Biological ageing and the risk of decreased handgrip strength among community-dwelling older adult Indians: a cross-sectional study.

BACKGROUND: Evidence from the literature demonstrates that the risk of decreased handgrip strength is associated with various health issues, particularly in older persons. To make judgments regarding their general health condition that are well-informed for longevity, it is crucial to assess the risk level of decreased handgrip strength among community-dwelling older adult Indians. However, no study has examined the relationship between biological aging and the risk of decreased handgrip strength in Indian men and women aged 60 and older. The goal of the current study was to fill this gap in the literature. METHODS: In this cross-sectional study, we included 31,464 (15,098 men and 16,366 women) community-dwelling older adult Indians aged 60 years and older using data from the Longitudinal Aging Study in India (LASI). The LASI is the world's most extensive and India's first multidisciplinary, internationally harmonized, longitudinal aging study. It has enrolled 72,250 individuals aged 45 and above across all 28 states and 8 union territories of India. Secondary analysis of biological ageing was performed by stratifying for age groups (60-64, 65-69, 70-74, 75-79, 80-84, and 85 + years) for both genders. The dominant right and nondominant left handgrip strength was assessed using the portable Smedley's Hand Dynamometer. All individuals had a dominant right hand. The adjusted logistic regression analysis assessed the association between biological ageing and the risk of decreased handgrip strength for both genders. RESULTS: Compared to those between the ages of 60-64, those at age 65 and those aged 85 and above had 1-fold and 12-fold odds of decreasing handgrip strength, respectively. Men 85 years or older had a 12-fold higher chance than women in the same age group of having decreased handgrip strength. CONCLUSIONS: The results indicate that community-dwelling older adult Indians aged 65 years and older are significantly associated with a higher risk of decreased handgrip strength, especially among older men. The results of this study can help assess and implement handgrip strength measurement in medicine for older Indians as part of regular admission assessment, particularly for older men.

Feasibility and Efficacy of Low-to-Moderate Intensity Aerobic Exercise Training in Reducing Resting Blood Pressure in Sedentary Older Saudis with Hypertension Living in Social Home Care: A Pilot Randomized Controlled Trial.

Background and Objectives: The effect of non-pharmacological aerobic exercise training on blood pressure in sedentary older individuals receiving social home care in Saudi Arabia has not been investigated. This study aimed to examine the effects of aerobic exercise on blood pressure in sedentary older Saudis with hypertension residing in these settings. Materials and Methods: A pilot randomized control trial was conducted with 27 sedentary individuals, aged 60-85, diagnosed with hypertension, and living in social home care in Makkah, Saudi Arabia. Recruitment took place between November 2020 and January 2021, and participants were randomly assigned to either the experimental or control group. The experimental group engaged in three 45 min sessions of low-to-moderate intensity aerobic activity per week for eight weeks. This trail was registered with the ISRCTN registry (ISRCTN50726324). Results: Following eight weeks of mild to moderate aerobic exercise training, the primary outcome of resting blood pressure showed a significant reduction in the experimental group (systolic blood pressure: mean difference [MD] = 2.91 mmHg, 95% confidence interval [CI] = 1.61, 4.21, p = 0.001; and diastolic blood pressure: MD = 1.33 mmHg, 95% CI = 1.16, 1.50, p = 0.001) compared to the control group. Within the experimental group, there was also a significant decrease in systolic blood pressure (MD = -2.75 mmHg, 95% CI = -7.73, 2.22, p = 0.005) and diastolic blood pressure (MD = -0.83 mmHg, 95% CI = -5.81, 4.14, p = 0.02). Conclusions: This trial demonstrates the feasibility and potential benefits of low-to-moderate intensity aerobic exercise training in reducing resting blood pressure among sedentary older Saudis with hypertension residing in this aged care setting.

Associations between social determinants and the presence of chronic diseases: data from the osteoarthritis Initiative.

