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1.
PLoS One ; 17(8): e0269003, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35921330

RESUMO

AIMS: Living alone, a reality in an increasing number of older adults recently, is a risk factor for low quality of life. This study identified the predictors of quality of life in older adults living alone based on mental health and the International Classification of Functioning, Disability, and Health. METHODS: This secondary data analysis used information from the 2018 Assessing the Requirements of Customized Health Care and Daily Living Support Services survey (N = 1,022), collected from adults aged ≥ 65 living alone in Siheung City, South Korea, from August to October 2018. The exogenous variables were body functions (hand grip strength, timed "up and go" test score, and body mass index), daily living activities (Korean Instrumental Activities of the Daily Living Scale), social activity participation (social activity engagement, neighbor contacts, and family contacts), and participation in economic activity (frequency). The endogenous variables were mental health (Geriatric Depression Scale Short Form-Korean Version and UCLA Loneliness Scale) and quality of life (EuroQoL-5 Dimension-3 Level and EuroQoL-Visual Analog Scale). RESULTS: After modifying the hypothetical model, which had failed to satisfy the recommended fitness level, the (modified) model had good fitness indices Q (CMIN / df) 2.90, GFI 1, AGFI 1, RMSEA 0.04, CFI 0.90 and PCFI 0.53. Of the nine pathways of the modified model, five were statistically significant. Quality of life was affected by body functions, daily living activities, social activity participation, and mental health. These variables explained 68.2% of the factors affecting quality of life. CONCLUSIONS: By highlighting the role of mental health, this model provides a useful framework for improving the quality of life of older adults who live alone and function at various levels in the community. Focusing on advancing mental health through body functions, daily living activities, and social activity participation can improve quality of life.


Assuntos
Atividades Cotidianas , Qualidade de Vida , Atividades Cotidianas/psicologia , Idoso , Força da Mão , Ambiente Domiciliar , Humanos , Saúde Mental , Qualidade de Vida/psicologia
2.
Sci Rep ; 12(1): 11961, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35831445

RESUMO

People with mild cognitive impairment (MCI) may be at higher risk of death than normal aging ones. On the other hand, patients with cardiovascular risk factors are also with higher risk of death. It may be logical to question then if the combination of MCI and cardio-vascular risk factors (in most cases arterial hypertension) can lead to higher mortality rate than expected both for high cardio-vascular risk patients and for the general population. This hypothesis is important in the light of effective early screening and prophylaxis. The general death rate of patients with very high-cardio-vascular-risk was compared in the subgroups of normal cognition and MCI. We used MMSE and MoCA (reassessment 6 months apart), Geriatric Depression scale and 4-point version of the scale for evaluating the performance in instrumental activities of daily living (4-IADL) in 249 patients. The patients also had laboratory testing, ambulatory blood pressure monitoring, ECG and echocardiography. The general mortality rate of this very high cardio-vascular risk group was assessed 8-10 years afterwards and also compared to the general national death rate published for the corresponding period from the National Social Security Institute of Bulgaria. We registered significantly higher general death rate in patients with MCI and very high cardio-vascular risk as compared to the group without MCI. The logistic regression analysis attributed approximately 14.6% of the mortality rate in this high-risk group to MCI. The major cardio-vascular risk factor was arterial hypertension-with 63.85% of the patients with home blood pressure values not in the target range at the initial cognitive screening. During the neuropsychological reevaluation 56.43% were with poor control despite the multidrug antihypertensive regimen. It is known that MCI is correlated with cardiovascular risk factors with the leading role of arterial hypertension. We found that the combination of MCI and arterial hypertension can lead to higher mortality rate than in the general aging population. This has important clinical implications for the everyday practice.


Assuntos
Doenças Cardiovasculares , Disfunção Cognitiva , Hipertensão , Atividades Cotidianas/psicologia , Idoso , Monitorização Ambulatorial da Pressão Arterial , Doenças Cardiovasculares/complicações , Fatores de Risco de Doenças Cardíacas , Humanos , Hipertensão/complicações , Testes Neuropsicológicos , Fatores de Risco
3.
BMJ Open ; 12(7): e061032, 2022 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-35790334

