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1.
BMJ ; 373: n740, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-33824131

RESUMEN

OBJECTIVE: To test whether StandingTall, a home based, e-health balance exercise programme delivered through an app, could provide an effective, self-managed fall prevention programme for community dwelling older people. DESIGN: Assessor blinded, randomised controlled trial. SETTING: Older people living independently in the community in Sydney, Australia. PARTICIPANTS: 503 people aged 70 years and older who were independent in activities of daily living, without cognitive impairment, progressive neurological disease, or any other unstable or acute medical condition precluding exercise. INTERVENTIONS: Participants were block randomised to an intervention group (two hours of StandingTall per week and health education; n=254) or a control group (health education; n=249) for two years. MAIN OUTCOME MEASURES: The primary outcomes were the rate of falls (number of falls per person year) and the proportion of people who had a fall over 12 months. Secondary outcomes were the number of people who had a fall and the number who had an injurious fall (resulting in any injury or requiring medical care), adherence, mood, health related quality of life, and activity levels over 24 months; and balance and mobility outcomes over 12 months. RESULTS: The fall rates were not statistically different in the two groups after the first 12 months (0.60 falls per year (standard deviation 1.05) in the intervention group; 0.76 (1.25) in the control group; incidence rate ratio 0.84, 95% confidence interval 0.62 to 1.13, P=0.071). Additionally, the proportion of people who fell was not statistically different at 12 months (34.6% in intervention group, 40.2% in control group; relative risk 0.90, 95% confidence interval 0.67 to 1.20, P=0.461). However, the intervention group had a 16% lower rate of falls over 24 months compared with the control group (incidence rate ratio 0.84, 95% confidence interval 0.72 to 0.98, P=0.027). Both groups had a similar proportion of people who fell over 24 months (relative risk 0.87, 95% confidence interval 0.68 to 1.10, P=0.239), but the proportion of people who had an injurious fall over 24 months was 20% lower in the intervention group compared with the control group (relative risk 0.80, 95% confidence interval 0.66 to 0.98, P=0.031). In the intervention group, 68.1% and 52.0% of participants exercised for a median of 114.0 min/week (interquartile range 53.5) after 12 months and 120.4 min/week (38.6) after 24 months, respectively. Groups remained similar in mood and activity levels. The intervention group had a 0.03 (95% confidence interval 0.01 to 0.06) improvement on the EQ-5D-5L (EuroQol five dimension five level) utility score at six months, and an improvement in standing balance of 11 s (95% confidence interval 2 to 19 s) at six months and 10 s (1 to 19 s) at 12 months. No serious training related adverse events occurred. CONCLUSIONS: The StandingTall balance exercise programme did not significantly affect the primary outcomes of this study. However, the programme significantly reduced the rate of falls and the number of injurious falls over two years, with similar but not statistically significant effects at 12 months. E-health exercise programmes could provide promising scalable fall prevention strategies. TRIAL REGISTRATION: ACTRN12615000138583.


Asunto(s)
Accidentes por Caídas/prevención & control , Terapia por Ejercicio/métodos , Telemedicina/métodos , Heridas y Traumatismos/prevención & control , Accidentes por Caídas/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Vida Independiente , Masculino , Cooperación del Paciente/estadística & datos numéricos , Estudios Prospectivos , Calidad de Vida , Método Simple Ciego , Resultado del Tratamiento , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/etiología
2.
BMC Psychiatry ; 21(1): 177, 2021 04 03.
Artículo en Inglés | MEDLINE | ID: mdl-33812389

