scholarly journals Pickleball for Inactive Mid-Life and Older Adults in Rural Utah: A Feasibility Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8374
Author(s):  
Paige Wray ◽  
Callahan K. Ward ◽  
Cindy Nelson ◽  
Sandra H. Sulzer ◽  
Christopher J. Dakin ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Feasibility Study ◽  
Positive Response ◽  
Vertical Jump ◽  
Good Adherence ◽  
Barriers To Exercise ◽  
Perceived Pain ◽  
The Impact

Many diseases, disabilities, and mental health conditions associated with aging can be delayed or prevented through regular exercise. Several barriers to exercise, many of which are exacerbated in rural communities, prevent mid-life and older adults from accessing its benefits. However, recently, a racquet sport named pickleball has become popular among older adults, and it appears to overcome some of these barriers. We conducted a feasibility study to evaluate the impact of a six-week pickleball intervention on measures of muscle function, cognitive function, perceived pain, and cardio-metabolic risk, as well as several psychosocial factors contributing to adherence in sedentary rural participants. Participants improved their vertical jump, cognitive performance, and reported a decrease in self-reported pain, suggesting improved physical and cognitive health across the sample. Participants also reported high levels of satisfaction and demonstrated good adherence over the duration of the study. Perhaps of greatest value was the overwhelmingly positive response from participants to the intervention and follow-up interviews reporting a desire to continue pickleball play beyond the study period. Overall, pickleball appears to be a promising intervention to, (1) elicit functional- and cognitive-related improvements, and (2) motivate mid-life and older adults to adhere to exercise sufficiently long to benefit their health.

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

Nutrients ◽  
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).

scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cohort Study ◽  
Primary Health Care ◽  
Rio Grande ◽  
Cognitive Testing ◽  
Rio Grande Do Sul ◽  
Primary Health ◽  
The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

scholarly journals A randomised controlled trial exploring the impact of a dedicated Health and Social Care Professionals team in the Emergency Department on the quality, safety, clinical and cost-effectiveness of care for older adults: Study Protocol

2019 ◽  
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Íde O’Shaughnessy ◽  
Eimear Smalle ◽  
Stephen White ◽  
...  
Keyword(s):  
Older Adults ◽  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Health And Social Care ◽  
Effectiveness Of Care ◽  
Randomised Controlled ◽  
The Impact

Abstract Background : Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-index visit, often have increased ED length of stay and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, clinical and cost-effectiveness of care of older adults when compared to usual care. Methods : The study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcome is ED length of stay (from arrival to discharge). Secondary outcomes include: rates of hospital admissions from the ED, ED re-visits, unplanned hospital admissions and healthcare utilisation at 30-days, four and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to usual care; and perceptions on implementation by ED staff members. Discussion : This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation. Trial registration : ClinicalTrials.gov, NCT03739515; registered on 12 th November 2018. Protocol version 1. URL: https://clinicaltrials.gov/ct2/show/NCT03739515

scholarly journals Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215013272110477
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Denisse A. Rumbea ◽  
Pedro Pérez ◽  
Bettsy Y. Recalde ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Body Composition ◽  
Regression Models ◽  
Community Dwelling ◽  
The Body ◽  
Study Results ◽  
The Impact ◽  
Community Dwelling Older Adults

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.

scholarly journals THE IMPACT OF THE OPIOID EPIDEMIC ON OLDER ADULTS: FINDINGS FROM A NATIONAL SURVEY OF COMMUNITY-BASED ORGANIZATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S738-S738
Author(s):  
Kathleen A Cameron ◽  
Lauren E Popham ◽  
Angelica Herrera-Venson
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
National Survey ◽  
National Council ◽  
Opioid Epidemic ◽  
Opioid Misuse ◽  
Strategic Partnerships ◽  
Community Based ◽  
Community Based Organizations ◽  
The Impact

