scholarly journals Functional Disability in Older Adults Maintained on Peritoneal Dialysis Therapy

2016 ◽  
Vol 36 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Ozkan Ulutas ◽  
Janine Farragher ◽  
Ernest Chiu ◽  
Wendy L. Cook ◽  
Sarbjit V. Jassal
Keyword(s):  
Peritoneal Dialysis ◽  
Daily Living ◽  
Functional Disability ◽  
Functional Performance ◽  
Functional Dependence ◽  
Cross Sectional Study ◽  
Dialysis Therapy ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Home Dialysis

♦ BackgroundOlder in-center hemodialysis patients have a high burden of functional disability. However, little is known about patients on home chronic peritoneal dialysis (PD). As patients opting for home dialysis are expected to play a greater role in their own dialysis care, we hypothesized that a relatively low number of PD patients would require help with basic self-care tasks (ADL) and instrumental activities of daily living (IADL).♦ MethodsWe used a cross-sectional study design to measure the proportion of patients aged 65 years and older undergoing outpatient PD who needed help with day-to-day activities. Patients living in nursing homes were excluded from the study. Functional dependence in ADL and IADL tasks were measured by the Barthel and Lawton Scales. Physical performance measures used included the timed up-and-go (TUG) test, chair stands and Folstein mini-mental score (MMSE).♦ResultsA total of 74 of 76 (97%) eligible PD patients participated. Patients had a mean age of 76.2 ± 7.5 years. Thirty-six percent had impaired MMSE scores, 69% were unable to stand from a chair without the use of their arms and 51% had abnormal TUG scores. Only 8 patients (11%) were fully independent for both ADL and IADL activities. Dependence in one or more ADL activity was reported by 64% of participants, while 89% reported dependence in one or more IADL.♦ConclusionsImpaired physical and functional performance is common in older patients maintained on PD. Collaborative geriatric-renal programs may be beneficial within the dialysis community.

Potential associated factors of functional disability in Chinese older inpatients: A multicenter cross-sectional study

2020 ◽  
Author(s):  
Hongpeng Liu ◽  
Jing Jiao ◽  
Chen Zhu ◽  
Minglei Zhu ◽  
Xianxiu Wen ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Older Inpatients ◽  
Hospital Wards

Abstract Background: Older adults are vulnerable to a decline in physical functioning, including basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL). The causes of functional disability in older adults are multifactorial. A comprehensive understanding of these factors will contribute toward future health service planning. However, studies of ADL and IADL in Chinese older adults are insufficient. The aim of this study is to describe the level of ADL and IADL in different age groups and explore the factors associated with functional disability in Chinese older inpatients. Methods: We conducted a cross-sectional study consisted of 9,996 Chinese older inpatients aged 65 years and older. Participants were recruited from six provinces or municipality city in southwest (Sichuan province), northeast (Heilongjiang), south central (Hubei province), northern (Beijing municipality city), northwest (Qinghai province), and eastern China (Zhejiang province) from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale in consecutive intervals from 65 years of age. After controlling for the cluster effect of hospital wards, a mixed-effect generalized linear model was used to examine the association between functional disability and covariates. Results: The average ADL score was 27.68±4.59 and the mean IADL score 6.76±2.01 for all participants. A negative correlation between scores and age was observed, and there was a significant difference in ADL and IADL scores among different age groups. The top negatively influential factor in ADL and IADL was stair climbing and shopping, respectively. After controlling for the cluster effect of hospital wards, aging, emaciation, frailty, depression, falling accidents in past 12 months, hearing dysfunction, cognitive dysfunction, urinary dysfunction, and defecation dysfunction were associated with ADL and IADL. Patients transitioned from the emergency department and other hospitals were also affected by ADL disability. Former smoking was associated with lower IADL scores. Higher level of education, living in a building without elevators, and current alcohol consumption were correlated with better IADL performance. Conclusion: Decreased functional ability was associated with the increasing age. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care.

scholarly journals Cluster analysis to identify elderly people's profiles: a healthcare strategy based on frailty characteristics

