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1.
Neurosciences (Riyadh) ; 26(2): 171-178, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33814370

RESUMEN

OBJECTIVES: To assess the overall and domain-specific quality of life (QOL) in post-stroke patients using the stroke-specific quality of life (SS-QOL) scale and to identify variables that may affect the QOL after stroke. METHODS: A prospective cross-sectional study, included 80 stroke patients, was conducted in the Neurology department at King Fahad Hospital of the University (KFHU), Khobar, Saudi Arabia, from December 2019 to February 2020. Stroke patients were interviewed using the Arabic version of the SS-QOL questionnaire and modified Rankin scale (mRS). RESULTS: The overall quality of life in the surveyed participants was at the level of 3.72 points, which is above the average recognized in the middle of the scale that ranges from 1 to 5. The overall quality of life was not significantly correlated with sex, age, type of stroke, recurrence of stroke, and time since stroke (p>0.05). Hypertension and atrial fibrillation were the only comorbidities that were determined to be significantly associated with the overall quality of life at the level of (3.53), and (2.97) respectively (p<0.05). There was a statistically significant correlation between the mRS score and the overall quality of life (p<0.05). CONCLUSION: Performing a comprehensive assessment of the overall QOL in post-stroke patients will result in better health outcomes, particularly in terms of quality of functioning in psycho-social aspects.


Asunto(s)
Actividades Cotidianas/psicología , Calidad de Vida/psicología , Accidente Cerebrovascular/psicología , Adulto , Anciano , Anciano de 80 o más Años , Fibrilación Atrial/complicaciones , Fibrilación Atrial/psicología , Estudios Transversales , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Arabia Saudita , Accidente Cerebrovascular/complicaciones , Rehabilitación de Accidente Cerebrovascular
2.
BMC Psychol ; 9(1): 56, 2021 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-33865455

RESUMEN

BACKGROUND: The childhood phenotype of myotonic dystrophy type 1 (DM1) involves impaired cognitive functioning starting in infancy, which may compromise later on their ability to carry out instrumental activities of daily living (IADLs) necessary for living independently. The current study aims to document the ability to perform IADLs among adults with the childhood phenotype of DM1 and to explore its links to cognitive functioning. METHODS: This cross-sectional exploratory study was conducted among 11 individuals living with DM1. IADLs related to money management, home management & transportation and health & safety activities were assessed by the Independent Living Scale (ILS). Neuropsychological tests assessed participants' intellectual abilities and executive functioning. Associations were investigated using Spearman's rho correlation. RESULTS: Important difficulties were found in all three categories of IADLs, mostly in money management in which only 2/11 participants were scored as independent. 8/11 participants showed low to very low intellectual functioning and limit to impaired executive functioning. Apathy was also a common feature as 5/11 participants showed clinical level of apathy. A lower IQ was associated with greater difficulty in the home management & transportation subtest of the ILS. CONCLUSIONS: Adults with the childhood phenotype of DM1 demonstrate relative dependence in regard to the following IADLs: money management and home management & transportation. Level of dependence is, at least partially, associated with cognitive impairments. The work relates to results from an exploratory study; thus, studies must be pursued to describe in more details difficulties experienced by this population.


Asunto(s)
Distrofia Miotónica , Actividades Cotidianas , Adulto , Niño , Cognición , Estudios Transversales , Humanos , Pruebas Neuropsicológicas , Fenotipo
3.
Artículo en Inglés | MEDLINE | ID: mdl-33802506

RESUMEN

Information support robots (ISRs) have the potential to assist older people living alone to have an independent life. However, the effects of ISRs on the daily activity, especially the sleep patterns, of older people have not been clarified; moreover, it is unclear whether the effects of ISRs depend on the levels of cognitive function. To investigate these effects, we introduced an ISR into the actual living environment and then quantified induced changes according to the levels of cognitive function. Older people who maintained their cognitive function demonstrated the following behavioral changes after using the ISR: faster wake-up times, reduced sleep duration, and increased amount of activity in the daytime (p < 0.05, r = 0.77; p < 0.05, r = 0.89, and p < 0.1, r = 0.70, respectively). The results suggest that the ISR is beneficial in supporting the independence of older people living alone since living alone is associated with disturbed sleep patterns and low physical activity. The impact of the ISR on daily activity was more remarkable in the subjects with high cognitive function than in those with low cognitive function. These findings suggest that cognitive function is useful information in the ISR adaptation process. The present study has more solid external validity than that of a controlled environment study since it was done in a personal residential space.


