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1.
Environ Health Prev Med ; 26(1): 45, 2021 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-33838644

RESUMO

BACKGROUND: Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. METHODS: We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2000 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. RESULTS: Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714-0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699-0.771). CONCLUSIONS: We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.


Assuntos
Avaliação Geriátrica/estatística & dados numéricos , Vida Independente/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Idoso , Estudos de Coortes , Feminino , Humanos , Vida Independente/psicologia , Japão , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco
2.
NeuroRehabilitation ; 48(2): 221-230, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33664159

RESUMO

BACKGROUND: Traumatic brain injury has multiple impacts on gait including decreased speed and increased gait variability. Rhythmic auditory stimulation (RAS) gait training uses the rhythm and timing structure of music to train and ultimately improve slow and variable walking patterns. OBJECTIVE: To describe the feasibility of RAS gait training in community-dwelling adults with traumatic brain injury (TBI). A secondary objective is to report changes in spatiotemporal gait parameters and clinical measures of balance and walking endurance. METHODS: Two individuals with a TBI participated in nine sessions of gait training with RAS over a 3-week period. At baseline, post-training and 3-week follow-up, spatiotemporal parameters of walking were analyzed at preferred pace, maximum pace and dual-task walking conditions. Secondary outcomes included the Community Balance and Mobility Scale and the 6-Minute Walk Test. Feasibility was assessed using reports of physical fatigue, adverse event reporting, and perceived satisfaction. RESULTS: Both participants completed all 9 planned intervention sessions. The sessions were well tolerated with no adverse events. Participant 1 and 2 exhibited different responses to the intervention in line with the therapeutic goals set with the therapist. Participant 1 exhibited improved speed and decreased gait variability. Participant 2 exhibited reduced gait speed but less fatigue during the 6MWT. CONCLUSIONS: RAS was found to be a safe and feasible gait intervention with the potential to improve some aspects of gait impairments related to gait speed, gait variability, dynamic balance and walking endurance. Further investigation including a pilot randomized controlled trial is warranted.


Assuntos
Estimulação Acústica/tendências , Lesões Encefálicas Traumáticas/terapia , Terapia por Exercício/tendências , Marcha/fisiologia , Vida Independente/tendências , Estimulação Acústica/psicologia , Adulto , Lesões Encefálicas Traumáticas/psicologia , Terapia por Exercício/psicologia , Estudos de Viabilidade , Humanos , Vida Independente/psicologia , Masculino , Pessoa de Meia-Idade , Velocidade de Caminhada/fisiologia
3.
Clin Interv Aging ; 16: 363-378, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33664568

RESUMO

Background: There is a need for interventions to foster and maintain independence for people with dementia to support community living, improve morale, and reduce stigma. We investigated a social intervention to promote living well and enhance independence for people with mild dementia. Methods: In this two arm parallel group, feasibility RCT at six sites in England, participants were randomized (1:1) to the PRIDE intervention (encompassing social, physical, and cognitive domains supported by a facilitator over three sessions) compared to usual care only. The main objective was to determine the feasibility of a main trial with respect to measures of recruitment, retention, and adherence to the intervention. Results: During a 7-month period, 402 people were invited to the trial, 148 were screened (37%, 95% confidence interval (CI)=32-42%), 137 were eligible at pre-consent, 94 consented to the trial (69% of those eligible, 95% CI=60-76%), and 92 were randomized (46 to each group). Of those allocated to the intervention, 42 (91%) received at least one of three intervention sessions. Outcome assessment follow-up visits were completed for 73 participants at 6 months (79%, 95% CI=70-87%), and this was similar for both groups. Conclusion: A large multi-center trial of the PRIDE intervention in community-dwelling people with mild dementia is feasible using systematic recruitment strategies. The intervention was successfully delivered and well received by participants. Findings from this study will be used to refine the design and processes for a definitive RCT. Trial Registration: ISRCTN, ISRCTN11288961, registered on 23 October 2018.