RESUMEN

BACKGROUND: The care of people with dementia is usually carried out by their family members, which can cause objective und subjective burden and raise their risk of depressiveness. Thus, the aim of this study is to identify predictors of the change in depressiveness of informal caregivers over 1 year in order to be able to derive hypotheses for interventions that promise success. METHODS: The Bavarian Dementia Survey (BayDem) is a multi-center, longitudinal study conducted at three different sites in Bavaria, Germany. Participants were people with dementia and their informal caregivers. Data was collected at baseline and after 12 months by standardized face-to-face interviews in cooperation with local players. The informal caregivers' depressiveness was assessed with the WHO-5. Data was also collected on the people with dementia's cognition (MMSE), behavioral symptoms (NPI) and comorbidities (Charlson Comorbidity Index) as well as caregivers' social inclusion (LSNS), time spent on care and care contribution (RUD). For statistical analysis, a multiple regression model was used. RESULTS: The data of 166 people with dementia and their informal caregivers was analyzed. Of the latter, 46% were categorized as "likely depressed". The change in depressiveness over a year was significantly predicted by baseline depressiveness as well as an increase in the time informal caregivers spent supervising the person with dementia. CONCLUSIONS: Informal caregivers of people with dementia are at high risk of depression. The time spent supervising the person with dementia has a significant impact on increasing depressiveness. This highlights the importance of support services to provide the informal caregiver with relief and possibly reduce depressiveness.


Asunto(s)
Cuidadores , Demencia , Alemania , Humanos , Vida Independiente , Estudios Longitudinales
3.
BMC Geriatr ; 21(1): 226, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-33823808

RESUMEN

BACKGROUND: Falls are one of the major causes of mortality and morbidity in older adults. However, despite adoption of prevention strategies, the number of falls in older adults has not declined. The aim of this study was to examine fall awareness behaviour and its associated factors among Malaysian community dwelling older adults. METHODS: A total of 144 community dwelling older adults (mean age of 70.69 ± 4.3 years) participated in this study. Physical performance were assessed using timed up and go (TUG), gait speed (GS), chair stand and hand grip tests. Fall Awareness Behaviour (FaB) and Fall Risk Assessment Questionnaires (FRAQ) were administered to assess behaviour and fall prevention knowledge respectively. RESULTS: Stepwise linear regression analysis showed that the practice of fall awareness behaviour (R2 = 0.256) was significantly associated with being male [95% C.I: 2.178 to 7.789, p < 0.001], having lower BMI [95% C.I: - 0.692 to - 0.135, p < 0.05], living with family [95% C.I: 0.022 to 5.953, p < 0.05] and those having higher functional mobility [95% C.I: - 2.008 to - 0.164, p < 0.05]. CONCLUSIONS: Fall awareness behaviour should be emphasized among older females, those with lower functional mobility, higher BMI and living alone.


Asunto(s)
Fuerza de la Mano , Vida Independiente , Anciano , Femenino , Evaluación Geriátrica , Humanos , Masculino , Equilibrio Postural , Factores de Riesgo
4.
BMC Geriatr ; 21(1): 228, 2021 04 07.
Artículo en Inglés | MEDLINE | ID: mdl-33827438

RESUMEN

BACKGROUND: Based on a conceptual framework, Kuspinar and colleagues analysed life-space mobility in community-dwelling older adults. However, a number of earlier mobility studies that used the same framework remained undiscussed. This correspondence article addresses similarities and differences between these studies, as well as highlight issues that need to be addressed to improve our understanding of mobility determinants in older adults. FINDINGS: Despite differences in methodological approach as well as in detailed results, the studies share one important outcome: regardless of the specific choice of potential mobility determinants, only a low to moderate proportion of mobility could be explained. CONCLUSIONS: Our present understanding of the determinants of mobility in community-dwelling older adults is limited. A consistent terminology that takes into account the different aspects of mobility; the use of objective methods to assess real-life mobility; and monitoring changes in real-life mobility in response to interventions will contribute to furthering our understanding of mobility determinants.