Abstract The National Council on Aging (NCOA) conducted a national survey of community-based organizations (CBOs) in early 2019 to better understand how older adults, people with disabilities, and their caregivers are affected by the opioid epidemic and identify new resources and tools needed by CBOs to better serve their community needs. Specifically, the survey asked about the extent to which CBOs’ service delivery and level of effort has changed as a result of the opioid epidemic; unique issues reported by this population, directly or indirectly resulting from opioid misuse by them or loved ones; how organizations screen and refer older adults and individual with disabilities for support associated with opioid misuse; how organizations may be connecting with local or state initiatives addressing the opioid epidemic, or forming strategic partnerships to respond to emerging client needs; and pinpoint gaps in resources that may help organizations to more effectively respond to these issues. Over 200 organizations, representing urban, suburban and rural communities, responded to the survey and included senior centers, area agencies on aging, Senior Health Insurance Assistance Programs, as well as health care organizations. Seventy percent of organizations report spending more effort to address the needs of older adults/caregivers who are adversely affected by opioid misuse/abuse since 2 years ago. Common health and financial concerns, current strategies related to screening, partnership development, and educational programming as reported by CBOs will be presented. This session will include a discussion of opportunities to assist CBOs address the opioid-related needs of their older adult clients.

scholarly journals Physical Functioning Decline and Mortality in Older Adults With Multimorbidity: Joint Modeling of Longitudinal and Survival Data

2018 ◽  
Vol 74 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Melissa Y Wei ◽  
Mohammed U Kabeto ◽  
Andrzej T Galecki ◽  
Kenneth M Langa
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Physical Functioning ◽  
Survival Data ◽  
Short Form ◽  
Joint Modeling ◽  
Full Spectrum ◽  
Increased Risk ◽  
The Impact

Abstract Background Multimorbidity is common among older adults and strongly associated with physical functioning decline and increased mortality. However, the full spectrum of direct and indirect effects of multimorbidity on physical functioning and survival has not been quantified. We aimed to determine the longitudinal relationship of multimorbidity on physical functioning and quantify the impact of multimorbidity and multimorbidity-attributed changes in physical functioning on mortality risk. Methods The Health and Retirement Study (HRS) is a nationally representative population-based prospective cohort of adults aged 51 or older. In 2000, participants were interviewed about physician-diagnosed chronic conditions, from which their multimorbidity-weighted index (MWI) was computed. Between 2000 and 2011, participants reported their current physical functioning using a modified Short Form-36. With MWI as a time-varying exposure, we jointly modeled its associations with physical functioning and survival. Results The final sample included 74,037 observations from 18,174 participants. At baseline, participants had a weighted mean MWI of 4.6 ± 4.2 (range 0–36.8). During follow-up, physical functioning declined: −1.72 (95% confidence interval [CI] −1.77, −1.67, p < .001) HRS physical functioning units per point MWI in adjusted models. Over follow-up, 6,362 (34%) participants died. Mortality risk increased 8% (hazard ratio 1.08, 95% CI 1.07–1.08, p < .001) per point MWI in adjusted models. Across all population subgroups, MWI was associated with greater physical functioning decline and mortality risk. Conclusions Multimorbidity and its associated decline in physical functioning were significantly associated with increased mortality. These associations can be predicted with an easily interpreted and applied multimorbidity index that can better identify and target adults at increased risk for disability and death.

scholarly journals Higher Hemoglobin Levels Are Associated With Better Physical Performance Among Older Adults Without Anemia: A Longitudinal Analysis