Asunto(s)
Robótica , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Cognición , Humanos
4.
Artículo en Inglés | MEDLINE | ID: mdl-33806474

RESUMEN

In this study, we measured the convergence rate using the mean-squared error (MSE) of the standardized neuropsychological test to determine the severity of Parkinson's disease dementia (PDD), which is based on support vector machine (SVM) regression (SVR) and present baseline data in order to develop a model to predict the severity of PDD. We analyzed 328 individuals with PDD who were 60 years or older. To identify the SVR with the best prediction power, we compared the classification performance (convergence rate) of eight SVR models (Eps-SVR and Nu-SVR with four kernel functions (a radial basis function (RBF), linear algorithm, polynomial algorithm, and sigmoid)). Among the eight models, the MSE of Nu-SVR-RBF was the lowest (0.078), with the highest convergence rate, whereas the MSE of Eps-SVR-sigmoid was 0.110, with the lowest convergence rate. The results of this study imply that this approach could be useful for measuring the severity of dementia by comprehensively examining axial atypical features, the Korean instrumental activities of daily living (K-IADL), changes in rapid eye movement sleep behavior disorder (RBD), etc. for optimal intervention and caring of the elderly living alone or patients with PDD residing in medically vulnerable areas.


Asunto(s)
Enfermedad de Alzheimer , Enfermedad de Parkinson , Actividades Cotidianas , Anciano , Algoritmos , Humanos , Pruebas Neuropsicológicas , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/epidemiología , Máquina de Vectores de Soporte
5.
Artículo en Inglés | MEDLINE | ID: mdl-33807061

RESUMEN

We aimed to explore and gain an understanding into how people with dementia experience apathy, and consequently suggest effective interventions to help them and their carers. Twelve participants (6 dyads of 6 people with dementia and their family carers) were recruited from "memory cafes" (meeting groups for people with dementia and their families), social groups, seminars, and patient and public involvement (PPI) meetings. People with dementia and their carers were interviewed separately and simultaneously. Quantitative data were collected using validated scales for apathy, cognition, anxiety, and depression. The interviews were semi-structured, focusing on the subjective interpretation of apathy and impacts on behaviour, habits, hobbies, relationships, mood, and activities of daily living. Interviews were recorded and transcribed. Transcripts were analysed using interpretative phenomenological analysis (IPA), which generated codes and patterns that were collated into themes. Four major themes were identified, three of which highlighted the challenging aspects of apathy. One described the positive aspects of the individuals' efforts to overcome apathy and remain connected with the world and people around them. This study is the first to illustrate the subjective experience of apathy in dementia, portraying it as a more complex and active phenomenon than previously assumed. Apathy and its effects warrant more attention from clinicians, researchers, and others involved in dementia care.


Asunto(s)
Apatía , Demencia , Actividades Cotidianas , Cuidadores , Humanos , Investigación Cualitativa
6.
Artículo en Inglés | MEDLINE | ID: mdl-33809101

RESUMEN

Injury claims associated with minimal damage rear impact traffic crashes are often defended using a "biomechanical approach," in which the occupant forces of the crash are compared to the forces of activities of daily living (ADLs), resulting in the conclusion that the risk of injury from the crash is the same as for ADLs. The purpose of the present investigation is to evaluate the scientific validity of the central operating premise of the biomechanical approach to injury causation; that occupant acceleration is a scientifically valid proxy for injury risk. Data were abstracted, pooled, and compared from three categories of published literature: (1) volunteer rear impact crash testing studies, (2) ADL studies, and (3) observational studies of real-world rear impacts. We compared the occupant accelerations of minimal or no damage (i.e., 3 to 11 kph speed change or "delta V") rear impact crash tests to the accelerations described in 6 of the most commonly reported ADLs in the reviewed studies. As a final step, the injury risk observed in real world crashes was compared to the results of the pooled crash test and ADL analyses, controlling for delta V. The results of the analyses indicated that average peak linear and angular acceleration forces observed at the head during rear impact crash tests were typically at least several times greater than average forces observed during ADLs. In contrast, the injury risk of real-world minimal damage rear impact crashes was estimated to be at least 2000 times greater than for any ADL. The results of our analysis indicate that the principle underlying the biomechanical injury causation approach, that occupant acceleration is a proxy for injury risk, is scientifically invalid. The biomechanical approach to injury causation in minimal damage crashes invariably results in the vast underestimation of the actual risk of such crashes, and should be discontinued as it is a scientifically invalid practice.


