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Sample records for community-dwelling elderly women

  1. Factors that affect the quality of life of community-dwelling elderly women with musculoskeletal disorders.

    Science.gov (United States)

    Takemasa, Seiichi; Nakagoshi, Ryoma; Uesugi, Masayuki; Inoue, Yuri; Gotou, Makoto; Koeda, Hideki; Naruse, Susumu

    2015-11-01

    [Purpose] This study aimed to examine the quality of life (QOL) of community-dwelling elderly women with musculoskeletal disorders and factors that affect it. [Subjects] The subjects were 27 community-dwelling elderly women with musculoskeletal disorders (mean age: 76.3 ± 7.4 years). Their physical and psychological conditions, QOL, and other characteristics were researched. [Methods] The Japanese version of Life-Space Assessment was used to assess the subjects' daily life activities; the Japanese version of Fall Efficacy Scale (FES), to assess their fear of falling; the Geriatric Depression Scale (GDS 15), to assess their depression status; and the Life Satisfaction Index K (LSIK), to assess their QOL. [Results] The results indicated that the number of family members living together, degree of pain, fear of falling, and depression affect the LSIK scores of the community-dwelling elderly women with musculoskeletal disorders. [Conclusion] The study results suggest that the LSIK scores of community-dwelling elderly women with musculoskeletal disorders can be improved by easing their pain, improving their physical abilities to prevent falls, and improving their mobility. The results also suggest that continuing rehabilitation treatment is required.

  2. Efficacy of Biofeedback Therapy in the Treatment of Dyssynergic Defecation in Community-Dwelling Elderly Women.

    Science.gov (United States)

    Simón, Miguel A; Bueno, Ana M

    The aim of this study was to evaluate the efficacy of biofeedback therapy in the treatment of dyssynergic defecation in chronically constipated community-dwelling elderly women. After an initial assessment phase carried out during 1 month, 20 chronically constipated women with dyssynergic defecation were randomly assigned to either electromyographic biofeedback (EMG-BF) group (n=10) or control group (n=10). Outcome measures used to evaluate the efficacy of treatment were weekly stool frequency, sensation of incomplete evacuation, difficulty evacuation level, mean EMG-activity (μV) of the external anal sphincter during straining to defecate and Anismus index. The results obtained in this randomized controlled trial showed significant differences between the groups in all the dependent variables after 1 month of treatment. Moreover, there was no difference between the groups neither in age nor in the duration of chronic constipation symptoms. At the follow-up, 3 months later, clinical gains were maintained. This study demonstrates that the EMG-BF is an effective behavioral therapy for the treatment of dyssynergic defecation in community-dwelling elderly women.

  3. Vitamin D and calcium supplementation prevents severe falls in elderly community-dwelling women

    DEFF Research Database (Denmark)

    Larsen, Erik Roj; Mosekilde, Leif; Foldspang, Anders

    2005-01-01

    Background and aims: We evaluated the effect of two programs for the prevention of falls leading to acute hospital admission in a population of elderly community-dwelling Danish residents. Methods: This was a factorial, pragmatic, intervention study. We included 9605 community-dwelling city......, or no intervention. Results: The Calcium and Vitamin D program was followed by 50.3% and the Environmental and Health Program by 46.4%. According to a multivariate analysis including age, marital status and intervention program, female residents who followed the Calcium and Vitamin D Program had a 12% risk reduction...... in severe falls (RR 0.88; 95% CI 0.79-0.98; pfalls leading to acute hospitalization in community-dwelling elderly females in a northern European region known to be deficient in vitamin D....

  4. Increased gait unsteadiness in community-dwelling elderly fallers

    Science.gov (United States)

    Hausdorff, J. M.; Edelberg, H. K.; Mitchell, S. L.; Goldberger, A. L.; Wei, J. Y.

    1997-01-01

    OBJECTIVE: To test the hypothesis that quantitative measures of gait unsteadiness are increased in community-dwelling elderly fallers. STUDY DESIGN: Retrospective, case-control study. SETTING: General community. PARTICIPANTS: Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9 yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0 yrs; n = 17) based on history; 22 young (age, 24.6 +/- 1.9 yrs), healthy subjects also participated as a second reference group. MAIN OUTCOME MEASURES: Stride-to-stride variability (standard deviation and coefficient of variation) of stride time, stance time, swing time, and percent stance time measured during a 6-minute walk. RESULTS: All measures of gait variability were significantly greater in the elderly fallers compared with both the elderly nonfallers and the young subjects (p elderly fallers was similar to that of the nonfallers. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects. CONCLUSIONS: Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increased in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly.

  5. Poor correlation between handgrip strength and isokinetic performance of knee flexor and extensor muscles in community-dwelling elderly women.

    Science.gov (United States)

    Felicio, Diogo Carvalho; Pereira, Daniele Sirineu; Assumpção, Alexandra Miranda; de Jesus-Moraleida, Fabianna Resende; de Queiroz, Barbara Zille; da Silva, Juscelio Pereira; de Brito Rosa, Naysa Maciel; Dias, João Marcos Domingues; Pereira, Leani Souza Máximo

    2014-01-01

    To investigate the correlation between handgrip strength and performance of knee flexor and extensor muscles determined using an isokinetic dynamometer in community-dwelling elderly women. This was a cross-sectional study. Sample selection for the study was made by convenience, and 221 (71.07 ± 4.93 years) community-dwelling elderly women were included. Knee flexor and extensor muscle performance was measured using an isokinetic dynamometer Biodex System 3 Pro. The isokinetic variables chosen for analysis were peak torque, peak torque/bodyweight, total work/bodyweight, total work, average power, and agonist/antagonist ratio at the angular velocities of 60°/s and 180°/s. Assessment of handgrip strength was carried out using the Jamar dynamometer. Spearman's correlation coefficient was calculated to identify intervariable correlations. Only knee flexor peak torque (60°/s) and average power (60°/s), and knee extensor peak torque (180°/s) and total work (180°/s) were significantly (P women. © 2013 Japan Geriatrics Society.

  6. Serum 25-hydroxyvitamin D level and risk of falls in Japanese community-dwelling elderly women: a 1-year follow-up study.

    Science.gov (United States)

    Shimizu, Y; Kim, H; Yoshida, H; Shimada, H; Suzuki, T

    2015-08-01

    The present prospective follow-up study among 1,393 community-dwelling elderly women aged 75 years or older was conducted to clarify the association between serum 25-hydroxyvitamin D (25(OH)D) level and risk of falls. Lower serum 25(OH)D, particularly level risk of falls. Serum 25(OH)D level has been revealed to be important factor not only for skeletal health but also for fall prevention among the elderly. Our previous cross-sectional study indicated that low serum 25(OH)D level is associated with inferior physical performance and falls among elderly Japanese women. The present prospective study was designed to clarify the association between serum 25(OH)D level and risk of falls before and after 1 year of follow-up. The community-dwelling elderly women aged 75 years or older (N = 1,393) who participated in a mass health examination were followed 1 year later by a mailed self-administered questionnaire. Responses were obtained from 1,285 subjects (response rate = 92.2%). The incidence of falls at baseline and at 1-year follow-up was 18.8 and 24.4%, respectively. The baseline prevalence of serum 25(OH)D falls and 1.47 (0.93-2.32) for recurrent falls vs. no falls adjusted for potential risk factors. Among elderly Japanese women, the lower serum 25(OH)D, particularly level risk of falls.

  7. Lower Jump Power Rather Than Muscle Mass Itself is Associated with Vertebral Fracture in Community-Dwelling Elderly Korean Women.

    Science.gov (United States)

    Lee, Eun Young; Lee, Su Jin; Kim, Kyoung Min; Seo, Da Hea; Lee, Seung Won; Choi, Han Sol; Kim, Hyeon Chang; Youm, Yoosik; Kim, Chang Oh; Rhee, Yumie

    2017-06-01

    Sarcopenia is considered to be a risk factor for osteoporotic fracture, which is a major health problem in elderly women. In this study, we aimed to investigate the association of sarcopenia, with regard to muscle mass and function, with prevalent vertebral fracture in community-dwelling elderly women. We recruited 1281 women aged 64 to 87 years from the Korean Urban Rural Elderly cohort study. Muscle mass and function were measured using bioimpedance analysis and jumping mechanography. Skeletal muscle index (SMI) and jump power were used as an indicator of muscle mass and function, respectively. Among the participants, we observed 282 (18.9%) vertebral fractures and 564 (44.0%) osteoporosis. Although age, body mass index, and prevalence of osteoporosis increased as both SMI and jump power decreased, prevalence of vertebral fracture increased only when jump power decreased. In univariate analysis, compared with the highest quartile of jump power, the lowest quartile had a significant odds ratio of 2.80 (95% CI 1.79-4.36) for vertebral fracture. This association between jump power and vertebral fracture remained significant, with an odds ratio of 3.04 (95% CI 1.77-5.23), even after adjusting for other risk factors including age, bone mineral density, previous fracture, and cognitive function. In contrast, there was no association between SMI and vertebral fracture. Based on our results, low jump power, but not SMI, is associated with vertebral fracture in community-dwelling elderly Korean women. This finding suggests that jump power may have a more important role than muscle mass itself for osteoporotic fracture.

  8. Contribution of social relationships to self-rated health among Japanese community-dwelling elderly.

    Science.gov (United States)

    Kawasaki, Ryoko; Nakao, Rieko; Ohnishi, Mayumi

    2018-05-01

    Objective: Participation in social activities is associated with physical and psychological health in the community-dwelling elderly population. We examined the two factors of social relations and community health resources, associated with higher self-rated health levels in the community-dwelling elderly. Methods: A total of 145 community-dwelling elderly people ≥ 65 years old from two neighborhood associations in Nagasaki City were recruited for this study, representing 85% of the officially registered ≥ 65-year-old population in the target area. Face-to-face interviews using a structured questionnaire were conducted by trained interviewers in August 2009, with questions related to sociodemographic characteristics, social relationships, and self-rated health (SRH). Community health resources (type and walking distance from home) were evaluated by one of the authors as a community assessment. Results: Seventy-eight community-dwelling elderly people (25 men and 53 women) participated in the study. Elderly people who reported going out every day were more likely to show higher SRH scores (excellent/good) than those going out less often (OR: 3.7; 95% confidence interval [CI]: 1.0, 14.2; P = 0.056). The numbers of interactions with friends in higher and lower SRH groups were 6.5 ± 8.4 (mean ± standard deviation) and 2.4 ± 1.1 ( P = 0.01, Mann-Whitney U test), respectively. The numbers of relatives talking on the phone in higher and lower SRH groups were 2.9 ± 1.3 and 2.2 ± 1.2 ( P = 0.031, Mann-Whitney U test), respectively. Meeting scores with friends in higher and lower SRH groups were 7.8 ± 5.8 and 4.5 ± 3.6 ( P = 0.068), respectively. The scores of community health resources among higher and lower SRH groups were 21.2 ± 1.5 and 20.9 ± 1.4 ( P = 0.547), respectively. The scores of community association/activities in higher and lower SRH groups were 3.9 ± 1.0 and 3.6 ± 0.9 ( P = 0.227), respectively. Conclusion: This study indicated the importance

  9. Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study.

    Science.gov (United States)

    Nakamura, K; Saito, T; Oyama, M; Oshiki, R; Kobayashi, R; Nishiwaki, T; Nashimoto, M; Tsuchiya, Y

    2011-01-01

    Data on the association between vitamin D status and osteoporotic fracture in Asians are sparse. We conducted a 6-year cohort study of 773 community-dwelling elderly Japanese women and found that serum 25-hydroxyvitamin D (25(OH)D) ≥ 71 nmol/L was associated with a reduced risk of osteoporotic limb and vertebral fractures. Data on the association between vitamin D status and osteoporotic fracture in Asians are sparse. This study aimed to clarify the association between vitamin D and other markers of nutritional status with the incidence of fracture in elderly Japanese women. We conducted a cohort study with a 6-year follow-up of 773 community-dwelling women aged 69 years and older. The 6-year follow-up ended in 2009. We assessed serum 25-hydroxyvitamin D, undercarboxylated osteocalcin (an index of vitamin K status), and calcium intake. The primary outcome was incident limb and vertebral fractures. Covariates were forearm bone mineral density (BMD), age, body mass index, osteoporosis treatment, and physical activity. The mean serum 25(OH)D concentration was 60.0 nmol/L. Thirty-seven limb fractures and 14 vertebral fractures occurred in 4,392 person-years. Lower forearm BMD was significantly associated with increased incident fracture (P = 0.0242). The adjusted hazard ratios (HR) of fracture for the first quartile (fracture. Sufficient vitamin D status, i.e., serum 25(OH)D ≥ 71 nmol/L, is associated with low limb and vertebral fracture risk in community-dwelling elderly women.

  10. A prospective study of hormonal treatment and anxiety disorders in community-dwelling elderly women (the Esprit Study).

    Science.gov (United States)

    Scali, Jacqueline; Ryan, Joanne; Carrière, Isabelle; Ritchie, Karen; Ancelin, Marie-Laure

    2009-05-01

    The impact of hormone therapy use on late-life anxiety disorder in elderly women has not been evaluated. Anxiety disorders were evaluated in 838 community-dwelling postmenopausal women aged 65 years and over, randomly recruited from electoral rolls. Anxiety disorders were assessed using a standardized psychiatric examination based on DSM-IV criteria, at baseline and as part of the 2- and 4-year follow-up. Multivariate logistic regression analyses adjusted for socio-demographic variables, measures of physical health and cognitive impairment, as well as current depressive symptomatology indicated no significant association between hormone therapy and anxiety disorders at baseline or after the 4-year follow-up period, regardless of type of treatment. Compared to women who have never taken hormonal therapy, no significant difference was observed for women taking continuously hormone therapy over the follow-up or those who stopped their treatment. The use of hormone therapy was not associated with improved anxiety symptomatology in elderly postmenopausal women.

  11. Comparison of prescription drug use between community-dwelling and institutionalized elderly in Sweden.

    Science.gov (United States)

    Johnell, Kristina; Fastbom, Johan

    2012-09-01

    Most previous studies about drug use in the elderly population have either investigated drug use in institutions or in the community-dwelling setting. Hence, very few studies have compared drug use in institutionalized and community-dwelling elderly, maybe because of a lack of sufficiently large databases. The aim of the study was to investigate differences in drug use patterns between community-dwelling and institutionalized elderly, after adjustment for age, gender and number of other drugs (used as a proxy for overall co-morbidity). We analysed data from individuals aged ≥65 years who filled at least one drug prescription between July and September 2008 and were consequently registered in the Swedish Prescribed Drug Register (n = 1,347,564; 1,260,843 community-dwelling and 86,721 institutionalized elderly). A list of current prescriptions was constructed for every individual on the arbitrarily chosen date 30 September 2008. Outcome measures were the 20 most common drug classes and the 20 most common individual drugs. Logistic regression analysis was used to investigate whether institutionalization was associated with use of these drugs, after adjustment for age, gender and number of other drugs. Institutionalized elderly were more likely than community-dwelling elderly to use antidepressants, laxatives, minor analgesics, opioids and hypnotics/sedatives, after adjustment for age, gender and number of other drugs. On the contrary, institutionalization was negatively associated with use of lipid modifying agents, angiotensin II antagonists, selective calcium channel blockers, β-blocking agents and ACE inhibitors, after adjustment for age, gender and number of other drugs. Our results indicate that institutionalized elderly are more likely than community-dwelling elderly to use psychotropics, analgesics and laxatives, but less likely to receive recommended cardiovascular drug therapy, which may indicate a need for implementation of evidence-based guidelines for

  12. Determinants of Perceived Physical Environment Barriers among Community-Dwelling Elderly in Taiwan.

    Science.gov (United States)

    Lien, W-C; Chang, J-H; Guo, N-W; Lin, Y-C; Hsieh, P-C; Kuan, T-S

    2015-05-01

    To test the hypothesis that mobility, activities of daily living, and the interaction between them can play a key role in determining perceived physical environment barriers among community-dwelling elderly. Cross-sectional. Community. One hundred and ninety-seven community-dwelling elderly with more than 7 points on the Short Portable Mental State Questionnaire and less than 7 points on the Geriatric Depression Scale (15 items). None. Time Get-up and Go test (TUG), the subscales of basic activity of daily living (BADL)/instrumental activities of daily living (IADL) of the Hierarchy of Care Required (HCR), and the physical/structural subscale of the Craig Hospital Inventory of Environmental Factors in Community-dwelling Elderly in Taiwan were used to measure mobility, activities of daily living and perceived physical environment barriers, respectively. Hierarchical linear regression analyses were used to test the study hypothesis. Significant and positive relations were found to exist between perceived physical environment barriers and (1) the TUG time (β=.300, pdwelling elderly under consideration. Strategies targeting the enhancement of mobility among community-dwelling elderly are suggested to lead to improvements in the degree to which physical environment barriers are perceived. This beneficial effect could be greater in the case of elderly individuals with better IADL function.

  13. [Prevalence of elder abuse in Spanish dwelling in community].

    Science.gov (United States)

    Pérez-Rojo, Gema; Izal, María; Montorio, Ignacio; Regato, Pilar; Espinosa, Juan Manuel

    2013-12-21

    Although elder abuse is not a new phenomenon, it remains hidden. There have been carried out various preliminary studies about the prevalence of elder abuse in different countries. The aim of this study is to estimate the prevalence of suspicion of elder abuse in old persons without cognitive impairment, dwelling in community, who were attended in Primary Health Care or Social Services Centres. We carried out a transverse study in which 340 elders participated. We found a 12.1% prevalence of suspicion of elder abuse. Psychological abuse suspicion was the most frequent type and it was very common the simultaneous presence of different types of abuse (psychological and physical and sexual). The suspicion of elder abuse was more frequent in women and spouses were responsible in a high great frequency. The information obtained allows advancing in the knowledge of elder abuse in Spain, where the research about this issue is poor. However, the prevalence found neither has to be considered as a social alarm nor as a social slackness. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  14. Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography

    OpenAIRE

    Tanaka, Erika H.; Santos, Paulo F.; Reis, J?lia G.; Rodrigues, Natalia C.; Moraes, Renato; Abreu, Daniela C. C.

    2015-01-01

    Background: Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. Objectives: The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. Method: Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mea...

  15. Association of sarcopenia with functional decline in community-dwelling elderly subjects in Japan.

    Science.gov (United States)

    Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Tanimoto, Keiji; Shishikura, Kanako; Sugiura, Yumiko; Kusabiraki, Toshiyuki; Kono, Koichi

    2013-10-01

    The present study aimed to determine the association of sarcopenia, defined by muscle mass, muscle strength and physical performance, with functional disability from a 2-year cohort study of community-dwelling elderly Japanese people. Participants were 743 community-dwelling elderly Japanese people aged 65 years or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. Functional disability was defined using an activities of daily living (ADL) scale and instrumental activities of daily living (IADL) scale at baseline and during follow-up examinations 2 years later. Logistic regression analysis, adjusted for age and body mass index, was used to examine the association between sarcopenia and the occurrence of functional disability. In the present study, 7.8% of men and 10.2% of women were classified as having sarcopenia. Among sarcopenia patients in the baseline study, 36.8% of men and 18.8% of women became dependent in ADL at 2-year follow up. From the logistic regression analysis adjusted by age and body mass index, sarcopenia was significantly associated with the occurrences of physical disability compared with normal subjects in both men and women. Sarcopenia, defined by muscle mass, muscle strength and physical performance, was associated with functional decline over a 2-year period in elderly Japanese. Interventions to prevent sarcopenia are very important to prevent functional decline among elderly individuals. © 2013 Japan Geriatrics Society.

  16. Effects of Short-Term Training of Community-Dwelling Elderly with Modular Interactive Tiles

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Jessen, Jari Due

    2014-01-01

    Objective: The objective of this study is to test for the increased mobility, agility, balancing, and general fitness of community-dwelling elderly individuals as a result of short-term training involving playing with modular interactive tiles (Entertainment Robotics, Odense, Denmark) at two...... individuals (63–95 years of age; mean, 83.2 years of age) were assessed in one intervention group without the use of a control group. The intervention group performed nine group sessions (1–1.5 hours each) of playful training with the modular interactive tiles over a 12-week period in two community activity...... community activity centers for the elderly. Three different tests from the Senior Fitness Test were used in order to test a variety of health parameters of the community-dwelling elderly, including those parameters related to fall prevention. Materials and Methods: Eighteen community-dwelling elderly...

  17. Vulnerability Risk Index Profile for Elder Abuse in Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Objectives Elder abuse is associated with increased morbidity and mortality. This study aims to develop a vulnerability index for elder abuse in a community-dwelling population. Design Population-based study Setting Geographically defined community in Chicago. Participants A population-based study was conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 8,157 participants in the CHAP study, 213 participants were reported to social services agency for suspected elder abuse. Measurements A vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes. Results Out of the selected risk index for elder abuse, every one point increase in the 9 item vulnerability index items, there was a two fold increase in the risk for reported elder abuse (OR, 2.19 (2.00–2.40) and confirmed elder abuse (OR, 2.19 (1.94–2.47). Compared to the reference group, older adults with 3–4 vulnerability index items had increased risk for reported elder abuse (OR, 2.98 (1.98–4.49) and confirmed elder abuse (OR, 3.90, (2.07–7.36); and older adults with 5 or more risk index items, there was an 18 fold increase in risk for reported elder abuse (OR, 18.46 (12.15–28.04) and confirmed elder abuse (OR, 26.79 (14.18–50.61). Receiver Operating Characteristic (ROC) statistically derived curves for identifying reported elder abuse ranged between 0.77–0.84 and for predicting confirmed elder abuse ranged between 0.79–0.86. Conclusion The vulnerability risk index demonstrates value for identifying individuals at risk for elder abuse. Additional studies are needed to validate this index in other community dwelling populations. PMID:25180376

  18. Estimation of prevalence of sarcopenia by using a new bioelectrical impedance analysis in Chinese community-dwelling elderly people.

    Science.gov (United States)

    Wang, Hui; Hai, Shan; Cao, Li; Zhou, Jianghua; Liu, Ping; Dong, Bi-Rong

    2016-12-28

    The aim of the present study was to validate the usefulness of the new octapolar multifrequency bioelectrical impedance analysis (BIA) for assessment of appendicular skeletal muscle mass (ASM) by comparing it with that of dual-energy X-ray absorptiometry (DXA) and to investigate the prevalence of sarcopenia in Chinese community-dwelling elderly according to Asian Working Group for Sarcopenia (AWGS) definition. A cross-sectional study was conducted in communities of Chengdu, China. A total of 944 community-dwelling elderly adults aged ≥60 years were included. ASM was measured by using DXA as a criterion method to validate a standing eight-electrode multifrequency BIA (InBody 720), followed by a further estimation of the prevalence of sarcopenia according the AWGS definition. In the Bland-Altman analysis, no significant difference was found between DXA and BIA based on the ASM measurements. The prevalence of AWGS-defined sarcopenia was 12.5% in the elderly women and 8.2% in the elderly men. BIA is suitable for body composition monitoring (ASM) in elderly Chinese as a fast, noninvasive, and convenient method; therefore, it may be a better choice in large epidemiological studies in the Chinese population. The prevalence of AWGS-defined sarcopenia was approximately 10.4% and increased with age in the Chinese community-dwelling elderly in this study.

  19. [Relationship between Quality of Life (QOL) and cognitive function among community-dwelling elderly].

    Science.gov (United States)

    Konagaya, Yoko; Watanabe, Tomoyuki; Ohta, Toshiki; Takata, Kazuko

    2009-03-01

    It has become important for elderly to live better rather than to live longer. There have been many reports about quality of life (QOL) of the elderly, but we have no knowledge about the relation between the QOL and the cognitive function. We investigated the relationship between the QOL and the cognitive function among community-dwelling elderly. A total of 12,059 community-dwelling elderly were invited to join a cognitive screening study by telephone (TICS-J) combined with a mailed QOL questionnaire. Among them, 1,920 subjects (age 71.87+/-5.50 (mean+/-SD) years old, duration of education 11.08+/-2.61 years) who completed both TICS-J and QOL questionnaire were actually measured. TICS-J was administered by the previously reported method, and the QOL questionnaire was developed based on the component of QOL proposed by Lawton, and consisted of 6 subscales (daily activity, satisfaction with health, satisfaction with human support, satisfaction with economic state, symptoms of depression, and positive mental attitude). Correlations were analyzed among the scores of TICS-J, age, duration of education, and scores on each QOL subscale. Multiple linear regression analysis was conducted after QOL subscale scores, adjusting for gender, age, and duration of education, were entered as dependent variables. Four out of 6 subscales scores of QOL showed significant differences between men and women. All QOL subscale scores showed significant differences between the two groups in the TICS-J scores. Partial correlations were seen among TICS-J scores and each QOL subscale score. Multiple linear regression analysis revealed significant influence of cognitive function by TICS-J on QOL subscales scores. Cognitive function was considered to have more influence on QOL scores than gender or age. TICS-J and the QOL questionnaire in this study were useful to evaluate the outcome of welfare in community-dwelling elderly.

  20. Exercise and Nutritional Supplementation on Community-Dwelling Elderly Japanese Women With Sarcopenic Obesity: A Randomized Controlled Trial.

    Science.gov (United States)

    Kim, Hunkyung; Kim, Miji; Kojima, Narumi; Fujino, Ken; Hosoi, Erika; Kobayashi, Hisamine; Somekawa, Shinji; Niki, Yoshifumi; Yamashiro, Yukari; Yoshida, Hideyo

    2016-11-01

    To investigate the effects of exercise and/or nutritional supplementation on body composition, blood components, and physical function in community-dwelling elderly Japanese women with sarcopenic obesity. Randomized controlled trial. Urban community in Tokyo, Japan. Among 1213 community-dwelling elderly women over 70 years of age, 307 were defined with sarcopenic obesity, and 139 women participated in the study. Participants were randomly assigned to one of four intervention groups. The exercise and nutrition (Ex + N) and exercise only (Ex) groups attended 60-minute exercise classes twice a week for 3 months. The Ex + N and nutrition only (N) groups were provided with essential amino acid supplementation and tea fortified with catechins to be taken daily for 3 months. Health education classes were provided to the control (HE) group every 2 weeks. Bioelectric impedance analysis was used to measure body composition. Skeletal muscle mass index was calculated using measures of muscle mass and height. Physical function measures included grip strength, knee extension strength, usual walking speed, and walking parameters (stride, step length, width, walking angles). Blood samples were obtained to analyze levels of albumin, triglycerides, cholesterol, hemoglobin A1c, leptin, cystatin C, vitamin D, interleukin-6, and high-sensitivity C-reactive protein. Significant between-group × time interactions were observed in usual walking speed (P = .012), stride (P = .004), right step length (P = .003), average number of steps (P = .029), and vitamin D (P exercise and nutrition have beneficial effects on individual variables of body composition, blood components, and physical function, improvements in muscle mass and variable combinations such as percent fat + skeletal muscle mass index or percent fat + physical functions were not observed in this population. Further large-scale and long-term investigation is necessary. Copyright © 2016 AMDA – The Society

  1. Falls in the community-dwelling elderly with a history of cancer.

    Science.gov (United States)

    Spoelstra, Sandra; Given, Barbara; von Eye, Alexander; Given, Charles

    2010-01-01

    Falls place older adults at risk for injuries, resulting in functional decline, hospitalization, institutionalization, higher healthcare costs, and decreased quality of life. This study examined community-dwelling elderly to identify if individuals with a history of cancer fall at a higher rate than those without cancer, and if the occurrence of falls was influenced by individual characteristics, symptoms, or function. This was a retrospective, cross-sectional study, in 2007, examining 7,448 community-dwelling elderly 65 years or older in a state in the Midwest. Fallers were identified based on a diagnosis of cancer, age, sex, race and ethnicity, poor vision, reduced activities of daily living (ADLs), instrumental ADLs, cognition, incontinence, pain, or depression. Findings indicated that 2,125 (28.5%) had at least 1 fall. Of those who fell, 967 (13.0%) had cancer, and 363 (4.9%) with cancer had a fall. Predictors of falls in this population included race, sex, ADLs, incontinence, depression, and pain, all with P falls in this study. This study found a high frequency of falls and suggests a predictive model for fall risk in the vulnerable, community-dwelling elderly and will be used to inform future studies.

  2. Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women.

    Directory of Open Access Journals (Sweden)

    Andreas Nilsson

    Full Text Available Whether amount of time spent in sedentary activities influences on clustered metabolic risk in elderly, and to what extent such an influence is independent of physical activity behavior, remain unclear. Therefore, the aim of the study was to examine cross-sectional associations of objectively assessed physical activity and sedentary behavior on metabolic risk outcomes in a sample of elderly community-dwelling women.Metabolic risk outcomes including waist circumference, systolic and diastolic blood pressures, fasting levels of plasma glucose, HDL-cholesterol and triglycerides were assessed in 120 community-dwelling older women (65-70 yrs. Accelerometers were used to retrieve daily sedentary time, breaks in sedentary time, daily time in light (LPA and moderate-to-vigorous physical activity (MVPA, and total amount of accelerometer counts. Multivariate regression models were used to examine influence of physical activity and sedentary behavior on metabolic risk outcomes including a clustered metabolic risk score.When based on isotemporal substitution modeling, replacement of a 10-min time block of MVPA with a corresponding time block of either LPA or sedentary activities was associated with an increase in clustered metabolic risk score (β = 0.06 to 0.08, p < 0.05, and an increase in waist circumference (β = 1.78 to 2.19 p < 0.01. All associations indicated between sedentary time and metabolic risk outcomes were lost once variation in total accelerometer counts was adjusted for.Detrimental influence of a sedentary lifestyle on metabolic health is likely explained by variations in amounts of physical activity rather than amount of sedentary time per se. Given our findings, increased amounts of physical activity with an emphasis on increased time in MVPA should be recommended in order to promote a favorable metabolic health profile in older women.

  3. Hip fracture prevention with a multifactorial educational program in elderly community-dwelling Finnish women.

    Science.gov (United States)

    Pekkarinen, T; Löyttyniemi, E; Välimäki, M

    2013-12-01

    Guidelines suggest identification of women at fracture risk by bone density measurement and subsequently pharmacotherapy. However, most women who sustain a hip fracture do not have osteoporosis in terms of bone density. The present non-pharmacological intervention among elderly women unselected for osteoporosis reduced hip fracture risk by 55 % providing an alternative approach to fracture prevention. Hip fractures are expensive for society and cause disability for those who sustain them. We studied whether a multifactorial non-pharmacological prevention program reduces hip fracture risk in elderly women. A controlled trial concerning 60- to 70-year-old community-dwelling Finnish women was undertaken. A random sample was drawn from the Population Information System and assigned into the intervention group (IG) and control group (CG). Of the 2,547 women who were invited to the IG, 1,004 (39 %) and of the 2,120 invited to the CG, 1,174 (55 %) participated. The IG participated in a fracture prevention program for 1 week at a rehabilitation center followed by review days twice. The CG received no intervention. During the 10-year follow-up, both groups participated in survey questionnaire by mail. Outcome of interest was occurrence of hip fractures and changes in bone-health-related lifestyle. During the follow-up, 12 (1.2 %) women in the IG and 29 (2.5 %) in the CG sustained a hip fracture (P = 0.039). The determinants of hip fractures by stepwise logistic regression were baseline smoking (odds ratio (OR) 4.32 (95 % confidence interval [CI] 2.14-8.71), age OR 1.15/year (95 % CI 1.03-1.28), fall history OR 2.7 (95 % CI 1.24-5.9), stroke history OR 2.99 (95 % CI 1.19-7.54) and participating in this program OR 0.45 (95 % CI 0.22-0.93). Starting vitamin D and calcium supplement use was more common in the IG compared with the CG. The results suggest that this non-pharmacological fracture prevention program may reduce the risk of hip fractures in elderly

  4. Analysis of dysphagia risk using the modified dysphagia risk assessment for the community-dwelling elderly

    OpenAIRE

    Byeon, Haewon

    2016-01-01

    [Purpose] The elderly are susceptible to dysphagia, and complications can be minimized if high-risk groups are screened in early stages and properly rehabilitated. This study provides basic material for the early detection and prevention of dysphagia by investigating the risks of dysphagia and related factors in community-dwelling elders. [Subjects and Methods] Participants included 325 community-dwelling elderly people aged 65 or older. The modified dysphagia risk assessment for the communit...

  5. Analysis of dysphagia risk using the modified dysphagia risk assessment for the community-dwelling elderly.

    Science.gov (United States)

    Byeon, Haewon

    2016-09-01

    [Purpose] The elderly are susceptible to dysphagia, and complications can be minimized if high-risk groups are screened in early stages and properly rehabilitated. This study provides basic material for the early detection and prevention of dysphagia by investigating the risks of dysphagia and related factors in community-dwelling elders. [Subjects and Methods] Participants included 325 community-dwelling elderly people aged 65 or older. The modified dysphagia risk assessment for the community-dwelling elderly was used to assess dysphagia risk. [Results] Approximately 52.6% (n=171) of participants belonged to the high-risk group for dysphagia. After adjusting for confounding variables, people aged 75+, who used dentures, and who needed partial help in daily living had a significantly higher risk of dysphagia. [Conclusion] It is necessary to develop guidelines for dysphagia for early detection and rehabilitation.

  6. The spectrum of worry in the community-dwelling elderly.

    LENUS (Irish Health Repository)

    Golden, Jeannette

    2011-11-01

    In this study, we examine the prevalence and distribution of worry, its content, and its associations with quality of life and depression, based on a large sample of community-dwelling elderly. We will attempt to distinguish between pathological and non-pathological worry based on these associations.

  7. [Methods of coping with musculoskeletal pain among community-dwelling elderly individuals].

    Science.gov (United States)

    Anzai, Saori; Sato, Miyuki; Ikeda, Shinpei; Shiba, Yoshitaka; Yoshida, Hiroto; Haga, Hiroshi; Ueki, Shouzoh

    2018-01-01

    Objectives Musculoskeletal pain impairs vital function and results in a requirement for long-term care. According to studies in other countries, a program that aims at reducing pain through instructions for pain-coping should be implemented. In Japan, a study on pain-coping has recently been initiated; however, the methods of coping with pain that are implemented by community-dwelling elderly individuals have not been evaluated. This study aimed to clarify the methods currently used for coping with musculoskeletal pain and to examine their association with the state of pain among community-dwelling elderly individuals.Methods A survey was performed by sending questionnaires by mail to 2,281 community-dwelling elderly individuals. Responses were obtained from 1,835 people. The survey items consisted of questions about basic attributes and pain. A total of 16 questionnaire items regarding the methods of coping with pain were used for measuring pain-coping that community-dwelling elderly individuals use. The methods of coping with pain were classified into various types by factor analysis. The scores were calculated by type and their association with the state of pain was analyzed using one-way analysis of variance.Results As a result of the factor analysis, methods of coping with pain were classified into five categories: "treatment in hospitals," "daily active coping," "restriction of daily behavior," "self-therapy," and "rest." From one-way analysis of variance for the site of pain, there was a significant difference between the "treatment in hospitals" and "restriction of daily behavior" categories. Among both scores, a higher score was observed in subjects with pain in both the lower back and the knee, compared to those with only pain in the lower back or the knee. Among the number of the sites, there was a significant difference between the "treatment in hospitals," "restriction of daily behavior," and "self-therapy" categories; subjects exhibiting two or

  8. Prospective Study on the Impact of Fear of Falling on Functional Decline among Community Dwelling Elderly Women

    Directory of Open Access Journals (Sweden)

    Kyungwon Choi

    2017-04-01

    Full Text Available Fear of falling (FOF is expected to have effects on functional decline in the elderly. In this study, we examined over 2 years the effect of change in FOF on functional decline in community dwelling elderly. We conducted a secondary analysis using data from elderly women, 70 years of age and older, who participated in the Korean Longitudinal Study of Aging (KLoSA. Participants were divided into four categories according to change in FOF between the 2010 and 2012 surveys. Multiple logistic regression analysis was conducted regarding the effects of changes in FOF on functional decline after controlling for variables as known risk factors for functional decline. Rates of functional decline were highest in the “consistently having FOF” group, whereas they were lowest in the “consistently no FOF” group in both 2010 and 2012. Characteristics independently associated with functional decline were change in FOF, depressive symptoms, low frequency of meeting friends, and fear-induced activity avoidance. Longer exposure to FOF was associated with an increased risk of functional decline. FOF is an important health problem that deserves attention in its own right. Public health approaches for elderly persons should address early detection, prevention, and intervention programs for FOF.

  9. Comparison of seven fall risk assessment tools in community-dwelling Korean older women.

    Science.gov (United States)

    Kim, Taekyoung; Xiong, Shuping

    2017-03-01

    This study aimed to compare seven widely used fall risk assessment tools in terms of validity and practicality, and to provide a guideline for choosing appropriate fall risk assessment tools for elderly Koreans. Sixty community-dwelling Korean older women (30 fallers and 30 matched non-fallers) were evaluated. Performance measures of all tools were compared between the faller and non-faller groups through two sample t-tests. Receiver Operating Characteristic curves were generated with odds ratios for discriminant analysis. Results showed that four tools had significant discriminative power, and the shortened version of Falls Efficacy Scale (SFES) showed excellent discriminant validity, followed by Berg Balance Scale (BBS) with acceptable discriminant validity. The Mini Balance Evaluation System Test and Timed Up and Go, however, had limited discriminant validities. In terms of practicality, SFES was also excellent. These findings suggest that SFES is the most suitable tool for assessing the fall risks of community-dwelling Korean older women, followed by BBS. Practitioner Summary: There is no general guideline on which fall risk assessment tools are suitable for community-dwelling Korean older women. This study compared seven widely used assessment tools in terms of validity and practicality. Results suggested that the short Falls Efficacy Scale is the most suitable tool, followed by Berg Balance Scale.

  10. Dietary Modification Trial in Community-Dwelling Japanese Elderly: A Pilot Study.

    Science.gov (United States)

    Momoki, Chika; Tsuji, Taeko; Shikata, Yukina; Urade, Hana; Morimoto, Hideki; Nakajima, Shinya; Habu, Daiki

    2017-07-01

    This study examined the effects of 6-month nutrition education programs for community-dwelling elderly. This study enrolled 50 community-dwelling elderly who regularly visit outpatient clinics. The programs had three goals: salt reduction, increase in dietary fiber, and adequate protein intake. Since it would be difficult for elderly to achieve all goals concurrently, a single goal was chosen by participants themselves. Anthropometric measurements, blood sampling, and assessment of dietary intake were performed at baseline, 3 months, and 6 months. The nutrition education program for salt reduction was well accepted by the participants and the amount of daily salt intake showed median value of 9.6 g at baseline, 8.0 g at 3 months and 8.1 g at 6 months (P = 0.005). The amount of dietary fiber intake only slightly increased after taking the nutrition program (median value of 13.4 g at baseline, 15.3 g at 3 months and 15.5 g at 6 months; P = 0.695), because of difficulties in introducing new food options to the diet. After taking the adequate protein intake program, participants showed small decreases in protein (a modification from 1.24 g/kg IBW to 1.20 g/kg IBW) and salt intake (8.2 to 7.3 g) at 3 months, but the effects were not sustained at 6 months. This nutrition education program focusing on a single nutrient may serve as a strategy to successfully reduce salt intake and improve systolic blood pressure control in community-dwelling elderly individuals who regularly visit outpatient clinics. In our view, dietary and lifestyle habits should be taken into account as much as possible in nutrition education for elderly individuals.

  11. Sedative-hypnotic drug use among community-dwelling elderly in Taiwan.

    Science.gov (United States)

    Tseng, Han-Yun; Yu, Shu-Han; Lee, Chun-Yi; Huang, Wen-Hao; Huang, Seng-Loong; Wu, Chi-Shin; Chiu, Yen-Feng; Hsiung, Chao A

    2018-03-21

    Sedative-hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan. A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders. Sedatives and hypnotics use was determined via both self-reporting and prescription records. Logistic regression modeling was used to evaluate associations between sedative-hypnotic use and demographic and health status. Among the 3,978 participants aged 65 years and over, the rate of sedative-hypnotic use was 19.7% (n = 785). 4.5% (n = 35) of users reported sedative-hypnotic use without a doctor's prescription. Several sociodemographic characteristics were positively associated with sedative and hypnotic use, including older age, female gender, higher education level, married status, unemployment, and current alcohol consumption. Comorbid chronic and cardiovascular diseases, mental illness, depression, pain, and sleep problems also increased the likelihood of sedative-hypnotic use. This study is one of the largest pioneer studies to date to survey sedatives-hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative-hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative-hypnotic use in geriatric patients.

  12. Reliability and validity of the Repeatable Battery for the Assessment of Neuropsychological Status in community-dwelling elderly

    Science.gov (United States)

    Cheng, Yan; Wu, Wenyuan; Wang, Jiaqi; Feng, Wei; Li, Chunbo

    2011-01-01

    Introduction The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used screening instrument in neuropsychological assessment and is a brief, individually administered measure. The present study aims to assess the reliability and validity of the Chinese version of the RBANS in community-dwelling elderly. Material and methods All subjects come from the community-dwelling elderly in Shanghai, China. They completed a questionnaire concerning demographic information, the mini-mental state examination (MMSE) and the Chinese version of the RBANS. To test for internal consistency, Cronbach's α was calculated for all six RBANS indices. Correlations between each of the RBANS and MMSE subtests were conducted to measure the concurrent validity. A confirmatory factor analysis (CFA) was conducted to test the construct validity. Results The final sample of participants included 236 community-dwelling elderly. The mean total score on the RBANS was 86.02 (±14.19). The RBANS total score showed strong internal consistency (r = 0.806), and the coefficient α value for each of the RBANS scales ranged from 0.142 to 0.727. The total RBANS score was highly correlated with that of the MMSE (r = 0.594, pvalidity in a community-dwelling elderly sample. It may be a useful screening instrument for conducting cognitive assessments in community-dwelling elderly. PMID:22291831

  13. [Factors related to sarcopenia in community-dwelling elderly subjects in Japan].

