Characteristics Associated with Improved Physical Performance among Community-Dwelling Older Adults in a Community-Based Falls Prevention Program

This was a retrospective analysis of quasi-longitudinal data from an ongoing, community-based falls prevention program. The purpose was to identify participant characteristics predicting improvement on physical performance measures associated with falls risk. Community-dwelling older adults ≥60 years old participated in a community-based implementation of the Otago Exercise Program (OEP). Participants with increased falls risk (n = 353) were provided with individualized exercises from OEP and were invited to return for monthly follow-up. One hundred twenty-eight participants returned for at least two follow-up visits within 6 months of their initial visit (mean time to second follow-up = 93 days with standard deviation = 43 days). Outcome measures assessed at initial and all follow-up visits included Four Stage Balance Test (4SBT), Timed Up and Go test (TUG), and Chair Rise Test (CRT). Distributions were examined, and results were categorized to depict improvement from initial visit (IVT) to second follow-up visit (F2). Key predictor variables were included in multivariable linear or logistic regression models. Improved 4SBT performance was predicted by greater balance confidence. Better TUG performance at F2 was predicted by no use of assistive device for walking, higher scores on cognitive screening, and better IVT TUG performance. Improvement on CRT was predicted by younger age and lower scores on cognitive screening. While improvements on each of the three measures were predicted by a unique combination of variables, these variables tended to be associated with less frailty.

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Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽

10.3390/nu13020407 ◽

2021 ◽

Vol 13 (2) ◽

pp. 407

Author(s):

Laetitia Lengelé ◽

Olivier Bruyère ◽

Charlotte Beaudart ◽

Jean-Yves Reginster ◽

Médéa Locquet

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Performance ◽

Community Dwelling ◽

Timed Up And Go ◽

P Values ◽

Student’S T ◽

The Impact ◽

Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

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88 Prospective Association of Obesity and Falls among Malaysian Community-Dwelling Older Adults

Age and Ageing ◽

10.1093/ageing/afz164.88 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Sheng Hui Kioh ◽

Sumaiyah Mat ◽

Phyo Myint ◽

Shahrul B Kamaruzzaman ◽

Maw Pin Tan

Keyword(s):

Older Adults ◽

Physical Performance ◽

Body Fat ◽

Community Dwelling ◽

Percentage Body Fat ◽

Waist Hip Ratio ◽

Increased Risk ◽

Prospective Association ◽

Community Dwelling Older Adults

Abstract Background Cross-sectional studies linking the association between obesity and falls are limited and their results are somewhat conflicting. The inconsistent evidence between obesity and falls could be explained by the utilization of different measures of obesity including BMI, WC, waist hip ratio (WHR) and percentage body fat (%BF) in different studies. Aims To examine the prospective association between various measures of obesity and falls among community-dwelling older adults. Methods We utilized data from the wave 1 and wave 2 of the Malaysian Elder’s Longitudinal Research Study (MELoR). Basic demographic characteristics, medical history, lifestyle factors and falls history in preceding 12 months was recorded by computer assisted questionnaire in participant’s home while anthropometric measurements, body composition assessments and physical performance were collected at the hospital during a hospital check-up at baseline. The main exposure variables were increased body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and percentage body fat (%BF) and the main outcome was self-report falls in the preceding 12 months at time of follow-up. Results Among 746 participants at baseline and follow-up (mean age 68.9 ± 7.3 years, old, 56.7% women), 150(20.1%) individuals had ≥1 time of fall at follow-up. No differences in mean age and proportion of men and women among fallers and non-fallers. However, fallers were found to have higher WHR, lower percentage muscle mass and performed poorer in physical performance (p-value<0.01). Of the four obesity indicators, higher WHR at baseline was associated with increased risk of fall 12 months later even after adjustment for all potential confounders (aOR= 2.01; 95%CI= 1.26-3.18). Conclusions In conclusion, our findings suggest that WHR is the measure of adiposity most likely to differentiate fallers from non-fallers prospectively. Future studies should evaluate the mechanisms underlying the increased risk of falls associated with increased WHR.

