Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 12.095
Filtrar
1.
BMC Public Health ; 24(1): 402, 2024 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-38326765

RESUMO

BACKGROUND: This study aimed to examine the associations between depressive symptoms, body mass index (BMI), waist circumference, waist-hip ratio and multimorbidity among community-dwelling older adults. We also examine the interaction effects between depressive symptoms, BMI, waist circumference and waist-hip ratio on multimorbidity among older adults in India. METHODS: A cross-sectional study was conducted, and the data were obtained from the Longitudinal Ageing Study in India (LASI) wave-1, with a sample of 31,464 older adults aged 60 years and above (men-15,098 and women-16,366). We used multinomial logistic regression to explore the independent associations between depressive symptoms, obesity-measures, and single and multimorbidity. We also estimated the interaction effects of depressive symptoms and obesity-measures on multimorbidity. RESULTS: The prevalence of multimorbidity was higher among individuals with depressive symptoms (39.22%) than individuals with no depressive symptoms (29.94%). Adjusted models indicated that older adults with depressive symptoms had higher odds of single and multimorbidity [(AOR = 1.40, 95% CI: 1.17-1.68) and (AOR = 1.85, 95% CI: 1.58-2.16), respectively]. Similarly, in comparison to the normal BMI category, overweight and obese older adults were more likely to report single morbidity [(AOR = 1.62, 95% CI: 1.37-1.92 and (AOR = 2.14, 95% CI: 1.67-2.75), respectively] and multimorbidity [(AOR = 2.00, 95% CI: 1.72-2.33) and (AOR = 3.77, 95% CI: 2.94-4.82), respectively]. CONCLUSION: The findings revealed that the presence of depressive symptoms, overweight or obesity, and high-risk anthropometric measures such as high-risk waist circumference and high-risk waist to hip ratio significantly increased the risk of morbidity among older adults in India. Thus, it is suggested to adopt an integrated public health policy approach to control depressive symptoms and high-risk body composition to strategically prepare against the elevated risk of multimorbidity among ageing populations.


Assuntos
Vida Independente , Sobrepeso , Masculino , Humanos , Feminino , Idoso , Multimorbidade , Depressão/epidemiologia , Estudos Transversais , Obesidade/epidemiologia , Índice de Massa Corporal , Circunferência da Cintura , Índia/epidemiologia
2.
Sci Rep ; 14(1): 2874, 2024 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-38311657

RESUMO

Pain is a major symptom of arthritis in older adults, often leading to frailty and cognitive decline. However, few studies have investigated the relationship among pain, frailty, and cognitive function in older adults with arthritis. This study aimed to investigate the factors influencing cognitive function and the impact of frailty severity and pain on cognitive function in older adults with arthritis using a Korean population-based dataset. This cross-sectional descriptive study involved the secondary data of 1089 participants from the seventh and eighth waves of the Korean Longitudinal Study on Aging. We examined general characteristics, health behaviors, health conditions (including severe pain and frailty), and cognitive function. Participants were categorized based on the presence or absence of pain severity and frailty status as follows: robust, only severe pain, only prefrail, prefrail with severe pain, only frail, and frail with severe pain. Multiple linear regression analysis was performed to establish correlations between groups and cognitive function. The only-prefrail group was the largest (19.7%) among participants experiencing either pain or frailty. Advanced age, sex, level of education, and visual and hearing impairments were significantly associated with cognitive function. Compared to the robust group, only prefrail (ß = -1.54, confidence interval [CI] = - 2.33; - 0.76), prefrail with severe pain (ß = - 2.69, CI = - 3.52; - 1.87), only frail (ß = - 4.02, CI = - 5.08; - 2.97), and frail with severe pain (ß = - 5.03, CI = - 5.99; - 4.08) groups were associated with lower Mini-Mental State Examination scores. The study confirmed that severe pain alone does not significantly impact cognitive function in older adults with arthritis. To prevent cognitive decline in this group, assessment of both pain and frailty severity is essential to predict high-risk groups and provide appropriate interventions, such as transfer to hospitals or primary clinics according to the severity of pain and frailty.


Assuntos
Artrite , Fragilidade , Humanos , Idoso , Fragilidade/complicações , Estudos Longitudinais , Estudos Transversais , Vida Independente , Idoso Fragilizado/psicologia , Cognição , Artrite/complicações , Artrite/epidemiologia , Dor/complicações , República da Coreia/epidemiologia , Avaliação Geriátrica
3.
Int J Rehabil Res ; 47(1): 34-40, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38323888

RESUMO

Physical activity has been shown to reduce the risk for first-ever stroke as well as recurrent stroke with positive effects on almost all known modifiable risk factors. However, the perceived barriers and facilitators for engaging in physical activity have been insufficiently studied and may differ between cultures. Therefore, the aim of this study was to explore the perceptions of community-dwelling physically inactive individuals with stroke about barriers and facilitators to their participation in physical activity. This qualitative study included two focus groups of ten individuals with stroke classified as physically inactive based on accelerometer recordings. A semi-structured set of questions was posed in each focus group session and the transcripts were analysed using thematic analysis. The results revealed three main themes and subthemes: individual factors (physical impairments, psychological factors, spirituality), interaction with the family (attitudes of family members/close community) and social and environmental factors (hobbies, lack of or presence of facilities, the use of orthosis). We conclude that physical activity participation is affected by a multitude of factors as well as cultural differences. Thus, interventions aimed at increasing participation in physical activity after stroke should not only be planned according to individual clinical characteristics but also take into account a range of personal-to-social factors, including cultural differences.


