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1.
BMC Geriatr ; 22(1): 763, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127642

RESUMO

BACKGROUND: As older adults ≥80 years are often underrepresented in previous studies, little is known about their characteristics associated with the utilization of nursing care services. Therefore, this study examined individual (predisposing, enabling, and need) predictors of nursing care utilization in the very old population of North Rhine-Westphalia (NRW) in Germany. METHODS: Data from a representative cross-sectional study included 1531 community-dwelling individuals and nursing home residents aged ≥80 years. Multinomial regression was applied to investigate the factors that explain the use of outpatient care services, day care, and/or private care (odpNCU), and inpatient nursing care (inpNCU). RESULTS: Overall, 1083 (69.9%) participants did not use nursing care services (noNCU), 339 (21.9%) used outpatient, day, and/or private care, and 127 (8.2%) used inpatient nursing care. Compared to noNCU, odpNCU was associated with a higher likelihood of being older [odds ratio (OR) = 1.06, 95% confidence interval (CI): 1.01-1.11], having no partner (OR = 0.58, 95%CI: 0.37-0.91), experiencing higher functional (basic activities of daily living, OR = 0.02, 95%CI: 0.01-0.04; instrumental activities of daily living, OR = 0.18, 95%CI: 0.11-0.30) and cognitive disabilities (OR = 0.63, 95%CI: 0.44-0.89). Compared to noNCU, nursing home residents were more likely older (OR = 1.14, 95%CI: 1.07-1.22), had lower socioeconomic status (OR = 0.98, 95%CI: 0.97-1.00), were childless (OR = 3.83, 95%CI: 1.71-8.56) and without partners (OR = 0.43, 95%CI: 0.20-0.96), socially isolated (OR = 3.94, 95%CI: 2.06-7.55), were more likely to be lonely (OR = 2.94, 95%CI: 1.58-7.89), more functionally (basic activities of daily living, OR = 0.01, 95%CI: 0.00-0.03; instrumental activities of daily living, OR = 0.04, 95%CI: 0.02-0.09) and cognitively impaired (OR = 0.48, 95%CI: 0.31-0.74), but they were less likely to experience five or more chronic conditions (OR = 0.42, 95%CI: 0.20-0.88) and less likely to be physically pre-frail (OR = 0.24, 95%CI: 0.10-0.58) and frail (OR = 0.09, 95%CI: 0.03-0.27). CONCLUSIONS: Individual need factors dominated in explaining odpNCU, suggesting that the very old population in NRW may have equitable access to these services. As social structure, region, and social resources explain inpNCU, this type of care may be inequitably accessible.


Assuntos
Atividades Cotidianas , Casas de Saúde , Idoso , Estudos Transversais , Humanos , Vida Independente , Razão de Chances
2.
BMC Psychiatry ; 22(1): 620, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127652

RESUMO

BACKGROUND: Falls are a common occurrence in psychiatric hospital settings, however population-based research among individuals with psychiatric disorders, in particular bipolar disorder (BD) is scant. Thus, we aimed to investigate falls risk in community-dwelling women diagnosed with BD. METHODS: Women with BD (cases, n = 119) were recruited from health care settings located in southeast Victoria, Australia. Age-matched controls (n = 357, ratio 3:1) without BD were participants in the Geelong Osteoporosis Study drawn from the same geographical region. Lifetime history of BD was identified by semi-structured clinical interview (SCID-IV/NP). Previous 12-month falls data were obtained via questionnaire. Information on mobility, alcohol use, general health, medication use, blood pressure, body mass index, socioeconomic status and use of a walking aid was collected. Generalised Estimating Equations, binary and ordinal logistic regression were used to determine the odds ratio (OR) and 95% confidence interval (CI) for falls following adjustment for confounders. RESULTS: During the 12-month period, 34 (28.6%, median age 48.4 yr) cases and 70 (19.6%, median age 49.1 yr) controls reported one fall; 22 (18.5%) cases and 18 (5.0%) controls reported ≥ two falls (p < 0.001). Cases had 2.5-fold increased odds of at least one fall and 2.9-fold increased likelihood of increasing falls categories (0 vs. 1 vs. 2 +), compared to controls [adjOR 2.5, 95%CI (1.8, 3.4), adjOR OR 2.9, 95%CI (2.0, 4.1)]. CONCLUSION: Risk of falls was greater among women with BD. Balance training could be a research and clinical focus for falls prevention programs among women with bipolar disorder to prevent the detrimental outcomes associated with falling.


