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1.
Artículo en Inglés | MEDLINE | ID: mdl-38541318

RESUMEN

A few studies on physical performance (PP) decline among community-dwelling older adults have simultaneously evaluated various outcomes in Brazil. This longitudinal cohort study aimed to verify the association between PP and health outcomes (negative health self-perception-NHSP; consultations with health professionals; disability; falls; and hospitalization) in older Brazilians (N = 476, 68 ± 6.7 years). PP assessments included Gait Speed (GS) and Timed Up and Go (TUG) tests, and changes were evaluated over time (2014 to 2019-2020). The association between the PP and the outcomes was estimated using Poisson's regression with robust variance. The physical tests were not associated with NSPH or with the number of consultations with health professionals. However, after adjustment (economic level, diet quality, physical activity, multimorbidity, depression, polypharmacy, and BMI), low PP at baseline (TUG and GS) was associated with disability at follow-up. A low TUG performance at baseline was also associated with subsequent falls (PR = 1.57, p = 0.007). A decline in GS was associated with hospitalization (PR = 1.86, p = 0.033). PP was associated with disability, falls, and hospitalization over a five- to six-year period in older Brazilians. Regular PP assessments should be conducted and low PP should be used as an indicator of the need for preventative measures to avoid poor health outcomes.


Asunto(s)
Evaluación Geriátrica , Rendimiento Físico Funcional , Pueblos Sudamericanos , Anciano , Humanos , Evaluación Geriátrica/métodos , Estudios Longitudinales , Evaluación de Resultado en la Atención de Salud , Persona de Mediana Edad
2.
Res Aging ; : 1640275241229411, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38361310

RESUMEN

Introduction: Identifying effective strategies to enroll African American, Caribbean, and Hispanic/Latino adults ≥65 years of age in health research is a public health priority. This study aimed to explore intergenerational influence (IGI) among these populations living throughout Florida. Methods: African American, Caribbean, and Hispanic/Latino adults ≥65 years of age and a trusted family member/friend between 25-64 years participated in virtual listening sessions (LS). Culturally matched facilitators used a semi-structured guide to lead LS that was recorded, transcribed, and uploaded into NVivo©. The constant comparative method was used for analysis. Results: 363 African American, Caribbean, and Hispanic/Latino participated in LS. Five (5) themes relate to IGI emerged: (1) parent-child relationships; (2) family caregiving/parental illness experiences; (3) historical research maltreatment; (4) transfer of cultural knowledge; and (5) future generations. Discussion: Our findings support that IGI can be leveraged to increase the participation of African American, Caribbean, and Hispanic/Latino older adults in health research.

3.
Implement Sci ; 19(1): 5, 2024 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-38273325

RESUMEN

BACKGROUND: Despite substantial research evidence indicating the effectiveness of a range of interventions to prevent falls, uptake into routine clinical practice has been limited by several implementation challenges. The complexity of fall prevention in municipality health care underlines the importance of flexible implementation strategies tailored both to general determinants of fall prevention and to local contexts. This cluster-randomised trial (RCT) investigates the effectiveness of a tailored intervention to implement national recommendations on fall prevention among older home-dwelling adults compared to usual practice on adherence to the recommendations in health professionals. METHODS: Twenty-five municipalities from four regions in Norway will be randomised to intervention or control arms. Each municipality cluster will recruit up to 30 health professionals to participate in the study as responders. The tailored implementation intervention comprises four components: (1) identifying local structures for implementation, (2) establishing a resource team from different professions and levels, (3) promoting knowledge on implementation and fall prevention and (4) supporting the implementation process. Each of these components includes several implementation activities. The Consolidated Framework for Implementation Research (CFIR) will be used to categorise determinants of the implementation process and the Expert Recommendations for Implementing Change (ERIC) will guide the matching of barriers to implementation strategies. The primary outcome measure for the study will be health professionals' adherence to the national recommendations on fall prevention measured by a questionnaire. Secondary outcomes include injurious falls, the feasibility of the intervention, the experiences of the implementation process and intervention costs. Measurements will be carried out at baseline in August 2023, post-intervention in May 2024 and at a follow-up in November 2024. DISCUSSION: This study will provide evidence on the effectiveness, intervention costs and underlying processes of change of tailored implementation of evidence-based fall prevention recommendations. TRIAL REGISTRATION: The trial is registered in the Open Science Registry: https://doi.org/10.17605/OSF.IO/JQ9T5 . Registered: March 03, 2023.


