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1.
Cardiol Rev ; 29(1): 39-42, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33136582

RESUMO

Patients older than 65 years hospitalized with COVID-19 have higher rates of intensive care unit admission and death when compared with younger patients. Cardiovascular conditions associated with COVID-19 include myocardial injury, acute myocarditis, cardiac arrhythmias, cardiomyopathies, cardiogenic shock, thromboembolic disease, and cardiac arrest. Few studies have described the clinical course of those at the upper extreme of age. We characterize the clinical course and outcomes of 73 patients with 80 years of age or older hospitalized at an academic center between March 15 and May 13, 2020. These patients had multiple comorbidities and often presented with atypical clinical findings such as altered sensorium, generalized weakness and falls. Cardiovascular manifestations observed at the time of presentation included new arrhythmia in 7/73 (10%), stroke/intracranial hemorrhage in 5/73 (7%), and elevated troponin in 27/58 (47%). During hospitalization, 38% of all patients required intensive care, 13% developed a need for renal replacement therapy, and 32% required vasopressor support. All-cause mortality was 47% and was highest in patients who were ever in intensive care (71%), required mechanical ventilation (83%), or vasopressors (91%), or developed a need for renal replacement therapy (100%). Patients older than 80 years old with COVID-19 have multiple unique risk factors which can be associated with increased cardiovascular involvement and death.


Assuntos
Lesão Renal Aguda/terapia , Mortalidade Hospitalar , Terapia de Substituição Renal/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Vasoconstritores/uso terapêutico , Centros Médicos Acadêmicos , Acidentes por Quedas , Lesão Renal Aguda/etiologia , Idoso de 80 Anos ou mais , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Aspartato Aminotransferases/metabolismo , Proteína C-Reativa/metabolismo , /metabolismo , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , Causas de Morte , Transtornos da Consciência/fisiopatologia , Dispneia/fisiopatologia , Feminino , Ferritinas/metabolismo , Febre/fisiopatologia , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Hospitalização , Humanos , Hipóxia/fisiopatologia , Hipóxia/terapia , Vida Independente , Unidades de Terapia Intensiva/estatística & dados numéricos , Hemorragias Intracranianas/etiologia , Hemorragias Intracranianas/fisiopatologia , Contagem de Leucócitos , Hepatopatias/etiologia , Hepatopatias/metabolismo , Contagem de Linfócitos , Masculino , Debilidade Muscular/fisiopatologia , Peptídeo Natriurético Encefálico/metabolismo , Casas de Saúde , Oxigenoterapia , Pró-Calcitonina/metabolismo , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia , Troponina I/metabolismo
2.
Nutrients ; 12(12)2020 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-33266217

RESUMO

The aim was to explore the self-reported impact of the COVID-19 pandemic on nutrition and physical activity behaviour in Dutch older adults and to identify subgroups most susceptible to this impact. Participants (N = 1119, aged 62-98 y, 52.8% female) of the Longitudinal Aging Study Amsterdam living independently completed a COVID-19 questionnaire. Questions on diagnosis, quarantine and hospitalization were asked, as well as impact of the pandemic on ten nutrition and physical activity behaviours. Associations of pre-COVID-19 assessed characteristics (age, sex, region, household composition, self-rated health, BMI, physical activity, functional limitations) with reported impact were tested using logistic regression analyses. About half of the sample (48.3-54.3%) reported a decrease in physical activity and exercise due to the pandemic. An impact on nutritional behaviour predisposing to overnutrition (e.g., snacking more) was reported by 20.3-32.4%. In contrast, 6.9-15.1% reported an impact on behaviour predisposing to undernutrition (e.g., skipping warm meals). Those who had been in quarantine (n = 123) more often reported a negative impact. Subgroups with higher risk of impact could be identified. This study shows a negative impact of the COVID-19 pandemic on nutrition and physical activity behaviour of many older adults, which may increase their risk of malnutrition, frailty, sarcopenia and disability.