Assuntos
Demência/psicologia , Demência/terapia , Vida Independente/psicologia , /métodos , Idoso , Idoso de 80 Anos ou mais , Inglaterra/epidemiologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde
4.
Clin Interv Aging ; 16: 281-289, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33623378

RESUMO

Background: Depressive symptoms are common in people with dementia. Purpose: This study examined the discrepancies in the ratings of depressive symptoms between people with dementia and their family caregivers, and the extent to which these discrepancies varied according to the functional status of people with dementia. Participants and Methods: This study is a cross-sectional secondary analysis. Twenty-five people living with dementia ("participants") and their family caregivers ("proxies") participated as pairs in the study (participant mean age = 71.36, SD = 8.63; proxy mean age = 67.54, SD = 11.46). Data were collected in Victoria, Australia between May 2018 and May 2019. Participants were administered a semi-structured interview comprising the Cornell Scale for Depression in Dementia (CSDD). Proxies independently completed the CSDD and the Functional Activities Questionnaire (FAQ). A paired sample t-test was used to investigate differences in CSDD scores between participants and proxies. Kendall's tau-b correlation was used to examine the relationship between FAQ scores and discrepancy scores of CSDD. Participants were then classified into either low or high functional impairment. Mann-Whitney U-test was used to examine whether the discrepancy scores of CSDD were similar between these two groups. Intraclass correlation coefficients were calculated to indicate the level of agreement between participants and proxies in each group. Results: The CSDD scores of participants were significantly lower than proxies. The size of the discrepancy in CSDD scores was positively correlated with FAQ scores. The "high functional impairment" group had larger discrepancy scores and a lower level of agreement than the "low functional impairment" group. Conclusion: The findings highlighted that relying on proxy CSDD scores may not reflect estimates of depressive symptoms by people with dementia. Hence, both perspectives need to be taken into account, particularly when the level of functional impairment in dementia is advanced.


Assuntos
Cuidadores/psicologia , Demência , Depressão , Vida Independente , Idoso , Austrália/epidemiologia , Índice Médico de Cornell , Estudos Transversais , Demência/diagnóstico , Demência/epidemiologia , Demência/psicologia , Depressão/diagnóstico , Depressão/etiologia , Feminino , Humanos , Vida Independente/psicologia , Vida Independente/estatística & dados numéricos , Masculino , Escalas de Graduação Psiquiátrica
6.
Nutrients ; 13(2)2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33503860

RESUMO

This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.


Assuntos
/epidemiologia , Estado Nutricional , Pandemias , Angústia Psicológica , Estresse Psicológico/epidemiologia , Idoso , /psicologia , Estudos Transversais , Feminino , Humanos , Vida Independente/economia , Vida Independente/psicologia , Vida Independente/estatística & dados numéricos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente/estatística & dados numéricos , Estresse Psicológico/diagnóstico , Estresse Psicológico/economia , Estresse Psicológico/psicologia
7.
Geriatr Gerontol Int ; 20 Suppl 2: 21-25, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33370850

RESUMO

AIM: This study aimed to assess the relationship between functional limitations and depression among community-dwelling older adults in Malaysia. METHODS: Data from a nation-wide community-based cross-sectional study were analyzed. This study was conducted using a two-stage stratified random sampling design. In total, 3772 older adults aged ≥60 years responded to the survey. Depression was identified using a validated Malay version of the Geriatric Depression Scale (M-GDS-14), with those scored ≥6 categorized as having depression. Functional limitations were assessed using both Barthel's Activities of Daily Living (ADL) and Lawton's Instrumental Activities of Daily Living (IADL). The relationship was determined by multivariate logistic regression, adjusted for other variables. RESULTS: The prevalence of depression was 11.5% (95% confidence interval [CI] 9.4, 13.4). Multiple logistic regression analysis found that older adults with limitations in ADL were 2.6 times more likely of having depression (adjusted odds ratio [aOR] 2.58, 95% CI 2.01, 3.32), while those with limitations in IADL the risk of having depression was almost doubled (aOR 1.68, 95% CI: 1.32, 2.14). Other significant factors were incontinence (aOR 3.33, 95% CI: 2.33, 4.74), chronic medical illness (aOR 1.44, 95% CI: 1.15, 1.81), current smoker (aOR 4.19, 95% CI: 1.69, 10.39), poor social support (aOR 4.30, 95% CI: 2.98, 6.20), do not have partner, ethnic minorities and low individual monthly income. CONCLUSIONS: Older adults with functional limitation in both basic ADL and complex IADL are independently at higher risk of having depression. Geriatr Gerontol Int 2020; 20: 21-25.