    Science.gov (United States)

    Tanimoto, Yoshimi; Watanabe, Misuzu; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

    2013-01-01

    This study aimed at determining the factors associated with sarcopenia, defined as low muscle mass and strength and low physical performance, in community-dwelling elderly subjects in Japan. The subjects included 1,074 elderly, community-dwelling Japanese people aged 65 years or older. We measured appendicular muscle mass (AMM) by bioelectrical impedance analysis, grip strength, and usual walking speed. A low muscle mass was defined by the AMM index (AMI, weight [kg]/height [m(2)] as >2 standard deviations below the mean AMI for normal young subjects. The lowest quartile for grip strength and usual walking speed were classified as low muscle strength and low physical performance, respectively. "Sarcopenia" was characterized by a low muscle mass, combined with either a low muscle strength or low physical performance. Subjects without low muscle mass or strength and low physical performance were classified as "normal." Subjects were classified as being "intermediate" if they were neither "sarcopenic" nor "normal." Items in the questionnaire included residential status, past medical history, admission during the past year, smoking and drinking habits, leisure-time physical activity, health status, depression, masticatory ability, and dietary variety score. Sarcopenia was identified in 13.7% of men and 15.5% of women. Among men, a large proportion of subjects with sarcopenia had poor masticatory ability and a low dietary variety score compared with normal or intermediate subjects. Among women, a large proportion of the subjects with sarcopenia lived alone, had poor exercise habits, considered themselves to be unhealthy, and had poor masticatory ability compared with normal or intermediate subjects. A multiple logistic regression analysis showed that age and dietary variety in men and age and masticatory ability in women were associated with sarcopenia. The present study carried out in Japan showed that sarcopenia, assessed by muscle mass, muscle strength, and physical

  14. [Fall risk factors and sex differences among community-dwelling elderly individuals in Japan. A Kameoka study].

    Science.gov (United States)

    Masumoto, Taeko; Yamada, Yosuke; Yamada, Minoru; Nakaya, Tomoki; Miyake, Motoko; Watanabe, Yuya; Yoshida, Tsukasa; Yokoyama, Keiichi; Yamagata, Emi; Date, Heiwa; Nanri, Hinako; Komatsu, Mitsuyo; Yoshinaka, Yasuko; Fujiwara, Yoshinori; Okayama, Yasuko; Kimura, Misaka

    2015-01-01

    Although factors associated with falls might differ between men and women, no large-scale studies were conducted to examine the sex difference of risk factors for falls in Japanese elderly. The purpose of this study was to examine fall risk factors and sex differences among community-dwelling elderly individuals using a complete survey of the geriatric population in Kameoka city. A self-administered questionnaire survey was conducted with 18,231 community-dwelling elderly individuals aged 65 years or over in Kameoka city, Kyoto Prefecture, between July and August 2011, excluding people who were publicly certified with a long-term care need of grade 3 or higher. The questionnaire was individually distributed and collected via mail. Out of 12,159 responders (recovery rate of 72.2%), we analyzed the data of 12,054 elderly individuals who were not certified as having long-term care needs. The questionnaire was composed of basic attributes, a simple screening test for fall risk, the Kihon Check List with 25 items, and the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence with 13 items. These items were grouped into nine factors: motor function, malnutrition, oral function, houseboundness, forgetfulness, depression, Instrumental Activity of Daily Living (IADL), intellectual activities, and social role. Of all the respondents, 20.8% experienced falls within the last year, and 26.6% were classified as having high fall risk. Fall risk increased with age in both sexes, and risk in all age groups was higher for women than for men. All factors were significantly associated with fall risk in both sexes. After controlling for these factors, a significant relationship was found between fall risk and motor function, malnutrition, oral function, forgetfulness, depression, and IADL in men and motor function, oral function, forgetfulness, depression, and IADL in women. The deterioration of motor function was associated with three-times-higher risk than non

  15. Sheltered housing or community dwelling: quality of life and ageism among elderly people.

    Science.gov (United States)

    Bodner, Ehud; Cohen-Fridel, Sara; Yaretzky, Abraham

    2011-10-01

    Previous studies have found correlations between negative perceptions of old age and perceived quality of life (QoL) among elderly people. It has also been suggested that a denial of aging mechanism is employed and might support ageist attitudes among private-sheltered housing tenants compared with elderly people who live in the community and experience intra-generational interactions. Therefore, we hypothesized that tenants of sheltered housing will report more ageist attitudes towards people of their own age, and report a lower QoL than elderly people who live in the community. The sample included 126 volunteers, aged between 64 and 94 years, who live in private-sheltered housing (n = 32) or in the community (n = 94). The participants completed the Fraboni scale of ageism, and a QoL Inventory (SF-36). People, and men in particular, who live in sheltered housing, reported more intergenerational ageist attitudes than men and women who live in the community. Tenants in sheltered housing expressed lower evaluations of their mental health, but higher evaluations on "social functioning" (QoL scales). Women from sheltered housing reported better mental health than men. Gender and some QoL scales were associated with higher ageism. Differences in ageist attitudes between both dwelling places can be interpreted according to Social Identity Theory, which refers to the impact of the ingroup on social attitudes. Differences in QoL can be understood by the accessibility of social activities in private-sheltered housing. Gender differences in ageism and QoL can be explained by women's better social adjustment. Findings should be regarded with caution because of the small sample.

  16. [Association between insomnia symptoms, daytime napping, and falls in community-dwelling elderly].

    Science.gov (United States)

    Pereira, Alexandre Alves; Ceolim, Maria Filomena; Neri, Anita Liberalesso

    2013-03-01

    This study focused on associations between insomnia symptoms, daytime napping, and falls in community-dwelling elderly, using a population-based cross-sectional design and probability sample with 689 community-dwelling elders. The protocol consisted of self-reported and physical performance variables. The study used univariate and multivariate logistic regression analysis with statistical significance set at p napping were 49.9% (n = 339) and 62.8% (n = 432), respectively. 14.4% reported a single fall and 11.9% reported multiple falls. Falls were associated with female gender (OR = 7.73; 95%CI: 3.03-19.72), age > 80 (OR = 3.48; 95%CI: 1.54-7.85), napping (OR = 2.24; 95%CI: 1.24-4.05), and depressive symptoms (OR = 1.98; 95%CI: 1.11-3.53). The association between daytime napping and falls corroborates data from international research. Identifying modifiable risk factors may help programs to prevent falls in the elderly.

  17. Role of environmental hazards in fall of community dwelling elderly

    International Nuclear Information System (INIS)

    Shabbir, M.; Shah, S.I.H.

    2013-01-01

    Evidence linking home hazards to falls has not been well established. Falls and fall injury are a major public health concern for the elderly. Fall of elderly is very much affected by environmental hazards. Falls are a major cause of morbidity and mortality in persons older than 60. There is a greater-than-linear increase in the rate of falls with environmental hazards. This cross section survey will not only lay the foundation for further study on this topic but also provide the basis for the development of preventive program of falls for the elders of Pakistan. Objective: To explore the role of environmental hazards of fall in the community dwelling elders is the area which is lacking in research. Methods: This cross sectional study was conducted from October to December 2010 in Lahore and its peripheries and also the patients in hospital settings come after fractures or fall injuries. The total number of people included was 100. Community dwelling Elders above 60 years having recent history of at least one fall were included regardless of gender. The data were entered and analyzed using SPSS 11.5. Results: There were 71 people out of 100 who fell inside the home, 10 fell outside the home and 18 were not applicable to this question. There were 19% people, who fell repeatedly at one place, 31 people replied about hazard environment where fallen that contribute to fall. According to 24 people they had Safety checks of their home yard and/ or neighborhood which will assist to avoid future fall. Conclusion: Most elderly persons live in a risky home setting. It is vital that environmental hazard be recognized and removed for wellbeing of elderly. (author)

  18. Association between sarcopenia and higher-level functional capacity in daily living in community-dwelling elderly subjects in Japan.

    Science.gov (United States)

    Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Tsuda, Yuko; Kimura, Motoshi; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

    2012-01-01

    This study aimed to determine the association between sarcopenia, defined by muscle mass, muscle strength, and physical performance, and higher-level functional capacity in community-dwelling Japanese elderly people. Subjects were 1158 elderly, community-dwelling Japanese people aged 65 or older. We used bioelectrical impedance analysis to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance. Sarcopenia was characterized by low muscle mass, plus low muscle strength or low physical performance. Subjects without low muscle mass, low muscle strength, and low physical performance were classified as "normal." Examination of higher-level functional capacity was performed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The TMIG-IC is a 13-item questionnaire completed by the subject; it contains five questions on self-maintenance and four questions each on intellectual activity and social role. Sarcopenia was identified in 11.3% and 10.7% of men and women, respectively. The percentage of disability for instrumental activities of daily living (IADL) was 39.0% in men with sarcopenia and 30.6% in women with sarcopenia. After adjustment for age, in men, sarcopenia was significantly associated with IADL disability compared with intermediate and normal subjects. In women, sarcopenia was significantly associated with every subscale of the TMIG-IC disability compared with intermediate and normal subjects. This study revealed that sarcopenia, defined by muscle mass, muscle strength, and physical performance, had a significant association with disability in higher-level functional capacity in elderly Japanese subjects. Interventions to prevent sarcopenia may prevent higher-level functional disability among elderly people. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. Prevalence of sarcopenia in healthy community-dwelling elderly in an urban area of Barcelona (Spain).

    Science.gov (United States)

    Masanes, F; Culla, A; Navarro-Gonzalez, M; Navarro-Lopez, M; Sacanella, E; Torres, B; Lopez-Soto, A

    2012-02-01

    The purpose of this study was to evaluate the prevalence of sarcopenia in a cohort of healthy community-dwelling elderly in an urban area in Barcelona (Spain) for native benchmarks and compare them with those published in other geographical areas. We prospectively evaluated a series of 200 healthy elderly in the community with preserved functional capacity and absence of cognitive impairment. We performed a comprehensive geriatric assessment and determined anthropometric data, muscle mass (MM) and the muscle mass index (MMI). Assessment of muscle mass was performed by bioelectrical impedance analysis (BIA). The cut-off point for defining sarcopenia MMI was established as less than 2 SD of the mean of a reference group comprising 220 healthy volunteers (20-42 years) in the same area. Results were compared with studies undertaken in the USA, France and Taiwan. The cut-off points obtained were 8.31 Kg/m(2) for men and 6.68 Kg/m2 for women, being similar to those observed in France and Taiwan but different from the USA. The prevalence of sarcopenia observed was 33% for elderly women and 10% for males. On comparison of the prevalence of sarcopenia in the four populations, we observed some differences, particularly in males. We have defined reference values for sarcopenia, determined by BIA, in our setting. We also observed a remarkable prevalence of sarcopenia in the healthy elderly community, especially in females, showing some differences from those in other geographical regions.

  20. Associations of low-intensity light physical activity with physical performance in community-dwelling elderly Japanese: A cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Kazuhiro P Izawa

    Full Text Available Physical activity and physical performance relate to quality of life, mortality, and morbidity in elderly people. However, little is known about differences in physical performance related to low-intensity light physical activity (LLPA, high-intensity light physical activity (HLPA, and moderate-intensity physical activity (MPA and how they are separated by sex in elderly populations.This study aimed to determine differences in LLPA, HLPA, MPA, and physical performance, and associations between these measures in community-dwelling elderly men and women.Physical activity and physical performance such as timed-up-and-go test, one-leg standing time, and maximum gait speed were measured in 181 community-dwelling elderly men (mean age, 75.1 ± 5.3 years and 109 women (mean age, 73.4 ± 4.8 years in 2013. Physical activity was classified as LLPA (1.6~1.9 METs of physical activity, HLPA (2.0~2.9 METs of physical activity, and MPA (over 3 METs of physical activity. The association between the values of these three intensities of physical activity in the participants was assessed by Pearson's correlation coefficients. Multiple linear regression analyses were used to assess the association of physical performance values with the three groups defined by accelerometer-measured physical activity intensity adjusted for sociographic, behavioral, and multiple diseases in the participants.MPA was beneficially associated with all physical performance indicators in the men (all P<0.05 and women (all P<0.05. Only HLPA showed significant associations with the timed-up-and-go test (P = 0.001 and maximum gait speed (P = 0.006 in women.These results may support the notion that not only HLPA in women but MPA in both sexes appears to improve physical performance in elderly populations.The present study findings provide novel epidemiological evidence for the potential benefits of HLPA in women and also reinforce the potential benefits of MPA in both sexes, which is the

  1. Suicidal ideation and associated factors among community-dwelling elders in Taiwan.

    Science.gov (United States)

    Yen, Yung-Chieh; Yang, Ming-Jen; Yang, Mei-Sang; Lung, For-Wey; Shih, Chun-Hua; Hahn, Cheng-Yi; Lo, Hsin-Yi

    2005-08-01

    The purpose of the present study was to explore the suicidal ideation of community-dwelling elderly and the factors associated with their intention to commit suicide. Using a multilevel stratified sampling strategy, 1000 elderly subjects were recruited (aged 65-74 years old) in Taiwan during the year 2001. The degree of depression and its correlates were assessed. Suicidal ideation was measured by asking respondents if they had had any suicidal thoughts in the previous week. In all, 16.7% of respondents reported suicidal ideation within the past week; its occurrence was related to sex, religious belief, employment status, marital status, average family monthly income, physical health status, depressive symptoms, and community activity participation. Further multivariate logistic regression revealed that, aside from depressive symptoms and a lower level of education, no community participation in the past 6 months was significantly associated with the appearance of suicidal ideation. The prevalence of suicidal ideation among the elderly in Taiwan is higher than in Western countries. Participation in social activities is negatively associated with elderly suicidal ideation. The dimension of social participation deserves further exploration and should be considered in community mental health promotion interventions for elderly people.

  2. Prevalence of lumbar spondylosis and its association with low back pain among community-dwelling Japanese women

    OpenAIRE

    Tsujimoto, Ritsu; Abe, Yasuyo; Arima, Kazuhiko; Nishimura, Takayuki; Tomita, Masato; Yonekura, Akihiko; Miyamoto, Takashi; Matsubayashi, Shohei; Tanaka, Natsumi; Aoyagi, Kiyoshi; Osaki, Makoto

    2016-01-01

    Background: Lumbar spondylosis is more prevalent among the middle-aged and elderly, but few population-based studies have been conducted, especially in Japan. The purpose of this study was to explore the prevalence of lumbar spondylosis and its associations with low back pain among community-dwelling Japanese women. Methods: Lateral radiographs of the lumbar spine were obtained from 490 Japanese women ≥ 40 years old, and scored for lumbar spondylosis using the Kellgren-Lawrence (KL) grade at ...

  3. [Cognitive function screening of community-dwelling elderly by Telephone Interview for Cognitive Status in Japanese (TICS-J)].

    Science.gov (United States)

    Konagaya, Yoko; Watanabe, Tomoyuki; Takata, Kazuko; Ohta, Toshiki

    2008-09-01

    The purpose of this study was to evaluate whether the Telephone Interview for Cognitive Status in Japanese (TICS-J) is accepted among community-dwelling elderly, to examine the correlations among gender, age or the duration of education and the TICS-J, as well as to grasp the subjects with probable cognitive impairment. A total of 12,059 community-dwelling elderly were invited to join the cognitive screening by the TICS-J, among which 3,482 responded, of these we were actually able to measure 2,620 and found out the educational back ground of the 2,431. They counted 1,186 men (age 72.3+/-5.7 (mean+/-SD) years old, duration of education 11.4+/-2.9 years) and 1,245 women (72.4+/-5.8, 10.3+/-2.2). The TICS-J was administered according to the TICS manual. The TICS-J consisted of orientation concerning name, time and place, counting backward from 20 to 1, remembering a word list, 7 serial subtractions, naming of verbal descriptions, repetition, recent memory, praxis and opposites. The subjects were divided into two groups by the duration of education (less than 11 years, or 11 years or more), or four groups by age (65-69, 70-74, 75-79 and 80 years old or more). There were no significant differences of total TICS-J scores between men and women, 34.3+/-3.5 and 34.4+/-3.6, respectively. The mean total score of the high education group (35.3+/-3.0) was significantly higher than that of the low education group (33.3+/-3.8). Moreover, the averages of the total scores decreased according to age increase. The number of the subjects who showed the total TICS-J scores below the cut-off point of 33 was 564 (23.2%). There was no difference between men and women with the average total score of the TICS-J, however, there were correlations between ages and extent of education and their average total scores. The TICS-J is useful to assess the cognitive function of the community-dwelling elderly.

  4. Relationship between occlusal force and falls among community-dwelling elderly in Japan: a cross-sectional correlative study.

    Science.gov (United States)

    Eto, Maki; Miyauchi, Shinji

    2018-05-09

    Falls may cause serious health conditions among older population. Fall-related physical factors are thought to be associated with occlusal conditions. However, few studies examined the relationship between occlusal force and falls. To identify the association between occlusal force and falls among community-dwelling elderly individuals in Japan, public health nurses conducted a cross-sectional descriptive study. We performed extensive physical assessments of five items: maximum occlusal force, handgrip strength, maximal knee extensor strength, one-leg standing time with eyes open and body sway. We also conducted a questionnaire survey concerning the participants' demographic characteristics, health status and fall experience during the past year. Mean scores and standard deviations were calculated for age and the total points of the index of activities of daily living. Associations were examined using Mann-Whitney tests and logistic regression. We examined 159 community-dwelling people aged ≥65 years, who were independent and active, including 38 participants (24.5%) with experience of falls in the past year. Maximum occlusal force had significant correlation with handgrip strength, maximal knee extensor strength, and one-leg standing time and body sway (P force (P = 0.004). This is the first study, led by public health nursing researchers, to examine the associations between maximum occlusal force and falls among community-dwelling elderly in Japan. The results showed that maximum occlusal force was significantly related to the other four extensive physical assessments, and might also suggest that maximum occlusal force assessment by public health nurses could contribute to more sophisticated and precise prediction of fall risks among the community-dwelling elderly. The latest occlusal force measurement device is non-invasive and easy to use. Public health nurses can introduce it at periodical community health checkup assembly events, which might

  5. Parenting style, resilience, and mental health of community-dwelling elderly adults in China.

    Science.gov (United States)

    Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A; Kua, Ee-Heok; Mahendran, Rathi

    2016-07-08

    Given the increasing elderly population worldwide, the identification of potential determinants of successful ageing is important. Many studies have shown that parenting style and mental resilience may influence mental health; however, little is known about the psychological mechanisms that underpin this relationship. The current study sought to explore the relationships among mental resilience, perceptions of parents' parenting style, and depression and anxiety among community-dwelling elderly adults in China. In total, 439 community-dwelling elderly Chinese adults aged 60-91 years completed the Personal and Parents' Parenting Style Scale, Connor-Davidson Resilience Scale, Zung Self-Rating Depression Scale, and Zung Self-Rating Anxiety Scale. Elderly adults whose parents preferred positive and authoritative parenting styles had higher levels of mental resilience and lower levels of depression and anxiety. Elderly adults parented in the authoritarian style were found to have higher levels of depression and anxiety, with lower mental resilience. The findings of this study provide evidence related to successful ageing and coping with life pressures, and highlight the important effects of parenting on mental health. The results suggest that examination of the proximal determinants of successful ageing is not sufficient-distal factors may also contribute to the 'success' of ageing by modifying key psychological dispositions that promote adaptation to adversity.

  6. Effect of self-rated health on cognitive performance in community dwelling elderly

    NARCIS (Netherlands)

    Jelicic, M; Kempen, GIJM

    1999-01-01

    The objective of this study was to examine the effect of self-reported health on. cognitive function in community dwelling elderly (N = 4,528). Research participants were divided into four groups with regard to self-rated health. Statistically controlling for the effects of depression, age, and

  7. Loneliness, social support networks, mood and wellbeing in community-dwelling elderly.

    Science.gov (United States)

    Golden, Jeannette; Conroy, Ronán M; Bruce, Irene; Denihan, Aisling; Greene, Elaine; Kirby, Michael; Lawlor, Brian A

    2009-07-01

    Both loneliness and social networks have been linked with mood and wellbeing. However, few studies have examined these factors simultaneously in community-dwelling participants. The aim of this study was to examine the relationship between social network, loneliness, depression, anxiety and quality of life in community dwelling older people living in Dublin. One thousand two hundred and ninety-nine people aged 65 and over, recruited through primary care practices, were interviewed in their own homes using the GMS-AGECAT. Social network was assessed using Wenger's typology. 35% of participants were lonely, with 9% describing it as painful and 6% as intrusive. Similarly, 34% had a non-integrated social network. However, the two constructs were distinct: 32% of participants with an integrated social network reported being lonely. Loneliness was higher in women, the widowed and those with physical disability and increased with age, but when age-related variables were controlled for this association was non-significant. Wellbeing, depressed mood and hopelessness were all independently associated with both loneliness and non-integrated social network. In particular, loneliness explained the excess risk of depression in the widowed. The population attributable risk (PAR) associated with loneliness was 61%, compared with 19% for non-integrated social network. Taken together they had a PAR of 70% Loneliness and social networks both independently affect mood and wellbeing in the elderly, underlying a very significant proportion of depressed mood.

  8. Detection of memory impairment among community-dwelling elderly by using the Rivermead Behavioural Memory Test

    International Nuclear Information System (INIS)

    Shinagawa, Shunichiro; Toyota, Yasutaka; Matsumoto, Teruhisa; Sonobe, Naomi; Adachi, Hiroyoshi; Mori, Takaaki; Ishikawa, Tomohisa; Fukuhara, Ryuji; Ikeda, Manabu

    2010-01-01

    The aim of this study was to use the Rivermead Behavioural Memory Test (RBMT) to evaluate everyday memory impairment among community-dwelling elderly who had normal cognitive function and performed daily activities normally but displayed memory impairments, and to diagnose the condition as either mild cognitive impairment or dementia. Among the 1,290 community-dwelling elderly persons who participated in the study, 72 subjects scored higher than 24 on the Mini-Mental State Examination (MMSE): these subjects performed daily activities normally, but their family members reported that they showed memory impairments. Fifty-two subjects completed RBMT, Clinical Dementia Rating, and brain computed tomography, and a final diagnosis was established. The mean standard profile score was 15.1±5.0 and mean screening score was 6.4±3.0. RBMT score was correlated with the MMSE score. Nine of the subjects were diagnosed with dementia and 26 of them were found to be normal. RBMT achieved 100% sensitivity and specificity with regard to the differentiation of subjects with Alzheimer's disease. However, some subjects were diagnosed with dementia even though their RBMT score was higher than the cut-off score. RBMT was useful in detecting memory impairments of Alzheimer's disease (AD) subjects in community-based surveys. However, some subjects were diagnosed with dementia because of the existence of other cognitive impairments among community-dwelling elderly. (author)

  9. Prevalence and risk factors of abuse among community dwelling elderly of Guwahati City, Assam

    Directory of Open Access Journals (Sweden)

    Anku Moni Saikia

    2015-01-01

    Full Text Available Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST. Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population.

  10. Prevalensi Sarkopenia pada Lansia di Komunitas (Community Dwelling berdasarkan Dua Nilai Cut-off Parameter Diagnosis

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    Vitriana

    2016-09-01

    Full Text Available Sarcopenia, aging muscle mass loss, and function syndromes can lead to decreased quality of life and increased elderly mortality. The availability of various screening methods and operational definitions in different studies has produced different findings of sarcopenia prevalence. The purpose of this study was to discover the prevalence of sarcopenia in Indonesian community-dwelling elderly based on muscle mass measured by bioimpedance analysis, handgrip strength using hand dynamometer, and physical performance based on six minutes walking test with two different cut-off point parameters of sarcopenia, i.e. the cut-off point recommended by Asian Working Group for Sarcopenia (AWGS and the cut-off point based on the reference used in Taiwan elderly population reference due to the lack of references for Indonesian elderly population. A cross-sectional study was conducted to 229 participants (71 men and 158 women from the community-dwelling elderly population between August and December 2014 in Bandung and Jatinangor. The results of the study showed that the sarcopenia prevalence in this study based on AWGS was 9.1% (7.4% in men and 1.7% in women while the prevalence based on the Taiwan reference revealed a prevalence of 40.6% (20.1% in men and 20.5% in women. This highly different prevalences shows the importance of defining a specific cut-off point for elderly population in community-dwelling Indonesia to get a more accurate sarcopenia prevalence.

  11. Household characteristics and influenza vaccination uptake in the community-dwelling elderly: a cross-sectional study

    Science.gov (United States)

    Chan, Denise P.C.; Wong, Ngai Sze; Wong, Eliza L.Y.; Cheung, Annie W.L.; Lee, Shui Shan

    2015-01-01

    Elderly people are at higher risk of influenza diseases. The morbidity benefit of vaccination is often offset by its low and variable coverage in elderly people in the community. To assess household and individual factors associated with influenza vaccination uptake in the community-dwelling elderly of age ≥ 65, data from a cross-sectional Thematic Household Survey conducted in 2011/12 in Hong Kong were analysed, using vaccination in the past 12 months as the outcome variable. Households comprising an elderly person living with non-elderly member(s) of age ≤ 64 were also evaluated. Data fields included socio-demographics, household structures, health status, eligibility to financial subsidy, and subscription to health insurance. The influenza vaccination rate was 27% in 4204 elderly persons from 3224 households. Being male, being economically active, attaining primary education, having smoking behaviours were negatively associated with vaccination, while chronic illness and age ≥ 70 were positively associated factors. Elderly people living alone gave a variable rate of vaccination ranging from 16.4% in males of age 65–69 to 36.3% in females ≥ 70. Household size per se was not associated with vaccination, but a positive correlation could be seen if the household was composed of vaccinated non-elderly member(s). Influenza vaccination uptake in the community-dwelling elderly is dependent on both individual and household characteristics, the latter including the influence of vaccinated non-elderly member(s). The low vaccination coverage of “younger” (age 65–69) elderly men living alone is particularly worrisome. Interventions focusing on vulnerable elderly people and their social networks would be desirable. PMID:26844153

  12. Interactive effect between depression and chronic medical conditions on fall risk in community-dwelling elders.

    Science.gov (United States)

    Kao, Senyeong; Wang, Yun-Chang; Tzeng, Ya-Mei; Liang, Chang-Kuo; Lin, Fu-Gong

    2012-09-01

    It is well documented that fall risk among elderly people is associated with poor health and depression. In this study, we set out to examine the combined effects of medical condition and depression status on fall incidents among community-dwelling elderly people. A cross-sectional study was carried out to investigate the fall history of community-dwelling elders involving 360 participants. Those who had experienced at least two falls over the previous year, or one injurious fall, were defined as "fallers." The Geriatric Depression Scale-15 was used as a screening instrument for depression status. Based on a multivariate logistic regression and stratification analysis, depression was found to interact with various medical conditions on fall risk. In comparison with the non-depressive reference group, a six-fold fall risk was discernible among depressed elders with polypharmacy, while a five-fold risk was found among depressive elders using ancillary devices, along with a four-fold risk among depressive elders with diabetes or cardiovascular disease. Finally, arthritis was found to produce a nine-fold risk of falls among such populations. These findings suggest that greater emphasis should be placed on the integration of depression screening as an element of fall risk assessment in elderly people.

  13. Determinants of falls in community-dwelling elderly: hierarchical analysis.

    Science.gov (United States)

    Brito, Thais Alves; Coqueiro, Raildo da Silva; Fernandes, Marcos Henrique; de Jesus, Cleber Souza

    2014-01-01

    To analyze the fall-related factors in community-dwelling elderly. Epidemiologic cross-sectional population-based household study with hierarchical interrelationships among the potential risk factors. The sample was made up of noninstitutionalized individuals over age 60, who were resident of a city in Brazil's Northeast Region. The dependent variable was fall occurrence in the last 12 months; independent variables were sociodemographic, behavioral, health, and functional status factors. Multivariate hierarchical Poisson regression analysis was used based on a proposed theoretic model. Three hundred and sixteen (89.0%) elderly participated of the survey, average age 74.2 years; the majority was female, with limited literacy and had low-medium family income. The fall prevalence was of 25.8%; occurrence was related to depression symptoms (PR = 1.55) and balance limitation (PR = 1.56). The high fall prevalence among elderly necessitates the identification of fall-related factors for action planning prevention programs with this group. © 2014 Wiley Periodicals, Inc.

  14. Factors related to falls among community dwelling elderly.

    Science.gov (United States)

    Kuhirunyaratn, Piyathida; Prasomrak, Prasert; Jindawong, Bangonsri

    2013-09-01

    Falls among the elderly can lead to disability, hospitalization and premature death. This study aimed to determine the factors related to falls among community dwelling elderly. This case-control study was conducted at the Samlium Primary Care Unit (SPCU), Khon Kaen, Thailand. Cases were elderly individuals who had fallen within the previous six months and controls were elderly who had not fallen during that same time period. Subjects were taken from elderly persons registered at the SPCU. The sample size was calculated to be 111 cases and 222 controls. Face to face interviews were conducted with subjects between May and June, 2011. The response rate was 100%. On bivariate analysis, the statistically significant factors related to falls were: regular medication use, co-morbidities, mobility, depression, cluttered rooms, slippery floors, unsupported toilets (without a hand rail), sufficient exercise, rapid posture change and wearing slippers. When controlling for others significant factors, multiple logistic regression revealed significant factors were: regular medication use (AOR: 2.22; 95%CI: 1.19 - 4.12), depression (AOR: 1.76, 95% CI: 1.03 - 2.99), sufficient exercise (AOR: 0.34; 95% CI: 0.19 - 0.58) and wearing slippery shoes (AOR: 2.31; 95% CI: 1.24 - 4.29). Interventions need to be considered to modify these significant factors associated with falls and education should be provided to these at risk.

  15. [The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes].

    Science.gov (United States)

    Sung, Ki Wol; Kang, Hye Seung; Nam, Ji Ran; Park, Mi Kyung; Park, Ji Hyeon

    2018-04-01

    This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population. © 2018 Korean Society of Nursing Science.

  16. Indicators of sarcopenia and their relation to intrinsic and extrinsic factors relating to falls among active elderly women

    OpenAIRE

    Rossetin, Liliana Laura; Rodrigues, Elisangela Valevein; Gallo, Luiza Herminia; Macedo, Darla Silvério; Schieferdecker, Maria Eliana Madalozzo; Pintarelli, Vitor Last; Rabito, Estela Iraci; Gomes, Anna Raquel Silveira

    2016-01-01

    Abstract Introduction: Musculoskeletal aging can impair functional performance increasing the risk of falls. Objective: To analyze the correlation between sarcopenia and the intrinsic and extrinsic factors involved in falls among community-dwelling elderly women. Method: A cross-sectional study evaluated the number of falls of 85 active community-dwelling elderly women in the previous year and then divided them into two groups: non-fallers (n=61) and fallers (n=24). The sarcopenia indic...

  17. Association of sarcopenia with depressive symptoms and functional status among ambulatory community-dwelling elderly.

    Science.gov (United States)

    Kilavuz, Asli; Meseri, Reci; Savas, Sumru; Simsek, Hatice; Sahin, Sevnaz; Bicakli, Derya Hopanci; Sarac, Fulden; Uyar, Mehmet; Akcicek, Fehmi

    Sarcopenia, functional disability, and depression are common problems in the elderly. Sarcopenia is associated with physical disability, functional impairment, depression, cardiometabolic diseases, and even mortality. This study aims to determine the association of sarcopenia with depression and functional status among ambulatory community-dwelling elderly aged 65 years and older. The sample of this cross-sectional study consisted of 28,323 people, aged 65 years and older, living in Bornova, Izmir. Multi-stage sample selection was performed to reach 1007 individuals. However, 966 elderly people could be reached, and 861 elderly people who can walk were included in the study. The data were collected by the interviewers at home through face-to-face interview. The mean age was 72.2 ± 5.8 (65-100) years. The prevalence of functional disability, depressive symptoms, and sarcopenia were 21.7%, 25.2%, and 4.6%, respectively. In multivariate analysis depression was associated with sarcopenia, being illiterate and divorced, perception of the economic situation as poor/moderate, increased number of chronic diseases, and having at least one physical disability. IADL associated functional disability with sarcopenia, being illiterate/literate and female, increased age and number of medications, and the BMI. Sarcopenia in ambulatory community-dwelling elderly is significantly associated with depressive symptoms and functional disability. Elderly people at high risk of sarcopenia should be screened for functional disability and depression. Appropriate interventions should also be implemented. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Association of Adiponectin With Cancer and All-Cause Mortality in a Japanese Community-Dwelling Elderly Cohort: A Case-Cohort Study.

    Science.gov (United States)

    Kojima, Reiji; Ukawa, Shigekazu; Zhao, Wenjing; Suzuki, Koji; Yamada, Hiroya; Tsushita, Kazuyo; Kawamura, Takashi; Okabayashi, Satoe; Wakai, Kenji; Noma, Hisashi; Ando, Masahiko; Tamakoshi, Akiko

    2018-03-24

    Most studies of plasma adiponectin (APN) and mortality among community-dwelling elderly focus on cardiovascular disease, but data on the relationship between plasma APN and cancer mortality is exiguous. We investigated whether APN is associated with cancer mortality in community-dwelling elderly people. We conducted a case-cohort study within the New Integrated Suburban Seniority Investigation (NISSIN) Project using a randomly drawn sub-cohort of 697 subjects (351 men and 346 women; mean age 64.5 [standard deviation, 0.5] years) among whom we compared cases of all-cause death (n = 269) and cancer death (n = 149) during a mean follow-up duration of 10.8 (standard deviation, 3.7) years. Associations between APN and mortality were assessed using weighted Cox regression analyses. We observed significant positive associations between the APN concentration and cancer death in the first and third APN tertiles compared with the second APN tertile (hazard ratio [HR] T1 vs T2 , 1.67; 95% confidence interval [CI], 1.00-2.79 and HR T3 vs T2 , 2.10; 95% CI, 1.30-3.40). Further adjustment for possible confounders attenuated the association (HR T1 vs T2 , 1.63; 95% CI, 0.93-2.84 and HR T3 vs T2 , 2.10; 95% CI, 1.26-3.50). A similar but weaker association was seen for all-cause mortality (multivariate HR T1 vs T2 , 1.45; 95% CI, 0.95-2.21 and HR T3 vs T2 , 1.51; 95% CI, 1.01-2.25). Plasma APN and cancer mortality have a significant relationship among community-dwelling elderly people, which warrants further study.

  19. Insomnia among community dwelling elderly in Alexandria, Egypt.

    Science.gov (United States)

    Ayoub, Abla I; Attia, Medhat; El Kady, Heba M; Ashour, Ayat

    2014-12-01

    Insomnia is a common problem in the elderly population. Poor sleep quality is associated with decreased memory and concentration, increased risk of falls, cognitive decline, and higher rate of mortality. Inadequate sleep hygiene such as irregular sleep schedules, use of stimulants, and daytime naps may predispose to insomnia. The aim of this study was to determine the prevalence of insomnia among community dwelling elderly in Alexandria and to assess some of the risk factors and comorbid conditions related to insomnia. This is a cross-sectional study conducted among 380 elderly people taken from different clubs in Alexandria using a predesigned structured interview questionnaire. Data on sociodemographic characteristics, medical history, and personal and sleeping habits were collected. The Insomnia Severity Index was used to assess insomnia and the Depression Anxiety Stress Scale was used to measure depression, anxiety, and stress. One-third (33.4%) of the elderly suffered from insomnia. On logistic regression, the most independent factors that were significantly associated with insomnia were number of chronic diseases [odds ratio (OR)=7.25 for having ≥5 diseases], being female (OR=2.37), anxiety (OR=1.91), watching television in bed before sleeping (OR=1.90), depression (OR=1.74), nocturia (OR=1.13), and daily sunlight exposure (OR=0.57). Insomnia is a common problem among the elderly in Alexandria. Female sex, chronic diseases, mental health problems, and bad sleep hygiene practice increase the risk for insomnia. Improving knowledge among the elderly about the prevalence and risk factors of insomnia could help the development of effective public health prevention and intervention programs for better sleep quality.

  20. Prevalence of Sarcopenia and Associated Factors in Chinese Community-Dwelling Elderly: Comparison Between Rural and Urban Areas.

    Science.gov (United States)

    Gao, Langli; Jiang, Jiaojiao; Yang, Ming; Hao, Qiukui; Luo, Li; Dong, Birong

    2015-11-01

    To compare the prevalence of sarcopenia in urban and rural Chinese elderly adults and to identify the risk factors related to sarcopenia. A cross-sectional study. Urban and rural communities in western China. A total of 887 community-dwelling elderly adults aged 60 years or older. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). Cognitive function, depression, and nutrition status were assessed using the Chinese version of the Mini-Mental Status Examination (MMSE), the Chinese version of the 30-item Geriatric Depression Scale (GDS-30), and the revised Mini Nutritional Assessment short-form (MNA-SF), respectively. A total of 612 individuals aged 70.6 ± 6.7 years (range, 60-91 years) were included in this study. The prevalence of sarcopenia in the study population was 9.8% (women, 12.0%; men, 6.7%; P = .031). The prevalence of sarcopenia was 13.1% in rural elders and 7.0% in urban elders (P = .012). Age (odds ratio [OR] 1.22; 95% confidence interval [CI] 1.15-1.29), women (OR 1.71; 95% CI 1.20-5.65), malnutrition or at risk for malnutrition (OR 3.53; 95% CI 1.68-7.41), rural residence (OR 2.15; 95% CI 1.33-4.51), and the number of medications (OR 1.23; 95% CI 1.06-1.44) were independently associated with sarcopenia. Rural elders are more vulnerable to sarcopenia than urban elders in a sample of western China's elderly population. More attention should focus on rural populations in future sarcopenia studies. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  1. Quality of prescribing in community-dwelling elderly patients in France: an observational study in community pharmacies.

    Science.gov (United States)

    Bourcier, E; Mille, F; Brunie, V; Korb-Savoldelli, V; Lafortune, C; Buyse, M; Fernandez, C; Hindlet, P

    2017-12-01

    Background In order to ensure safer prescriptions in the elderly, lists of potentially inappropriate medications (PIMs) and guidelines have been introduced. Whereas the effectiveness of these measures has been well studied in hospitals, data are sparse for the community-dwelling patients. Objective To assess the quality of prescriptions among community-dwelling elderly patients, and potential associations between prescription patterns, patient characteristics and medication adherence. Setting Community pharmacies in France. Method We conducted a prospective observational study between January and June 2013. Patients aged 75 and over coming to the community pharmacy with a prescription from a general practitioner were invited to participate to the study. The compliance of the prescription was assessed with regards to Beers Criteria and French Health Authority guidelines (FHA) for prescription in the elderly, the degree of adherence was assessed with the Girerd score. Main outcome measure Percentage of prescriptions compliant with Beers Criteria and FHA guidelines. Results Among the 1206 prescriptions analysed, 67.49% (n = 814) contained a PIM. Only 12.77% (n = 154) complied with mandatory requirements of the FHA. Prescriptions were ordered by therapeutic field in 51.24% (n = 618) of cases. Dosing regimen was incomplete in 57.21% (n = 690) of prescriptions. Only 29.19% (n = 352) of patients reported no difficulty with regard to adherence (Girerd score = 0). The use of International Non-proprietary Name was associated with an increased risk of nonadherence (adjusted OR = 1.59 [95% CI = 1.13-2.23] and 1.68 [95% CI = 1.12-2.49] respectively). Patient satisfaction with formulation was associated with a lower risk of non-adherence (adjusted OR = 0.63 [95% CI = 0.45-0.90]). Conclusion A substantial proportion of patients are exposed to PIMs and prescriptions that do not comply with the FHA Guidelines. This issue, as well as identified risk factors for

  2. Application of Pole Walking to Day Service Centers for Use by Community-dwelling Frail Elderly People

    Directory of Open Access Journals (Sweden)

    Susumu Ota

    2014-03-01

    Conclusion: The effects of 3 months of pole walking on community-dwelling elderly day service users showed improved Physical Component Summary scores of higher QoL. However, there was no significant effect of physical functions due to the intervention.

  3. Psycho-social activity factors associated with self-rated health among community-dwelling elderly people A five-year longitudinal study.

    Science.gov (United States)

    Yamauchi, Kanako; Saito, Isao; Kato, Tadahiro; Tanigawa, Takeshi; Kobayashi, Toshio

    2015-01-01

    This longitudinal study examined psychological and social activity factors related to poor self-rated health (SRH) in community-dwelling elderly people. The general health of 7,413 elderly individuals aged 65 years and over in Toon City, Ehime Prefecture, Japan was surveyed. We followed 4,372 participants, over a five-year period, after excluding those who were aged 85 years and over, had a disability, had moved away, or had died. The data from 3,358 respondents (response rate: 76.8%) were analyzed. We divided the patients into two groups based on their SRH responses: healthy, including those who answered "excellent" or "good," and unhealthy, including those who answered "not good" or "poor." We examined changes in SRH for both groups between the first survey and the survey conducted after five years. Among the healthy subjects at the first survey, we analyzed the relationship between SRH, after five years, and psycho-social activity factors using a logistic regression analysis. These factors included physical and social competence, life satisfaction, and tendency towards dementia and/or depression. SRH of both men and women significantly declined over five years. The percentage of men and women, who maintained SRH as healthy, after the 5-year follow-up period, was approximately 60% in those aged 65-74 years and 40% in those aged 75-84 years. In those aged 65-74 years, the odds ratio (OR) for a SRH of unhealthy (after five years), associated with Life Satisfaction Index-K (LSI-K) scores (at the first survey), was significantly lower at 0.85 (95% confidence interval [CI]: 0.77-0.93) for men and 0.79 (95% CI: 0.72-0.87) for women. The OR of tendency toward depression was significantly higher at 1.68 (95% CI: 1.11-2.56) for women only. In those aged 75-84 years, the OR for a SRH of unhealthy (after five years), associated with LSI-K scores (at the first survey), was significantly lower at 0.87 (95% CI: 0.77-1.00) for men and 0.89 (95% CI: 0.80-0.99) for women. The OR

  4. Association of frailty in hospitalized and institutionalized elderly in the community-dwelling

    Directory of Open Access Journals (Sweden)

    Suzele Cristina Coelho Fabrício-Wehbe

    2016-08-01

    Full Text Available ABSTRACT Objective: to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents. Method: the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS, and functional capacity through the Functional Independence Measure. Results: we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years. Conclusion: the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.

