scholarly journals Association between Pneumonia, Fracture, Stroke, Heart Attack and Other Hospitalizations with Changes in Mobility Disability and Gait Speed in Older Adults

2021 ◽  
Vol 10 (17) ◽  
pp. 3802
Author(s):  
Joshua D. Brown ◽  
Reiko Sato ◽  
John E. Morley
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Repeated Measures ◽  
Heart Attack ◽  
Physical Activity Intervention ◽  
Self Report ◽  
Walk Test ◽  
Short Term ◽  
Mobility Disability

Pathophysiological changes after acute hospitalizations may influence physical functioning in older adults, which can lead to disability and loss of independence. This study evaluated the association between pneumonia, fracture, heart attack, stroke, and other hospitalizations with major mobility disability (MMD) and gait speed. This was a secondary analysis of the Lifestyle Interventions and Independence for Elders (LIFE) Study, which was conducted across eight sites during 2010–2013 with longitudinal follow-up for 1635 individuals over an average of 2.6 years. Participants included adults ≥70 years old with pre-existing mobility limitations randomized to a physical activity intervention or a health education control arm. Hospitalizations were recorded via self-report and adjudicated by medical reviewers. MMD was measured by the inability to complete a 400 m walk test, or other proxies, as a binary outcome. Gait speed was recorded during the walk test in meters per second (m/s) and measured on a linear scale. Mixed-effects repeated measures regression adjusted for baseline demographics, comorbid conditions, and frailty. Among the 1635 participants, there were 1458 hospitalizations, which included 80 (5.5% of all hospitalizations) cases of pneumonia, 92 (6.3%) hospitalized fractures, 87 (6.0%) heart attacks, and 61 (4.2%) strokes. In the short-term measurement period immediately following hospitalization (1 day to 6 months), stroke (OR = 3.98 (3.41–4.54)) had the strongest association with MMD followed by fracture (OR = 3.03 (2.54–3.52)), pneumonia (OR = 2.76 (2.23–3.30)), and heart attack (OR = 2.03 (1.52–2.53)). Associations with long-term (6–12 months after) MMD were decreased or not significant for all causes. Pneumonia, fracture, stroke, and other hospitalizations were associated with short-term relative gait speed changes between −4.8% up to −19.5%, and only fracture was associated with long-term changes. Hospitalizations for pneumonia, heart attack, stroke, and fractures were associated with short-term decreases in mobility in older adults. Older adults may be at risk for decreased mobility and disability following acute hospitalizations, with the magnitude determined by the cause of the precipitating event.

scholarly journals Short- and Long-Term Exposure to Higher Temperatures is Linked to Cognitive Impairment in Taiwanese Older Adults

2020 ◽  
Author(s):  
Wei-Peng Su ◽  
Yuan-Ting C. Lo ◽  
Shu-Hsuan Mei ◽  
Yu-Hung Chang ◽  
Han-Bin Huang
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Air Temperature ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Short Term ◽  
Multiple Wave ◽  
Temperature Exposure

Abstract Background: Evidence on the associations between short-term and long-term air temperature exposure and cognitive function in older adults, particularly those in Asia, is limited. Therefore, we explored the relationships of short-term and long-term air temperature exposure with cognitive function in Taiwanese older adults through a repeated measures survey.Methods: We used data from between 1996 and 2007 from the ongoing Taiwan Longitudinal Study on Aging (N = 1956), a multiple-wave nationwide survey. Participants’ cognitive function assessment was based on the Short Portable Mental Status Questionnaire. We calculated the temperature moving average (TMA) for temperature exposure windows between 1993 and 2007 using data from air quality monitoring stations, depending on the administrative zone of each participant’s residence. Generalized linear mixed models were used to examine the effects of short-term and long-term temperature changes on cognitive function.Results: Short-term and long-term temperature exposure was significantly and positively associated with moderate-to-severe cognitive impairment, with the greatest increase in odds ratios (ORs) found for 3-year TMAs (OR = 1.247; 95% confidence interval [CI]: 1.107, 1.404). The higher the quintiles of temperature exposure were, the higher were the ORs. The strongest association found was in long-term TMA exposure (OR = 3.674; 95% CI: 2.103, 6.417) after covariates were controlled for.Conclusions: The risk of mild cognitive impairment increased with ambient temperature in community-dwelling older adults in Taiwan.

scholarly journals Effect of Inpatient and Outpatient Pneumonia on Mobility Disability, Gait Speed, and Physical Activity in Older Adults