Assuntos
Dieta , Exercício Físico , Comportamentos Relacionados com a Saúde , Estado Nutricional , Pandemias , Quarentena , Idoso , Idoso de 80 Anos ou mais , Comportamento Alimentar , Feminino , Fragilidade , Avaliação Geriátrica , Humanos , Vida Independente , Estilo de Vida , Masculino , Desnutrição , Pessoa de Meia-Idade , Países Baixos , Hipernutrição , Sarcopenia , Autorrelato
3.
Environ Health Prev Med ; 25(1): 82, 2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33302863

RESUMO

BACKGROUND: We investigated the association between psychological distress and oral health status/oral health-related quality of life (OHQoL) in Japanese community-dwelling people. METHODS: We conducted a cross-sectional study using data from the Nagasaki Islands Study. A total of 1183 (455 men and 728 women) has been analyzed in this study. Psychological distress was measured using the Kessler Psychological Distress Scale (K6). Oral health status was measured by dental examination. The OHQoL was measured using the General Oral Health Assessment Index (GOHAI). We defined the total score of ≥5 points on the K6 as high psychological distress (high-K6 group). RESULTS: The multiple linear regression analysis to identify the GOHAI showed that gender, K6, the total number of teeth, the number of dental caries, and visiting a dental clinic within the past 6 months significantly associated with the GOHAI. Among all of these variables, high-K6 (≥ 5) was a substantial contributing factor of the GOHAI (ß = - 0.23, 95% Cl - 2.31 to -1.41, p < 0.0001). CONCLUSIONS: It is likely that the individual with high psychological distress was strongly related to poor OHQoL even in the general population.


Assuntos
Cárie Dentária/epidemiologia , Vida Independente/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida/psicologia , Estresse Psicológico/epidemiologia , Idoso , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Estresse Psicológico/complicações
4.
Rev Saude Publica ; 54: 129, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33295595

RESUMO

OBJECTIVE: To identify the strategies developed by people in the aging process to keep living in their own home, despite the weaknesses and difficulties they face. METHODS: The research was carried out based on a survey of population aged 65 years or older in the Portuguese municipality of Portimão. Data were collected by questionnaire, in 2017, and submitted to statistical and content analysis. RESULTS: Most respondents own their household, where they feel safe and satisfied, and they show awareness and concern about the changes they have to make in their home to stay there. In addition to housing and livability conditions, health, economic resources, social network, and available services play a major role in the community. CONCLUSIONS: We identified several strategies used by older adults to stay in their households as they age and the ways they mobilize their available resources, as well as constraints of aging in place.


Assuntos
Envelhecimento Saudável , Vida Independente , Idoso , Brasil , Humanos , Portugal/etnologia , Inquéritos e Questionários
5.
Ann Acad Med Singap ; 49(10): 723-730, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33283835

RESUMO

INTRODUCTION: The worldwide emergence of COVID-19 has been associated with diverse consequences, including anxiety. Hope is believed to act as a motivation to enable one to cope with the anxiety. This study was conducted to identify the role of hope in alleviating anxiety due to the COVID-19 outbreak during the primary phase among community dwellers in Iran. METHODS: This cross-sectional study recruited 3,565 subjects with the convenience sampling method. Data collection tools used included the COVID-19 knowledge checklist, Generalised Anxiety Disorder (GAD-7) questionnaires and Snyder Hope Scale. Participants were asked to fill in the questionnaires online. The data were analysed using descriptive and inferential statistics (multivariate linear regression analysis). RESULTS: Participants' mean scores of anxiety and hope were 6.06±4.52 and 31.27±4.52, respectively. The results indicated that 27.1% of the changes in the anxiety scores were predictable with some of the variables examined in this study. A high score of hope was directly associated with a lower level of anxiety. In addition, the number of hours spent following news and information on COVID-19 was significantly related to anxiety level. Moreover, female gender, urban residence, and having relatives suffering from COVID-19 were significantly related to a higher level of anxiety (P<0.05). CONCLUSION: The morbidity and mortality associated with the COVID-19 outbreak had brought a lot of anxiety among community dwellers. Hope, potentially, can contribute to overcoming anxiety. Therefore, health policymakers can introduce appropriate social interventions to enable the community to cope with stress and anxiety.