2014 ◽  
Vol 132 (4) ◽  
pp. 224-230 ◽  
Author(s):  
André Fattori ◽  
Ivan Mazivieiro Oliveira ◽  
Rosalia Matera de Angelis Alves ◽  
Maria Elena Guariento
Keyword(s):  
Cluster Analysis ◽  
Cognitive Impairment ◽  
Functional Performance ◽  
Functional Dependence ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cognitive Capacity ◽  
Cross Sectional ◽  
Analysis Strategy ◽  
Specific Care

CONTEXT AND OBJECTIVES: The new social panorama resulting from aging of the Brazilian population is leading to significant transformations within healthcare. Through the cluster analysis strategy, it was sought to describe the specific care demands of the elderly population, using frailty components.DESIGN AND SETTING: Cross-sectional study based on reviewing medical records, conducted in the geriatric outpatient clinic, Hospital de Clínicas, Universidade Estadual de Campinas (Unicamp).METHODS: Ninety-eight elderly users of this clinic were evaluated using cluster analysis and instruments for assessing their overall geriatric status and frailty characteristics.RESULTS: The variables that most strongly influenced the formation of clusters were age, functional capacities, cognitive capacity, presence of comorbidities and number of medications used. Three main groups of elderly people could be identified: one with good cognitive and functional performance but with high prevalence of comorbidities (mean age 77.9 years, cognitive impairment in 28.6% and mean of 7.4 comorbidities); a second with more advanced age, greater cognitive impairment and greater dependence (mean age 88.5 years old, cognitive impairment in 84.6% and mean of 7.1 comorbidities); and a third younger group with poor cognitive performance and greater number of comorbidities but functionally independent (mean age 78.5 years old, cognitive impairment in 89.6% and mean of 7.4 comorbidities).CONCLUSION: These data characterize the profile of this population and can be used as the basis for developing efficient strategies aimed at diminishing functional dependence, poor self-rated health and impaired quality of life.

scholarly journals Family health strategy: relevance to the functional capacity of older people

2018 ◽  
Vol 71 (suppl 2) ◽  
pp. 740-746 ◽  
Author(s):  
Carla Silvana de Oliveira e Silva ◽  
Mayke Müller Soares Barbosa ◽  
Lucinéia de Pinho ◽  
Maria Fernanda Santos Figueiredo ◽  
Caroline Oliveira Amaral ◽  
...  
Keyword(s):  
Older People ◽  
Functional Capacity ◽  
Daily Living ◽  
Functional Dependence ◽  
Family Health ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy

ABSTRACT Objective: to identify the functional capacity of older people based on their performance on basic activities of daily living. Method: a cross-sectional study, carried out through the record of the Family Health teams working in the urban area of a city in northern Minas Gerais, in 2015. To assess the functional capacity of 373 older people, the Katz Scale was applied, which includes dimensions on the performance of daily living activities. The interviews took place in the participants’ households. Results: of the total participants, 6.9% had some degree of dependence. Those aged over 80 years old and were living without a partner had about three times more chances of presenting higher levels of functional dependence. Conclusion: most older people enrolled in a Family Health Strategy had their functional capacity preserved.

scholarly journals Evidence for Reliability and Validity of Functional Performance Testing in the Evaluation of Nonarthritic Hip Pain

2019 ◽  
Vol 54 (3) ◽  
pp. 276-282 ◽  
Author(s):  
Ryan P. McGovern ◽  
John J. Christoforetti ◽  
RobRoy L. Martin ◽  
Amy L. Phelps ◽  
Benjamin R. Kivlan
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Interrater Reliability ◽  
Functional Performance ◽  
Reliability And Validity ◽  
Performance Testing ◽  
Cross Sectional Study ◽  
Hip Pain ◽  
Performance Tests ◽  
Cross Sectional

