ABSTRACT
Impairment of cognitive functions is the primary reason for admission to long-term care units, with executive functions playing a pivotal role in dependency and behavioral issues. These functions pose significant challenges to nursing staff in providing care. However, the assessment of executive functions in elderly individuals residing in nursing homes often relies on tests that are both time-consuming and difficult for this demographic. In many instances, executive functions are either not assessed or only examined in broad terms. OBJECTIVE: The objective of this study was to analyze the feasibility of assessing executive functions in elderly nursing home residents, specifically aiming to distinguish sub-components such as mental flexibility, working memory, planning, and inhibition. The residents included in the study underwent executive function assessments over three visits, using various tests for each sub-component. METHODS: Out of 530 residents, 46 gave their consent and 38 completed the three visits, with an average age of 90±5 years (76.2% women) and a median MMSE score of 20/30. Feasibility was evaluated based on the test being executed and the frequency of interruptions due to difficulty or fatigue on the part of the resident. RESULTS: Only four tests proved suitable for elderly individuals in nursing homes, and we propose grouping them into a battery named SETE (Screening Executive Tests for Elderly): the conflicting instructions from the FAB, the alpha test, the clock test, and the verbal span test. CONCLUSION: The use of these four tests would enable the construction of a map delineating executive function impairment by sub-component. Enhanced knowledge of executive functions in long-term care residents will facilitate better adapted dependency management and the implementation of non-pharmacological interventions for behavioral disorders.
Subject(s)
Cognition , Executive Function , Aged , Humans , Female , Aged, 80 and over , Male , Hospitalization , Knowledge , Long-Term CareABSTRACT
Frailty and quality of life are concepts that emerged in the second half of the 20th century. Frailty can be defined as a clinical syndrome of decreased physiological reserves and resistance against stressful events conferring high risk for adverse health outcomes, including loss of independence, falls, hospitalization, institutionalization and mortality. However, it is considered that frailty can potentially be prevented or treated with specific modalities. Quality of life has various definitions because of its subjective nature. The World Health Organisation defined quality of life as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". The aim of this study is to review information regarding the potential association between frailty and quality of life in the elderly, and the effects of physical activity among different parameters of these phenomena. There are few studies that investigate links between frailty, quality of life and physical activity. However, results tend to show that physical aspects of frailty syndrome are inversely proportional to the quality of life in several of its dimensions. Furthermore, community-based exercise programs involving the elderly seem to improve the quality of life. Considering that physical activity can potentially have an impact on the quality of life among frail elderly and promote healthy aging, further research will be necessary to corroborate these results.
La fragilité et la qualité de vie sont des concepts qui font leur apparition dans la deuxième moitié du XXe siècle. La fragilité se situe entre le vieillissement usuel et pathologique. Il reflète une diminution de la faculté de l'organisme à résister à un stress, favorisant la survenue d'évènements péjoratifs de santé. Il s'agit d'un syndrome clinique multifactoriel potentiellement réversible via des actions de prévention. La qualité de vie est un concept très large et multifactoriel correspondant à la perception qu'un individu a de sa place dans la vie. Ce travail a pour double objectif d'étudier l'existence d'un lien potentiel entre fragilité et qualité de vie, et d'évaluer les bénéfices de la pratique d'une activité physique sur ces phénomènes. Les recherches dans ce domaine tendent à montrer que la présence d'une fragilité chez la personne âgée induit une altération des différents domaines de la qualité de vie, notamment en termes d'état de santé perçu. Les résultats d'études interventionnelles incluant des programmes d'activité physique indiquent un bénéfice à la fois sur les paramètres physiques de la fragilité, mais également sur la qualité de vie. Toutefois, le niveau de preuve reste faible et de futures recherches seront nécessaires.
Subject(s)
Frailty , Healthy Aging , Aged , Humans , Quality of Life , Frail Elderly , ExerciseABSTRACT
Frailty and quality of life are concepts that emerged in the second half of the 20th century. Frailty can be defined as a clinical syndrome involving decreased physiological reserves and resistance against stressful events conferring a high risk of adverse health outcomes, including loss of independence, falls, hospitalisation, institutionalisation and mortality. However, it is considered that frailty can potentially be prevented or treated in specific ways. There are various definitions of "quality of life" due to its subjective nature. The World Health Organization defines quality of life as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". The aim of this study is to review information regarding the potential association between frailty and quality of life in the elderly, and the effects of physical activity among the various parameters of these phenomena. Few studies investigate the links between frailty, quality of life and physical activity. However, results tend to show that the physical aspects of frailty syndrome are inversely proportional to several aspects of quality of life. Furthermore, community-based exercise programmes involving the elderly seem to improve their quality of life. Considering that physical activity can potentially have an impact on quality of life among frail elderly people and can promote healthy ageing, further research will be necessary to corroborate these results.