Assuntos
Vida Independente , Acidente Vascular Cerebral , Humanos , Infarto Cerebral , Exercício Físico , Fatores de Risco
4.
BMC Geriatr ; 24(1): 125, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38302872

RESUMO

BACKGROUND: Falls pose a severe threat to the health of older adults worldwide. Determining gait and kinematic parameters that are related to an increased risk of falls is essential for developing effective intervention and fall prevention strategies. This study aimed to investigate the discriminatory parameter, which lay an important basis for developing effective clinical screening tools for identifying high-fall-risk older adults. METHODS: Forty-one individuals aged 65 years and above living in the community participated in this study. The older adults were classified as high-fall-risk and low-fall-risk individuals based on their BBS scores. The participants wore an inertial measurement unit (IMU) while conducting the Timed Up and Go (TUG) test. Simultaneously, a depth camera acquired images of the participants' movements during the experiment. After segmenting the data according to subtasks, 142 parameters were extracted from the sensor-based data. A t-test or Mann-Whitney U test was performed on the parameters for distinguishing older adults at high risk of falling. The logistic regression was used to further quantify the role of different parameters in identifying high-fall-risk individuals. Furthermore, we conducted an ablation experiment to explore the complementary information offered by the two sensors. RESULTS: Fifteen participants were defined as high-fall-risk individuals, while twenty-six were defined as low-fall-risk individuals. 17 parameters were tested for significance with p-values less than 0.05. Some of these parameters, such as the usage of walking assistance, maximum angular velocity around the yaw axis during turn-to-sit, and step length, exhibit the greatest discriminatory abilities in identifying high-fall-risk individuals. Additionally, combining features from both devices for fall risk assessment resulted in a higher AUC of 0.882 compared to using each device separately. CONCLUSIONS: Utilizing different types of sensors can offer more comprehensive information. Interpreting parameters to physiology provides deeper insights into the identification of high-fall-risk individuals. High-fall-risk individuals typically exhibited a cautious gait, such as larger step width and shorter step length during walking. Besides, we identified some abnormal gait patterns of high-fall-risk individuals compared to low-fall-risk individuals, such as less knee flexion and a tendency to tilt the pelvis forward during turning.


Assuntos
Vida Independente , Equilíbrio Postural , Humanos , Idoso , Equilíbrio Postural/fisiologia , Marcha/fisiologia , Caminhada , Medição de Risco/métodos , Acidentes por Quedas/prevenção & controle
5.
J Frailty Aging ; 13(1): 1-9, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38305437

RESUMO

OBJECTIVES: This study aimed to explore the feasibility (including recruitment, safety and adherence) and the effects of a twice weekly supervised Judo-based exercise program over eight weeks on mobility, balance, physical performance, quality of life, fear of falling and physical activity (including by frailty status) in community-dwelling older people aged ≥65 years. DESIGN: Pre-post study. PARTICIPANTS: A total of 17 participants (mean age 74.3±6.2; range 66-87 years; 76.5% female). INTERVENTION: A Judo-based exercise program conducted twice weekly for 60 minutes per session over eight weeks. MEASUREMENTS: Pre and post assessments included the Timed Up and Go (TUG); the Berg Balance Scale (BBS); the Short Physical Performance Battery (SPPB); the Short Form Health Survey-36 (SF-36); the Falls Efficiency Scale International (FES-I); and an ActivPal accelerometer to measure participants' physical activity. RESULTS: Most participants had low (≤3) Charlson's Comorbidity Index scores (n=17, 100%), were well nourished (n=16, 94.1%), not sarcopenic (n=16, 94.1%), and not cognitively impaired (n=13, 76.5%), anxious or depressed (n=14, 82.4%). Ten participants (58.8%) were non-frail and seven were pre-frail (41.2%). Significant improvements (p<0.05) were seen for mobility (TUG), balance (BBS) and physical performance (SPPB). Pre-frail participants showed greater improvement in mobility (TUG) than non-frail participants (p=0.020). No changes (p≥0.05) were seen in quality of life, fear of falling, or physical activity. Participants' adherence (i.e., attending sessions) was high (i.e., ≥81.2%). No serious adverse events or withdrawals were reported. CONCLUSION: Findings suggest that the eight week Judo-based exercise program can be delivered safely to older adults aged ≥65 years, including those at-risk of frailty, as long as there is close supervision with individualisation of the program in response to emergent health symptoms and the program is conducted on requisite Judo mats. This Judo-based exercise program is effective in improving physical function with potential to prevent falls and frailty risk.