Assuntos
Acidentes por Quedas , Transtorno Bipolar , Estudos de Casos e Controles , Feminino , Humanos , Vida Independente , Pessoa de Meia-Idade , Fatores de Risco , Vitória
3.
BMC Geriatr ; 22(1): 765, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36131257

RESUMO

BACKGROUND: Identifying peripheral biomarkers related to modifiable risk factors to prevent dementia at an early stage will be extremely beneficial. We have been studying how older adults can maintain their mental health and continue to live in a familiar community. The aim of this study is to investigate the association between serum cortisol levels and brain volume among older adults in rural Japan. METHODS: This was a longitudinal study conducted in Kurokawa-cho, Imari, Saga Prefecture, Japan, among people aged 65 years and above, as reported previously. We conducted a survey twice. The first survey was conducted from October 2009 to March 2011 (Timepoint 1) and the second was conducted from November 2016 to September 2017 (Timepoint 2). Blood samples for serum cortisol levels analysis were collected from participants at Timepoint 1. Serum cortisol levels were measured using the enzyme-linked immunosorbent assay. The participants underwent brain MRI examinations, and Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) for cognitive function assessment at Timepoint 1 and Timepoint 2. We obtained 70 participants (16 men, mean age 72.69 ± 3.18 years; 54 women, mean age 72.69 ± 4.60 years, at Timepoint 1) for analysis. Correlation analysis was performed between serum cortisol levels at baseline (Timepoint 1) and brain volume (Timepoint 1, Timepoint 2, and Timepoint 1-Timepoint 2 difference) using voxel-based morphometry method. RESULTS: There was no significant difference in serum cortisol levels between men (72.32 ± 17.30 ng/ml) and women (76.60 ± 21.12 ng/ml) at baseline. Additionally, no effect of blood collection time on cortisol levels was observed in these participants. Small volume correction analysis at the cluster level by applying multiple comparison corrections (family-wise error; P < 0.05) showed a negative correlation between serum cortisol levels (Timepoint 1) and brain volume (Timepoint 2) within the region containing the left hippocampus. CONCLUSIONS: Serum cortisol levels may serve as a peripheral biomarker of age-related volume changes involving the hippocampus in older adults aged 65 years and above.


Assuntos
Hidrocortisona , Vida Independente , Idoso , Envelhecimento , Biomarcadores , Cognição , Feminino , Seguimentos , Hipocampo/diagnóstico por imagem , Humanos , Estudos Longitudinais , Masculino
4.
J Med Internet Res ; 24(9): e37618, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36069842

RESUMO

BACKGROUND: Pressure injury is a common complication after a spinal cord injury. Long-term multidisciplinary follow-up is difficult after such patients have been discharged. Telemedicine promises to provide convenient and effective support for the prevention and treatment of pressure injury, but previous attempts to demonstrate that have produced inconsistent results. OBJECTIVE: The aim of this study is to evaluate the effectiveness of telemedicine in preventing and treating pressure injury among community-dwelling patients with spinal cord injury, and determine which telemedicine form is more effective. METHODS: This systematic review was performed according to the PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Network Meta-Analysis) standards. Ten databases were searched to identify randomized controlled trials and quasi-experimental studies related to the effectiveness of telemedicine intervention in patients with spinal cord injury. Two researchers worked independently and blindly selected studies, extracted data, and assessed the risk of bias. The results were described as relative risk (RR) and weighted mean difference and 95% CI. RESULTS: The 35 studies comprised 25 randomized controlled trials and 10 quasi-experimental studies involving 3131 patients. The results showed that telemedicine can significantly (P<.05) reduce the incidence of pressure injury (RR 0.24, 95% CI 0.14-0.41; P<.05; I2=0%), promote faster healing (RR 0.73, 95% CI 0.62-0.85; P<.05; I2=0%), and yield lower scores on the pressure ulcer scale of healing (weighted mean difference=-1.98, 95% CI -3.51 to -0.46; P<.05; I2=0%). Cumulative ranking estimates showed that combining telemedicine with conventional intervention (93.5%) was the most effective approach. CONCLUSIONS: Telemedicine is a feasible way to prevent pressure injury among patients with spinal cord injuries. It can decrease the incidence and severity of pressure injury and accelerate patients' healing without imposing economic burden. It is best used in tandem with other, more conventional interventions. Due to the limited quality and quantity of included studies, large-scale and well-designed randomized controlled trials are warranted.