Asunto(s)
Accidentes de Tránsito , Actividades Cotidianas , Aceleración , Cabeza , Humanos , Voluntarios
7.
BMC Geriatr ; 21(1): 262, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-33879078

RESUMEN

BACKGROUND: During the first pandemic wave, Sweden experienced a high mortality rate. Home healthcare reflects a group of people especially vulnerable to coronavirus disease 2019 (COVID-19). We aimed to evaluate the pattern of comorbidity and frailty in a group of individuals having fatal outcomes in home healthcare during the COVID-19 pandemic March to September 2020, and to assess the contribution of COVID-19 in the fatal outcomes. METHODS: A cohort of adults with confirmed COVID-19 diagnosis that deceased in home healthcare between March and September 2020 were analysed in a retrospective study comprising home healthcare in 136 facilities in one Swedish county. Main outcome measures were comorbidity and frailty. RESULTS: One hundred fifty-five individuals (88 women, 67 men) aged 57-106 (median 88) years were included in the analysis. Nine had considerable frailty (ability to perform various activities of daily living but confined to bed or chair on occasion) and the remaining 146 had severe frailty (unable to perform activities of daily living and/or confined to bed or chair; dementia necessitating care). Three or more diagnoses besides COVID-19 were present in 142 individuals and another eight had two diagnoses in addition to COVID-19. In 20 (13%) individuals, COVID-19 was assessed as the principal cause of death, in 100 (64.5%) a contributing cause, and for the remaining 35 (22.5%) death was probably caused by another comorbidity. This seemed to change over the course of the COVID - 19 pandemic, with its contributing role decreasing from the middle of the summer. CONCLUSIONS: Death in home healthcare during the first wave of the pandemic mostly affected individuals with severe frailty and comorbidity at very advanced ages. One fifth of the individuals who died in home health care had another cause than Covid-19. TRIAL REGISTRATION: Clinical Trials.gov NCT04642196 date 24/11/2020.


Asunto(s)
Servicios de Atención de Salud a Domicilio , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Causas de Muerte , Prestación de Atención de Salud , Femenino , Anciano Frágil , Humanos , Masculino , Pandemias , Estudios Retrospectivos , Suecia/epidemiología
8.
Artículo en Inglés | MEDLINE | ID: mdl-33799366

RESUMEN

This study aimed to investigate the patterns and predictive factors of healthcare-seeking behavior among older Chinese adults. A sample of 10,914 participants aged ≥60 years from the 2011, 2013 and 2015 China Health and Retirement Longitudinal Study (CHARLS) was included. The bivariate analyses and Heckman selection model was used to identify predictors of healthcare-seeking behavior. Results shows that the utilization rate of outpatient services increased from 21.61% in 2011 to 32.41% in 2015, and that of inpatient services increased from 12.44% to 17.68%. In 2015, 71.93% and 92.18% chose public medical institutions for outpatient and inpatient services, 57.63% and 17.00% chose primary medical institutions. The individuals who were female, were younger, lived in urban, central or western regions, had medical insurance, had poor self-rated health and exhibited activity of daily living (ADL) impairment were more inclined to outpatient and inpatient services. Transportation, medical expenses, the out-of-pocket ratio and the urgency of the disease were associated with provider selection. The universal medical insurance schemes improved health service utilization for the elderly population but had little impact on the choice of medical institutions. The older adults preferred public institutions to private institutions, preferred primary institutions for outpatient care, and higher-level hospitals for hospitalization.