RESUMO

OBJECTIVE: There is a lack of research on experiences of WASH-related violence. This study aims to quantify the association between experience or worry of violence when using the toilet or collecting water and depressive symptoms among a cohort of young women in South Africa. METHODS: Data are from visit 3 of the HPTN 068 cohort of adolescent girls in rural Mpumalanga Province, South Africa. Participants (n=1798) included in this analysis were aged 13-21 at baseline. Lifetime experience of violence or fear of violence when using the toilet and collecting water was collected by self-report; depressive symptoms in the past week were measured using the Center for Epidemiological Studies Depression Scale (CES-D). We used G-computation to calculate the prevalence difference (PD) and prevalence ratio of depression (CES-D score >15) associated with each domain of violence, controlling for baseline covariates. FINDINGS: A total of 15.1% of respondents reported experiencing violence when using the toilet; 17.1% reported experiencing violence when collecting water and 26.7% reported depression. In adjusted models, those who reported experiencing violence when using the toilet had an 18.1% higher prevalence of depression (95% CI: 11.6% to 24.4%) than those who did not experience violence when using the toilet. Adjusted prevalence of depression was also higher among those who reported violence when collecting water (PD 11.9%, 95% CI: 6.7% to 17.2%), and who worried about violence when using the toilet (PD 12.8%, 95% CI: 7.9% to 19.8%), as compared with those who did not report these experiences. Worrying about violence when collecting water was not associated with depression after adjusting for covariates. CONCLUSION: Experience of WASH-related violence is common among young women in rural South Africa, and experience or worry of experiencing violence is associated with higher prevalence of depressive symptoms. TRIAL REGISTRATION NUMBER: NCT01233531; Post-results.


Assuntos
Atividades Cotidianas , Depressão , Violência , Atividades Cotidianas/psicologia , Adolescente , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Medo/psicologia , Feminino , Humanos , Higiene , Prevalência , População Rural/estatística & dados numéricos , Saneamento , África do Sul/epidemiologia , Toaletes , Violência/psicologia , Violência/estatística & dados numéricos , Água , Abastecimento de Água , Adulto Jovem
4.
J Frailty Aging ; 11(3): 302-308, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35799437

RESUMO

OBJECTIVE: To determine the prevalence and distribution of intrinsic capacity (IC) impairments and examine their associations with health outcomes. METHODS: Community-dwelling people aged 60 years and older were interviewed at baseline and followed up for one to three years. IC domains including cognitive, locomotor, vitality, sensory (vision, hearing), and psychological capacities were assessed at baseline. Incident polypharmacy, incontinence, poor/fair self-rated health, and instrumental activities of daily living (IADL) difficulty were ascertained at each follow-up. FINDINGS: 10,007 participants were interviewed at baseline. Overall mean age was 75.7±7.9 years. At baseline, 85.3% had impairments in one or more IC domains, where cognitive capacity was the domain that was most frequently affected (71.3%). The prevalence of impairments in one or more domains increased with age (p<0.001) and was higher among women than men (p<0.001). Among the 1,601 participants who were interviewed at each follow-up, those with impairments in three or more domains had the greatest risk for the incidence of polypharmacy (adjusted OR 2.2, 95%CI 1.1-4.2), incontinence (adjusted OR 3.0, 95%CI 1.8-5.0), poor/fair self-rated health (adjusted OR 3.7, 95%CI 1.9-7.2), and IADL difficulty (adjusted OR 3.3, 95%CI 1.8-6.1) compared with those without IC impairments. CONCLUSION: IC impairments are highly prevalent and those with IC impairments had increased risks of polypharmacy, incontinence, poor/fair self-rated health, and IADL difficulty. The findings could potentially lead to a refinement and the adoption of IC as a screening measure which could be served as a target of intervention in the care for older people.


Assuntos
Atividades Cotidianas , Telemedicina , Atividades Cotidianas/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Prevalência
5.
BMC Public Health ; 22(1): 1083, 2022 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-35642026

RESUMO

BACKGROUND: This review is focused on workers with developmental dyslexia (DD). In this review DD is considered an expression of neurodiversity, a consequence of a natural variant of the brain. Evidence was synthesized to explore which factors workers with DD consider relevant for their participation in work and whether these factors reflect shifts in the concepts of health and sustainable employability. The factors were classified according to the International Classification of Functioning, Disability and Health (ICF), adapted for occupational health. METHODS: A systematic review of qualitative studies was performed. Two search strings were used to determine the population and the context of work. The factors were classified using a recently proposed rearrangement of the ICF scheme that places participation in a central position and incorporates preliminary lists of work-related environmental factors and personal factors. RESULTS: Fifty-one factors were found that appeared in 35% or more of the included studies and that were relevant to work participation according to the workers themselves. These factors were dispersed over all ICF categories. In the category Functions and Structures (11 factors), most of the factors had negative connotations. In the category Activities (9 factors), all the factors cause difficulties, except speaking (which is ambiguous). In the category Participation (4 factors), the formal relationships are important for the degree of participation. Overall, more than half of the factors are environmental (18) or personal (9) and they both hinder and facilitate work participation. CONCLUSIONS: The results of this review give an indication for the importance of the biopsychosocial model as a relevant approach for people with a disability in the world of work. This review also adds data for the usefulness of the proposals for the reconsideration of the ICF scheme. The data has not (yet) returned any visible trends revealing that the concept of neurodiversity is common in organizations.