Assuntos
Atividades Cotidianas/psicologia , Depressão/epidemiologia , Vida Independente/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Avaliação da Deficiência , Grupos Étnicos/psicologia , Feminino , Humanos , Malásia/epidemiologia , Masculino , Razão de Chances , Prevalência
8.
Ann Agric Environ Med ; 27(4): 621-629, 2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33356070

RESUMO

INTRODUCTION: In Poland, the number of the oldest-old people is increasing. The prevalence of health problems increases with age, which expands the cost of medical and social care. Therefore, there is a need to assess factors affecting the level of disability and quality of life in order to modify them. MATERIAL AND METHODS: The study was carried out in a group of 498 people aged 80 and over who live in community in south-eastern Poland. The researchers collected socio-demographic and health data, the WHODAS 2.0 questionnaire was used to assess disability and functioning. Quality of life was studied using the WHOQOL-BREF questionnaire. RESULTS: The general average level of disability was 37.41, with women having a higher level of general disability than men (38.94 vs. 33.94). The highest levels of disability occurred in areas such as mobility, life activity and participation. Statistically, a significantly higher level of disability develops in women who are older, with lower education, social involvement, not able to get help from other people and having more chronic diseases. In men, disability increased with age and greater number of chronic illnesses. The general quality of life of the study group was average (62.53) and comparable for both genders. The lowest quality of life was found in the domain of physical health. A significantly lower quality of life appeared in lonely people, with more chronic diseases, lower education, physical and social inactivity, as well as a lack of help from other people and non-adjustment to the environment. CONCLUSIONS: Factors affecting the disability and quality of life of the oldest-old people should be considered in developing senior health policy in Poland.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Vida Independente/estatística & dados numéricos , Qualidade de Vida , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Vida Independente/psicologia , Masculino , Polônia
9.
Health Qual Life Outcomes ; 18(1): 294, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873306

RESUMO

BACKGROUND: Fear of falling (FOF) is a very pervasive problem among older adults. Consequently, many scales have been developed for its assessment. The Modified Falls Efficacy Scale (MFES) is one of the most popular FOF scales. The MFES was originally developed for use in developed countries, and thus may not be entirely suitable for use in developing countries due to cultural and environmental differences between the two country categories. This study was therefore designed to cross-culturally adapt and validate the MFES to Igbo culture and environment among community-dwelling older adults in Nnewi community using established guidelines. METHODS: The original English version of the MFES (E-MFES) was translated, synthesized, back-translated, subjected to expert panel review, and pretested before producing the final Igbo version of the MFES (I-MFES). The I-MFES and the Short Falls Efficacy Scale International were randomly administered to consecutively recruited 109 consenting older adult residents of Nnewi (43.1% males; mean age = 74.45 ± 8.78 years). Convergent and structural validities and internal consistency of the I-MFES were assessed at 0.05 level of significance. RESULTS: All the 14 items on the E-MFES were retained on the I-MFES. The I-MFES exhibited the same structure as the E-MFES. The correlation between the total scores on the I-MFES and the Short Falls Efficacy Scale International was excellent (rho = - 0.93) indicating evidence of convergent validity of the I-MFES. The Cronbach's alpha value of the I-MFES was 0.97 showing evidence of excellent internal consistency of the items on the I-MFES. CONCLUSION: This study provides evidence of some aspects of validity and reliability of the I-MFES.