Asunto(s)
Vida Independiente , Limitación de la Movilidad , Anciano , Humanos
5.
BMC Geriatr ; 21(1): 235, 2021 04 08.
Artículo en Inglés | MEDLINE | ID: mdl-33832424

RESUMEN

BACKGROUND: During a disaster, home-based care fills the critical need for continuation of health care. Home-based care is intended to function using existing care delivery models, continuing to provide care for patients wherever they are located, including in shelters and hotels. Home-based care providers are often the closest in contact with their patients -seeing them in place, even throughout a disaster- through which they develop a unique insight into aging in place during a disaster. The purpose of this study was to identify individual and community-level support needs of older adults after a disaster through the lens of home-based care providers. METHODS: Using qualitative inquiry, five focus groups were conducted with home-based care providers (n = 25) who provided in-home care during Hurricane Irma and Hurricane Harvey. Participants were identified by contacting home health agencies listed in an open-source database of agencies participating in Centers for Medicare and Medicaid Services programs. Data were coded using an abductive analytic approach, and larger themes were generated in light of existing theory. RESULTS: The results were distilled into eight themes that related to the importance of community and family, informal and formal supports throughout the disaster management cycle, maintaining autonomy during a disaster, and institutional and systemic barriers to obtaining assistance. CONCLUSIONS: In this study, home-based care providers described the challenges aging adults face in the response and recovery period after a large-scale disaster including maintaining continuity of care, encouraging individual preparedness, and accessing complex governmental support. Listening to home-based care providers offers new and important insights for developing interventions to address social and health needs for older adults aging in place after a large-scale disaster.


Asunto(s)
Planificación en Desastres , Desastres , Servicios de Atención de Salud a Domicilio , Anciano , Humanos , Vida Independiente , Medicare , Estados Unidos
6.
BMC Geriatr ; 21(1): 245, 2021 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-33853530

RESUMEN

BACKGROUND: Salivary function has been suggested to be associated with cognitive impairment. However, the effect of salivary flow rate (SFR) on cognitive impairment remains unclear. This study aimed to investigate whether SFR is associated with cognitive impairment among Korean elders. METHODS: This cross-sectional study included 649 elders aged 65 and older in the Korean community-dwelling population. Cognitive impairment was assessed using the Mini-Mental Status Examination. Unstimulated SFR was measured and dichotomized. Denture status, age, sex, education level, smoking, drinking, diabetes, hypertension, and obesity were considered confounders. Multivariable logistic regression analysis was applied to assess the adjusted association. Stratified analysis by sex and denture status was performed to clarify the effect modification. RESULTS: Participants without cognitive impairment showed a higher SFR level than those with cognitive impairment (0.81 mL/min for non-cognitive impairment versus 0.52 mL/min for cognitive impairment, p < 0.001). After controlling for confounders, participants with low SFR (< 0.3 mL/min) were more likely to have cognitive impairment by 1.5 times than participants with normal SFR (odds ratio [OR] = 1.5, confidence interval [CI] = 1.05-2.10). The association of low SFR with cognitive impairment was higher in women and dentate participants: about 10% higher in women (OR = 1.63, CI = 1.07-2.50) and about 22% higher in dentate participants (OR = 1.82, CI = 1.41-2.90). CONCLUSIONS: Salivary flow rate is independently associated with cognitive impairment among Korean elders. The association was modified in females and dentate elders. Physicians and dentists should consider low SFR and cognitive impairment as a risk factor between them in clinics.


Asunto(s)
Disfunción Cognitiva , Anciano , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/epidemiología , Estudios Transversales , Femenino , Humanos , Vida Independiente , República de Corea/epidemiología , Factores de Riesgo
7.
Clin Interv Aging ; 16: 571-582, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33854307