Assuntos
Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia , Esperança , Adulto , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Estudos Transversais , Família , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Vida Independente , Irã (Geográfico)/epidemiologia , Modelos Lineares , Masculino , Meios de Comunicação de Massa , Pessoa de Meia-Idade , Análise Multivariada , Questionário de Saúde do Paciente , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto Jovem
6.
Rehabilitation (Stuttg) ; 59(6): 341-347, 2020 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-33285613

RESUMO

AIM OF THE STUDY: In Germany, a disability that prevents a person from fully participating in the labor market can partly be compensated for financially with temporary disability pension. Due to fewer financial resources, this group is at a higher risk of poverty, which in conjunction with a worse health status might be related to other limitations such as lower social participation, loneliness and reduced life satisfaction. This study examined the relationships between household income, subjective financial resources, loneliness and life satisfaction. METHODOLOGY: 199 former employees with current reduced earning capacity status were interviewed at 2 points in time (T1; T2=T1+approx. 8 months) by means of structured telephone interviews. RESULTS: Income was not related to loneliness or life satisfaction. However, lower perceived financial resources were associated with higher levels of loneliness, which in turn was related to lower life satisfaction. Loneliness partially mediated this relationship. A lower health status was associated with more loneliness and lower life satisfaction. CONCLUSION: Rehabilitative measures that teach money management skills and aim to overcome loneliness could improve the life satisfaction of people with reduced earning capacity. This is highly relevant, as other studies have shown a connection between life satisfaction and return to work as well as social participation.


Assuntos
Solidão/psicologia , Pensões/estatística & dados numéricos , Satisfação Pessoal , Participação Social , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha , Humanos , Vida Independente , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , Isolamento Social/psicologia
7.
Arch Osteoporos ; 15(1): 173, 2020 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-33141362

RESUMO

The present study demonstrated that the lower-extremity muscle performance in Chinese community-dwelling postmenopausal women with lower bone mineral density (BMD) was positively associated with hip BMD and negatively associated with estimated fracture risk. PURPOSE: Postmenopausal women are at high risk for osteoporotic fractures. It has been shown that decreased lower-extremity muscle performance is associated with osteoporotic fractures. However, the relationship between muscle performance and bone mineral density in postmenopausal women is inconsistent in the literature. The present study was to investigate the relationship between lower-extremity muscle performance and BMD or estimated fracture risk in community-dwelling postmenopausal women. METHODS: Two hundred forty-seven postmenopausal women aged 50-85 years were recruited in the study. The short physical performance battery (SPPB) tool including the chair stand test (CST), gait speed test (GST), and balance test (BT) was used to determine lower-extremity functioning and the CST, GST, BT, and SPPB total scores were recorded. The BMD of lumbar spine (LSBMD), femoral neck (FNBMD), and total hip (THBMD) were measured by dual-energy X-ray absorptiometry (DXA), and the vertebral fracture was confirmed by lateral spine X-rays radiographs. In addition, patients' 10-year estimated major osteoporotic fracture risk (MOFR) and hip fracture risk (HFR) were assessed by the Fracture Risk Assessment Tool (FRAX). Linear regression analysis was used to analyze the association between muscle performance and BMD. RESULTS: The CST, GST, and SPPB total scores were positively associated with LSBMD, THBMD, and FNBMD before adjustment for age, height, and weight. The SPPB total score was positively associated with FNBMD and THBMD, but not with LSBMD after adjustment for age, height, and weight. The BT score was positively associated with FNBMD and THBMD, but not with LSBMD before and after adjustment for age, height, and weight. Moreover, the CST, GST, BT, and SPPB scores were negatively associated with the FRAX score. CONCLUSION: The lower-extremity muscle performance in community-dwelling postmenopausal women is positively associated with FNBMD and THBMD and negatively associated with the FRAX score.


Assuntos
Densidade Óssea , Fraturas por Osteoporose , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Vida Independente , Pessoa de Meia-Idade , Músculos , Fraturas por Osteoporose/epidemiologia , Pós-Menopausa , Medição de Risco , Fatores de Risco
8.
Artigo em Inglês | MEDLINE | ID: mdl-33233408