Asunto(s)
Actividades Cotidianas , Aceptación de la Atención de Salud , Anciano , China , Femenino , Humanos , Seguro de Salud , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Jubilación
9.
BMC Infect Dis ; 21(1): 314, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794779

RESUMEN

BACKGROUND: Older patients hospitalized with community-acquired pneumonia (CAP) are at high risk for short-term mortality. Activity of daily living (ADL) is associated with clinical outcomes in older patients. We aimed to investigate the prognostic value of ADL upon admission on the in-hospital mortality in older patients with CAP. METHODS: We conducted a retrospective cohort study involving patients aged ≥65 years admitted to Beijing Chao-Yang hospital due to CAP between June 2012 and June 2020. ADL evaluation upon admission was performed by Barthel Index (BI). Data from all patients were extracted from the electronic medical records. RESULTS: Four thousand eight hundred eighty patients were included, 131 patients (2.7%) died during their hospitalization. Median BI in the Deceased group was 45 (20-65), Deceased group had lower BI scores than Survivors group (p < 0.001). Low BI (< 60) was more frequent in patients who died in the hospital than in patients discharged alive (69.5% vs. 13%, p < 0.001). In-hospital mortality was higher among patients with worse ADL upon admission (BI< 60) compared to those BI≥60 (12.6% vs. 0.9%). The worse ADL upon admission (BI< 60) was associated with an increase in the risk of death during CAP hospitalization, worse ADL upon admission (BI< 60) showed an odds ratio (OR) for in-hospital mortality of 7.53 (95%CI: 2.77-20.48; P < 0.01). This association remained significant after adjustment for age, comorbid conditions, respiratory failure, pathogens and laboratory findings (OR, 3.74; 95%CI, 2.37-5.91; P < 0.01). Receiver operating characteristic (ROC) curve revealed that BI upon admission is a predictor related to in-hospital mortality in elderly patients, the area under the ROC curve of BI in predicting in-hospital mortality was 0.81 (with 95% confidence interval: 0.78-0.85). The predictive value of ADL upon admission was better than age in our study population. CONCLUSION: Activity of daily living upon admission is an independent predictor of in-hospital mortality in older patients with community-acquired pneumonia.


Asunto(s)
Actividades Cotidianas , Infecciones Comunitarias Adquiridas/mortalidad , Neumonía/mortalidad , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Infecciones Comunitarias Adquiridas/diagnóstico , Comorbilidad , Femenino , Mortalidad Hospitalaria , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Oportunidad Relativa , Neumonía/diagnóstico , Pronóstico , Curva ROC , Estudios Retrospectivos
10.
Occup Ther Int ; 2021: 8874953, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33824630

RESUMEN

Purpose: This study is aimed at validating the A-ONE scale in an Italian population with Central Nervous System (CNS) dysfunction. Material and Methods. Between May and November 2018, people aged between 60 and 90 with CNS dysfunction were recruited in a hospital in Rome, Italy. Patients were observed and evaluated during the activities of daily living. Internal consistency and reliability were evaluated with Cronbach's coefficient alpha and intraclass correlation coefficient, respectively. As measured with Pearson's correlation coefficient, the validity was examined comparing results of the A-ONE with the Barthel index. Responsiveness was evaluated 30 days after the first administration. Results: A total of 70 people having a diagnosis of neurological disorders were evaluated. The internal consistency showed Cronbach's coefficient alpha ranging from 0.634 to 0.959. The measurement of reliability varied from 0.984 to 0.997 for intrarater and from 0.979 to 0.998 for interrater. Pearson's correlation coefficient between the A-ONE and the Barthel index and the responsiveness showed statistically significant values (p < 0.01). Conclusions: The present study provides preliminary evidence of reliability, validity, and responsiveness of the A-ONE when using elderly people with CNS dysfunction.