Assuntos
Fragilidade , Artes Marciais , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Fragilidade/prevenção & controle , Vida Independente , Estudos de Viabilidade , Qualidade de Vida , Medo , Exercício Físico , Terapia por Exercício , Equilíbrio Postural
6.
J Frailty Aging ; 13(1): 57-63, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38305444

RESUMO

BACKGROUND: Most people value quality of life over mere duration. At least 50% of people are extremely averse to ever living in a nursing home (NH). OBJECTIVES: Assess whether pre-operative frailty is associated with new, post-operative NH placement. DESIGN, SETTING: Retrospective, population-based cohort study in the Canadian province of Manitoba, 2000-2017. PARTICIPANTS: 7408 persons ≥65 years undergoing any of 16 specific, elective, noncardiac surgeries of varying Operative Surgical Stress (OSS). MEASUREMENTS: The primary outcome was new admission to a NH, or being placed on a waiting list for a NH, within 180 days of index hospital admission, among index hospital survivors. Frailty was assessed from administrative data by the Preoperative Frailty Index (pFI), which ranges 0-1. Other outcomes were 30-day and 90-180 day mortality, and post-hospital medical resource use to 180 days. Analyses used multivariable regression models, adjusted for age, sex, OSS, year of surgery, anesthetic technique, and socioeconomic status. P-values were adjusted for the six outcomes. RESULTS: Subjects had mean age (±SD) of 74±7 yrs; 61% were male. pFI ranged 0-0.68, with a mean±SD of 0.21±0.09. All six outcomes were significantly associated with greater frailty. Each additional 0.1 unit increase in pFI was associated with a hazard ratio for new NH admission or wait-listing of 3.01 (p<0.0006). CONCLUSIONS: While our study agrees with prior work indicating that greater frailty is associated with higher probability of post-operative discharge to a NH, it overcomes a number of limitations of all prior work. Strong arguments follow that prospective surgical candidates be evaluated for their degree of frailty, and that their informed consent include discussion of the possibility of survival with loss of independence.


Assuntos
Fragilidade , Humanos , Masculino , Idoso , Idoso de 80 Anos ou mais , Feminino , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Estudos Retrospectivos , Estudos de Coortes , Idoso Fragilizado , Vida Independente , Estudos Prospectivos , Qualidade de Vida , Canadá
7.
Zhonghua Xin Xue Guan Bing Za Zhi ; 52(2): 191-198, 2024 Feb 24.
Artigo em Chinês | MEDLINE | ID: mdl-38326072

RESUMO

Objective: To evaluate the incidence and case fatality rate of cardiovascular disease (CVD) among populations in urban and rural communities in eastern, central and western regions of China. Methods: The present study was based on the data of the Prospective Urban and Rural Epidemiology (PURE)-China cohort, which enrolled participants who had at least one follow-up visit and complete information on age and sex. Information on baseline demographics, cardiovascular risk factors, and prevention and treatment for CVD were collected. CVD and mortality events were documented using the standardized case report form of the PURE Global Study to assess the incidence and case fatality rate of CVD among populations in urban and rural communities in eastern, central and western China. Results: This study included a total of 47 262 community-dwelling participants (age: (51.1±9.6) years; female, n=27 529, 58.2%) from 115 urban and rural communities in 12 provinces across the eastern, central, and western regions of China. Over a follow-up period of 11.9 (9.5, 12.6) years, 2 686 deaths and 5 873 cardiovascular events were documented. The incidence of CVD was 11.90 (95%CI: 11.60-12.21)/1 000 person-years. A significant difference in CVD incidence was observed across regions (Ptrend<0.001), which was highest in the western provinces (13.99 (95%CI: 13.33-14.65)/1 000 person-years), intermediate in the eastern provinces (11.92 (95%CI: 11.52-12.33)/1 000 person-years), and lowest in the central provinces (8.87 (95%CI: 8.25-9.50)/1 000 person-years). The 1-year case fatality rate of CVD demonstrated an increasing trend from eastern to western regions (eastern: 10.20% (95%CI: 6.95-14.73); central: 13.50% (95%CI: 9.90-18.14); western: 18.62% (95%CI: 14.95-22.94); Ptrend<0.001). Moreover, the incidence of major CVD was consistently higher in rural areas compared with urban areas across eastern (P<0.001), central (P=0.01) and western (P<0.001)_regions, respectively. The 1-year case fatality rate in rural areas was also significantly higher compared with that in urban areas in both eastern (P<0.001) and western regions (P=0.02). Conclusions: The incidence and case fatality rate of CVD were high among middle-aged population in China, especially those in western regions with low socioeconomic levels and in rural areas.