RESUMEN

Purpose: Temporary cessation of exercise but maintenance of habitual physical activity might be a frequent situation in older people's lives. Particularly the COVID-19 induced lockdown of exercise training facilities with individual outdoor activities still being allowed might be a blueprint for this potentially harmful scenario. Thus, the aim of the present study was to determine the effects of 6 months of detraining after 18 months of high-intensity resistance exercise (HIT-RT) on body composition and cardiometabolic outcomes in predominately obese older men with osteosarcopenia. Materials and Methods: Community-dwelling predominately obese men 72-91 years old with low muscle and bone mass (n=43) were randomly assigned to an 18-month HIT-RT (EG: n=21) or a non-training control group (CG, n=22). After the intervention, participants of the EG discontinued HIT-RT for 6 months, but increased their habitual physical activity. Study outcomes were group differences in detraining changes ("effects") for lean body mass (LBM), total and abdominal body fat rate (determined by dual-energy x-ray absorptiometry) and the Metabolic Syndrome Z-Score (MetSZ). We applied an intention-to-treat analysis with multiple imputation to analyze the data. Results: After the 18-month HIT-RT, we observed significant positive training effects for LBM, total and abdominal body fat rate and the MetSZ (all p<0.001). Abrupt cessation of HIT-RT for 6 months resulted in significantly higher unfavorable changes in the HIT-RT compared with the CG for LBM (p=0.001), total body fat (p=0.003) and the MetSZ (p=0.003), apart from abdominal body fat (p=0.059). However, significant overall effects were still present after 24 months for LBM and body fat indices but not for the MetSZ. Conclusion: The present study clearly indicates the unfavorable effects of 6 months of detraining after HIT-RT. Correspondingly, exercise protocols particularly for older people should focus on continuous exercise with short regeneration periods rather than on intermitted protocols with pronounced training breaks.


Asunto(s)
Composición Corporal , Enfermedades Óseas Metabólicas/fisiopatología , Obesidad/fisiopatología , Sarcopenia/fisiopatología , Grasa Abdominal , Absorciometría de Fotón , Anciano , Anciano de 80 o más Años , Densidad Ósea , Enfermedades Óseas Metabólicas/complicaciones , Ejercicio Físico/fisiología , Estudios de Seguimiento , Humanos , Vida Independiente , Masculino , Síndrome Metabólico/fisiopatología , Obesidad/complicaciones , Entrenamiento de Resistencia , Sarcopenia/complicaciones
8.
BMC Geriatr ; 21(1): 255, 2021 04 16.
Artículo en Inglés | MEDLINE | ID: mdl-33863274

RESUMEN

BACKGROUND: Unintended weight loss and the reduction in appetite are common phenomenon among older people. Reduced appetite has been linked to medication related reductions in saliva production, reduced taste ability and poor oral health. Poor appetite can result in reduced nutrient intake ensuing weight loss. It is possible that poor appetite is a mediating step on the causal pathway between oral health and weight loss. This study investigates whether poor oral health and loss of appetite are related to weight loss. METHODS: This is an observational study where data were obtained from the Concord Health and Ageing in Men Project (CHAMP). Information on socio-demographics, appetite and health related behavior was collected by self-completed questionnaire. Intraoral assessment was conducted by calibrated oral health therapists. Height and weight were measured by trained staff. Regression analysis investigated associations between oral health and appetite as risk factors for weight loss. RESULTS: Participants included 542 community dwelling older males. 99 older men (18.3%) experienced 5% or more weight loss over 3 years. Men who lost weight from baseline had lower BMI and lower body weight, had higher prevalence of frailty and depression, reported poorer appetite, and had fewer teeth (13.8 ± 9.5) than those who did not lose weight (16.3 ± 9.3). Before adjustment, the prevalence ratio (PR) for weight loss was 1.76 (95% Confidence Interval (CI), 1.19-2.59) for participants with 0-19 natural teeth present compared to those with 20 or more teeth. When adding appetite and other variables to the model, the PR for number of teeth and weight loss was unchanged: 1.78 (95% CI, 1.06-3.00). The mediation analysis showed that the indirect effect of appetite on the association between number of natural teeth on weight loss was not found to be significant. CONCLUSION: This study found that number of natural teeth present and appetite are independently related to weight change among elderly men in Australia. Tooth loss can increase the risk of swallowing difficulty leading to change in food preference, avoidance of foods and a decrease in energy intake. Our study showed the importance of oral health interventions to encourage maintenance of 20 or more natural teeth in older people.