Asunto(s)
Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Anciano , Ciudades , Noruega
4.
BMC Public Health ; 23(1): 2083, 2023 10 24.
Artículo en Inglés | MEDLINE | ID: mdl-37875861

RESUMEN

BACKGROUND: Living in hilly neighbourhoods can be associated with sedentary behaviour, but no study has compared sedentary behaviour and its associations with frailty, chronic diseases, and poor health between flat and hilly neighbourhoods among older adults. This study, therefore, compared older adults' sedentary behaviour and its association with frailty, poor health, and chronic disease status between low and hilly neighbourhoods. METHODS: This study utilised a STROBE-compliant cross-sectional design with sensitivity analyses and a common methods bias assessment. The participants were 1,209 people aged 50+ years who resided in flat (Ablekuma North, n = 704) and hilly (Kwahu East, n = 505) neighbourhoods in Ghana. The data were analysed with the independent samples t-test and hierarchical linear regression. RESULTS: Older adults in the hilly neighbourhood were more sedentary than those in the flat neighbourhood. The association between sedentary behaviour and chronic disease status was significant in both neighbourhoods, but this relationship was stronger in the hilly neighbourhood. Older adults in the flat neighbourhood reported lower sedentary behaviour at higher frailty (ß = -0.18; t = -3.2, p < 0.001), but those in the hilly neighbourhood reported higher sedentary behaviour at higher frailty (ß = 0.16; t = 3.54, p < 0.001). CONCLUSIONS: Older adults living in the hilly neighbourhood reported higher sedentary behaviour. In the hilly neighbourhood, sedentary behaviour was more strongly associated with frailty and chronic disease status. Older adults in hilly neighbourhoods may need extra support to avoid sedentary behaviour.


Asunto(s)
Fragilidad , Humanos , Anciano , Fragilidad/epidemiología , Conducta Sedentaria , Estudios Transversales , Características de la Residencia , Enfermedad Crónica
5.
PLoS One ; 18(10): e0292957, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37871003

RESUMEN

The aim of this study was to investigate the independent and joint associations of low cardiorespiratory fitness and lower-limb muscle strength with cardiometabolic risk in older adults. A total of 360 community-dwelling older adults aged 60-80 years participated in this cross-sectional study. Cardiometabolic risk was based on the diagnosis of Metabolic Syndrome and poor Ideal Cardiovascular Health according to the American Heart Association guidelines. Cardiorespiratory fitness and lower-limb muscle strength were estimated using the six-minute walk and the 30-second chair stand tests, respectively. Participants in the 20th percentile were defined as having low cardiorespiratory fitness and lower-limb muscle strength. Poisson's regression was used to determine the prevalence ratio (PR) and 95% confidence intervals (CI) of Metabolic Syndrome and poor Ideal Cardiovascular Health. Participants with low cardiorespiratory fitness alone and combined with low lower-limb muscle strength were similarly associated with a higher risk for Metabolic Syndrome (PR 1.27, 95% CI 1.09-1.48, and PR 1.32, 95% CI 1.10-1.58, respectively), and poor Ideal Cardiovascular Health (PR 1.76, 95% CI 1.25-2.47, and PR 1.65, 95% CI 1.19-2.28, respectively). Low lower-limb muscle strength alone was not associated with a higher risk for either Metabolic Syndrome or poor Ideal Cardiovascular Health (PR 1.23, 95% CI 0.81-1.87, and PR 1.11, 95% CI 0.89-1.37, respectively). Low cardiorespiratory fitness alone or combined with low lower-limb muscle strength, but not low lower-limb muscle strength alone, was associated with a higher cardiometabolic risk in older adults. The assessment of physical fitness may be a "window of opportunity" to identify youngest-old adults with a high cardiovascular disease risk.