Assuntos
Doenças Cardiovasculares , Humanos , Pessoa de Meia-Idade , Feminino , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos Prospectivos , População Rural , Incidência , Vida Independente , População Urbana , China/epidemiologia
8.
Aging Clin Exp Res ; 36(1): 35, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38345775

RESUMO

BACKGROUND: Body fat mass (FM) is associated with multiple organ damage. However, data regarding the relationship between various organ damage and FM are rare in the elderly. Therefore, we aim to perform an analysis on the relationship between organ damage and FM in a geriatric cohort. METHODS: 3331 participants were included in this analysis. Based on age, body height, body weight, waist circumference, and race, we calculated FM with the established formula. Organ damage, including arterial stiffening, lower extremity atherosclerosis, left ventricular hypertrophy (LVH), micro-albuminuria, and chronic kidney disease (CKD), were measured and calculated with standard methods. RESULTS: All organ damage parameters were significantly related to FM (all p < 0.001). In univariate logistics regression, the highest quartile of FM was tied to the increased risk of arterial stiffening, lower extremity atherosclerosis, LVH, micro-albuminuria, and CKD (all p < 0.05). After adjustment, participants with higher quantiles of FM had a significantly increased odd ratio (OR) for arterial stiffening [OR = 1.51, 95% confidence interval (CI): 1.15-1.99, p = 0.002] and LVH (OR = 1.99, 95% CI: 1.48-2.67, p < 0.001). Moreover, FM was linearly associated with arterial stiffening and LVH in total population and gender subgroups. Independent of confounders, FM was significantly correlated with arterial stiffening, lower extremity atherosclerosis, LVH and CKD in female, while was only related to LVH in male. CONCLUSIONS: Among various organ damage, elevated FM is significantly and independently associated with arterial stiffening and LVH in the elderly. Compared with men, women with increased FM are more likely to have multiple organ damage.


Assuntos
Aterosclerose , Hipertensão , Insuficiência Renal Crônica , Humanos , Masculino , Feminino , Idoso , Fatores de Risco , Vida Independente , Albuminúria/epidemiologia , China/epidemiologia
9.
JMIR Mhealth Uhealth ; 12: e48526, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38335026

RESUMO

BACKGROUND: Smart home technology (SHT) can be useful for aging in place or health-related purposes. However, surveillance studies have highlighted ethical issues with SHTs, including user privacy, security, and autonomy. OBJECTIVE: As digital technology is most often designed for younger adults, this review summarizes perceptions of SHTs among users aged 50 years and older to explore their understanding of privacy, the purpose of data collection, risks and benefits, and safety. METHODS: Through an integrative review, we explored community-dwelling adults' (aged 50 years and older) perceptions of SHTs based on research questions under 4 nonmutually exclusive themes: privacy, the purpose of data collection, risk and benefits, and safety. We searched 1860 titles and abstracts from Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, and IEEE Xplore or IET Electronic Library, resulting in 15 included studies. RESULTS: The 15 studies explored user perception of smart speakers, motion sensors, or home monitoring systems. A total of 13 (87%) studies discussed user privacy concerns regarding data collection and access. A total of 4 (27%) studies explored user knowledge of data collection purposes, 7 (47%) studies featured risk-related concerns such as data breaches and third-party misuse alongside benefits such as convenience, and 9 (60%) studies reported user enthusiasm about the potential for home safety. CONCLUSIONS: Due to the growing size of aging populations and advances in technological capabilities, regulators and designers should focus on user concerns by supporting higher levels of agency regarding data collection, use, and disclosure and by bolstering organizational accountability. This way, relevant privacy regulation and SHT design can better support user safety while diminishing potential risks to privacy, security, autonomy, or discriminatory outcomes.


Assuntos
Vida Independente , Privacidade , Idoso , Humanos , Pessoa de Meia-Idade , Percepção , Tecnologia
10.
BMC Geriatr ; 24(1): 178, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38383320

RESUMO

BACKGROUND: Chinese National Essential Public Health Service Package (NEPHSP) has mandated primary health care providers to provide falls prevention for community-dwelling older people. But no implementation framework is available to guide better integration of falls prevention for older people within the primary health care system. METHODS: This is a two-stage online participatory design study consisting of eight workshops with stakeholders from three purposively selected cities. First, two workshops were organised at each study site to jointly develop the framework prototype. Second, to refine, optimise and finalise the prototype via two workshops with all study participants. Data analysis and synthesis occurred concurrently with data collection, supported by Tencent Cloud Meeting software. RESULTS: All participants confirmed that the integration of falls prevention for older people within the NEPHSP was weak and reached a consensus on five opportunities to better integrate falls prevention, including workforce training, community health promotion, health check-ups, health education and scheduled follow-up, during the delivery of NEPHSP. Three regional-tailored prototypes were then jointly developed and further synthesised into a generic implementation framework by researchers and end-users. Guided by this framework, 11 implementation strategies were co-developed under five themes. CONCLUSIONS: The current integration of falls prevention in the NEPHSP is weak. Five opportunities for integrating falls prevention in the NEPHSP and a five-themed implementation framework with strategies are co-identified and developed, using a participatory design approach. These findings may also provide other regions or countries, facing similar challenges, with insights for promoting falls prevention for older people.