  5. Sarcopenia and falls in community-dwelling elderly subjects in Japan: Defining sarcopenia according to criteria of the European Working Group on Sarcopenia in Older People.

    Science.gov (United States)

    Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Tamaki, Junko

    2014-01-01

    This study assessed the association between sarcopenia (using the definition of the European Working Group on Sarcopenia in Older People) and fall in the past year among community-dwelling Japanese elderly. Subjects were 1110 community-dwelling Japanese aged 65 or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. "Sarcopenia" was characterized by low muscle mass and low muscle strength or low physical performance. "Presarcopenia" was characterized only by low muscle mass. Subjects who did not have any of these deficiencies were classified as "normal." We then administered a questionnaire assessing age, sex, household status, chronic illness, lifestyle-related habits, and fall. This study showed the prevalence of fall was 16.9% and 21.3% in men and women, respectively, while that of sarcopenia was 13.4% and 14.9% in men and women, respectively. In men and women, the prevalence of sarcopenia was higher among those who had fallen. A logistic regression analysis using age, body fat, current drinker status, and physical inactivity for men, and age, body fat, smoking, and diabetes for women as covariate variables revealed that sarcopenia was significantly associated with a history of fall. The odds ratio for fall in the sarcopenia group relative to the normal group was 4.42 (95%CI 2.08-9.39) in men and 2.34 (95%CI 1.39-3.94) in women. This study revealed sarcopenia to be associated with falling in elderly Japanese. Sarcopenia prevention interventions may help prevent falls among elderly individuals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Probing problems and priorities in oral health (care) among community dwelling elderly in the Netherlands: a mixed method study

    NARCIS (Netherlands)

    Everaars, B.; Jerković-Ćosić, K.; van der Putten, G.J.; van der Heijden, G.J.M.G.

    2015-01-01

    Background: Complex dentitions and decline in adequate oral hygiene in elderly may lead to poor oral health. This may have impact on their general health, wellbeing and quality of life. With increased longevity, the problems and needs in oral health of community dwelling elderly lead to changes in

  7. Effect of a resistance exercise program for sarcopenic elderly women: quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Joana Ude Viana

    2018-04-01

    Full Text Available Abstract Introduction: Resistance training is quoted as one of the best pathways to manage sarcopenia and progressive resistance training is supposed to improve muscle mass, strength and performance in older adults. Objective: The aim was to examine the impact of a progressive resistance exercise program (PREP on muscle and function performance in sarcopenic community-dwelling elder women. Methods: Quasi-experimental study (pre - post intervention. Participated 18 sarcopenic community-dwelling elder women (65 years or older. PREP based on 75% of the participant’s maximum load (12/wk, 3 times/wk. Main outcome measures: muscle strength of knee extensors (isokinetic dynamometry, muscle mass (dual-x ray absorptiometry - DXA, functional performance (Short Physical Performance Battery - SPPB. Paired t-test was used to evaluate differences pre and post intervention. Results: Improvements on power (p = 0.01 and peak torque (p = 0.01 were observed when measured by the isokinetic dynamometer at low speed (60º/s. Improvements on DXA (pre PREP: 5.49 kg/m2 vs. post PREP: 6.01 kg/m2; p = 0.03 and SPPB scores (pre PREP: 9.06 vs. post PREP: 10.28; p = 0.01 were also observed. Conclusion: The PREP was able to improve muscle and functional performance in sarcopenic community-dwelling elder women. This program should be considered in clinical practice.

  8. Association between the nutritional status and the severity of sarcopenia among community-dwelling elderly Japanese people.

    Science.gov (United States)

    Komai, Satsuki; Watanabe, Yutaka; Fujiwara, Yoshinori; Kim, Hunkyung; Edahiro, Ayako; Kawai, Hisashi; Yoshida, Hideyo; Obuchi, Shuichi; Tanaka, Yayoi; Hirano, Hirohiko

    2016-01-01

    To investigate the association between nutritional evaluation indices (body mass index, albumin, and weight loss) and sarcopenia severity among community-dwelling elderly people in Japan. The subjects consisted of 758 community-dwelling elderly people ≥65 years of age, categorized into two groups by based on Operation of long life medical care system (medical care system for elderly in the latter stage of life), the cut-off value for age used was 75. The outcome measures were basic characteristics, anthropometric measures, physical function, and blood biochemistry (five assessments). The appendicular skeletal muscle mass was calculated via a bioelectrical impedance analysis. The subjects were categorized into three groups by the body mass index (BMI) [BMI 3 group]. The cut-off value for albumin used was 3.8 g/dL [A1b 2 group]. Weight loss was assessed using item 11 on the Kihon check list: "Have you experienced more than 2-3 kg weight loss over the past 6 months? Yes=1, No=0." [weight loss 2 group]. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People definition, using the Asian Working Group for Sarcopenia cut-off values. All subjects were then categorized into four groups based on their sarcopenia status: non-sarcopenic (non-), pre-sarcopenic (pre-), sarcopenic (sarco-), or severely sarcopenic (severe-) [sarco4 group]. The prevalence of sarcopenia and severe sarcopenia in men was 5.6% (n=18) and 1.2% (n=4), respectively, and in women was 7.8% (n=34) and 1.6% (n=7), respectively. The analysis showed that, among the people (>75 years of age) with normal BMI (18.5-25.0), 10.4%-15.6% were in the Sarco group. Further, among women over 75 years of age with BMI >25.0, 5.7% (n=2) were in the Sarco group. There was a significant association between weight loss and sarcopenia severity in older men. No significant association between albumin levels and sarcopenia severity was observed. 80.0% of weight-loss was presented in above BMI 18

  9. Changes in social interaction over 20 years and the effects of community resources use among community-dwelling elderly persons.

    Science.gov (United States)

    Watanabe, Kumi; Tanaka, Emiko; Wu, Bailiang; Kobayashi, Zyunko; Mochizuki, Yukiko; Kim, Yeon; Watanabe, Taeko; Okumura, Rika; Ito, Sumio; Anme, Tokie

    2017-01-01

    Objectives Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.Results Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.Conclusion The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social

  10. Loneliness and all-cause mortality in community-dwelling elderly Singaporeans

    Directory of Open Access Journals (Sweden)

    Angelique Chan

    2015-06-01

    Full Text Available Background: Loneliness is a significant risk factor for mortality among older adults. There are several pathways through which loneliness may operate to increase mortality risk, ranging from biological responses and individual perceptions to social interactions and environmental factors. The proportion of single older (65+ person households has doubled in the last ten years in Singapore. Yet little is understood about the relationship between loneliness, social isolation, and mortality risk among older adults, in Singapore and in Asian contexts in general. Objective: To assess the impact of loneliness and social isolation on the risk of all-cause mortality over a four-year period, controlling for demographic characteristics and health status at baseline. Methods: We used data from a longitudinal survey of community-dwelling Singaporean elderly (N=4,522. Loneliness was assessed using the UCLA three-item loneliness scale. Unadjusted and adjusted Cox proportional hazards regressions were used to estimate mortality risk. Results: In the final adjusted model, living arrangements and social networks outside the household were not associated with all-cause mortality. Loneliness increased the risk of all-cause mortality; those sometimes lonely and mostly lonely were 44.0Š (p=0.005 and 39.0Š (p=0.059 more likely to die compared to those not lonely. Conclusions: Loneliness is associated with higher mortality risks among Singaporean elderly. Mental health among the older population is a major public health concern and community interventions are needed to more efficiently identify, raise awareness of, and increase care for the lonely elderly in the community.

  11. Suicidality-based prediction of suicide attempts in a community-dwelling elderly population: Results from the Osan Mental Health Survey.

    Science.gov (United States)

    Oh, Dae Jong; Park, Jae Young; Oh, Miyoung; Kim, Kayoung; Hong, Jongwoo; Kim, Taehyun; Han, Ji Won; Kim, Tae Hui; Kim, Ki Woong

    2015-09-15

    Data on outcomes of suicidality in the community-dwelling elderly are scarce. We investigated the association of suicidality with the suicide attempts in a community-dwelling elderly cohort. In the Osan Mental Health Survey, 848 randomly sampled elderly Koreans participated in the baseline evaluation, 623 completed 2-year follow-up evaluation and 32 died during the follow-up period. The survey was conducted between February 2010 and January 2013. We evaluated suicidality using the Mini-International Neuropsychiatric Interview suicidality module that includes both suicidal ideation and attempts. The incidences of suicidality and suicide attempts were 70.7 and 13.1 per 1000 persons per year, respectively. Suicidality was associated with increased risk of suicide attempts (odds ratio (OR) = 3.84, 95% CI = 1.06-13.87). Two men with suicidality committed suicide by self-poisoning. Moderate to high intensity daily exercise decreased the risk of suicidality to become persistent or recurrent (OR = 0.32, 95% CI = 0.12-0.81). Low education level (OR = 2.41, 95% CI = 1.21-4.77) and depression (OR = 3.02, 95% CI = 1.65-5.53) were associated with risk of incident suicidality. Study sample was enrolled from a single city of Korea, and the size of the study sample was small. We may reduce suicide attempts by screening for suicidality and implementing exercise programs in community-dwelling elderly people. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. The prevalence and related factors of restless leg syndrome in the community dwelling elderly; in Kayseri, Turkey: A cross-sectional study.

    Science.gov (United States)

    Safak, Elif Deniz; Gocer, Semsinur; Mucuk, Salime; Ozturk, Ahmet; Akin, Sibel; Arguvanli, Sibel; Mazicioglu, Mumtaz M

    2016-01-01

    The aim of this study is to determine the prevalence and related factors of restless leg syndrome (RLS) in the community-dwelling elderly living in Kayseri. This is a cross-sectional population based study in 960 community-dwelling elderly living in an urban area. We sampled 1/100 of elderly people aged 60 years and older. The diagnosis of RLS was made according to the criteria of the International RLS Study Group. The demographic data were collected by face-to-face interviews. Additionally, the Mini-Mental State Examination, Geriatric Depression Scale and anthropometric measurements were used. Logistic regression analyses were performed to define risk factors for RLS. We excluded elderly people with cognitive impairment (295). One hundred and five (15.8%) of the remaining 665 elderly subjects met the criteria to diagnose RLS. There was female predominance (3/1). Gender, length of education, employment status, smoking, hypertension, diabetes mellitus, depressive mood, high body mass index, and high waist circumferences, sleep quality, sleep duration, and difficulty in falling asleep in the first 30min were all detected as risk factors for RLS. However in logistic regression analysis, being a housewife, sleeping less than 6h a day and having diabetes was found as significantly related risk factors for RLS. This is the first epidemiologic study of RLS conducted in the Turkish community-dwelling elderly in an urban area. RLS is a common but underestimated disease in the elderly. Although RLS is prevalent we found very few risk factors for RLS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women.

    Science.gov (United States)

    Park, Kyung-Ae; Park, Yeon-Hwan; Suh, Min-Hee; Choi-Kwon, Smi

    2015-09-01

    Differing lifestyle, nutritional, and genetic factors may lead to a differing stiffness index (SI) determined by quantitative ultrasound in elderly men and women. The purpose of this study was to determine SI and the gender-specific factors associated with low SI in a Korean elderly cohort. This was a cross-sectional descriptive study identifying the gender-specific factors related to SI in 252 men and women aged 65 years and greater from local senior centers in Seoul, Korea between January and February 2009. The mean SI of elderly men was significantly higher than that of the women's. A multiple regression analysis reveals that age, nutritional status, and physical activity were predictive factors of lower SI in men, whereas age, alcohol consumption, educational level, and genetic polymorphism were predictive factors for elderly women. Low SI was common in both elderly men and women. We found gender differences in factors linked to low SI. In multiple regression analysis, nutritional status and physical activity were more important factors in men, whereas alcohol consumption, educational level, and genetic polymorphism were significant factors predicting low SI in women. Gender-specific modifiable risk factors associated with low SI should be considered when developing osteoporosis prevention programs for the elderly. Copyright © 2015. Published by Elsevier B.V.

  14. Association of unipedal standing time and bone mineral density in community-dwelling Japanese women.

    Science.gov (United States)

    Sakai, A; Toba, N; Takeda, M; Suzuki, M; Abe, Y; Aoyagi, K; Nakamura, T

    2009-05-01

    Bone mineral density (BMD) and physical performance of the lower extremities decrease with age. In community-dwelling Japanese women, unipedal standing time, timed up and go test, and age are associated with BMD while in women aged 70 years and over, unipedal standing time is associated with BMD. The aim of this study was to clarify whether unipedal standing time is significantly associated with BMD in community-dwelling women. The subjects were 90 community-dwelling Japanese women aged 54.7 years. BMD of the second metacarpal bone was measured by computed X-ray densitometry. We measured unipedal standing time as well as timed up and go test to assess physical performance of the lower extremities. Unipedal standing time decreased with increased age. Timed up and go test significantly correlated with age. Low BMD was significantly associated with old age, short unipedal standing time, and long timed up and go test. Stepwise regression analysis revealed that age, unipedal standing time, and timed up and go test were significant factors associated with BMD. In 21 participants aged 70 years and over, body weight and unipedal standing time, but not age, were significantly associated with BMD. BMD and physical performance of the lower extremities decrease with older age. Unipedal standing time, timed up and go test, and age are associated with BMD in community-dwelling Japanese women. In women aged 70 years and over, unipedal standing time is significantly associated with BMD.

  15. Relationships between sarcopenia and household status and locomotive syndrome in a community-dwelling elderly women in Japan.

    Science.gov (United States)

    Momoki, Chika; Habu, Daiki; Ogura, Juri; Tada, Arisa; Hasei, Ai; Sakurai, Kotone; Watanabe, Hatsumi

    2017-01-01

    The aim of the present study was to identify factors associated with sarcopenia in community-dwelling elderly women in Japan. A total of 186 women aged over 65 years attending preventive care classes were enrolled in the study. Muscle mass was assessed using bioelectrical impedance analysis. Sarcopenia was defined as low muscle mass and low muscle strength in accord with the consensus report of the Asian Working Group for Sarcopenia. Data regarding household status (living alone, with a spouse, or with children and/or grandchildren), calf circumference and the presence of locomotive syndrome were obtained, as well as dietary variety score, Tokyo Metropolitan Institute of Gerontology Index of Competence and Mini-Nutritional Assessment short form, and 10-item Eating Assessment Tool scores. Sarcopenia was identified in 21.0% of participants. Participants with sarcopenia were older, had a lower body mass index and calf circumference, and were more likely to have locomotive syndrome, and living with children and/or grandchildren. In multivariate analysis, age, body mass index sarcopenia, as were associated living alone (OR 1.69, 95% CI 0.45-6.41), and living with children and/or grandchildren (OR 2.46, 95% CI 0.71-8.54) and dietary variety score ≥9 (OR 4.98, 95% CI 0.97-25.56). Age, body mass index, dietary variety score, locomotive syndrome and household status were associated with sarcopenia. Early interventions are required for older adults identified as having a higher risk of sarcopenia to prevent its adverse health consequences. Geriatr Gerontol Int 2017; 17: 54-60. © 2016 Japan Geriatrics Society.

  16. Fear of falling and changed functional ability following hip fracture among community-dwelling elderly people

    DEFF Research Database (Denmark)

    Jellesmark, Annette; Herling, Suzanne Forsyth; Egerod, Ingrid

    2012-01-01

    The aims of the study were to assess self-reported fear of falling (FOF) and functional ability among community-dwelling elderly people 3-6 months post hospital discharge after a hip fracture, to investigate the association between FOF and functional ability, and to explore the lived experience...... of FOF and disability when recovering from a hip fracture....

  17. Low peak jump power is associated with elevated odds of dysmobility syndrome in community-dwelling elderly individuals: the Korean Urban Rural Elderly (KURE) study.

    Science.gov (United States)

    Hong, Namki; Kim, Chang Oh; Youm, Yoosik; Kim, Hyeon Chang; Rhee, Yumie

    2018-06-01

    In a community-dwelling elderly cohort (Korean Urban Rural Elderly), low peak jump power was associated with elevated odds of dysmobility syndrome and its components, independent of age and comorbidities. Jump power measurement improved discrimination of individuals with dysmobility syndrome when added to conventional risk factors. Dysmobility syndrome was proposed to encompass the risks affecting musculoskeletal outcomes. Jump power measurement is a safe, reproducible high-intensity test for physical function in elderly. However, the relationship between jump power and dysmobility syndrome remains unknown. A total of 1369 subjects (mean 71.6 years; women, 66%) were analyzed from a community-based cohort. Dysmobility syndrome was defined as the presence of ≥ 3 factors among falls in the preceding year, low lean mass, high fat mass, osteoporosis, low grip strength, and low timed get-up-and-go (TUG) performance. Subjects were grouped into tertiles of jump power relative to weight based on sex-stratified cutoffs (32.4 and 27.6 W/kg in men; 23.9 and 19.9 W/kg in women) or into the failed-to-jump group. The prevalence of dysmobility syndrome was 20% overall, increasing from the highest (T1) to lowest (T3) jump power tertile (1, 11, 15% in men; 11, 16, 39% in women) and the failed-to-jump group (39% in men; 48% in women). Low jump power or failed-to-jump was associated with elevated odds of dysmobility syndrome (T3 vs. T1, adjusted odds ratio [aOR] 4.35, p jump vs. T1, aOR 7.60, p Jump power modestly discriminated dysmobility syndrome (area under the curve [AUC], 0.71, p jump power was associated with elevated odds of dysmobility syndrome and its components, independent of age and comorbidities.

  18. Relationship between alcohol consumption and periodontal tissue condition in community-dwelling elderly Japanese.

    Science.gov (United States)

    Suwama, Kana; Yoshihara, Akihiro; Watanabe, Reiko; Stegaroiu, Roxana; Shibata, Satoko; Miyazaki, Hideo

    2018-03-25

    To examine the associations among alcohol consumption level, dietary intake and other lifestyle factors, and periodontal condition, in community-dwelling elderly Japanese of a specific age. The relationship between alcohol consumption level and periodontitis is a controversial issue. Participants were 438 dentate elders aged 73 years from a larger cohort survey of elders in Niigata City, Japan. Data collected from oral examination of each participant, including number of the existing teeth, mean probing pocket depth and mean clinical attachment level (CAL) were used for the analyses. A semiquantitative food frequency questionnaire and a lifestyle habit questionnaire were used to assess food and alcohol consumption, smoking experience, frequency of tooth brushing, interdental brush use, and visits to a dental clinic during the previous year. Blood glucose control was assessed by the glycated haemoglobin (HbA1c) level. Body mass index was calculated from height and weight measurements. The relationships between each variable and the individual mean CAL were analysed by univariate and multivariate analyses. According to logistic regression analysis, the mean CAL was significantly associated with the number of existing teeth (odds ratio [OR] = 0.90; P dwelling elderly Japanese (aged 73 years) compared with non-drinking. Our results provide new evidence that high alcohol consumption is associated with an increased risk of periodontal disease and its progression. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  19. Fall Risk Index predicts functional decline regardless of fall experiences among community-dwelling elderly.

    Science.gov (United States)

    Ishimoto, Yasuko; Wada, Taizo; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wenling; Hirosaki, Mayumi; Nakatsuka, Masahiro; Fujisawa, Michiko; Sakamoto, Ryota; Ishine, Masayuki; Okumiya, Kiyohito; Otsuka, Kuniaki; Matsubayashi, Kozo

    2012-10-01

    The 21-item Fall Risk Index (FRI-21) has been used to detect elderly persons at risk for falls. The aim of this longitudinal study was to evaluate the FRI-21 as a predictor of decline in basic activities of daily living (BADL) among Japanese community-dwelling elderly persons independent of fall risk. The study population consisted of 518 elderly participants aged 65 years and older who were BADL independent at baseline in Tosa, Japan. We examined risk factors for BADL decline from 2008 to 2009 by multiple logistic regression analysis on the FRI-21 and other functional status measures in all participants. We carried out the same analysis in selected participants who had no experience of falls to remove the effect of falls. A total of 45 of 518 participants showed decline in BADL within 1 year. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05-1.20), FRI-21 ≥ 10 (OR 3.81, 95% CI 1.49-9.27), intellectual activity dependence (OR 3.25, 95% CI 1.42-7.44) and history of osteoarthropathy (OR 3.17, 95% CI 1.40-7.21) were significant independent risk factors for BADL decline within 1 year. FRI-21 ≥ 10 and intellectual activity dependence (≤ 3) remained significant predictors, even in selected non-fallers. FRI-21 ≥ 10 and intellectual activity dependence were significant predictive factors of BADL decline, regardless of fall experience, after adjustment for confounding variables. The FRI-21 is a brief, useful tool not only for predicting falls, but also future decline in functional ability in community-dwelling elderly persons. © 2012 Japan Geriatrics Society.

  20. CORRELATIONS BETWEEN MUSCLE MASS, MUSCLE STRENGTH, PHYSICAL PERFORMANCE, AND MUSCLE FATIGUE RESISTANCE IN COMMUNITY-DWELLING ELDERLY SUBJECTS

    Directory of Open Access Journals (Sweden)

    Elizabeth

    2016-03-01

    Full Text Available Objective: To determine the correlations between muscle mass, muscle strength, physical performance, and muscle fatigue resistance in community-dwelling elderly people in order to elucidate factors which contribute to elderly’s performance of daily activities. Methods: A cross-sectional study was conducted on community-dwelling elderly in Bandung from September to December 2014. One hundred and thirty elderly, 60 years old or above, were evaluated using bioelectrical impedance analysis to measure muscle mass; grip strength to measure muscle strength and muscle fatigue resistance; habitual gait speed to measure physical performance; and Global Physical Activity Questionnaire (GPAQ to assess physical activity. Results: There were significant positive correlations between muscle mass (r=0,27, p=0,0019, muscle strength (r=0,26, p=0,0024, and physical performance (r=0,32, p=0,0002 with muscle fatigue resistance. Physical performance has the highest correlation based on multiple regression test (p=0,0025. In association with muscle mass, the physical activity showed a significant positive correlation (r=0,42, p=0,0000. Sarcopenia was identified in 19 (14.61% of 130 subjects. Conclusions: It is suggested that muscle mass, muscle strength, and physical performance influence muscle fatigue resistance.

  1. Functional ability of community dwelling elderly. Criterion-related validity of a new measure of functional ability

    DEFF Research Database (Denmark)

    Schultz-Larsen, K; Avlund, K; Kreiner, S

    1992-01-01

    Criterion-related validity of a new measure of functional ability was conducted according to a causal model based on conceptual models employed in the area of rehabilitative and geriatric medicine. The criteria variables included concurrent diagnosed diseases, global self-rated health, drug...... consumption and general practitioner (GP) consultations. The measure of functional ability was developed with the intention of achieving a high degree of discrimination among a group of community dwelling elderly. Data were derived from a sample survey of 70-year-old men and women conducted in 1984...... different unidimensional index scales of functional ability divided into two types, with reduced speed and tiredness as subdimensions. The two scale types were mobility function and lower limb function. Early losses of ability together with global self-rated health were treated as outcome measures...

  2. Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography

    Directory of Open Access Journals (Sweden)

    Erika H. Tanaka

    2015-06-01

    Full Text Available Background: Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. Objectives: The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis in elderly community-dwelling women. Method: Static posturography was used in two groups: elderly women with (WC group and without (NC group complaints of impaired balance. The area, mean sway amplitude and mean speed of the center of pressure (COP in the anterior-posterior (AP and medial-lateral (ML directions were analyzed in three stances: single-leg stance, double-leg stance and tandem stance, with eyes open or closed on two different surfaces: stable (firm and unstable (foam. A digital chronometer was activated to measure the time limit (Tlimit in the single-leg stance. Kruskal-Wallis tests followed by Mann-Whitney tests, Friedman analyses followed by post hoc Wilcoxon tests and Bonferroni corrections, and Spearman statistical tests were used in the data analysis. Differences of p<0.05 were considered statistically significant. Results: The results of posturography variables revealed no differences between groups. The timed single-leg stance test revealed a shorter Tlimit in the left single-leg stance (p=0.01 in WC group compared to NC group. A negative correlation between posturography variables and Tlimit was detected. Conclusions: Posturography did not show any differences between the groups; however, the timed single-leg stance allowed the authors to observe differences in postural control performance between elderly women with and those without complaints of impaired balance.

  3. Age differences and interindividual variation in cognition in community-dwelling elderly.

    Science.gov (United States)

    Christensen, H; Mackinnon, A; Jorm, A F; Henderson, A S; Scott, L R; Korten, A E

    1994-09-01

    The cognitive test performance of 897 community-dwelling elderly Ss, aged 70 years and over, was examined for age trends and interindividual variation. Data were subjected to factor analysis, and 3 factors emerged (Crystallized Intelligence, Fluid Intelligence, and Memory). Over the age span sampled, Crystallized Intelligence, Fluid Intelligence, and Memory all decreased with the decrease being greatest for Fluid Intelligence and least for Crystallized Intelligence. Interindividual variation increased for Fluid Intelligence and Memory, but not for Crystallized Intelligence. These findings give support to the view that crystallized intelligence is lower in the very old and that there is a greater degree of variability in test performance with advancing age.

  4. Prevalence of falls among community-dwelling elderly and its associated factors: A cross-sectional study in Perak, Malaysia.

    Science.gov (United States)

    Yeong, U Y; Tan, S Y; Yap, J F; Choo, W Y

    2016-01-01

    Fall is a major cause of injuries and can increase the risk of early mortality among elderly. The objective of this study was to determine the prevalence of falls among community-dwelling elderly in rural Malaysia and its associated factors. Data were obtained from a cross-sectional survey in five randomly selected districts in the state of Perak, Malaysia. A total of 250 households were randomly selected. A total of 811 individuals aged 60 years or more were recruited and interviewed using a structured questionnaire. Information about socio-demographic, history of falls in the past 1 year, medical history, drug history and physical activity level were enquired. The prevalence of falls in the past 1 year among community-dwelling elderly was reported to be 4.07%. Indigenous elderly (Adjusted odd ratio, AOR = 6.06, 95% CI = 1.10-33.55, p = 0.039) and living alone (AOR = 2.60, 95% CI = 1.04-6.50, p = 0.042) were shown to be factors associated with falls. Physical activity level, number of co-morbidities and number of medications used were not associated with falls. Elderly of indigenous ethnicity and living alone are the main factors associated with falls in this population. Indigenous people may be at higher risk, which warrant further investigation with a larger sample to improve the precision of estimates.

  5. The association between sleep duration and physical performance in Chinese community-dwelling elderly.

    Science.gov (United States)

    Fu, Liyuan; Jia, Liye; Zhang, Wen; Han, Peipei; Kang, Li; Ma, Yixuan; Yu, Hairui; Zhai, Tianqi; Chen, Xiaoyu; Guo, Qi

    2017-01-01

    Physical performance is an important healthy factor in elder people. Good living habits, which include sleep, can maintain physical strength and physical performance. The aim of the present study was to conduct a cross-sectional study to determine the association between total sleep duration and physical performance. Our study population comprised residents of the township central hospital in the suburban of Tianjin, China. We measured muscle strength, walk speed and balance function by grip, 4-m walk test and timed up and go test (TUGT). We divided sleep duration into four groups 8-9h, >9h. A total 898 participants had completed data (392 men and 506 women, mean age 67.71 years). In man, adjusted sleep duration was associated with lower grip in > 9 h group, the mean value (95% CI) was 0.429 (0.409, 0.448), and longer TUGT time was also associated with long sleep duration, 10.46s (9.97 s, 10.95 s). In women, adjusted slower 4-m walk speed present an inverse U-shaped relation with sleep duration, by 0.93 m/s (0.86 m/s, 0.98 m/s), 0.97 m/s (0.96 m/s, 1.00 m/s), 0.97 m/s (0.95 m/s, 0.99 m/s) and 0.92 m/s (0.89 m/s, 0.96 m/s); longer TUGT time were associated with long sleep duration (> 9 h), by 11.23 s (10.70 s, 11.77 s). In Chinese community-dwelling elderly, lower muscle strength and lower balance function were associated with long sleep duration in men. Slower walk speed and lower balance function were associated with long sleep duration in women.

  6. The effect of caregiver support interventions for informal caregivers of community-dwelling frail elderly: a systematic review

    Directory of Open Access Journals (Sweden)

    Maja Lopez Hartmann

    2012-08-01

    Full Text Available Introduction: Informal caregivers are important resources for community-dwelling frail elderly. But caring can be challenging. To be able to provide long-term care to the elderly, informal caregivers need to be supported as well. The aim of this study is to review the current best evidence on the effectiveness of different types of support services targeting informal caregivers of community-dwelling frail elderly. Methods: A systematic literature search was performed in Medline, PsychINFO, Ovid Nursing Database, Cinahl, Embase, Cochrane Central Register of Controlled Trials and British Nursing Index in september 2010. Results: Overall, the effect of caregiver support interventions is small and also inconsistent between studies. Respite care can be helpful in reducing depression, burden and anger. Interventions at the individual caregivers' level can be beneficial in reducing or stabilizing depression, burden, stress and role strain. Group support has a positive effect on caregivers' coping ability, knowledge, social support and reducing depression. Technology-based interventions can reduce caregiver burden, depression, anxiety and stress and improve the caregiver's coping ability. Conclusion: Integrated support packages where the content of the package is tailored to the individual caregivers' physical, psychological and social needs should be preferred when supporting informal caregivers of frail elderly. It requires an intense collaboration and coordination between all parties involved.

  7. No association between dietary vitamin K intake and fracture risk in chinese community-dwelling older men and women: a prospective study.

    Science.gov (United States)

    Chan, R; Leung, J; Woo, J

    2012-05-01

    Data on the association between dietary vitamin K intake and fracture risk are limited among Chinese. This study examined such an association in community-dwelling elderly in Hong Kong. We present data from 2,944 subjects (1,605 men, 1,339 women) who participated in a prospective cohort study. Baseline dietary intakes of energy, protein, calcium, vitamin D, and vitamin K were assessed using a food-frequency questionnaire. Data on incident hip fracture and nonvertebral fracture during a median of 6.9 follow-up years were collected from a hospital database. Cox regression analyses were performed with adjustments for age, education attainment, smoking status, alcohol use, body mass index, hip bone mineral density, physical activity, use of calcium supplement, and energy-adjusted nutrient intakes. There were 29 (1.8 %) men and 19 (1.4 %) women with incident hip fractures and 97 (6.0 %) men and 88 (6.6 %) women with nonvertebral fractures. The median (interquartile range) of dietary vitamin K intake was 241.8 (157.5-360.8) and 238.9 (162.4-343.6) μg/day in men and women, respectively. Similar dietary vitamin K intakes were observed between subjects with hip or nonvertebral fractures and subjects without hip or nonvertebral fractures. In both men and women, dietary vitamin K intake was not associated with fracture risks at all measured sites in either crude or adjusted models. In Chinese community-dwelling elderly, hip or nonvertebral fracture risk was not associated with dietary vitamin K intake. The high dietary vitamin K intake of the studied group may have limited the ability to detect the association between vitamin K intake and fracture risk.

  8. Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

    Science.gov (United States)

    Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

    2017-01-01

    This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (psarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning of the lower limbs from the perspective of sarcopenia improvement among the elderly

  9. Risk factors of falls in community dwelling active elderly.

    Science.gov (United States)

    Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Pyykkö, Ilmari

    2014-02-01

    To search for measures to describe and relate to accidental falls in community dwelling elderly. A EuroQol EQ-5D questionnaire based on a patient's otoneurological case history provided a general health related quality of life measure, a fall history for the last 3 months and force platform measures for 96 active elderly from a pensioner organization. On average, the elderly experienced 0.3 falls over the preceding three months. A fall was seen to cause a significant deterioration in the quality of life and vertigo and caused fear of falling. The postural instability correlated with falls. Vertigo was present among 42% and was most commonly characterized as episodic and rotatory in factorial analysis items relating to vertigo correlated to falls and balance complaints. Four factors were identified and three of these correlated with falls. Vestibular failure correlated to a fall occurring when a person was rising up; Movement intolerance correlated with falls due to slips and trips, and Near-syncope factor correlated to falls for other reasons. In posturography, the variable measuring critical time describing the memory based "closed loop" control of postural stability carried a risk for accidental fall with an odds ratio of 6. The variable measuring zero crossing velocity showed a high rate of velocity change around the neutral position of stance. Vertigo and poor postural stability were the major reasons for falls in the active elderly. In ageing, postural control is shifted towards open loop control (visual, proprioception, exteroception and vestibular) instead of closed loop control and is a factor that contributes to a fall. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Comparison of Happiness and Spiritual Well-Being among the Community Dwelling Elderly and those who Lived in Sanitariums.

    Science.gov (United States)

    Adib-Hajbaghery, Mohsen; Faraji, Mona

    2015-07-01

    Several studies are available on the lifestyle, psychological and mental health of the elderly adults. This study aimed to compare the spiritual well-being and happiness in the elderly who lived in sanitariums with those lived in the community. A comparative study was conducted on 384 elderly adults. A census sampling was used in sanitariums and a convenience sampling was performed to select the community dwelling (CD) older adults. A demographic questionnaire, the Pauloutzian and Ellison's spiritual well-being scale and the Oxford happiness questionnaire were used in this study. Descriptive statistics and Kolmogorov-Smirnov, Chi-square and Mann-Whitney U tests and Spearman correlation coefficient were employed for data analysis, using the SPSS software, version 13.0. From the total participants, 56% were CD elderly and 44% were in sanitariums. Among the CD older adults, no one was at a high level of spiritual well-being while in sanitariums 24.4% were at a high level of spiritual well-being. Also, 71.2% of the community dwelling older adults were at a high level of happiness while only 3.6% of those living in sanitariums expressed a high level of happiness. A significant association was found between the level of spiritual well-being and happiness in those who lived in sanitariums (r=0.177, Pspiritual well-being and low happiness. Therefore, nurses and health authorities are responsible not only to inform the community about the importance of spiritual well-being and happiness, but also to establish some strategies in this regard.

  11. Vitamin D and Calcium supplementation prevents severe falls in elderly community dwelling residents: a pragmatic population-based 3-year intervention study

    DEFF Research Database (Denmark)

    Larsen, Erik Roj; Mosekilde, Leif; Foldspang, Anders

    2005-01-01

    Background and aims: We evaluated the effect of two programs for the prevention of falls leading to acute hospital admission in a population of elderly community-dwelling Danish residents. Methods: This was a factorial, pragmatic, intervention study. We included 9605 community-dwelling city......, or no intervention. Results: The Calcium and Vitamin D program was followed by 50.3% and the Environmental and Health Program by 46.4%. According to a multivariate analysis including age, marital status and intervention program, female residents who followed the Calcium and Vitamin D Program had a 12% risk reduction...... in severe falls (RR 0.88; 95% CI 0.79-0.98; pfalls leading to acute hospitalization in communitydwelling elderly females in a northern European region known to be deficient in vitamin D....

  12. Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community-dwelling elderly.

    Science.gov (United States)

    Kimura, Yumi; Ogawa, Hiroshi; Yoshihara, Akihiro; Yamaga, Takayuki; Takiguchi, Tomoya; Wada, Taizo; Sakamoto, Ryota; Ishimoto, Yasuko; Fukutomi, Eriko; Chen, Wenling; Fujisawa, Michiko; Okumiya, Kiyohito; Otsuka, Kuniaki; Miyazaki, Hideo; Matsubayashi, Kozo

    2013-07-01

    The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly. The study population consisted of 269 community-dwelling elderly aged ≥ 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11). Number of teeth was significantly related to chewing ability (Pchewing ability had significantly lower ADL scores in the items of self-maintenance (P=0.029) and intellectual activity (P=0.021). There was a significant association between low chewing ability and depression (Pchewing ability; MMSE (P=0.022), HDSR (P=0.017) and FAB (P=0.002). The participants with low chewing ability had lower food variety (Pchewing ability. Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings. © 2012 Japan Geriatrics Society.

  13. [Relationship between cognitive function and physical activities: a longitudinal study among community-dwelling elderly].

    Science.gov (United States)

    Konagaya, Yoko; Watanabe, Tomoyuki; Ohta, Toshiki

    2012-01-01

    The purpose of this study was to evaluate whether physical activities reduce the risk of cognitive decline in community-dwelling elderly. We investigated correlations between cognitive functions at baseline and physical activities, correlations between cognitive functions at baseline and cognitive decline over 4 years, as well as correlations between physical activity at baseline and cognitive decline over 4 years. At baseline, 2,431 community-dwelling elderly completed the cognitive screening by telephone (TICS-J), and answered the questionnaires about physical activities. Of these, 1,040 subjects again completed the TICS-J over 4 years. Physical activities contained moving ability, walking frequency, walking speed, the exercise frequency. At baseline, 870 elderly (age 75.87±4.96 (mean±SD) years, duration of education 11.05±2.41) showed normal cognitive functions and 170 (79.19±6.22, 9.61±2.23) showed cognitive impairment. The total TICS-J score was significantly higher in cognitive normal subjects compared with that of cognitive impaired subjects (36.02±1.89, 30.19±2.25, respectively, p<0.001). Logistic regression analyses showed that moving ability significantly reduced the risk of cognitive impairment in an unadjusted model, and walking speed also reduced the risk of cognitive impairment at baseline even in an adjusted model. Cognitive function at baseline might be a predictor of cognitive function over 4 years. The longitudinal study revealed that walking speed and exercise frequency significantly correlate with maintenance of cognitive function over 4 years. This study provides that physical activities, especially walking speed have significant correlation with cognitive function.

  14. A Screening Tool Using Five Risk Factors Was Developed for Fall-Risk Prediction in Chinese Community-Dwelling Elderly Individuals.

    Science.gov (United States)

    Kang, Li; Chen, Xiaoyu; Han, Peipei; Ma, Yixuan; Jia, Liye; Fu, Liyuan; Yu, Hairui; Wang, Lu; Hou, Lin; Yu, Xing; An, Zongyang; Wang, Xuetong; Li, Lu; Zhang, Yuanyuan; Zhao, Peng; Guo, Qi

    2018-01-22

    The objective of this study was to determine falls risk profiles to derive a falls risk prediction score and establish a simple and practical clinical screening tool for Chinese community-dwelling elderly individuals. This was a prospective cohort study (n = 619) among adults aged 60 years and older. Falls were ascertained at a 1-year follow-up appointment. Sociodemographic information, medical history, and physical performance data were collected. The mean age was 67.4 years; 57.7% were women. Female sex (odds ratios [ORs] 1.82; 95% confidence interval [95% CI] 1.17-2.82), diabetes (OR 2.13; 95% CI 1.13-3.98), a Timed Up and Go Test (TUGT) ≥10.49 seconds (OR 1.51; 95% CI 1.23-1.94), a history of falls (OR 3.15; 95% CI 1.72-5.79), and depression (Geriatric Depression Scale [GDS] ≥11, OR 2.51; 95% CI 1.36-4.63) were the strongest predictors. These predictors were used to establish a risk score. The area under the curve of the score was 0.748. From a clinical point of view, the most appropriate cutoff value was 7 (97.5% specificity, 70.7% positive predictive value, and 83.6% negative predictive value). For this cutoff, the fraction correctly classified was 82.5%. A cutoff score of 7 derived from a risk assessment tool using four risk factors (gender, falls history, diabetes, and depression) and the TUGT may be used in Chinese community-dwelling elderly individuals as an initial step to screen those at low risk for falls.

  15. Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women

    Directory of Open Access Journals (Sweden)

    Kyung-Ae Park, PhD

    2015-09-01

    Conclusions: Low SI was common in both elderly men and women. We found gender differences in factors linked to low SI. In multiple regression analysis, nutritional status and physical activity were more important factors in men, whereas alcohol consumption, educational level, and genetic polymorphism were significant factors predicting low SI in women. Gender-specific modifiable risk factors associated with low SI should be considered when developing osteoporosis prevention programs for the elderly.