Asunto(s)
Capacidad Cardiovascular , Enfermedades Cardiovasculares , Síndrome Metabólico , Humanos , Anciano , Síndrome Metabólico/epidemiología , Estudios Transversales , Aptitud Física/fisiología , Fuerza Muscular/fisiología , Enfermedades Cardiovasculares/epidemiología
6.
Comput Inform Nurs ; 41(12): 993-1015, 2023 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-37652446

RESUMEN

The application of technological advances and clear articulation of how they improve patient outcomes are not always well described in the literature. Our research team investigated the numerous ways to measure conditions and behaviors that precede patient events and could signal an important change in health through a scoping review. We searched for evidence of technology use in fall prediction in the population of older adults in any setting. The research question was described in the population-concept-context format: "What types of sensors are being used in the prediction of falls in older persons?" The purpose was to examine the numerous ways to obtain continuous measurement of conditions and behaviors that precede falls. This area of interest may be termed emerging knowledge . Implications for research include increased attention to human-centered design, need for robust research trials that clearly articulate study design and outcomes, larger sample sizes and randomization of subjects, consistent oversight of institutional review board processes, and elucidation of the human costs and benefits to health and science.


Asunto(s)
Accidentes por Caídas , Humanos , Anciano , Anciano de 80 o más Años , Accidentes por Caídas/prevención & control
7.
Games Health J ; 12(6): 472-479, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37410502

RESUMEN

Virtual reality (VR) allows visuotactile interaction in a virtual environment. VR has several potential applications such as surgical training, phobia treatments, and gait rehabilitation. However, further interface development is required. Therefore, the objective of this study was to develop a noninvasive wearable device control to a VR gait training program. It consists of custom-made insoles with vibratory actuators, and plantar pressure sensor-based wireless interface with a VR game. System usability testing involved a habituation period and three gaming sessions. Significant gait improvement was associated with game scores (P < 0.05). This VR gait training system allowed real-time virtual immersive interaction with anticipatory stimulus and feedback during gait.


Asunto(s)
Marcha , Realidad Virtual , Humanos , Interfaz Usuario-Computador , Terapia por Ejercicio
8.
Sensors (Basel) ; 23(10)2023 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-37430617

RESUMEN

Cues are commonly used to overcome the effects of motor symptoms associated with Parkinson's disease. Little is known about the impact of cues on postural sway during transfers. The objective of this study was to identify if three different types of explicit cues provided during transfers of people with Parkinson's disease results in postural sway more similar to healthy controls. This crossover study had 13 subjects in both the Parkinson's and healthy control groups. All subjects completed three trials of uncued sit to stand transfers. The Parkinson's group additionally completed three trials of sit to stand transfers in three conditions: external attentional focus of reaching to targets, external attentional focus of concurrent modeling, and explicit cue for internal attentional focus. Body worn sensors collected sway data, which was compared between groups with Mann Whitney U tests and between conditions with Friedman's Tests. Sway normalized with modeling but was unchanged in the other conditions. Losses of balance presented with reaching towards targets and cueing for an internal attentional focus. Modeling during sit to stand of people with Parkinson's disease may safely reduce sway more than other common cues.


Asunto(s)
Enfermedad de Parkinson , Humanos , Señales (Psicología) , Estudios Cruzados , Estado de Salud , Estadísticas no Paramétricas
9.
Gerontol Geriatr Med ; 9: 23337214231179826, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37324645

RESUMEN

This survey study aimed to assess the willingness of culturally diverse older adults to participate in COVID-19 research. The majority of the 276 participants were women (81%, n = 223) and Black/African American (62%, n = 172) or White Hispanic (20%, n = 56). A key finding from the survey was less than 1 of 10 respondents would be likely to participate in COVID-19 related research if given the opportunity. There were no differences observed by gender, race or ethnicity. Implications of these findings are considered. These study findings indicate continued effort and better messaging strategies are required to increase awareness that COVID-19 related research needs to include culturally diverse older adults to ensure vaccines and treatments are efficacious in different populations.