RESUMO

Purpose: To identify the interrelations among determinants of multidimensional frailty, physical frailty, and their individual components. Methods: A group of 1024 community-dwelling people older than 65 years completed questionnaires regarding: multidimensional frailty (Tilburg Frailty Indicator, TFI) and physical frailty (FRAIL scale), and common frailty risk factors. Results: Multidimensional frailty was recognized in 559 subjects (54.6%) and determined by 13 factors (R2 = 0.21 in logistic regression). After incorporating TFI components to the models, the majority of previous risk factors became non-essential, and the frailty deficits mainly determined each other with R2 ranging between 0.07-0.67. Physical frailty and non-robust status (i.e., either physical frailty or pre-frailty) were recognized in 64 (6.3%) and 542 (52.9%) participants, and were determined by 5 factors (R2 = 0.33) and 11 factors (R2 = 0.34), respectively. Associations between the frailty deficits were detected within and between different dimensions (i.e., physical, psychological and social); the physical domain was mainly related to the psychological one which in turn was additionally associated with the social one. Conclusion: Frailty is the accumulation of deficits and is determined by factors other than the determinants of the individual deficits. The associations between deficits coming from various dimensions of human functioning presumably amplify their effects and accelerate frailty development.


Assuntos
Idoso Fragilizado , Fragilidade , Avaliação Geriátrica/métodos , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Estudos Transversais , Fragilidade/epidemiologia , Humanos , Vida Independente , Masculino , Inquéritos e Questionários
9.
PLoS One ; 15(11): e0242608, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33216812

RESUMO

Human postural control is a complex system and changes as we age. Frequency based analyses have been argued to be useful to identify altered postural control strategies in balance tasks. The aim of this study was to explore the frequency domain of the quiet stance centre of pressure of older adults with various degrees of fall-related concerns and sensorimotor functioning. We included 45 community dwelling older adults and used a force plate to register 30 seconds of quiet stance with eyes open and closed respectively. We also measured sensory and motor functions, as well as fall-related concerns and morale. We analysed the centre of pressure power spectrum density and extracted the frequency of 4 of its features for each participant. Orthogonal projection of latent structures-discriminant analysis revealed two groups for each quiet stance trial. Group 1 of each trial showed less sensory and motor decline, low/no fall-related concerns and higher frequencies. Group 2 showed more decline, higher fall-related concerns and lower frequencies. During the closed eyes trial, group 1 and group 2 shifted their features to higher frequencies, but only group 1 did so in any significant way. Higher fall-related concerns, sensory and motor decline, and explorative balancing strategies are highly correlated. The control system of individuals experiencing this seems to be highly dependent on vision. Higher fall-related concerns, and sensory and motor decline are also correlated with the inability to adjust to faster, more reactive balancing strategies, when vision is not available.


Assuntos
Acidentes por Quedas , Envelhecimento , Vida Independente , Equilíbrio Postural , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino
10.
J Nutr Health Aging ; 24(9): 948-950, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33155619

RESUMO

OBJECTIVES: The objective of this study was to investigate changes in physical activity (PA) between January (before the COVID-19 epidemic) and April (during the COVID-19 epidemic) 2020 in community-dwelling older adults in Japan. DESIGN: Cross-sectional online survey. SETTING AND SUBJECTS: From April 23 to 27, 2020, an online survey was completed by 1,600 community-dwelling older adults in Japan. METHODS: We assessed the frailty status using the Kihon checklist, and other demographics and asked questions regarding PA at two time points: January and April 2020. We defined the total PA time (minutes) per week based on activity frequency and time. RESULTS: The study participants' mean age, proportion of women, and prevalence of frailty were 74.0±5.6 years, 50% (n=800), and 24.3% (n=388), respectively. We found a significant decrease in total PA time in April 2020 (median [interquartile range (IQR)], 180 [0 to 420]) when compared to January 2020 (median [IQR], 245 [90 to 480]) (P<0.001). We also performed a subgroup analysis according to the frailty category; total PA time significantly decreased in April 2020 when compared to January 2020 for all frailty categories (P<0.001). CONCLUSION: In conclusion, due to the COVID-19 epidemic, the total PA time in April 2020 significantly decreased compared to that in January 2020 in older adults. This finding may lead to a higher incidence of disability in the near future in older people.