2021 ◽  
Author(s):  
Ligiana Pires Corona ◽  
Flavia Cristina Drummond Andrade ◽  
Tiago Silva Alexandre ◽  
Tábatta Renata Pereira Brito ◽  
Daniella Pires Nunes ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Well Being ◽  
World Health ◽  
Aging Study ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Abstract Background Anemia is the most common hematological abnormality among older adults, and it is associated with decreased physical performance. But the role of hemoglobin in the absence of anemia remains unclear. Thus, this study aimed to assess the impact of hemoglobin levels on physical performance in Brazilian older adults without anemia. Methods The study is longitudinal in that it relies on two waves of the Saúde, Bem-Estar e Envelhecimento (SABE; Health, Well-being, and Aging) study: 2010 and 2015–2016. Mixed-effects linear regression was used to determine the effects of the hemoglobin concentrations on the Short Physical Performance Battery-SPPB over time among the 1,020 who had complete data and did not have anemia in 2010. In the follow-up, there were 562 without anemia. Analyses were stratified by sex. Results In analyses adjusted for age, education, grip strength, comorbidities, and body mass index, hemoglobin levels were positively associated with physical performance scores among older women (β = 0.15, p < 0.05) and men (β = 0.18, p < 0.05) without anemia. Conclusion Our study demonstrates that higher hemoglobin levels were associated with better physical performance among older men and women without anemia. This finding is important because, in clinical practice, most health professionals focus on the World Health Organization definition of anemia. Our study suggests the importance of hemoglobin levels among older adults, even those without anemia.

scholarly journals 407 - Living through the pandemic as an older person: Long-term psychological impacts in low- and middle-income countries

2021 ◽  
Vol 33 (S1) ◽  
pp. 33-33
Author(s):  
Clarissa Giebel ◽  
Bwire Ivan ◽  
Maria Isabel Zuluaga ◽  
Suresh Kumar ◽  
Mark Gabbay ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Well Being ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health And Social Care ◽  
The Impact ◽  
Low And Middle Income

Background:The pandemic has put a huge strain on people’s mental health, with varying restrictions affecting people’s lives. Little is known how the pandemic affects older adults’ mental health, particularly those living in low- and middle-income countries (LMICs) where restrictions are affecting people’s access to basic necessities. Thus, the aim of this 3-country study was to understand the long- term impacts of the pandemic on the mental well-being of older adults with and without dementia in LMICs.Methods:We are collecting 30 baseline and 15 follow-up interviews with older adults (aged 60+), people with dementia, and family carers in Colombia, India, and Uganda, as well as a baseline and follow-up focus group with health and social are professionals in each country. Interviews are conducted remotely over the phone due to pandemic restrictions, with data collection taking place between March and July 2021. Transcripts are translated into English before being analysed using thematic analysis.Results:To date, we have completed close to 90 baseline interviews and 3 focus groups with health and social care professionals. Analysis is ongoing, but findings are capturing the detrimental second wave in India and follow-up interviews will capture the longitudinal impacts on mental health.Conclusions:Whilst vaccines are starting to be rolled out in LMICs, albeit at different rates, the virus will likely take much longer to be somewhat managed in LMICs. This leaves more room for people’s physical as well as mental health to be impacted by the restrictions, and with often limited mental health service coverage, it is all the more important o understand the impact of the pandemic on older people’s mental health.

scholarly journals Using Mobile Health Tools to Engage Rural Underserved Individuals in a Diabetes Education Program in South Texas: Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Zenong Yin ◽  
Janna Lesser ◽  
Kristi A Paiva ◽  
Jose Zapata Jr ◽  
Andrea Moreno-Vasquez ◽  
...  
Keyword(s):  
Rural Communities ◽  
Feasibility Study ◽  
Mobile Health ◽  
Education Program ◽  
Financial Incentives ◽  
Diabetes Education ◽  
South Texas ◽  
Self Management ◽  
Study Participants