Assuntos
Lesão por Pressão , Traumatismos da Medula Espinal , Telemedicina , Humanos , Incidência , Vida Independente , Lesão por Pressão/etiologia , Lesão por Pressão/prevenção & controle , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/terapia
5.
Front Public Health ; 10: 923767, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36111197

RESUMO

Objective: Maintaining and delaying a decline in physical function in older adults is critical for healthy aging. This study aimed to explore trajectories, critical points of the trajectory changes, and predictors among older people in the Chinese community. Design: This study was one with a longitudinal design performed in China. Setting and participants: The target population was community-dwelling older adults aged over 65 years. A total of 2,503 older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included in this study. Methods: Physical functioning was measured by instrumental activities of daily living (IADL). Population-based trajectory models were used to identify potential heterogeneity in longitudinal changes over 12 years and to investigate associations between baseline predictors and different trajectories for different cohort members using LASSO regression and logistic regression. Results: Four trajectories of physical function were identified: slow decline (33.0%), poor function and moderate decline (8.1%), rapid decline (23.5%), and stable function (35.4%). Older age, male sex, worse self-reported health status, worse vision status, more chronic diseases, worse cognitive function, and a decreased frequency of leisure activity influenced changes in the trajectory of physical function. Having fewer teeth, stronger depressive symptoms, a lack of exercise, and reduced hearing may increase the rate of decline. Conclusion and implications: Four trajectories of physical function were identified in the Chinese elderly population. Early prevention or intervention of the determinants of these trajectories can maintain or delay the rate of decline in physical function and improve healthy aging.


Assuntos
Atividades Cotidianas , Vida Independente , Idoso , China/epidemiologia , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino
6.
BMC Geriatr ; 22(1): 744, 2022 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-36096746

RESUMO

BACKGROUND: Aging societies are a public health concern worldwide. It is critical to develop strategies that harness technology to enhance older adults' mastery, achievement motives, self-esteem, isolation and depression effectively. METHODS: This study aimed to explore the effects of a combination of three-dimensional virtual reality (VR) and hands-on horticultural activities on the psychological well-being of community-dwelling older adults. We used a quasi-experimental design. A total of 62 community-dwelling older adults were recruited and assigned to the experimental (n = 32) and comparison groups (n = 30). The members of the experimental group participated in an 8-week intervention program. Participants of both groups completed before-and-after intervention measurements for outcome variables that included perceived self-esteem, depression, isolation, and mastery and achievement motives, which were analyzed using the generalized estimating equation (GEE). A baseline score of depression was used as an adjustment for the GEE analyses to eliminate the effects of depression on outcomes. RESULTS: After controlling age and gender as confounders, GEE analyses indicated that the experimental group showed significant post-intervention improvements in scores for self-esteem (ß = 2.18, P = .005) and mastery (ß = 1.23, P = .039), compared to the control group. CONCLUSIONS: This study supported a combination of three-dimensional VR and hands-on horticultural activities on community-dwelling older adults to improve self-esteem and mastery. The findings suggest that the future implementation of a similar program would be feasible and beneficial to community-dwelling older adults. TRIAL REGISTRATION: The study was posted on www. CLINICALTRIALS: gov (NCT05087654) on 21/10/2021. It was approved by the Institutional Review Board of En Chu Kong Hospital and performed in accordance with the Declaration of Helsinki.


Assuntos
Depressão , Realidade Virtual , Idoso , Envelhecimento/psicologia , Depressão/psicologia , Depressão/terapia , Humanos , Vida Independente/psicologia , Autoimagem
7.
BMC Geriatr ; 22(1): 751, 2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-36104775