KEYPOINTS: The integration of falls prevention for older people was weak in the Chinese PHC system.Five opportunities were identified for better integrating falls prevention for older people in the Chinese PHC system.We developed an implementation framework to strengthen the solid integration of falls prevention in the Chinese PHC system.


Assuntos
Educação em Saúde , Vida Independente , Humanos , Idoso , Coleta de Dados , Atenção à Saúde
11.
BMC Oral Health ; 24(1): 260, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38383363

RESUMO

OBJECTIVE: This study aimed to investigate the current situation of oral frailty (OF) in the elderly in the community in China and analyse its influencing factors. METHODS: Using convenience sampling, 380 elderly people from three communities in our city were selected as participants in the study. The Oral Frailty Index-8, the Frailty Scale, the Oral Health Assessment Tool, the Mini-nutritional Assessment Scale and the Pittsburgh Sleep Quality Index were used to investigate and analyse OF influencing factors. RESULTS: In this study, the 380 elderly participants were categorized into three groups: frailty, pre-frailty, and non-physical frailty, based on their responses to the questionnaires.The influencing factor analysis showed that age, gender, education level, frailty score, frailty stage, number of dentures, dry mouth, subjective chewing difficulty, oral health score and sleep quality were the influencing factors of OF in the elderly in the community (R2 = 0.712, F = 434.73, P < 0.05). The evaluation of the prediction results showed that the frailty score (area under the curve [AUC]: 0.751, 95% confidence interval [CI]: 0.683-0.862), subjective chewing difficulty (AUC: 0.765, 95% CI: 0.655-0.831) and sleep quality (AUC: 0.736, 95% CI: 0.652-0.781) had a higher predictive value for OF. CONCLUSION: The main OF influencing factors in the elderly in the community are age, gender, education level, physical frailty (PF) score, PF stage, number of dentures, dry mouth, subjective chewing difficulties, oral health score and sleep quality. Nursing staff should pay attention to the OF of the elderly in the community and take targeted intervention measures in time to reduce and control OF occurrence and progression.


Assuntos
Fragilidade , Xerostomia , Humanos , Idoso , Fragilidade/epidemiologia , Idoso Fragilizado , Saúde Bucal , Escolaridade , Xerostomia/epidemiologia , Avaliação Geriátrica/métodos , Vida Independente
12.
Clin Interv Aging ; 19: 265-276, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38384404

RESUMO

Purpose: This study aimed to establish equations for estimating muscle mass through anthropometric parameters or together with physical function parameters in the community-dwelling older adults, providing a simple way of muscle mass assessment. Methods: In this cross-sectional descriptive study, a total of 1537 older adults were recruited from the community and accepted the measurements of height, weight, upper arm and calf circumferences, grip strength, and walking speed. Body composition including appendicular skeletal muscle mass (ASM) was measured using bioelectrical impedance analysis (BIA). Participants were randomly divided into the development or validation group. Stepwise multiple linear regression was applied to develop equations in the development group. Thereafter, Pearson correlation coefficients, Bland-Altman plots, paired t-test, intraclass correlation coefficient (ICC) and paired-samples t-tests were used to assess the validity of the equations. Results: All parameters were significantly correlated with ASM (r = 0.195~0.795, P < 0.001) except for the age in the validation group (P = 0.746). The most optimal anthropometric equation was: [adjusted R2 = 0.911, standard error of the estimate (SEE) = 1.311, P < 0.001]. Comparatively speaking, this equation showed high correlation coefficient (r = 0.951, P < 0.001) and ICC (ICC = 0.950, P < 0.001). No significant differences were found between BIA-measured ASM and the estimated ASM. The Bland-Altman plot showed that the mean difference between the estimated ASM and BIA-measured ASM was 0 kg and the limits of agreement of ASM was -2.70~2.60 kg. Furthermore, inclusion of physical function did not significantly improve the adjusted R2 and SEE. Conclusion: The anthropometric equation offers a practical alternative simple and dependable method for estimating ASM in community-dwelling older adults.


Assuntos
Vida Independente , Músculo Esquelético , Humanos , Idoso , Índice de Massa Corporal , Músculo Esquelético/fisiologia , Estudos Transversais , Composição Corporal/fisiologia , Absorciometria de Fóton/métodos , China , Impedância Elétrica
13.
Front Public Health ; 12: 1242798, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38384874

RESUMO

Background: Healthcare workers are concerned with promoting behavior changes that enhance patients' health, wellness, coping skills, and well-being and lead to improved public health. The purpose of this randomized controlled trial was to determine if participation in an 8-week arts-based program leads to improved mood, health, resilience, and well-being in individuals with chronic health conditions as compared to a wait list control group. Methods: Self-report questionnaires for well-being, mental health, physical health, overall health, social health, mood, coping, and resilience were administered at baseline, Week 8 (end of program), and Week 16 (8-week follow-up). Results: Statistically significant improvements were noted in all outcome measures for the treatment group, as well as in most areas compared to the control group. Many of the positive results at Week 8 were either maintained or further improved at Week 16. Discussion: These results suggest that arts-based programming can have a positive effect on the mood, health, resilience, and well-being of individuals with chronic health conditions. Therefore, arts-based programming should be utilized more frequently in the management of chronic conditions in community-dwelling individuals. These benefits should be further assessed in larger clinical trials.