BACKGROUND Access to diabetes education and resources for diabetes self-management is limited in rural communities, despite higher rates of diabetes in rural populations compared with urban populations. Technology and mobile health (mHealth) interventions can reduce barriers and improve access to diabetes education in rural communities. Screening, Brief Intervention, and Referral to Treatment (SBIRT) and financial incentives can be used with mHealth interventions to increase the uptake of diabetes education; however, studies have not examined their combined use for diabetes self-management in rural settings. OBJECTIVE This two-phase Stage 1 feasibility study aimed to use a mixed methods design to examine the feasibility and acceptability of an mHealth diabetes education program combining SBIRT and financial incentives to engage rural individuals. METHODS In Phase 1, we aimed to develop, adapt, and refine the intervention protocol. In Phase 2, a 3-month quasi-experimental study was conducted with individuals from 2 rural communities in South Texas. Study participants were individuals who attended free diabetes screening events in their community. Those with low or medium risk received health education material, whereas those with high risk or those with a previous diagnosis of diabetes participated in motivational interviewing and enrolled in the 6-week mHealth Diabetes Self-Management Education Program under either an unconditional or aversion incentive contract. The participants returned for a 3-month follow-up. Feasibility and acceptability of the intervention were determined by the rate of participant recruitment and retention, the fidelity of program delivery and compliance, and the participant’s satisfaction with the intervention program. RESULTS Of the 98 screened rural community members in South Texas, 72 individuals met the study eligibility and 62 individuals agreed to enroll in the study. The sample was predominately female and Hispanic, with an average age of 52.6 years. The feedback from study participants indicated high levels of satisfaction with the mHealth diabetes education program. In the poststudy survey, the participants reported high levels of confidence to continue lifestyle modifications, that is, weight loss, physical activity, and diet. The retention rate was 50% at the 3-month follow-up. Participation in the intervention was high at the beginning and dissipated in the later weeks regardless of the incentive contract type. Positive changes were observed in weight (mean -2.64, SD 6.01; <i>P</i>&lt;.05) and glycemic control index (-.30; <i>P</i>&lt;.05) in all participants from baseline to follow-up. CONCLUSIONS The finding showed strong feasibility and acceptability of study recruitment and enrollment. The participants’ participation and retention were reasonable given the unforeseen events that impacted the study communities during the study period. Combining mHealth with SBIRT has the potential to reach individuals with need to participate in diabetes education in rural communities.

scholarly journals Unexpected shock in a fallen older adult: a case report

2020 ◽  
Vol 5 (1) ◽  
pp. 15-19
Author(s):  
Gary Matthews ◽  
Helen Booth ◽  
Gregory Adam Whitley
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Spinal Injury ◽  
Extended Period ◽  
Spine Injury ◽  
Common Mechanism ◽  
Complex Nature ◽  
Major Trauma Patient ◽  
The Impact

Introduction: Falls are common in older adults and frequently require ambulance service assistance. They are the most frequent cause of injury and associated morbidity and mortality in older adults. In recent years, the typical major trauma patient has changed from being young and male to being older in age, with falls of < 2 metres being the most common mechanism of injury. We present a case of an 84-year-old male who had fallen in his home. This case highlights the complex nature of a relatively common incident.Case presentation: The patient was laid on the floor in the prone position unable to move for 12 hours. He did not complain of any pain in his neck, back, hips or legs, and wished to be lifted off the floor promptly. On examination, he had bruising to his chest and abdomen and had suffered a suspected cervical spine injury due to a step-like protrusion around C5‐C6. Distal sensory and motor function was intact. While in the ambulance his blood pressure dropped from 154/119 mmHg to 49/28 mmHg unexpectedly. We successfully reversed the shock using the modified Trendelenburg position and intravenous fluids. On follow-up he was diagnosed with dislocated C3, C6 and C7 vertebrae.Conclusion: The unexpected episode of shock witnessed in this patient may have been caused by a number of phenomena, including but not limited to crush syndrome, spinal cord concussion and orthostatic hypotension. We recommend that clinicians anticipate sudden shock in older adult patients who have fallen and a) have remained static on the floor for an extended period of time or b) are suspected of a spinal injury. We recommend assertive management of these patients to mitigate the impact of shock through postural positioning and consideration of early cannulation.

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