  16. Association between lifestyle factors and mental health measures among community-dwelling older women.

    Science.gov (United States)

    Cassidy, Kellie; Kotynia-English, Ria; Acres, John; Flicker, Leon; Lautenschlager, Nicola T; Almeida, Osvaldo P

    2004-01-01

    To investigate the association between potentially modifiable lifestyle factors and cognitive abilities/depressive symptoms in community-dwelling women aged 70 years and over. Cross-sectional study of community-dwelling women aged 70 years and over (n=278; mean age=74.6 years). Lifestyle variables assessed included smoking, alcohol consumption, physical activity, nutrition and education. The mental health measures of interest were depression, anxiety, quality of life and cognitive function, as assessed by the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), SF-36, and the Cambridge Cognitive Examination for Mental Disorders of the Elderly (CAMCOG), respectively. Physically active women were half as likely to be depressed (BDI score > or =10) and anxious (BAI score > or = 8) when compared to their physically inactive counterparts (OR=0.5, 95% CI=0.3-0.8 for both, adjusted for marital status and smoking in the case of depression). Having ever smoked more than 20 cigarettes per day was associated with increased risk of depression (OR=2.8, 95% CI=1.4-5.5, adjusted for marital status and physical activity). Moderate alcohol use was associated with increased likelihood of having a CAMCOG score within the highest 50 percentile (OR=2.0, 95% CI=1.1-3.5, adjusted for age and education), as was more than minimum statutory education (OR=2.0, 95% CI=1.1-3.5, adjusted for age and alcohol consumption). There was no obvious association between vitamin B12/folate deficiency or obesity with any of the measures of interest. The results of this study are consistent with the hypothesis that depression is directly associated with heavy smoking and inversely associated with physical activity. They also support the idea that non-harmful alcohol consumption is associated with better cognitive performance. Randomised clinical trials should be now designed to clarify whether management of lifestyle factors reduces the incidence of mood disorders and cognitive impairment in

  17. Functional and cognitive changes in community-dwelling elderly: longitudinal study.

    Science.gov (United States)

    Figueiredo, Carolina S; Assis, Marcella G; Silva, Silvia L A; Dias, Rosângela C; Mancini, Marisa C

    2013-01-01

    The relationship between aging and increased life expectancy in the overall population likely contributes to a higher frequency rate and incidence of illnesses and functional disabilities. Physical dependence and cognitive impairment might hinder the performance of activities and result in an overload of care duties for the patient's family and the healthcare system. The aim of this study was to compare the functional and cognitive changes exhibited by the elderly over a 6-month period. This longitudinal and observational study was conducted in a sample of 167 elderly people, who were selected from the database of the Network of Studies on Frailty in Brazilian Elderly, Universidade Federal de Minas Gerais - UFMG. The participants submitted to the Mini Mental State Examination (MMSE), Katz Index, Lawton and Brody's scale and responded to items on Advanced Activities of Daily Living (AADLs). We analyzed the data using multivariate regression models. The participants' functional capacity exhibited reduced performance of specific instrumental activities of daily living (IADLs), p=0.002, and basic activities of daily living (BADLs), p=0.038. Living alone (odds ratio (OR), 2.53; 95% confidence interval (CI), 1.09-5.87) and work status (OR, 2.52; 95% CI, 1.18-5.41) were associated with changes in the IADLs. The scores in the AADL scale (p=0.163) and MMSE (p=0.059) did not exhibit any significant difference during the study period. The participants with better cognitive function were more independent in their performance of AADLs and IADLs. The results depict specific patterns of loss and stability of functional capacity in community-dwelling elderly.

  18. Functional and cognitive changes in community-dwelling elderly: Longitudinal study

    Directory of Open Access Journals (Sweden)

    Carolina S. Figueiredo

    2013-06-01

    Full Text Available BACKGROUND: The relationship between aging and increased life expectancy in the overall population likely contributes to a higher frequency rate and incidence of illnesses and functional disabilities. Physical dependence and cognitive impairment might hinder the performance of activities and result in an overload of care duties for the patient's family and the healthcare system. OBJECTIVE: The aim of this study was to compare the functional and cognitive changes exhibited by the elderly over a 6-month period. METHOD: This longitudinal and observational study was conducted in a sample of 167 elderly people, who were selected from the database of the Network of Studies on Frailty in Brazilian Elderly, Universidade Federal de Minas Gerais - UFMG. The participants submitted to the Mini Mental State Examination (MMSE, Katz Index, Lawton and Brody's scale and responded to items on Advanced Activities of Daily Living (AADLs. We analyzed the data using multivariate regression models. RESULTS: The participants' functional capacity exhibited reduced performance of specific instrumental activities of daily living (IADLs, p=0.002, and basic activities of daily living (BADLs, p=0.038. Living alone (odds ratio (OR, 2.53; 95% confidence interval (CI, 1.09-5.87 and work status (OR, 2.52; 95% CI, 1.18-5.41 were associated with changes in the IADLs. The scores in the AADL scale (p=0.163 and MMSE (p=0.059 did not exhibit any significant difference during the study period. The participants with better cognitive function were more independent in their performance of AADLs and IADLs. CONCLUSION: The results depict specific patterns of loss and stability of functional capacity in community-dwelling elderly.

  19. The prevalence of frailty and related factors in community-dwelling Turkish elderly according to modified Fried Frailty Index and FRAIL scales.

    Science.gov (United States)

    Akın, Sibel; Mazıcıoglu, Mumtaz M; Mucuk, Salime; Gocer, Semsinnur; Deniz Şafak, Elif; Arguvanlı, Sibel; Ozturk, Ahmet

    2015-10-01

    The purpose of this study is to determine the prevalence of frailty with the Fried Frailty Index (FFI) and FRAIL scales (Fatigue, Resistance, Ambulation, Illness, Low weight) and also its associated factors in the community-dwelling Turkish elderly. This is a cross-sectional population-based study in an urban area with a population of over 1,200,000. We sampled 1/100 of the elderly population. Frailty prevalence was assessed with a modified version of the FFI and FRAIL scale. Nutritional status was assessed by Mini Nutritional Assessment. Cognitive function was assessed by Mini-Mental State Examination. Depressive mood was assessed by GDS. Functional capacity was assessed by the instrumental activities of daily living scale. Falls and fear of falling were noted. Uni- and multivariate analyses were done to determine associated factors for frailty. A total of 906 community-dwelling elderly were included, in whom the mean age and standard deviation (SD) of age were 71.5 (5.6) years (50.6 % female). We detected frailty (female 30.4 %, male 25.2 %), pre-frailty and non-frailty prevalence with FFI as 27.8, 34.8, and 37.4 %, respectively. The prevalence of frailty (female 14.5 %, male 5.4 %), pre-frailty and non-frailty with the FRAIL scale was detected as 10, 45.6, and 44.4 %. Coexisting associated factors related with frailty in both models were found as depressive mood, cognitive impairment, and malnutrition in multivariate analysis. According to both scales, frailty was strongly associated with cognitive impairment, depressive mood, and malnutrition in the community-dwelling Turkish elderly population.

  20. [Prevalence and characteristics of urinary incontinence in community-dwelling-elderly as determined by comprehensive health examination and interview for the prevention of geriatric syndrome and bed-ridden state].

    Science.gov (United States)

    Yoshida, Yuko; Kim, Hunkyung; Iwasa, Hajime; Kwon, Jinhee; Sugiura, Miho; Furuna, Taketo; Yoshida, Hideyo; Suzuki, Takao

    2007-01-01

    We examined the prevalence and characteristics of urinary incontinence in community-dwelling elderly individuals. The participants were 1,783 individuals (768 men and 1,015 women) aged over 70 years who participated in a comprehensive health examination involving a medical examination and interview, plus physical performance tests. Differences in characteristics between individuals with and without urinary incontinence were examined, and multivariate logistic regression models were used to describe the characteristics associated with urinary incontinence. The prevalence of urinary incontinence was 13.4% in men and 23.3% in women. Urinary incontinence was significantly associated with a lower level of physical fitness. Multivariate logistic regression showed that urinary incontinence was significantly associated with a slower walking speed (Odds Ratio (OR) = 0.19, 95% Confidence Intervals (CI) 0.08-0.48) and lower serum albumin level (OR = 0.40, 95% CI 0.16-0.99) in men, and with a slower walking speed (OR = 0.29, 95% CI 0.15-0.56), a higher BMI (OR = 1.09, 95% CI 1.04-1.14), depression (OR = 3.06, 95% CI 1.40-6.69), and lack of physical activity (OR = 0.70, 95% CI 0.50-0.98) in women. The characteristics of urinary incontinence in this cohort of community-dwelling elderly individuals were a low level of physical fitness and poor nutritional state in men, and a low level of physical fitness, a tendency to be obese, a poor mental health state, and lack of physical activity in women.

  1. Impact of urinary incontinence on sexual functioning in community-dwelling older women

    NARCIS (Netherlands)

    Visser, Els; de Bock, Geertruida H.; Berger, Marjolein Y.; Dekker, Janny H.

    Introduction. Knowledge on the sexual health of patients with urinary incontinence in primary care is scarce; therefore, the impact of urinary incontinence on sexual functioning was examined in community-dwelling older women. Aim. The aim of this study was to provide primary health care

  2. Relationship between masticatory function and frailty in community-dwelling Japanese elderly.

    Science.gov (United States)

    Horibe, Yasuhiro; Watanabe, Yutaka; Hirano, Hirohiko; Edahiro, Ayako; Ishizaki, Ken; Ueda, Takayuki; Sakurai, Kaoru

    2017-12-28

    Frailty likely results in impaired functioning, and frail individuals requiring long-term care have recently attracted the attention of researchers. In the oral health field, the number of elderly individuals who require intervention for retaining occlusion has been increasing, as has the number of remaining teeth and required prosthetic treatment. Additionally, the number of elderly with reduced masticatory function has also been increasing, and frailty is a suspected factor. The aim of this study is to clarify the relationship between frailty and masticatory function decline. A cross-sectional study. A total of 747 participants (total mean age 73.6 ± 5.8 years old) underwent a comprehensive examination at the Tokyo Metropolitan Institute of Gerontology. Three masticatory functions were evaluated: maximum occlusal force, mixing ability, and self-reported chewing ability. Frailty was determined using all 25 questions of the Basic checklist developed by the Japanese Ministry of Health, Labour and Welfare, following the method reported by Satake et al. Binomial logistic analysis clarified the relationship between frailty and evaluation of each of the three masticatory functions. Significant correlations of pre-frailty or frailty with maximum occlusal force, mixing ability, and subjective chewing ability were observed. All three masticatory functions (maximum occlusal force, mixing ability, and self-reported chewing ability) were associated with pre-frailty or frailty in community-dwelling Japanese elderly.

  3. Fall risks assessment among community dwelling elderly using wearable wireless sensors

    Science.gov (United States)

    Lockhart, Thurmon E.; Soangra, Rahul; Frames, Chris

    2014-06-01

    Postural stability characteristics are considered to be important in maintaining functional independence free of falls and healthy life style especially for the growing elderly population. This study focuses on developing tools of clinical value in fall prevention: 1) Implementation of sensors that are minimally obtrusive and reliably record movement data. 2) Unobtrusively gather data from wearable sensors from four community centers 3) developed and implemented linear and non-linear signal analysis algorithms to extract clinically relevant information using wearable technology. In all a total of 100 community dwelling elderly individuals (66 non-fallers and 34 fallers) participated in the experiment. All participants were asked to stand-still in eyes open (EO) and eyes closed (EC) condition on forceplate with one wireless inertial sensor affixed at sternum level. Participants' history of falls had been recorded for last 2 years, with emphasis on frequency and characteristics of falls. Any participant with at least one fall in the prior year were classified as faller and the others as non-faller. The results indicated several key factors/features of postural characteristics relevant to balance control and stability during quite stance and, showed good predictive capability of fall risks among older adults. Wearable technology allowed us to gather data where it matters the most to answer fall related questions, i.e. the community setting environments. This study opens new prospects of clinical testing using postural variables with a wearable sensor that may be relevant for assessing fall risks at home and patient environment in near future.

  4. Obstacle-negotiating gait and related physical measurement indicators for the community-dwelling elderly in Japan.

    Science.gov (United States)

    Sun, Wei; Watanabe, Misuzu; Hirota, Chika; Tanimoto, Yoshimi; Kono, Rei; Takasaki, Kyosuke; Kono, Koichi

    2010-01-01

    The aim of this study is to assess obstacle-negotiating gait (ONG) and explore its related physical factors. Subjects comprised 571 community-dwelling persons (195 men and 376 women) age>or=65 years and without cognitive impairment. ONG, timed up and go (TUG), and stair-climbing were measured and their relations were assessed. Walking ability (usual walking speed=UWS and daily walking steps=DWS), balance deficiency, and musculoskeletal function (handgrip strength and bone health) were examined objectively to explore ONG related physical factors. Logistic regression and general linear model analysis were performed with adjustment for age and body mass index (BMI). Time of ONG was 7.72s in men and 8.93s in women. Logistic regression analysis showed that the fast tertiles of ONG corresponding to the fast levels of TUG and stair-climbing had the highest odds ratio values. General linear model analysis showed that ONG was significantly associated with UWS and balance deficiency (no) in men, and with UWS, handgrip strength, DWS and balance deficiency (no) in women. Overall, ONG was considerably associated with falls screening tools and its determinants were also the main causes of falls. Training in ONG could be an attractive strategy for the prevention of falls among the elderly. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  5. The Informal Caregivers’ Viewpoint About Care Inhibitors for Community-Dwelling Elderly in an Iranian Context: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Samaneh Pourhadi

    2016-09-01

    Discussion: The inhibitors affect a proper caregiving and based on their own nature, cause discomfort to the caregiver and care receiver. Many of these cases are deemed as rectifiable hindrances that can lead us to optimal care for community-dwelling elderly if the cases are taken into consideration and proper strategies are designed and implemented in small and large scale planning.

  6. The impact of exercise and vitamin D supplementation on physical function in community-dwelling elderly individuals: A randomized trial.

    Science.gov (United States)

    Aoki, Kana; Sakuma, Mayumi; Endo, Naoto

    2018-04-25

    We investigated the impact of exercise and vitamin D supplementation on physical function and locomotor dysfunction in community-dwelling elderly individuals. In total, 148 community-dwelling elderly individuals (aged ≥60 years) who were not taking osteoporosis medications participated in a 24-week intervention. The participants were randomly divided into an exercise group, vitamin D group, and exercise and vitamin D group. The participants and outcome-assessing staff were not blinded to group assignment. Exercise comprised three daily sets each of single-leg standing (1 min/leg/set) and squatting (5-6 repetitions/set); vitamin D supplementation was 1000 IU/day. Participants were contacted every 2 weeks to check on their condition and encourage continued participation. The primary outcome was lower limb muscle strength and mass; secondary outcomes were several physical function measurements, serum 25-hydroxyvitamin D levels, and results of a self-assessment questionnaire completed pre- and post-intervention. We analyzed data from 45, 42, and 43 participants in the exercise, vitamin D, and exercise and vitamin D groups, respectively, who completed the intervention. Locomotive syndrome, which involves reduced mobility due to locomotive organ impairment, was diagnosed in 99 participants (76.2%). Many physical function measurements improved in all groups. Lower limb muscle mass increased significantly in all three groups, with no significant differences between the groups in the degree of change. The average serum 25-hydroxyvitamin D of all vitamin D-supplemented participants increased from 28.1 ng/ml to 47.3 ng/ml after vitamin D supplementation. Both exercise and vitamin D supplementation independently improved physical function and increased muscle mass in community-dwelling elderly individuals. Moreover, the combination of exercise and vitamin D supplementation might further enhance these positive effects. UMIN Clinical Trial, UMIN000028229. Copyright © 2018

  7. Reduced Flexibility Associated with Metabolic Syndrome in Community-Dwelling Elders

    Science.gov (United States)

    Chang, Ke-Vin; Hung, Chen-Yu; Li, Chia-Ming; Lin, Yu-Hung; Wang, Tyng-Guey; Tsai, Keh-Sung; Han, Der-Sheng

    2015-01-01

    Background The ageing process may lead to reductions in physical fitness, a known risk factor in the development of metabolic syndrome. The purpose of the current study was to evaluate cross-sectional and combined associations of metabolic syndrome with body composition and physical fitness in a community based geriatric population. Methods A total of 628 community-dwelling elders attending a geriatric health examination were enrolled in the study. The diagnosis of metabolic syndrome was based on the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criterion with Asian cutoff of waist girth was adopted in this study. Body composition was obtained using bioimpedance analysis, and physical fitness was evaluated through the measurement of muscle strength (handgrip force), lower extremity muscle endurance (sit-to-stand test), flexibility (sit-and-reach test), and cardiorespiratory endurance (2-minute step test). Multivariable logistic regression and correlation analysis were performed to determine the association of metabolic syndrome with body composition and functionality variables. Results Metabolic syndrome was associated with increased skeletal muscle index (SMI) (odds ratio (OR), 1.61, 95% confidence interval (CI), 1.25–2.07) and decreased flexibility (OR, 0.97, 95% CI, 0.95–0.99) compared with those without metabolic syndrome. When body mass index was accounted for in the analysis, the association of SMI with metabolic syndrome was reduced. Waist circumference was positively correlated with SMI but negatively correlated with flexibility, whereas high density lipoprotein was positively correlated with flexibility but negatively correlated with SMI. Conclusion Reduced flexibility was positively associated with metabolic syndrome independent of age, gender, body composition, and functionality measurements in a community based geriatric population. Significant associations between metabolic syndrome with muscle strength

  8. Reduced flexibility associated with metabolic syndrome in community-dwelling elders.

    Directory of Open Access Journals (Sweden)

    Ke-Vin Chang

    Full Text Available The ageing process may lead to reductions in physical fitness, a known risk factor in the development of metabolic syndrome. The purpose of the current study was to evaluate cross-sectional and combined associations of metabolic syndrome with body composition and physical fitness in a community based geriatric population.A total of 628 community-dwelling elders attending a geriatric health examination were enrolled in the study. The diagnosis of metabolic syndrome was based on the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III criterion with Asian cutoff of waist girth was adopted in this study. Body composition was obtained using bioimpedance analysis, and physical fitness was evaluated through the measurement of muscle strength (handgrip force, lower extremity muscle endurance (sit-to-stand test, flexibility (sit-and-reach test, and cardiorespiratory endurance (2-minute step test. Multivariable logistic regression and correlation analysis were performed to determine the association of metabolic syndrome with body composition and functionality variables.Metabolic syndrome was associated with increased skeletal muscle index (SMI (odds ratio (OR, 1.61, 95% confidence interval (CI, 1.25-2.07 and decreased flexibility (OR, 0.97, 95% CI, 0.95-0.99 compared with those without metabolic syndrome. When body mass index was accounted for in the analysis, the association of SMI with metabolic syndrome was reduced. Waist circumference was positively correlated with SMI but negatively correlated with flexibility, whereas high density lipoprotein was positively correlated with flexibility but negatively correlated with SMI.Reduced flexibility was positively associated with metabolic syndrome independent of age, gender, body composition, and functionality measurements in a community based geriatric population. Significant associations between metabolic syndrome with muscle strength and cardiorespiratory fitness in the

  9. Evidence for the Treatment of Osteoporosis with Vitamin D in Residential Care and in the Community Dwelling Elderly

    Directory of Open Access Journals (Sweden)

    John A. A. Geddes

    2013-01-01

    Full Text Available Introduction. Vitamin D is common treatment for osteoporosis. Both age >70 years and living in residential care are associated with increased fracture risk. Community dwelling elderly are a heterogeneous group who may have more similatiry with residential care groups than younger community dwelling counterparts. Aims. To review the evidence for cholecalciferol or ergocalciferol tretment of osteoporosis in either community dwelling patients aged ≥70 years of age, or redidential care patients. Secondly endpoints were changes in bone mineral denisty, and in bone turnover markers. Methods. We performed a literature search using search terms for osteoporosis and vitamin D. Treatment for at least one year was required. Results. Only one residential care study using cholecalciferol, showed non-vertebral and hip fracture reduction in vitamin D deficient subjects. In the community setting one quasi randomised study using ergocalciferol showed reduction in total but not hip or non-vertebral fracture, and a second randomised study showed increased hip fracture risk. Three studies reported increases in hip bone mineral denisty. Discussion. A minority of studies demonstrated a fracture benefit form vitamin D and one suggested possible harm in a community setting. Current practice should be to only offer this treatment to subjects identified as deficient.

  10. Better functional mobility in community-dwelling elderly is related to D-hormone serum levels and to daily calcium intake.

    Science.gov (United States)

    Dukas, L; Staehelin, H B; Schacht, E; Bischoff, H A

    2005-01-01

    The influence of calcitropic hormones on functional mobility has been studied in vitamin D (calcidiol) deficient elderly or elderly with a history of falls, however, data in community-dwelling independent vitamin D replete elderly are missing. We therefore assessed in an observational survey the association of calcidiol (25(OH)D3) and calcitriol (D-hormone / 1,25(OH)2D3) status as well as of daily calcium intake on functional mobility in older subjects We evaluated 192 women and 188 men, aged superior 70 years and living independently. Average Timed-up and go test (TUG-test) in seconds was taken as measure of functional mobility. Calcidiol and D-hormone serum concentrations and daily calcium intake were studied in multivariate controlled linear regression models with TUG-test performance as the dependent variable and/or as dichotomous variables (deficient vs. non-deficient, above vs. below the median, respectively). Subjects with low D-hormone serum concentrations took significantly more time to perform the TUG-test (low = 7.70s +/- 2.52 SD ; high = 6.70s +/- 1.29 SD; p = 0.004). In the linear multivariate controlled regression model increased D-hormone serum concentrations predicted better TUG-test performance (estimate -0.0007, p = 0.044). Participants with a calcium intake of > or =512 mg/day were significantly faster to perform the TUG-test than participants with a daily calcium intake of better TUG-test performance in both models were: male gender, less comorbid conditions, younger age, lower BMI, iPTH serum levels and creatinine clearance. Calcidiol serum levels were not associated with TUG-test performance. Higher D-hormone status and a calcium intake of > or =512 mg/day in community-dwelling independent older persons are significant determinants of better functional mobility. Therefore, to ensure optimal functional mobility, the care of older persons should address correction of D-hormone deficiency and increasing daily calcium intake.

  11. A health campaign for the elderly: developing a health promotion strategy for the elderly using functional assessments of community dwelling individuals

    Directory of Open Access Journals (Sweden)

    Thiago de Oliveira Monaco

    2007-03-01

    Full Text Available Objective: To develop a functional health screening strategy forcommunity-dwelling elderly individuals, including eventual referralto existing health services. We justified the study by considering thelimitations of the Brazilian health system. A second objective was totest whether this strategy would show benefits a year later. Methods:We conducted a prospective cohort study in an urban community inthe city of São Paulo. Subjects included community-dwelling men andwomen aged 60 years or more, capable of walking, recruited throughan announcement in a local newspaper. Patients were invited to aspecific place on a scheduled date to undergo functional screeningtests for elderly patients; we chose tests that are well established inliterature. The tests resulted in a health score showing the number ofchanges found. This database was subsequently used for registrationpurposes, counseling and referral to primary health care facilities inSão Paulo. After one year, each patient was recalled by mail for asecond assessment that used the same methodology. Results: Theinitial assessments included 187 subjects (mean age 68.8 years. Oneyear later 90 patients returned (48% of the total; mean age 69.7 years.This group presented 4.23 alterations in our score against 5.23 in thefirst assessment (p < 0.05. Conclusions: Results show that a tool toidentify functional changes may benefit large groups of elderly subjects.We raised the possibility of whether more functionally disabled peoplewould have a higher absence rate. In the first assessment, patientsthat did not return after one year had a score of 5.75, compared to 5.23for those returning after one year. This difference was not statisticallysignificant (p = 0.33.

  12. [Degree of dry mouth and factors influencing oral health-related quality of life for community-dwelling elders].

    Science.gov (United States)

    Park, Myung Sook; Ryu, Se Ang

    2010-10-01

    This study was conducted to investigate the degree of dry mouth and oral health-related quality of life and to identify factors contributing to oral health-related quality of life for community-dwelling elders. A descriptive correlational study design was used. Participants were 156 older adults from two senior welfare centers. Data were collected on February 21, 22 and 29, 30, 2009 using structured questionnaires. Enter type multiple regression analysis was used to identify factors influencing oral health-related quality of life according to general and oral health characteristics. There were significant differences in oral health-related quality of life according to living arrangement, insurance, smoking, number of natural teeth, and denture type. The oral health-related quality of life had significant correlations with the number of chronic disease, number of medications, and dry mouth. Factors influencing oral health-related quality of life for community-dwelling older adults were dry mouth, number of chronic disease, and medical aid, which explained about 47.9% of total variance. These results indicate that in order to promote oral health-related quality of life for older adults, prevention or management of chronic diseases as well as oral health and dry mouth are needed for this population, and especially economically poor elders.

  13. Examination of validity of fall risk assessment items for screening high fall risk elderly among the healthy community-dwelling Japanese population

    OpenAIRE

    DEMURA, Shinichi; SATO, Susumu; YAMAJI, Shunsuke; KASUGA, Kosho; NAGASAWA, Yoshinori

    2010-01-01

    We aimed to examine the validity of fall risk assessment items for the healthy community-dwelling elderly Japanese population. Participants were 1122 healthy elderly individuals aged 60 years and over (380 males and 742 females). The percentage who had experienced a fall was 15.8%. This study used fall experience and 50 fall risk assessment items representing the five risk factors (symptoms of falling, physical function, disease and physical symptom, environment, and behavior and character), ...

  14. The linear relationship between the Vulnerable Elders Survey-13 score and mortality in an Asian population of community-dwelling older persons.

    Science.gov (United States)

    Wang, Jye; Lin, Wender; Chang, Ling-Hui

    2018-01-01

    The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting. This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used. The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting. The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Fear of Falling among Community-dwelling Elderly Women Receiving Visiting Nursing Services in Japan

    OpenAIRE

    Takai, Kiyako; Honda, Sumihisa; Ye, Zhaojia; Abe, Yasuyo; Takamura, Noboru; Osaki, Makoto; Kusano, Yosuke; Takemoto, Tai-Ichiro; Aoyagi, Kiyoshi

    2007-01-01

    Although fear of falling is a common and serious problem among elderly people, little is known about the risk factors associated with fear of falling among frail elderly persons in Japan. To assess the fear of falling and investigate related factors, we conducted a study among 167 Japanese women aged 59 or older, who were receiving visiting nursing services. Fear of falling was measured by asking subjects about being afraid of falling (yes/no) and completing the Japanese version of Falls Effi...

  16. Incidence and predictors of sarcopenia onset in community-dwelling elderly Japanese women: 4-year follow-up study.

    Science.gov (United States)

    Kim, Hunkyung; Suzuki, Takao; Kim, Miji; Kojima, Narumi; Yoshida, Yuko; Hirano, Hirohiko; Saito, Kyoko; Iwasa, Hajime; Shimada, Hiroyuki; Hosoi, Erika; Yoshida, Hideyo

    2015-01-01

    Several studies have explored the prevalence and risk factors of sarcopenia, but they have been based on cross-sectional data. The objective of this study was to determine the incidence and predictors of the onset of sarcopenia over 4 years in community-dwelling elderly women. Four-year longitudinal follow-up study. Urban community in Tokyo, Japan. A total of 538 nonsarcopenic women older than 75 years. Body composition was determined by bioelectrical impedance analysis. Functional fitness measurements, including grip strength, usual walking speed, timed up and go (TUG), and interview surveys were conducted at baseline and 4-year follow-up. Blood samples were obtained to analyze serum albumin and hemoglobin A1c, and kidney function was analyzed using serum creatinine and cystatin C. Sarcopenia was defined based on the criteria suggested by the European Working Group on Sarcopenia in Older People, and the development of all stages, that is, presarcopenia, sarcopenia, and severe sarcopenia as well as the components of sarcopenia skeletal muscle index (SMI), grip strength, and walking speed, were analyzed. The incidence of total sarcopenia was 39.6% (presarcopenia 23.8%, sarcopenia 11.2%, severe sarcopenia 4.6%). Older age was significantly predictive of the development of presarcopenia and severe sarcopenia. Body mass index (BMI) lower than 21.0 kg/m(2) was significantly predictive of the development of all stages of sarcopenia, as well as declines in SMI, grip strength, and walking speed. Slow TUG was a predictor of the development of presarcopenia and severe sarcopenia. Increased calf circumference showed protective effects from the development of all stages of sarcopenia. Greater albumin levels also showed lower risk of declines in SMI, walking speed, and development of presarcopenia. Cystatin C was positively associated with the development of severe sarcopenia (odds ratio 1.83, 95% confidence interval 1.08-3.12). Heart disease and hyperlipidemia history were

  17. Validity of the SF-36 five-item Mental Health Index for major depression in functionally impaired, community-dwelling elderly patients.

    Science.gov (United States)

    Friedman, Bruce; Heisel, Marnin; Delavan, Rachel

    2005-11-01

    To examine criterion and construct validity of the five-item Mental Health Index (MHI-5) of the 36-item Short Form health survey (SF-36) in relation to the presence of major depression in functionally impaired, community-dwelling elderly patients and of eight subsamples defined by cognitive functioning, levels of functional impairment, and proxy report versus self-report. Cross-sectional observational. Nineteen counties in western New York, West Virginia, and Ohio. One thousand four hundred forty-four functionally impaired, community-dwelling Medicare beneficiaries aged 65 and older who participated in the Medicare Primary and Consumer-Directed Care Demonstration. MHI-5, Mini-International Neuropsychiatric Interview Major Depressive Episode (MINI-MDE) module. The MHI-5 demonstrated sufficient criterion validity (area under the receiver operating characteristic curve=0.837; sensitivity=78.7% and specificity=72.1% using a cutpoint of 59/60) with respect to the presence of depression for the entire sample. A significant correlation between MHI-5 scores and presence of major depression as identified using the MINI-MDE (Spearman correlation=-0.426, Pvalidity. Additional evidence is provided by decline in mean MHI-5 score as level of formal education and number of close friends and relatives decreased. All eight subsamples demonstrated similar criterion and construct validity. A Cronbach alpha of 0.794 demonstrated internal consistency reliability. This study provides evidence for adequate criterion and construct validity of the MHI-5 in relation to the presence of major depression among functionally impaired, community-dwelling elderly Medicare patients.

  18. A risk profile for identifying community-dwelling elderly with a highrisk of recurrent falling: results of a 3-year prospective study

    NARCIS (Netherlands)

    Pluym, S.M.F.; Smit, J.H.; Tromp, A.M.; Stel, V.S.; Deeg, D.J.H.; Bouter, L.M.; Lips, P.T.A.M.

    2007-01-01

    Introduction: The aim of the prospective study reported here was to develop a risk profile that can be used to identify community-dwelling elderly at a high risk of recurrent falling. Materials and methods: The study was designed as a 3-year prospective cohort study. A total of 1365

  19. Plasma amyloid β, depression, and dementia in community-dwelling elderly.

    Science.gov (United States)

    Direk, Nese; Schrijvers, Elisabeth M C; de Bruijn, Renée F A G; Mirza, Saira; Hofman, Albert; Ikram, M Arfan; Tiemeier, Henning

    2013-04-01

    Plasma amyloid β (Aβ) levels have been associated with an increased risk of Alzheimer's disease (AD). As depression is common before the onset of AD, a few clinical studies tested the cross-sectional association of Aβ levels with depression in elderly and showed incongruous findings. Hence, we tested the longitudinal association between Aβ levels and depressive symptoms in community-dwelling elderly. The study is embedded in a population-based cohort of 980 participants aged 60 years or older from the Rotterdam Study with Aβ levels. Participants were evaluated for depressive symptoms with the Centre for Epidemiological Studies-Depression scale at baseline and repeatedly over the mean follow-up of 11 years. We first performed cross-sectional analyses. Then, we tested the longitudinal association between Aβ levels and depressive symptoms after excluding participants with dementia during follow-up. In cross-sectional analyses, persons with high Aβ(1-40) levels had more clinically relevant depressive symptoms. However, this association was accounted for by persons with clinically relevant depressive symptoms who developed dementia within the next 11 years. In longitudinal analyses, persons with low levels of Aβ(1-40) and Aβ(1-42) without dementia had a higher risk of clinically relevant depressive symptoms during the follow-up. These findings suggest that the cross-sectional association between high plasma Aβ levels and clinically relevant depressive symptoms in the elderly is due to prodromal dementia. In contrast, the longitudinal association between low plasma Aβ levels and depressive symptoms could not be explained by dementia during follow-up suggesting that Aβ peptides may play a distinct role on depression etiology. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. [A study of factors influenced by self-efficacy for exercise among community-dwelling elderly men in urban areas].

    Science.gov (United States)

    Takai, Itsushi

    2012-01-01

    It is important to promote self-efficacy for exercise for developing exercise habit. The purpose of this study was to investigate factors influenced by self-efficacy for exercise among community-dwelling elderly men in urban areas. The subjects were 69 elderly men (mean age of 74.2±2.0 SD) who had given approval for participation in the study. We examined the following factors: family situation, history of falls, frequency of going out, stage model of a change, self-efficacy for exercise, fall efficacy scale (FES), geriatric depression scale (GDS), subjective health, functional ability and motor function (5 m walking time, chair stand test-5times). Analysis of variance was used to assess a stage model of a change differences in self-efficacy for exercise and other measures. Correlation analysis and multiple regression analysis were performed to determine the relationships between self-efficacy for exercise and other measures. We found that self-efficacy of exercise, FES, GDS (pSelf-efficacy for exercise was found to correlate with psychological factors and functional ability (|r|=0.47-0.67). Multiple regression analysis revealed that the independent factors related to self-efficacy for exercise were FES and GDS. FES and GDS were found to be significant and independent predictors of self-efficacy for exercise in community-dwelling elderly men in urban areas. We should consider not only the approach based on behavioral science but also mental support for depression and fear of falling to promote exercise self-efficacy.

  1. Teenage girls and elderly women living in northern Europe have low winter vitamin D status

    DEFF Research Database (Denmark)

    Andersen, Rikke; Molgaard, C.; Skovgaard, L. T.

    2005-01-01

    Objective: To determine the vitamin D status (serum 25-hydroxyvitamin D; S-25OHD) in adolescent girls and elderly community-dwelling women living in four countries of northern Europe and to explain differences in S-25OHD concentrations between and within the countries. Design: A cross-sectional o......Objective: To determine the vitamin D status (serum 25-hydroxyvitamin D; S-25OHD) in adolescent girls and elderly community-dwelling women living in four countries of northern Europe and to explain differences in S-25OHD concentrations between and within the countries. Design: A cross......-sectional observational study conducted in a standardised way during February-March. S-25OHD was analysed by high-performance liquid chromatography. Vitamin D and calcium intake was calculated using a standardised food composition database. Setting: Denmark, Finland, Ireland, and Poland. Subjects: A total of 199 girls...... (mean (s.d.) age 12.6 (0.5) y) and 221 women (mean (s.d.) age 71.8 (1.4) y). Results: The median ( inter quartiles) concentration of S-25OHD was 29.4 (20.3, 38.3) nmol/l for the girls and 40.7 (28.0, 54.2) nmol/l for the women. S-25OHD below 25 nmol/l was found in 37% of the girls and 17% of the women...

  2. Interrelationship among the health-related and subjective quality of life, daily life activities, instrumental activities of daily living of community-dwelling elderly females in orthopedic outpatients.

    Science.gov (United States)

    Takemasa, Seiichi; Nakagoshi, Ryoma; Uesugi, Masayuki; Inoue, Yuri; Gotou, Makoto; Naruse, Susumu; Nanba, Yoshihumi

    2017-05-01

    [Purpose] This study aimed to examine the health-related and subjective quality of life of community-dwelling elderly females in orthopedic outpatients, and also examined how such quality of life correlate with their daily life activities and instrumental activities of daily living. [Subjects and Methods] Subjects were 27 community-dwelling elderly females in orthopedic outpatients (mean age: 76.3 ± 7.4 years). Their health-related quality of life and subjective quality of life, life-space assessment, frenchay activities index were researched. [Results] For the relationships between the total subjective quality of life scores and health-related quality of life scores, significant positive correlations were observed for body pain, general health, vitality, social functions and mental health. The correlations were not statistically significant between the subjective quality of life scores and the life-space assessment and frenchay activities index scores. The correlations were statistically significant between some health-related quality of life scores and the life-space assessment and frenchay activities index scores. [Conclusion] The results suggest that supporting community-dwelling elderly females in orthopedic outpatients to improve their sense of physical and mental well-being, and prevent and reduce their depression and physical pain, is required in order to improve their QOL.

  3. Screening for frailty in community-dwelling elderly subjects: Predictive validity of the modified SEGA instrument.

    Science.gov (United States)

    Oubaya, N; Dramé, M; Novella, J-L; Quignard, E; Cunin, C; Jolly, D; Mahmoudi, R

    2017-11-01

    To study the capacity of the SEGAm instrument to predict loss of independence among elderly community-dwelling subjects. The study was performed in four French departments (Ardennes, Marne, Meurthe-et-Moselle, Meuse). Subjects aged 65 years or more, living at home, who could read and understand French, with a degree of autonomy corresponding to groups 5 or 6 in the AGGIR autonomy evaluation scale were included. Assessment included demographic characteristics, comprehensive geriatric assessment, and the SEGAm instrument at baseline. Subjects had follow-up visits at home at 6 and 12 months. During follow-up, vital status and level of independence were recorded. Logistic regression was used to study predictive validity of the SEGAm instrument. Among the 116 subjects with complete follow-up, 84 (72.4%) were classed as not very frail at baseline, 23 (19.8%) as frail, and 9 (7.8%) as very frail; 63 (54.3%) suffered loss of at least one ADL or IADL at 12 months. By multivariable analysis, frailty status at baseline was significantly associated with loss of independence during the 12 months of follow-up (OR=4.52, 95% CI=1.40-14.68; p=0.01). We previously validated the SEGAm instrument in terms of feasibility, acceptability, internal structure validity, reliability, and discriminant validity. This instrument appears to be a suitable tool for screening frailty among community-dwelling elderly subjects, and could be used as a basis to plan early targeted interventions for subjects at risk of adverse outcome. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Prevalence of falls among community-dwelling elderly and its associated factors: A cross-sectional study in Perak, Malaysia

    Directory of Open Access Journals (Sweden)

    Yeong Uen Yea

    2016-11-01

    Full Text Available Fall is a major cause of injuries and can increase the risk of early mortalityamong elderly. The objective of this study was to determine the prevalence of falls among community-dwelling elderly in rural Malaysia and its associated factors. Data were obtained from a cross-sectional survey in five randomly selected districts in the state of Perak, Malaysia. A total of 250 households were randomly selected. A total of 811 individuals aged 60 years or more were recruited and interviewed using a structured questionnaire. Information about socio-demographic, history of falls in the past 1 year, medical history, drug history and physical activity level were enquired.

  5. Reliability and validity of revised Turkish version of Mini Mental State Examination (rMMSE-T) in community-dwelling educated and uneducated elderly.

    Science.gov (United States)

    Keskinoglu, Pembe; Ucku, Reyhan; Yener, Görsev; Yaka, Erdem; Kurt, Pinar; Tunca, Zeliha

    2009-11-01

    To evaluate the reliability and validity of the revised Turkish version of Mini Mental State Examination (rMMSE-T) in educated and uneducated community-dwelling elderly, to re-organize the present Turkish version of MMSE and to determine cut-off point of the revised test. This cross-sectional and analytical study involved totally 490 elderly subjects selected by cluster sampling method. Receiver operating characteristic (ROC) analysis, kappa analysis and Cronbach's alpha coefficients were used for statistical analysis. Areas under ROC curve in educated and uneducated elderly were found as 0.953 and 0.907. Cut-off point of 22/23 of rMMSE-T in educated elderly had the highest sensitivity (90.9), specificity (97.0) and positive likelihood ratio (30.3), whereas cut-off point of 18/19 of the test in uneducated elderly had the highest sensitivity (82.7), specificity (92.3) and positive likelihood ratio (10.7). The Cronbach's alpha values of the rMMSE-T for educated and uneducated elderly were higher than 0.7 (sign of good internal consistency of the test). A significant correlations between intrarater and interrater test-retest in educated elderly subjects were observed (0.966 (p = 0.000); 0.855 (p = 0.000), respectively), and also in uneducated elderly (0.988 (p = 0.000); 0.934 (p = 0.000), respectively). Kappa value of the test in educated and uneducated elderly showed a perfect agreement interraters (1.000) and a substantial agreement in intraraters (1.000, 0.784; 0.826, 0.656, respectively). rMMSE-T had a high reliability and validity. It will be more appropriate to use the revised test and the new cut-off point for the diagnosis and screening of dementia among community-dwelling Turkish elderly population. Copyright 2009 John Wiley & Sons, Ltd.

  6. The relative and absolute reliability of the Functional Independence and Difficulty Scale in community-dwelling frail elderly Japanese people using long-term care insurance services.

    Science.gov (United States)

    Saito, Takashi; Izawa, Kazuhiro P; Watanabe, Shuichiro

    2017-06-01

    The newly developed Functional Independence and Difficulty Scale is a tool for assessing the performance of basic activities of daily living in terms of both independence and difficulty. The reliability of this new scale has not been assessed. The aim of this study was to examine the relative reliability and absolute reliability of the newly developed scale in community-dwelling frail elderly people in Japan. Participants were 47 community-dwelling elderly subjects (22 for assessing test-retest reliability and 25 for assessing inter-rater reliability). As relative reliability indices, intra-class correlation coefficients were used. From an absolute reliability perspective, we conducted Bland-Altman analysis and calculated the limit of agreement or minimal detectable change to determine the acceptable range of error. Intra-class correlation coefficients for test-retest and inter-rater reliability were 0.90 (P reliability was -5.2 to 1.8, representing an increase of over six points for improvement and a decrease of over two points for decline of basic activities of daily living ability. The minimal detectable change for inter-rater reliability was 3.7, indicating that a three-point difference might be existed between difference raters. The results of this study demonstrated that the FIDS appeared to be a reliable instrument for use in Japanese community-dwelling frail elderly people. While further research using a large and more diverse sample of participants is needed, our findings support the use of FIDS in clinical practice or clinical research targeting frail elderly Japanese people.