BACKGROUND: Some studies investigated the relationship between musculoskeletal conditions and chronic diseases. However, no study examined the association between social determinants and chronic diseases among people at high risk for knee osteoarthritis. Thus, the current study was aimed to address this gap. METHODS: A secondary data analysis was conducted on a total of 3280 men and women aged 45 to 79 who were recruited in the Osteoarthritis Initiative. RESULTS: Multivariable logistic regression analyses show that age ≥ 65 years was associated with 1.98, 1.96, and 1.46 times odds of the presence of diabetes, heart attack, and multi-morbidity, respectively than age ≤ 64 years. Men were associated with 1.39, 1.41, 1.76, and 2.24 times odds of the presence of arthritis, cancer, diabetes, and heart attack, respectively than women. African American/Asian/ non-Caucasian was associated with 2.71, 2.56, and 1.93 times odds of the presence of arthritis, diabetes, and heart attack, respectively than Caucasian. Primary school/less education was associated with twice or more times the odds of arthritis and chronic obstructive pulmonary disease (COPD) than ≥high school education. Unemployment was associated with 1.41-, 1.73-, 1.58-, and 1.70-time odds of the presence of arthritis, cancer, COPD, and heart attack, respectively, then employed. Unmarried/widowed/separated was associated with 1.41, 1.75, 2.77, 2.76, 1.86, and 3.34 times odds of the presence of arthritis, asthma, cancer, COPD, diabetes, and heart attack, respectively than married. Annual income < 50,000 was associated with 1.33-, 1.44-, and 1.38-time odds of the presence of arthritis, diabetes, and multi-morbidity, respectively, then annual income ≥50,000. Overweight/obese was associated with 2.28 times the odds of the presence of diabetes than healthy weight. Current/former smoker was associated with 1.57, 2.47, 2.53, 1.63, and 1.24 times odds of the presence of arthritis, cancer, COPD, heart attack, and multi-morbidity, respectively than a nonsmoker. Consuming alcohol was associated with 1.32-, 1.65-, 1.50-, and 1.24-time odds of the presence of arthritis, COPD, diabetes, and multi-morbidity, respectively, then nonalcoholic. CONCLUSIONS: Social determinants are associated with the presence of chronic diseases. Some of the social determinants are modifiable or treatable. Thus, these findings can inform public health strategies in the United States.

The effect of a multicomponent exercise programme onelderly adults' risk of falling in nursing homes: A systematic review.

OBJECTIVE: To determine the effect of a multi-component exercise programme on elderly adults' risk of falling in nursing homes. METHODS: A computerised search of published randomised controlled trials in the English language was performed using PubMed, Cochrane Library, the Cumulative Index of Nursing and Allied Health Literature, Physiotherapy Evidence Database (PEDro), and the Institute for Scientific Information up to December 2017. We included highquality articles that reported a score of ≥5 on the Physiotherapy Evidence Databasescale which compared multicomponent exercise with a single exercise programme in nursing homes, with the risk of falling as an outcome, among participants aged ≥65 years. RESULTS: A total of 8 articles, comprising 382 participants, were included. All these articles scored 6-8 points out of 10 on the PEDro scale, with an average of 6.7 points. The mean age of participants in the included articles was ranged from 76±8.0 to 92±2.0 years, and286 (75%) participants were females. A multi-component exercise programme in the experimental group, which had 204 (53.4%) subjects significantly reduced the risk of falling in nursing homes compared to a single-exercise programme, which was used in the control group that had 178(46.6%) subjects. CONCLUSIONS: A multi-component exercise programme was found to be useful for reducing elderly adults' risk of falling in nursing homes.

Normative Data for Handgrip Strength in Saudi Older Adults Visiting Primary Health Care Centers.