Assuntos
Exercício Físico , Fragilidade , Vida Independente , Pandemias , Comportamento Sedentário , Fatores Etários , Idoso , Lista de Checagem , Estudos Transversais , Feminino , Idoso Fragilizado , Humanos , Japão/epidemiologia , Masculino , Prevalência , Inquéritos e Questionários
11.
J Gerontol Nurs ; 46(12): 7-13, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33232492

RESUMO

Age-friendly cities optimize opportunities for health, participation, and security to enhance quality of life as people age. The Age-Friendly Cities framework evaluates eight evidence-based domains, including: outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services. The COVID-19 pandemic has impacted each of these domains, necessitating reconsideration of opportunities to promote safety, wellness, and empowerment for older adults and persons with disabilities in this new reality. This qualitative descriptive study provides perspectives of gerontologists, senior service providers, and diverse older adults. Participants identified emerging issues and concerns related to the eight age-friendly domains, as well as highlighted best practices and potential solutions. The findings provide direction for gerontological nurses in practice and research who aim to address social determinants of health while promoting aging in place for older adults. [Journal of Gerontological Nursing, 46(12), 7-13.].


Assuntos
Envelhecimento , Vida Independente , Pandemias , Idoso , Idoso de 80 Anos ou mais , Cidades , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , /isolamento & purificação
12.
Nat Commun ; 11(1): 5997, 2020 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-33244003

RESUMO

The vitamin D receptor is highly expressed in the gastrointestinal tract where it transacts gene expression. With current limited understanding of the interactions between the gut microbiome and vitamin D, we conduct a cross-sectional analysis of 567 older men quantifying serum vitamin D metabolites using LC-MSMS and defining stool sub-Operational Taxonomic Units from16S ribosomal RNA gene sequencing data. Faith's Phylogenetic Diversity and non-redundant covariate analyses reveal that the serum 1,25(OH)2D level explains 5% of variance in α-diversity. In ß-diversity analyses using unweighted UniFrac, 1,25(OH)2D is the strongest factor assessed, explaining 2% of variance. Random forest analyses identify 12 taxa, 11 in the phylum Firmicutes, eight of which are positively associated with either 1,25(OH)2D and/or the hormone-to-prohormone [1,25(OH)2D/25(OH)D] "activation ratio." Men with higher levels of 1,25(OH)2D and higher activation ratios, but not 25(OH)D itself, are more likely to possess butyrate producing bacteria that are associated with better gut microbial health.


Assuntos
Calcifediol/análise , Calcitriol/análise , Microbioma Gastrointestinal/fisiologia , Idoso , Idoso de 80 Anos ou mais , Butiratos/metabolismo , Calcifediol/metabolismo , Calcitriol/metabolismo , Estudos Transversais , DNA Bacteriano/isolamento & purificação , Fezes/química , Fezes/microbiologia , Humanos , Vida Independente , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Masculino , Filogenia , RNA Ribossômico 16S/genética
13.
Artigo em Inglês | MEDLINE | ID: mdl-33081016

RESUMO

Identifying and treating co-existing diseases are essential in healthcare for the elderly, while physical rehabilitation care teams can provide interdisciplinary geriatric care for the elderly. To evaluate the appropriateness of demand and supply between the population at demand and physical rehabilitation resources, a comparative analysis was carried out in this study. Our study applied seven statistical indices to assess five proposed methods those considered different factors for geographic accessibility analysis. Google ratings were included in the study as a crucial factor of choice probability in the equation for calculating the geographic accessibility scores, because people's behavioral decisions are increasingly dependent on online rating information. The results showed that methods considering distances, the capacity of hospitals, and Google ratings' integrally generated scores, are in better accordance with people's decision-making behavior when they determine which resources of physical rehabilitation to use. It implies that concurrent considerations of non-spatial factors (online ratings and sizes of resource) are important. Our study proposed an integrated assessment method of geographical accessibility scores, which includes the spatial distribution, capacity of resources and online ratings in the mechanism. This research caters to countries that provide citizens with a higher degree of freedom in their medical choices and allows these countries to improve the fairness of resource allocation, raise the geographic accessibilities of physical rehabilitation resources, and promote aging in place.