Asunto(s)
Vida Independiente , Salud Bucal , Anciano , Anciano de 80 o más Años , Envejecimiento , Apetito , Australia , Estudios Transversales , Humanos , Masculino , Pérdida de Peso
9.
BMC Geriatr ; 21(1): 261, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-33879099

RESUMEN

BACKGROUND: Informal caregiving for people with dementia can negatively impact caregivers' health. In Asia-Pacific regions, growing dementia incidence has made caregiver burnout a pressing public health issue. A cross-sectional study with a representative sample helps to understand how caregivers experience burnout throughout this region. We explored the prevalence and contributing factors of burnout of caregivers of community-dwelling older people with dementia in Hong Kong (HK), China, and New Zealand (NZ) in this study. METHODS: Analysis of interRAI Home Care Assessment data for care-recipients (aged ≥65 with Alzheimer's disease/other dementia) who had applied for government-funded community services and their caregivers was conducted. The sample comprised 9976 predominately Chinese in HK and 16,725 predominantly European in NZ from 2013 to 2016. Caregiver burnout rates for HK and NZ were calculated. Logistic regression was used to determine the adjusted odds ratio (AOR) of the significant factors associated with caregiver burnout in both regions. RESULTS: Caregiver burnout was present in 15.5 and 13.9% of the sample in HK and NZ respectively. Cross-regional differences in contributing factors to burnout were found. Care-recipients' ADL dependency, fall history, and cohabitation with primary caregiver were significant contributing factors in NZ, while primary caregiver being child was found to be significant in HK. Some common contributing factors were observed in both regions, including care-recipients having behavioural problem, primary caregiver being spouse, providing activities-of-daily-living (ADL) care, and delivering more than 21 h of care every week. In HK, allied-health services (physiotherapy, occupational therapy and speech therapy) protected caregiver from burnout. Interaction analysis showed that allied-health service attenuates the risk of burnout contributed by care-recipient's older age (85+), cohabitation with child, ADL dependency, mood problem, and ADL care provision by caregivers. CONCLUSIONS: This study highlights differences in service delivery models, family structures and cultural values that may explain the cross-regional differences in dementia caregiving experience in NZ and HK. Characteristics of caregiving dyads and their allied-health service utilization are important contributing factors to caregiver burnout. A standardized needs assessment for caregivers could help policymakers and healthcare practitioners to identify caregiving dyads who are at risk of burnout and provide early intervention.


Asunto(s)
Cuidadores , Vida Independiente , Anciano , Anciano de 80 o más Años , Agotamiento Psicológico/epidemiología , China , Estudios Transversales , Hong Kong/epidemiología , Humanos , Nueva Zelanda
10.
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
11.
Sensors (Basel) ; 21(5)2021 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-33800728

RESUMEN

In this paper, we present an exhaustive description of an extensible e-Health Internet-connected embedded system, which allows the measurement of three biometric parameters: pulse rate, oxygen saturation and temperature, via several wired and wireless sensors residing to the realm of Noncommunicable Diseases (NCDs) and cognitive assessment through Choice Reaction Time (CRT) analysis. The hardware used is based on ATMEGA AVR + MySignals Hardware printed circuit board (Hardware PCB), but with multiple upgrades (including porting from ATMEGA328P to ATMEGA2560). Multiple software improvements were made (by writing high-level device drivers, text-mode and graphic-mode display driver) for increasing functionality, portability, speed, and latency. A top-level embedded application was developed and benchmarked. A custom wireless AT command firmware was developed, based on ESP8266 firmware to allow AP-mode configuration and single-command JavaScript Object Notation (JSON) data-packet pushing towards the cloud platform. All software is available in a git repository, including the measurement results. The proposed eHealth system provides with specific NCDs and cognitive views fostering the potential to exploit correlations between physiological and cognitive data and to generate predictive analysis in the field of eldercare.