10.
Artículo en Inglés | MEDLINE | ID: mdl-37107860

RESUMEN

Changes in physical performance (PP) occur with aging, and understanding the magnitude of these changes over time is important. This study evaluated changes in Gait Speed (GS) and Timed Up and Go (TUG) performance and their association with related factors among community-dwelling older adults over a period of five to six years. A cohort study of 476 older adults with baseline assessment conducted in 2014 and reassessment in 2019-2020 was carried out. Associations between PP changes over time and sociodemographic, behavioral, and health variables were evaluated using mixed linear models. Approximately 68% of the participants declined PP; 20% had no relevant change in GS and 9% in TUG time (sustained PP); 12% increased GS, and 23% decreased TUG time (improved PP). Being male (p = 0.023), living without a partner/separated (p = 0.035), higher education (p = 0.019), and alcohol consumption in the prior month (p = 0.045) were associated with decreased GS, while older age (p < 0.001), having lower socioeconomic status (p < 0.004), physical inactivity (p = 0.017), and being overweight (p = 0.007) were associated with increased TUG time. PP declined for most participants. Factors most strongly associated with PP decline are non-modifiable. The high prevalence of PP decline over time signals the importance of including physical tests in yearly health assessments.


Asunto(s)
Evaluación Geriátrica , Vida Independiente , Humanos , Masculino , Anciano , Femenino , Estudios de Cohortes , Velocidad al Caminar , Rendimiento Físico Funcional
11.
PLoS One ; 18(2): e0280465, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36791078

RESUMEN

BACKGROUND: There is scarce evidence on changes at the functional level associated with the respiratory area in women. This study aims to analyse the relationship between inspiratory muscle strength and balance in women. MATERIAL AND METHODS: In this cross-sectional observational study, the sample consisted of groups according to the results obtained in the balance test. Inspiratory muscle weakness was defined as maximum inspiratory pressure (MIP) ≤ 80% of the predictive value. MIP was carried out using through a mouthpiece, with an electronic manometer. Logistic regression model was used to examine if MIP predicts balance. RESULTS: 159 women participated in the study. Approximately 20% of them achieved balance ≤ 2 seconds and 18% presented MIP≤80%. MIP was associated with the time achieved in the one-leg support test. Subjects with MIP ≤ 80% of the predictive value show 3 times more risk of having a lower performance in the balance test (OR = 3.26). CONCLUSIONS: Inspiratory muscle weakness is associated with deficient balance in this sample. It shows the need for multidimensional assessment and rehabilitation strategies for patients identified as having MIP weakness and/or balance disorders.


Asunto(s)
Fuerza Muscular , Músculos Respiratorios , Humanos , Femenino , Estudios Transversales , Presiones Respiratorias Máximas/métodos , Debilidad Muscular , Paresia
12.
Work ; 74(4): 1419-1427, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36530114

RESUMEN

BACKGROUND: Backpacks used by children is a global concern, because may cause musculoskeletal discomforts and pain. OBJECTIVE: The purpose of this study was to test the usability and effects on gait kinematics wearing the Trunkpack versus a traditional backpack and no backpack. METHODS: Twenty-four children (9 to 11 years old) from a public school participated in this study. The usability was evaluated after a five-week testing period using a questionnaire. Gait kinematics was evaluated (Vicon) when the children were wearing a standard backpack, an optimized backpack (Trunkpack), and no backpack. Both backpacks were loaded with 10% of body weight. RESULTS: Was observed more trunk, hip and knee flexion when the children carried a standard backpack in comparison using the Trunkpack and not carrying a backpack (p < 0.01). The Trunkpack and no backpack were similar. The Trunkpack was well accepted by the schoolchildren (81% positive responses), 79% liked the head opening, 88% liked the waist straps, and 83% liked the facility to put and take objects in and out of the Trunkpack. CONCLUSION: Trunkpack requires less postural adjustments during gait than a standard backpack. Gait kinematics with the Trunkpack was comparable to the gait without carrying a backpack.


Asunto(s)
Marcha , Dolor , Niño , Humanos , Soporte de Peso/fisiología , Marcha/fisiología , Peso Corporal , Fenómenos Biomecánicos
13.
Ann Phys Rehabil Med ; 66(2): 101675, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35577313