Assuntos
Acidentes por Quedas/prevenção & controle , Medo/psicologia , Inquéritos e Questionários/normas , Idoso , Idoso de 80 Anos ou mais , Comparação Transcultural , Feminino , Humanos , Vida Independente/psicologia , Masculino , Nigéria , Qualidade de Vida , Reprodutibilidade dos Testes , Traduções
10.
BMC Geriatr ; 20(1): 347, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928151

RESUMO

BACKGROUND: Moving into a long-term care facility (LTCF) can reduce the ability for older adults to engage in meaningful roles and activities and the size of their social network. These changes and losses can lead them to experience existential loneliness (EL)-the intolerable emptiness and lack of meaningful existence resulted from the losses they have experienced. While EL has often been understood as a universal human experience, it has primarily been studied in people from Western cultures; little is known about how EL may be experienced by and manifested in people from Eastern cultures. Hence, this qualitative study aimed to describe the experience and coping of EL in Hong Kong Chinese and Swedish older adults living in LTCFs. METHODS: A qualitative study using Thorne's (2004) interpretive description was conducted. Thirteen Chinese and 9 Swedes living in LTCFs in Hong Kong, China and Malmo, Sweden, respectively were interviewed about their experience of EL in two series of semi-structured interviews. Data were analyzed using thematic analysis. RESULTS: The core theme of "overcoming EL" described the participants' experience of EL, which came about through the combined process of "Feeling EL" and "Self-Regulating". Both Chinese and Swedish participants had similar experience with EL. Realizing that they did not want to living with EL anymore, they coped by reframing their experience and identifying new meaning in their life. CONCLUSIONS: The study findings suggested that early and clear counselling support that help older adults to define new meaning in life may help them cope. In addition, more opportunities should be available at the LTCFs to promote quality relationships, enable older adults to reflect on their lives with pride, and support their ability to do the things they enjoy.


Assuntos
Envelhecimento/psicologia , Comparação Transcultural , Idoso Fragilizado/psicologia , Solidão/psicologia , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Hong Kong , Humanos , Vida Independente/psicologia , Entrevistas como Assunto , Assistência de Longa Duração , Masculino , Pesquisa Qualitativa , Qualidade de Vida , Suécia
11.
Am J Geriatr Psychiatry ; 28(11): 1175-1184, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32873496

RESUMO

OBJECTIVES: Social distancing under the COVID-19 pandemic has restricted access to community services for older adults with neurocognitive disorder (NCD) and their caregivers. Telehealth is a viable alternative to face-to-face service delivery. Telephone calls alone, however, may be insufficient. Here, we evaluated whether supplementary telehealth via video-conferencing platforms could bring additional benefits to care-recipient with NCD and their spousal caregivers at home. PARTICIPANTS: Sixty older adults NCD-and-caregiver dyads were recruited through an activity center. DESIGN, INTERVENTION: The impact of additional services delivered to both care-recipient and caregiver through video conference (n = 30) was compared with telehealth targeted at caregivers by telephone only (n = 30), over 4 weeks in a pretest-post-test design. Interviews and questionnaires were conducted at baseline and study's end. MEASUREMENTS, RESULTS: Supplementary telemedicine had averted the deterioration in the Montreal Cognitive Assessment evident in the telephone-only group (ηp2 = 0.50). It also reversed the falling trend in quality of life observed in the telephone only group (QoL-AD, ηp2 = 0.23). Varying degrees of improvements in physical and mental health (Short-Form 36 v2), perceived burden (Zarit Burden Interview Scale) and self-efficacy (Revised Caregiving Self-Efficacy Scale) were observed among caregivers in the video-conferencing group, which were absent in the telephone-only group (ηp2 = 0.23-0.51). CONCLUSION: Telemedicine by video conference was associated with improved resilience and wellbeing to both people with NCD and their caregivers at home. The benefits were visible already after 4 weeks and unmatched by telephone alone. Video conference as the modus operandi of telehmedicine beyond the context of pandemic-related social distancing should be considered.


Assuntos
Cuidadores/psicologia , Infecções por Coronavirus , Demência , Pandemias , Pneumonia Viral , Qualidade de Vida , Telemedicina/métodos , Comunicação por Videoconferência , Idoso , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Demência/epidemiologia , Demência/terapia , Demência/virologia , Feminino , Serviços de Assistência Domiciliar/tendências , Hong Kong/epidemiologia , Humanos , Vida Independente/psicologia , Masculino , Saúde Mental , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Fatores de Proteção
13.
Med Clin North Am ; 104(5): 791-806, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32773046

RESUMO

A large body of research has addressed the assessment and management of fall risk among community-dwelling older adults. Persons with dementia are at higher risk for falls and fall-related injuries, yet less is known about effective strategies for reducing falls and injuries among those with dementia. Falls and dementia are regularly considered to be discrete conditions and are often managed separately. Increasing evidence shows that these conditions frequently co-occur, and one may precede the other. This article explores the relationship between falls and dementia, including the importance of rehabilitation strategies for reducing fall risk in these individuals.