Background and objective: Handgrip strength (HGS) plays a vital role as a predictor of adverse health outcomes. Several studies have established HGS norms by age, sex, hand, occupation, culture or disability in different countries and for children in Saudi Arabia. However, standardized values for Saudi older adults have not yet been reported. Therefore, the current study was aimed to establish normative data for HGS in Saudi older adults visiting primary health care centers (PHCCs). Material and Method: In this descriptive cross-sectional study, HGS in kilograms was measured using a hydraulic hand dynamometer in Saudi older adults (n = 2045) aged ≥60 years visiting 15 PHCCs selected randomly from the five geographical regions of Riyadh, Saudi Arabia between January 2015 and April 2017. The average mean from three successive trials, standard deviations, and 95% confidence intervals presented for the left and right hands of men and women in six age groups (60-64, 65-69, 70-74, 75-79, 80-84, and 85+ years). The analyses were performed using the ANOVA test for all the age groups and to determine whether any differences exist between them. Results: The average mean HGS was significantly (p < 0.0001) differ by the left and right hands of men and women in six age groups. Conclusions: The current study presents specific norms for HGS in Saudi older adults by age, sex, and hand. Further studies are required to examine the utility of these norms for prediction of morbidity and mortality in this population.

Longitudinal Relationship Between Knee Pain Status and Incident Frailty: Data from the Osteoarthritis Initiative.

Objective: Examine the longitudinal association between knee pain and prefrailty/frailty. Design: Longitudinal study. Setting: Five clinical centers across the United States. Subject: Data from 3,053 nonfrail participants aged 45-79 years at baseline from the Osteoarthritis Initiative. Methods: According to self-reported knee pain at baseline, the participants were placed into three groups: no knee pain (N = 1,600), unilateral knee pain (N = 822), and bilateral knee pain (N = 631). Frailty status was assessed over time using the five frailty indicators (unintentional weight loss, exhaustion, weak energy, slow gait speed, and little physical activity). Based on the number of frailty indicators present, prefrailty (1-2) and frailty (≥3) were diagnosed. Generalized estimating equations logistic regression analyses were conducted to examine the relationship between knee pain status and prefrailty/frailty. Results: After adjusting for age, sex, race, education, marital status, smoking status, comorbidities, and body mass index, unilateral knee pain at baseline was associated with an increased odds of developing prefrailty (odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.01-1.27) and frailty (OR = 1.89, 95% CI = 1.38-2.62), and bilateral knee pain at baseline was also associated with an increased risk of prefrailty (OR = 1.41, 95% CI = 1.24-1.62) and frailty (OR = 2.21, 95% CI = 1.63-3.01) over time in comparison with no knee pain. The interaction of knee pain status by time was not significantly associated with either prefrailty or frailty. Conclusions: Knee pain (particularly bilateral knee pain) is associated with an increased risk of developing prefrailty and frailty over time.

Length of Stay and Functional Outcomes Among Patients with Stroke Discharged from an Inpatient Rehabilitation Facility in Saudi Arabia.

BACKGROUND In many countries, the length of stay (LOS) for inpatient rehabilitation following stroke has gradually decreased. It is unclear whether this trend is associated with differences in functional outcomes, especially in developing countries. This study aimed to examine associations between LOS and functional outcomes among patients with stroke discharged from an inpatient rehabilitation facility in Saudi Arabia. MATERIAL AND METHODS This retrospective study included all patients (N=409) aged ≥18 years who were admitted to an inpatient rehabilitation for stroke during 2008-2014. There were no deaths in the cohort during the study period. Patients were divided into 4 groups according to days of rehabilitation: ≤30 days (n=114), 31-60 days (n=199), 61-90 days (n=72), and >90 days (n=24). Multivariate regression analyses were used to evaluate functional outcomes using the functional independence measure (FIM). RESULTS The fully adjusted model showed that higher total and subscale FIM scores were significantly associated with a LOS ≤30 days (total ß: 18.2, standard error [SE]=4.43, P≤0.0001; motor-FIM: ß=13.9, SE=3.70, P=0.0002; cognitive-FIM: ß=4.3, SE=1.29, P=0.001), and 31-60 days (total ß: 11.3, SE=4.07, P=0.005; motor-FIM: ß=8.8, SE=3.40, P=0.009; cognitive-FIM: ß=2.4, SE=1.19, P=0.038) compared with >90 days. CONCLUSIONS A short or intermediate LOS is not necessarily associated with worse outcomes, assuming adequate care is provided.