Asunto(s)
Vida Independiente , Telemedicina , Computadores , Monitoreo Fisiológico , Programas Informáticos
12.
Artículo en Inglés | MEDLINE | ID: mdl-33806599

RESUMEN

The study is cross-sectional in nature and aims to investigate the relationship of the frequency of socialization (FOS) to the daily life, social life, and physical function of community-dwelling adults aged 60 and over after the COVID-19 outbreak. A self-reported questionnaire survey was conducted on 3000 members of CO-OP Kagoshima, out of which 342 responses were received. Bivariate statistics was conducted followed by multiple logistic regression analysis. Questions with significant differences were set as independent variables, whereas the FOS was set as the dependent variable. Results indicate significant group differences between the decreased and increased/unchanged groups. After adjusting for potential covariates, multiple logistic regression analysis revealed decreases in the frequencies of cooking (OR: 0.07; 95% CI: 0.01-0.69; p = 0.02), shopping (OR: 18.76; 95% CI: 7.12-49.41; p < 0.01), and eating out (OR: 3.47; 95% CI: 1.21-9.97; p = 0.02), which were significantly associated with decreased FOS. The finding may inform policy making in identifying priorities for support in daily life for community-dwelling adults over the age of 60 undergoing social distancing.


Asunto(s)
Pandemias , Adulto , Anciano , Estudios Transversales , Humanos , Vida Independiente , Persona de Mediana Edad , Socialización , Encuestas y Cuestionarios
13.
Medicine (Baltimore) ; 100(14): e25082, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832075

RESUMEN

ABSTRACT: Noncommunicable diseases (NCDs) are an important cause of disability and death in Muntinlupa, Manila, Philippines. However, there is little community-based research on lifestyle behaviors that affect the progression of NCDs or on the hindrances to NCD prevention.This cross-sectional study investigated the lifestyle behaviors associated with the progression and prevalence of NCDs and clarified factors associated with health promotion for the NCDs prevention among 168 Filipino adults aged 50 years and above in the community setting.The prevalence of diabetes, cardiovascular disease, cancer, chronic respiratory disease, hypertension, and overweight/obesity found 13.1%, 8.9%, 1.8%, 4.2%, 59.5%, and 36.9%, respectively. Of 63 adults who underwent blood tests, high blood glucose and abnormal lipids found 20.6% and 80.9%, respectively. Filipino adults ate breakfast, lunch, and dinner more than 5 days a week, Merienda 4.2 days a week, and a midnight snack 1.7 days a week. The mean frequencies of physical activity at vigorous, moderate, and light intensity levels were 2.6 times a week, 1.9 times a week, and 3.8 times a week, respectively. Men were more likely to be smokers than women. Mean frequencies of alcohol consumption were 0.6 days a week. Filipino adults who practiced diet control, regular physical activities, no smoking, limited alcohol intake, stress control, and regular health checkups were 68.3%, 34.1%, 35.9%, 35.3%, 32.9%, and 24.6%, respectively. Hypertension was positively associated with the duration of tobacco use and frequency of salt intake. Overweight/obesity was positively associated with the frequency of Merienda. Diet control was positively related with internal Multidimensional Health Locus of Control scale. Smoking and alcohol control were significantly related with income level.Community-dwelling Filipino adults in this study had a high prevalence of NCD progression and insufficient awareness of preventative behaviors. Diet control is associated with self-awareness of health and smoking and alcohol control are associated with economic status. These findings ought to contribute to develop the effective strategies for NCD prevention in community-dwelling Filipino adults.