Assuntos
Assistência à Saúde/organização & administração , Sistemas de Informação Geográfica , Recursos em Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Vida Independente , Reabilitação/economia , Alocação de Recursos , Idoso , Instalações de Saúde , Humanos
14.
BMC Geriatr ; 20(1): 401, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054728

RESUMO

BACKGROUND: Previous research has shown that not only falls, but also fear of falling (FoF) influences health-related quality of life (HrQoL) negatively. The EQ-5D (consisting of an index and a visual analogue scale [EQ-VAS]) is a frequently used instrument to determine HrQoL in clinical studies and economic evaluations, but no previous study compared the association between FoF and the EQ-5D index with the association between FoF and the EQ-VAS. Moreover, factors that influence the association between FoF and HrQoL are rarely examined. Thus, this study aimed to examine the association between FoF and HrQoL and to examine factors that mediate the association. METHODS: FoF (Short Falls Efficacy Scale International) and HrQoL (EQ-5D descriptive system, EQ-5D index, and EQ-VAS) were assessed in a sample of community-dwelling older persons (≥70 years) participating in the baseline assessment of a randomized controlled trial (N = 309). Linear and logistic regression analyses were performed, adjusting for sociodemographic variables, frequency of falls, number of chronic conditions, functional mobility (Timed up-and-go test), and subjective functional capacity (LLFDI function and disability scales). Multiple regression models were used to test the mediating effects. RESULTS: Moderate or high FoF was prevalent in 66% of the sample. After adjusting for covariates, FoF was negatively associated with the EQ-5D index, but not with the descriptive system or the EQ-VAS. Subjective functional capacity partly mediated the association between FoF and the EQ-5D index and completely mediated the association between FoF and the EQ-VAS. CONCLUSION: FoF was negatively associated with the EQ-5D index. As subjective functional capacity mediated the association between FoF and HrQoL, future interventions should account for subjective functional capacity in their design.


Assuntos
Acidentes por Quedas , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Medo , Humanos , Vida Independente , Inquéritos e Questionários
15.
BMC Geriatr ; 20(1): 403, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054731

RESUMO

BACKGROUND: It has not been clarified whether physical frailty symptoms predict social. frailty. The purpose of this study was to elucidate the effect of physical frailty on social frailty, and to determine which domains of physical frailty predict the development of social frailty. METHODS: We employed a two-year prospective cohort study. A total of 342 socially robust community-dwelling older adults were recruited. We used a modified social frailty screening index consisting of four social domains including financial difficulties, living alone, social activity, and contact with neighbors. Physical frailty status was also assessed at baseline. At the two-year follow-up, we assessed the development of social frailty. Social status was assessed using four social subdomains for the primary analysis. Social status was assessed using the two social subdomains of social activity and contact with neighbors, which would be affected by the physical frailty component, for the secondary analysis. The risk ratios (RR) of physical frailty for the development of social frailty were estimated. RESULTS: Although physical frailty symptoms were not a significant risk factor for future development of social frailty as assessed by four social subdomains (adjusted RR 1.39, 95% CI 0.95-2.15), it became significant when development of social frailty was assessed by the two social subdomains (adjusted RR 1.78, 95% CI 1.10-2.88). An analysis using the physical frailty subdomain showed that slow gait speed (adjusted RR 3.41, 95% CI 1.10-10.53) and weakness (adjusted RR 1.06, 95% CI 1.01-1.12) were independent risk factors for development of social frailty as assessed by two social subdomains. CONCLUSIONS: Physical frailty symptoms predict the development of social frailty. Among physical frailty subdomains, gait speed and muscle strength are critical independent risk factors for future decline in the social aspect. The prevention of physical frailty, especially by maintaining gait ability and muscle strength, may be effective for avoiding social frailty.


Assuntos
Fragilidade , Idoso , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Avaliação Geriátrica , Humanos , Vida Independente , Estudos Prospectivos , Velocidade de Caminhada
16.
BMC Geriatr ; 20(1): 412, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33081715