Cross-cultural adaptation and validation of the Saudi Arabic version of the Knee Injury and Osteoarthritis Outcome Score (KOOS).

The Knee Injury Osteoarthritis Outcome Score (KOOS) is a widely used joint-specific measure employed to evaluate pain, symptoms, activities of daily living, recreational activities, and quality of life in patients with knee osteoarthritis (OA). Although the original KOOS has been translated into many languages, a Saudi Arabic version is not available. This study aimed to culturally adapt and evaluate the psychometric properties of the Saudi Arabic version of the KOOS in patients with knee OA. The original KOOS was translated and adapted into Saudi Arabic version over six stages according to the guidelines suggested by Beaton and recommended by the American Association of Orthopedic Surgeons Outcome Committee. Patients diagnosed with knee OA (n = 136) were recruited to examine the psychometric properties, such as internal consistency that was tested using Cronbach's alpha, test-retest reliability that was analyzed using the intra-class correlation coefficient (ICC2,1), and construct validity that examined by testing the correlations between the new version subscales, Form 36 Health Survey subscales, and the Visual Analog Scale, Spearman's correlation coefficient (rs) was used to measure the correlations. A total of 122 (89.7%) of the 136 participants with knee OA completed the second re-test of new Saudi Arabic version. Excellent internal consistency (Cronbach's alpha = 0.87-0.92) was detected in the subscales of the adapted version, as well as excellent test-retest reliability (ICC2,1 = 0.92-0.94). The pattern of correlation between the subscales of the Saudi Arabic version of the KOOS, SF-36 domains and the Visual Analog Scale for pain supported the construct validity of the adapted version. The Saudi Arabic version of the KOOS was well accepted and exhibited excellent reliability, internal consistency, and construct validity in Saudi patients with knee OA.

Functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis.

OBJECTIVE: To examine the functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis. METHODS: In this retrospective study, we included data from the medical record of all 383 patients with uni- or bilateral hemiparesis after stroke who were admitted to King Fahad Medical City-Rehabilitation Hospital between 2008 and 2014 in Riyadh, Kingdom of Saudi Arabia. According to the site of hemiparesis, we classified patients into 3 groups: right hemiparesis (n=208), left hemiparesis (n=157), and bilateral hemipareses (n=18). The patients (n=49) who did not have either site of hemiparesis were excluded. The Functional Independence Measures (FIM) instrument was used to assess the score at admission and discharge. A post hoc test was conducted to examine the functional recovery differences between groups. Multiple regression analyses were used to confirm the findings. RESULTS: Amongst the three groups, there were significant (p<0.05) differences in the total-FIM score as well as motor- and cognitive-FIM sub-scores between admission and discharge of stroke rehabilitation. The differences were significantly greater in the bilateral hemipareses group than in either unilateral hemiparesis group. Multiple regression analyses also confirmed that the site of hemiparesis significantly (p<0.05) differs in the total-FIM score as well as motor-FIM and cognitive-FIM sub-scores. CONCLUSION: Our results demonstrate that differences in functional recovery after stroke rehabilitation may be influenced by the site of hemiparesis after stroke.

Stroke rehabilitation. A call to action in Saudi Arabia.

Stroke is a major cause of death and other complications worldwide. In Saudi Arabia, stroke has become an emerging health issue leading to disability and death. However, stroke care including rehabilitation services, in Saudi Arabia lags behind developed countries. Stroke rehabilitation is an essential recovery option after stroke and should start as early as possible to avoid potential complications. The growing evidence on stroke rehabilitation effectiveness in different health care settings and outcome measures used widely are reviewed in this call to action paper.

