Psychological Factors Associated with Functional Disability in Patients with Hip and Knee Osteoarthritis.

Several studies have shown an association between psychosocial variables and functional capacity in chronic pain processes such as osteoarthritis. The aim of this study was to test a structural equations model that shows the predictive weight of certain variables such as catastrophizing, self-efficacy and kinesiophobia on functional pain and WOMAC subscales scores of pain and physical function of older patients diagnosed with hip and knee osteoarthritis. We also assessed the specific weight of age in terms of the factors. The study was conducted on a sample of 170 patients (142 women and 28 men mean age, 74.44 years range, 50-96 years). The main variables evaluated were WOMAC subscales scores of pain and physical function, self-efficacy, catastrophizing and kinesiophobia. To assess these variables, we used the Spanish validated version of the Western Ontario and McMaster Universities questionnaire, the Chronic Pain Self-Efficacy Scale, the Pain Catastrophizing Scale and the Tampa Scale for Kinesiophobia, respectively. We tested a structural equations model (IBM SPSS Amos version 22). The results showed the predominant predictive weight (both direct and indirect) of catastrophizing while simultaneously ruling out the relevance of age as a predictor of WOMAC subscales scores of pain and physical function. This study provides data of interest on the explanatory mechanisms that underlie the direct and inverse relationships between the studied psychological variables.

[Cognitive activities and cognitive functioning in the elderly]. / Actividades cognitivas y funcionamiento cognitivo en personas muy mayores.

INTRODUCTION: The aim of this study was to analyse whether the activity is a protective factor of intellectual decline, and specifically to examine whether intellectual activity versus other activities, is a better predictor for the maintenance of cognitive functioning in a group of people over 90 years, independent in basic daily living activities and having preserved cognitive capacity. MATERIAL AND METHODS: This sample was selected from a bio-psycho-social longitudinal study of independent persons 90 and over. This is a longitudinal study involving 188 people, 67 males and 121 females. Measurements were taken of cognitive functioning and level of activity and repeated between 6 and 14 months; inferential analysis was performed at baseline and follow-up. RESULTS: At base-line, there is a strong association between the level of activity and performance. Also, and most important, intellectual activities at baseline predict cognitive functioning at follow-up. According to our results, intellectual activities and the maintenance of cognitive functioning are associated with the absence of cognitive impairment in the very elderly. CONCLUSIONS: This has important implications for the scientific community in finding a predictive index and strategies, but also for the individual to identify factors of change on which to act to reduce problems associated with aging.

Mortality and refusal in the longitudinal 90+ project.

Attrition is one of the most important threats for longitudinal studies on aging mainly due to refusal and mortality. This study deals with those individuals who were assessed in the base line of 90+ project but died, dropped out or were examined in the follow-up. Participants of the 90+ project baseline consist of a sample of 188 older than 90 years, independent individuals (mean age = 92.9; 67 men and 121 women) living in the community (n = 76) or in residences (n = 112). They were assessed through the European Survey on Aging Protocol (ESAP) by collecting anthropometric, health and life styles, bio-behavioral, psychological and social data. After 6-14 months from the baseline, 55% individuals were re-assessed, 11% died and 34% dropped out for several reasons. Comparisons between the individuals deceased, interviewed and those who dropped out yielded significant differences mainly due to contextual variables. The mortality rate of participants living in residences is three times greater than those of participants living in the community. Trying to determine the differences between these three groups due to bio-psycho-social variables, we found that regular physical activity, mental status, leisure activities, fitness, perceived control and openness assessed at the baseline differentiate our three groups. Finally, 90% of those individuals who died were identified at the baseline as "non successful agers", while more than a half of those who participated and a third of the non-participants were identified as "successful agers". It can be concluded that among those independent but very old people, mortality is less important than willing to participate and contextual, behavioral and psychological factors are relevant for distinguishing mortality, survival and participation.