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Life satisfaction and frailty in community-based older adults: cross-sectional and prospective analyses

International Psychogeriatrics ◽

10.1017/s1041610213000902 ◽

2013 ◽

Vol 25 (10) ◽

pp. 1709-1716 ◽

Cited By ~ 17

Author(s):

Philip D. St John ◽

Suzanne L. Tyas ◽

Patrick R. Montgomery

Keyword(s):

Older Adults ◽

Life Satisfaction ◽

Population Based ◽

Community Dwelling ◽

Community Based ◽

Cross Sectional ◽

Gender Education ◽

Community Dwelling Older Adults ◽

Prospective Analyses

ABSTRACTBackground:Frailty may be associated with reduced life satisfaction (LS). The objectives of this paper are to determine if (1) frailty is associated with LS in community-dwelling older adults in cross-sectional analyses; (2) frailty predicts LS five years later; and (3) specific domains of LS are preferentially associated with frailty.Methods:This paper presents analysis of an existing population-based cohort study of 1,751 persons aged 65+ who were assessed in 1991, with follow-up five years later. LS was measured using the terrible–delightful scale, which measures overall LS and LS in specific domains. Frailty was measured using the Brief Frailty Instrument. Analyses were adjusted for age, gender, education, and marital status.Results:Frailty was associated with overall LS at time 1 and predicted overall LS at time 2. This was seen in unadjusted analyses and after adjusting for confounding factors. Frailty was associated with all domains of LS at time 1, and predicted LS at time 2 in all domains except housing and self-esteem. However, the effect was stronger for LS with health than with other domains for both times 1 and 2.Conclusions:Frailty is associated with LS, and the effect is strongest for LS with health.

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LEVERAGING COMMUNITIES AS NETWORKS TO REDUCE MALNUTRITION IN OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.834 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S226-S227

Author(s):

Tina Sadarangani ◽

Jeannette Beasley ◽

Shannon E Jarrott

Keyword(s):

Older Adults ◽

At Risk ◽

Asian American ◽

Prevention Program ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

Adverse Outcomes ◽

Community Dwelling ◽

Community Based ◽

Community Dwelling Older Adults

Abstract Malnutrition in older adults, while ubiquitous, remains largely underrecognized and undertreated. In community-dwelling older adults, 25% of those at risk of over or under nutrition do not receive any dietary interventions; routine screenings for malnutrition are not typically required in community-based settings. In this interdisciplinary symposium, we explore issues focused on the delivery of evidence-based nutrition interventions to meet the needs of community-dwelling older adults. Using national survey data, we begin by underscoring the importance of treating the complex needs of adults at risk of malnutrition by examining health sequelae, specifically hospitalizations, in community-dwelling adults receiving home-delivered meals. We subsequently examine approaches to malnutrition screening in community-based settings, focusing on the utility of the DETERMINE checklist. We explore barriers and facilitators of providing person-centered nutrition to ethnically diverse Asian American older adults in the adult day healthcare setting. Finally, we shift our focus to overnutrition, discussing the dissemination of a telehealth diabetes prevention program, BRInging the Diabetes prevention program to GEriatric populations (BRIDGE) among older adult meal program recipients. Older adults in community-based health settings are at risk of malnutrition, and among them, those who are prone to social isolation, are at highest risk for adverse outcomes. While congregate settings can facilitate social interaction, honoring food preferences and facilitating choice to address undernutrition, is challenging. Conversely, telehealth interventions may present a feasible approach for addressing overnutrition. We conclude by discussing how current and future research can inform innovative person-centered community-based approaches to identify and treat malnutrition.

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Long-term Effects of a Group Community-based Constraint-induced Movement Therapy on Motor Recovery and Activities of Daily Living in Community-dwelling Older Adults with Chronic Stroke: A Preliminary Study with 6-month Follow-Up

Asian Journal of Occupational Therapy ◽

10.11596/asiajot.7.1 ◽

2009 ◽

Vol 7 (1) ◽

pp. 1-11

Author(s):

Min Y. JUNG ◽

Jung R. KIM ◽

Eun Y. YOO ◽

Hye S. JEON ◽

Joshua H. YOU

Keyword(s):

Older Adults ◽

Daily Living ◽

Community Dwelling ◽

Long Term Effects ◽

Community Based ◽

Constraint Induced Movement Therapy ◽

Preliminary Study ◽

Community Dwelling Older Adults

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Sex-Specific Differences in the Effect of Free Testosterone on Sarcopenia Components in Older Adults

Frontiers in Endocrinology ◽

10.3389/fendo.2021.695614 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hyung Eun Shin ◽

Jeremy D. Walston ◽

Miji Kim ◽

Chang Won Won

Keyword(s):