Asunto(s)
Estilo de Vida , Enfermedades no Transmisibles/epidemiología , Anciano , Estudios Transversales , Progresión de la Enfermedad , Conducta Alimentaria , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Vida Independiente/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Enfermedades no Transmisibles/prevención & control , Filipinas/epidemiología , Factores de Riesgo , Encuestas y Cuestionarios
15.
Front Public Health ; 9: 577079, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33898369

RESUMEN

Older individuals are at an increased risk of experiencing adverse social and health consequences due to both the COVID-19 pandemic and the measures taken to manage it, such as social distancing. To promote community-dwelling older individuals' well-being during this time, the aims of the current project are to develop effective strategies in order (a) to increase older individuals' digital literacy, and (b) to help them acquire behavioral and cognitive skills that will improve their coping abilities with the stressful situation created as a result of the pandemic, as well as reducing adverse mental health effects. The project comprises an intervention arm that includes digital group sessions for older individuals meant to improve their digital literacy, promote their effective coping, and relieve their mental distress and loneliness. Subjects receive a short-term (seven sessions), twice-weekly, digitally guided group intervention through Zoom (a video conferencing app), and WhatsApp (instant messaging app). The wait list control-group participants receive twice-weekly telephone calls from a research assistant during a parallel period. Web-based questionnaires are filled in pre- and post-participation. The effectiveness of the intervention will be analyzed by comparing pre- and post-measures, between intervention and control groups. This protocol offers a model for helping to support vulnerable populations during the COVID-19 pandemic. However, it is applicable regardless of the outbreak of a global health crisis or the imposition of lockdown rules; in fact, it has the potential to contribute to the social inclusion of vulnerable populations during routine times as well as during emergencies. Furthermore, ideas for future expansion include the integration of multilingual facilitators in order to reach seniors from underserved minority groups in various social contexts, even across borders.


Asunto(s)
Adaptación Psicológica , Promoción de la Salud , Pandemias , Distrés Psicológico , Anciano , Control de Enfermedades Transmisibles , Alfabetización Digital , Brotes de Enfermedades , Humanos , Vida Independiente , Internet , Aplicaciones Móviles , Estudios Prospectivos
16.
Artículo en Inglés | MEDLINE | ID: mdl-33804561

RESUMEN

There is a strong relationship between loneliness and depression, but depression is a heterogeneous disorder. We examined the profile of depressive symptoms most strongly related to loneliness. Study participants were 2007 community-dwelling individuals (median age 31 years, 70.4% women) who completed an online survey on loneliness (single-item question: "never", "sometimes", "often"), depressive symptoms (Patient Health Questionnaire-9) and demographics. The relationship between loneliness and depressive symptoms was evaluated with linear regression and network analyses. The prevalence of loneliness (sometimes or often) and of moderate depression was 47.1% and 24.0%, respectively. Loneliness explained 26% of the variance in the total depressive symptom score (p < 0.001), independent of covariates. This result was almost exclusively explained by the relationship with a single depression symptom ("feeling down, depressed, or hopeless"), irrespective of whether loneliness was treated as a nominal or continuous variable. The findings of our study suggest that the role of loneliness in depression should not only be investigated at the syndrome level, but also at the symptom level. Studies are warranted to test whether targeted treatment of depressive affect is particularly effective against loneliness.


Asunto(s)
Depresión , Trastorno Depresivo , Adulto , Depresión/epidemiología , Emociones , Femenino , Humanos , Vida Independiente , Soledad , Masculino
17.
Artículo en Inglés | MEDLINE | ID: mdl-33808633

RESUMEN

Previous studies indicated that Tai Chi might be an effective way to improve or prevent cognitive impairments in older populations. However, existing research does not provide clear recommendations about the optimal dose of Tai Chi practice, which is the most effective in improving cognitive function in older adults. The purpose of this systematic review and meta-analysis was to investigate the dose-response relationship between Tai Chi and cognition in community-dwelling older adults. A total of 16 studies with 1121 subjects were included in this study. Meta-regression analyses of Tai Chi duration (Tai Chi session duration, Tai Chi practice duration per week, study duration, and Tai Chi practice duration for the entire study) on the study effect size (ES) were performed to examine the dose-response association of Tai Chi and cognition. The results showed that there was a positive effect of Tai Chi on cognitive function, but there were no statistically significant dose duration effects on cognition. The findings suggest that Tai Chi has beneficial effects on cognitive function, but a longer duration was not associated with larger effects. In order to establish evidence-based clinical interventions using Tai Chi, future research should clearly demonstrate intervention protocol, particularly the style and intensity of Tai Chi.