Health-related quality of life in older adults with bilateral knee pain and back pain: data from the Osteoarthritis Initiative.

This study's objective was to examine the association of self-reported bilateral knee pain (KP) and back pain (BP) with health-related quality of life (HRQoL) among older adults. In this cross-sectional study, data for 1252 older adults (≥65 years) were included from the Osteoarthritis Initiative project. Self-reported bilateral KP and BP were used to classify participants into four groups: (1) neither bilateral KP nor BP; (2) no bilateral KP with BP; (3) bilateral KP without BP; and (4) both bilateral KP and BP. Health-related quality of life was measured using the health survey short form (SF)-12. We used multiple linear regression analyses to examine the associations of bilateral KP and/or BP with the HRQoL. After controlling for covariates, bilateral KP and BP were associated with poorer HRQoL [physical composite scale (PCS): estimated average (ß) = -13.1, SE = 1.15, p < 0.0001; mental composite scale: ß = -2.71, SE = 1.09, p = 0.013, respectively] compared with the group with neither bilateral KP nor BP. In conclusion, older adults with coexisting bilateral KP and BP had significantly poorer physical and mental HRQoL when compared to peers without these conditions.

Drinking water, sanitation, hygiene, and health conditions in India: Findings from the national sample survey.

Introduction: Uncertainty exists in the drinking water, sanitation, hygiene, and health conditions due to mosquitoes and flies across India. Therefore, this study aimed to assess the availability of drinking water, sanitation, hygiene, and health in India. Methods: We used secondary analysis data on 95,548 household members from the National Sample Survey, which included 113,822 homes and 555,351 persons across India between June 2017 and 2018. Results: About 36.4% of household members stated that tube wells or boreholes outside the property at a distance of less than 0.2 km were their main source of drinking water. More than 87% of respondents said that the water they drank was free of impurities, and 55.1% said that it had not been treated. About 45.7% of respondents stated that there were no bathrooms in the dwellings. More than 50% of the time, according to the respondents, garbage was not collected. A flea or mosquito problem was reported by about 97% of households. Around 97% of households reported fevers that were caused by a disease. Conclusion: In India, poor access to drinking water, sanitary facilities, good hygiene, and healthcare existed. The results will support the next visionary programs to increase living standards in the country.

Polypharmacy Is Associated with Sociodemographic Factors and Socioeconomic Status in United States Adults.

A thorough understanding of polypharmacy is required to create public health initiatives that minimize the potential for adverse outcomes. This study aimed to investigate the relationship between sociodemographic factors, socioeconomic status (SES), and polypharmacy risk in United States (US) individuals between 1999-2000 and 2017-2018. The cross-sectional National Health and Nutrition Examination Survey dataset covered ten cycles between 1999-2000 and 2017-2018. All individuals aged ≥18 years were included. The simultaneous use of at least five medications by one person is known as polypharmacy. Multivariable logistic regression showed that there was a statistically significant association between polypharmacy sociodemographic factors (such as age between 45 and 64 (odds ratio [OR] = 3.76; 95% confidence interval [CI] = 3.60-3.92; p < 0.0001) and age of 65 years or above (OR = 3.96; 95% CI = 3.79-4.13; p < 0.0001), especially women (OR = 1.09; 95% CI = 1.06-1.13; p < 0.0001), non-Hispanic blacks (OR = 1.66; 95% CI = 1.51-1.83; p < 0.0001), and veterans (OR = 1.27; 95% CI = 1.22-1.31; p < 0.0001)) and SES (such as being married (OR = 1.14; 95% CI = 1.08-1.19; p = 0.031), widowed, divorced, or separated (OR = 1.21; 95% CI = 1.15-1.26; p < 0.0001), a college graduate or above (OR = 1.21, 95% CI = 1.15-1.27, p < 0.0001), and earning > USD 55,000 per year (OR = 1.86; 95% CI = 1.79-1.93; p < 0.0001)). Individuals aged 45 years and above, women, and non-Hispanic blacks with higher educational levels and yearly incomes were more likely to experience polypharmacy in the US between 1999-2000 and 2017-2018.