2021 ◽  
Vol 10 (6) ◽  
pp. 1236
Author(s):  
Joshua Brown ◽  
Reiko Sato ◽  
John E. Morley
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Gait Speed ◽  
Fold Increase ◽  
Activity Levels ◽  
Short Term ◽  
Life Study ◽  
Physical Activity Levels

Pathophysiological changes caused by pneumonia may influence physical functioning in older adults. This study was a secondary analysis of the Lifestyle Interventions and Independence for Elders (LIFE) Study. The LIFE Study included 1635 individuals over an average follow-up of 2.6 years at eight clinical sites during 2010–2013. Adults ≥ 70 years-old with mobility limitations (Short Physical Performance Battery score ≤ 9) were randomized to a physical activity (exercise) intervention or health education control arm. This analysis evaluated the association between pneumonia events and major mobility disability (MMD), gait speed, and physical activity levels. Pneumonia events, classified as inpatient or outpatient, were assessed by self-report during longitudinal follow-up. MMD was measured by the inability to complete a 400-m walk test, or other proxies, as a binary outcome and separately analyzed as “short-term” and “long-term” MMD. Short-term MMD was defined as MMD occurring in the assessment period immediately following (between 1-day to 6-months after) a pneumonia event and long-term was in the following assessment period (6 to 12 months after the event). Short- and long-term gait speed was similarly recorded during the walk test in meters per second (m/s) and measured on a linear scale. Physical activity levels were captured via accelerometry and shown visually. Mixed-effects repeated measures regression adjusted for intervention assignment, baseline demographics, comorbid conditions, and frailty. Among the 1635 participants, n = 174 (10.7%) had a pneumonia event of which 80 (46% of events) were hospitalized. Those with pneumonia during follow-up had higher baseline medication use, prior hospitalizations, and higher prevalence of lung disorders but similar baseline functioning. Pneumonia hospitalization was associated with a 4-fold increase [OR = 4.1 (3.2–5.0)] and outpatient events were associated with a 2-fold increase [OR = 2.6 (2.1–3.1)] in the odds of short-term MMD. Pneumonia hospitalizations, but not outpatient events, were associated with a nearly 10% decrement in short-term gait speed. Pneumonia events were not associated with either long-term MMD or gait speed outcomes. Physical activity levels decreased from baseline immediately following the pneumonia episode (10–30% reductions) and returned to baseline after 6 months. These results emphasize the importance of managing pneumonia risk factors to prevent disease in order to maintain physical independence and activity in older adults.

scholarly journals Motor and Pulmonary Function and Mobility Disability Among Black and White Older Adults With and Without HIV

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 232-232
Author(s):  
Brittney Lange-Maia ◽  
Aron Buchman ◽  
Sue Leurgans ◽  
Elizabeth Lynch ◽  
Melissa Lamar ◽  
...  
Keyword(s):  
Older Adults ◽  
Pulmonary Function ◽  
Racial Differences ◽  
Motor Function ◽  
Gait Speed ◽  
Self Report ◽  
Hiv Status ◽  
Mobility Disability ◽  
Related Factors ◽  
Black And White

Abstract Black-White disparities in gait speed have been observed in studies of adults reporting HIV, consistent with work among older adults without HIV. However, it is unknown if racial differences exist among adults with HIV for other mobility-related factors. We aimed to determine if racial differences exist in mobility disability among older adults with and without HIV and assess if pulmonary and motor function contribute to mobility disability. We examined older adults age 50+ with HIV (N=177; 72% Black) and without HIV (N=191; 68% Black). Motor function summarized 10 motor performances including gait speed; pulmonary function summarized 3 measures assessed using hand-held spirometry. Mobility disability was based on self-report. In regression models adjusted for age, sex, medical conditions, and smoking, neither race nor HIV status were associated with mobility-related factors. However, in models stratified by HIV status, Blacks with HIV had worse motor (β=-4.3, p=0.04) and pulmonary function (β=-50.5, <0.001) and higher odds of mobility disability (odds ratio [OR]=2.9, 95% confidence interval [CI]=1.01-8.2) compared to Whites with HIV. Racial differences were not apparent among uninfected participants in motor function, pulmonary function, or mobility disability. In subsequent models, racial differences in mobility disability were attenuated and no longer significant in HIV when adjusting for motor function (OR=0.88 per/% higher motor composite, 95% CI=0.84-0.93). Racial differences in mobility disability in HIV were unaffected when controlling for pulmonary function. Results suggest that Blacks with HIV have greater mobility disability compared to Whites with HIV, and these differences are due to differences in motor function.