RESUMO

BACKGROUND: Voice assistants enable older adults to communicate regarding their health as well as facilitate ageing in place. This study investigated the effects of communication style, anthropomorphic setting, and individual differences on the trust, acceptance, and mental workload of older adults using a voice assistant when communicating health issues. METHODS: This is a mixed-methods study utilising both quantitative and qualitative methods. One hundred and six older adults (M = 71.8 years, SD = 4.6 years) participated in a 2 (communication style: social- vs. task-oriented; between-subject)[Formula: see text] 2 (anthropomorphic setting: ordinary profession vs. medical background; within-subject) mixed design experiment. The study used multivariate analysis of variance (MANOVA) to examine the effects of communication style, anthropomorphic setting of the voice assistant, and participants' use frequency of digital devices on the trust, technology acceptance, and mental workload of older adults using a voice assistant in a health context. End-of-study interviews regarding voice assistant use were conducted with participants. Qualitative content analyses were used to assess the interview findings about the communication content, the more trustworthy anthropomorphic setting, and suggestions for the voice assistant. RESULTS: Communication style, anthropomorphic setting, and individual differences all had statistically significant effects on older adults' evaluations of the voice assistant. Compared with a task-oriented voice assistant, older adults preferred a social-oriented voice assistant in terms of trust in ability, integrity, and technology acceptance. Older adults also had better evaluations for a voice assistant with a medical background in terms of trust in ability, integrity, technology acceptance, and mental workload. In addition, older adults with more experience using digital products provided more positive evaluations in terms of trust in ability, integrity, and technology acceptance. CONCLUSIONS: This study suggests that when designing a voice assistant for older adults in the health context, using a social-oriented communication style and providing an anthropomorphic setting in which the voice assistant has a medical background are effective ways to improve the trust and acceptance of older adults of voice assistants in an internet-of-things environment.


Assuntos
Vida Independente , Individualidade , Idoso , Comunicação , Humanos , Tecnologia , Confiança
8.
Res Gerontol Nurs ; 15(5): 229-237, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36113009

RESUMO

The current randomized controlled trial investigated the effect of a robotic pet on social and physical frailty in community-dwelling older adults. The intervention group (n = 107) received a robotic pet and the control group (n = 113) received usual care following hospital discharge. Social and physical frailty were measured using the Questionnaire to Define Social Frailty Status and the FRAIL questionnaire. Cognitive function and depression were assessed using the Short Portable Mental Status Questionnaire and Geriatric Depression Scale, respectively. Continuous outcomes were compared between groups using t tests or Wilcoxon rank sum tests, as appropriate. Categorical outcomes were compared between groups using chi-square tests or Fisher's exact tests, as appropriate. Main findings showed the robotic pet positively impacted cognitive status in participants who reported they enjoyed engaging with their pet. This finding supported the theoretical premise of the current study that greater engagement with the robotic pet would yield greater improvement in study outcomes. [Research in Gerontological Nursing, 15(5), 229-237.].


Assuntos
Fragilidade , Procedimentos Cirúrgicos Robóticos , Idoso , Idoso Fragilizado/psicologia , Fragilidade/psicologia , Avaliação Geriátrica , Humanos , Vida Independente/psicologia
9.
BMC Prim Care ; 23(1): 237, 2022 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-36114459

RESUMO

BACKGROUND: Medication treatment can reduce morbidity but can also cause drug-related problems (DRPs). One method to identify and solve DRPs is medication reviews (MRs) that are aimed at increased patient safety and quality in drug treatment. In Skåne county, Sweden, a well-established multi-professional model for MRs in nursing homes is practiced. However, a demand for MRs regarding community-dwelling patients has emerged. These patients may be extra vulnerable since they have less supervision from healthcare personnel. AIM: To describe the community-dwelling patients in primary healthcare considered in need of an MR, as well as the outcomes of these pharmacist-led MRs. METHODS: Personnel from 14 primary healthcare centers selected patients for the MRs. Based on electronic medical records, the symptom assessment tool PHASE-20 (PHArmacotherapeutical Symptom Evaluation 20 questions) and medication lists, pharmacists conducted MRs and communicated adjustment suggestions via the medical record to the general practitioners (GPs). RESULTS: A total of 109 patients were included in the study and 90.8% (n = 99) of the patients were exposed to at least one DRP, with an average of 3.9 DRPs per patient. Patients with impaired renal function (glomerular filtration rate, GFR < 45 ml/min) or ≥ 10 medications were exposed to a significantly higher number of DRPs per patient, 5.1 DRP and 5.3 respectively. The most frequent DRP-categories were Unnecessary drug therapy and Adverse drug reaction, which represented 23.0% respectively 22.9% of the total amount of DRPs. CONCLUSIONS: Our results indicate a prioritized need for MRs for community-dwelling patients, specifically with impaired renal function or polypharmacy.