Assuntos
Pessoas com Deficiência , Dislexia , Atividades Cotidianas/psicologia , Adulto , Avaliação da Deficiência , Pessoas com Deficiência/psicologia , Humanos , Pesquisa Qualitativa
6.
PLoS One ; 17(6): e0270284, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35749416

RESUMO

Emergency department visits (EDV) are common among older adults with and without dementia. The risk factors and demands of EDVs for people with dementia have been well studied; however, the association between EDVs and conversion to dementia among people with predementia has not been thoroughly explored. To study the predictive value of EDVs in predementia's progression to dementia. The baseline predementia cohort registered from September 2015 to August 2017, with longitudinal follow-up in the History-based Artificial Intelligent Clinical Dementia Diagnostic System database, was retrospectively analyzed. The rates of conversion among the different EDVs were compared. Multivariate logistic regression and Cox proportional hazards analyses were applied to study the influence of EDVs on progression. Age, education, sex, neuropsychological tests, activities of daily living, neuropsychiatric symptoms, parkinsonism, and multiple vascular risk factors were adjusted for. A total of 512 participants were analyzed, including 339 (66.2%) non-converters and 173 (33.8%) converters with a mean follow-up of 3.3 (range 0.4-6.1) and 2.8 (range 0.5-5.9) years, respectively. Compared to people without EDV (EDV 0), the hazard ratios for conversion to dementia were 3.6, 5.9, and 6.9 in those with EDV once (EDV 1), twice (EDV 2), and more than twice (EDV >2), respectively. In addition, older age, lower education, poorer cognition, poorer ADL performance, and longer follow-up periods also increased the conversion rates. EDVs in the predementia stages highly predict progression to dementia. Therefore, a sound public health as well as primary healthcare system that provide strategies for better management of mental and physical condition might help prevention of EDVs among older people in the predementia stages.


Assuntos
Atividades Cotidianas , Demência , Atividades Cotidianas/psicologia , Idoso , Demência/diagnóstico , Demência/epidemiologia , Demência/psicologia , Serviço Hospitalar de Emergência , Humanos , Testes Neuropsicológicos , Estudos Retrospectivos
7.
Am J Alzheimers Dis Other Demen ; 37: 15333175221104354, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35656899

RESUMO

BACKGROUND: The Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale is a versatile functional assessment tool for patients with Alzheimer's disease (ad). We evaluated its performance in controls, Peruvians with MCI or AD. METHODS: A cross-sectional study of older adults attending a neurology institute in Lima (Peru) with mild cognitive impairment (MCI), ad or cognitively healthy. Test-retest reliability (intraclass correlation coefficient, ICC; internal consistency, Cronbach's alpha) and validity were assessed. RESULTS: We enrolled 276 individuals (ad: 113, MCI: 68, controls: 95) with no age, sex, educational level, and depressive symptom differences. Reliability was ideal (ICC: .996), and Cronbach's alpha was adequate (.937). The ADCS-ADL could not differentiate MCI from controls but did differentiate ad severity. The ADCS-ADL correlated highly with nearly all tools. CONCLUSIONS: The ADCS-ADL scale is reliable in a population with ad in Lima, Peru. Future work may validate a tool for Peruvians with lower educational levels.


Assuntos
Doença de Alzheimer , Atividades Cotidianas/psicologia , Idoso , Estudos Transversais , Humanos , Peru , Reprodutibilidade dos Testes
8.
Cad Saude Publica ; 38(6): e00142021, 2022.
Artigo em Português | MEDLINE | ID: mdl-35766630

RESUMO

This study aimed to investigate the association between social capital and functional disability, based on a longitudinal perspective, using data from the cohort of older adults from Bambuí, Minas Gerais State, Brazil. The baseline of this study was composed of all surviving and disability-free - up until the seventh year of follow-up (2004) - older adults who were followed up until 2011. The outcome variable was functional disability for basic activities of daily living (ADL) and instrumental activities of daily living (IADL), separately analyzed. Social capital was the exposure of interest, measured through its cognitive (cohesion and social support) and structural (social participation and satisfaction with the neighborhood) components. Sociodemographic variables, health conditions, and lifestyle habits were used for adjustment purposes, and the occurrence of death was considered a competitive event. The hypothesis of association between social capital and functional disability was tested using the competing risk model, which provides hazard ratios (HR) and a 95% confidence interval (95%CI). After multivariate analysis, social capital - in its structural component - was associated with functional disability. Older adults who were dissatisfied with the neighborhood had a higher risk of developing functional disability for IADL (HR = 2.36; 95%CI: 1.31-4.24), in relation to their counterparts. This study results suggest that functional disability is associated with aspects other than health, evidencing the need for the development of policies and interventions that support aspects related to the physical and social environment in which older adults live.