Assuntos
Acidentes por Quedas , Demência , Avaliação Geriátrica/métodos , Medição de Risco/métodos , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Causalidade , Demência/diagnóstico , Demência/epidemiologia , Humanos , Vida Independente/psicologia , Atenção Primária à Saúde/métodos
14.
Med Clin North Am ; 104(5): 909-917, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32773054

RESUMO

Advancing age is associated with increasing risk of activities important for independence, such as driving and living alone. Cognitive impairment is more common with older age; financial resources and social support may dwindle. Risk, cognitive impairment, and decisional capacity each change over time. Transparent decision making and harm reduction help balance risk and safety. When a patient lacks decisional capacity, an option that considers the patient's preferences and shows respect for the person is favored. Vulnerable patients making choices that are high risk, and patients for whom others are making such choices, may require state intervention.


Assuntos
Condução de Veículo , Disfunção Cognitiva , Vida Independente , Segurança , Populações Vulneráveis , Idoso , Condução de Veículo/legislação & jurisprudência , Condução de Veículo/psicologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Função Executiva , Humanos , Vida Independente/ética , Vida Independente/psicologia , Risco , Populações Vulneráveis/legislação & jurisprudência , Populações Vulneráveis/psicologia
15.
Am J Geriatr Psychiatry ; 28(11): 1185-1194, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32736918

RESUMO

OBJECTIVE: To describe the experiences and needs of caregivers of persons with dementia during the COVID-19 pandemic and lockdown in a city in India. DESIGN: Qualitative study using a telephonic semistructured interview. SETTING: A specialist geriatric outpatient mental health service based in a nongovernmental organization in Chennai, India. PARTICIPANTS: A purposive sampling of family members of persons with dementia registered in the database and seen within the previous 6 months. RESULTS: Thirty-one caregivers participated. Thematic analysis of the data showed two sets of issues that the caregivers of persons with dementia faced in their experiences during the pandemic. The first set was unique to the caregivers that directly related to their caregiving role, while the second set did not relate directly to their caregiving role. These two sets also appeared to have a two-way interaction influencing each other. These issues generated needs, some of which required immediate support while others required longer-term support. The caregivers suggested several methods, such as use of video-consultations, telephone-based support and clinic-based in-person visits to meet their needs. They also wanted more services postpandemic. CONCLUSION: Caregivers of persons with dementia had multiple needs during the pandemic. Supporting them during these times require a pragmatic multilayered approach. Systemic changes, policies and frameworks, increased awareness, use of technology, and better access to health are necessary.


Assuntos
Cuidadores/psicologia , Infecções por Coronavirus , Demência , Pandemias , Pneumonia Viral , Qualidade de Vida , Telemedicina/métodos , Comunicação por Videoconferência , Idoso , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Demência/epidemiologia , Demência/terapia , Demência/virologia , Feminino , Serviços de Assistência Domiciliar/tendências , Humanos , Vida Independente/psicologia , Índia/epidemiologia , Masculino , Saúde Mental , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Sistemas de Apoio Psicossocial
16.
BMC Public Health ; 20(1): 1294, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847576

