Associations between occupational performance and quality of life, well-being, and instrumental activities of daily living in older adults / Associações entre desempenho ocupacional e qualidade de vida, bem-estar e atividades instrumentais da vida diária em idosos

Abstract This study aimed to investigate the associations between occupational performance and quality of life, well-being, and instrumental activities of daily living in older Japanese adults by examining the correlations between the Canadian Occupational Performance Measure and other assessment instruments. We recruited 45 participants (≥65 years old, without dementia) from inpatient and outpatient rehabilitation services in Japan. The associations between the Canadian Occupational Performance Measure as a measure of occupational performance and satisfaction and the Medical Outcomes Study Short Form-36 as a measure of the quality of life, Philadelphia Geriatric Center Morale Scale as a measure of well-being, and Tokyo Metropolitan Institute of Gerontology Index of Competence as a measure of instrumental activities of daily living were examined using Spearman's correlation coefficient. The Canadian Occupational Performance Measure performance and satisfaction scores showed fair correlations with the physical and mental component summary scores of the Medical Outcomes Study Short Form-36 (r = 0.35 and 0.45, respectively) but not with the role or social component summary scores. Both performance and satisfaction scores showed fair correlations with the total Philadelphia Geriatric Center Morale Scale score (r = 0.35 and 0.41, respectively), but not with the total Tokyo Metropolitan Institute of Gerontology Index of Competence score. The occupational performance showed fair correlations with quality of life and well-being but not with instrumental activities of daily living in older Japanese adults.

Resumo Este estudo teve como objetivo investigar associações entre desempenho ocupacional e qualidade de vida, bem-estar e atividades instrumentais da vida diária em idosos japoneses, examinando as correlações entre a Medida Canadense de Desempenho Ocupacional e outros instrumentos de avaliação. Quarenta e quatro participantes (≥65 anos, sem demência) foram recrutados a partir de serviços de reabilitação hospitalar e ambulatorial no Japão. Associações entre a Medida de Desempenho Ocupacional Canadense, como medida de desempenho e satisfação ocupacional, o Estudo de Resultados Médicos Versão Curta-36, como medida de qualidade de vida, a Escala Moral do Centro Geriátrico da Filadélfia, como medida de bem-estar, e o Índice de Competência do Instituto Metropolitano de Gerontologia de Tóquio, como medida das atividades instrumentais da vida diária, foram examinadas usando o coeficiente de correlação de Spearman. Os escores de performance e satisfação da Medida de Desempenho Ocupacional Canadense mostraram correlações altas com os escores de componentes físicos e mentais do Estudo de Resultados Médicos Versão Curta-36 (r = 0,35 e 0,45, respectivamente), mas não com os escores de função ou componente social. Ambos os escores de desempenho e satisfação mostraram correlações altas com o escore total da Escala Moral do Centro Geriátrico da Filadélfia (r = 0,35 e 0,41, respectivamente), mas não com o Índice de Competência do Instituto Metropolitano de Gerontologia de Tóquio. A performance demonstrou correlações altas com qualidade de vida e bem-estar, mas não com atividades instrumentais de vida diária em idosos japoneses.

Validity and reliability of the Japanese version of the FIM + FAM in patients with cerebrovascular accident.

BACKGROUND AND AIM: The study aim was to investigate the validity and reliability of the Functional Independence Measure and Functional Assessment Measure (FIM + FAM), which is unfamiliar in Japan, by using its Japanese version (FIM + FAM-j) in patients with cerebrovascular accident (CVA). MATERIAL AND METHODS: Forty-two CVA patients participated. Criterion validity was examined by correlating the full scale and subscales of FIM + FAM-j with several well-established measurements using Spearman's correlation coefficient. Reliability was evaluated by internal consistency (tested by Cronbach's alpha coefficient) and intra-rater reliability (tested by Kendall's tau correlation coefficient). RESULTS: Good-to-excellent criterion validity was found between the full scale and motor subscales of the FIM + FAM-j and the Barthel Index, National Institutes of Health Stroke Scale, modified Rankin Scale, and lower extremity Brunnstrom Recovery Stage. High internal consistency was observed within the full-scale FIM + FAM-j and the motor and cognitive subscales (Cronbach's alphas were 0.968, 0.954, and 0.948, respectively). Additionally, good intra-rater reliability was observed within the full scale and motor subscales, and excellent reliability for the cognitive subscales (taus were 0.83, 0.80, and 0.98, respectively). CONCLUSION AND SIGNIFICANCE: This study showed that the FIM + FAM-j demonstrated acceptable levels of validity and reliability when used for CVA as a measure of disability.

Feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function in elderly cancer patients in Japan.

OBJECTIVE: We conducted this study with the aim of demonstrating the feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function in elderly cancer patients. METHODS: The subjects were patients with breast or prostate cancer who were 65 years of age or over. Among 146 patients, 78 were randomly assigned to the intervention group (n = 38) or the control group (n = 40). The intervention group received speed-feedback therapy with a bicycle ergometer once a week for four successive weeks. The control group was advised to spend the 4-week period engaged in their routine activities. Evaluations were carried out at the baseline and 4 weeks after the baseline (week 4) using the Frontal Assessment Battery, the Barthel Index, the Lawton and Brody Instrumental Activities of Daily Living, and the Functional Assessment of Cancer Therapy-General ver.4. Data were analyzed by a two-way repeated-measures analysis of variance. RESULTS: The mean score of Frontal Assessment Battery for the intervention group was higher than that for the control group at week 4. In addition to significant main effects of time and group, we also found a significant interaction between the two groups (p = 0.006). Moreover, all of the subjects in the intervention group could complete all the four sessions of therapy without any pain or distress. CONCLUSION: These results suggest that speed-feedback therapy with a bicycle ergometer may be feasible as well as effective for improving the cognitive function in elderly cancer patients.

Clinical usefulness of the Frontal Assessment Battery at bedside (FAB) for elderly cancer patients.

BACKGROUND: The number of elderly cancer patients has been rising in recent years, and decreases in cognitive function are reportedly seen in 25-50% of these patients. However, no validated and practical tests are available for the assessment of cognitive function in cancer patients. Age and the effects of cancer treatment have been pointed out as possible causes of these decreases in cognitive function; in both instances, a strong possibility of a decrease in frontal lobe function exists. METHODS: We administered the Frontal Assessment Battery at bedside (FAB), the Mini-Mental State Examination (MMSE), the Barthel Index, and the Instrumental Activities of Daily Living (IADL) to 54 cancer patients who were 65 years of age or older and assessed the clinical usefulness of the FAB. RESULTS: The results showed that the FAB scores were significantly correlated with the MMSE and IADL scores and were unaffected by the number of years of education. Moreover, when the subjects were divided into two groups according to whether their total FAB score was less than 16 points or 16 points or more, significant differences in the total MMSE scores and the total IADL scores were observed. CONCLUSIONS: Based on these findings and because the FAB sensitively detected decreases in cognitive function, accurately reflected the status of everyday life, and could be performed conveniently and in a short time, we concluded that the FAB may be very useful clinically as a means of evaluating the cognitive function of elderly cancer patients.