Context The single-legged–squat test (SLST) and step-down test (SDT) are 2 functional performance tests commonly used to evaluate active people with nonarthritic hip pain and dysfunction. However, evidence to support the use of the SLST and SDT in this population is lacking. Objective To offer evidence of reliability and validity for the SLST and SDT in evaluating patients with nonarthritic hip pain. Design Cross-sectional study. Setting Orthopaedic surgeon's clinical office. Patients or Other Participants Forty-five patients (27 female and 18 male participants; age = 28.5 ± 10 years, height = 171.6 ± 10.1 cm, weight = 73.9 ± 15.2 kg, and body mass index = 25 ± 4.1) diagnosed with nonarthritic hip pain. Main Outcome Measure(s) Participants performed the SLST and SDT. Interrater reliability and validity of passive internal rotation of the hip, visual analog scale (VAS) scores, and hip outcome scores (HOSs) for limitations in activities of daily living and sport-related activities (SRAs) were collected. Results Interrater reliability was moderate to excellent for both the SLST (0.603–0.939) and SDT (0.745–0.943). Participants who passed or failed the SLST and SDT differed on the following measures: VAS for the SLST (F1,43 = 16.21, P < .001); VAS for the SDT (F1,43 = 13.41, P = .001); HOS-activities of daily living for the SLST (F1,40 = 5.15, P = .029); HOS-SRAs for the SLST (F1,40 = 7.48, P = .009); and HOS-SRAs for the SDT (F1,40 = 6.42, P = .015). Conclusions Our study offers evidence for the use of the SLST and SDT as reliable and valid functional performance tests in the evaluation of physical function for patients with nonarthritic hip pain.

scholarly journals A Cross-sectional Study of Fixed and Growth Mindset in Adult Peritoneal Dialysis Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110552
Author(s):  
Rachel B. Fissell ◽  
David Schlundt ◽  
Kerri L. Cavanaugh ◽  
Claudia Mueller ◽  
Ebele M. Umeukeje ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Self Efficacy ◽  
Convergent Validity ◽  
Cross Sectional Study ◽  
Growth Mindset ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Home Dialysis ◽  
Targeted Interventions ◽  
New Strategies

Increasing home dialysis prevalence is an international priority. Many patients start peritoneal dialysis, then transition to hemodialysis after complications. New strategies are needed to support modality persistence. Health mindset refers to individual belief about capacity to change to improve health. Mindset was measured in a cross-section of 101 adult peritoneal dialysis patients from April 2019 to June 2020. The Health Mindset Scale was administered to characterize the continuum of fixed vs. growth mindset with respect to health. Health literacy and health self-efficacy were also assessed. Participants were 43% female, 32% African American, and 42% diabetic. Health mindset scores were skewed toward growth (range 3–18), with average (SD) 12.83 (4.2). Growth mindset was strongly associated with health self-efficacy. Adults receiving peritoneal dialysis report health mindset variation. Growth mindset and health self-efficacy correlation suggests measurement of similar constructs, demonstrating convergent validity. The Health Mindset Scale may identify individuals who could benefit from targeted interventions to improve mindset, and foster peritoneal dialysis modality persistence.

Using Functional Ability Measures to Assess Fall Risk in Acute Care

2020 ◽  
Vol 42 (12) ◽  
pp. 1050-1058
Author(s):  
Alaina M. Bassett ◽  
Ka-Chun Siu ◽  
Julie A. Honaker
Keyword(s):  
Acute Care ◽  
Functional Ability ◽  
Fall Risk ◽  
Assessment Tool ◽  
Functional Performance ◽  
Risk Measures ◽  
Cross Sectional Study ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Acute Care Settings

Currently, it is not known whether integration of functional performance measures is sensitive and feasible for use in acute care settings. This cross-sectional study explored the subjective and objective measures of the risks of falling, falls efficacy, and functional abilities for inpatients in an adult acute care unit. The Morse Fall Scale ( n = 30) and Timed Up and Go (TUG; n = 10) had excellent sensitivity (100%) for identifying participants with prior fall histories, while the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients only had good sensitivity (87.5%). Study findings suggest that implementation of feasible functional ability measures in conjunction with subjective fall risk measures could enhance accuracy and performance in identifying inpatient risks of falling in acute care settings.