RESUMO

BACKGROUND: Mild to moderate road traffic injury (RTI) in people of working age is associated with limited recovery. Less is known about RTI recovery in older age. This study explored the perspectives and factors associated with recovery and health-related quality of life following mild to moderate RTI in older age in New South Wales, Australia. METHODS: A qualitative study using content analysis was undertaken. Participants aged 65 or more years were purposively selected from a larger inception cohort study of health outcomes following mild to moderate RTI conducted in New South Wales, Australia. Semi-structured interviews were undertaken at approximately 12 or 24 months post-injury. Content analysis was used to code and analyse the data, with methodological rigour obtained by double-coding and discussing findings to reach consensus. Results were reported using the consolidated criteria for reporting qualitative research (COREQ). RESULTS: Nineteen participants were invited to participate in the study of which 12 completed interviews. Data saturation was reached at the twelfth interview. Recovery experiences were diverse. Five main themes were identified: recovery is regaining independence; injury and disability in older age; the burden of non-obvious disability; the importance of support; and positive personal approaches. Key facilitators of recovery were: regaining independence; support from family and friends; and positive personal approaches. Key barriers were: threats to independence; passive coping behaviours; non-obvious disabilities (chronic pain, psychological impacts); and reluctance to raise ongoing issues with General Practitioners. Threats to independence, especially not driving and self-care, appeared to have a more profound effect on recovery than physical functioning. CONCLUSION: Older people view injury as a threat to independent functioning. This is somewhat different to what younger people report. Regaining independence is key to older people's recovery and health-related quality of life following RTI, and should be a key consideration for health professionals, services and supports working with this unique cohort. Greater efforts to help older people regain their independence following RTI are needed and can be facilitated by health professionals and appropriate service provision. TRIAL REGISTRATION: Australia New Zealand clinical trial registry identification number ACTRN12613000889752 .


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Pessoas com Deficiência/psicologia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/reabilitação , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Vida Independente/psicologia , Masculino , New South Wales/epidemiologia , Pesquisa Qualitativa , Qualidade de Vida/psicologia
17.
J Cross Cult Gerontol ; 35(3): 237-254, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32725292

RESUMO

Psychosocial, socioeconomic and sociocultural aspects can influence cognitive function among community-dwelling older adults. Life-space restriction is potentially related to cognitive status. We examined the longitudinal association between life-space mobility and changes in cognitive function in community-dwelling older adults in different social settings of North and South America and Europe. We used data from 1486 participants of the International Mobility in Aging Study (IMIAS) conducted at five sites: Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston and Saint-Hyacinthe (Canada). Life-space mobility was assessed using the Life-Space Assessment (LSA) questionnaire at baseline (2012), and the Leganes Cognitive Test was used to evaluate cognitive function at baseline and follow-up (2016). The Quantile regressions (QR) were used to evaluate the factors associated with cognitive score in 2016 by adjusting for the cognitive score in 2012, with two distinct models for analyzing variables. A decrease in the cognitive function was observed at all research sites, except in Manizales. Participants with more restricted life-space at baseline had a decrease in their cognitive function 4 years later (ß = -0.79, 95% CI: -1.400 to -0.18, p value<0.01) compared to those with the highest level. This decrease was independent of gender, age, research site, education, income sufficiency, social support, depression, cognitive function at baseline, chronic conditions and physical performance. Restriction in life-space is an important prognostic factor for cognitive function. Maintaining life-space can be a goal in public policies aimed at encouraging healthy aging, and might be useful in clinical practice to promote health status and to monitor older people at higher risk of cognitive decline.


Assuntos
Disfunção Cognitiva/diagnóstico , Vida Independente/psicologia , Limitação da Mobilidade , Idoso , Albânia , Brasil , Canadá , Colômbia , Feminino , Avaliação Geriátrica/métodos , Humanos , Estudos Longitudinais , Masculino , Fatores de Risco , Fatores Sexuais , Apoio Social , Fatores Socioeconômicos
18.
Z Gerontol Geriatr ; 53(5): 382-388, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32647990

RESUMO

BACKGROUND: Even though the effects of cultural activities on active and positive ageing have been extensively examined, spatial aspects have hardly been considered by research in this field. OBJECTIVES: Instead of understanding active ageing as a result of cultural education, this article focuses on practices of (active) ageing in cultural education programs for older adults. We examined the meanings of space and spatial arrangements in which cultural education takes place and how these spatial aspects limit or enable active ageing. MATERIAL AND METHODS: The article is based on six qualitative case studies of programs for cultural education for older adults. In programs, such as a yodel seminar or a theater workshop, data were collated by participatory observation and qualitative interviews with the participants and trainers of each program. All data were analyzed using situational analysis. RESULTS: We found that the spaces where the programs took place had a special meaning to the older participants. This was mainly because these spaces where not exclusively designed for target groups of older adults. The experience of the program was not only characterized by these meanings but also by how these spaces were used within the program. Active ageing was realized through the appropriation of new spaces and specific spatial arrangements. CONCLUSION: This article shows how spatial arrangements and the experience of (active) ageing are intertwined. To foster active ageing, cultural education programs need to provide spaces which can be used accordingly. For environmental gerontology, this paper highlights the necessity to consider the symbolic dimension of spaces and environments in research.