Association between chronic disease, sensory impairment, walking limitation, and activities of daily living of community-dwelling older Indians.

Due to the paucity of existing evidence, this study aims to investigate the relationship between chronic disease, sensory impairment, walking limitation, and difficulty in activities of daily living (ADLs) in community-dwelling older Indians. This cross-sectional study included data from 31,394 individuals aged ≥ 60 years from the 2017 to 2018 Longitudinal Ageing Study in India. Participants were divided into 2 groups: 12,993 with chronic disease, sensory impairment, and a walking limitation, and 18,401 healthy individuals without such conditions. Participants with any chronic disease were further divided into 2 groups: sensory impairment (n = 12,462), and a walking limitation (n = 4745). Self-reported close-ended questionnaires with yes or no were used to assess each chronic disease (such as hypertension, diabetes, lung disorders, joint disorders, or heart disease), sensory impairment (vision or hearing), and walking limitation. A walking limitation was defined as being when a person could only walk at their usual pace for less than 500 meters on a flat surface. ADLs were assessed and classified as physical ADLs including basic physical requirements like dressing. Instrumental ADLs (IADLs) included more complicated community-based tasks like meal preparation. Findings showed that older Indians with chronic disease, sensory impairment, and a walking limitation were more likely to be significantly associated with physical ADLs (adjusted odds ratio [aOR] = 1.85, 95% confidence interval [CI] = 1.34-1.57, P < .0001) and IADLs (aOR = 1.45, 95% CI = 1.70-2.03, P < .0001) than those without such conditions. Among older Indians with chronic disease, sensory impairment was more likely associated with physical ADLs (aOR = 1.98, 95% CI = 1.82-2.16, P < .0001) and IADLs (aOR = 1.26, 95% CI = 1.15-1.37, P < .0001) followed by a walking limitation (aOR = 1.53, 95% CI = 1.42-1.65, P < .0001; aOR = 1.27, 95% CI = 1.17-1.38, P < .0001, respectively). These findings suggest that older Indians with chronic disease, sensory impairment, and walking limitation, can experience increased difficulty in overall and individual physical ADL and IADL than those without these conditions. Older Indians with any chronic condition who had sensory impairment or a walking limitation were also more likely to have difficulty with physical ADLs and IADLs.

Anticoagulation dosage strategy therapy, length of stay, and all-cause mortality in critically ill COVID-19 patients admitted to the intensive care unit.

Few studies examined several anticoagulation (AC) dosage strategy therapies for various outcomes among coronavirus disease-2019 (COVID-19) patients. However, this AC dosage strategy therapy has not been investigated to assess the length of stay (LOS) and all-cause mortality among critically ill COVID-19 patients admitted to the intensive care unit (ICU), especially in the eastern province of Saudi Arabia. Thus, this study aimed to examine the association of AC dosage strategy therapy with the LOS and all-cause mortality among critically ill COVID-19 patients admitted to the ICU. We enrolled 170 patients aged 18 years or older, had a confirmed COVID-19, and were hospitalized in a tertiary care facility in the eastern province of Saudi Arabia between March 1, 2020, and January 31, 2021. Patients (n = 56) who received Enoxaparin at a dose of less than or equal to 5000 units of unfractionated heparin thrice daily were categorized as receiving a "prophylaxis" dose. Patients (n = 114) who received a therapeutic dose but not a prophylaxis dose were categorized as receiving a "therapeutic dose." The 30-day ICU LOS was the main outcome, while all-cause mortality was the secondary outcome. The covariate-adjusted logistic regression analysis revealed that the therapeutic dose was significantly associated with a 1.74-fold longer ICU LOS and 6.60-fold greater mortality risk than the prophylaxis dose. Critically ill COVID-19 patients who received the therapeutic dose had a longer ICU LOS and higher mortality than those who received the prophylaxis dose.