RESUMEN

BACKGROUND: Frailty increases the risk of falls, disability and death in older adults. The Cardiovascular Health Study identified a frailty phenotype (the Fried Phenotype) that was primarily based on physical domains. Instruments that incorporate additional domains (e.g., cognitive, disability or mood) may more accurately identify falls. OBJECTIVES: The study aimed i) to evaluate the association between falls and the number of phenotypes identified by the Fried Phenotype and CFVI-20 scores and ii) to compare the strength of the association between falls and each frailty instrument. METHODS: This study used the CFVI-20 and the Fried Phenotype and reported falls during the last twelve months. Logistic regression models, odds ratios (ORs), and ROC curves were used to identify associations and perform comparisons (p<0.05). The reporting of the study followed the Strobe guidelines. RESULTS: This study included 1,826 individuals (mean 70.9 (SD 7.3) years old). Prevalence of pre-frailty and low vulnerability was high (72% and 69%) and comparable between frailty instruments. The number of Fried phenotypes increased the odds of having fallen in the past 12 months (OR: 1.5 to 29.5) and the CFVI-20 scores (11% increase/unit change). The CFVI-20 identified falls more accurately than the Fried Phenotype (AUC: 0.68 vs. 0.60, p < 0.001). CONCLUSIONS: The number of phenotypes and the CFVI-20 scores were associated with falls; continuous scores identified falls more accurately than categorical classifications. The CFVI-20 was more strongly associated with falls in community-dwelling older adults than the Fried Phenotype.


Asunto(s)
Fragilidad , Humanos , Anciano , Anciano Frágil/psicología , Accidentes por Caídas , Estudios Transversales , Evaluación Geriátrica , Vida Independiente , Fenotipo
14.
Artículo en Inglés | MEDLINE | ID: mdl-36360952

RESUMEN

Several studies have compared physical activity (PA) levels between countries, but none of these studies focused on older adults and occupational PA. This study aimed to assess potential inequalities in older adults' occupational PA across six countries and to ascertain whether having multiple jobs is a factor that interacts with country of residence to modify inequalities. This study adopted a cross-sectional design with a statistical technique screening for potential covariates. Older adults (mean age = 64 years; range = 50-114 years) from six countries (Russia, Mexico, China, India, Ghana, and South Africa) participated in the study. We utilised data from the first wave of the Study on Global AGEing and Adult Health (SAGE). These data were collected from 2007 to 2010. A random sample of 34,114 older adults completed the survey. We analysed the data with a two-way multivariate analysis of variance after screening for the ultimate covariates. There were differences in occupational PA levels (i.e., vigorous and moderate PA) among the six countries. Occupational PA levels were not significantly associated with having multiple jobs. However, having multiple jobs interacted with country of residence to influence vigorous occupational PA. Older adults from most countries who had more than one job reported more vigorous occupational PA. Older adults' occupational PA differed among the six countries, and having multiple jobs was associated with more vigorous occupational PA. Older adults who keep multiple jobs at a time may be more active than their counterparts who had one job or were unemployed.


Asunto(s)
Países en Desarrollo , Ejercicio Físico , Estudios Transversales , India , China
15.
Geriatrics (Basel) ; 7(5)2022 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-36286214

RESUMEN

Physical activity is important for healthy aging, but few older adults achieve the goal of 150 min per week of moderate activity. The purpose of this study was to employ a robust statistical approach in the analysis of the factors related to physical activity in a diverse sample of older adults. A secondary analysis of factors associated with calculated MET-h/week was conducted in a sample of 601 African Americans, Afro-Caribbeans, European Americans, and Hispanic Americans age 59 to 96 living independently in the community. Age, education, social network, pain, and depression were the five variables that accounted for a statistically significant proportion of unique variance in the model. The strongest correlation to total MET-h/week was with depression. Directionality of the relationship between these variables and physical activity is complex: while pain and depression can reduce physical activity, activity may also help to reduce pain and depression. Additionally, of note is that many of these factors may be modified, calling for the design and testing of individual, group, and community level interventions to increase physical activity in the older population.