Assuntos
Clínicos Gerais , Farmacêuticos , Adulto , Humanos , Vida Independente , Revisão de Medicamentos , Atenção Primária à Saúde
10.
BMC Public Health ; 22(1): 1702, 2022 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-36076194

RESUMO

BACKGROUND: Sarcopenia is associated with age-related loss of muscle mass and function and is becoming prevalent in the older Chinese population. This systematic review aims to obtain a reliable estimation of the prevalence of sarcopenia among community-dwelling Chinese populations aged 65 years and older and to characterize its epidemiology. METHODS: A literature search was performed in the Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and CQVIP databases up to September 31, 2021. All studies that reported the prevalence of sarcopenia in Chinese community-dwelling older adults were included, and Hoy et al.'s tool was used to assess the risk of bias. The overall prevalence of sarcopenia will be calculated as the primary outcome, and subgroup analyses will be performed by study year, age, sex, muscle mass assessment method, diagnostic criteria and area. RESULTS: A total of 26 studies were included in this study, which involved 25,921 subjects, and 3597 had sarcopenia. Although significant heterogeneity between studies was reported, no statistically significant publication bias was detected. The overall prevalence of sarcopenia in community-dwelling older adults aged over 65 years in the Chinese population was 17.4% (95% CI: 14.6%-20.2%). Subgroup analysis based on study year, age and sex, muscle mass assessment method, diagnostic criteria, region and area showed that the prevalence of sarcopenia was different in each subgroup. IMPLICATIONS: The prevalence of sarcopenia in Chinese community-dwelling older adults was higher than that in previous studies. As a multidimensional survey of the prevalence of sarcopenia in older adults, this meta-analysis provides data support for the targeted management of sarcopenia among Chinese older adults.


Assuntos
Sarcopenia , Idoso , China/epidemiologia , Humanos , Vida Independente , Prevalência , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Inquéritos e Questionários
11.
BMC Geriatr ; 22(1): 762, 2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36123606

RESUMO

BACKGROUND: Frailty is a geriatric syndrome associated with disability and negative health outcome. To determine the factors associated with frailty and functional disability in older participants living in community in France. We included 753 community-dwelling old participants with available frailty data at baseline. RESULTS: Overall, 31.9% were frail, 58.3% were prefrail, and 9.8% were robust. The SMAF (French acronym for Functional Autonomy Measurement System) score was significantly lower (mean ± standard deviation: -25.8 ± 11.2) in frail participants compared to prefrail (-14.3 ± 9.7) or robust participants (-8.1 ± 7.0); 82% of frail older participants had limitation in at least one ADL and 97.5% in at least one IADL compared to 54.2 and 76.8%, respectively of pre-frail and 29.7 and 47.3% of robust participants. Age, depression, impaired cognition and diabetes were significantly associated with higher odds of frailty. These variables were also strongly associated with functional disability. Female gender, polypharmacy, and smoking were additional variables significantly associated with degraded SMAF and/or ADL/IADL. CONCLUSIONS: This study showed that functional disability increased proportionally to frailty, and depression, cognitive decline and diabetes are modifiable risk factors significantly associated with frailty and functional disability.


Assuntos
Fragilidade , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Idoso Fragilizado/psicologia , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Liberdade , Avaliação Geriátrica , Humanos , Vida Independente , Fatores de Risco
12.
Geriatr Gerontol Int ; 22(9): 766-772, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36058627

RESUMO

AIM: This study aimed to examine the relationship between oral health and social activity, and explore the mediating effect of depressive symptoms on the relationship between oral health and social activity among community-dwelling older adults in Korea. METHODS: A total of 5033 community-dwelling older adults aged ≥65 years were included in the analysis. Data were obtained from the seventh wave (2018) of the Korean Longitudinal Study of Aging. Descriptive statistics, Pearson's correlation analysis and path analysis for mediation analysis were used. RESULTS: Path analysis showed that older adults with better oral health had more social activities (ß = 0.177, P < 0.001) and fewer depressive symptoms (ß = -0.174, P < 0.001). Depressive symptoms had a mediating role partially in the relationship between oral health and social activity (ß = 0.014, P < 0.001). The results of in-depth exploration using oral health subdomains showed that physical oral function and oral pain or discomfort were directly related to the social activity (ß = 0.083 and ß = 0.149, respectively) and indirectly mediated by depressive symptoms (ß = 0.006 and ß = 0.004, respectively). However, psychosocial oral function only had an indirect effect on social activity mediated by depressive symptoms (ß = 0.006, P = 0.005). CONCLUSIONS: Better oral health had a significant association with higher levels of social activities, which was partially mediated by decreased depressive symptoms. It is necessary to pay more attention to oral health promotion for older adults to decrease depressive symptoms and increase participation in social activities. Geriatr Gerontol Int 2022; 22: 766-772.