Dynamic Balance Performance In Relation To the Dependence in Activities of Daily Living: A Cross-Sectional Study in Stroke Patients

2020 ◽  
Vol 04 (5) ◽  
pp. 01-04
Author(s):  
Víctor Silverio
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Dynamic Balance ◽  
Cross Sectional Study ◽  
Step Test ◽  
Sectional Study ◽  
Balance Performance ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Cross Sectional

Aim: to determine if dynamic balance is related to activities of daily living (ADL) dependence in stroke patients. Methods: a cross-sectional study was carried out. The Barthel index (BI) was used to assess ADL dependence. The Timed Up and Go Test (TUG) and the Four Square Step Test (FSST) were used to evaluate dynamic balance. A Spearman correlation was used assuming a data abnormality in the performance of TUG and FSST and considering a significance of p<0.05. Results: 62 stroke patients were evaluated. The BI showed correlations with the performance of the TUG and the FSST. These correlations were also found between performance of both balance tests and ADLs, such as bathing, moving, and going up and down stairs. In contrast to TUG, correlations were estimated between the ADL related to dressing and the performance of the FSST. Conclusion: dynamic balance evaluated by the TUG and the FSST showed correlations with the ADL dependency in stroke patients.

Prevalence and Factors Associated with Impairment of Instrumental Activities of Daily Living in Older People: A Population Study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nunes DP ◽  
◽  
Castro DC ◽  
Mota JPN ◽  
Moura BM ◽  
...  
Keyword(s):  
Older People ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
Cross Sectional Study ◽  
International Studies ◽  
Cross Sectional ◽  
Factors Associated ◽  
Instrumental Activities ◽  
The City

Objective: To identify the prevalence and factors associated with functional disability for Instrumental Activities of Daily Living (IADL) among older people in a Brazilian capital. Methods: This is a cross-sectional study carried out on 927 older people in the city of Goiânia, Goiás, Brazil. Lawton’s scale was used to assess IADL. Functional disability was characterized as difficulty in performing at least one activity. Multiple logistic regression was employed for the analysis of association. Results: A 58.2% prevalence of disability was identified, and the most compromised activities were doing manual work, doing the laundry, and ironing. There was an association between disability and old age, poor/very poor self-rated health, cerebrovascular accident, widowhood, cognitive impairment, musculoskeletal disorder, and living alone. Conclusions: The prevalence of functional disability for IADL was higher than that of national and international studies. We verified associated factors that can be modified by health promotion initiatives, which are configured as priority areas for interventions.

scholarly journals Functional disability in Brazilian octogenarians: data from the 2013 National Health Survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P M Stolses Bergamo Francisco ◽  
D de Assumpção ◽  
F Silva Arbex Borim ◽  
A Gomes de Macedo Bacurau ◽  
A M Pita Ruiz ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
National Health ◽  
Health Survey ◽  
Daily Living ◽  
Functional Disability ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
National Health Survey ◽  
Cross Sectional ◽  
Instrumental Activities

Abstract Background The impairment of function capacity implies a greater risk of biological and social vulnerability, increasing the demand for healthcare services and caregivers. Objective Estimate the prevalence of functional disability in the performance of basic and instrumental activities of daily living (BADL and IADL) among long-lived Brazilians (≥80 years) according to sociodemographic characteristics and self-rated health. Methods A cross-sectional study was conducted with data from seniors who participated in the 2013 National Health Survey (n = 1498). Functional disability was defined as difficulty performing at least one of the six BADL or five IADL. Independent associations were determined using Poisson multiple regression analysis, with the calculation of prevalence ratios and 95% confidence intervals adjusted for chronic diseases. Results Mean age was 84.8 years (CI95%: 84.5-85.1); 59% were women; 62% were self-declared white; and 63% had no private health insurance. The prevalence of functional disability in BADL and IADL was 33.8% (CI95%: 30.6-37.2) and 66.4% (CI95%: 62.5-70.2), respectively. Only 17.7% participated in organized social activities and only 15.5% rated their health as poor/very poor. Regarding BADL, greater disability was found among those ≥85 years of age, among men and those who rated their health as poor (p &lt; 0.05). Regarding IADL, greater disability was found among those ≥85 years of age, those without a conjugal life, illiterate individuals and those who rated their health as poor (p &lt; 0.05). Conclusions Approximately 1/3 and 2/3 of long-lived Brazilian exhibited restricted skills for maintaining their autonomy and independence regarding the performance of BADL and IADL, respectively. The present findings underscore the importance of family and social support networks to assist older adults in the performance of basic and instrumental activities of daily living as well as activities related to mobility. Key messages The impairment of function capacity increases the demand for healthcare services and caregivers. Approximately 1/3 and 2/3 of long-lived Brazilians have functional disability regarding the performance of basic and instrumental activities of daily living, respectively.

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