  7. Metabolic syndrome and physical activity in southern Brazilian community-dwelling elders: a population-based, cross-sectional study

    Directory of Open Access Journals (Sweden)

    Reichert César L

    2009-01-01

    Full Text Available Abstract Background - The association between a sedentary lifestyle and obesity is well documented, and is linked to an increased prevalence of metabolic syndrome (MS. There is some evidence that information regarding the health benefits of physical activity is beginning to impact on the elderly people and is beginning to change their behavior. We aimed to investigate the level of physical activity undertaken by elderly people with MS and those without this condition. Methods - We evaluated 362 community-dwelling elders of Novo Hamburgo, southern Brazil. Diagnosis of MS was based on the International Diabetes Federation criteria and the physical activity (PA level was estimated by the International Physical Activity Questionnaire. Analysis of covariance was carried out to verify associations between MS risk factors and the level of PA. Logistic regression was used to estimate the MS odds ratio for each level of PA. Results - No significant association was found between MS and the level of physical activity, irrespective of sex. The odds ratio for the presence of MS adjusted for sex and age and using insufficiently active elderly people as reference was 1.04 (95% CI, 0.6 to 1.7 in sufficiently active elderly people and 1.15 (95% CI, 0.7 to 2.0 in very active elderly people. Conclusion - The elderly citizens of a southern Brazilian community who were diagnosed with MS presented the same levels of PA as the individuals who did not have this diagnosis. This may imply that information on the importance of physical activity has already reached this higher risk population.

  8. [Relationships between foot problems, fall experience and fear of falling among Japanese community-dwelling elderly].

    Science.gov (United States)

    Harada, Kazuhiro; Oka, Koichiro; Shibata, Ai; Kaburagi, Hironobu; Nakamura, Yoshio

    2010-08-01

    Although a foot care program for long-term care prevention has been launched in Japan, few studies have examined its effectiveness. The purpose of the present investigation was to examine the association of foot problems with fall experience and fear of falling among Japanese community-dwelling elderly people. The participants were 10,581 community-dwelling elderly people (75.2 +/- 5.6 years) and the study design was cross-sectional using a questionnaire. Self-reported tinea pedis, skin problems (inflammation, swelling, or discoloration), nail problems (thickening or deformities), impairment (in function or blood flow), regular foot care, and wearing of appropriate shoes were selected as parameters of foot problems and their care. Logistic regression analysis was conducted to examine whether these were related to fall experience (in the past 1 year) and fear of falling adjusted for age, the Tokyo Metropolitan institute of gerontology index of competence, medical conditions, and lower limb functions. Forty-six percents of males and 39.0% of females reported at least one foot problem. After adjusting for covariates, tinea pedis (male: adjusted odds ratio = 1.37[95% confidence interval= 1.15-1.63], female: 1.29[1.08-1.53]), skin problems (male: 1.66[1.32-2.101, female: 1.37[1.13-1.66]), nail problems (male: 1.72[1.45-2.051, female: 1.48[1.26-1.74]), and functional impairment (male: 2.42[1.91-3.05], female: 1.66[1.36-2.04]) were significantly associated with fall experience. Also, each problem was negatively associated with fear of falling (tinea pedis[male: 1.37 [1.15-1.62], female: 1.25[1.07-1.47

  9. Effects of gum chewing exercises on saliva secretion and occlusal force in community-dwelling elderly individuals: A pilot study.

    Science.gov (United States)

    Nakagawa, Kazuharu; Matsuo, Koichiro; Takagi, Daisuke; Morita, Yu; Ooka, Takafumi; Hironaka, Shouji; Mukai, Yoshiharu

    2017-01-01

    Elderly individuals face the risk of reductions in saliva secretion and occlusal force caused by systemic diseases or medications that can eventually result in malnutrition and systemic complications. We tested the hypothesis that regular gum chewing exercises (GCE) would enhance saliva secretion and occlusal force in an elderly population. A total of 12 community-dwelling elderly individuals (3 men and 9 women) participated in this study after providing informed consent. Participants carried out GCE regimens using a soft gum (GCE-S) or hard gum (GCE-H) for 2 weeks each, with a 2-week rest period between trials. Mucosal moisture on the tongue surface, resting saliva, and occlusal force were measured before and after each test gum, and changes in parameters at relevant time-points were statistically analyzed. Differences in each measurement item were assessed using the Friedman test for before and after the GCE. We used the Holm's correction for multiple comparisons if the Friedman test results were significant. The critical value for rejecting the null hypothesis was set at P GCE-S, returned to baseline levels during the rest period and significantly increased again after GCE-H. Mucosal moisture and occlusal force followed a similar trend, with a significant rise after GCE-H. The results of the present study suggest that GCE can increase resting saliva secretion and occlusal force in elderly individuals. Further investigations are required on the appropriate use of soft and hard gums to address oral frailty in elderly individuals. Geriatr Gerontol Int 2017; 17: 48-53. © 2015 The Authors. Geriatrics & Gerontology International published by Wiley Publishing Asia Pty Ltd on behalf of Japan Geriatrics Society.

  10. A study on the relationship between muscle function, functional mobility and level of physical activity in community-dwelling elderly.

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    Garcia, Patrícia A; Dias, João M D; Dias, Rosângela C; Santos, Priscilla; Zampa, Camila C

    2011-01-01

    to evaluate the relationship between lower extremity muscle function, calf circumference (CC), handgrip strength (HG), functional mobility and level of physical activity among age groups (65-69, 70-79, 80+) of older adults (men and women) and to identify the best parameter for screening muscle function loss in the elderly. 81 community-dwelling elderly (42 women and 39 men) participated. Walking speed (Multisprint Kit), HG (Jamar dynamometer), hip, knee and ankle muscle function (Biodex isokinetic dynamometer), level of physical activity (Human Activity Profile) and CC (tape measure) were evaluated. ANOVA, Pearson correlation and ROC curves were used for statistical analysis. Dominant CC (34.9±3 vs 37.7±3.6), habitual (1.1±0.2 vs 1.2±0.2) and fast (1.4±0.3 vs 1.7±0.3) walking speed, HG (23.8±7.5 vs 31.8±10.3), average peak torque and average hip, knee and ankle power (pphysical activity level among age groups. Moderate significant correlations were found between muscle function parameters, walking speed and HG; a fair degree of relationship was found between muscle function parameters, CC and level of physical activity (pwomen (p=0.03). This study demonstrated an association between muscle function, HG and fast walking speed, a decrease in these parameters with age and the possibility of using HG to screen for muscle function of the lower extremities.

  11. Informal and formal support among community-dwelling Japanese American elders living alone in Chicagoland: an in-depth qualitative study.

    Science.gov (United States)

    Lau, Denys T; Machizawa, Sayaka; Doi, Mary

    2012-06-01

    A key public health approach to promote independent living and avoid nursing home placement is ensuring that elders can obtain adequate informal support from family and friends, as well as formal support from community services. This study aims to describe the use of informal and formal support among community-dwelling Nikkei elders living alone, and explore perceived barriers hindering their use of such support. We conducted English and Japanese semi-structured, open-ended interviews in Chicagoland with a convenience sample of 34 Nikkei elders age 60+ who were functionally independent and living alone; 9 family/friends; and 10 local service providers. According to participants, for informal support, Nikkei elders relied mainly on: family for homemaking and health management; partners for emotional and emergency support; friends for emotional and transportation support; and neighbors for emergency assistance. Perceived barriers to informal support included elders' attitudinal impediments (feeling burdensome, reciprocating support, self-reliance), family-related interpersonal circumstances (poor communication, distance, intergenerational differences); and friendship/neighbor-related interpersonal situations (difficulty making friends, relocation, health decline/death). For formal support, Nikkei elders primarily used adult day care/cultural programs for socializing and learning and in-home care for personal/homemaking assistance and companionship. Barriers to formal support included attitudinal impediments (stoicism, privacy, frugality); perception of care (incompatibility with services, poor opinions of in-home care quality); and accessibility (geographical distance, lack of transportation). In summary, this study provides important preliminary insights for future community strategies that will target resources and training for support networks of Nikkei elders living alone to maximize their likelihood to age in place independently.

  12. Quality of life and its contributing factors in an elderly community-dwelling population in Shanghai, China.

    Science.gov (United States)

    Shou, Juan; Du, Zhaohui; Wang, Haitang; Ren, Limin; Liu, Yao; Zhu, Shanzhu

    2018-03-01

    We aimed to investigate the relationship between quality of life and the factors that may influence it in an elderly community-dwelling population in Shanghai. From August to October 2014, elderly individuals were enrolled from three randomly selected communities in Shanghai. Participant information was collected from responses to a general questionnaire and to the Lubben Social Network Scale-6, Cumulative Illness Rating Scale for Geriatrics, Patient Health Questionnaire, and the 12-item Short Form Health Survey. The factors influencing quality of life were explored in a multivariate stepwise linear regression model. Physical and mental component summary scores for the elderly in Shanghai communities were 50.1 ± 10.1 and 47.3 ± 7.9, respectively. Physical component summary scores in the rural area were higher than those in the urban-rural intersection area (a place where urban and rural transitions are taking place) (52.32 ± 9.81 vs 49.63 ± 9.33, P < 0.05) and the urban area (52.32 ± 9.81 vs 47.34 ± 10.18, P < 0.05). Additionally, mental component summary scores in the rural area were higher than those in the urban-rural intersection area (52.63 ± 9.28 vs 48.43 ± 9.42, P < 0.05) and the urban area (52.63 ± 9.28 vs 48.13 ± 10.69, P < 0.05). Depression, self-care ability, and medical care burden were found to be significantly associated with the quality of life of elderly individuals in Shanghai, China. Therefore, more attention should be paid to the mental health of this elderly population. © 2018 Japanese Psychogeriatric Society.

  13. Vitamin D receptor variability and physical activity are jointly associated with low handgrip strength and osteoporosis in community-dwelling elderly people in Taiwan: the Taichung Community Health Study for Elders (TCHS-E).

    Science.gov (United States)

    Wu, F-Y; Liu, C-S; Liao, L-N; Li, C-I; Lin, C-H; Yang, C-W; Meng, N-H; Lin, W-Y; Chang, C-K; Hsiao, J-H; Li, T-C; Lin, C-C

    2014-07-01

    We studied 472 elders to assess joint association of vitamin D receptor (VDR) variability and physical activity on low handgrip strength (LHS) and osteoporosis (OST). Our findings showed that higher risks of OST were associated with physically inactive elders with some specific VDR variations, highlighting the importance of promotion program for physical activity. The aim of this study was to determine the joint association between VDR variability and physical activity on LHS and OST in community-dwelling elders. Bone mineral density of the lumbar spine (LS), the femoral neck (FN), and the total hip were measured by dual-energy X-ray absorptiometry. Four single-nucleotide polymorphisms (SNPs) (rs7975232, rs1544410, rs2239185, and rs3782905) of the VDR gene were examined in 472 participants. Physical inactivity and each of the four SNPs were jointly associated with a significantly greater risk of LHS in people than that associated with each of the VDR SNPs or low physical activity alone. Physically inactive men with the AG or AA genotype of rs2239185 had a significantly greater risk of overall, LS, and FN OST than those of physically active men with the GG genotype [odds ratio (OR) 3.57, 95 % confidence interval (CI) 1.10-11.65; OR 4.74, 95 % CI 1.43-15.70; and OR 5.06, 95 % CI 1.08-23.71, respectively]. Similarly, physically inactive women with the CG or CC genotype of rs3782905 and the AG or AA genotype of rs1544410 had a significantly greater risk of FN OST than physically active women with the GG genotype (OR 5.33, 95 % CI 1.23-23.06 and OR 5.36, 95 % CI 1.11-25.94, respectively). VDR polymorphisms and physical activity are jointly associated with LHS and OST in elders. Health care programs should promote physical activity among elders as a cost-effective way to prevent LHS and OST, especially in those who may be genetically predisposed.

  14. Effects of a deep-water running program on muscle function and functionality in elderly women community dwelling

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    Daisy Alberti

    2017-12-01

    Full Text Available Abstract AIMS The aim of the study was to determine the effects of deep-water running on muscle function and functionality in community dwelling old women. METHODS Older women (n=19 were randomly assigned to one of the two groups: deep-water running (DWR: n=09, 64.33±4.24 years, 75.15±12.53 kg, 160.45±7.52 cm; or control group CG: n=10, 64.40±4.22 years, 74.46±12.39 kg, 158.88±5.48 cm. The DWR group carried out 18 weeks of deep-water running, twice/week 50 min sessions. Dynamic isokinetic strength for the lower limb and functionality was assessed before and after intervention. RESULTS DWR group increased peak torque, total work and average power of the knee and hip flexors and extensors. Additionally showed better performance on gait speed, timed up and go test, five-times-sit-to-stand-test repetitions from a chair as well as the six-minute walk test. CONCLUSION The deep-water running program was effective to improve muscle function and functionality.

  15. Stratifying Risk of Falls in Community-Dwelling Elderly Adults Through a Simple Tool

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    Schettino Ludmila

    2016-12-01

    Full Text Available Purpose. Falls are among the main disabling events for elderly adults and the identification of old people prone to falls enables the development of preventive and rehabilitative strategies. This study aimed to develop a simple tool, based on easily obtained variables (anthropometric measurements, motor performance tests and sociodemographic characteristics, to early identify community-dwelling old people prone to falls. Methods. The population-based household study was conducted among 316 elders (≥ 60 years old of both sexes, living in the urban area of Lafaiete Coutinho in Brazil. History of falls in the previous 12 months (dependent variable, sociodemographic characteristics, anthropometric measurements and motor performance tests results (explanatory variables were recorded, and a multivariate logistic regression was applied to identify the association between the explanatory variables and the history of falls. Fall probability for each elderly adult was calculated from the logistic regression parameters, and the predictive power of the final model and the cutoff for higher propensity to fall were evaluated on the basis of the receiver operating characteristic curve. Results. The prevalence of falls was 25.8% and the final model was influenced by the variables of sex (female and poor performance in the balance test. The estimated probability model predicted approximately 66.5% (95% CI, 61-72% of the falls. The sensitivity and specificity were 58 and 70%, respectively. Conclusions. We conclude that there is a high prevalence of falls among the studied elderly individuals, and the proposed method allowed to construct a simple tool for screening old adults prone to fall.

  16. A Longitudinal Study of Symptoms of Oropharyngeal Dysphagia in an Elderly Community-Dwelling Population.

    Science.gov (United States)

    Nimmons, Danielle; Michou, Emilia; Jones, Maureen; Pendleton, Neil; Horan, Michael; Hamdy, Shaheen

    2016-08-01

    Dysphagia has been estimated to affect around 8-16 % of healthy elderly individuals living in the community. The present study investigated the stability of perceived dysphagia symptoms over a 3-year period and whether such symptoms predicted death outcomes. A population of 800 and 550 elderly community-dwelling individuals were sent the Sydney Swallow Questionnaire (SSQ) in 2009 and 2012, respectively, where an arbitrary score of 180 or more was chosen to indicate symptomatic dysphagia. The telephone interview cognitive screen measured cognitive performance and the Geriatric Depression Scale measured depression. Regression models were used to investigate associations with dysphagia symptom scores, cognition, depression, age, gender and a history of stroke; a paired t test was used to examine if individual mean scores had changed. A total of 528 participants were included in the analysis. In 2009, dysphagia was associated with age (P = 0.028, OR 1.07, CI 1.01, 1.13) and stroke (P = 0.046, OR 2.04, CI 1.01, 4.11) but these associations were no longer present in 2012. Those who had symptomatic dysphagia in 2009 (n = 75) showed a shift towards improvement in swallowing (P < 0.001, mean = -174.4, CI -243.6, -105.3), and for those who died from pneumonia, there was no association between the SSQ derived swallowing score and death (P = 0.509, OR 0.10, CI -0.41, -0.20). We conclude that swallowing symptoms are a temporally dynamic process, which increases our knowledge on swallowing in the elderly.

  17. The combined status of physical performance and depressive symptoms is strongly associated with a history of falling in community-dwelling elderly: cross-sectional findings from the Obu Study of Health Promotion for the Elderly (OSHPE).

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    Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Yoshida, Daisuke; Tsutsumimoto, Kota; Uemura, Kazuki; Anan, Yuya; Park, Hyuntae; Lee, Sangyoon; Ito, Tadashi; Suzuki, Takao

    2014-01-01

    The purpose of this study was to examine whether the combined factors of physical performance, depressive symptoms and cognitive status are significantly associated with a history of falling in community-dwelling elderly. We performed a cross-sectional community-based survey, the OSHPE, from August 2011 to February 2012. In total, 5104 community-dwelling older adults aged 65 years and older (mean age 72.0) participated in the OSHPE. Participants underwent a grip strength (GS) test, chair stand test (CST), Timed Up & Go (TUG) test, Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). Of the 4481 participants who met our requirements, 645 (14.4%) participants reported falling at least once in the past year. In a signal detection analysis (SDA), we found that the combination of GDS (≥6 points) and TUG (≥10.6 s) had the highest fall rate (36.4%), and the combination of GDS (fall rate (11.7%). The highest fall rate group had a significantly higher odds ratio (OR) compared with the lowest fall rate group after adjusting for other potentially confounding variables [OR 3.12 (95% confidence interval (CI) 2.08-4.68) phistory of falling in community-dwelling elderly. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Effect of Pet Insects on the Psychological Health of Community-Dwelling Elderly People: A Single-Blinded, Randomized, Controlled Trial.

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    Ko, Hae-Jin; Youn, Chang-Ho; Kim, Seong-Hyun; Kim, So-Yun

    2016-01-01

    There is evidence that animal-assisted therapy has positive effects on mental health, especially in elderly people. Caring for insects is easy, relatively inexpensive, and does not require much space. The aim of this 8-week randomized, controlled, single-blinded study was to investigate the effect of pet insects on the psychological health of community-dwelling elderly people. Elderly subjects (≥65 years old) attending a community center in Daegu, Korea, were enrolled in the study between April and May 2014 and randomized at a 1:1 ratio to receive insect therapy and health advice or only health advice. The insect group received 5 crickets in a cage with sufficient fodder and a detailed instruction manual. At baseline and at 8 weeks, all subjects underwent psychometric tests via a direct interview [Beck Anxiety Inventory, Geriatric Depression Scale (GDS-15), Mini-Mental State Examination (MMSE), 36-Item Short Form Health Survey, Insomnia Severity Index, Fatigue Severity Scale, and Brief Encounter Psychosocial Instrument] and laboratory analyses of inflammatory and oxidative stress markers (erythrocyte sedimentation rate, high-sensitivity C-reactive protein, biological antioxidant potential, and derivatives of reactive oxygen metabolites). The insect-caring (n = 46) and control (n = 48) groups did not differ in baseline characteristics. The insect-caring group had significantly lower GDS-15 scores at week 8 (3.20 vs. 4.90, p = 0.004) and, after adjustment for baseline values, a significantly greater change in GDS-15 scores relative to baseline (-1.12 vs. 0.20, p = 0.011). They also had a significantly greater change in MMSE scores relative to baseline (1.13 vs. 0.31, p = 0.045). The two groups did not differ in terms of other psychometric and laboratory tests. No serious risks or adverse events were reported. Caring for insects, which is cost-effective and safe, was associated with a small to medium positive effect on depression and cognitive function in community-dwelling

  19. Depression in elderly women resident in a long-stay nursing home.

    Science.gov (United States)

    Lampert, Melissa Agostini; Rosso, Ana Luiza Pereira

    2015-01-01

    Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men. To investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH). This retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version) above 5. Other clinical and psychiatric diagnoses were obtained from medical files. Out of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3%) of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent. The prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.

  20. Depression in elderly women resident in a long-stay nursing home

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    Melissa Agostini Lampert

    Full Text Available Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men. OBJECTIVE: To investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH. METHODS: This retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version above 5. Other clinical and psychiatric diagnoses were obtained from medical files. RESULTS: Out of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3% of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent. CONCLUSION: The prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.

  1. [Effect of cognitive stimulation in elderly community].

    Science.gov (United States)

    Apóstolo, João Luís Alves; Cardoso, Daniela Filipa Batista; Paúl, Constança; Rodrigues, Manuel Alves; Macedo, Marinha Sofia

    2016-01-01

    To demonstrate that the implementation of the Cognitive Stimulation (CS) program 'Making a Difference' (MD) improves cognition and depressive symptoms in retired community elders. This was a multicenter quasi-experimental study of 45 community dwelling elders (38 women and 7 men), with a mean age of 75.29, from 3 day-care centers in rural, semi-rural and urban environments in the central region of Portugal. Participants attended 14 sessions twice a week over seven weeks. The Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale (GDS-15) were administered at the following three time points: baseline, post-test, and follow-up. From baseline to post-test, there is a statistically significant difference in depressive symptoms (F=7.494; P=.010) explaining 21% of the variance (partial eta squared [ηp(2)]=.21), power=.75, but there is no statistically significant difference in cognition. From post-test to follow-up, there is no difference in both cognition and depression outcomes. Our results showed improvement in elders' depressive symptoms after a seven weeks intervention program but it did not have a protective effect after the three months follow-up. No evidence was found for its efficacy in improving cognition. Cognitive stimulation may be a useful in preventing elder's depressive symptoms when included in their health promotion care plan. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  2. Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study.

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    Wang, Chao; Hua, Yujie; Fu, Hua; Cheng, Longfeng; Qian, Wen; Liu, Junyang; Crawford, Paul; Dai, Junming

    2017-01-03

    The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai. Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects. There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups

  3. Factors associated with poor nutritional status among community dwelling Lebanese elderly subjects living in rural areas: results of the AMEL study.

    Science.gov (United States)

    Boulos, C; Salameh, P; Barberger-Gateau, P

    2014-05-01

    This study aimed to assess the nutritional status, measured by MNA, and its association with socio-demographic indicators and health related characteristics of a representative sample of community dwelling elderly subjects. Cross-sectional study. Community dwelling elderly individuals living in rural communities in Lebanon. 1200 elderly individuals aged 65 years or more. Socio-demographic indicators and health related characteristics were recorded during a standardized interview. Nutritional status was assessed through Mini Nutritional Assessment (MNA). The 5-item GDS score and the WHO-5-A score were used to assess mood, whereas Mini Mental Status (MMS) was applied to evaluate cognitive status. The prevalence of malnutrition and risk of malnutrition was 8.0% respective 29.1% of the study sample. Malnutrition was significantly more frequent in elderly subjects aged more than 85 years, in females, widowed and illiterate people. Moreover, participants who reported lower financial status were more often malnourished or at risk of malnutrition. Regarding health status, poor nutritional status was more common among those reporting more than three chronic diseases, taking more than three drugs daily, suffering from chronic pain and those who had worse oral health status. Also, depressive disorders and cognitive dysfunction were significantly related to malnutrition. After multivariate analysis following variables remained independently associated to malnutrition: living in the governorate of Nabatieh (ORa 2.30, 95% CI 1.35 -3.93), reporting higher income (ORa 0.77, 95% CI 0.61-0.97), higher number of comorbidities (ORa 1.22, 95% CI 1.12-1.32), chronic pain (ORa 1.72, 95% CI 1.24-2.39), and depressive disorders (ORa 1.66, 95% CI 1.47-1.88). On the other hand, better cognitive functioning was strongly associated with decreased nutritional risk (ORa 0.27, 95%CI 0.17-0.43). Our results highlighted the close relationship between health status and malnutrition. The

  4. "Chair Stand Test" as Simple Tool for Sarcopenia Screening in Elderly Women.

    Science.gov (United States)

    Pinheiro, P A; Carneiro, J A O; Coqueiro, R S; Pereira, R; Fernandes, M H

    2016-01-01

    To investigate the association between sarcopenia and "chair stand test" performance, and evaluate this test as a screening tool for sarcopenia in community-dwelling elderly women. Cross-sectional Survey. 173 female individuals, aged ≥ 60 years and living in the urban area of the municipality of Lafaiete Coutinho, Bahia's inland, Brazil. The association between sarcopenia (defined by muscle mass, strength and/or performance loss) and performance in the "chair stand test" was tested by binary logistic regression technique. The ROC curve parameters were used to evaluate the diagnostic power of the test in sarcopenia screening. The significance level was set at 5 %. The model showed that the time spent for the "chair stand test" was positively associated (OR = 1.08; 95% CI = 1.01 - 1.16, p = 0.024) to sarcopenia, indicating that, for each 1 second increment in the test performance, the sarcopenia's probability increased by 8% in elderly women. The cut-off point that showed the best balance between sensitivity and specificity was 13 seconds. The performance of "chair stand test" showed predictive ability for sarcopenia, being an effective and simple screening tool for sarcopenia in elderly women. This test could be used for screening sarcopenic elderly women, allowing early interventions.

  5. Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study

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    de Moraes Suzana Albuquerque

    2013-01-01

    Full Text Available Abstract Background Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people. Methods This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults, with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness. Results The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004. The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29–3.35, perceived fatigue (OR = 1.93; 95% CI 1.21-3.10, recurring falls (OR = 2.01; 95% CI 1.11-3.62 and excessive drowsiness (OR = 1.91; 95% CI 1.11–3.29. The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727 (p Conclusions The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our

  6. Preparedness for Protecting the Health of Community-Dwelling Vulnerable Elderly People in Eastern and Western Japan in the Event of Natural Disasters.

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    Tsukasaki, Keiko; Kanzaki, Hatsumi; Kyota, Kaoru; Ichimori, Akie; Omote, Shizuko; Okamoto, Rie; Kido, Teruhiko; Sakakibara, Chiaki; Makimoto, Kiyoko; Nomura, Atsuko; Miyamoto, Yukari

    2016-01-01

    We clarified the preparedness necessary to protect the health of community-dwelling vulnerable elderly people following natural disasters. We collected data from 304 community general support centres throughout Japan. We found the following in particular to be challenging: availability of disaster-preparedness manuals; disaster countermeasures and management systems; creation of lists of people requiring assistance following a disaster; evacuation support systems; development of plans for health management following disasters; provision of disaster-preparedness guidance and training; disaster-preparedness systems in the community; disaster information management; the preparedness of older people themselves in requiring support; and support from other community residents.

  7. Prevalence and incidence of dementia among 75-80-year-old community-dwelling elderly in different districts of Antwerp, Belgium: the Antwerp Cognition (ANCOG) Study.

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    De Deyn, P P; Goeman, J; Vervaet, A; Dourcy-Belle-Rose, B; Van Dam, D; Geerts, E

    2011-11-01

    To analyse the prevalence and incidence of dementia in a population of community-dwelling elderly (aged 75-80), living in socio-economically differing districts of Antwerp (Belgium), taking into account possible gender and educational differences. A longitudinal cohort study (N=825) with a 3-year follow-up period (N=363). The Mini Mental State Examination (MMSE) was used as a primary screen of cognitive functioning. Scoring 21 or below led to a second phase examination by a neurologist, including the CAMDEX-R-N and a neurological examination, to provide a tentative aetiological diagnosis of dementia. These procedures were conducted annually during a 3-year follow-up period. In accordance with international literature, the overall prevalence rate of dementia was 8.7%. The cumulative incidence rate (IR) of dementia was 36.60 per 1000Py with annual IRs ranging from 34.39 over 35.16 to 49.04 per 1000Py. Dementia of the Alzheimer type (DAT) was the most occurring prevalent and incident cause. Women appeared to be at higher risk and the occurrence of cognitive deterioration was more prominent in districts with lower socio-economic status, possibly related to a lower education level. We demonstrate dementia is a considerable health problem in an urban Belgian population of community-dwelling elderly aged between 75 and 80 years old. In order to prepare health care and social security systems for the future management of dementia, proper epidemiological insight into the current and future magnitude of the burden of dementia, taking into account socio-economic differences, to which this study contributes, are required. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. Examining the association between participation in late-life leisure activities and cognitive function in community-dwelling elderly Chinese in Hong Kong.

    Science.gov (United States)

    Leung, Grace T Y; Fung, Ada W T; Tam, Cindy W C; Lui, Victor W C; Chiu, Helen F K; Chan, W M; Lam, Linda C W

    2010-02-01

    Growing evidence suggests that participation in late-life leisure activity may have beneficial effects on cognitive function. The objective of the study was to evaluate the association between leisure activity participation and cognitive function in an elderly population of community-dwelling Hong Kong Chinese. 512 participants were assessed in the follow-up study of a population-based community survey of the prevalence of cognitive impairment among Hong Kong Chinese aged 60 years and over. Leisure activities were classified into four categories (physical, intellectual, social and recreational). Information regarding leisure activity participation, cognitive function and other variables was collected. Multivariate linear regression analyses were performed to examine the association between leisure activity participation and cognitive function. A higher level of late-life leisure activity participation, particularly in intellectual activities, was significantly associated with better cognitive function in the elderly, as reflected by the results of the Cantonese Mini-mental State Examination (p = 0.007, 0.029 and 0.005), the Category Verbal Fluency Test (p = 0.027, 0.003 and 0.005) and digit backward span (p = 0.031, 0.002 and 0.009), as measured by the total frequency, total hours per week and total number of subtypes, respectively; the Chinese Alzheimer's Disease Assessment Scale-Cognitive Subscale (p = 0.045) and word list learning (p = 0.003), as measured by the total number of subtypes; and digit forward span (p = 0.007 and 0.015), as measured by the total hours per week and total number of subtypes, respectively. Late-life intellectual activity participation was associated with better cognitive function among community-dwelling Hong Kong elderly Chinese.

  9. Determinants of meeting the public health recommendations for physical activity among community-dwelling elderly Japanese.

    Science.gov (United States)

    Oka, Koichiro; Shibata, Ai

    2012-02-01

    Although regular physical activity can facilitate healthy aging, improve functional capacity, and prevent chronic diseases in the elderly, many of the Japanese elderly are not sufficiently active. Thus, examining the determinants is an important prerequisite for designing effective programs. The present study investigated the demographic, behavioral, psychosocial, and environmental determinants of meeting the national pedometer-determined physical activity recommendations for the elderly Japanese. Data were analyzed for 137 community-dwelling elderly Japanese aged 70 to 89 years (47% male, mean age = 74.5 years), who completed a questionnaire and wore a pedometer. Demographic (gender, age, marital status), behavioral (BMI, smoking, alcohol consumption), psychosocial (self-efficacy, social support, health professional advice), and environmental (perceived neighborhood environment) variables were self-reported. Averaged daily steps were obtained using 1-year pedometer measurements. Based on the national physical activity recommendations in Japan (males: 6700 steps; females: 5900 steps), the participants were divided into two categories - sufficiently active and insufficiently active. An adjusted logistic regression model was utilized. Totally, 47.4% of the participants (males: 51.5%; females: 43.8%) met the national recommendations. When adjusting for all other variables, a higher self-efficacy for exercise (AOR = 1.16; 95% CI: 1.04-1.28) and positive perception of the neighborhood environment (AOR = 1.43; 95% CI: 1.03-1.98) significantly influenced the meeting of the national recommendations. The findings clarified the need to identify effective intervention strategies to promote physical activity and suggest that an intervention design that accounts for these determinants may more effectively promote physical activity among the elderly Japanese.

  10. Calcium Intake in Elderly Australian Women Is Inadequate

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    Colin W. Binns

    2010-09-01

    Full Text Available The role of calcium in the prevention of bone loss in later life has been well established but little data exist on the adequacy of calcium intakes in elderly Australian women. The aim of this study was to compare the dietary intake including calcium of elderly Australian women with the Australian dietary recommendation, and to investigate the prevalence of calcium supplement use in this population. Community-dwelling women aged 70–80 years were randomly recruited using the Electoral Roll for a 2-year protein intervention study in Western Australia. Dietary intake was assessed at baseline by a 3-day weighed food record and analysed for energy, calcium and other nutrients. A total of 218 women were included in the analysis. Mean energy intake was 7,140 ± 1,518 kJ/day and protein provided 19 ± 4% of energy. Mean dietary calcium intake was 852 ± 298 mg/day, which is below Australian recommendations. Less than one quarter of women reported taking calcium supplements and only 3% reported taking vitamin D supplements. Calcium supplements by average provided calcium 122 ± 427 mg/day and when this was taken into account, total calcium intake increased to 955 ± 504 mg/day, which remained 13% lower than the Estimated Average Requirement (EAR, 1,100 mg/day for women of this age group. The women taking calcium supplements had a higher calcium intake (1501 ± 573 mg compared with the women on diet alone (813 ± 347 mg. The results of this study indicate that the majority of elderly women were not meeting their calcium requirements from diet alone. In order to achieve the recommended dietary calcium intake, better strategies for promoting increased calcium, from both diet and calcium supplements appears to be needed.

  11. Factors Associated With Self-reported and Medically Diagnosed Urinary Incontinence Among Community-Dwelling Older Women In Korea

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    Jeongok Park

    2015-06-01

    Full Text Available Purpose: The purpose of this study was to examine the prevalence of urinary incontinence (UI in community-dwelling Korean women 60 years or older, and to identify factors associated with self-reported and medically diagnosed UI. Methods: This study was a secondary analysis of data from the 2008 Actual Living Condition of the Elderly and Welfare Need Survey, which used a stratified two-stage cluster sampling method to select a representative sample of 8,961 elderly Korean women. Results: Of the 8,961 women in this study, 579 (6.5% had self-reported UI, and 209 (2.3% were medically diagnosed with UI. As patient age and exercise ability of the upper extremities increased, risk for self-reported UI decreased (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.96–0.99; OR, 0.99; 95% CI, 0.98–0.99, respectively. In contrast, as the number of limited instrumental activities of daily living (IADL increased, the risk for self-reported UI increased (OR, 1.30; 95% CI, 1.24–1.35. Overweight women were 1.94 times more likely to have self-reported UI compared to underweight women. Women with a history of stroke or asthma were more likely to have self-reported UI compared to women with no history. Also, women who reported being in good health were less likely to have UI, compared to women who reported being in poor health (OR, 0.47; 95% CI, 0.31–0.70. Medically diagnosed UI was negatively associated with the number of limited IADL and exercise ability scores for the lower extremities (OR, 0.86; 95% CI, 0.80–0.92; OR, 0.98; 95% CI, 0.97–0.99, respectively. In contrast, as the exercise ability score for the upper extremities increased, so did the risk for medically diagnosed UI (OR, 1.02; 95% CI, 1.01–1.03. Conclusions: An interventional program for home visit health services is needed for incontinent women who are highly dependent on others for IADL.

  12. Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study

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    Chao Wang

    2017-01-01

    Full Text Available Abstract Background The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai. Methods Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237 into either the intervention group (3 communities, n = 105 or to a wait-list control group (3 communities, n = 132. All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15. From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1, before intervention at 24 weeks (T2, and immediately after intervention at 32 weeks (T3. Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5 and the Self-administered Sleep Questionnaire (SSQ. Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects. Results There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there

  13. Fall predictors in the community dwelling elderly: a cross sectional and prospective cohort study.

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    Sai, A J; Gallagher, J C; Smith, L M; Logsdon, S

    2010-06-01

    To ascertain the risk factors for falls, stumbles and recurrent falls in a cohort of elderly people with mean age of 76.7-/+6.1 years. 137 community dwelling elderly living independently or in assisted living institutions participated in the study. Each subject was assessed by history, physical examination and physical performance tests at the beginning and end of study. Falls and stumbles were recorded in a falls dairy for 1 year. Significant predictors of being a faller were a history of falls at baseline (Odds Ratio (OR) = 3.85, 95% Confidence Interval (CI) = 1.56 - 9.50), depression (OR = 1.19, 95% CI = 1.02 - 1.38) and timed rise (Incident Rate Ratio (IRR) = 1.24, 95% CI = 1.03 - 1.50). For predicting recurrent fallers Receiver Operator Characteristic (ROC) curves were as follows: 0.71 (95%CI 0.61-0.81) for timed up and go, 0.67 (95%CI 0.56-0.78) for timed rise and 0.70 (95%CI 0.60-0.80) for timed walk fast pace. Timed rise was the single most important test that was able to predict both a first time faller and recurrent faller. Timed up and go was the most significant test to predict recurrent fallers.

  14. [Prevalence and associated factors of falls in community-dwelling elderly].

    Science.gov (United States)

    Lavedán Santamaría, Ana; Jürschik Giménez, Pilar; Botigué Satorra, Teresa; Nuin Orrio, Carmen; Viladrosa Montoy, Maria

    2015-01-01

    To estimate the prevalence of falls and to identify their associated factors in community-dwelling elderly. A descriptive, cross-sectional study. Primary Health Care, Lleida. Six hundred and forty people aged 75 and older were included, in possession of a health card and living in single-family houses, through random sampling. Main measurements Data source comes from the survey of frailty in Lleida (FRALLE Survey). The variables used were the occurrence of falls, sociodemographic factors, health status, quality of life related to health and fear of falling. The prevalence of falls was 25.0% (95% CI 24.8-25.1). After multivariate analysis, basic disability (OR=2.17; 95% CI 1.32-3.58), depressive symptoms (OR=1.67; 95% CI 1.07-2.59) and fear of falling (OR=2.53; 95% CI 1.63-3.94) were the only factors independently associated with falls in the last year. One out of 4 older people reported at least a fall in the last year. This study demonstrates that fear of falling, depressive symptoms and basic disability are independent variables associated with previous falls. These 3 factors can lead to a flattering spiral of falling and may be potential targets for effective functioning in the context of falls. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  15. Racial and ethnic disparities in depression care in community-dwelling elderly in the United States.

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    Akincigil, Ayse; Olfson, Mark; Siegel, Michele; Zurlo, Karen A; Walkup, James T; Crystal, Stephen

    2012-02-01

    We investigated racial/ethnic disparities in the diagnosis and treatment of depression among community-dwelling elderly. We performed a secondary analysis of Medicare Current Beneficiary Survey data (n = 33,708) for 2001 through 2005. We estimated logistic regression models to assess the association of race/ethnicity with the probability of being diagnosed and treated for depression with either antidepressant medication or psychotherapy. Depression diagnosis rates were 6.4% for non-Hispanic Whites, 4.2% for African Americans, 7.2% for Hispanics, and 3.8% for others. After we adjusted for a range of covariates including a 2-item depression screener, we found that African Americans were significantly less likely to receive a depression diagnosis from a health care provider (adjusted odds ratio [AOR] = 0.53; 95% confidence interval [CI] = 0.41, 0.69) than were non-Hispanic Whites; those diagnosed were less likely to be treated for depression (AOR = 0.45; 95% CI = 0.30, 0.66). Among elderly Medicare beneficiaries, significant racial/ethnic differences exist in the diagnosis and treatment of depression. Vigorous clinical and public health initiatives are needed to address this persisting disparity in care.

  16. Noctural Enuresis as a Risk Factor for Falls in Older Community Dwelling Women with Urinary Incontinence.

    Science.gov (United States)

    Pahwa, Avita K; Andy, Uduak U; Newman, Diane K; Stambakio, Hanna; Schmitz, Kathryn H; Arya, Lily A

    2016-05-01

    We determined the association of urinary symptoms with fall risk and physical limitations in older community dwelling women with urinary incontinence. We performed an in-depth assessment of daytime and nighttime urinary symptoms, fall risk, physical function, physical performance tests and mental function in older community dwelling women with urinary incontinence who had not sought care for urinary symptoms. All assessments were performed in participant homes. We used univariable and multivariable linear regression to examine the relationship of urinary symptoms to fall risk, physical function and physical performance. Of 37 women with a mean ± SD age of 74 ± 8.4 years who had urinary incontinence 48% were at high risk for falls. Nocturnal enuresis was reported by 50% of the women. Increased fall risk was associated with increasing frequency of nocturnal enuresis (p = 0.04), worse lower limb function (p Women with nocturnal enuresis had significantly lower physical performance test scores than women without nocturnal enuresis (median 7, range 0 to 11 vs 9, range 1 to 12, p = 0.04). In a multivariable regression model including age, nocturnal enuresis episodes and physical function only physical function was associated with an increased fall risk (p women with urinary incontinence. It may serve as a marker of fall risk even in women who do not seek care for urinary symptoms. Interventions targeting upper and lower body physical function could potentially decrease the risk of falls in older women with urinary incontinence. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Hypoactive sexual desire dysfunction in community-dwelling older women.

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    Zeleke, Berihun M; Bell, Robin J; Billah, Baki; Davis, Susan R

    2017-04-01

    To determine the prevalence of hypoactive sexual desire dysfunction (HSDD) and its associated factors in women aged 65 to 79 years. A questionnaire-based, cross-sectional study was conducted amongst community-dwelling older women. Participants were recruited between April and August 2014 from a national database based on electoral rolls. Sexual function and sexual distress were assessed by the Female Sexual Function Index and the Female Sexual Distress Scale-Revised, respectively. HSDD was defined as the presence of both low sexual desire and sexually related personal distress. The mean ± SD age of the 1,548 women was 71 ± 3.4 years and 52.6% were partnered. Among the participants, 88.0% (95% confidence interval [CI], 86.3%-89.6%) had low sexual desire, 15.5% (95% CI, 13.8%-17.4%) had sexually related personal distress, and 13.6% (95% CI, 11.9%-15.4%) had HSDD. The HSDD was more common among partnered than among unpartnered women (23.7% vs 5.9%; P dysfunction (AOR = 1.92; 95% CI, 1.29-2.92), and having moderate-to-severe depressive symptoms (AOR = 4.15; 95% CI, 2.16-7.96) were independently associated with having HSDD. In a subanalysis, HSDD was more common among sexually active than sexually inactive women (31.5% vs 17.3%; P sexually active women had HSDD, as did 22% (95% CI, 11.5%-37.8%) of unpartnered sexually active women. HSDD is common and associated with potentially modifiable risk factors in older women. It should not be assumed that unpartnered older women are sexually inactive or are not distressed by low sexual desire.

  18. Depression, quality of life (QoL) and will to live of community-dwelling postmenopausal women in three Asian countries: Korea, China and Japan.