O objetivo do presente estudo foi investigar a associação entre capital social e a incapacidade funcional, numa perspectiva longitudinal, utilizando dados da coorte de idosos de Bambuí, Minas Gerais, Brasil. A linha de base do estudo foi composta por todos os idosos sobreviventes e livres de incapacidade no sétimo ano de seguimento (2004), acompanhados até 2011. A variável desfecho foi a incapacidade funcional para as ABVD (atividades básicas de vida diária) e AIVD (atividades instrumentais de vida diária), analisadas separadamente. A exposição de interesse foi o capital social, mensurado por meio de seus componentes cognitivo (coesão e suporte social) e estrutural (participação social e satisfação com a vizinhança). Variáveis sociodemográficas, de condições de saúde e de hábitos de vida foram utilizadas para efeitos de ajuste, e a ocorrência de óbito foi considerada evento competitivo. A hipótese de associação entre capital social e incapacidade funcional foi testada por meio do modelo de riscos competitivos, que fornece hazard ratios (HR) e intervalos de 95% de confiança (IC95%). Após a análise multivariada, o capital social, em seu componente estrutural, esteve associado à incapacidade funcional. Idosos insatisfeitos com a vizinhança apresentaram risco maior de desenvolver incapacidade funcional para AIVD (HR = 2,36; IC95%: 1,31-4,24), em relação às suas contrapartes. Os resultados desse estudo sugerem que a incapacidade funcional está associada a outros aspectos que não somente da saúde, evidenciando a necessidade de desenvolver políticas e intervenções que abarquem aspectos ligados ao ambiente físico e social em que o idoso está inserido.


El objetivo de este estudio fue investigar la asociación entre el capital social y la discapacidad funcional desde una perspectiva longitudinal, utilizando datos de la cohorte de ancianos de Bambuí, Minas Gerais, Brasil. La línea de base de este estudio estaba compuesta por todos los supervivientes de edad avanzada y sin discapacidad en el séptimo año de seguimiento (2004), seguidos hasta 2011. La variable de resultado fue la discapacidad funcional para las ABVD (actividades básicas de la vida diaria) y las AIVD (actividades instrumentales de la vida diaria), analizadas por separado. La exposición de interés fue el capital social, medido a través de sus componentes cognitivo (cohesión y apoyo social) y estructural (participación social y satisfacción con el barrio). Se utilizaron variables sociodemográficas, de condiciones de salud y de estilo de vida para los efectos de ajuste, y la ocurrencia de la muerte se consideró un evento competitivo. La hipótesis de asociación entre el capital social y la discapacidad funcional se probó mediante el modelo de riesgos competitivos, que proporciona tasas de riesgo (hazard ratios, HR) e intervalos del 95% de confianza (IC95%). Tras el análisis multivariante, el capital social en su componente estructural se asoció con la discapacidad funcional. Los ancianos insatisfechos con su vecindario tenían un mayor riesgo de desarrollar una discapacidad funcional para las AIVD (HR = 2,36; IC95%: 1,31-4,24) en comparación con sus homólogos. Los resultados sugieren que la discapacidad funcional está asociada a otros aspectos además de la salud, lo que pone de manifiesto la necesidad de desarrollar políticas e intervenciones que abarquen aspectos relacionados con el entorno físico y social en el que se insertan las personas mayores.


Assuntos
Pessoas com Deficiência , Capital Social , Atividades Cotidianas/psicologia , Idoso , Brasil , Pessoas com Deficiência/psicologia , Humanos , Vida Independente , Estudos Longitudinais
9.
Rev Bras Epidemiol ; 25(Supl 1): e220019, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35766776

RESUMO

OBJECTIVE: To analyze factors associated with functional disability in older adults with cancer treated at reference outpatient clinics in the state of Mato Grosso, Brazil. METHODS: This is a cross-sectional study of 463 older adults aged 60 years or older. The outcome variable was functional disability, evaluated by Lawton and Brody's Instrumental Activities of Daily Living (IADL) scale. The independent variables were sociodemographic characteristics, lifestyle, social support, and health aspects. We performed bivariate and multivariate analyses and calculated prevalence ratios (PR) using Poisson regression with robust variance. RESULTS: The prevalence of IADL functional disability was 55.3%. The variables associated with this disability in the multivariate analysis were: not working (PR=1.36; 95% confidence interval - 95%CI 1.03-1.78); low (PR=1.49; 95%CI 1.10-2.03) and moderate (PR=1.30; 95%CI 1.04-1.64) perceived affectionate support; depressive symptoms (PR=1.31; 95%CI 1.10-1.56); malnutrition (PR=1.28; 95%CI 1.03-1.59); having two or more comorbidities (PR=1.30; 95%CI 1.03-1.64), and having a companion to health services (PR=1.39; 95%CI 1.05-1.83). CONCLUSION: In addition to physical health aspects, comorbidities, and malnutrition, functional disability was associated with emotional, social support, and work issues, reinforcing the importance of comprehensive care and actions to maintain and recover functional capacity, promoting a better quality of life, the independence of older adults with cancer, and a reduced risk of adverse biopsychosocial outcomes.