Assuntos
Resiliência Psicológica , Humanos , Vida Independente , Saúde Mental , Doença Crônica
14.
Aging Clin Exp Res ; 36(1): 44, 2024 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-38367133

RESUMO

BACKGROUND: Mobile devices have been used by many older adults and have the potential to assist individuals with subjective cognitive complaints (SCCs) in daily living tasks. Financial management is one of the most complex daily activity for older adults, as it is easily impaired in the prodromal stage of dementia and cognitive impairment. AIM: To investigate financial management ability among older adults from SCCs and mobile device proficiency. METHODS: A self-administered questionnaire was sent to 529 participants who were ≥ 65 years and regularly use mobile devices. Participants were divided into four groups based on SCC prevalence and scores of the Mobile Device Proficiency Questionnaire (MDPQ-16). Financial management abilities were compared between groups using the Process Analysis of Daily Activities for Dementia subscale. Regression model and crosstabulation table were used to investigate associations in detail. RESULTS: A significant difference in financial management ability was observed among the four groups (p < 0.001), with the dual impairment group showed significantly lower than the robust and SCC groups (p < 0.001). Educational history, sex, and MDPQ-16 score were significantly associated with participants' financial management ability (p ≤ 0.01). The proportion of participants who could use ATMs and electronic money independently was significantly lower among those with low proficiency in mobile devices (LPM), regardless of SCC (p < 0.05). CONCLUSION: The LPM group showed an impaired ability to manage their finances, particularly in situations where they would use information devices. Therefore, healthcare professionals should assess not only the SCC but also their proficiency with mobile devices to predict their impairment in activities of daily living.


Assuntos
Disfunção Cognitiva , Demência , Administração Financeira , Humanos , Idoso , Vida Independente , Estudos Transversais , Atividades Cotidianas , Disfunção Cognitiva/terapia , Disfunção Cognitiva/psicologia , Computadores de Mão , Cognição
15.
J Neuropathol Exp Neurol ; 83(3): 181-193, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38300796

RESUMO

This study examined the frequency of chronic traumatic encephalopathy-neuropathologic change (CTE-NC) and aging-related tau astrogliopathy (ARTAG) in community-dwelling older adults and tested the hypothesis that these tau pathologies are associated with a history of moderate-to-severe traumatic brain injury (msTBI), defined as a TBI with loss of consciousness >30 minutes. We evaluated CTE-NC, ARTAG, and Alzheimer disease pathologies in 94 participants with msTBI and 94 participants without TBI matched by age, sex, education, and dementia status TBI from the Rush community-based cohorts. Six (3%) of brains showed the pathognomonic lesion of CTE-NC; only 3 of these had a history of msTBI. In contrast, ARTAG was common in older brains (gray matter ARTAG = 77%; white matter ARTAG = 54%; subpial ARTAG = 51%); there were no differences in severity, type, or distribution of ARTAG pathology with respect to history of msTBI. Furthermore, those with msTBI did not have higher levels of PHF-tau tangles density but had higher levels of amyloid-ß load (Estimate = 0.339, SE = 0.164, p = 0.040). These findings suggest that CTE-NC is infrequent while ARTAG is common in the community and that both pathologies are unrelated to msTBI. The association of msTBI with amyloid-ß, rather than with tauopathies suggests differential mechanisms of neurodegeneration in msTBI.


Assuntos
Doença de Alzheimer , Lesões Encefálicas Traumáticas , Encefalopatia Traumática Crônica , Humanos , Idoso , Idoso de 80 Anos ou mais , Encefalopatia Traumática Crônica/patologia , Vida Independente , Astrócitos/patologia , Proteínas tau/metabolismo , Envelhecimento/patologia , Encéfalo/patologia , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/patologia , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides
16.
J Prev Alzheimers Dis ; 11(2): 356-365, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38374742