    Science.gov (United States)

    Ina, Koichiro; Hayashi, Toshio; Nomura, Hideki; Ishitsuka, Asako; Hirai, Hisako; Iguchi, Akihisa

    2011-01-01

    The purpose of this study was to examine the prevalence of screening-detected depression and the association of depression with QoL in community-dwelling postmenopausal women living in three Asian countries. We examined self-reported questionnaires and conducted the study. A total of 698 community-dwelling postmenopausal women living in three Asian countries participated in this study. The mean age was 59.4±6.6 years (±SD) Depressive symptoms were assessed using a 15-item geriatric depression scale (GDS-15). Using the cut-off of 5/6 for the GDS-15, the percentages of subjects with depression were 39.0% of the Korean subjects, 29.2% of the Chinese subjects, and 33.9% of the Japanese subjects. For the assessment of QoL, we used the EQ-5D of the EuroQoL Group. The following five dimensions were assessed: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The proportions of subjects reporting problems for each dimension were examined. Subjects with depression had significantly lower levels of some dimensions of QoL than those without depression in all three countries. In all three countries, 29.2-39.0% of community-dwelling postmenopausal women had screening-detected depression, which was significantly associated with a lower level of some dimensions of QoL. These results suggest that clinicians should pay more attention to depression in community-dwelling postmenopausal women. Copyright © 2010. Published by Elsevier Ireland Ltd.

  19. The contribution of hypoxia to the association between sleep apnoea, insomnia, and cardiovascular mortality in community-dwelling elderly with and without cardiovascular disease.

    Science.gov (United States)

    Johansson, Peter; Svensson, Erland; Alehagen, Urban; Jaarsma, Tiny; Broström, Anders

    2015-06-01

    This study explores if nightly hypoxia (i.e. percentage of sleep time with oxygen saturation lower than 90% (SaO2insomnia in community-dwelling elderly with and without cardiovascular disease (CVD). A second aim was to explore a potential cut-off score for hypoxia to predict insomnia and the association of the cut-off with clinical characteristics and cardiovascular mortality. A total of 331 community-dwelling elderly aged 71-87 years underwent one-night polygraphic recordings. The presence of insomnia was recorded by a self-report questionnaire. The presence of CVD was objectively established and mortality data were collected after three and six years. In both patients with CVD (n=119) or without CVD (n=212) SDB was associated with hypoxia (pinsomnia (pinsomnia. Hypoxia of more than 1.5% of sleep time with SaO2causing insomnia. According to this criterion 32% (n=39) and 26% (n=55) of those with and without CVD had hypoxia, respectively. These groups did not differ with respect to age, gender, body mass index, diabetes, hypertension, respiratory disease or levels of SDB. However, in the CVD group, hypoxia was associated with cardiovascular mortality at the three-year follow-up (p=0.008) and higher levels of insomnia (p=0.002). In the elderly with CVD, SDB mediated by hypoxia can be associated with more insomnia and a worse prognosis. © The European Society of Cardiology 2014.

  20. Assessments of functional status, comorbidities, polypharmacy, nutritional status and sarcopenia in Turkish community-dwelling male elderly.

    Science.gov (United States)

    Bahat, Gulistan; Tufan, Fatih; Bahat, Zumrut; Aydin, Yucel; Tufan, Asli; Akpinar, Timur Selcuk; Erten, Nilgun; Karan, Mehmet Akif

    2013-06-01

    Functionality, comorbidities, polypharmacy, nutritional status and sarcopenia affect the prognosis of elderly excessively. These parameters are influenced by the population, living settings and age. We aimed to study these parameters in Turkish community-dwelling male elderly. We studied 274 male elderly ≥60 years of age admitted to our Geriatrics outpatient clinics. Mean age was 74.4 ± 7.1 years; 47.4% of the subjects were ≥75 years, 24.1% were ≥80 years. Mean activities-of-daily-living (ADL) and instrumental ADL (IADL) scores were 9.4 and 11.1, respectively. Patients with at least one-dependence at ADL-IADL were 22.6%-47.2%, and more than half-dependence at ADL-IADL were 2.8%-17.9%, respectively. Mean number of comorbidities were 2.6. Most common diagnosis was hypertension with 65%; mean number of drugs were 4.5; 55.3% were using ≥4 chronic drugs. Prevalences of malnutrition were 3.7%-6.9%, malnutrition risk were 23.5%-26.7% by the mini nutritional assessment test-long form and short form, respectively. Calf circumference was measured elderly may have greater prevalences of functional dependence, sarcopenia but lower rates of malnutrition and similar rates of polypharmacy compared with the western developing countries and developed countries. This study emphasized the geographical differences in and/or between the individual countries highlighting the need for studies both country- and world-wide.

  1. Examining the association between late-life leisure activity participation and global cognitive decline in community-dwelling elderly Chinese in Hong Kong.

    Science.gov (United States)

    Leung, Grace Tak Yu; Fung, Ada Wai Tung; Tam, Cindy Woon Chi; Lui, Victor Wing Cheong; Chiu, Helen Fung Kum; Chan, Wai Man; Lam, Linda Chiu Wa

    2011-01-01

    This study examines the association between late-life leisure activity participation and global cognitive decline in community-dwelling elderly Chinese in Hong Kong. Five hundred and five participants, not clinically demented at the baseline, were analysed in the follow-up study of a population-based community survey among Hong Kong Chinese aged 60 and over. Information regarding leisure activity participation, global cognitive function and important sociodemographic variables was collected. Late life leisure activity profiles were classified into intellectual, social, physical and recreational categories, and were measured by total hours per week, total frequency and total number of subtypes. Multivariate logistic regression analyses were used to evaluate the association between leisure activity participation at the baseline and the incidence of global cognitive decline at the 22-month follow-up. The incidence of global cognitive decline was defined as a one-point drop in z-score of the Cantonese version of the mini-mental state examination (CMMSE). At the follow-up, a higher level of participation in intellectual activities was significantly associated with a lower incidence of global cognitive decline as measured by both the total hours per week (multivariate-adjusted OR 0.97 (95% CI 0.94-0.99, p=0.003)), and the total number of subtypes (multivariate-adjusted OR 0.74 (95% CI 0.58-0.95, p=0.018)). A higher level of late-life intellectual activity participation was associated with less global cognitive decline among community-dwelling elderly Chinese in Hong Kong. Copyright © 2010 John Wiley & Sons, Ltd.

  2. Characteristics of depression in community-dwelling elderly people as indicated by the tree-drawing test.

    Science.gov (United States)

    Murayama, Norio; Endo, Tadashi; Inaki, Koichiro; Sasaki, Shinsai; Fukase, Yuko; Ota, Kazumi; Iseki, Eizo; Tagaya, Hirokuni

    2016-07-01

    The tree-drawing test (TDT) is a typical projective method, but previous studies have paid little attention to it for elderly people. We investigated the characteristics of depression in community-dwelling elderly people as indicated by the TDT. This study was a complete enumeration survey of elderly people conducted through home visits. The contents of the survey included gender, age, presence or absence of housemates, frequency of going out, the 15-item Geriatric Depression Scale, and TDT. The subjects were divided into three groups (normal, depressed tendency, and depressed) according to the total 15-item Geriatric Depression Scale score. In TDT, no significant difference was observed in drooping crown, shadow of the whole tree, or shadow near the base, which have been regarded as indices of depression in younger people. However, the values concerning the size of the tree, such as the height and width of the whole tree, height and width of the crown, and number of occupied areas (of the paper), were significantly lower in the depressed group than in the other groups. In addition, the width of the trunk was significantly smaller in the depressed group than in the normal group. Subjects were classified as being in a 'depressed state' if they used 40 or fewer areas for drawing (i.e. occupied areas) and a 'non-depressed state' if they used 41 or more areas. This enabled depression to be detected (sensitivity: 71.4%; specificity: 79.9%). The size of the tree in TDT is suggested to reflect characteristics of depression in elderly people, such as introversion, reserve, antisocial attitude, a feeling of inferiority, weakness of ego, and lack of vigour. Furthermore, the numbers of occupied areas were found to be relatively useful in detecting depression in elderly people. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

  3. Risk factors of indoor fall injuries in community-dwelling older women: a prospective cohort study.

    Science.gov (United States)

    Hu, Jia; Xia, Qinghua; Jiang, Yu; Zhou, Peng; Li, Yuhua

    2015-01-01

    The aims of the study were to explore the characteristics and the potential risk factors of indoor fall injuries in community-dwelling older women, and to provide evidence for the future intervention strategy. A prospective cohort of 3043 women aged 60 years old and above from 3 selected counties in Shanghai was followed up on the outcomes of indoor fall injuries for up to 1 year. Demographic and health data were collected during admission; the physical function, balance ability and home-living environment were examined by a structured questionnaire when admitted. The outcome of indoor fall injury was investigated by a visit in month 3, month 6 and month 12 after baseline survey. Univariate analysis and Multiple Logistic Regression Model were used to examine the associations between potential risk factors and outcomes of indoor fall injuries. Two hundred and thirty-one of the 3043 women (7.6%) eventually suffered indoor fall injuries at least once during the 1-year follow-up. The injurious falls of women were significantly associated with age, educational level, marital status, health status, balance ability, physical activity and home-living environment in the univariate analyses. Women who worried about falls and restrained activities for it were more likely to suffer fall injury. Younger women, with less chronic disease, with good balance ability and living in good corridor environment, were less likely to receive fall injury in multiple logistic regression analyses. Multidimensional factors were associated with indoor fall injuries for community-dwelling older women. Proper clinical treatment of chronic disease and improvement of women's balance ability, as well as reducing the risk factor of indoor environment, which will play vital roles in preventing indoor fall injuries, should be prioritized for the intervention strategy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. The circumstances, orientations, and impact locations of falls in community-dwelling older women.

    Science.gov (United States)

    Crenshaw, Jeremy R; Bernhardt, Kathie A; Achenbach, Sara J; Atkinson, Elizabeth J; Khosla, Sundeep; Kaufman, Kenton R; Amin, Shreyasee

    2017-11-01

    We sought to characterize the circumstances, orientations, and impact locations of falls in community-dwelling, ambulatory, older women. For this longitudinal, observational study, 125 community-dwelling women age≥65years were recruited. Over 12-months of follow-up, fall details were recorded using twice-monthly questionnaires. More than half (59%) of participants fell, with 30% of participants falling more than once (fall rate=1.3 falls per person-year). Slips (22%) and trips (33%) accounted for the majority of falls. Approximately 44% of falls were forward in direction, while backward falls accounted for 41% of falls. About a third of all falls were reported to have lateral (sideways) motion. Subjects reported taking a protective step in response to 82% of forward falls and 37% of backward falls. Of falls reporting lateral motion, a protective step was attempted in 70% of accounts. Common impact locations included the hip/pelvis (47% of falls) and the hand/wrist (27%). Backwards falls were most commonly reported with slips and when changing direction, and increased the risk of hip/pelvis impact (OR=12.6; 95% CI: 4.7-33.8). Forward falls were most commonly reported with trips and while hurrying, and increased the risk of impact to the hand/wrist (OR=2.6; 95% CI: 1.2-5.9). Falls in older ambulatory women occur more frequently than previously reported, with the fall circumstance and direction dictating impact to common fracture locations. Stepping was a common protective recovery strategy and that may serve as an appropriate focus of interventions to reduce falls in this high risk population. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Relationship between Sensory Perception and Frailty in a Community-Dwelling Elderly Population.

    Science.gov (United States)

    Somekawa, S; Mine, T; Ono, K; Hayashi, N; Obuchi, S; Yoshida, H; Kawai, H; Fujiwara, Y; Hirano, H; Kojima, M; Ihara, K; Kim, H

    2017-01-01

    Aging anorexia, defined as loss of appetite and/or reduced food intake, has been postulated as a risk factor for frailty. Impairments of taste and smell perception in elderly people can lead to reduced enjoyment of food and contribute to the anorexia of aging. To evaluate the relationship between frailty and taste and smell perception in elderly people living in urban areas. Data from the baseline evaluation of 768 residents aged ≥ 65 years who enrolled in a comprehensive geriatric health examination survey was analyzed. Fourteen out of 29-items of Appetite, Hunger, Sensory Perception questionnaire (AHSP), frailty, age, sex, BMI, chronic conditions and IADL were evaluated. AHSP was analyzed as the total score of 8 taste items (T) and 6 smell items (S). Frailty was diagnosed using a modified Fried's frailty criteria. The area under the receiver operator curves for detection of frailty demonstrated that T (0.715) had moderate accuracy, but S (0.657) had low accuracy. The cutoffs, sensitivity, specificity and Youden Index (YI) values for each perception were T: Cutoff 26.5 (YI: 0.350, sensitivity: 0.639, specificity: 0.711) and S: Cutoff 18.5 (YI: 0.246, sensitivity: 0.690, specificity: 0.556). Results from multiple logistic regression models, after adjusting for age, sex, IADL and chronic conditions showed that participants under the T cutoff were associated with exhaustion and those below the S cutoff were associated with slow walking speed. The adjusted logistic models for age, sex, IADL and chronic conditions showed significant association between T and frailty (OR 2.81, 95% CI 1.29-6.12), but not between S and frailty (OR 1.73, 95% CI 0.83-3.63). Taste and smell perception, particularly taste perception, were associated with a greater risk of frailty in community-dwelling elderly people. These results suggest that lower taste and smell perception may be an indicator of frailty in old age.

  6. Disability and quality of life in community-dwelling elderly cancer survivors: Case-control study in the Korean population.

    Science.gov (United States)

    Lee, Myung Kyung

    2016-10-01

    Advanced age is a significant risk factor for cancer and functional disabilities increase with age. The purpose of this case-control study of Korean individuals was to determine the effect of cancer and cancer treatment on functional disability and quality of life (QOL). Thus, we compared community-dwelling elderly cancer patients (ECPs) with individuals from the general elderly population (GEP) who never had diagnoses of cancer. We selected 1776 ECP who were at least 65 years-old from the 2008 Korean Community Health Survey data and used propensity score matching to randomly select 1766 individuals from the GEP who closely resembled the ECPs. Functional disability was measured using the Instrumental Activities of Daily Living (IADL) scale, and QOL was measured by the EuroQol Group EQ-5D. ECPs were more dependent in preparation of food, doing laundry, and shopping (IADL scale), and in mobility and usual activities (EQ-5D). Although ECP had more problems with pain, discomfort, anxiety, and depression, they were more independent in self-care and handling of financial responsibilities. ECPs had multiple physical and psychological symptoms that adversely affected functional disability and QOL, but higher functional ability, such as self-care and handling of financial responsibilities. Promotion of self-care by ECPs is pivotal for effective management in community practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai.

    Science.gov (United States)

    Samnieng, P; Ueno, M; Shinada, K; Zaitsu, T; Wright, F A C; Kawaguchi, Y

    2012-03-01

    This study was to analyze the association of hyposalivation with oral function, nutritional status and oral health in community-dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8, SD 5.9 years). Oral function (tasting, speaking, swallowing and chewing) and Mini Nutritional Assessment (MNA) were evaluated. Oral examination investigated teeth and periodontal status. Both unstimulated and stimulated whole saliva were collected for 5 minutes. Among all subjects, 14.4 % were classified within the hyposalivation. Hyposalivation was associated with gender, systemic disease, medication, and smoking. Subjects within the hyposalivation group had a higher number of decayed teeth and a higher prevalence of periodontitis than the normal salivation group (p < 0.05). The hyposalivation group also had a lower number of teeth present and a lower mean MNA score than the normal salivation group (p < 0.05). Logistic regression analysis showed that hyposalivation in both dentate and edentulous subjects was significantly associated with tasting, speaking, swallowing and chewing. This study suggested that hyposalivation is a risk factor not only for dental caries and periodontal disease but also for taste disturbances, speaking problems, swallowing problems, poor chewing ability and malnutrition. Monitoring salivary flow is an important measure in the care of older people.

  8. Use, perceived effectiveness, and gender differences of pain relief strategies among the community-dwelling elderly in Taiwan.

    Science.gov (United States)

    Yu, Hsing-Yi; Tang, Fu-In; Yeh, Ming-Chen; Kuo, Benjamin Ing-Tiau; Yu, Shu

    2011-03-01

    Pain is a common problem among the elderly. The entire scope of chronic pain relief strategies used by community elderly is still unclear. A limited number of studies have investigated this issue from diverse culture perspectives. In the present study, we investigated the use and perceived effectiveness of pain relief strategies adopted by the elderly; gender differences between frequently used relief strategies were also explored. Two hundred nineteen participants living in Taiwan City, Taiwan, were recruited by a random sampling method and interviewed face to face. The prevalence of chronic pain among the elderly was 42.0% (n = 92). The elderly tended to adopt multiple strategies (mean ± SD = 9.08 ± 3.56; range = 2-18) to relieve their chronic pain. In three domains of pain relief strategies, conventional medicine was used more frequently than complementary and alternative medicine and psychologic approaches. Most pain relief strategies were ineffective. Among the 22 strategies used, no strategy was reported as "much improved" by a majority of users. The top five pain relief strategies used by men and women were the same. Elderly women tended to adopt more psychologic approaches, such as acceptance and ignoring to relieve pain, than men. The findings suggest that nurses should pay more attention to the issue of chronic pain relief and provide the elderly with more effective pain relief strategies. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  9. Cross-cultural adaptation and validation of the Arabic version of the Physical Activity Scale for the Elderly among community-dwelling older adults in Saudi Arabia.

    Science.gov (United States)

    Alqarni, Ayidh M; Vennu, Vishal; Alshammari, Sulaiman A; Bindawas, Saad M

    2018-01-01

    Older adults are the fastest growing population group worldwide. Regular physical activity (PA) is reported to reduce the risk of health conditions and improve personal well-being. Few validated instruments can be used to measure the PA levels among older adults in Saudi Arabia. The Physical Activity Scale for the Elderly (PASE) is used worldwide for evaluating the PA levels of the elderly in epidemiological studies. However, this scale has not been translated into Arabic. This study aimed to cross-culturally adapt the PASE into Arabic language and evaluate its reliability and validity among community-dwelling older adults in Saudi Arabia. This study was a cross-sectional one following Beaton guidelines to translate and perform cultural adaptation, as well as test the reliability and validity of the PASE Arabic version (PASE-A). Elderly (N=74) people from both genders, who lived in a community dwelling in Riyadh city, were selected from several primary health care centers. The study used Cronbach's alpha coefficient to assess the internal consistency reliability, while intraclass correlation coefficient (ICC 2,1 ) was used for test-retest reliability and the Spearman's rank correlation coefficient ( r ) was used to evaluate the correlation among PASE-A and grip strength, Timed Up and Go test, body mass index, and fat percentage. Out of 74 older adults, 59 (79.7%) completed the PASE-A questionnaire twice. The internal consistency of the PASE-A components was good (Cronbach's alpha 0.70-0.75), and the reliability of the components was excellent (ICC 2,1 0.90-0.98). A higher PASE-A score was associated with higher grip strength ( r =0.28, p =0.05) and with shorter Timed Up and Go test times ( r =-0.45, p =0.01). The PASE-A version was easy, understandable, and relevant for Saudi older adults' culture. This scale was a reliable and valid tool for evaluating and assessing the PA level among community-dwelling older adults in Saudi Arabia.

  10. SENSITIVITY AND SPECIFICITY OF INDIVIDUAL BERG BALANCE ITEMS COMPARED WITH THE TOTAL SCORE TO PREDICT FALLS IN COMMUNITY DWELLING ELDERLY INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Hazel Denzil Dias

    2014-09-01

    Full Text Available Background: Falls are a major problem in the elderly leading to increased morbidity and mortality in this population. Scores from objective clinical measures of balance have frequently been associated with falls in older adults. The Berg Balance Score (BBS which is a frequently used scale to test balance impairments in the elderly ,takes time to perform and has been found to have scoring inconsistencies. The purpose was to determine if individual items or a group of BBS items would have better accuracy than the total BBS in classifying community dwelling elderly individuals according to fall history. Method: 60 community dwelling elderly individuals were chosen based on a history of falls in this cross sectional study. Each BBS item was dichotomized at three points along the scoring scale of 0 – 4: between scores of 1 and 2, 2 and 3, and 3 and 4. Sensitivity (Sn, specificity (Sp, and positive (+LR and negative (-LR likelihood ratios were calculated for all items for each scoring dichotomy based on their accuracy in classifying subjects with a history of multiple falls. These findings were compared with the total BBS score where the cut-off score was derived from receiver operating characteristic curve analysis. Results: On analysing a combination of BBS items, B9 and B11 were found to have the best sensitivity and specificity when considered together. However the area under the curve of these items was 0.799 which did not match that of the total score (AUC= 0.837. A, combination of 4 BBS items - B9 B11 B12 and B13 also had good Sn and Sp but the AUC was 0.815. The combination with the AUC closest to that of the total score was a combination items B11 and B13. (AUC= 0.824. hence these two items can be used as the best predictor of falls with a cut off of 6.5 The ROC curve of the Total Berg balance Scale scores revealed a cut off score of 48.5. Conclusion: This study showed that combination of items B11 and B13 may be best predictors of falls in

  11. SENSITIVITY AND SPECIFICITY OF INDIVIDUAL BERG BALANCE ITEMS COMPARED WITH THE TOTAL SCORE TO PREDICT FALLS IN COMMUNITY DWELLING ELDERLY INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Hazel Denzil Dias

    2014-06-01

    Full Text Available Background: Falls are a major problem in the elderly leading to increased morbidity and mortality in this population. Scores from objective clinical measures of balance have frequently been associated with falls in older adults. The Berg Balance Score (BBS which is a frequently used scale to test balance impairments in the elderly ,takes time to perform and has been found to have scoring inconsistencies. The purpose was to determine if individual items or a group of BBS items would have better accuracy than the total BBS in classifying community dwelling elderly individuals according to fall history. Method: 60 community dwelling elderly individuals were chosen based on a history of falls in this cross sectional study. Each BBS item was dichotomized at three points along the scoring scale of 0 – 4: between scores of 1 and 2, 2 and 3, and 3 and 4. Sensitivity (Sn, specificity (Sp, and positive (+LR and negative (-LR likelihood ratios were calculated for all items for each scoring dichotomy based on their accuracy in classifying subjects with a history of multiple falls. These findings were compared with the total BBS score where the cut-off score was derived from receiver operating characteristic curve analysis. Results: On analysing a combination of BBS items, B9 and B11 were found to have the best sensitivity and specificity when considered together. However the area under the curve of these items was 0.799 which did not match that of the total score (AUC= 0.837. A, combination of 4 BBS items - B9 B11 B12 and B13 also had good Sn and Sp but the AUC was 0.815. The combination with the AUC closest to that of the total score was a combination items B11 and B13. (AUC= 0.824. hence these two items can be used as the best predictor of falls with a cut off of 6.5 The ROC curve of the Total Berg balance Scale scores revealed a cut off score of 48.5. Conclusion: This study showed that combination of items B11 and B13 may be best predictors of falls in

  12. Individual and Area Level Socioeconomic Status and Its Association with Cognitive Function and Cognitive Impairment (Low MMSE) among Community-Dwelling Elderly in Singapore.

    Science.gov (United States)

    Wee, Liang En; Yeo, Wei Xin; Yang, Gui Rong; Hannan, Nazirul; Lim, Kenny; Chua, Christopher; Tan, Mae Yue; Fong, Nikki; Yeap, Amelia; Chen, Lionel; Koh, Gerald Choon-Huat; Shen, Han Ming

    2012-01-01

    Neighborhood socioeconomic status (SES) can affect cognitive function. We assessed cognitive function and cognitive impairment among community-dwelling elderly in a multi-ethnic urban low-SES Asian neighborhood and compared them with a higher-SES neighborhood. The study population involved all residents aged ≥60 years in two housing estates comprising owner-occupied housing (higher SES) and rental flats (low SES) in Singapore in 2012. Cognitive impairment was defined as cognitive function, while multilevel logistic regression determined predictors of cognitive impairment. Participation was 61.4% (558/909). Cognitive impairment was found in 26.2% (104/397) of residents in the low-SES community and in 16.1% (26/161) of residents in the higher-SES community. After adjusting for other sociodemographic variables, living in a low-SES community was independently associated with poorer cognitive function (β = -1.41, SD = 0.58, p cognitive impairment (adjusted odds ratio 5.13, 95% CI 1.98-13.34). Among cognitively impaired elderly in the low-SES community, 96.2% (100/104) were newly detected. Living in a low-SES community is independently associated with cognitive impairment in an urban Asian society.

  13. Hippocampal atrophy and memory dysfunction associated with physical inactivity in community-dwelling elderly subjects: The Sefuri study.

    Science.gov (United States)

    Hashimoto, Manabu; Araki, Yuko; Takashima, Yuki; Nogami, Kohjiro; Uchino, Akira; Yuzuriha, Takefumi; Yao, Hiroshi

    2017-02-01

    Physical inactivity is one of the modifiable risk factors for hippocampal atrophy and Alzheimer's disease. We investigated the relationship between physical activity, hippocampal atrophy, and memory using structural equation modeling (SEM). We examined 213 community-dwelling elderly subjects (99 men and 114 women with a mean age of 68.9 years) without dementia or clinically apparent depression. All participants underwent Mini-Mental State Examination (MMSE) and Rivermead Behavioral Memory Test (RBMT). Physical activities were assessed with a structured questionnaire. We evaluated the degree of hippocampal atrophy (z-score-referred to as ZAdvance hereafter), using a free software program-the voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) based on statistical parametric mapping 8 plus Diffeomorphic Anatomical Registration Through an Exponentiated Lie algebra. Routine magnetic resonance imaging findings were as follows: silent brain infarction, n  = 24 (11.3%); deep white matter lesions, n  = 72 (33.8%); periventricular hyperintensities, n  = 35 (16.4%); and cerebral microbleeds, n  = 14 (6.6%). Path analysis based on SEM indicated that the direct paths from leisure-time activity to hippocampal atrophy (β = -.18, p  physical inactivity, and hippocampal atrophy appeared to cause memory dysfunction, although we are unable to infer a causal or temporal association between hippocampal atrophy and memory dysfunction from the present observational study.

  14. Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents.

    Science.gov (United States)

    Haran, John P; Bradley, Evan; Howe, Emily; Wu, Xun; Tjia, Jennifer

    2018-02-01

    It is unclear how medication exposures differ in their association with recurrent Clostridium difficile infection (rCDI) in elderly nursing home (NH) residents and community-dwelling individuals. This study examined these exposures to determine whether the risk of rCDI differs according to living environment. Retrospective. Academic and community healthcare settings. Individuals aged 65 and older with CDI (N = 616). Information on participant characteristics and medications was extracted from the electronic medical record (EMR). We used separate extended Cox models according to living environment to identify the association between medication use and risk of rCDI. Of the 616 elderly adults treated for CDI, 24.1% of those living in the community and 28.1% of NH residents experienced recurrence within 1 year. For community-dwelling participants, the risk of rCDI was 1.6 times as high with antibiotic exposure and 2.5 times as high with acid-reducing medication exposure, but corticosteroid exposure was associated with a 39% lower risk of recurrence. For NH residents, the risk of rCDI was 2.9 times as high with acid-reducing medication exposure and 5.9 times as high with corticosteroid medication exposure. Antibiotic exposure was associated with an increased risk of recurrence only in community-dwelling participants (adjusted hazard ratio = 1.63, 95% confidence interval = 1.00-2.67). Risk of rCDI is greater with acid-reducing medication use than antibiotic use after initial CDI treatment, although the risk varied depending on living environment. Corticosteroid use is associated with greater risk of recurrence in NH residents but lower risk in community-dwelling elderly adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  15. Dietary Health Behaviors of Women Living in High Rise Dwellings: A Case Study of an Urban Community in Malaysia

    OpenAIRE

    Karupaiah, Tilakavati; Swee, Winnie Chee Siew; Liew, Siew Ying; Ng, Boon Koon; Chinna, Karuthan

    2012-01-01

    Diet-related non-communicable disease (DR-NCD) occurrence is a serious problem amongst Malaysian women and urbanization is probably a challenge to their achieving the nutritional environment conducive to healthy eating. This case study aimed to determine diet quality of an urban community using women respondents from high rise dwellings in Kuala Lumpur. The sample consisted of 135 households and a healthy eating index (HEI) scale was used to evaluate the women?s diet quality. A total of 128 w...

  16. Differences in lifestyle, physical performance and quality of life between frail and robust Brazilian community-dwelling elderly women.

    Science.gov (United States)

    Sewo Sampaio, Priscila Yukari; Sampaio, Ricardo Aurélio Carvalho; Coelho Júnior, Hélio José; Teixeira, Luis Felipe M; Tessutti, Vitor D; Uchida, Marco Carlos; Arai, Hidenori

    2016-07-01

    To investigate the lifestyles, physical performance and quality of life (QOL) of frail and robust Brazilian community-dwelling older women, and to identify risk factors for frailty. Frailty was assessed using the Kihon Checklist. Lifestyles were assessed using a questionnaire. Physical performance was assessed by measuring walking speeds, performance on the one-leg stand test and the five-times chair stand test and handgrip strength. QOL was assessed using the Short Form-8 questionnaire. Participants were divided into frail and robust groups based on their total Kihon Checklist scores. A total of 109 participants (age 70.8 ± 6.87 years) were included in this study (robust n = 85, frail n = 24). Differences in living structures (P financial satisfaction (P = 0.004) and the frequencies with which participants leave the house (P performance (walking speed P financial dissatisfaction, a sedentary lifestyle, falls, and malnutrition. Furthermore, they showed poorer physical performance and QOL. An early, well-focused approach is crucial, especially for older adults who walk slowly and have bodily pain to preserve health and QOL. Geriatr Gerontol Int 2016; 16: 829-835. © 2015 Japan Geriatrics Society.

  17. Association of personality traits with oral health-related quality of life independently of objective oral health status: a study of community-dwelling elderly Japanese.

    Science.gov (United States)

    Takeshita, Hajime; Ikebe, Kazunori; Kagawa, Ryosuke; Okada, Tadashi; Gondo, Yasuyuki; Nakagawa, Takeshi; Ishioka, Yoshiko; Inomata, Chisato; Tada, Sayaka; Matsuda, Ken-ichi; Kurushima, Yuko; Enoki, Kaori; Kamide, Kei; Masui, Yukie; Takahashi, Ryutaro; Arai, Yasumichi; Maeda, Yoshinobu

    2015-03-01

    Oral health-related quality of life (OHRQoL) is being increasingly used in epidemiologic studies of dentistry. However, patient-reported OHRQoL does not always coincide with clinical measures. Previous studies have shown a relationship between OHRQoL and personality, but did not concomitantly investigate oral function. We aimed to examine the association among personality traits, oral function, and OHRQoL using a large sample of community-dwelling Japanese elderly. The participants (n = 938; age, 69-71 years) were drawn from a complete enumeration of an urban area and a rural area of both the Tokyo metropolitan area and Hyogo Prefecture. The self-perceived impact of OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). The oral status and socioeconomic characteristics were recorded in each participant, and personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness) were assessed with the NEO-five-factor inventory. Multiple linear regression analysis was performed to examine the relationships between OHRQoL and other factors, with p Personality traits are associated with OHRQoL independently of objective measures of oral health status in community-dwelling elderly Japanese. This study showed personality traits are associated with OHRQoL independently of dental status and oral function in old Japanese people. As elderly patients undergo increasingly complex dental treatments, there is a need to evaluate patient personality traits prior to dental treatment and predict patient expectations and responses to planned treatment. This is advantageous in determining the most appropriate therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Oral health conditions and frailty in Mexican community-dwelling elderly: a cross sectional analysis

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    Castrejón-Pérez Roberto

    2012-09-01

    Full Text Available Abstract Background Oral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly. Methods Analysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate, utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factors Results Of the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Those who had a higher probability of being

  19. Orofacial pain conditions and impact on quality of life in community-dwelling elderly people in Hong Kong.

    Science.gov (United States)

    Luo, Yan; McMillan, Anne S; Wong, May C M; Zheng, Jun; Lam, Cindy L K

    2007-01-01

    To determine orofacial pain (OFP) characteristics, associated disability, and effect on quality of life in elderly community-dwelling Chinese people. A cross-sectional survey involving elderly people registered with the Family Medicine Unit of the University of Hong Kong served as the sampling frame. Elderly people with recent OFP symptoms and a comparison control group without OFP participated. Standard questions were asked about OFP conditions in the previous month and the Oral Health Impact Profile (OHIP-14), General Health Questionnaire (GHQ-12), and pain-related disability questions were administered prior to a standard clinical examination. Ninety-five people with OFP and 100 people without OFP participated. The median number of pain symptoms per subject was 2.0. Toothache was the most common symptom (58.9%); shooting pain across the face and muscle tenderness were the least common (6.3%). More than half of the pain participants described moderate to severe OFP. The prevalences of patients with neurological/vascular (NV), musculoligamentous/soft tissue (MST), or dentoalveolar (DA) OFP were 35.8%, 33.7%, and 30.5%, respectively. Chronic OFP was common (80%). The mean OHIP-14 summary score was significantly higher in OFP subjects than controls (P or = 4, indicating greater psychological distress, were more common in OFP subjects than controls (P life activities, and in 9.9% it affected ability to work. OFP had a substantial detrimental impact on daily life activities, psychological distress level, and quality of life in Chinese elders. MST and DA conditions had the greatest adverse impact on quality of life.

  20. Nonimaging clinical assessment of impaired swallowing in community-dwelling older adults in Taiwan.

    Science.gov (United States)

    Chen, Miao-Yen; Lin, Li-Chan

    2012-12-01

    Impaired swallowing is common in elderly patients as well as those with neurological disorders and degenerative diseases. Convenient and accurate assessments should be available to community-dwelling older adults to diagnose and provide early management and care of swallowing difficulties, an important factor of influence on elderly life quality. This study used convenient nonimaging methods to assess swallowing functions in community-dwelling older adults and estimated the prevalence of swallowing difficulties. The study adopted a survey method and recruited 216 community-dwelling older adults over 65 years old in northern Taiwan. Researchers used tools including a swallowing test, questionnaire, water test, peripheral arterial pulse oximeter, and laryngeal S-EMG to assess participant swallowing functions and the prevalence of impaired swallowing. We found a 9.5% prevalence of impaired swallowing based on swallow questionnaire and water test results. Age correlated negatively with swallowing speed. A one-way ANOVA showed a significant difference in swallowing speed among the four age groups (F = 6.478, p < .00). A post hoc Scheffe comparison showed significant differences in swallowing time between the 60- to 69- and 70- to 79-year-old groups and 60- to 69- and 80- to 89-year-old groups. Multiple regression of impaired swallowing on various independent variables showed a significant standardized coefficient of 0.163 for age (t = 2.328, p = .021). Logistic regression showed a significant Wals test value for age (p = .007). The Kappa value was 0.307 for agreement analysis between impaired swallowing and SaO(2) value reduction of more than 2%. Swallowing function deteriorates with age. Results of this study provide an assessment of the prevalence of impaired swallowing in community-dwelling older adults in Taiwan. Results can help guide clinical nurses to enhance their objective assessment of impaired swallowing to improve patient quality of life.

  1. Cross-cultural adaptation and validation of the Arabic version of the Physical Activity Scale for the Elderly among community-dwelling older adults in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alqarni AM

    2018-03-01

    Full Text Available Ayidh M Alqarni,1,2 Vishal Vennu,1 Sulaiman A Alshammari,3 Saad M Bindawas1 1Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 2Department of Physical Therapy, King Abdullah Hospital, Bisha, Saudi Arabia; 3Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia Purpose: Older adults are the fastest growing population group worldwide. Regular physical activity (PA is reported to reduce the risk of health conditions and improve personal well-being. Few validated instruments can be used to measure the PA levels among older adults in Saudi Arabia. The Physical Activity Scale for the Elderly (PASE is used worldwide for evaluating the PA levels of the elderly in epidemiological studies. However, this scale has not been translated into Arabic. This study aimed to cross-culturally adapt the PASE into Arabic language and evaluate its reliability and validity among community-dwelling older adults in Saudi Arabia. Patients and methods: This study was a cross-sectional one following Beaton guidelines to translate and perform cultural adaptation, as well as test the reliability and validity of the PASE Arabic version (PASE-A. Elderly (N=74 people from both genders, who lived in a community dwelling in Riyadh city, were selected from several primary health care centers. The study used Cronbach’s alpha coefficient to assess the internal consistency reliability, while intraclass correlation coefficient (ICC2,1 was used for test–retest reliability and the Spearman’s rank correlation coefficient (r was used to evaluate the correlation among PASE-A and grip strength, Timed Up and Go test, body mass index, and fat percentage. Results: Out of 74 older adults, 59 (79.7% completed the PASE-A questionnaire twice. The internal consistency of the PASE-A components was good (Cronbach’s alpha 0.70–0.75, and the reliability of the components

  2. Early Hospital Readmission is a Predictor of One-Year Mortality in Community-Dwelling Older Medicare Beneficiaries

    NARCIS (Netherlands)

    Lum, H.D.; Studenski, S.A.; Degenholtz, H.B.; Hardy, S.E.

    2012-01-01

    BACKGROUND: Hospital readmission within thirty days is common among Medicare beneficiaries, but the relationship between rehospitalization and subsequent mortality in older adults is not known. OBJECTIVE: To compare one-year mortality rates among community-dwelling elderly hospitalized Medicare

  3. Experiences of the home-dwelling elderly in the use of telecare in home care services: a qualitative systematic review protocol.

    Science.gov (United States)

    Karlsen, Cecilie; Ludvigsen, Mette S; Moe, Carl E; Haraldstad, Kristin; Thygesen, Elin

    2017-05-01

    The objective of this systematic review is to identify and synthesize the best evidence on the home-dwelling elderly's experiences with the use of telecare in home care services. Furthermore, the study will identify experiences with telecare devices and examine what beliefs the home-dwelling elderly hold regarding the impact of telecare on the ability to age in place.Review question 1: How do the home-dwelling elderly experience the use of telecare in the context of home care services?Review question 2: How do the home-dwelling elderly experience telecare devices?Review question 3: What beliefs do the home-dwelling elderly hold regarding the impact of telecare on the ability to age in place?

  4. The role of social relationships among elderly community-dwelling and nursing-home residents: findings from a quality of life study.

    Science.gov (United States)

    Scocco, Paolo; Nassuato, Mario

    2017-07-01

    In Western countries, older adults' needs are often managed through institutionalization. Based on the assumption that quality of life, particularly social relationships, may be perceived differently according to residential setting, the aims of this study were to compare World Health Organization Quality of Life brief version (WHOQOL-BREF) scores of elderly community-dwelling residents and nursing home residents. A sample of 207 older adults (135 community-dwelling residents, 72 nursing home residents) was evaluated with Mini-Mental State Examination (MMSE), WHOQOL-BREF, and Geriatric Depression Scale (GDS). Nursing home residents achieved lower WHOQOL-BREF scores on the physical health scale only (P = 0.002). In a linear regression model, physical score correlated negatively with GDS score (P = 0.0001) and Mini-Mental State Examination score (P = 0.04), but positively with male gender (P = 0.02) and community-dwelling residence (P = 0.001); psychological score correlated negatively with GDS score (P = 0.0001) and being married (P = 0.03), but positively with male gender (P = 0.009) and being unmarried (P = 0.03). The social relationships score correlated negatively with the GDS score (P = 0.0001) and male gender (P = 0.02), but positively with high education level (P = 0.04). The environment score negatively correlated with GDS score (P = 0.0001). In a logistic regression model, living in a nursing home correlated with female gender (P = 0.001), age (P = 0.0001), a lower physical score (P = 0.0001), and a higher social relationships score (P = 0.02). Depressive symptoms correlated with low scores in all WHOQOL-BREF domains. The variables that correlated with living conditions in a nursing home were older age, male gender, lower physical domain scores, and higher social relationship scores. Opportunities for socialization in nursing homes may thus improve perception of quality of life in this domain. © 2017 Japanese Psychogeriatric Society.

  5. A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Women.

    Science.gov (United States)

    Marshall, Lynn M; Litwack-Harrison, Stephanie; Cawthon, Peggy M; Kado, Deborah M; Deyo, Richard A; Makris, Una E; Carlson, Hans L; Nevitt, Michael C

    2016-09-01

    Back pain and falls are common health conditions among older U.S. women. The extent to which back pain is an independent risk factor for falls has not been established. We conducted a prospective study among 6,841 community-dwelling U.S. women at least 65 years of age from the Study of Osteoporotic Fractures (SOF). Baseline questionnaires inquired about any back pain, pain severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Two outcomes were studied: recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and each fall outcome were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression. Adjustments were made for age, education, smoking status, fainting history, hip pain, stroke history, vertebral fracture, and Geriatric Depression Scale. Most (61%) women reported any back pain. During follow-up, 10% had recurrent falls and 26% fell at least once. Any back pain relative to no back pain was associated with a 50% increased risk of recurrent falls (multivariable RR = 1.5, 95% CI: 1.3, 1.8). Multivariable RRs for recurrent falls were significantly elevated for all back pain symptoms, ranging from 1.4 (95% CI: 1.1, 1.8) for mild back pain to 1.8 (95% CI: 1.4, 2.3) for activity-limiting back pain. RRs of any fall were also significantly increased albeit smaller than those for recurrent falls. Older community-dwelling women with a recent history of back pain are at increased risk for falls. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

    Science.gov (United States)

    Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

    2014-01-01

    In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

  7. The relationship between seven health practices and oral health status in community-dwelling elderly Thai.

    Science.gov (United States)

    Samnieng, Patcharaphol; Ueno, Masayuki; Zaitsu, Takashi; Shinada, Kayoko; Wright, Fredrick A C; Kawaguchi, Yoko

    2013-12-01

    This study aims to analyse the relationship between seven health practices, oral health behaviors, and oral health status in community dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8 ± 5.9 years). Questionnaires survey about sociodemographics, self-reported seven health practices and oral health behaviors were conducted by trained interviewers. Oral examinations investigated the number of teeth present, decayed teeth, periodontal status and functional tooth units (FTUs). Oral malodor was assessed by Organoleptic Test, and unstimulated saliva was collected for 5 min. Five health practices (smoking, drinking, physical activity, breakfast and weight maintenance) were significantly related with oral health behaviors. ancova analysis demonstrated the following significant associations: (i) smoking behavior with number of teeth present, number of FTUs, decayed teeth, periodontal disease, oral malodor and salivary flow rate, (ii) drinking alcohol behavior with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (iii) eating breakfast behavior with periodontal disease, oral malodor and salivary flow rate, (iv) eating between-meal snack with number of teeth present, number of FTUs, decayed teeth and periodontal disease, (v) maintaining weight with number of teeth present, number of FTUs, periodontal disease and oral malodor, (vi) sleeping with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (vii) physical activity with periodontal disease and salivary flow rate. Good health practices were related with good oral health behaviors. Moreover, general health practices were associated with the clinical oral health status such as number of teeth present, decayed teeth, FTUs, periodontal disease, oral malodor and salivary flow rate. The elderly with good general health practices were considered to have good oral health status. Improving general health

  8. Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement: A randomized controlled trial.

