi Yin Chee

Keyword(s):

Older Adults ◽

Lived Experiences ◽

Well Being ◽

Aged Care ◽

Care Homes ◽

World Health ◽

Phenomenological Method ◽

Structured Interviews ◽

The World ◽

Health Organization

The COVID-19 pandemic has caused untold fear and suffering for older adults across the world. According to the World Health Organization, older adults in aged care homes are at a higher risk of the infection living in an enclosed environment with others. This article adopts a qualitative approach using Colaizzi’s phenomenological method to explore the lived experiences of older adults during COVID-19. Between December 2019 and June 2020, 10 in-depth, semi-structured interviews were conducted with participants aged 60 years and above in two aged care homes. The lived tension that has penetrated all participants’ stories in five themes of the meanings described as ‘disconnected in a shrinking world’ filled with uncertainties. COVID-19 has brought unprecedented challenges and disproportionate threat onto older adults’ lives, relationships and well-being. The overarching message was that older adults believe that ‘this too shall pass’ and regain their freedom that was lost during the pandemic.

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