ABSTRACT
Frailty and quality of life are concepts that emerged in the second half of the 20th century. Frailty can be defined as a clinical syndrome of decreased physiological reserves and resistance against stressful events conferring high risk for adverse health outcomes, including loss of independence, falls, hospitalization, institutionalization and mortality. However, it is considered that frailty can potentially be prevented or treated with specific modalities. Quality of life has various definitions because of its subjective nature. The World Health Organisation defined quality of life as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". The aim of this study is to review information regarding the potential association between frailty and quality of life in the elderly, and the effects of physical activity among different parameters of these phenomena. There are few studies that investigate links between frailty, quality of life and physical activity. However, results tend to show that physical aspects of frailty syndrome are inversely proportional to the quality of life in several of its dimensions. Furthermore, community-based exercise programs involving the elderly seem to improve the quality of life. Considering that physical activity can potentially have an impact on the quality of life among frail elderly and promote healthy aging, further research will be necessary to corroborate these results.
Subject(s)
Exercise , Frailty , Quality of Life , Accidental Falls/prevention & control , Aged , Frail Elderly , HumansABSTRACT
Many aged adults want to stay as long as possible in their own homes. Hence, it is important to identify factors that can predict nursing home admission, in order to prevent this admission and maintain people at home. Several studies have investigated the risk factors of nursing home admission but syntheses are still rare. The present study aimed to identify risk and protective factors for nursing home admission for aged adults. A literature review was conducted using the PubMed search engine. Of 177 relevant reports, 27 were analyzed. We have included studies, literature reviews and meta-analyses that have highlights 59 potential factors. Falls, especially when fall causes serious injuries, cognitive impairment, activities daily living dependencies and stroke were identified as the highest risk factors. In contrast, living with spouse, having adult children, receiving a home care program based on case management or being homeowner were identified as protectives factors. This knowledge of risk and protective factors can help our prevention strategies to delay or find alternatives to nursing home admission.
Subject(s)
Mass Screening , Nursing Homes , Protective Factors , Risk Assessment , Aged , Aged, 80 and over , Female , Homes for the Aged , Humans , Male , Patient Admission , Predictive Value of TestsABSTRACT
Complex formation between octyl beta-D-glucopyranoside (OG) and alpha-cyclodextrin (alphaCD) was investigated on the basis of three highly accurate and appropriate experimental techniques. First, surface tension measurements showed that alphaCD directly acts on the surfactant monomers in the aqueous phase, leading to progressive depletion of the air-water interface with increasing cyclodextrin contents. Significant shift of OG critical micelle concentration (cmc) was consequently observed: the higher alphaCD concentration, the higher the cmc value. Experiments performed at surfactant and cyclodextrin concentrations in the Gibbs regime of surface tension versus OG content were performed on one hand to establish Job's plot that showed 1:1 stoichiometry of the OG-alphaCD complex and on the other hand to calculate the association constant found equal to (1.85 +/- 0.35) x 10(3) L mol(-1). An inclusion process of the surfactant alkyl residue within the cyclodextrin cavity was confirmed by one-dimensional (1)H NMR, and the structure of the mixed assembly was extensively characterized by two-dimensional NOESY (1)H NMR. OG penetrates alphaCD so that its hydrocarbon chain is embedded inside the cyclodextrin cavity, and its polar head as well as the alpha-methylene group emerges outside the alphaCD secondary face. Solubility behavior of the OG-alphaCD complex in a wide range of host-guest ratios and concentrations was finally examined by turbidity recording and optical microscopy. At very low free cyclodextrin levels in the solution, the complex presented high solubility behavior up to more than 70 mM. By increasing nonassociated alphaCD in the mixture, propensity of the cyclodextrin molecules to crystallize was observed at concentrations far below the 100 mM aqueous solubility of the pure cyclodextrin. The hexagonal shape of the crystals seen in the optical microscopy images suggested they were, partially at least, composed of the solid complex.