16.
BMC Womens Health ; 22(1): 423, 2022 10 26.
Artículo en Inglés | MEDLINE | ID: mdl-36284340

RESUMEN

BACKGROUND: Metabolic syndrome (MetS) is a group of diseases characterized by insulin resistance. MetS has high prevalence among women, which is impacted by food intake. MetS is related to high level of inflammation; however, the impacts of whole diets on biochemical and anthropometrical markers and the effects on MetS need to be further elucidated. In this case, the objective of this study was to assess the relationship between food intake, biochemical and anthropometrical markers in women with MetS. METHODS: This is a cross-sectional study, in which 1 hundred and 22 women participated in the assessment of biochemical (glycated hemoglobin, glycaemia, insulin, uric acid, total cholesterol, HDL-c, LDL-c, triglycerides, C-reactive protein) and anthropometrical (body mass, height, waist circumference - WC) variables. Participants also performed blood pressure and 24-hour dietary recall assessments. Out of the 122 participants, 44 (36%, age: 59 ± 11 years) had MetS and were included in the analysis. RESULTS: The consumption of monounsaturated fats had direct relationship with glycaemia (b = 7.48), whereas the consumption of fibers had inverse relationship with body mass (b = - 0.71) and WC (b = - 0.56). CONCLUSION: The intake of monounsaturated fats and fiber was related to higher blood sugar levels and lower body mass and WC, respectively. These relationships elucidate and highlight the significance and importance of adequate diet in women with MetS.


Asunto(s)
Insulinas , Síndrome Metabólico , Femenino , Humanos , Persona de Mediana Edad , Anciano , Síndrome Metabólico/epidemiología , Glucemia/análisis , HDL-Colesterol , Hemoglobina Glucada , Estudios Transversales , Ácido Úrico , LDL-Colesterol , Proteína C-Reactiva/análisis , Índice de Masa Corporal , Circunferencia de la Cintura , Triglicéridos , Biomarcadores , Factores de Riesgo
17.
Artículo en Inglés | MEDLINE | ID: mdl-36078566

RESUMEN

This study investigated the balance and dorsiflexion strength of older adults after eight weeks of resistance training, with the exercise velocity cadenced by the Pilates breathing technique and the volume modulated by the session duration. Forty-four older adults were divided into two groups: resistance training (TR; n = 22) and resistance training with the Pilates breathing technique cadencing all exercises (TR + P; n = 22), both during eight weeks. The total exercising volume was controlled by time of execution (50 min/session). The dorsiflexion strength and balance were assessed. The RT group showed higher dorsiflexion strength after the protocol: Right (RT = 29.1 ± 7.7 vs. RT + P = 22.9 ± 5.2, p = 0.001) and Left (RT = 29.5 ± 6.9 vs. RT + P = 24.0 ± 5.2, p = 0.001). All balance parameters were improved in RT + P group compared to its own baseline: Path Length (cm) (pre = 71.0 ± 14.3 vs. post = 59.7 ± 14.3, p = 0.003); Sway Velocity (cm/s) (pre = 3.6 ± 0.7; post = 2.9 ± 0.7; p = 0.001); Sway Area (cm2) (pre = 8.9 ± 5.3 vs. post = 5.7 ± 2.1, p = 0.003); Excursion Medio Lateral (cm) (pre = 3.0 ± 0.7 vs. post = 2.6 ± 0.5 cm, p = 0.002); and Excursion AP (cm) (pre = 3.6 ± 1.4 vs. post = 2.8 ± 0.7 cm, p = 0.010). Resistance training using slower velocity movement cadenced by Pilates breathing technique produced balance improvements compared to baseline (moderate to large effect sizes), but no between-group effect was observed at the end of the protocol. The dorsiflexion strength was higher in the RT group compared to RT + P group.


Asunto(s)
Técnicas de Ejercicio con Movimientos , Entrenamiento de Fuerza , Anciano , Técnicas de Ejercicio con Movimientos/métodos , Terapia por Ejercicio , Humanos , Fuerza Muscular/fisiología , Equilibrio Postural/fisiología
18.
Artículo en Inglés | MEDLINE | ID: mdl-35805607

RESUMEN

Objectives: The study aimed to determine which domains, sets, and isolated or combined questions of the Clinical-Functional Vulnerability Index (CFVI-20) are associated with falls history in older adults. Methods: Instruments used were the CFVI-20 assessment and reported falls during the last year. The receiver operating characteristics (ROC) curves identified the performance of the CFVI-20 domains and questions in identifying older adults with and without falls history, while logistic regression identified relevant questions to identify fall history. Results: This study included 1725 individuals (71.9 ± 7.3 years). The area under the curve (AUC) between the CFVI-20 and fall history was 0.69. The mobility domain presented the largest AUC (0.71; p < 0.01), and most isolated domains showed low AUCs (0.51 to 0.58). Isolated questions were limited to identifying fallers. The regression analysis identified 7 questions of the CFVI-20 with falls. Conclusions: The CFVI-20 general score identified older adults with a fall history. When considered in isolation, most domains were limited to identifying falls, except for the mobility domain. Combining the CFVI-20 questions enabled identification of fallers.