Asunto(s)
Actividades Cotidianas , Trastornos Cerebrovasculares/rehabilitación , Pruebas Neuropsicológicas/normas , Psicometría/estadística & datos numéricos , Encuestas y Cuestionarios/normas , Anciano , Anciano de 80 o más Años , Estudios Transversales , Evaluación de la Discapacidad , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Análisis y Desempeño de Tareas
11.
Artículo en Inglés | MEDLINE | ID: mdl-33806244

RESUMEN

BACKGROUND: The purpose of this study was to analyze which gait variables are the best for detecting cognitive impairment and to determine if age and gender can influence gait variations in older people. METHODS: 65 participants took part in this study (22 men and 43 women; age: 73.88 ± 9.56 years). We use the Montreal Cognitive Assessment (MoCA) to assess mild cognitive impairment (MCI). Gait speed (GS) and the complex gait test (CGT) were analyzed with photocells Witty (Microgate, Italia). The OptoGait system (Microgate, Italia) was used to analyze step length (SL) and step coefficient of variation (CV sl). RESULTS: There was a significant association between MoCA and SL (r = 0.420; p = 0.002), CV sl (r = -0.591; p < 0.001), and CGT (r = -0.406; p = 0.001). Instrumental activities of daily living showed significant association with SL (r = 0.563; p < 0.001); CV sl (r = -0.762; p < 0.001), CGT (r = -0.622; p < 0.001), and GS (r = 0.418; p < 0.001). CV sl showed the best results with MoCA when linear regression analysis was applied (R2 = 0.560; p = 0.007; Y = 23.669 - 0.320x). Participants older than 79 years showed lower MoCA scores and poorer gait parameters than people younger than 79 years. CONCLUSIONS: CV sl, SL, CGT, and GS make it possible to detect MCI in older people, especially when these variables are evaluated as a whole.


Asunto(s)
Trastornos del Conocimiento , Disfunción Cognitiva , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Cognición , Disfunción Cognitiva/diagnóstico , Femenino , Marcha , Humanos , Masculino , Persona de Mediana Edad
12.
Sensors (Basel) ; 21(6)2021 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-33807104

RESUMEN

Over the last few years, the use of smartwatches in automatic Fall Detection Systems (FDSs) has aroused great interest in the research of new wearable telemonitoring systems for the elderly. In contrast with other approaches to the problem of fall detection, smartwatch-based FDSs can benefit from the widespread acceptance, ergonomics, low cost, networking interfaces, and sensors that these devices provide. However, the scientific literature has shown that, due to the freedom of movement of the arms, the wrist is usually not the most appropriate position to unambiguously characterize the dynamics of the human body during falls, as many conventional activities of daily living that involve a vigorous motion of the hands may be easily misinterpreted as falls. As also stated by the literature, sensor-fusion and multi-point measurements are required to define a robust and reliable method for a wearable FDS. Thus, to avoid false alarms, it may be necessary to combine the analysis of the signals captured by the smartwatch with those collected by some other low-power sensor placed at a point closer to the body's center of gravity (e.g., on the waist). Under this architecture of Body Area Network (BAN), these external sensing nodes must be wirelessly connected to the smartwatch to transmit their measurements. Nonetheless, the deployment of this networking solution, in which the smartwatch is in charge of processing the sensed data and generating the alarm in case of detecting a fall, may severely impact on the performance of the wearable. Unlike many other works (which often neglect the operational aspects of real fall detectors), this paper analyzes the actual feasibility of putting into effect a BAN intended for fall detection on present commercial smartwatches. In particular, the study is focused on evaluating the reduction of the battery life may cause in the watch that works as the core of the BAN. To this end, we thoroughly assess the energy drain in a prototype of an FDS consisting of a smartwatch and several external Bluetooth-enabled sensing units. In order to identify those scenarios in which the use of the smartwatch could be viable from a practical point of view, the testbed is studied with diverse commercial devices and under different configurations of those elements that may significantly hamper the battery lifetime.


Asunto(s)
Accidentes por Caídas , Dispositivos Electrónicos Vestibles , Accidentes por Caídas/prevención & control , Actividades Cotidianas , Anciano , Estudios de Factibilidad , Humanos , Movimiento (Física)
13.
Sensors (Basel) ; 21(6)2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33808554