Assuntos
Desnutrição , Neoplasias , Atividades Cotidianas/psicologia , Idoso , Instituições de Assistência Ambulatorial , Brasil/epidemiologia , Estudos Transversais , Humanos , Neoplasias/epidemiologia , Qualidade de Vida
10.
J Med Syst ; 46(8): 53, 2022 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-35716194

RESUMO

This study aims to assess mobile technology use (cell phones and smartphones), level of digital addiction, and the association of these factors with physical, mental and social health and quality of life (QOL) in community-dwelling older adults. A population-based study of a city with a low-income population in Brazil was carried out. Sociodemographics, cognition(MMSE), mental health(DASS-21), QOL(WHOQOL-bref), sleep quality(Pittsburgh Index), instrumental activities of daily living(Lawton), loneliness(UCLA), digital addiction(Internet Addiction Test) and cell phone/smartphone use were investigated. A total of 668 older adults (93.6% of total) were included; 175(26.2%) owned cell phones, 172(25.7%) smartphones and 321(48.1%) no mobile device. Smartphones owners were predominantly younger, white, had higher income, MMSE scores and social support, and were less dependent. However, no group differences were observed for depression, anxiety or stress symptoms, QOL, sleep disturbances or loneliness. Among 172 smartphone users, Structural Equation Models revealed that the degree of digital addiction was correlated with better physical and environmental conditions, in detriment of a poorer sleep quality. Hours of use were not correlated with health outcomes, whereas greater importance of the smartphone in life correlated with less depressive symptoms and lower loneliness. Different from previous studies in adults or adolescents, older adults who were smartphones users had similar health outcomes than those without Internet access. These findings serve to further our understanding on technology use in this age group.


Assuntos
Vida Independente , Smartphone , Atividades Cotidianas/psicologia , Adolescente , Idoso , Depressão/diagnóstico , Depressão/epidemiologia , Humanos , Saúde Mental , Qualidade de Vida/psicologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-35627426

RESUMO

OBJECTIVES: To investigate the effect of the number of cohabitating household members on falls among an disabled aging Korean population. METHODS: We used data from the first to the fourth waves of the Korea Longitudinal Study of Aging. Using the first wave at baseline, data included 1414 individuals aged 45 years and older who needed assistance for performance of activities of daily living (ADL) or instrumental activities of daily living (IADL). We classified falls as overall falls, falls requiring medical treatment, and hip fractures caused by falls. The number of cohabitating family members was classified as none (living alone), one, two, or more. A generalized estimating equation with logit link was used to examine the association between the number of cohabitating household members with overall falls and injuries caused by falls. RESULTS: Compared to living with two or more household members, living alone was associated with higher odds of overall falls, falls needing medical treatment, and hip fractures caused by falls (odds ratio (OR) 2.13, 95% confidence interval [CI] 1.36-3.34; OR 2.13, 95% CI 1.28-3.53; OR 1.93, 95% CI 1.01-3.69, respectively). These associations were particularly strong in individuals with cognitive decline. Conclusions Living alone is associated with higher odds of overall falls, falls needing medical treatment, and hip fractures caused by falls, particularly for those with cognitive decline. CONCLUSIONS: Intervention programs to prevent falls in disabled, aging adults, especially those living alone and those with declined cognitive function, need to provide home care services and promote the use of safety equipment.


Assuntos
Pessoas com Deficiência , Fraturas do Quadril , Atividades Cotidianas/psicologia , Idoso , Envelhecimento , Fraturas do Quadril/epidemiologia , Humanos , Estudos Longitudinais
12.
Dement Geriatr Cogn Disord ; 51(3): 221-232, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35533657

RESUMO

INTRODUCTION: Discrepancy scores reflecting the difference between parallel ratings made by people living with dementia (PwD) in the mild-to-moderate stages and by their informants provide a way to investigate awareness of functional ability in relation to activities of daily living (ADL). METHODS: Two measures of ADL (Functional Activities Questionnaire; Dependence Scale) were completed by 1,227 PwD and their informants in the IDEAL cohort study baseline assessment. Self-rated and informant-rated scores were used to calculate discrepancies, which were used as an indicator of awareness of functional ability. Smaller discrepancy scores were considered to reflect greater awareness on the part of PwD. PwD completed questionnaires on depression, personality, comorbidities, neuropsychiatric symptoms, and completed a measure of cognition. Informants provided ratings of stress. Univariable and multiple regressions were used to investigate factors related to ADL discrepancy. RESULTS: A similar pattern of associations were found for both ADL discrepancy scores. Smaller discrepancy scores were associated with higher levels of depression, higher neuroticism, fewer neuropsychiatric symptoms, higher comorbidity, lower carer stress, and receipt of less than 1 hour of care per day from the informant. DISCUSSION/CONCLUSION: There was a clear pattern of factors that were associated with greater awareness for both measures of functional ability. These factors associated with smaller discrepancy scores could be used to identify PwD who might benefit from targeted interventions to support their independence.