RESUMO

BACKGROUND: Physical Activity Monitors (PAMs) have been shown to effectively enhance level of physical activity (PA) in older adults. Motivational interviewing is a person-centred model where participants are guided using self-reflection and counselling, and addresses the behavioural and psychological aspects of why people initiate health behaviour change by prompting increases in motivation and self-efficacy. The addition of motivational interviewing to PA interventions may increase the effectiveness of PAMs for older adults. METHODS: This motivational interviewing and PA monitoring trial is designed as an investigator-blinded, two arm parallel group, randomized controlled superiority trial with primary endpoint after 12 weeks of intervention. The intervention group will receive a PAM-based intervention and motivational interviewing and the control group will only receive the PAM-based intervention. The primary outcome is PA, objectively measured as the average daily number of steps throughout the intervention period. Secondary outcome measures include self-reported PA health-related quality of life, loneliness, self-efficacy for exercise, outcome expectancy for exercise, and social relations. The outcomes will be analysed with a linear regression model investigating between-group differences, adjusted for baseline scores. Following the intention to treat principle, multiple imputation will be performed to handle missing values. DISCUSSION: A moderate effect of daily PA measured using PAMs is expected in this superiority RCT investigating the effect of adding motivational interviewing to a PAM intervention. According to the World Health Organization, walking and cycling are key activities in regular PA and should be promoted. To increase the general public health and lower the burden of inactivity in older adults, cost-beneficial solutions should be investigated further. If this RCT shows that motivational interviewing can enhance the effect of PAM-based interventions, it might be included as an add-on intervention when appropriate. No matter what the results of this study will be, the conclusions will be relevant for clinicians as the dependence on technology is increasing, especially in relation to public health promotion. TRIAL REGISTRATION: NCT03906162 , April 1, 2019.


Assuntos
Entrevista Motivacional , Idoso , Exercício Físico , Promoção da Saúde , Humanos , Vida Independente , Qualidade de Vida
17.
BMC Geriatr ; 20(1): 430, 2020 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-33115447

RESUMO

BACKGROUND: Disability, which is considered a health-related condition, increases care demands and socioeconomic burdens for both families and communities. To confirm the trend of dynamic longitudinal changes in disability, this study aims to explore how disability is divided by the trajectory method, which deals with time-sequenced data. Additionally, this study examines the differences in demographics, geriatric conditions, and time spent at home among the trajectory groups in community-dwelling older adults. Home time is defined as the period during which the patient was not in a hospital or health care facility during their lifetime. METHODS: Records of 786 community-dwelling older participants were analyzed from the Aging Study of PyeongChang Rural Area, a population-based cohort study that took place over three years. Using 7 domains of activities of daily living and 10 domains of instrumental activities of daily living, participants were grouped into no dependency (0 disabled domain), mild (1 disabled domain), and severe (2 or more disabled domains) disability groups. The longitudinal trajectory group of disability was calculated as a trajectory method. Three distinct trajectory groups were calculated over time: a relatively-stable group (78.5%; n = 617), a gradually-aggravated group (16.0%; n = 126), and a rapidly-deteriorated group (5.5%; n = 43). RESULTS: The average age of 786 participants was 73.3 years (SD: 5.8), and the percentage of female was 52.7%. It was found that 78.5% of patients showed relatively no dependence and 5.5% of older adults in a rural area showed severe dependence. Through applying the trajectory method, it was shown that the Short Physical Performance Battery (SPPB) score was 10.2 points in the relatively-stable group and 3.1 points in the rapidly-deteriorating group by the 3rd year. Additionally, by the trajectory method, the rate of decrease in home time was 3.33% in the rapidly-deteriorated group compared to the relatively-stable group. CONCLUSIONS: This study shows the difference in demographics and geriatric conditions (such as SPPB) through the examination of longitudinal trajectory groups of disability in community-dwelling older adults. Significant differences were also found in the amount of home time among the trajectory groups.


Assuntos
Pessoas com Deficiência , Vida Independente , Atividades Cotidianas , Idoso , Estudos de Coortes , Avaliação da Deficiência , Feminino , Avaliação Geriátrica , Humanos , República da Coreia/epidemiologia
18.
BMC Geriatr ; 20(1): 431, 2020 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-33121444