RESUMEN

Continuous monitoring of knee motion can provide deep insights into patients' rehabilitation status after knee injury and help to better identify their individual therapeutic needs. Potentiometers have been identified as one possible sensor type for continuous monitoring of knee motion. However, to verify their use in monitoring real-life environments, further research is needed. We aimed to validate a potentiometer-embedded knee brace to measure sagittal knee kinematics during various daily activities, as well as to assess its potential to continuously monitor knee motion. To this end, the sagittal knee motion of 32 healthy subjects was recorded simultaneously by an instrumented knee brace and an optoelectronic reference system during activities of daily living to assess the agreement between these two measurement systems. To evaluate the potentiometer's behavior during continuous monitoring, knee motion was continuously recorded in a subgroup (n = 9) who wore the knee brace over the course of a day. Our results show a strong agreement between the instrumented knee brace and reference system across all investigated activities as well as stable sensor behavior during continuous tracking. The presented potentiometer-based sensor system demonstrates strong potential as a device for measuring sagittal knee motion during daily activities as well as for continuous knee motion monitoring.


Asunto(s)
Actividades Cotidianas , Rodilla , Fenómenos Biomecánicos , Humanos , Articulación de la Rodilla , Rango del Movimiento Articular
14.
Sensors (Basel) ; 21(6)2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33809080

RESUMEN

Given the high prevalence and detrimental effects of unintentional falls in the elderly, fall detection has become a pertinent public concern. A Fall Detection System (FDS) gathers information from sensors to distinguish falls from routine activities in order to provide immediate medical assistance. Hence, the integrity of collected data becomes imperative. Presence of missing values in data, caused by unreliable data delivery, lossy sensors, local interference and synchronization disturbances and so forth, greatly hamper the credibility and usefulness of data making it unfit for reliable fall detection. This paper presents a noise tolerant FDS performing in presence of missing values in data. The work focuses on Deep Learning (DL) particularly Recurrent Neural Networks (RNNs) with an underlying Bidirectional Long Short-Term Memory (BiLSTM) stack to implement FDS based on wearable sensors. The proposed technique is evaluated on two publicly available datasets-SisFall and UP-Fall Detection. Our system produces an accuracy of 97.21% and 97.41%, sensitivity of 96.97% and 99.77% and specificity of 93.18% and 91.45% on SisFall and UP-Fall Detection respectively, thus outperforming the existing state of the art on these benchmark datasets. The resultant outcomes suggest that the ability of BiLSTM to retain long term dependencies from past and future make it an appropriate model choice to handle missing values for wearable fall detection systems.


Asunto(s)
Aprendizaje Profundo , Dispositivos Electrónicos Vestibles , Actividades Cotidianas , Anciano , Algoritmos , Humanos , Redes Neurales de la Computación
15.
Artículo en Inglés | MEDLINE | ID: mdl-33802559

RESUMEN

Total knee arthroplasty (TKA) is used to treat end-stage osteoarthritis. However, this surgical procedure affects the mechanical receptor function and impairs the ability to balance. Dynamic balance training has been reported to improve stability and self-confidence and safely yield increased physical activity. This study aimed to investigate the effect of dynamic balance training on physical function, the ability to balance and quality of life among patients who underwent TKA. Thirty-eight participants were assigned to either the progressive dynamic balance training (PDBT) with physical therapy group (n = 19) or the control group (n = 19). The experimental group undertook a dynamic balance program with physical therapy for 30 minutes per day, five times per week for six weeks, while the control group undertook physical therapy only. A continuous passive motion exercise was performed for 20 minutes after training by both groups. The outcomes were evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, pain pressure threshold (PPT), range of motion (ROM), Knee Outcome Survey-Activities of Daily Living (KOS-ADLS), Multifunction Force Measuring Plate, timed up and go (TUG) test and Short-Form Health Survey 36 (SF-36). Physical function (WOMAC Osteoarthritis Index, ROM and KOS-ADLS score) and the ability to balance (TUG test score, confidence ellipse area, path length and average velocity) significantly improved (p < 0.05) in the experimental group compared with the control group. In contrast, the physical component summary score for the SF-36 regarding quality of life significantly improved (p < 0.05); however, the mental component summary score for the SF-36 and PPT did not significantly differ between the groups. Therefore, we suggest that PDBT with physical therapy has positive effects on physical function, the ability to balance and quality of life among patients who underwent TKA.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Rodilla , Actividades Cotidianas , Anciano , Método Doble Ciego , Femenino , Humanos , Ontario , Osteoartritis de la Rodilla/cirugía , Calidad de Vida , Rango del Movimiento Articular , Resultado del Tratamiento
16.
BMJ Case Rep ; 14(4)2021 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-33820804