Assuntos
Atividades Cotidianas , Demência , Atividades Cotidianas/psicologia , Conscientização , Cuidadores/psicologia , Cognição , Estudos de Coortes , Demência/psicologia , Humanos , Personalidade
13.
J Clin Exp Neuropsychol ; 44(2): 103-108, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35603512

RESUMO

INTRODUCTION: The information regarding neuropsychiatric symptoms associated with the main subtypes of mild cognitive impairment (MCI) is inadequate. Indeed, it is unclear whether patients with amnestic MCI (aMCI) and those with non-amnestic MCI (naMCI) are characterized by a different behavioral profile and whether the decline in the activities of daily living (ADL) is different between the two groups. Therefore, the main aim of the study is to describe the behavioral and functional profile of the two MCI subgroups and to determine whether apathy and depression are associated with functional autonomy. METHODS: Sixty-eight patients with MCI were enrolled. Out of these, 37 were classified as aMCI while 31 as naMCI according to an extensive neuropsychological evaluation assessing memory, attention, executive functions, visuospatial abilities and language. Moreover, questionnaires assessing apathy, depression and functional autonomy were administered. RESULTS: aMCI patients showed more severe depressive symptoms when compared to naMCI ones, whereas no difference was found on apathy scores. The two subgroups achieved similar results in questionnaires assessing functional autonomy. CONCLUSION: Our results supported the clinical utility of the amnestic and non-amnestic distinction since a different cognitive and behavioral profile characterized the two MCI subtypes and, as a consequence, different treatments are needed.


Assuntos
Apatia , Disfunção Cognitiva , Atividades Cotidianas/psicologia , Amnésia/psicologia , Disfunção Cognitiva/psicologia , Depressão , Humanos , Testes Neuropsicológicos
14.
Brain Inj ; 36(6): 775-781, 2022 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-35446745

RESUMO

BACKGROUND: The evaluation of functional cognition is a central concern in clinical practice. However, there are few standardized or validated tools, and many of them take too long, requiring screening tests. AIMS: To explore the convergent validity of the ACLS-5 with other cognitive screening test and functional independence test in a sample of people with acquired brain injury. Moreover, to examine the prediction of ACLS-5 on functioning and cognitive performance outcomes. MATERIALS AND METHODS: A cross-sectional design was applied following the guidelines of the STROBE checklist. A consecutive sample of people with acquired brain injury was recruited from rehabilitation centers. A cognitive screening test and daily living activity tests were implemented, such as ACLS-5, MoCA, Barthel, and FIM+FAM. Data were analyzed using non-parametric methods. In addition, a structural analysis and simple regression models were performed. RESULTS: Eighty patients with chronic acquired brain injury, with a mean age of 52, were recruited. All tests are significantly related to the ACLS-5 score, a moderate effect size for MoCA (ρ = 0.36), and a strong effect size for the other two (ρ > 0.50). CONCLUSIONS: ACLS-5 predicts functional and cognitive performance quickly and effectively, optimizing assessment time and avoiding mental fatigue or physical exhaustion.


Assuntos
Lesões Encefálicas , Avaliação da Deficiência , Atividades Cotidianas/psicologia , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/reabilitação , Cognição , Estudos Transversais , Humanos , Pessoa de Meia-Idade
15.
Artigo em Inglês | MEDLINE | ID: mdl-35457442

RESUMO

One of the prominent interventions to tackle loneliness and social isolation in older adults is social facilitation. The present study investigated whether similarities in cognitive functions that are sensitive to age play a role in confidant social networks among older adults. We analyzed the data of 252 community-dwelling older adults in Wakuya City, Miyagi Prefecture, Japan, who responded to a self-administered questionnaire and cognitive health checkups provided by the city in 2017. We performed Exponential Random Graph Model and investigated educational attainment, orientation, word registration, clock drawing, delayed recall, verbal fluency and logical memory homophily while adjusting for density, reciprocity, age, sex living arrangement, presence of disability in instrumental activities of daily living, educational attainment and cognitive impairment status. The probability of a confidant tie with an older adult was significantly reduced by 6% (odds ratio (OR): 0.94, 95% confidence interval (CI): 0.90-0.99) for one score difference in logical memory, and marginally increased by 5% (OR: 1.05; 95% CI: 1.00-1.11) for one score difference in delayed recall. There was no significant association between educational attainment and other age-associated cognitive functional scores. Our findings suggest that similar logical memory functions play a role in strong social network building among community-dwelling older adults in Japan.


Assuntos
Disfunção Cognitiva , Vida Independente , Atividades Cotidianas/psicologia , Idoso , Cognição , Humanos , Rede Social
16.
BMC Geriatr ; 22(1): 267, 2022 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-35361135