Association Between Musculoskeletal Pain and Frailty Over Time in Older Adults.

BACKGROUND AND PURPOSE: There is a high frequency of frailty in patients with musculoskeletal pain. Pain from osteoarthritis and lower back pain may be associated with frailty. However, the future risk of frailty among older adults with pain remains unclear. Thus, the primary objective of this study was to examine the association between musculoskeletal pain and the risk of becoming prefrail and frail in older adults. PARTICIPANTS AND METHODS: A secondary analysis was performed using data from baseline and 1-, 2-, 3-, 4-, 6-, and 8-year follow-ups of the Osteoarthritis Initiative (OAI). The OAI recruited participants from 4 clinical sites in the United States, between February 2004 and May 2006. A self-reported questionnaire was used to determine the baseline musculoskeletal pain status in older adults (n = 1780) 65 years and older, including pain in the lower back, hip, knee, and at 2 or more sites. Using the Fried phenotypic criteria, participants were classified as nonfrail, prefrail, and frail at each period over 8 years. RESULTS: After adjusting for age, sex, race, education, marital status, annual income, smoking status, comorbidities, and body mass index, binary logistic regression modeling using generalized estimating equations revealed that in older adults musculoskeletal pain in the lower back and at multiple sites was associated with a slightly but significantly decreased risk of prefrailty over time (adjusted odds ratio [AOR] = 0.98, 95% CI = 0.95-0.99, P = .019; AOR = 0.96, CI = 0.92-0.99, P = .032). The association between musculoskeletal pain and frailty among older adults was not statistically significant (all P > .05). CONCLUSIONS: Musculoskeletal pain did not independently significantly increase the risk of prefrailty or frailty over time. It remains possible that when musculoskeletal is combined with other factors, the risk of prefrailty and frailty may be heightened. Further research into the combination of characteristics that best predict prefrailty and frailty, including but not limited to musculoskeletal pain, is warranted.

Are physical therapy interns competent in patient management skills? Assessment of the views of clinical and academic physical therapists.

[Purpose] This study aimed at evaluating PT interns' performance from the perspectives of clinical and academic physical therapists (PTs). [Methods] An online questionnaire based on a modified version of the Clinical Internship Evaluation Tool (CIET) was used to evaluate PT interns' performance in patient management skills. Assessors comprised clinical and academic PTs from Saudi Arabia. The survey aimed at assessing the competency of interns in 25 patient management skills comprising four major domains: clinical examination, patient evaluation, diagnosis and prognosis, and intervention. Assessors were also asked to rank the importance of possessing each skill and evaluating the internship programs at their facilities. A multivariate logistic regression analysis assessed whether the demographic variables between the two groups influenced their views. [Results] A total of 148 participants (112 clinical PTs and 36 academic PTs) responded to the survey. The majority of the participants agreed that interns were competent in all 25 skills. Differences between the two groups of assessors were observed for five out of the 25 skills. Interestingly, skills with the highest means were perceived as the most important skills by both groups of assessors. There was no association between sociodemographic variables and evaluation scores. [Conclusion] There were no differences observed between clinical and academic PTs in their evaluation of PT interns in 20 of the 25 clinical skills. There were indications of a need for further improvement in certain competencies and skills such as clinical examination, evaluation, diagnosis and prognosis, and intervention.

Deaths, causes, and their frequency among Saudi citizens: A descriptive analysis of data from the 2017 Population Characteristics Survey.