Assuntos
Depressão , Vida Independente , Idoso , Depressão/epidemiologia , Depressão/psicologia , Humanos , Vida Independente/psicologia , Estudos Longitudinais , Saúde Bucal , República da Coreia/epidemiologia
13.
Geriatr Gerontol Int ; 22(9): 753-758, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36058629

RESUMO

AIM: To investigate the association of the Japan Science and Technology Agency Index of Competence with physical and cognitive functions in community-dwelling older adults. METHODS: This study used the data of 565 community-dwelling adults aged ≥65 years (mean age: 74.3 ± 5.2 years) from the Kasama Health Checkup for Longevity survey in Japan. The Japan Science and Technology Agency Index of Competence was used to comprehensively evaluate the higher-level functional capacity and subscale functional capacity: technology usage, information practice, life management and social engagement. Physical functions were assessed using grip strength, the five-repetition sit-to-stand test, 5-m habitual walking test, one-leg standing test and hand working test with a pegboard. Cognitive functions were evaluated using the Five-Cog test consisting of attention, memory ability, visuospatial function, language ability and reasoning ability. Multiple regression analysis was conducted to examine the associations between total Japan Science and Technology Agency Index of Competence score and physical and cognitive functions. RESULTS: After adjusting for potential confounders, the total Japan Science and Technology Agency Index of Competence score was favorably associated with static balance ability (ß = 0.09; B = 0.01; 95% confidence interval: 0.00-0.02), lower limb strength (ß = -0.19; B = -0.29; 95% confidence interval: -0.41 to -0.16), walking ability (ß = -0.15; B = -0.67; 95% confidence interval: -1.05 to -0.30), hand dexterity (ß = -0.13; B = -0.08; 95% confidence interval: -0.14 to -0.03) and overall cognitive function (ß = 0.28; B = 0.04; 95% confidence interval: 0.03-0.05). CONCLUSIONS: Physical and cognitive functions are important for maintaining higher-level functional capacity. Geriatr Gerontol Int 2022; 22: 753-758.


Assuntos
Cognição , Vida Independente , Idoso , Humanos , Vida Independente/psicologia , Japão , Exame Físico , Tecnologia
14.
Nihon Ronen Igakkai Zasshi ; 59(3): 275-283, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-36070899

RESUMO

In Japan, the ageing population is increasing, and the issue of "the declining birthrate and increasing ageing population", "population declining", and "extending healthy life expectancy" have been taken up in various academic fields, but they are still unsolved in the term of effective methods. Currently, in each region of Japan unlike big cities such as Tokyo and Osaka, there is the shortage of medical doctors, hospitals, living supportive infrastructure of roads, communications, public transportation, banks, post offices, and supermarkets, etc. All the necessary infrastructure is collapsing, and the current situation is becoming apparent in population declining villages of Japan. Will our country become more concentrated in big cities in the future? In particular, it is the elderly living in the community who are directly affected by these factors. In this article, we would like to introduce the history and recent activities of "Age-friendly cities and communities (AFCC)" led by the World Health Organization (WHO), and also introduce the efforts of "The Ageing in Place in Cities" project by Manchester Urban Ageing Research Group, the University of Manchester, UK, Akita City Hall, and Advanced Research Center for Geriatric and Gerontology (ARGG), Akita University, Japan.


Assuntos
Geriatria , Vida Independente , Idoso , Envelhecimento , Cidades , Humanos , Japão , Reino Unido , Universidades
15.
Nihon Ronen Igakkai Zasshi ; 59(3): 331-338, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-36070907

RESUMO

AIM: To determine the relationship between performance on the Digital Trail Making Peg test (DTMP) and cognitive function in older adults. METHODS: A total of 203 community-dwelling older adults (mean age: 76.4±5.1 years old) participated in this study. The five-cog test was used to assess the cognitive function. The DTMP measured completion time, number of errors and intra-individual variability for performance variability (coefficient of variation, CV; inter-elemental variability, IEV). Spearman's rank correlation coefficient (ρ) was calculated to examine the association between each variable. In addition, a multiple regression analysis was performed with the cognitive function score as the dependent variable and the DTMP completion time, number of errors, CV, and IEV as the independent variables, with adjusting for the sex, age, years of education, body mass index, medical history, depression, and physical function. RESULTS: The rank correlation coefficients with cognitive function scores were as follows: completion time, ρ = -0.479 (P < 0.01), number of errors, ρ = -0.068 (P = 0.332), CV, ρ = 0.085 (P = 0.225), IEV, ρ = -0.316 (P < 0.01). The results of the multiple regression analysis showed that completion time (ß = -0.566), CV (ß = 0.164), IEV (ß = 2.736) were significantly associated with cognitive function scores. CONCLUSIONS: The shorter the DTMP completion time, the better the overall cognitive function. However, the intra-individual variability of CV and IEV did not show consistent results, with smaller values indicating less intra-individual variability.