RESUMO

BACKGROUND: Physical performances including upper and lower limb functions have predictive roles in activities of daily living (ADL) disability, but they have rarely been incorporated into prediction models. This study primarily aimed to develop and validate novel physical performance-based models for ADL disability among Chinese older adults. Comparisons of predictive performance across multiple models were performed, and model simplification was further explored. METHODS: Data were obtained from the China Health and Retirement Longitudinal Study in the 2011 and 2015 waves, containing 2192 older adults over 60 years old. Our models were constructed by logistic regression analysis, using a backward stepwise selection. Model performance was internally validated by discrimination, calibration, and clinical utility. Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) were used to assess the incremental benefit of the extended models. Moreover, nomograms were built for visualization. RESULTS: We selected gender, age, smoking, self-report health condition, BMI, depressive symptoms, and cognitive function into the fundamental model (Model 1). Based on Model 1, five novel prediction models were constructed by adding handgrip strength (Model 2), Short Physical Performance Battery (SPPB) (Model 3), gait speed (Model 4), handgrip strength plus SPPB (Model 5), and handgrip strength plus gait speed (Model 6), respectively. Significant improvement in predictive values were observed for all five novel models compared with Model 1 (C-index = 0.693). The lower limb model (Model 3 SPPB model: C-index = 0.731) may play a key role in the prediction of ADL disability, reflecting a comparable predictive value to the comprehensive models combining both upper and lower limbs (Model 5 handgrip strength + SPPB model: C-index = 0.732). When we simplified the lower limb models by replacing SPPB with gait speed, the predictive values attenuated slightly (C-index: Model 3 vs Model 4: 0.731 vs 0.714; Model 5 vs Model 6: 0.732 vs 0.718), but still better than the upper limb model (Model 2 handgrip strength model: C-index = 0.701). CONCLUSIONS: Physical performance-based models, especially lower limb model, provided improved prediction for ADL disability among Chinese older adults, which may help guide the targeted intervention.


Assuntos
Atividades Cotidianas , Pessoas com Deficiência , Atividades Cotidianas/psicologia , Idoso , Força da Mão , Humanos , Estudos Longitudinais , Desempenho Físico Funcional
17.
PLoS One ; 17(4): e0266614, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35381051

RESUMO

OBJECTIVE: Our aim is to determine the strong predictors of the onset of instrumental activities of daily living (IADL) decline in community-dwelling older people. DESIGN: A prospective cohort study with a two-year follow-up. SETTING: Kashiwa City, Chiba Prefecture, Japan and Toshima Ward, Tokyo Metropolitan, Japan. PARTICIPANTS: The data were acquired from two cohorts. The final sample comprised 1,523 community-dwelling older people aged 65-94 years (681 men, 842 women). They were individuals who were independent in IADL at baseline and participated in follow-up IADL assessments two years later. MEASUREMENTS: At baseline, comprehensive assessments were performed including: health interview, gait function, hand-grip strength, skeletal muscle mass, balance function, oral function, dietary lifestyle, cognitive function, quality of life, mental status, and social network. When the two-year follow-up was performed, IADL declines were observed in 53 out of 1,523 people. The association of each Z-transformed parameter with the occurrence of IADL decline was examined by employing a binominal logistic regression model adjusting for age, gender, body weight, body height, and medical history. An odds ratio (OR) and a 95% confidence interval were calculated and compared between different parameters. RESULTS: A decrease in walking speed and one-legged stance time, whereas an increased timed up & go test time was associated with significant ORs for the occurrence of IADL decline. CONCLUSION: Gait-related parameters appear to be the strong predictors of the onset of IADL decline in community-dwelling older people.


Assuntos
Atividades Cotidianas , Vida Independente , Atividades Cotidianas/psicologia , Idoso , Feminino , Humanos , Vida Independente/psicologia , Japão/epidemiologia , Masculino , Estudos Prospectivos , Qualidade de Vida
18.
Nihon Koshu Eisei Zasshi ; 69(6): 459-472, 2022 Jun 15.
Artigo em Japonês | MEDLINE | ID: mdl-35400725

RESUMO

Objectives We selected assessment items that can be used to evaluate the physical, mental, and social functions of community-dwelling older people comprehensively and easily, and examined whether these items could predict a future transition to the requirement for nursing care and dementia.Methods We conducted a self-administered mail survey of 4,439 community-dwelling older people, who were not certified as requiring nursing care in 2011. The items for the survey were shortlisted out of a total of 54 items that were selected by referring to existing scales, and the evaluation items were determined by pass rate and factor analysis. The cut-off point of the total scores was estimated by ROC analysis using the certification of requiring long-term care (support level 1 or higher) and level of independence in the daily lives of older people with dementia (independence level I or higher) in 2014 as external criteria. The predictive validity was examined by binomial logistic regression analysis using the cut-off point of the total score and the score of the sub-domains as explanatory variables, and the requirement of nursing care and independence level of dementia in 2014 as objective variables.Results A factor analysis of 1,810 subjects with no deficiencies in the 54 items identified 24 items in five domains (mental health, walking function, Instrumental Activities of Daily Living (IADL), cognitive function, and social support). During the ROC analysis, the cut-off point of the total score was estimated to be 20/21 points (nursing care: AUC 0.75, sensitivity 0.77, specificity, 0.56; dementia: AUC 0.75; sensitivity 0.79, specificity 0.55). The binomial logistic regression analysis showed that persons with a total score of less than 20 points in 2011 were significantly more likely to be certified as requiring nursing care (odds ratio 2.57, 95%CI 1.69-3.92, P<0.01) or show a decline in their independence level of dementia (odds ratio 3.12, 95%CI 1.83-5.32, P<0.01) in 2014. The scores of mental health, walking function, and IADL were significantly associated with certification of requiring nursing care, while walking function and cognitive function were significantly associated with dementia.Conclusion We believe that the selected items in this study can successfully predict a transition to needing nursing care and dementia in the future. In the sub-domains, the results suggested an association with physical and mental function, as has been previously reported, but little association with social function.