BACKGROUND: The number of deaths, causes, and frequency measures are crucial in determining the health of a country's population. OBJECTIVE: The current study aimed to estimate deaths, causes of death, and their frequency for Saudi nationals in 2017. METHODS: In this descriptive study, we used data from the 2017 Population Characteristics Survey (n = 14,215,901) and performed secondary data analysis between November 2021 and February 2022. We used a total number of survey samples to compute the deaths. The cause of death was determined by dividing the total number of fatalities according to sex. We calculated the overall population-, administrative region-, and gender-wise percentages, rates per 1,000 people per year, the ratios for mortality, and their reasons. RESULTS: There were 58,915 (0.4%) total deaths, including 0.3% and 0.2% deaths among females and males, respectively. The illness was the most frequent cause of mortality (46.5% or 465 per 1,000 population/year), notably in women (52.5% or 525 per 1,000 population/year). The fatality rate was higher due to traffic accidents (a total of five in every female and four males in every female). CONCLUSION: In 2017, illness-especially in women-was the cause of death. Road car accidents had a high mortality rate, especially among males. Saudi Arabia has lower death rates than other Arab nations and high-, moderate-, and low-income nations.

Metabolic syndrome is associated with an increased risk of falls in the elderly.

Numerous studies have investigated the causes of falls in the elderly. However, there is little information about metabolic syndrome (MS) as a risk factor for falls in older adults. No evaluations have given a qualitative overview of studies examining the relationship between MS and falls in the elderly. We did a literature search in electronic databases to look for studies that assessed a link between MS and falls among people over the age of 55 years. We found three studies of high quality. These included 2774 people with an average age of 72 years. Even after controlling for other risk factors, two studies found that MS was significantly associated with an older adult's 1.3-2.5-fold increased risk of falling. We found that MS and its independent components were strongly linked with falls among the elderly, even after correcting for numerous variables.

A conceptual model of factors associated with health-related quality of life in men and women with knee osteoarthritis in Riyadh, Saudi Arabia: A multicenter cross-sectional study.

This study used a conceptual model to examine the factors influencing physical, mental, and overall health-related quality of life (HRQoL) in women and men aged 45 and older with knee osteoarthritis (KOA) in Saudi Arabia. In this multicenter cross-sectional study, we randomly included 356 individuals aged 45 years or above with doctor-confirmed KOA from the orthopedic and physiotherapy departments of the 5 tertiary hospitals in Riyadh, Saudi Arabia, between March 2016 and March 2017. We split all participants into men (n = 146) and women (n = 210) based on gender. A conceptual model was developed using the HRQoL influential potential factors, such as age, sex, education, occupation, and way of eating (sociodemographic), and clinical factors, such as osteoarthritis knee and its severity, duration, pain, and body mass index. The 36-item short form health survey and its subscales of the physical composite scale and mental composite scale were used to evaluate overall HRQoL, physical, and mental health, respectively. We used unadjusted multiple linear regression analyses to investigate the associations between gender-specific potential factors and HRQoL outcomes. Women and men aged between 60 and 64 years were more strongly associated significantly with less physical composite scale score by -3.17, (standard error [SE] = 1.71, P = .021) and -3.18 (SE = 1.69, P = .023) respectively, followed by the primary school or less education by -3.40 (SE = 1.27, P = .0002), severe KOA of -8.94 (SE = 0.99, P < .001), eating on the floor bending the knee of -3.93 (SE = 1.63, P = .042), and pain of -2.39 (SE = 0.26, P < .0001). Women and men with primary school or less education significantly had low mental composite scale and 36-item short form health survey scores of -3.07 (SE = 1.22, P = .041) and -3.23 (SE = 0.99, P = .018), respectively, followed by severe KOA of -4.07 (SE = 1.22, P = .001) and -6.50 (SE = 0.83, P < .0001) and eating on the floor, extending the knee at -3.35 (SE = 1.74, P = .043). Risk factors like age, education, pain, body mass index, and severe KOA are linked to poor physical, mental, and overall HRQoL among women and men in Saudi Arabia.