    Science.gov (United States)

    Macpherson, Helen; Ellis, Kathryn A; Sali, Avni; Pipingas, Andrew

    2012-03-01

    There is potential for multivitamin supplementation to improve cognition in the elderly. This randomized, double-blind, placebo-controlled trial was conducted to investigate the effects of 16 weeks multivitamin supplementation (Swisse Women's 50+ Ultivite ®) on cognition in elderly women. Participants in this study were 56 community dwelling, elderly women, with subjective complaints of memory loss. Cognition was assessed using a computerized battery of memory and attention tasks designed to be sensitive to age-related declines to fluid intelligence, and a measure of verbal recall. Biochemical measures of selected nutrients, homocysteine, markers of inflammation, oxidative stress, and blood safety parameters were also collected. All cognitive and haematological parameters were assessed at baseline and 16 weeks post-treatment. The multivitamin improved speed of response on a measure of spatial working memory, however benefits to other cognitive processes were not observed. Multivitamin supplementation decreased levels of homocysteine and increased levels of vitamin B(6) and B(12), with a trend for vitamin E to increase. There were no hepatotoxic effects of the multivitamin formula indicating this supplement was safe for everyday usage in the elderly. Sixteen weeks ssupplementation with a combined multivitamin, mineral and herbal formula may benefit working memory in elderly women at risk of cognitive decline.

  9. Falls in the community-dwelling older adult: A review for primary-care providers

    Directory of Open Access Journals (Sweden)

    Theresa A Soriano

    2008-01-01

    Full Text Available Theresa A Soriano1, Linda V DeCherrie2, David C Thomas11The Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA; 2Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, USAAbstract: Falls in the elderly are an important independent marker of frailty. Up to half of elderly people over 65 experience a fall every year. They are associated with high morbidity and mortality and are responsible for greater than 20 billion dollars a year in healthcare costs in the United States. This article presents a review and guide for the primary care provider of the predisposing and situational risk factors for falls; comprehensive assessment for screening and tailored intervention; and discussion of single and multicomponent measures for fall prevention and management in the older person living in the community. Interventions for the cognitively impaired and demented elderly will also be addressed.Keywords: falls, elderly, community-dwelling, review

  10. Association Between Social Participation and 3-Year Change in Instrumental Activities of Daily Living in Community-Dwelling Elderly Adults.

    Science.gov (United States)

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2017-01-01

    To investigate whether social participation (SP) in older adults is associated with ability to perform instrumental activities of daily living (IADLs). Prospective cohort study. Two local municipalities of Nara, Japan. Individuals aged 65 to 96 (n = 2,774 male, n = 3,586 female) free of IADL disability at baseline. SP and IADLs were assessed using self-administered questionnaires. SP was categorized into five types and assessed using the number and type of social activities. IADLs were evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression analysis stratified according to sex was used to examine change in IADLs according to SP, with nonparticipation as a reference. During the 3-year follow-up, 13.6% of men and 9.0% of women reported IADL decline. After adjusting for age, family structure, body mass index, pension, occupation, medical treatment, self-rated health, drinking, smoking, depression, cognitive function, and activities of daily living, participation in various social activities was inversely associated with change in IADLs in women but not men. Participation in the following types of social activities had significant inverse associations with IADL disability: hobby clubs (odds ratio (OR) = 0.68, 95% confidence interval (CI) = 0.49-0.94) for men and local events (OR = 0.68, 95% CI = 0.48-0.95), hobby clubs (OR = 0.53, 95% CI = 0.36-0.79), senior citizen clubs (OR = 0.74, 95% CI = 0.56-0.97), and volunteer groups (OR = 0.56, 95% CI = 0.32-0.99) for women. Participation in a variety of different types of social activities was associated with change in IADLs over the 3 years of this study in women, and participation in hobby clubs was associated with change in IADLs in men and women. Recommending that community-dwelling elderly adults participate in social activities appropriate for their sex may promote successful aging. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics

  11. Oral Frailty as a Risk Factor for Physical Frailty and Mortality in Community-Dwelling Elderly.

    Science.gov (United States)

    Tanaka, Tomoki; Takahashi, Kyo; Hirano, Hirohiko; Kikutani, Takeshi; Watanabe, Yutaka; Ohara, Yuki; Furuya, Hiroyasu; Tsuji, Tetsuo; Akishita, Masahiro; Iijima, Katsuya

    2017-11-17

    Oral health is important for maintaining general health among the elderly. However, a longitudinal association between poor oral health and general health has not been reported. We investigated whether poor oral status can predict physical weakening (physical frailty, sarcopenia, subsequent disability) and identified the longitudinal impact of the accumulated poor oral health (i.e., oral frailty) on adverse health outcomes, including mortality. A total of 2,011 elderly individuals (aged ≥65 years) participated in the baseline survey of the Kashiwa study in 2012. At baseline, 16 oral status measures and covariates such as demographic characteristics were assessed. As outcomes, physical frailty and sarcopenia were assessed at baseline and at follow-up in 2013 and 2014. Physical independence and survival were assessed from 2012 to 2016 at the time of long-term care certification and time of death. Poor oral status as determined by the number of natural teeth, chewing ability, articulatory oral motor skill, tongue pressure, and subjective difficulties in eating and swallowing significantly predicted future physical weakening (new-onsets of physical frailty, sarcopenia, and disability). Oral frailty was defined as co-existing poor status in ≥3 of the 6 measures. Sixteen percent of participants had oral frailty at baseline, which was significantly associated with 2.4-, 2.2-, 2.3-, and 2.2-fold increased risk of physical frailty, sarcopenia, disability, and mortality, respectively. Accumulated poor oral status strongly predicted the onset of adverse health outcomes, including mortality among the community-dwelling elderly. Prevention of oral frailty at an earlier stage is essential for healthy aging. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. The Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the U.S

    Science.gov (United States)

    Dong, XinQi; Chen, Ruijia; Wu, Bei; Zhang, Ning Jackie; Mui, Ada Chan Yuk-Sim; Chi, Iris

    2015-01-01

    Background Elder mistreatment and suicidal ideation are important public health concerns among aging populations. However, very few studies have been conducted to explore the association between elder mistreatment and suicidal ideation. Objectives To examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the U.S. Methods Guided by a community-based participatory research approach, this study conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago Area from 2011–2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstok Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results Overall, 3,159 Chinese older adults participated in this study and the mean age was 72.8. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with increased risk for 2-week suicidal ideation (OR 2.46, 95% CI 1.52 – 4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62 – 3.73). With respect to gender differences, the study found that the association remained significant in older women but not in older men after adjusting for all confounding factors. Conclusion As the largest epidemiology study conducted among Chinese older adults in the U.S., this study suggests that elder mistreatment was a risk factor for 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation. PMID:26336817

  13. Predictive Cutoff Values of the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test for Disability Incidence in Older People Dwelling in the Community.

    Science.gov (United States)

    Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Tsutsumimoto, Kota; Nakakubo, Sho; Hotta, Ryo; Suzuki, Takao

    2017-04-01

    Lower extremity functioning is important for maintaining activity in elderly people. Optimal cutoff points for standard measurements of lower extremity functioning would help identify elderly people who are not disabled but have a high risk of developing disability. The purposes of this study were: (1) to determine the optimal cutoff points of the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test for predicting the development of disability and (2) to examine the impact of poor performance on both tests on the prediction of the risk of disability in elderly people dwelling in the community. This was a prospective cohort study. A population of 4,335 elderly people dwelling in the community (mean age = 71.7 years; 51.6% women) participated in baseline assessments. Participants were monitored for 2 years for the development of disability. During the 2-year follow-up period, 161 participants (3.7%) developed disability. The optimal cutoff points of the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test for predicting the development of disability were greater than or equal to 10 seconds and greater than or equal to 9 seconds, respectively. Participants with poor performance on the Five-Times Sit-to-Stand Test (hazard ratio = 1.88; 95% CI = 1.11-3.20), the Timed "Up & Go" Test (hazard ratio = 2.24; 95% CI = 1.42-3.53), or both tests (hazard ratio = 2.78; 95% CI = 1.78-4.33) at the baseline assessment had a significantly higher risk of developing disability than participants who had better lower extremity functioning. All participants had good initial functioning and participated in assessments on their own. Causes of disability were not assessed. Assessments of lower extremity functioning with the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test, especially poor performance on both tests, were good predictors of future disability in elderly people dwelling in the community. © 2017 American Physical Therapy Association

  14. Factors affecting cognitive function according to gender in community-dwelling elderly individuals

    Directory of Open Access Journals (Sweden)

    Miwon Kim

    2017-11-01

    Full Text Available OBJECTIVES This study aimed to identify the factors affecting the cognitive function of elderly people in a community by gender. METHODS We obtained 4,878 secondary data of people aged ≥65 years in 2016 at a dementia prevention center in Gyeyang-gu, Incheon. Data were obtained through Mini-Mental Status Examination optimized for screening dementia and a questionnaire. The data were statistically analyzed using analysis of variance, analysis of covariance, and hierarchical regression. RESULTS There were significant differences in cognitive function according to gender, and the differences were significant even when age was controlled, but gender differences disappeared when education was controlled. Age, education, social activities, number of comorbid diseases, and alcohol drinking affected cognitive function through interaction with gender, but interaction with gender disappeared when education was controlled. Regression analysis showed that depression, cohabitant, social activities etc., had a significant impact on both men and women under controlled education and age. In men, the effect of social activities was greater than that of women, and hyperlipidemia had the effect only in women. CONCLUSIONS The differences in gender-related cognitive functions were due to differences in gender education period. The period of education is considered to have a great influence on cognitive function in relation to the economic level, occupation, and social activity.

  15. Serum uric acid concentration and metabolic syndrome among elderly Koreans: The Korean Urban Rural Elderly (KURE) study.

    Science.gov (United States)

    Choi, Hansol; Kim, Hyeon Chang; Song, Bo Mi; Park, Ji Hye; Lee, Ju-Mi; Yoon, Da-Lim; Yoon, Young Mi; Rhee, Yumie; Youm, Yousik; Kim, Chang Oh

    2016-01-01

    Epidemiologic studies have demonstrated that elevated serum uric acid concentration is an independent risk factor for metabolic syndrome. However, few studies have focused on elderly populations. Thus, we investigated the association of serum uric acid concentration with metabolic syndrome in community-dwelling elderly Koreans. This cross-sectional analysis included 2940 participants (986 men and 1954 women) aged 65 years or older who participated in a baseline health assessment for the Korean Urban Rural Elderly cohort study from 2012 to 2014. Serum uric acid concentration was analyzed using both continuous and dichotomous variables. Hyperuricemia was defined as a uric acid concentration ≥7.0 mg/dL in men and ≥6.0 mg/dL in women. Metabolic syndrome was defined according to the 2009 harmonizing definition. Multiple logistic regression models were used to investigate independent association between serum uric acid and metabolic syndrome, after adjusting for age, body mass index, LDL cholesterol, glycated hemoglobin, blood urea nitrogen, estimated glomerular filtration rate health behaviors, and medications. Prevalence of metabolic syndrome and its components increased significantly according to uric acid concentration in both sexes. The adjusted odds ratios for having metabolic syndrome per 1.0mg/dL higher uric acid concentration were 1.16 (95% CI: 1.03-1.31) in men and 1.27 (95% CI: 1.13-1.42) in women. Hyperuricemia was also associated with metabolic syndrome, with adjusted odds ratios of 1.71 (95% CI: 1.11-2.63) in men and 1.55 (95% CI: 1.05-2.29) in women. Elevated serum uric acid concentration was independently associated with an increased prevalence of metabolic syndrome in community-dwelling elderly Koreans. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. An analysis of structural relationship among achievement motive on social participation, purpose in life, and role expectations among community dwelling elderly attending day services

    Directory of Open Access Journals (Sweden)

    Nobuyuki Sano

    2016-01-01

    Full Text Available Background. Achievement motive is defined as the intention to achieve one’s goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154 answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model’s statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044–0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001, a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001 and a total effect on purpose in life (total effect = 0.615. Discussion. This result suggests that enhancing the intention to achieve one’s goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.

  17. An analysis of structural relationship among achievement motive on social participation, purpose in life, and role expectations among community dwelling elderly attending day services.

    Science.gov (United States)

    Sano, Nobuyuki; Kyougoku, Makoto

    2016-01-01

    Background. Achievement motive is defined as the intention to achieve one's goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154) answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model's statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044-0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001), a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001) and a total effect on purpose in life (total effect = 0.615). Discussion. This result suggests that enhancing the intention to achieve one's goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.

  18. Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial.

    Science.gov (United States)

    Oh, SeJun; Lim, Jong-Min; Kim, Yushin; Kim, MinSeock; Song, WoonGang; Yoon, BumChul

    2015-01-01

    The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life (QOL) in community-dwelling elderly people with history of falling. Participants were randomly assigned to the water-based exercise group (n=34) or land-based exercise groups (n=32). To identify the effects on physical functions, muscle strength, flexibility, and mobility were measured. QOL and fear of falling were evaluated using the Short Form 36-item questionnaire and the modified falls efficacy scale (M-FES). The measurements were performed before and after the 10-week training period. Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups (p=0.005; p=0.007). However, no statistically significant within-group differences were found in the back scratch test (p=0.766) and chair sit-and-reach test (p=0.870). QOL was significantly different in both groups (health transition: p=0.014, physical functioning: pwater-based exercises are beneficial to improve the QOL, as well as physical activities, of community-dwelling elderly compared with land-based exercise. Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Age and gender differences in the association between social participation and instrumental activities of daily living among community-dwelling elderly.

    Science.gov (United States)

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2017-04-28

    Although many studies have suggested social participation (SP) has beneficial effects on elderly people's health, most of them failed to deal with paid work. Additionally, few studies have focused on the age effect between SP and older people's health. To investigate whether the association between SP, including paid work, and instrumental activities of daily living (IADL), exhibits not only in gender, but also in age among community-dwelling older adults. In 2014, we distributed self-administered questionnaires to all community-dwelling elderly aged ≥65 in two medium-sized cities in Nara Prefecture, Japan (n = 32,825). 22,845 residents submitted the questionnaire (response rate, 69.6%). Analyzed subjects were limited to 17,680 persons who had neither dependency in basic ADL nor missing data for required items. SP was assessed based on participation frequency in seven types of social activities: volunteer groups, sports groups, hobby groups, cultural groups, senior citizens' clubs, neighborhood community associations, and paid work. Using Poisson regression models, prevalence ratio for poor IADL was calculated. To examine age and gender differences in the association between SP and IADL, we performed stratified analyses by age and gender group; male young-old (aged 65-74), male old-old (aged ≥75), female young-old, and female old-old. Prevalence of those with poor IADL was 17.1% in males and 4.5% in females, showing a significant gender difference. After adjustment for relevant covariates, volunteer groups were inversely associated with poor IADL only in males and the relationship was stronger in the old-old group than in the young-old group. Conversely, only females had a significant inverse association between paid work and poor IADL, and the association was not reliant on their ages but only those who participated infrequently had a favorable effect. Influence of age in the beneficial association between SP and IADL was generally larger in the old

  20. Prevalence of sarcopenia among older community-dwelling people with normal health and nutritional state.

    Science.gov (United States)

    Hedayati, Kerstin Khalaj; Dittmar, Manuela

    2010-01-01

    This study analyzed whether sarcopenia, a risk factor for disability in the aged, also occurs in healthy community-dwelling elders with normal nutritional state. As indicators, body cell mass (BCM) and lean body mass (LBM) were determined in 110 Germans (ages 60-83) using bioimpedance analysis. Nutritional status, muscle function, anthropometry, and physical activity level were investigated. Sarcopenia was already present in well nourished healthy elders. Its prevalence depended on the measure of muscle mass used (BCM percent, 22 percent males, 20 percent females; LBM percent, 4 percent males, 11 percent females). In conclusion, screening for presence of sarcopenia is needed in healthy, well-nourished elderly populations requiring an international standardization. Copyright © Taylor & Francis Group, LLC

  1. Relation among 25(OH)D, Aquatic Exercises, and Multifunctional Fitness on Functional Performance of Elderly Women from the Community.

    Science.gov (United States)

    Nascimento, N A Perigo; Moreira, P F P; Marin, R V; Moreira, L D F; Castro, M Lazaretti; Santos, C A F; Filho, C M A; Cendoroglo, M Seabra

    2016-04-01

    The aim of this study was to investigate if there is a relation among 25(OH)D, aquatic training, and multifunctional fitness on functional performance of elderly woman from the community. Cross-sectional study. Community. We evaluated elderly women aged ≥ 60 years (67±5 years old). One-hundred eighty were engaged in aquatic training (AT), 119 in multifunctional fitness (MF) for at least one year, and sedentary group (SED) with 162 independent elderly women from the community centers who had not practicing any regular physical exercise at least one year before. Timed up-and-go (TUG), 2-minute step test (2MST), 30-second chair stand (CS), arm curl (AC), functional reach test (FRT), unipedal balance test (UB) with visual control, handgrip right (HR) and handgrip left (HL) portable dynamometer for strength hip flexors (Hip strength) and knee extensors (Knee strength), serum 25(OH)D, intact parathyroid hormone (PTH), and creatinine clearance. Physical and functional tests showed differences among the three groups (ST; TUG, CS, AC, FR and USB = p test correlated inversely with 25(OH)D (r = -0.29 - p test showed positive correlation (r = 0, 1 - p test (p= 0.049). TUG performance was associated with age, exercise type and serum levels of 25(OH)D. The 25(OH)D insufficiency was common in elderly women from subtropical areas.

  2. Hierarchy of higher-level physical functions: a longitudinal investigation on a nationally representative population of community-dwelling middle-aged and elderly persons.

    Science.gov (United States)

    Yeh, Chih-Jung; Wang, Ching-Yi; Tang, Pei-Fang; Lee, Meng-Chih; Lin, Hui-Sheng; Chen, Hui-Ya

    2012-01-01

    Understanding the hierarchy of higher-level physical functions to infer disability level (mild, moderate or severe) is essential for the precise targeting of preventive interventions and has been examined previously in a cross-sectional study. Based on longitudinal data, this study evaluated the hierarchy of higher-level physical functions. Data from a cohort of 2729 community-dwelling persons aged over 50 with no initial disability were drawn from the "Survey of Health and Living Status of the Elderly in Taiwan" from 1996 through 2007. The three-level hierarchy of eight chosen activities was examined by the median ages to disability onset with survival analyses and by Cox regressions, which examined the effects of sex and age on the development of this hierarchy. The progression of incident disability was as follows: mild level-running, carrying weight, and squatting; moderate level-climbing stairs, walking, and standing; and severe level-grasping and raising arms up. Women and older persons were at greater risk of developing more severe levels of disability. Another Cox regression with one index activity from each hierarchical level revealed similar results. The three-level hierarchy of higher-level physical functions has been validated longitudinally, suggesting rich research and clinical implications.

  3. Supervised dance intervention based on video game choreography increases quadriceps cross sectional area and peak of torque in community dwelling older women

    Directory of Open Access Journals (Sweden)

    Elisângela Valevein Rodrigues

    2018-06-01

    Full Text Available Abstract AIMS the purpose of this study was to assess the effects of a supervised dance intervention based on video game choreography on isokinetic concentric and eccentric knee peak of torque (PT, quadriceps and hamstrings cross sectional area (CSA and functionality in community-dwelling older women. METHODS Forty-seven older women were allocated in Control Group (CG, n=25 and Intervention Group (IG, n=22. The IG performed dance based on video game choreography (Dance Central, XBOX 360®, Kinect, during 12 weeks, ~40 minutes, 3x/week, without foam (1-6week and with foam and visual disturbances (7-12 week. The pretest-training-posttest assessments included: isokinetic concentric and eccentric knee PT and CSA (Magnetic resonance imaging of quadriceps and hamstrings and functional tests. RESULTS The light-to-moderate-intensity 12-weeks training increased 8.5% the eccentric PT of quadriceps at 60°/s (p=0.04 and 1.3% quadriceps CSA (p=0.02. CONCLUSIONS These findings suggest that dance training based on video game choreography can enhance PT and induce hypertrophy in community-dwelling older women.

  4. VNTR polymorphisms of the IL-4 and IL-1RN genes and their relationship with frailty syndrome in Mexican community-dwelling elderly.

    Science.gov (United States)

    Pérez-Suárez, Thalía Gabriela; Gutiérrez-Robledo, Luis Miguel; Ávila-Funes, José Alberto; Acosta, José Luis; Escamilla-Tilch, Mónica; Padilla-Gutiérrez, Jorge Ramón; Torres-Carrillo, Norma; Torres-Castro, Sara; López-Ortega, Mariana; Muñoz-Valle, José Francisco; Torres-Carrillo, Nora Magdalena

    2016-10-01

    Inflammation is a key event that is closely associated with the pathophysiology of frailty. The relationship of genetic polymorphisms into inflammatory cytokines with frailty remains poorly understood. The aim of this study was to investigate the association between VNTR polymorphisms of the IL-4 and IL-1RN genes with the risk of frailty. We included a sample of 630 community-dwelling elderly aged 70 and older. Both IL-4 and IL-1RN VNTR polymorphisms were genotyped by the polymerase chain reaction (PCR) method. Mean age was 77.7 years (SD = 6.0) and 52.5 % were women. The participants classified as frail were more likely to be older, had lower MMSE score (p VNTR polymorphism did not show significant differences between study groups (p > 0.05). However, we just observed a significant difference in the allelic frequencies for the A2 allele of the IL-1RN VNTR polymorphism between frail and nonfrail groups (OR 1.84, 95 % CI 1.08-3.12, p = 0.02). In addition, we analyzed the combined effect of the IL-4 and IL-1RN VNTR polymorphisms and their possible association with frailty, where the combined IL-4 (low) -IL-1Ra (high) genotype was identified as a marker of risk to frailty syndrome (OR 7.86, 95 % CI 1.83-33.69, p = 0.006). Our results suggest that both A2 allele and the combined IL-4 (low) -IL-1Ra (high) genotype might be genetic markers of susceptibility to frailty in Mexican elderly.

  5. Assessing the relative and absolute reliability of the Falls Efficacy Scale-International questionnaire in elderly individuals with increased fall risk and the questionnaire's convergent validity in elderly women with osteoporosis.

    Science.gov (United States)

    Halvarsson, A; Franzén, E; Ståhle, A

    2013-06-01

    The Falls Efficacy Scale-International (FES-I) is a highly reliable questionnaire for assessing fear of falling in elderly individuals with increased fall risk and has low or no convergent validity with balance performance tests and health-related quality of life (HRQL) among elderly women with osteoporosis, which indicates that both measurements should be included as they are measuring different components. Fear of falling is increased in elderly individuals with osteoporosis and FES-I is a widely used questionnaire to assess fear of falling. There is limited evidence of the reliability and convergent validity in elderly with increased risk of falling and osteoporosis. Reliability and validity study of the FES-I. Community-dwelling elderly with increased fall risk, 59 subjects, were recruited to the reliability assessment, and 81 women with osteoporosis, in the validity assessment. For the reliability assessment, two postal surveys were used. For the validity assessment, we used baseline data from an on-going study in women with osteoporosis. The FES-I was correlated to a single-item question regarding fear of falling, self-reported history of falls, balance performance tests and health-related quality of life. The FES-I had very good relative reliability (intra-class correlation 0.88) and internal consistency reliability (Cronbach's alpha 0.94). The value for absolute reliability was a standard error of measure 2.9 (10.6 %), smallest real difference 7.9 (29 %). There was "little if any" to "low" correlation between the FES-I and the single-item question regarding fear of falling and self-reported history of falls, HRQL and balance performance tests. The FES-I seems to be a highly reliable questionnaire for assessing fear of falling in elderly with increased fall risk but has low relation to/convergent validity with balance performance and HRQL among elderly women with osteoporosis.

  6. Association between chronic musculoskeletal pain and executive function in community-dwelling older adults.

    Science.gov (United States)

    Murata, S; Sawa, R; Nakatsu, N; Saito, T; Sugimoto, T; Nakamura, R; Misu, S; Ueda, Y; Ono, R

    2017-11-01

    We examined the association of chronic musculoskeletal pain with executive function in community-dwelling older adults. This cross-sectional study recruited 234 community-dwelling older adults in Japan (mean age: 72.7, women: 62.8%). Chronic musculoskeletal pain was defined as having moderate or more severe pain lasting ≥ 3 months. Executive function was assessed using the Digit Symbol Substitution Test (DSST), Trail Making Test (TMT) parts A and B, Letter Verbal Fluency Test (LVFT) and Category Verbal Fluency Test (CVFT). Prevalence of chronic musculoskeletal pain was 19% (n = 44). In the univariate analysis, the DSST and CVFT scores were significantly lower in the chronic musculoskeletal pain group than in the control group (DSST: chronic musculoskeletal pain group vs. control group, 40.2 vs. 45.4, respectively, p dwelling older adults. The association of chronic musculoskeletal pain with executive function requires further investigation. Our results suggest an association between moderate-severe chronic musculoskeletal pain and impairments of semantic fluency and processing speed in community-dwelling older adults. © 2017 European Pain Federation - EFIC®.

  7. Association between statin use and physical function among community-dwelling older Japanese adults.

    Science.gov (United States)

    Kawai, Hisashi; Ihara, Kazushige; Kera, Takeshi; Hirano, Hirohiko; Fujiwara, Yoshinori; Tanaka, Masashi; Kojima, Motonaga; Obuchi, Shuichi

    2018-04-01

    Statin-associated muscle symptoms (SAMS) are the muscle-related side-effects of statins, but the association between statin use and physical function among community-dwelling older adults is unclear. The objective of the present study was to examine the association between statin use and physical function among community-dwelling older Japanese adults by considering the risk factors of statin-associated muscle symptoms. The participants were 1022 community-dwelling older adults aged 65-88 years, who participated in comprehensive health checkups from 2013 to 2015. Statin use in the participants (381 men and 559 women) was verified by using data from their medicine notebooks. The differences between statin use (users and non-users) and physical functions (grip strength, knee extension torque, normal and maximum gait speed, Timed Up & Go test, one-legged stance, quadriceps muscle thickness and echo intensity) were analyzed using the t-test. Multiple regression analyses were also carried out to examine the association between statin use and physical function. A total of 93 men (24.4%) and 154 women (27.5%) were statin users. Grip strength, normal gait speed and one-legged stance declined significantly in statin users compared with the non-users. In multiple regression analysis while controlling for the risk factors of statin-associated muscle symptoms, including age, sex, body mass index and number of medicines, no independent association, between statin use and the reduction of physical functions, was observed. Statin use was not associated with the decline of physical function in community-dwelling older Japanese adults. Geriatr Gerontol Int 2018; 18: 623-630. © 2017 Japan Geriatrics Society.

  8. Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis.

    Science.gov (United States)

    2008-01-01

    and older will fall. Of those individuals who fall, 12% to 42% will have a fall-related injury. Several meta-analyses and cohort studies have identified falls and fall-related injuries as a strong predictor of admission to a long-term care (LTC) home. It has been shown that the risk of LTC home admission is over 5 times higher in seniors who experienced 2 or more falls without injury, and over 10 times higher in seniors who experienced a fall causing serious injury. Falls result from the interaction of a variety of risk factors that can be both intrinsic and extrinsic. Intrinsic factors are those that pertain to the physical, demographic, and health status of the individual, while extrinsic factors relate to the physical and socio-economic environment. Intrinsic risk factors can be further grouped into psychosocial/demographic risks, medical risks, risks associated with activity level and dependence, and medication risks. Commonly described extrinsic risks are tripping hazards, balance and slip hazards, and vision hazards. NOTE: It is recognized that the terms "senior" and "elderly" carry a range of meanings for different audiences; this report generally uses the former, but the terms are treated here as essentially interchangeable. EVIDENCE-BASED ANALYSIS OF EFFECTIVENESS: Since many risk factors for falls are modifiable, what interventions (devices, systems, programs) exist that reduce the risk of falls and/or fall-related injuries for community-dwelling seniors? English language;published between January 2000 and September 2007;population of community-dwelling seniors (majority aged 65+); andrandomized controlled trials (RCTs), quasi-experimental trials, systematic reviews, or meta-analyses. special populations (e.g., stroke or osteoporosis; however, studies restricted only to women were included);studies only reporting surrogate outcomes; orstudies whose outcome cannot be extracted for meta-analysis. number of fallers, andnumber of falls resulting in injury

  9. Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol.

    Science.gov (United States)

    Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

    2016-05-25

    Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and

  10. Physical activity and depressive symptoms in community-dwelling elders from southern Brazil Atividade física e sintomas depressivos em idosos sul-brasileiros da comunidade

    Directory of Open Access Journals (Sweden)

    César L. Reichert

    2011-06-01

    Full Text Available OBJECTIVE: To determine the existence of a relationship between physical activity and depressive symptoms in community-dwelling elders. METHOD: This is a cross-sectional, population-based study, which included 379 community-dwelling elders from Novo Hamburgo, state of RS, Brazil. The level of physical activity was estimated using the International Physical Activity Questionnaire and depressive symptoms were diagnosed according to the Yesavage Geriatric Depression Scale. The association between the level of physical activity and depressive symptoms was analyzed by logistic regression. RESULTS: A tendency towards a lower prevalence of depressive symptoms was observed in individuals with higher levels of physical activity, both in the sample as a whole as well as among men, but not among women (p for linear trend 0.04, 0.03 and 0.36, respectively. The odds ratio of the presence of depressive symptoms in the very active group as compared against that of the insufficiently active group was 0.32 (95% CI: 0.12-0.86 for men and 0.76 (95% CI: 0.39-1.46 for women. CONCLUSION: In this population of aged individuals, more intense physical activity is related to a lower prevalence of depressive symptoms. As shown by gender stratification, physical activity is inversely related to depressive symptoms in men, albeit not in women.OBJETIVO: Avaliar a relação entre atividade física e sintomas depressivos em idosos da comunidade. MÉTODO: Estudo transversal de base populacional que incluiu 379 idosos da comunidade da cidade de Novo Hamburgo-RS, Brasil. O nível de atividade física foi estimado pelo Questionário Internacional de Atividade Física e os sintomas depressivos foram diagnosticados por meio da Escala de Depressão Geriátrica de Yesavage. A associação entre nível de atividade física e sintomas depressivos foi analisada por regressão logística. RESULTADOS: Foi observada uma tendência a menor prevalência de sintomas depressivos em indiv

  11. Physical activity and depressive symptoms in community-dwelling elders from southern Brazil Atividade física e sintomas depressivos em idosos sul-brasileiros da comunidade

    Directory of Open Access Journals (Sweden)

    César L. Reichert

    2011-01-01

    Full Text Available OBJECTIVE: To determine the existence of a relationship between physical activity and depressive symptoms in community-dwelling elders. METHOD: This is a cross-sectional, population-based study, which included 379 community-dwelling elders from Novo Hamburgo, state of RS, Brazil. The level of physical activity was estimated using the International Physical Activity Questionnaire and depressive symptoms were diagnosed according to the Yesavage Geriatric Depression Scale. The association between the level of physical activity and depressive symptoms was analyzed by logistic regression. RESULTS: A tendency towards a lower prevalence of depressive symptoms was observed in individuals with higher levels of physical activity, both in the sample as a whole as well as among men, but not among women (p for linear trend 0.04, 0.03 and 0.36, respectively. The odds ratio of the presence of depressive symptoms in the very active group, as compared against that of the insufficiently active group was 0.32 (95% CI: 0.12-0.86 for men and 0.76 (95% CI: 0.39-1.46 for women. CONCLUSION: In this population of aged individuals, more intense physical activity is related to a lower prevalence of depressive symptoms. As shown by gender stratification, physical activity is inversely related to depressive symptoms in men, albeit not in women.OBJETIVO: Avaliar a relação entre atividade física e sintomas depressivos em idosos da comunidade. MÉTODO: Estudo transversal de base populacional que incluiu 379 idosos da comunidade da cidade de Novo Hamburgo-RS, Brasil. O nível de atividade física foi estimado pelo Questionário Internacional de Atividade Física e os sintomas depressivos foram diagnosticados por meio da Escala de Depressão Geriátrica de Yesavage. A associação entre nível de atividade física e sintomas depressivos foi analisada por regressão logística. RESULTADOS: Foi observada uma tendência a menor prevalência de sintomas depressivos em indiv

  12. The burden of hospitalised fall-related injury in community-dwelling older people in Victoria: a database study.

    Science.gov (United States)

    Vu, Trang; Day, Lesley; Finch, Caroline F

    2014-04-01

    To estimate the burden of hospitalised fall-related injury in community-dwelling older people in Victoria. We analysed fall-related, person-identifying hospital discharge data and patient-level hospital treatment costs for community-dwelling older people aged 65+ years from Victoria between 1 July 2005 and 30 June 2008, inclusive. Key outcomes of interest were length of stay (LOS)/episode, cumulative LOS (CLOS)/patient and inpatient costs. The burden of hospitalised fall-related injury in community-dwelling older people aged 65+ years in Victoria was 284,781 hospital bed days in 2005-06, rising to 310,031 hospital bed days in 2007-08. Seventy-one per cent of episodes were multiday. One in 15 acute care episodes was a high LOS outlier and 14% of patients had ≥1 episode classified as high LOS outlier. The median CLOS/patient was nine days (interquartile range 2-27). The annual costs of inpatient care, in June 2009 prices, for fall-related injury in community-dwelling people aged 65+ years in Victoria rose from $213 million in 2005-06 to $237 million in 2007-08. The burden of hospitalised fall-related injury in community-dwelling older women, people aged 85+ years and those with comorbidity was considerable. The burden of hospitalised fall-related injury in community-dwelling older people aged 65+ years in Victoria is significantly more than previously projected. Importantly, this study identifies that women, patients with comorbidity and those aged 85+ years account for a considerable proportion of this burden. A corresponding increase in falls prevention effort is required to ensure that the burden is properly addressed. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

  13. Abuse, Neglect, and Violence Against Elderly Women in Ghana: Implications for Social Justice and Human Rights.

    Science.gov (United States)

    Sossou, Marie-Antoinette; Yogtiba, Joseph A

    2015-01-01

    This article discusses abuse and neglect of elderly women in Ghana and the traditional practices that adversely affect their human rights. Their situation is characterized by pervasive poverty, illiteracy, widowhood, predominantly rural dwelling, and subjection to insidious cultural practices and superstitious beliefs. Increase in life expectancy and population trends point to significant increases in the numbers of the elderly women. Breakdown of the extended family support system and the waning of filial obligations are factors affecting their welfare. Accurate data on these abuses is lacking due to cultural inhibitions and non-reporting. Legislations and NGO programs are addressed to combat abuses.

  14. Prevalence of lumbar spondylosis and its association with low back pain among community-dwelling Japanese women.

    Science.gov (United States)

    Tsujimoto, Ritsu; Abe, Yasuyo; Arima, Kazuhiko; Nishimura, Takayuki; Tomita, Masato; Yonekura, Akihiko; Miyamoto, Takashi; Matsubayashi, Shohei; Tanaka, Natsumi; Aoyagi, Kiyoshi; Osaki, Makoto

    2016-12-01

    Lumbar spondylosis is more prevalent among the middle-aged and elderly, but few population-based studies have been conducted, especially in Japan. The purpose of this study was to explore the prevalence of lumbar spondylosis and its associations with low back pain among community-dwelling Japanese women. Lateral radiographs of the lumbar spine were obtained from 490 Japanese women ≥ 40 years old, and scored for lumbar spondylosis using the Kellgren-Lawrence (KL) grade at lumbar intervertebral level from L1/2 to L5/S1. Height and weight were measured, and body mass index (BMI) was calculated. Low back pain in subjects was assessed using a self-administered questionnaire. Stiffness index (bone mass) was measured at the calcaneal bone using quantitative ultrasound. Prevalence of radiographic lumbar spondylosis for KL ≥ 2, KL ≥ 3 and low back pain were 76.7%, 38.8% and 20.0%, respectively. Age was positively associated with radiographic lumbar spondylosis (KL = 2, KL ≥ 3) and low back pain. Greater BMI was associated with lumbar spondylosis with KL = 2, but not with KL ≥ 3. Stiffness index was associated with neither radiographic lumbar spondylosis nor low back pain. Multiple logistic regression analysis identified radiographic lumbar spondylosis (KL ≥ 3) at L3/4, L4/5 and L5/S1 was associated with low back pain, independent of age, BMI and stiffness index. Severe lumbar spondylosis at the middle or lower level may contribute to low back pain.

  15. Assessing the Psychoeducational Approach to Transcendence and Health Program: An Intervention to Foster Self-Transcendence and Well-Being in Community-Dwelling Older Adults.

    Science.gov (United States)

    McCarthy, Valerie Lander; Bowland, Sharon; Hall, Lynne A; Connelly, Jennifer

    2015-12-01

    The late-life developmental process of self-transcendence shapes elders' perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators' and participants' experiences and perceptions, the intervention will be revised and strengthened. © The Author(s) 2015.

  16. Developing a gender-based approach to chronic conditions and women's health: a qualitative investigation of community-dwelling women and service provider perspectives.

    Science.gov (United States)

    DiGiacomo, Michelle; Green, Anna; Rodrigues, Emma; Mulligan, Kathryn; Davidson, Patricia M

    2015-11-21

    Chronic conditions contribute to over 70 % of Australia's total disease burden, and this is set to increase to 80 % by 2020. Women's greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia. Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis. Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women's disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement. This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention.

  17. CHRONIC MEDICAL CONDITIONS AND REPRODUCIBILITY OF SELF-REPORTED AGE AT MENOPAUSE AMONG COMMUNITY DWELLING WOMEN

    Science.gov (United States)

    de Vries, Heather F.; Northington, Gina M.; Kaye, Elise M.; Bogner, Hillary R.

    2011-01-01

    OBJECTIVE To examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. METHOD Age at menopause was assessed in a population-based longitudinal survey of 240 women twice, in 1993 and 2004. Women who recalled age at menopause in 2004 within one year or less of the age at menopause recalled in 1993 (concordant) were compared with women who did not recall of age at menopause in 2004 within 1 year of age at menopause recalled in 1993 (discordant). Type of menopause (surgical or natural) and chronic medical conditions were assessed by self-report. RESULTS One hundred and forty three women (59.6%) reported surgical menopause and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) of women recalled age at menopause in 2004 within one year or less of recalled age at menopause in 1994 while 110 (45.8%) women did not recall age at menopause in 2004 within one year or less of recalled age at menopause in 1994. Among women with surgical menopause, women with three or more medical conditions were less likely to have concordant recall of age at menopause than women with less than three chronic medical conditions (adjusted odds ratio (OR) = 0.36, 95% confidence interval (CI) [0.15, 0.91]) in multivariate models controlling for potentially influential characteristics including cognition and years from menopause. CONCLUSIONS Among women who underwent surgical menopause, the presence of three or more medical conditions is associated with decreased reproducibility of self-reported age at menopause. PMID:21971208

  18. Chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women.

    Science.gov (United States)

    de Vries, Heather F; Northington, Gina M; Kaye, Elise M; Bogner, Hillary R

    2011-12-01

    The aim of this study was to examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. Age at menopause was assessed in a population-based longitudinal survey of 240 women twice, in 1993 and 2004. Women who recalled age at menopause in 2004 within 1 year or less of age at menopause recalled in 1993 (concordant) were compared with women who did not recall age at menopause in 2004 within 1 year of age at menopause recalled in 1993 (discordant). Type of menopause (surgical or natural) and chronic medical conditions were assessed by self-report. One hundred forty-three women (59.6%) reported surgical menopause, and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) women recalled age at menopause in 2004 within 1 year or less of recalled age at menopause in 1994, whereas 110 (45.8%) women did not recall age at menopause in 2004 within 1 year or less of recalled age at menopause in 1994. Among the women with surgical menopause, the women with three or more medical conditions were less likely to have concordant recall of age at menopause than the women with less than three chronic medical conditions (adjusted odds ratio, 0.36; 95% CI, 0.15-0.91) in multivariate models controlling for potentially influential characteristics including cognition and years since menopause. Among women who underwent surgical menopause, the presence of three or more medical conditions is associated with decreased reproducibility of self-reported age at menopause.

  19. Associations Between Resilience, Community Belonging, and Social Participation Among Community-Dwelling Older Adults: Results From the Eastern Townships Population Health Survey.