Asunto(s)
Disfunción Cognitiva , Tai Ji , Anciano , Cognición , Disfunción Cognitiva/prevención & control , Humanos , Vida Independiente , Factores de Tiempo
18.
Artículo en Inglés | MEDLINE | ID: mdl-33809322

RESUMEN

This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22-4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73-0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.


Asunto(s)
Fragilidad , Anciano , Estudios Transversales , Anciano Frágil , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , Vida Independiente
19.
Rev Bras Epidemiol ; 24: e210015, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33825775

RESUMEN

OBJECTIVE: To evaluate all-cause mortality in approximately three years of follow-up and related sociodemographic, behavioral and health factors in community-dwelling older adults in Pelotas, RS. METHODS: This was a longitudinal observational study that included 1,451 older adults (≥ 60 years) who were interviewed in 2014. Information on mortality was collected from their households in 2016-2017 and confirmed with the Epidemiological Surveillance department of the city and by documents from family members. Associations between mortality and independent variables were assessed by crude and multiple Cox regression, with hazard ratio with respective 95% confidence intervals (95%CI). RESULTS: Almost 10% (n = 145) of the participants died during an average of 2.5 years of follow-up, with a higher frequency of deaths among males (12.9%), ?80 years (25.2%), widowhood (15.0%), no education (13.8%) and who did not work (10.5%). Factors associated with higher mortality were: being a male (HR = 2.8; 95%CI 1.9 - 4.2), age ?80 years (HR = 3.9; 95%CI 2.4 - 6.2), widowhood (HR = 2.2; 95%CI 1.4 - 3.7), physical inactivity (HR = 2.3; 95%CI 1.1 - 4..6), current smoking (HR = 2.1; 95%CI 1.2 - 3.6), hospitalizations in the previous year (HR = 2.0; 95%CI 1.2 - 3.2), depressive symptoms (HR = 2.0; 95%CI 1.2 - 3,4) and dependence for two or more daily life activities (HR = 3.1; 95%CI 1,7 - 5.7). CONCLUSION: The identification of factors that increased the risk of early death makes it possible to improve public policies aimed at controlling the modifiable risk factors that can lead to aging with a better quality of life.


Asunto(s)
Vida Independiente , Mortalidad , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Causas de Muerte/tendencias , Femenino , Humanos , Vida Independiente/estadística & datos numéricos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Factores de Riesgo , Factores Socioeconómicos
20.
Artículo en Inglés | MEDLINE | ID: mdl-33808083

RESUMEN

We compared the physical function performances of community-dwelling and day care center older adults with and without regular physical activity (PA). A total of 163 Taiwanese older adults living in rural communities participated. PA habits and physical functional performances were assessed. The participants were divided into community-dwelling (CD) and senior day care (DC) center groups that were further classified into regular physical activity (RPA) and non-physical activity (NPA) subgroups. Comparison took place between subgroups. In the CD group, only the grip strength, pinch strength, and box and blocks test scored significantly better for the participants with regular PA. Muscle strength, flexibility, and three items of functional ability of participants with regular PA were significantly better in the DC group. An active lifestyle contributes to a good old-age life. The effective amount of PA and the reduction of sedentary time should be advocated to prevent frailty and disability in older adults.


Asunto(s)
Fragilidad , Rendimiento Físico Funcional , Anciano , Ejercicio Físico , Humanos , Vida Independiente , Conducta Sedentaria
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