scholarly journals Walking Skill Can Be Assessed in Older Adults: Validity of the Figure-of-8 Walk Test

2010 ◽  
Vol 90 (1) ◽  
pp. 89-99 ◽  
Author(s):  
Rebecca J. Hess ◽  
Jennifer S. Brach ◽  
Sara R. Piva ◽  
Jessie M. VanSwearingen
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Coefficient Of Variation ◽  
Gait Speed ◽  
Fear Of Falling ◽  
Movement Control ◽  
Community Dwelling ◽  
Walk Test ◽  
Step Width ◽  
Mobility Disability

Background The Figure-of-8 Walk Test (F8W) involves straight and curved paths and was designed to represent walking skill in everyday life. Objective The purposes of this study were to validate the measure in older adults with walking difficulties and to explore correlates of the curved-path walking measure not represented by a straight-path walking measure. Design Fifty-one community-dwelling older adults with mobility disability participated in 2 baseline visits as part of an intervention study. Methods The F8W time, steps, and smoothness and measures of gait (gait speed, modified Gait Abnormality Rating Scale [GARS-M]), physical function (Late Life Function and Disabilities Index [LLFDI], Survey of Activities and Fear of Falling in the Elderly [SAFFE], Gait Efficacy Scale [GES], Physical Performance Test [PPT], and fall history), and movement control and planning (gait variability, Trail Making Test B [Trails B]) were recorded in each test session. Bivariate correlations for the F8W with each variable were conducted to examine concurrent and construct validity. Adjusted linear regression analyses were performed to explore the variance in mobility explained by F8W independent of gait speed. Results Figure-of-8 Walk Test time correlated with gait (gait speed, r=−.570; GARS-M, r=.281), physical function (LLFDI function, r=−.469; SAFFE restriction subscale, r=.370; PPT, r=−.353), confidence in walking (GES, r=−.468), and movement control (step length coefficient of variation, r=.279; step width coefficient of variation, r=−.277; Trails B, r=.351). Figure-of-8 Walk Test steps correlated with step width variability (r=−.339) and was related to fear of falling (t=−2.50). All correlations were significant (P<.05). Limitations This pilot study had a small sample size, and further research is needed. Conclusions The F8W is a valid measure of walking skill among older adults with mobility disability and may provide information complementary to gait speed.

Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Gait Speed ◽  
Well Being ◽  
Self Report ◽  
Subjective Report ◽  
Healthy Older Adults ◽  
Relative Value ◽  
Cognitive Speed ◽  
Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

scholarly journals Feasibility and Enjoyment of Exercise Video Games in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 559-559
Author(s):  
Sara Freed ◽  
Briana Sprague ◽  
Lesley Ross
Keyword(s):  
Older Adults ◽  
Video Games ◽  
Game Design ◽  
Long Term Effects ◽  
Short Term ◽  
Qualitative And Quantitative ◽  
Before And After ◽  
Xbox Kinect ◽  
Game Developers

Abstract Interventions using exercise video games, or exergames, have shown short-term cognitive and physical benefits to older adults, though long-term effects are less promising. Enjoyment of exergames may promote exergame use after the intervention period, though little work has examined older adults’ views of exergames before and after gameplay experience. We invited 20 older adults between 65 and 84 years of age (M=73.30, SD=5.95) to play two Xbox Kinect games, Just Dance and Kinect Sports Rivals, for twenty minutes. In our presentation, we will present qualitative and quantitative findings of this pilot study, including findings that older adults reported that they were not likely to play similar exergames in the future and that they did not find the exergames to be more fun compared to other ways of exercising. We will discuss implications for game design and research relevant to game developers, manufacturers, and researchers. Part of a symposium sponsored by Technology and Aging Interest Group.

scholarly journals Standard Error of the Mean and Minimal Detectable Change of Gait Speed in Older Adults Using Japanese Long-Term Care Insurance System

2021 ◽  
Vol 7 ◽  
pp. 233372142110489
Author(s):  
Yui Takada ◽  
Shigeharu Tanaka
Keyword(s):  
Older Adults ◽  
Standard Error ◽  
Gait Speed ◽  
Long Term Care ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Term Care ◽  
Long Term Care Insurance ◽  
The Mean