Assuntos
Demência , Vida Independente , Atividades Cotidianas/psicologia , Idoso , Humanos , Vida Independente/psicologia , Assistência de Longa Duração , Serviços Postais
19.
Breast ; 63: 101-107, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35366503

RESUMO

INTRODUCTION: Treatment of early breast cancer in older women is usually not guideline concordant owing to lack of routine evaluation of their potential frailty. We assessed the feasibility and impact of a self-administered geriatric assessment on the decision-making process in women aged 65 and above treated in a UK District General Hospital. METHODS: One hundred and one patients, aged 65 and above, with early stage, non-metastatic breast cancer were prospectively recruited between Dec-2018 and March-2021. Patients with metastatic breast cancer, a previous history of cancer and dementia were excluded. All patients had a geriatric assessment with a self-administered questionnaire (mycarg.org). All cases were discussed in the multidisciplinary meeting (MDT) and a pre geriatric assessment recommendations was made, based on the tumour grade, size, node status and receptor status. The findings of the assessment were later discussed in a second meeting and a further recommendation was made based on the geriatric assessment. Any change in the proposed treatment was recorded. Potential factors (age, Body Mass Index, co-morbidities, medications, instrumental activities of daily living, and basic activities of daily living, social support and psychological status) associated with a change in the treatment recommendation were compared using Pearson's Chi square tests for categorized data, and Mann Whitney U test for continuous data. A multivariate logistic regression was performed to test the association between geriatric assessment domains and change in treatment decision. The multivariate model was built using variables which were associated in the bivariate analysis with a p-value< 0.20. RESULTS: Patients aged less than 70 years were more likely to be diagnosed through screening programme as compared to older women (64.4% vs. 35.6%, p = 0.001). Self-administered geriatric assessment identified patients who were requiring assistance in their daily routine activities, and hence, were assessed to have higher morbidity status. A third of patients required assistance in their routine activities, with 18/101 patients requiring significant help during self-care. 90% patients were independent for Activity of Daily Living (ADL) at baseline and 34.76% for Instrumental Activity of Daily Living (IADL). Among the 101 patients evaluated, proposed change in the initial cancer treatment plan was made in 21.8% of patients after the second MDT. Omission of chemotherapy was recommended in 4 patients, omission of radiotherapy in 15 patients and omission of both chemo and radiotherapy in 2 patients. One patient was advised to omit Zolidronic acid, as she was noted to have renal impairment. No patient in this cohort had suggestion for omission of surgery or endocrine therapy. In the bivariate analysis, need for assistance for activities of daily living (ADLs), low physical performance (KPS), polypharmacy (3 or more medications), lack of social support as assessed using the Social Support: Medical Outcomes Study (MOS) Social Support Survey and high BMI (30 or more) all showed significance but on multivariate analysis only polypharmacy was significantly associated with change in the initial cancer treatment plan. CONCLUSIONS: The results of this study of breast cancer patients aged 65 and above suggest that a self-administered geriatric assessment may influence treatment recommendations in a subset of patients. Recommendations that were influenced by the geriatric assessment mainly included those related to the significant morbidity that may have impacted the use of chemotherapy and/or radiotherapy.


Assuntos
Neoplasias da Mama , Fragilidade , Atividades Cotidianas/psicologia , Idoso , Neoplasias da Mama/tratamento farmacológico , Feminino , Avaliação Geriátrica/métodos , Humanos , Polimedicação
20.
Artigo em Inglês | MEDLINE | ID: mdl-35270755

RESUMO

This study aims to investigate the factors of care-level deterioration in older adults with mild and moderate disabilities using nationally standardized survey data for care-needs certification. We enrolled people aged 68 years or older, certified as support levels 1-2 (mild disability) or care levels 1-2 (moderate disability) with no cancer. The outcome was care-level deterioration after two years. The possible factors were physical and mental functions which were categorized as the following five dimensions according to the survey for care-needs certification: body function, daily life function, instrumental activities of daily living (IADL) function, cognitive function, and behavioral problems. A multivariate logistic regression analysis was conducted after stratifying the care level at baseline. A total of 2844 participants were included in our analysis. A low IADL function was significantly associated with a risk of care-level deterioration in all participants. In addition, low cognitive function was linked to care-level deterioration, except for those with support level 1 at baseline. Participants with more behavioral problems were more likely to experience care-level deterioration, except for those with care level 2 at baseline. Our study showed the potential utility of the care-needs certification survey for screening high-risk individuals with care-level deterioration.


Assuntos
Atividades Cotidianas , Pessoas com Deficiência , Atividades Cotidianas/psicologia , Idoso , Certificação , Humanos , Japão/epidemiologia , Inquéritos e Questionários
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