Asunto(s)
Evaluación Geriátrica , Anciano , Estudios Transversales , Humanos , Modelos Logísticos , Curva ROC
19.
Ther Adv Musculoskelet Dis ; 14: 1759720X221104935, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35859927

RESUMEN

Background: Osteoarthritis (OA) has traditionally been considered a disease of older adults (⩾65 years old), but it may appear in younger adults. However, the risk factors for OA in younger adults need to be further evaluated. Objectives: To develop a prediction model for identifying risk factors of OA in subjects aged 20-50 years and compare the performance of different machine learning models. Methods: We included data from 52,512 participants of the National Health and Nutrition Examination Survey; of those, we analyzed only subjects aged 20-50 years (n = 19,133), with or without OA. The supervised machine learning model 'Deep PredictMed' based on logistic regression, deep neural network (DNN), and support vector machine was used for identifying demographic and personal characteristics that are associated with OA. Finally, we compared the performance of the different models. Results: Being a female (p < 0.001), older age (p < 0.001), a smoker (p < 0.001), higher body mass index (p < 0.001), high blood pressure (p < 0.001), race/ethnicity (lowest risk among Mexican Americans, p = 0.01), and physical and mental limitations (p < 0.001) were associated with having OA. Best predictive performance yielded a 75% area under the receiver operating characteristic curve. Conclusion: Sex (female), age (older), smoking (yes), body mass index (higher), blood pressure (high), race/ethnicity, and physical and mental limitations are risk factors for having OA in adults aged 20-50 years. The best predictive performance was achieved using DNN algorithms.

20.
Dement Neuropsychol ; 16(1): 28-32, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35719255

RESUMEN

Sarcopenic obesity (SO), the co-occurrence of sarcopenia and obesity, is associated with functional loss, frailty, and incapacity in older adults. Recently, SO was associated with reduced cognitive performance in adults. However, no SO studies have been done with older adults with Alzheimer's disease (AD). Objective: The objective of this study was to verify the occurrence of SO and associated factors in 43 older adults with AD. Methods: We applied the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). SO was verified by using dual-emission X-ray absorptiometry. Results: We found five women with SO. Women had higher body fat and lower muscle mass compared with men. There was a significant relationship between body fat and cognitive performance only in men (r=0.65; p<0.01) adjusted by age and education. Men with obesity and aged >75 years had better cognitive performance compared with non-obese men aged <75 years (p=0.010) and women with obesity aged >75 years (p=0.033). Conclusions: Women with AD had higher body fat and lower muscle mass than men. SO occurs in older women with AD. Men with higher body fat showed better cognitive performance, independent of age and education.


A obesidade sarcopênica (SO), coocorrência de sarcopenia e obesidade, está associada à perda funcional, à fragilidade e à incapacidade em idosos. Recentemente, verificou-se que a SO está associada ao desempenho cognitivo reduzido em adultos. No entanto, não foram feitos estudos de SO em idosos com doença de Alzheimer (AD). Objetivo: Verificar a ocorrência de obesidade sarcopênica e fatores associados em 43 adultos idosos com doença de Alzheimer. Métodos: Aplicamos o miniexame do estado mental (MEEM) e a avaliação clínica da demência (CDR). A SO foi verificada utilizando a absorciometria de dupla emissão de raios X. Resultados: Foram classificadas cinco idosas com SO. As mulheres idosas tinham maior gordura corporal e menor massa muscular em comparação com os homens. Houve relação significativa, ajustada por idade e educação, entre gordura corporal e desempenho cognitivo apenas nos homens (r=0,65; p<0,01). Os homens com obesidade e com mais de 75 anos tiveram melhor desempenho cognitivo em comparação com os homens não obesos <75 anos (p=0,010) e com as mulheres com obesidade >75 anos (p=0,033). Conclusões: As mulheres com AD tinham maior gordura corporal e menor massa muscular do que os homens. A SO ocorreu em mulheres mais velhas com AD. Os homens com maior gordura corporal apresentaram melhor desempenho cognitivo, independentemente da idade e da educação.

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