Assuntos
Envelhecimento/psicologia , Educação/métodos , Meio Ambiente , Geriatria/educação , Vida Independente/psicologia , Comportamento Espacial , Humanos , Pesquisa Qualitativa , Meio Social
19.
Pain Physician ; 23(4): E389-E398, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32709185

RESUMO

BACKGROUND: Low back pain (LBP) ranks first for disability and sixth for overall burden on world health, with an annual approximate cost of $135 billion. There are limited data on the prevalence and risk factors for LBP in developing countries, such as India. OBJECTIVES: To assess the prevalence, pain intensity, and quality of life (QOL) associated with LBP in northern India. STUDY DESIGN: Cross-sectional study. SETTINGS: Northern states of India. METHODS: Adult population of different strata of the community were interviewed. Lifetime, point, 1-year, and age standardized lifetime prevalence with 95% confidence intervals (CI) and QOL, and pain intensity using the Numeric Rating Scale (NRS-11) were determined. Binary logistic regression test was conducted to determine the predictors of LBP prevalence; odds ratio (OR) with 95% CI are presented. Significance level was set at P <= 0.05. RESULTS: A total of 1,531 patients were interviewed of whom 48% were men and mean (standard deviation [SD]) age was 32 (10) years. Lifetime, point, 1-year, and age standardized lifetime prevalence (95% CI) were 57% (54%-59%), 32% (30%-34%), 48% (46%-51%), and 59% (56%-62%), respectively. Average (SD) NRS-11 was 4.2 (2.6). Significant impact of LBP on sleep (24%), depression/psychological problems (24%), and social life (28%) were observed. Women (OR, 2.23; 95% CI, 1.80-2.77; P < 0.05), walking/lifting activity (OR, 1.362; 95% CI, 1.097-1.692; P < 0.05), and increasing age (OR, 1.03; 95% CI, 1.02-1.04; P < 0.05) were most significant positive predictors of LBP. LIMITATIONS: The progression of LBP could not be assessed in the enrolled patients. CONCLUSIONS: LBP is highly prevalent in India, adversely affecting QOL in respondents. This calls for action by health officials to plan prevention, education, and management programs in the society. KEY WORDS: Low back pain, pain intensity, prevalence, incidence, quality of life.


Assuntos
Vida Independente/psicologia , Dor Lombar/epidemiologia , Dor Lombar/psicologia , Medição da Dor/psicologia , Vigilância da População , Qualidade de Vida/psicologia , Adolescente , Adulto , Idoso , Estudos Transversais , Pessoas com Deficiência/psicologia , Feminino , Humanos , Incidência , Índia/epidemiologia , Dor Lombar/diagnóstico , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Vigilância da População/métodos , Prevalência , Fatores de Risco , Sono/fisiologia , Adulto Jovem
20.
Psychol Trauma ; 12(S1): S220-S221, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32584105

RESUMO

Restrictions related to the 2019 novel coronavirus (COVID-19) pose unique and significant challenges for community-dwelling caregivers and people with dementia, including disrupted routines, a lack of structure, decreased access to respite care, and new or worsening safety issues related to interpersonal violence and hygiene. In addition to identifying issues confronting caregivers, the authors also describe possible ways to address some of these pressing concerns. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Cuidadores/psicologia , Infecções por Coronavirus , Demência/enfermagem , Demência/psicologia , Vida Independente/psicologia , Controle de Infecções , Pandemias , Pneumonia Viral , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Solidão/psicologia , Pessoa de Meia-Idade , Cuidados Intermitentes , Isolamento Social/psicologia
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