Assuntos
Transtornos Cognitivos , Timidina Monofosfato , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Cognição , Humanos , Vida Independente
16.
Stud Health Technol Inform ; 297: 93-100, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36073383

RESUMO

The "aging" world implies a rethinking of housing models, to meet the needs of the elderly for physical and mental well-being, independence, social interaction, safety, and accessibility. "Aging in place" is recognized by experts and international literature as a fundamental strategy for maintaining conditions of well-being and reducing public spending on health care. However, often the houses do not have the requirements to easily adapt to the needs that change with aging and possible downsizing of the family unit. For the elderly, maintaining their own home can become unsustainable due to problems of costs, oversizing, physical and perceptual accessibility, and safety. The contribution, taking as a case study the residential building heritage of Turin (Italy), illustrates and critically compares scenarios of adaptive recovery of homes to make them suitable for the needs of the elderly, intending to promote "aging in place" and housing adaptive refurbishment as a sustainable strategy.


Assuntos
Envelhecimento , Vida Independente , Idoso , Instalações de Saúde , Habitação , Humanos , Saúde Mental
17.
Age Ageing ; 51(9)2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36074716

RESUMO

BACKGROUND: Motor and gait disturbances are evident in early Alzheimer and non-Alzheimer dementias and may predict the likelihood of mild cognitive impairment (MCI) or progression to dementia. OBJECTIVE: We investigated the Timed-Up-and-Go (TUG) measure of functional mobility in predicting cognitive decline and incident MCI or early dementia (MCI-dementia). DESIGN: Prospective cohort study with 4.5 years follow-up. SETTING: Population based. PARTICIPANTS: 2,544 community-dwelling older adults aged 55+ years. METHODS: Participants with baseline data on TUG, fast gait speed (GS), knee extension strength (KES) and performance-oriented mobility assessment (POMA) gait and balance were followed up for cognitive decline (Mini-Mental State Exam; MMSE drop of ≥2, among 1,336 dementia-free participants) and incident MCI-dementia (among 1,208 cognitively normal participants). Odds ratio (OR) and 95% confidence intervals (95% CI) were adjusted for age, sex, education, smoking, physical, social and productive activity, multi-morbidity, metabolic syndrome and MMSE. RESULTS: Per standard deviation increase in TUG, POMA, GS and KES were significantly associated with incident MCI-dementia: TUG (OR = 2.84, 95% CI = 2.02-3.99), GS (OR = 2.17, 95% CI = 1.62-2.91), POMA (OR = 1.88, 95% CI = 1.22-2.92) and KES (OR = 1.52, 95% CI = 1.15-2.02). Adjusted OR remained significant only for TUG (OR = 1.52, 95% CI = 1.01-2.31) and GS (OR = 1.53, 95% CI = 1.08-2.16). Areas under the curve (AUC) for TUG (AUC = 0.729, 95% CI = 0.671-0.787) were significantly greater than GS (AUC = 0.683, 95% CI = 0.619-0.746), KES (AUC = 0.624, 95% CI = 0.558-0.689) and POMA (AUC = 0.561, 95% CI = 0.485-0.637). Similar associations with cognitive decline were significant though less pronounced, and adjusted ORs remained significant for TUG, GS and POMA. CONCLUSION: Functional mobility decline precedes incident MCI and early dementia. The TUG appears to be especially accurate in predicting the future risks of adverse cognitive outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT03405675. Registered 23 January 2018 (retrospectively registered).