RESUMEN

This is a case of a 54-year-old woman managed as a case of osteogenesis imperfecta type 1 who sustained a left subtrochanteric fracture and eventual ankylosis of both hips after surgery and immobilisation. These injuries rendered her bedridden, maximally assisted in transitions and transfers, and unable to be positioned past 30° of backrest elevation. The patient underwent a bilateral Girdlestone procedure and had tailored progressive postoperative rehabilitation in both the inpatient and outpatient settings. The patient also continued to receive bisphosphonates during her preoperative and postoperative period, to improve bone stock and aid in relieving pain. Through the efforts of a team of physiatrists, geneticists and orthopaedic surgeons, the patient was able to achieve pain-free sitting, independent transitions and short-distance ambulation, which have allowed her to care for herself more effectively and return to her work and activities of daily living.


Asunto(s)
Fracturas de Cadera , Osteogénesis Imperfecta , Actividades Cotidianas , Adulto , Difosfonatos , Femenino , Humanos , Persona de Mediana Edad , Osteogénesis Imperfecta/complicaciones
17.
BMC Psychiatry ; 21(1): 179, 2021 04 07.
Artículo en Inglés | MEDLINE | ID: mdl-33823847

RESUMEN

BACKGROUND: Older people coming from a lower wealth gradient are more vulnerable to have stressful life events further adding more risk for common mental health disorders and psychological distress situations. The present study explores the associations between socioeconomic and health-related variables and psychological distress among older adults in India and the contribution of such factors to the inequalities in psychological distress. METHODS: A cross-sectional survey of 9181 older adults conducted as 'Building a Knowledge Base on Population Ageing in India' was assessed. Logistic regression and decomposition models were used to analyze the data. Psychological distress was measured from General Health Questionnaire (GHQ-12). The value of Cronbach's alpha was 0.90. It was having a scale of 0 to 12 on the basis of experiencing stressful symptoms and was re-coded as 0 (representing 6+ stressful symptoms) and 1 (representing 5 and fewer symptoms). RESULTS: Older adults from the poored, suffering from multi-morbidity, disabled, with low activities of daily living and low instrumental activities of daily living and poor cognitive ability were suffering from high psychological distress in India. Further, factors such as religion, caste, education, living arrangements, and self-worth in the family were major contributors to the concentration of psychological distress in older adults from poor households (concentration index: - 0.23). CONCLUSION: The study suggests that among older people, there is a wide disparity of experiencing psychological distress across different socio-economic groups with significant factors being responsible for inequality in psychological distress. There is a need to build a "win-win" circumstance across sectors, including a broad spectrum of health, social and economic benefits to the vulnerable older population.


Asunto(s)
Actividades Cotidianas , Distrés Psicológico , Anciano , Anciano de 80 o más Años , Estudios Transversales , Humanos , India , Factores Socioeconómicos , Estrés Psicológico/epidemiología
18.
BMC Geriatr ; 21(1): 270, 2021 04 23.
Artículo en Inglés | MEDLINE | ID: mdl-33892624

RESUMEN

BACKGROUND: To (a) describe the pattern of leisure time physical activities (LTPA) in community-dwelling persons who have been screened positive for dementia and (b) determine the health-related and sociodemographic factors associated with LTPA. METHODS: Data of the general practitioner-based, randomized, controlled intervention trial, DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) were used. Patients aged 70 years or older, who lived at home and had a DemTect< 9 were informed about the study by their General practitioners and invited to participate. Data from 436 participants with complete baseline data were used. Standardized, computer-assisted assessments were made during face-to-face interviews at the participants' homes. RESULTS: Two hundred thirty-eight patients (54.6%) carried out LTPA (men 58.4%, women 51.8%). Physically active patients mentioned one to two different activities; diversity of LTPA was higher for men than for women. The most-frequently mentioned types of activity were gardening (35.3%), cycling (24.1%) and mobility training (12.4%); there was only a statistically significant difference between men and women in cycling, χ2(1) = 21.47, p < .001. The odds of LTPA increased with increasing quality of life (OR = 2.41), lower impairments in activities of daily living (OR = 0.85), and living in a rural environment (OR = 2.02). CONCLUSIONS: Our findings suggest that people who have been screened positive for dementia living in a rural area are more likely to be active than people living in an urban area. Following studies should investigate whether this difference has an effect on the progression of dementia. TRIAL REGISTRATION: ClinicalTrial.gov Identifier NCT01401582 .