RESUMO

BACKGROUND: Proton pump inhibitors (PPIs) are effective in treating gastroesophageal reflux, peptic ulcers, and esophagitis. However, the long-term use of PPIs by older adults is associated with adverse health outcomes. There is limited evidence about older adults' awareness of long-term PPI use and its associated adverse effects. This study aimed to assess older adults' awareness of the adverse effects of the long-term use of PPIs, and their willingness to stop PPI use given of the risks and benefits of PPI use. METHODS: this cross-sectional study was conducted on a convenience sample of 120 older adults from three local healthcare centers located in Irbid, Jordan. Older adults' awareness of PPI use was measured using the Patients' Perceptions of Proton Pump Inhibitor Risks and Attempts at Discontinuation Survey. RESULTS: the majority of the participating older adults were not familiar with any reports linking long-term PPI use with adverse effects, reported no concerns related to the chronic use of PPIs, and reported that they had not discussed the benefits and risks of PPI use with their primary care providers (PCPs). Although the majority of the participants had not previously attempted to stop using PPIs, the majority expressed a willingness to stop PPIs due to their adverse effects, especially if advised to do so by a PCP. The factors associated with the long-term use of PPIs included age, indications for gastrointestinal reflux disease (GERD), improvement of GERD symptoms, and the willingness to reduce or stop PPIs. Being advised by a PCP to stop PPIs (p = 0.049) and having increased concerns about the adverse effects of long-term PPI use (p < 0.0001) were the only two statistically significant predictors of previous attempts to stop PPIs. CONCLUSIONS: concerns regarding the adverse effects of long-term PPI use were associated with attempts to stop PPIs, especially in cases where this was recommended by a PCP. Discussions between PCPs and patients regarding the risks and benefits of PPIs are necessary in order to ensure that patients do not make inappropriate decisions regarding ongoing PPI therapy. Careful evaluation of the long-term use of PPIs among older adults is required.


Assuntos
Refluxo Gastroesofágico , Gastroenteropatias , Idoso , Estudos Transversais , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Humanos , Vida Independente , Inibidores da Bomba de Prótons/efeitos adversos
19.
BMJ Open ; 10(10): e040341, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33051236

RESUMO

INTRODUCTION: Local activities that functioned to prevent frailty in the elderly have been suspended or reduced as a countermeasure against COVID-19. As a result, frailty rates are expected to increase, and frailty is expected to worsen as a secondary problem associated with COVID-19 countermeasures. Therefore, this study aims to determine the extent of frailty in the elderly associated with lifestyle changes implemented as COVID-19 countermeasures, to ascertain actual lifestyle changes and clarify the existence of Corona-Frailty. We will also conduct Corona-Frailty screening to verify the effect of support provided as feedback to supporters of the elderly. METHODS AND ANALYSIS: The survey target area is Takasaki City, Gunma Prefecture, Japan. Phase I aims to verify the short-term effects of COVID-19. A questionnaire will be distributed to 465 community-dwelling elderly people, and responses will be obtained by post. Frailty will be evaluated using the Frailty Screening Index. Respondents who are frail and have had many changes in their lifestyle will be screened as high-risk people, and feedback will be provided to local supporters. The aim of Phase II will be to verify the long-term effects of COVID-19 and the effect of screening. A similar survey will be distributed twice after the first survey, once after 6 months and again after 1 year and the frailty rate will be tested. Furthermore, out of the subjects identified with frailty in Phase I, the progress of those who were screened and those who were not screened will be compared between groups. ETHICS AND DISSEMINATION: This study has been approved by the Research Ethics Committee of the Takasaki University of Health and Welfare (approval number: 2009). The results of this study will be reported to the policymaker, presented at academic conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: UMIN000040335.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/epidemiologia , Avaliação Geriátrica/métodos , Vida Independente/estatística & dados numéricos , Estilo de Vida , Pneumonia Viral/epidemiologia , Atividades Cotidianas , Idoso , Envelhecimento/fisiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pandemias , Inquéritos e Questionários
20.
J Alzheimers Dis ; 78(2): 537-541, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33074240

RESUMO

We aimed to evaluate the frequency and mortality of COVID-19 in patients with Alzheimer's disease (AD) and frontotemporal dementia (FTD). We conducted an observational case series. We enrolled 204 patients, 15.2% of whom were diagnosed with COVID-19, and 41.9% of patients with the infection died. Patients with AD were older than patients with FTD (80.36±8.77 versus 72.00±8.35 years old) and had a higher prevalence of arterial hypertension (55.8% versus 26.3%). COVID-19 occurred in 7.3% of patients living at home, but 72.0% of those living at care homes. Living in care facilities and diagnosis of AD were independently associated with a higher probability of death. We found that living in care homes is the most relevant factor for an increased risk of COVID-19 infection and death, with AD patients exhibiting a higher risk than those with FTD.


Assuntos
Doença de Alzheimer/complicações , Doença de Alzheimer/mortalidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Demência Frontotemporal/complicações , Demência Frontotemporal/mortalidade , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hipertensão/complicações , Vida Independente , Masculino , Casas de Saúde , Pandemias , Prevalência , Fatores de Risco
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