RESUMO

BACKGROUND: Impaired intrinsic capacity (IC), which affects approximately 90% of older adults, is associated with a significantly heightened risk of frailty and cognitive decline. Existing evidence suggests that multidomain interventions have the potential to enhance cognitive performance and yield positive effects on physical frailty. OBJECTIVE: To examine roles of baseline IC and its subdomains on the efficacy of multidomain interventions in promoting healthy aging in older adults. DESIGN: a cluster-randomized controlled trial. SETTING AND PARTICIPANTS: 1,054 community-dwelling older adults from 40 community-based clusters across Taiwan. INTERVENTION: A 12-month pragmatic multidomain intervention of exercise, cognitive training, nutritional counseling and chronic condition management. MEASUREMENTS: Baseline IC was measured by 5 subdomains, including cognition (Montreal Cognitive Assessment, MoCA), sensory (visual and hearing impairment), vitality (handgrip strength or Mini-Nutritional Assessment-short form), psychological well-being (Geriatric Depression Scale-5), and locomotion (6m gait speed). Outcomes of interest were cognitive performance (MoCA scores) and physical frailty (CHS frailty score) over a follow-up period of 6 and 12 months. RESULTS: Of all participants (mean age:75.1±6.4 years, 68.6% female), about 90% participants had IC impairment at baseline (2.0±1.2 subdomains). After covariate adjustment using a generalized linear mixed model (GLMM), the multidomain intervention significantly prevented cognitive declines and physical frailty, particularly in those with IC impairment ≥ 3 subdomains (MoCA: coefficient: 1.909, 95% CI: 0.736 ~ 3.083; CHS frailty scores: coefficient = -0.405, 95% CI: -0.715 ~ -0.095). To assess the associations between baseline poor capacity in each IC subdomain and MoCA/CHS frailty scores over follow-up, a 3-way interaction terms (time*intervention*each poorer IC subdomains) were added to GLMM models. Significant improvements in MoCA scores were shown for participants with poorer baseline cognition (coefficient= 1.138, 95% CI: 0.080 ~ 2.195) and vitality domains (coefficient= 1.651, 95% CI: 0.541 ~ 2.760). The poor vitality domain also had a significant modulating effect on the reduction of CHS frailty score after the 6- and 12-month intervention period (6 months: coefficient= -0.311, 95% CI: -0.554 ~ -0.068; 12 months: coefficient= -0.257, 95% CI: -0.513 ~ -0.001). CONCLUSION AND IMPLICATIONS: A multidomain intervention in community-dwelling older adults improves cognitive decline and physical frailty, with its effectiveness influenced by baseline IC, highlighting the importance of personalized strategies for healthy aging.


Assuntos
Disfunção Cognitiva , Fragilidade , Envelhecimento Saudável , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Fragilidade/prevenção & controle , Vida Independente , Força da Mão , Disfunção Cognitiva/prevenção & controle
17.
Sci Rep ; 14(1): 3504, 2024 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-38347070

RESUMO

This study aims to assess the prevalence of geriatric syndromes and identify factors associated with multiple geriatric syndromes in community-dwelling older adults in China. We utilized a convenience sampling method to recruit older adults and from one rural and one urban community in Chengdu, China, from October 2022 to March 2023. A total of 706 older adults aged 60 years or older were included. Ten geriatric syndromes were investigated including two mental disorders: depressive symptoms, cognitive impairment; and eight somatic disorders: pain, falls, sleep disturbance, constipation, polypharmacy, multimorbidity, malnutrition and frailty. Multiple geriatric syndromes were defined as an individual having two or more geriatric syndromes. The data obtained were analysed using descriptive statistics. The independent risk factors for multiple geriatric syndromes were assessed using a logistic regression model. This study found that 90.5% of the participants had at least one geriatric syndrome, with 72.8% experiencing multiple geriatric syndromes. The top four geriatric syndromes in our study were polypharmacy (58.5%), malnutrition/at risk of malnutrition (43.1%), multimorbidity (42.1%), and frailty/prefrailty (34.3%). Of the older adults, 368(52.1%) had only somatic disorders, 18(2.5%) had only mental disorders and 253 (35.8%) had somatic-mental disorders. According to the logistic regression analysis, residence, age, marriage, BMI, and self-related health were significantly associated with multiple geriatric syndromes among older adults. This study highlights that multiple geriatric syndromes are prevalent among community-dwelling older adults in China, and underscores the significance of certain demographic factors in their occurrence. Future longitudinal studies are needed to establish the temporal relationship between multiple geriatric syndromes and these demographic factors, as well as to explore causal relationships and effective prevention strategies for geriatric syndrome.


Assuntos
Disfunção Cognitiva , Fragilidade , Desnutrição , Humanos , Idoso , Fragilidade/epidemiologia , Fragilidade/diagnóstico , Vida Independente , Disfunção Cognitiva/epidemiologia , Fatores de Risco , Desnutrição/epidemiologia , Síndrome , Avaliação Geriátrica/métodos
18.
BMC Geriatr ; 24(1): 147, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38350861