Asunto(s)
Demencia , Vida Independiente , Actividades Cotidianas , Anciano , Demencia/diagnóstico , Demencia/epidemiología , Ejercicio Físico , Femenino , Humanos , Actividades Recreativas , Masculino , Calidad de Vida
19.
BMC Geriatr ; 21(1): 272, 2021 04 23.
Artículo en Inglés | MEDLINE | ID: mdl-33892638

RESUMEN

BACKGROUND: Depression and suicide rates are relatively high in the colder regions of Russia. Older individuals in these regions are especially susceptible to these issues and are understudied in this regard. This study aims to better understand the current depression prevalence, and the factors related to depression, among the older individuals in these colder regions of Russia by studying a population in Novosibirsk oblast. METHODS: A questionnaire survey was administered to 422 older individuals, assessing basic attributes and health status, and employing the following standardized scales: 8-item Short-Form Health Survey, Pittsburgh Sleep Quality Index, and 15-item Geriatric Depression Scale (GDS). Participants were divided in two groups (GDS ≤ 6, GDS > 6) and compared, using Student's t test, χ2 test, and logistic regression analysis. RESULTS: Young old (YO) adults showed significant correlation of depression with asthma (P = 0.005, OR = 6.40, 95%CI: 1.74-23.5), having a spouse (P = 0.016, OR = 1.99, 95%CI: 1.14-3.48), and daily communication with others (P < 0.001, OR = 0.336, 95%CI: 0.197-0.572). Among old old (OO) adults, significant correlation with depression was found for the variables work status (P = 0.047, OR = 0.115, 95%CI: 0.014-0.974), and weekly walking (P = 0.014, OR = 0.288, 95%CI: 0.106-0.778). CONCLUSIONS: Twenty eight percent of the participants have depression. In YO adults, frequent communication and social ties with individuals outside of the family can mitigate depression prevalence. As for OO adults, the factors that have the highest impact on mitigating depression are related to daily activity, including both frequent walking and working or self-employment. Asthma patients are one of the more sensitive groups towards depression, but further research on this topic is needed.


Asunto(s)
Actividades Cotidianas , Depresión , Anciano , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Evaluación Geriátrica , Humanos , Federación de Rusia/epidemiología , Siberia/epidemiología
20.
Artículo en Inglés | MEDLINE | ID: mdl-33810298

RESUMEN

The purpose of this study is to understand the functional status distribution and to explore the factors associated with changes in functional status and social participation in people with depression using two-year follow-up data. Subjects were selected from the Taiwan Databank of Persons with Disabilities (TDPD) if they had an evaluation date between July 2012 and 31 December 2017. We used data for 1138 individuals with multiple evaluation records and who were diagnosed with depression. The WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) was the primary functional status measure. Other factors selected from the TDPD included social demographic data, living situation, employment status, economic status, and educational level. The results show scores in all dimensions of the WHODAS 2.0 declined over two years, especially in the domains of cognition, household activities, social participation, and total WHODAS 2.0 score. Aging groups showed poor recovery in cognition, getting along with others, and household activities. People living in suburban areas showed poorer recovery than people living in rural and urban areas in cognition, self-care, and general function (total score of WHODAS 2.0). Employment was also strongly associated with functional recovery in household activities, social participation, and general function. The original scores for cognition and getting along with others showed a significant negative relationship with social participation improvement. Our results can be used by policy makers to provide resources and conduct investigations, and by clinicians when making rehabilitation plans.


Asunto(s)
Depresión , Personas con Discapacidad , Actividades Cotidianas , Depresión/epidemiología , Evaluación de la Discapacidad , Estudios de Seguimiento , Humanos , Taiwán/epidemiología
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