Assuntos
Disfunção Cognitiva , Vida Independente , Idoso , Envelhecimento , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Humanos , Estudos Prospectivos , Singapura/epidemiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-36078847

RESUMO

The accelerated growth of elderly populations in many countries and regions worldwide is creating a major burden to the healthcare system. Intelligent approaches for continuous health monitoring have the potential to promote the transition to more proactive and affordable healthcare. Electrocardiograms (ECGs), collected from portable devices, with noninvasive and cost-effective merits, have been widely used to monitor various health conditions. However, the dynamic and heterogeneous pattern of ECG signals makes relevant feature construction and predictive model development a challenging task. In this study, we aim to develop an integrated approach for one-day-forward wellness prediction in the community-dwelling elderly using single-lead short ECG signal data via multiple-features construction and predictive model implementation. Vital signs data from the elderly were collected via station-based equipment on a daily basis. After data preprocessing, a set of features were constructed from ECG signals based on the integration of various models, including time and frequency domain analysis, a wavelet transform-based model, ensemble empirical mode decomposition (EEMD), and the refined composite multiscale sample entropy (RCMSE) model. Then, a machine learning based predictive model was established to map the l-day lagged features to wellness condition. The results showed that the approach developed in this study achieved the best performance for wellness prediction in the community-dwelling elderly. In practice, the proposed approach could be useful in the timely identification of elderly people who might have health risks, and could facilitating decision-making to take appropriate interventions.


Assuntos
Algoritmos , Vida Independente , Idoso , Eletrocardiografia/métodos , Humanos , Aprendizado de Máquina , Análise de Ondaletas
19.
Nutrients ; 14(17)2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36079764

RESUMO

BACKGROUND: Gastrointestinal symptoms have been reported to occur frequently in diabetes, but their prevalence in Chinese community-dwelling individuals with diabetes is unknown. The present study aimed to address this issue and explore the risk factors for gastrointestinal symptoms. METHODS: A total of 1304 community-dwelling participants (214 with diabetes, 360 with prediabetes and 730 with normoglycemia) were surveyed for gastrointestinal symptoms using the Diabetes Bowel Symptom Questionnaire. Logistic regression analyses were applied to identify risk factors for gastrointestinal symptoms. RESULTS: Of the overall study population, 18.6% reported at least one gastrointestinal symptom, without a significant difference between subjects with normoglycemia (17.7%), prediabetes (19.7%) and diabetes (20.1%). In all three groups, lower gastrointestinal symptoms, particularly diarrhea and constipation, were the most frequent. There was an interaction between age (≥65 years) and diabetes on the prevalence of at least one gastrointestinal symptom (p = 0.01) and of constipation (p = 0.004), with these being most frequent in subjects with diabetes aged ≥ 65 years. After multivariable adjustment, female gender and older age were associated with increased odds of at least one gastrointestinal symptom, specifically lower gastrointestinal symptoms. Older age was also associated with an increase in upper gastrointestinal symptoms. CONCLUSIONS: Gastrointestinal symptoms are common in Chinese community-dwelling adults with and without diabetes. Females, and the elderly with diabetes, are at an increased risk of symptoms.


Assuntos
Diabetes Mellitus , Gastroenteropatias , Estado Pré-Diabético , Adulto , Idoso , China/epidemiologia , Constipação Intestinal/etiologia , Diabetes Mellitus/epidemiologia , Feminino , Gastroenteropatias/diagnóstico , Humanos , Vida Independente , Estado Pré-Diabético/complicações , Prevalência
20.
Nutrients ; 14(17)2022 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-36079802

RESUMO

BACKGROUND: Sarcopenia is a major cause of frailty, which relates to nutrition-related, physical, and social factors. In this study, we aimed to discuss the cross-sectional association of sarcopenia with the above three factors both individually and comprehensively. METHODS: Overall, 1257 older adults (≥65 years old) participated in this study. Sarcopenia was determined via the Asian Working Group for Sarcopenia 2019 criteria. The independent variables for nutrition-related, physical, and social factors and especially their criteria for health condition were defined separately. Binomial logistic regression analysis was carried out to testify the associations of sarcopenia with three factors individually and in combination. RESULTS: The mean age was 74.6 (±5.5), and women were 47.7%. Sarcopenia prevalence was 7.5%. Participants who did not meet the criteria of nutritional health, physical fitness, or social robustness independently had significant associations with a higher adjusted odds ratio (aOR) of sarcopenia or its indices of lower grip strength, muscle mass, or gait speed. In comparison to participants meeting three criteria, those who met two, one, or none showed (marginally) significant association with increased aOR for sarcopenia (aOR (95% confidence interval)): two: 1.97 (0.84-4.64); one: 2.35 (1.00-5.23); none: 5.52 (2.30-13.23). CONCLUSIONS: Comprehensive countermeasures with the above three factors are indispensable for sarcopenia prevention.


Assuntos
Sarcopenia , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Avaliação Geriátrica , Força da Mão/fisiologia , Humanos , Vida Independente , Sarcopenia/epidemiologia , Fatores Sociais
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