RESUMO

BACKGROUND: The relationship of testosterone and estradiol concentrations with cognitive function among community-dwelling older men was inconclusive. To examine the association of serum testosterone and estradiol concentrations with cognitive function in older men with or without vascular risk factors (VRFs). METHODS: This cross-sectional study consisted of 224 community-dwelling men aged 65-90 years in the Songjiang District of Shanghai, China. Serum testosterone and estradiol were measured by electrochemiluminescence immunoassay. The following five factors were defined as VRFs in this study: obesity, history of hypertension, diabetes, stroke, and coronary heart disease. Multivariable linear regression was used to examine the association of testosterone and estradiol with the Mini-Mental State Examination (MMSE) in participants with or without VRF. Restricted cubic spline (RCS) regression was performed to account for the nonlinearity of these associations. RESULTS: An inverted "U" shaped non-linear relationship was found between testosterone concentration and MMSE score in men with one VRF (P overall =.003, non-linear P =.002). Estradiol showed an inverted "U" shaped non-linear relationship with MMSE score independent of VRFs (men without VRF, P overall =.049, non-linear P =.015; men with one VRF, overall P =.007, non-linear P =.003; men with two or more VRFs, overall P =.009, non-linear P =.005). CONCLUSION: In older men, an optimal level of sex steroid concentration may be beneficial to cognitive function and the VRFs should be considered when interpreting the relationship between sex steroid and cognitive function.


Assuntos
Cognição , Estradiol , Hormônios Esteroides Gonadais , Idoso , Humanos , Masculino , China/epidemiologia , Estudos Transversais , Estradiol/sangue , Hormônios Esteroides Gonadais/sangue , Vida Independente , Fatores de Risco , Testosterona
19.
BMC Geriatr ; 24(1): 152, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38355464

RESUMO

BACKGROUND: Smart home health technologies (SHHTs) have been discussed in the frame of caregiving to enable aging-in-place and independence. A systematic review was conducted in accordance with the PRISMA guidelines to gather the up-to-date knowledge on the benefits and barriers of using SHHTs in the care of older persons from the perspective of older persons and their caregivers. METHODS: Ten electronic databases were reviewed for empirical peer-reviewed literature published from 01.01.2000 to 31.12.2021 in English, German, and French reporting on experimental, qualitative, quantitative, and other empirical study designs were included. Included studies contained user-feedback from older persons over 65 years of age or their caregivers (formal and informal). We used an extraction document to collect relevant data from all included studies and applied narrative synthesis to analyze data related to benefits and barriers of SHHTs. RESULTS: 163 empirical peer-reviewed articles were included, the majority of those published between 2014 and 2021. Five first-order categories of benefits and five of barriers were found with individual sub-themes. SHHTs could be useful in the care context where continuous monitoring is needed. They improve self-management and independent living of older persons. Barriers currently exist with respect to ease of usability, social acceptance, and cost. CONCLUSIONS: SHHTs could be useful in the care context but are not without concerns. Researchers and policy makers can use the information as a starting point to better understand how the roles and outcomes of SHHTs could be improved for the care of older persons, while caregivers of older adults could use our findings to comprehend the scope of SHHTs and to decide when and where such technology could best address their individual family needs. Limitations lie in the possible exclusion of relevant articles published outside the inclusion criteria as well as the fact that due to digital divide, our review represents opinions of those who could and wanted to participate in the included 163 studies. TRIAL REGISTRATION: This review has been registered as PROSPERO CRD42021248543. A protocol was completed in March 2021 with the PRISMA-P guidance. We have extended the review period from 2000 to 2020 since the registration of the protocol to 2000-2021.


Assuntos
Cuidadores , Cuidados Paliativos , Humanos , Idoso , Idoso de 80 Anos ou mais , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Vida Independente
20.
BMC Psychiatry ; 24(1): 124, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38355472

RESUMO

BACKGROUND: This study examined the association between social support and the severity of positive symptoms in rural community-dwelling schizophrenia patients during the COVID-19 pandemic. METHOD: The cross-sectional study included 665 rural community-dwelling schizophrenia patients investigated during the COVID-19 pandemic. Social support was measured using the Social Support Rating Scale, and positive symptoms were assessed using the Positive Scale extracted from the Positive and Negative Syndrome Scale. Multiple linear regression was adopted to examine the association of social support with positive symptoms. RESULT: The scores for total social support, subjective support, objective support and the use of social support were 28.3 ± 5.9, 16.4 ± 5.2, 6.5 ± 1.4 and 5.4 ± 2.8, respectively. Total social support (ß = -0.08, 95%CI: -0.13 to -0.02, P < 0.01) and subjective social support (ß = -0.10, 95%CI: -0.16 to -0.04, P < 0.01) were significantly and negatively associated with the Positive Scale score after adjustment for confounders. Objective social support (ß = 0.11, 95%CI: -0.10 to 0.32, P = 0.31) and the use of social support (ß = -0.03, 95%CI: -0.14 to 0.07, P = 0.53) were not significantly associated with the Positive Scale score. CONCLUSION: The study confirmed the importance of social support, especially subjective support, provided to rural community-dwelling schizophrenia patients during the COVID-19 pandemic. This support should be addressed and strengthened for such patients in emergent events.


Assuntos
COVID-19 , Esquizofrenia , Humanos , Vida Independente , Esquizofrenia/epidemiologia , Estudos Transversais , Pandemias , Apoio Social
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...