Evaluation of motor function, such as gait ability, can accurately predict the subsequent occurrence of disability in older adults. There are no reports of standard error of the mean (SEM) or minimal detectable change (MDC) with respect to gait in Japanese long-term care insurance-certified individuals. The purpose of this study was to investigate the values of preferred gait, fast gait, and the timed up and go (TUG) test. This study included 46 participants using the Japanese long-term care insurance system. (age 86.5 ± 6.6 years, 12 men, 34 women). The duration of three gait were measured twice using a stopwatch. The SEM was 0.07 for preferred gait, 0.09 for fast gait and 2.59 for TUG. The MDC was 0.19 for preferred gait, 0.26 for fast gait, and 7.17 for TUG. The SEM and MDC values of preferred gait, fast gait, and TUG in this study corroborated with those of previous studies, whereas others were different. Considering that gait speed differs with the country, it may be difficult to compare it among different population groups. We obtained the results of gait speed of Japanese long-term care insurance-certified individuals, which is a new finding

The Relationship between Goal Proximity and Specificity in Bowling: A Field Experiment

1990 ◽  
Vol 4 (2) ◽  
pp. 145-154 ◽  
Author(s):  
Steven H. Frierman ◽  
Robert S. Weinberg ◽  
Allen Jackson
Keyword(s):  
Goal Setting ◽  
Repeated Measures ◽  
Questionnaire Data ◽  
Short Term ◽  
Level Of Confidence ◽  
Goal Condition ◽  
Main Effect ◽  
The Relationship ◽  
Better Than

The purpose of this investigation was twofold: to determine if individuals who were assigned specific, difficult goals perform better than those assigned “do your best” goals, and to examine the importance of goal proximity (longterm vs. short-term) on bowling performance. Subjects were 72 students enrolled in two beginning bowling courses at a 4-year university. They were matched according to baseline bowling averages and then randomly assigned to one of four goal-setting conditions. A 4 × 5 (Goal Condition × Trials) ANOVA with repeated measures on the last factor revealed a significant goal condition main effect, with the long-term goal group improving more than the do-your-best group. No other performance comparisons reached significance. Questionnaire data revealed that subjects in all three numerical goal conditions rated their level of confidence significantly higher than the do-your-best goal group in Week 1, but the long-term goal group displayed a significantly higher level of confidence than the other three goal groups in Week 4. All other questions indicated that all groups tried hard and were committed to and accepted their goals.

The Association of Mobility Determinants and Life Space Among Older Adults

2021 ◽  
Author(s):  
Pamela M Dunlap ◽  
Andrea L Rosso ◽  
Xiaonan Zhu ◽  
Brooke N Klatt ◽  
Jennifer S Brach
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Energy Cost ◽  
Community Dwelling ◽  
Walk Test ◽  
Personal Factors ◽  
Linear Regression Models ◽  
Life Space ◽  
Mobility Disability ◽  
Energy Cost Of Walking

Abstract Background It is important to understand the factors associated with life space mobility so that mobility disability can be prevented/treated. The purpose of this study was to identify the association between mobility determinants and life space among older adults. Methods This study was a cross-sectional analysis of 249 community-dwelling older adults (mean age=77.4 years, 65.5% female, 88% white) who were recruited for a randomized, controlled, clinical intervention trial. Associations between cognitive, physical, psychosocial, financial, and environmental mobility determinants and the Life Space Assessment (LSA) at baseline were determined using Spearman’s correlation coefficients and one-way analysis of variance. Multivariate analysis was performed using multivariable linear regression models. Results The mean LSA score for the sample was 75.3 (SD=17.8). Personal factors (age, gender, education, comorbidities), cognitive (Trail Making Test A and B), physical (gait speed, lower extremity power, Six Minute Walk Test, Figure of 8 Walk Test, tandem stance, energy cost of walking, and Late Life Function and Disability Function Scale), psychosocial (Modified Gait Efficacy Scale), and financial (neighborhood socio-economic status) domains of mobility were significantly associated with LSA score. In the final regression model, age (β=-0.43), lower extremity power (β=0.03), gait efficacy (β=0.19), and energy cost of walking (β=-57.41) were associated with life space (R 2=0.238). Conclusions Younger age, greater lower extremity power, more confidence in walking, and lower energy cost of walking were associated with greater life space. Clinicians treating individuals with mobility disability should consider personal, physical, and psychosocial factors assessing barriers to life space mobility.

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