Older Adults ◽

Muscle Mass ◽

Physical Performance ◽

Longitudinal Analysis ◽

Handgrip Strength ◽

Free Testosterone ◽

Community Dwelling ◽

Cross Sectional ◽

Community Dwelling Older Adults

ObjectiveThe association of free testosterone (FT) with sarcopenia and its components is well known in men but incompletely understood in women. We examined the association of baseline FT with the prevalence and incidence of sarcopenia and its components in community-dwelling older adults.DesignCross-sectional and longitudinal analysis from the prospective population-based Korean Frailty and Aging Cohort Study.MethodsA total of 1,879 community-dwelling older adults aged 70–84 years were enrolled for cross-sectional analysis and 1,583 subjects who participated in the 2-year follow-up survey were included for longitudinal analysis. Baseline FT levels was measured by radioimmunoassay. Skeletal muscle mass, handgrip strength, and physical performance tests were measured at baseline and after 2-year follow-up. Sarcopenia was defined by the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS).ResultsContinuous FT levels was positively associated with the prevalence of sarcopenia in men (odds ratio [OR]=0.95; 95% confidence interval [CI]=0.89–1.00)] and women (OR=0.64, 95% CI=0.42–0.99) after adjusting for multiple confounders. In prospective analysis, low FT levels was associated with a decrease in handgrip strength in women (β=-0.61; p=0.010) and a reduction in Timed “Up and Go” (TUG) test (β=0.53; p=0.008) in men after 2 years. No significant correlations were found between FT levels and the incidence of sarcopenia.ConclusionsLow levels of FT may be a significant determinant of decreases in muscle strength in women and declines in physical performance in men after 2 years. Low FT do not predict loss of muscle mass in both men and women.

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The design and implementation of a theory-based interdisciplinary falls prevention pilot program for community dwelling older adults

American Journal of Health Studies ◽

10.47779/ajhs.2017.79 ◽

2017 ◽

Vol 32 (4) ◽

Author(s):

Jennifer L. Tripken ◽

Cathy S. Elrod ◽

Susan Bills

Keyword(s):

Risk Factors ◽

Older Adults ◽

Prevention Program ◽

Self Efficacy ◽

Fall Risk ◽

Community Dwelling ◽

Falls Prevention ◽

Metropolitan County ◽

Fall Risk Factors ◽

Community Dwelling Older Adults

The purpose of this research was to describe the development of an interdisciplinary community-based falls prevention program that integrated self-efficacy theory and to evaluate its impact on awarenessof fall risk factors and self-efficacy to engage in behaviors that reduce fall risk. Twenty-three communitydwelling older adults participated in a five-week falls prevention program held at a community centerin a large metropolitan county in the Mid-Atlantic. Positive improvements were demonstrated across alloutcome measures. Our findings indicate that a theory-based interdisciplinary falls prevention programincreased self-efficacy and awareness of falls risk factors in older adults.

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Forgiveness Interventions for Older Adults: A Review

Journal of Clinical Medicine ◽

10.3390/jcm10091866 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1866

Author(s):

Javier López ◽

Maria Inés Serrano ◽

Isabel Giménez ◽

Cristina Noriega

Keyword(s):

Older Adults ◽

Intervention Studies ◽

Satisfaction With Life ◽

Meta Analysis ◽

Specific Treatment ◽

Community Dwelling ◽

Group Treatments ◽

Receive Treatment ◽

Community Dwelling Older Adults

A meta-analysis of the efficacy of forgiveness interventions in older adults was conducted. International databases (Medline, PsycINFO, Scopus, Web of Science) were searched for studies published from 1990 to 2020 that attempted to promote forgiveness in older adults. Most intervention studies are group treatments targeted towards community-dwelling older adults. Participants in these studies are mainly women. The intervention objectives and contents vary widely and often criteria are not well-defined. Participants that received forgiveness interventions reported significantly higher levels of forgiveness than participants that did not receive treatment. Additionally, forgiveness interventions resulted in more changes in depression, stress and anger than no intervention conditions. Forgiveness treatment also enhances positive states (satisfaction with life, subjective happiness, and psychological wellbeing). The reported effects are moderate. The specific treatment model (e.g., Enright’s, Worthington’s) and format (e.g., group-based interventions and individually delivered programs) do not differentially predict better outcomes. In conclusion, future intervention studies should include more male participants and utilize a broader range of follow-up periods. Caution must be exercised because of the limited number of studies developed to date; researchers must be cautious when generalizing the results.

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

Physical Therapy ◽

10.1093/ptj/pzab059 ◽

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.

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