    Science.gov (United States)

    Levasseur, Mélanie; Roy, Mathieu; Michallet, Bernard; St-Hilaire, France; Maltais, Danielle; Généreux, Mélissa

    2017-12-01

    To examine the associations between resilience, community belonging, and social participation, and the moderating effect of resilience on the association between community belonging and social participation among community-dwelling older adults. Cross-sectional; secondary analyses of the Eastern Townships Population Health Survey. Community. A sample (N=4541) of women (n=2485) and men (n=2056) aged ≥60 years was randomly selected according to area. Most participants had community belonging, and resilience were collected by phone interviewer-administered questionnaire. A social participation scale measured frequency of participation in 8 community activities. A 4-point Likert scale ranging from "very strong" to "very weak" estimated sense of belonging to the local community. Social participation and sense of belonging questions came from Statistics Canada surveys. Resilience was assessed with the 10-item Connor-Davidson Resilience Scale, capturing the ability to cope with adversity. Controlling for age, education, and psychological distress, greater resilience and community belonging were associated with greater social participation among women (R 2 =.13; Pcommunity belonging and social participation varied as a function of resilience, especially in men. Greater community belonging further enhanced social participation, especially among women (P=.03) and men (Pcommunity belonging and social participation among community-dwelling older women and, especially, men. Interventions targeting social participation should consider the potential impact of resilience on improving community belonging. Future studies should investigate why resilience moderates associations between community belonging and social participation, and how to enhance resilience among older adults. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  20. Anxiety symptoms in 74+ community-dwelling elderly: associations with physical morbidity, depression and alcohol consumption.

    Directory of Open Access Journals (Sweden)

    Martina Forlani

    Full Text Available OBJECTIVE: Anxiety among community-dwelling older adults has not been studied sufficiently. The aims of this cross-sectional population-based study were to estimate the point prevalence of clinically relevant anxiety symptoms and to describe their socio-demographic and clinical features, with particular focus on the association with somatic illnesses. METHODS: Three-hundred-sixty-six non-demented older adults (mean age 83.7±6.2, range 74-99 years from the Faenza Project (Northern Italy were assessed using the Cambridge Mental Disorders of the Elderly Examination-Revised (CAMDEX-R and the Geriatric Anxiety Inventory short form (GAI-sf. Multi-adjusted regression analyses were used to estimate Odds Ratio (OR and 95% Confidence Intervals (95% CI. RESULTS: Clinically relevant anxiety symptoms occurred in one out of five participants (point prevalence 21.0% and were significantly associated with depression (OR 5.6 per rank; 95% CI: 3.1-10.1, physical morbidity (OR 3.5 per illness; 95% CI: 1.0-11.9 and female gender (OR 2.8; 95% CI: 1.4-5.5. Further, there were significant associations with a consumption of alcohol exceeding 1 alcoholic unit/day. CONCLUSIONS: Anxiety symptoms are very common in older subjects, especially when medically ill. Depression and alcohol consumption often co-occur with late-life anxiety symptoms, thus requiring special attention in daily clinical practice.

  1. Management and outcomes of ST-elevation myocardial infarction in nursing home versus community-dwelling older patients: a propensity matched study.

    Science.gov (United States)

    Khera, Sahil; Kolte, Dhaval; Gupta, Tanush; Mujib, Marjan; Aronow, Wilbert S; Agarwal, Pallak; Palaniswamy, Chandrasekar; Jain, Diwakar; Ahmed, Ali; Fonarow, Gregg C; Frishman, William H; Panza, Julio A

    2014-08-01

    The influence of admission source (nursing home [NH] versus community-dwelling) on treatment strategies and outcomes among elderly patients with ST-elevation myocardial infarction (STEMI) has not been investigated. Nationwide Inpatient Sample databases from 2003 to 2010 were used to identify 270,117 community-dwelling and 4082 NH patients 75 years of age or older with STEMI. Retrospective observational study. Propensity scores for admission source were used to assemble a matched cohort of 3081 community-dwelling and 3132 NH patients, who were balanced on baseline demographic and clinical characteristics. Bivariate logistic regression models were then used to determine the associations of NH with in-hospital outcomes among matched patients. In-hospital mortality was significantly higher in patients with STEMI presenting from a NH as compared with community-dwelling patients (30.5% versus 27.6%; odds ratio [OR] 1.15, 95% confidence interval [CI] 1.03-1.29; P = .012). Overall, NH patients were less likely to receive reperfusion (thrombolysis, percutaneous coronary intervention, or coronary artery bypass grafting) (11.5% versus 13.4%; OR 0.84, 95% CI 0.72-0.98; P = .022). However, rates of percutaneous coronary intervention alone were similar in both groups (9.9% in NH versus 9.1% in community-dwelling; OR 1.10, 95% CI 0.93-1.30; P = .276). Mean length of stay was also similar in both groups (5.68 ± 5.40 days in NH versus 5.69 ± 4.98 days in community-dwelling, P = .974). Compared with their community-dwelling counterparts, older NH patients are less likely to receive reperfusion therapy for STEMI and have higher in-hospital mortality. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  2. The reliability and preliminary validity of game-based fall risk assessment in community-dwelling older adults.

    Science.gov (United States)

    Yamada, Minoru; Aoyama, Tomoki; Nakamura, Masatoshi; Tanaka, Buichi; Nagai, Koutatsu; Tatematsu, Noriatsu; Uemura, Kazuki; Nakamura, Takashi; Tsuboyama, Tadao; Ichihashi, Noriaki

    2011-01-01

    The purpose of this study was to examine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older adults. Forty-five community-dwelling older women participated in this study. The "Basic Step" and "Ski Slalom" modules were selected from the Wii Fit game program. The following 5 physical performance tests were performed: the 10-m walk test under single- and dual-task conditions, the Timed Up and Go test under single- and dual-task conditions, and the Functional Reach test. Compared with the faller group, the nonfaller group showed a significant difference in the Basic Step (P game-based fall risk assessment using the Basic Step has a high generality and is useful in community-dwelling older adults. Copyright © 2011 Mosby, Inc. All rights reserved.

  3. Urodynamics in a community-dwelling population of females 80 years or older: which motive? Which diagnosis?

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    Françoise A. Valentini

    2010-04-01

    Full Text Available PURPOSE: To determine why community-dwelling women aged 80 years or over were referred for urodynamic evaluation despite their advanced age and which urodynamic diagnosis was made. MATERIALS AND METHODS: One hundred consecutive females (80-93 years were referred to our urodynamics outpatient clinic for evaluation of lower urinary tract symptoms (LUTS between 2005 and 2008. Clinical evaluation comprised of a previous history of LUTS, previous medical history of neurological disease or dementia, pelvic floor dysfunction or prior pelvic surgery. Exclusion criteria were complete retention and severe dementia involving failure to understand simple instructions. Assessed items were results of uroflows (free flow and intubated flow, cystometry and urethral pressure profilometry, and final urodynamic diagnosis. RESULTS: The main complaint evoked by the patients was incontinence (65.0% of which 61.5% was "complicated" and urgency was reported by 70.0%. Interpretable free flow at arrival was very low (44.0%. Prevalence of detrusor overactivity was high, found in 45 patients of whom 16 had detrusor hyperactivity with impaired detrusor contractility. Detrusor overactivity and urgency were strongly associated (p = 0.004. Twenty-five patients had intrinsic sphincteric deficiency alone and 15 detrusor underactivity. CONCLUSION: In this particular community-dwelling with an elderly female population, urodynamics is easily feasible. Incontinence, mainly "complicated" is the more frequent complaint and urgency the more frequent symptom. Urodynamic diagnosis underlines the high incidence of detrusor overactivity as well as impaired detrusor function.

  4. Association of anorexia with sarcopenia in a community-dwelling elderly population: results from the ilSIRENTE study.

    Science.gov (United States)

    Landi, Francesco; Liperoti, Rosa; Russo, Andrea; Giovannini, Silvia; Tosato, Matteo; Barillaro, Christian; Capoluongo, Ettore; Bernabei, Roberto; Onder, Graziano

    2013-04-01

    There is increasing evidence that anorexia of aging can cause physical and mental impairment. The aim of the present study was to evaluate the relationship between anorexia and sarcopenia in elderly persons aged 80 years or older. Data are from the baseline evaluation of 354 subjects enrolled in the ilSIRENTE study. The ilSIRENTE study is a prospective cohort study performed in the mountain community living in the Sirente geographic area (L'Aquila, Abruzzo) in Central Italy. We defined anorexia as the presence of loss of appetite and/or lower food intake. According to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, diagnosis of sarcopenia required the documentation of low muscle mass plus the documentation of either low muscle strength or low physical performance. The relationship between anorexia and sarcopenia was estimated by deriving odds ratios from the multiple logistic regression models considering sarcopenia as the dependent variable. Nearly 21 % of the study sample showed symptoms of anorexia. Using the EWGSOP-suggested algorithm, 103 subjects (29.1 %) with sarcopenia were identified. Thirty-four (46.6 %) participants were affected by sarcopenia among subjects with anorexia compared to 69 subjects [24.6 %] without anorexia (p sarcopenia compared with non-anorexic subjects (HR 1.88, 95 % CI 1.01-3.51). Anorexia is common among community-dwelling older subjects in Italy. Our results suggest that among old-old subjects, anorexia is independently associated with sarcopenia.

  5. Ankle brachial index values, leg symptoms, and functional performance among community-dwelling older men and women in the lifestyle interventions and independence for elders study

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    The prevalence and significance of low normal and abnormal ankle brachial index (ABI) values in a community dwelling population of sedentary, older individuals is unknown. We describe the prevalence of categories of definite peripheral artery disease (PAD), borderline ABI, low-normal ABI and no PAD...

  6. Mildly elevated serum total bilirubin is negatively associated with hemoglobin A1c independently of confounding factors among community-dwelling middle-aged and elderly persons

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    Ryuichi Kawamoto

    2017-08-01

    Full Text Available Abnormally high glycated hemoglobin (Hb (HbA1c is significantly associated with oxidative stress and an increased risk of cardiovascular disease (CVD. Serum total bilirubin (T-B may have a beneficial role in preventing oxidative changes and be a negative risk factor of CVD. Limited information is available on whether serum T-B is an independent confounding factor of HbA1c. The study subjects were 633 men aged 70 ± 9 (mean ± standard deviation (SD years and 878 women aged 70 ± 8 years who were enrolled consecutively from among patients aged ≥40 years through a community-based annual check-up process. We evaluated the relationship between various confounding factors including serum T-B and HbA1c in each gender. Multiple linear regression analysis pertaining to HbA1c showed that in men, serum T-B ( β = −0.139 as well as waist circumference ( β = 0.099, exercise habit ( β = 0.137, systolic blood pressure (SBP ( β = 0.076, triglycerides ( β = 0.087, and uric acid ( β = −0.123 were significantly and independently associated with HbA1c, and in women, serum T-B ( β = −0.084 as well as body mass index ( β = 0.090, smoking status ( β = −0.077, SBP ( β = 0.117, diastolic blood pressure (DBP ( β = −0.155, low-density lipoprotein cholesterol ( β = 0.074, prevalence of antidyslipidemic medication ( β = 0.174, and uric acid ( β = 0.090 were also significantly and independently associated with HbA1c. Multivariate-adjusted serum HbA1c levels were significantly high in subjects with the lowest serum T-B levels in both genders. Serum T-B is an independent confounding factor for HbA1c among community-dwelling middle-aged and elderly persons.

  7. Impact of resistance exercise program on functional capacity and muscular strength of knee extensor in pre-frail community-dwelling older women: a randomized crossover trial.

    Science.gov (United States)

    Lustosa, Lygia P; Silva, Juscélio P; Coelho, Fernanda M; Pereira, Daniele S; Parentoni, Adriana N; Pereira, Leani S M

    2011-01-01

    Frailty syndrome in elderly people is characterized by a reduction of energy reserves and also by a decreased of resistance to stressors, resulting in an increase of vulnerability. The aim of this study was to verify the effect of a muscle-strengthening program with load in pre-frail elder women with regards to the functional capacity, knee extensor muscle strength and their correlation. Thrity-two pre-frail community-dwelling women participated in this study. Potential participants with cognitive impairment (MEEM), lower extremities orthopedic surgery, fractures, inability to walk unaided, neurological diseases, acute inflammatory disease, tumor growth, regular physical activity and current use of immunomodulators were excluded. All partcipants were evaluated by a blinded assessor using: Timed up and go (TUG), 10-Meter Walk Test (10MWT) and knee extensor muscle strength (Byodex System 3 Pro® isokinetic dynamometer at angular speeds of 60 and 180(0)/s). The intervention consisted of strengthening exercises of the lower extremities at 70% of 1RM, three times/ week for ten weeks. The statistical analysis was performed using the ANOVA and Spearman tests After the intervention, it was observed statistical significance on the work at 180(0)/s (F=12.71, p=0.02), on the power at 180(0)/s (F=15.40, p=0.02) and on the functional capacity (TUG, F=9.54, p=0.01; TC10, F=3.80, p=0.01). There was a good negative and statistically significant correlation between the TUG and work at 60(0)/s, such as the TUG and work at 180(0)/s (r=-0.65, p=0.01; r=-0.72, p=0.01). The intervention improved the muscular power and the functional capacity. The increase of the power correlated with function, which is an important variable of the quality of life in the pre-frail elders. Article registered in the ISRCT register under number ISRCTN62824599.

  8. Association of Physical Performance and Pain With Fear of Falling Among Community—Dwelling Japanese Women Aged 65 Years and Older

    Science.gov (United States)

    Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

    2015-01-01

    Abstract Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women. The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured. The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts. Maintaining physical functioning and managing pain may be important for elderly women with fear of falling. PMID:26334906

  9. Frailty and its impact on health-related quality of life: a cross-sectional study on elder community-dwelling preventive health service users.

    Directory of Open Access Journals (Sweden)

    Yaw-Wen Chang

    Full Text Available BACKGROUND: The purpose of this study was to identify the incidence of frailty and to investigate the relationship between frailty status and health-related quality of life (HRQoL in the community-dwelling elderly population who utilize preventive health services. METHODS: People aged 65 years and older who visited a medical center in Taipei City from March to August in 2011 for an annual routine check-up provided by the National Health Insurance were eligible. A total of 374 eligible elderly adults without cognitive impairment had a mean age of 74.6±6.3 years. Frailty status was determined according to the Fried frailty criteria. HRQoL was measured with Short Form-36 (SF-36. Multiple regression analyses examined the relationship between frailty status and the two summary scales of SF-36. Models were adjusted for the participants' sociodemographic and health status. RESULTS: After adjusting for sociodemographic and health-related covariables, frailty was found to be more significantly associated (p<0.001 with lower scores on both physical and mental health-related quality of life summary scales compared with robustness. For the frailty phenotypes, slowness represented the major contributing factor in the physical component scale of SF-36, and exhaustion was the primary contributing factor in the mental component scale. CONCLUSION: The status of frailty is closely associated with HRQoL in elderly Taiwanese preventive health service users. The impacts of frailty phenotypes on physical and mental aspects of HRQoL differ.

  10. The Epidemiology of Hip and Major Osteoporotic Fractures in a Dutch Population of Community-Dwelling Elderly: Implications for the Dutch FRAX® Algorithm.

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    Corinne Klop

    Full Text Available Incidence rates of non-hip major osteoporotic fractures (MOF remain poorly characterized in the Netherlands. The Dutch FRAX® algorithm, which predicts 10-year probabilities of hip fracture and MOF (first of hip, humerus, forearm, clinical vertebral, therefore incorporates imputed MOF rates. Swedish incidence rate ratios for hip fracture to MOF (Malmo 1987-1996 were used to perform this imputation. However, equality of these ratios between countries is uncertain and recent evidence is scarce. Aims were to estimate incidence rates of hip fracture and MOF and to compare observed MOF rates to those predicted by the imputation method for the Netherlands.Using hospitalisation and general practitioner records from the Dutch PHARMO Database Network (2002-2011 we calculated age-and-sex-specific and age-standardized incidence rates (IRs of hip and other MOFs (humerus, forearm, clinical vertebral and as used in FRAX®. Observed MOF rates were compared to those predicted among community-dwelling individuals ≥50 years by the standardized incidence ratio (SIR; 95% CI.Age-standardized IRs (per 10,000 person-years of MOF among men and women ≥50 years were 25.9 and 77.0, respectively. These numbers were 9.3 and 24.0 for hip fracture. Among women 55-84 years, observed MOF rates were significantly higher than predicted (SIR ranged between 1.12-1.50, depending on age. In men, the imputation method performed reasonable.Observed MOF incidence was higher than predicted for community-dwelling women over a wide age-range, while it agreed reasonable for men. As miscalibration may influence treatment decisions, there is a need for confirmation of results in another data source. Until then, the Dutch FRAX® output should be interpreted with caution.

  11. Saccadic Eye Movement Improves Plantar Sensation and Postural Balance in Elderly Women.

    Science.gov (United States)

    Bae, Youngsook

    2016-06-01

    Vision, proprioception and plantar sensation contribute to the control of postural balance (PB). Reduced plantar sensation alters postural response and is at an increased risk of fall, and eye movements reduce the postural sway. Therefore, the aim of this study was to study the improvement of plantar sensation and PB after saccadic eye movement (SEM) and pursuit eye movement (PEM) in community-dwelling elderly women. Participants (104 females; 75.11 ± 6.25 years) were randomly allocated into the SEM group (n = 52) and PEM groups (n = 52). The SEM group performed eye fixation and SEM for 5 minutes, and the PEM group performed eye fixation and PEM for 5 minutes. The plantar sensation was measured according to the plantar surface area of the feet in contact with the floor surface before and after the intervention. Before and after SEM and PEM with the eyes open and closed, PB was measured as the area (mm(2)), length (cm), and velocity (cm/s) of the fluctuation of the center of pressure (COP). The plantar sensation of both feet improved in both groups (p eye open and close in both groups (p < 0.01). The length and velocity of the COP significantly decreased in the SEM group compared to the PEM group (p < 0.05). In conclusion, SEM and PEM are effective interventions for improving plantar sensation and PB in elderly women, with greater PB improvement after SEM.

  12. [A review of current studies on leisure activities performed by community-dwelling elders].

    Science.gov (United States)

    Li, Yueh-Ping; Chen, Ching-Huey

    2010-02-01

    This article reviewed and summarized the findings of previously published studies on the leisure activities of community elders over 55 years of age. A total of 17 related articles, published before 2008, were identified in the search of electronic databases, which included the Chinese Periodical Table of Contents Index Image System, CEPS, Medline and Ageline. Leisure activities measurements used in this study consisted of recoding activities either categorically or by frequency. The majority of research indicated that elderly engage in primarily static activities and that participation in leisure activities had positive effects on cognitive and psychological health. However, inconsistencies in results were found due to differences in measurement tools and sample populations used among studies, making it difficult to conduct a valid comparison of specific features of elderly leisure activities. Most current leisure activity studies utilize cross-sectional research methodologies with restricted topics, which result in limited applicability of research results. In conclusion, we suggest that future studies should develop instruments to assess leisure activities that correspond to local conditions identified through qualitative research. With such, researchers can study different age groups by applying relevant ageing theories to construct empirical data related to current elderly leisure activities.

  13. The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey.

    Science.gov (United States)

    Sooryanarayana, Rajini; Choo, Wan Yuen; Hairi, Noran N; Chinna, Karuthan; Hairi, Farizah; Ali, Zainudin Mohamad; Ahmad, Sharifah Nor; Razak, Inayah Abdul; Aziz, Suriyati Abdul; Ramli, Rohaya; Mohamad, Rosmala; Mohammad, Zaiton Lal; Peramalah, Devi; Ahmad, Noor Ani; Aris, Tahir; Bulgiba, Awang

    2017-09-01

    As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia. Cross-sectional study, analysing baseline findings of a cohort of older adults. Kuala Pilah district, Negeri Sembilan state, Malaysia. To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census. Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined. The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse. Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

  14. Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea.

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    Imai, Hissei; Chen, Wen-ling; Fukutomi, Eriko; Okumiya, Kiyohito; Wada, Taizo; Sakamoto, Ryota; Fujisawa, Michiko; Ishimoto, Yasuko; Kimura, Yumi; Chang, Chia-Ming; Matsubayashi, Kozo

    2015-01-01

    The objective of this study is to investigate the cross-cultural relationship between depressive state and subjective economic status, as well as subjective quality of life (QOL) and activities of daily living (ADL) among elderly people in communities in Japan, Taiwan, and Korea. We studied 595 subjects aged 65 years or older in three Asian communities (261 subjects in T town in Japan, 164 in D town in Taiwan, and 170 in H town in Korea). The Geriatric Depression Scale-15, a self-rating questionnaire assessing ADL, subjective QOL, social situations, and past and current medical status, was used. Depression of the elderly was associated with dependence in basic ADL, subjective QOL, and subjective sense of low economic status. After adjusting for the effects of age, sex, and basic ADL, subjective sense of low economic status was closely associated with depression in community-living elderly people in all three communities in Asia. In conclusion, absolute and objective economic status is an important contributing factor to depressive state or psychosocial deterioration, however, we should pay more attention to the roles of perception of low economic status in determining depressive state in community-dwelling elderly people. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Aromatherapy: Does It Help to Relieve Pain, Depression, Anxiety, and Stress in Community-Dwelling Older Persons?

    OpenAIRE

    Tang, Shuk Kwan; Tse, M. Y. Mimi

    2014-01-01

    To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part i...

  16. Elder women's perceptions around optimal perinatal health: a constructivist grounded-theory study with an Indigenous community in southern Ontario.

    Science.gov (United States)

    Kandasamy, Sujane; Vanstone, Meredith; Oremus, Mark; Hill, Trista; Wahi, Gita; Wilson, Julie; Davis, A Darlene; Jacobs, Ruby; Anglin, Rebecca; Anand, Sonia Savitri

    2017-05-18

    Women play important roles in translating health knowledge, particularly around pregnancy and birth, in Indigenous societies. We investigated elder Indigenous women's perceptions around optimal perinatal health. Using a methodological framework that integrated a constructivist grounded-theory approach with an Indigenous epistemology, we conducted and analyzed in-depth interviews and focus groups with women from the Six Nations community in southern Ontario who self-identified as grandmothers. Our purposive sampling strategy was guided by a Six Nations advisory group and included researcher participation in a variety of local gatherings as well as personalized invitations to specific women, either face-to-face or via telephone. Three focus groups and 7 individual interviews were conducted with 18 grandmothers. The participants' experiences converged on 3 primary beliefs: pregnancy is a natural phase, pregnancy is a sacred period for the woman and the unborn child, and the requirements of immunity, security (trust), comfort, social development and parental responsibility are necessary for optimal postnatal health. Participants also identified 6 communal responsibilities necessary for families to raise healthy children: access to healthy and safe food, assurance of strong social support networks for mothers, access to resources for postnatal support, increased opportunities for children to participate in physical activity, more teachings around the impact of maternal behaviours during pregnancy and more teachings around spirituality/positive thinking. We also worked with the Six Nations community on several integrated knowledge-translation elements, including collaboration with an Indigenous artist to develop a digital story (short film). Elder women are a trusted and knowledgeable group who are able to understand and incorporate multiple sources of knowledge and deliver it in culturally meaningful ways. Thus, tailoring public health programming to include elder women

  17. Association of Pulse Pressure with Serum TNF-α and Neutrophil Count in the Elderly

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    Eriko Yamada

    2014-01-01

    Full Text Available Aims. Elevated pulse pressure (PP has been reported to be a risk factor for type 2 diabetes in elderly patients with hypertension. Methods. Cross-sectional relationships of PP with known risk factors for type 2 diabetes and inflammatory markers were examined in 150 elderly community-dwelling women, 79 women (52.7% of whom had hypertension. Results. Systolic blood pressure (standardized β, 0.775, log tumor necrosis factor-α (TNF-α, standardized β, 0.110, age (standardized β, 0.140, and neutrophil count (standardized β, 0.114 emerged as determinants of PP independent of high-sensitivity C-reactive protein, interleukin-6, monocyte count, plasminogen activator inhibitor-1, homeostasis model assessment of insulin resistance, HDL-cholesterol, and adiponectin (R2 = 0.772. Conclusions. The present studies have demonstrated an independent association of higher PP with higher TNF-α, a marker of insulin resistance, and neutrophil count in community-living elderly women and suggest that insulin resistance and chronic low-grade inflammation may in part be responsible for the association between high PP and incident type 2 diabetes found in elderly patients with hypertension.

  18. Racial differences in anticholinergic use among community-dwelling elders.

    Science.gov (United States)

    Felton, Maria; Hanlon, Joseph T; Perera, Subashan; Thorpe, Joshua M; Marcum, Zachary A

    2015-04-01

    Few studies have examined racial differences in potentially inappropriate medication use. The objective of this study was to examine racial disparities in using prescription and/or nonprescription anticholinergics, a type of potentially inappropriate medication, over time. Longitudinal. Data from the Health, Aging, and Body Composition Study (years 1, 5, and 10). Three thousand fifty-five community-dwelling older adults, both blacks and whites, at year 1. Highly anticholinergic medication use per the 2012 American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Blacks represented 41.4% of the participants at year 1. At year 1, 13.4% of blacks used an anticholinergic medication compared with 17.8% of whites, and this difference persisted over the ensuing 10-year period. Diphenhydramine was the most common anticholinergic medication reported at baseline and year 5, and meclizine at year 10, for both races. Controlling for demographics, health status, and access to care factors, blacks were 24% to 45% less likely to use any anticholinergics compared with whites over the years considered (all P blacks than whites over a 10-year period, and the difference was unexplained by demographics, health status, and access to care.

  19. A 5-year cohort study of the effects of high protein intake on lean mass and BMC in elderly postmenopausal women.

    Science.gov (United States)

    Meng, Xingqiong; Zhu, Kun; Devine, Amanda; Kerr, Deborah A; Binns, Colin W; Prince, Richard L

    2009-11-01

    Long-term effects of high dietary protein intake on muscle and bone structure in the elderly are not clear. The aim of this study was to investigate the relationship between baseline protein intake and lean mass and BMC 5 yr later in a cohort of elderly postmenopausal women. A total of 862 community-dwelling women 75 +/- 3 yr of age provided baseline data including nutrient intake assessed by a food frequency questionnaire. At 5 yr, upper arm muscle area (UAMA) and body composition using DXA were measured. Baseline protein intake was 81 +/- 28 g/d (1.2 +/- 0.4 g/kg/d), contributing 19 +/- 3% of total energy intake. There were positive correlations between baseline protein intake and whole body and appendicular bone-free lean mass and BMC (r = 0.14-0.18, p 87 g/d) had 5.4-6.0% higher whole body and appendicular lean mass and UAMA and 5.3-6.0% higher whole body and appendicular BMC. These effects remained after adjusting for potential confounders. However, the effect on BMC disappeared after further adjustment for lean mass. This study shows that high protein intake is associated with long-term beneficial effects on muscle mass and size and bone mass in elderly women. The protein effect on bone may be partly mediated by its effects on muscle.

  20. Association between sleep duration and sarcopenia among community-dwelling older adults: A cross-sectional study.

    Science.gov (United States)

    Hu, Xiaoyi; Jiang, Jiaojiao; Wang, Haozhong; Zhang, Lei; Dong, Birong; Yang, Ming

    2017-03-01

    Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions.This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults.Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS).We included 607 participants aged 70.6 ± 6.6 years (range, 60-90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6-8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74-10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05-6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96-8.39) in the short sleep duration group and 2.25 (0.88-6.87) in the long sleep duration group, respectively.A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women.

  1. A home-based nutrition intervention to increase consumption of fruits, vegetables, and calcium-rich foods in community dwelling elders.

    Science.gov (United States)

    Bernstein, A; Nelson, Miriam E; Tucker, Katherine L; Layne, Jennifer; Johnson, Elizabeth; Nuernberger, Andrea; Castaneda, Carmen; Judge, James O; Buchner, David; Singh, Maria Fiatarone

    2002-10-01

    To increase fruit, vegetable, and calcium-rich food consumption in community-dwelling, functionally impaired elderly. Six-month, home-based nutrition intervention study. Seventy men and women older than age 69 years were randomized to either a nutrition education intervention (n = 38) or a control group that received an exercise intervention (n = 32). Nutrition education was designed to increase fruit, vegetable, and calcium-rich food consumption. Food intake was assessed by a food frequency questionnaire. Fasting blood measures of nutrients and carotenoids were performed. Statistical Analysis Two-group randomized controlled trial with pre-test and post-test design and intention-to-treat analysis. Analysis of covariance to was used to assess differences between the two groups. Baseline and change partial correlation coefficients were performed between intake and blood nutrient levels. Paired t tests were conducted to test within-group changes. Compared with the exercise group, subjects in nutrition group increased their self-reported intake of fruits by 1.1 +/- 0.2 (mean +/- SEM) servings per day (2.8 to 3.9, P = .01), vegetables 1.1 +/- 0.2 servings per day (2.3 to 3.4, P = .001), and milk/dairy 0.9 +/- 0.2 servings per day (3.0 to 3.9, P = .001). There was an increase in the dietary intake of alpha-carotene and beta-carotene in the nutrition group and this correlated with the increase in blood concentrations of alpha-carotene and beta-carotene (P foods. Recommendations for increasing consumption of fruits, vegetables, and calcium-rich foods should be specific and individualized to meet the dietary pattern and lifestyle of the individual. Compliance should be encouraged with record keeping as well as through continuous monitoring and positive reinforcement.

  2. Amount and type of alcohol consumption and missing teeth among community-dwelling older adults

    DEFF Research Database (Denmark)

    Heegaard, Karen; Avlund, Kirsten; Holm-Pedersen, Poul

    2011-01-01

    Objectives: To study if an association between total weekly intake of alcohol, type-specific weekly alcohol intake, alcoholic beverage preference, and the number of teeth among older people exists. Methods: A cross-sectional study including a total of 783 community-dwelling men and women aged 65-...

  3. Cognitive impairment associated with locomotive syndrome in community-dwelling elderly women in Japan

    Directory of Open Access Journals (Sweden)

    Nakamura M

    2017-09-01

    Full Text Available Misa Nakamura,1 Fumie Tazaki,1 Kazuki Nomura,1 Taeko Takano,1 Masashi Hashimoto,1 Hiroshi Hashizume,2 Ichiro Kamei1 1Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan; 2Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan Abstract: In our worldwide aging society, elderly people should maintain cognitive and physical function to help avoid health problems. Dementia is a major brain disease among elderly people, and is caused by cognitive impairment. The locomotive syndrome (LS refers to a condition in which people require healthcare services because of problems associated with locomotion. The purpose of this study was to determine the association between cognitive impairment and LS. Study participants were 142 healthy elderly female volunteers living in a rural area in Japan. Cognitive function was assessed using the Mini-Mental State Examination (MMSE. A score of ≤26 points on the MMSE was used to indicate categorically defined poor cognitive performance (cognitive impairment. The LS was defined by a score ≥16 points, and non-LS as <16 points, on the 25-question Geriatric Locomotive Function Scale (GLFS-25. Twenty-one participants (14.8% had an MMSE score ≤26, and 19.0% were found to have LS. Compared with the MMSE >26 group, the ≤26 group was significantly older, had a higher percentage of body fat, and a higher GLFS-25 score. Those with LS were significantly older, had a higher body mass index, a higher percentage of body fat, and a lower MMSE score. Participants in the LS group had higher odds of cognitive impairment than those without LS [odds ratio (OR =3.08] by logistic regression analysis adjusted for age. Furthermore, participants with GLFS-25 scores ≥6 had higher odds of cognitive impairment than those with a GLFS-25 score <6 by logistic regression analysis adjusted for both age (OR =4.44, and age and percent body fat (OR =4.12. These findings

  4. Dietary health behaviors of women living in high rise dwellings: a case study of an urban community in Malaysia.

    Science.gov (United States)

    Karupaiah, Tilakavati; Swee, Winnie Chee Siew; Liew, Siew Ying; Ng, Boon Koon; Chinna, Karuthan

    2013-02-01

    Diet-related non-communicable disease (DR-NCD) occurrence is a serious problem amongst Malaysian women and urbanization is probably a challenge to their achieving the nutritional environment conducive to healthy eating. This case study aimed to determine diet quality of an urban community using women respondents from high rise dwellings in Kuala Lumpur. The sample consisted of 135 households and a healthy eating index (HEI) scale was used to evaluate the women's diet quality. A total of 128 women (Malays = 45, Chinese = 56, Indian = 27) participated. Total HEI score was significantly different (P 0.05) regardless of ethnicity. Income strata (ρ = 0.159, P = 0.048) and eating out frequency (ρ = -0.149, P = 0.046) also independently affected HEI scores. Income negatively correlated with sodium restriction score (ρ = -0.294, P = 0.001) but positively with cereals (ρ = 0.181; P = 0.025), fruits (ρ = 0.178; P = 0.022), dairy products (ρ = 0.198; P = 0.013) and food variety (ρ = 0.219, P = 0.007). Decreased vegetable intake (ρ = -0.320; P diet quality of urban women.

  5. Alcohol and Medication Use Among Elderly Community-dwelling Brazilians

    Directory of Open Access Journals (Sweden)

    Patrícia Veríssimo Costa e Silva

    2014-09-01

    Conclusion: Harmful consumption of alcohol in the evaluated sample was very low. The average of used medicines (2.5 medicines/day was similar to those obtained previously in elderly populations in the same region, with relatively low use of inappropriate drugs for the elderly.

  6. Prevalence and Predictors of Geriatric Depression in Community-Dwelling Elderly

    Directory of Open Access Journals (Sweden)

    Jeung-Im Kim, RN, PhD

    2009-09-01

    Conclusion: In this research, perceived health status was the most powerful predictor of elderly depression. TMIG-IC, hand-grip strength and social activities also predicted Korean elderly depression. These factors should be considered when the program is developed for elderly people with depression. [Asian Nursing Research 2009;3(3:121–129

  7. Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals.

    Science.gov (United States)

    Johansson, Jonas; Nordström, Anna; Gustafson, Yngve; Westling, Göran; Nordström, Peter

    2017-11-01

    fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls. this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015. postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination. during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22). objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  8. Selection of useful items for fall risk screening for community dwelling Japanese elderly from the perspective of fall experience, physical function, and age level differences.

    Science.gov (United States)

    Demura, Shinichi; Yamada, Takayoshi; Uchiyama, Masanobu; Sugiura, Hiroki; Hamazaki, Hiroshi

    2011-01-01

    This study aimed to examine useful items for screening the fall risk of community dwelling elderly from various perspectives, including fall experience, physical function level, and age level difference. 968 independently living elderly persons over the age of 60 (age: 70.0 ± 7.0) responded to 80 fall risk items representing 7 factors (physical function, fall history, using devices, fear of falling and inactivity, dosing, disease and disability, and environment) and an ADL questionnaire. The high fall risk response rate was calculated for each item and tested for statistical significance among age groups and those with and without fall experience. Cramer's V was calculated to examine the relationship between each item and the ADL. In addition, we selected items with significant differences in the high fall risk response rates between the faller and the non-faller groups, a significant relationship with ADL, and a significant difference among age groups. A total of 40 useful items were selected from each fall risk factor (decrease in physical function: 21 items, fall history: 2 items, device usage: 3 items, fear of falling and inactivity: 5 items, dosing: 0 items, disease and disability: 8 items, and environment: 1 item). Selected items can comprehensively and properly assess the fall risk of the healthy elderly as compared with existing questionnaires. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Parenting style, resilience, and mental health of community-dwelling elderly adults in China

    OpenAIRE

    Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A.; Kua, Ee-Heok; Mahendran, Rathi

    2016-01-01

    Background Given the increasing elderly population worldwide, the identification of potential determinants of successful ageing is important. Many studies have shown that parenting style and mental resilience may influence mental health; however, little is known about the psychological mechanisms that underpin this relationship. The current study sought to explore the relationships among mental resilience, perceptions of parents? parenting style, and depression and anxiety among community-dwe...

  10. Person-centredness in elder care: A secondary analysis of data from a study among home-dwelling men and women in the Faroe Islands.

    Science.gov (United States)

    Róin, Ása

    2018-06-01

    As individuals in Western societies age, there is increasing demand for home-based care to help older people stay in their homes for as long as possible and provide services that ensure a person's quality of life in old age. Numerous attempts are made to develop a framework to secure quality of care. However, research has shown insufficient quality in care for older people. In this study, the purpose is to study how older people's experiences with home care reflect a person-centred approach to care. Data derived from an earlier study on ageing among home-dwelling men and women who are aged 67-91 and living in the Faroe Islands. Person-centredness as a concept is an often quoted, but ill-defined concept. Most studies concerning person-centred care are conducted within hospital wards or long-term care institutions. Empirical studies concerning home-dwelling older people receiving home care are scarce. The study is a secondary analysis of data from an earlier qualitative study. Latent thematic analysis was used which meant coding issues of potential interest and collecting these codes into themes. Three themes appeared to combine the initial codes: sense of involvement, sense of meaningfulness and contextual conditions. Overall, the analysis showed that the users were seldom involved in planning or scheduling the care they received. What they were offered did not always make sense to them or correspond to their needs or preferences. The number of interviews included was limited. However, findings from this study point at some possible barriers to successful implementation of person-centredness within elder care. Especially, contextual conditions seem to limit the facilitation of person-centred practices. Healthcare providers must take the user's preferences, resources and networks into consideration when coordinating and planning home care and, importantly, be open for negotiating needs. It is important to draw attention to the contrast between political intentions

  11. Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2018-04-17

    Because of the aging population, osteoporotic fractures are an increasingly important cause of morbidity and mortality in the United States. Approximately 2 million osteoporotic fractures occurred in the United States in 2005, and annual incidence is projected to increase to more than 3 million fractures by 2025. Within 1 year of experiencing a hip fracture, many patients are unable to walk independently, more than half require assistance with activities of daily living, and 20% to 30% of patients will die. To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on vitamin D supplementation, with or without calcium, to prevent fractures. The USPSTF reviewed the evidence on vitamin D, calcium, and combined supplementation for the primary prevention of fractures in community-dwelling adults (defined as not living in a nursing home or other institutional care setting). The review excluded studies conducted in populations with a known disorder related to bone metabolism (eg, osteoporosis or vitamin D deficiency), taking medications known to be associated with osteoporosis (eg, long-term steroids), or with a previous fracture. The USPSTF found inadequate evidence to estimate the benefits of vitamin D, calcium, or combined supplementation to prevent fractures in community-dwelling men and premenopausal women. The USPSTF found adequate evidence that daily supplementation with 400 IU or less of vitamin D and 1000 mg or less of calcium has no benefit for the primary prevention of fractures in community-dwelling, postmenopausal women. The USPSTF found inadequate evidence to estimate the benefits of doses greater than 400 IU of vitamin D or greater than 1000 mg of calcium to prevent fractures in community-dwelling postmenopausal women. The USPSTF found adequate evidence that supplementation with vitamin D and calcium increases the incidence of kidney stones. The USPSTF concludes that the current evidence is insufficient to assess the balance of the

  12. Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2016-10-05

    Population-based data examining the relationship between social participation (SP) and instrumental activities of daily living (IADL) are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%). Data from 14 956 respondents (6935 males and 8021 females) without dependency in basic activities of daily living (ADL) were analyzed. The number, type, and frequency of participation in social groups (SGs) were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens' clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001). A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens' clubs among males. Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.

  13. Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Kimiko Tomioka

    2016-10-01

    Full Text Available Background: Population-based data examining the relationship between social participation (SP and instrumental activities of daily living (IADL are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Methods: Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%. Data from 14 956 respondents (6935 males and 8021 females without dependency in basic activities of daily living (ADL were analyzed. The number, type, and frequency of participation in social groups (SGs were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens’ clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. Results: After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001. A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens’ clubs among males. Conclusions: Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.

  14. QOL models constructed for the community-dwelling elderly with ikigai (purpose in life) as a composition factor, and the effect of habitual exercise.

    Science.gov (United States)

    Demura, Shinichi; Kobayashi, Hidetsugu; Kitabayashi, Tamotsu

    2005-09-01

    The purpose of this study was to construct QOL models for the elderly that included ikigai as a composition factor and to clarify differences in two kinds of models, one constructed for the elderly with habitual exercise and the other for those without it. The subjects were 1,566 healthy community-dwelling independent people aged 60 years or more (752 males, 814 females). First, the ratio of subjects with ikigai was calculated. The ratios of subjects with different kinds of objects of ikigai were also calculated. Next, structural equation models (SEM) were constructed on the basis of social, physical, and mental QOL and ikigai. Fits of the models were evaluated. To examine whether the presence or absence of habitual exercise caused any difference in the QOL model, subjects were divided into 4 groups according to whether they were male or female and whether they had or did not have an exercise habit. Multi-population group simultaneous analysis was then performed among the four groups. More than 85% of the subjects had objects of ikigai. Ikigai is an important factor for comprehending the QOL of the elderly. It was possible to construct QOL models for the elderly with ikigai as a composition factor. The effect of physical QOL on mental QOL was negligible in females irrespective of whether they had an exercise habit. The effect of social QOL on mental QOL was profound in aged females with an exercise habit. The effect of the living situation on mental QOL was profound in aged females without an exercise habit. The effect of mental QOL on ikigai was more marked in subjects without an exercise habit than in those with an exercise habit.

  15. Use of Medicines Among a Brazilian Elderly Sample: A Cross-sectional Study

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    Adriana Mathias Pereira da Silva Marchini

    2011-06-01

    Conclusion: In this Brazilian elderly sample, the most widely used medicines were antihypertensives, diuretics, and nonsteroidal anti-inflammatory drugs, and institutionalized used more medications than community-dwelling elderly.

  16. Cross-sectional association between medical expenses and intellectual activity in community-dwelling older adults.

    Science.gov (United States)

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2017-08-25

    Little is known concerning the lifestyle habits and health conditions in community-dwelling elderly who do not get medical care. We investigated the cross-sectional association between medical expenses (ME) and intellectual activity (IA) in community-dwelling older Japanese. Self-administered questionnaires were mailed to all residents born between 1945 and 1949 and covered by A City's medical insurance system (n = 19,354). Independent variables including health behaviors, oral health, social capital, neighborhood environment, and physical and mental functioning were included in the questionnaires. Medical fee receipts were used to evaluate ME for fiscal 2014, and respondents were classified into no, low, medium, and high ME groups. Higher-level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence, which is comprised of three subscales: instrumental activities of daily living, IA, and social role. Poisson regression models were used to examine the association of ME with IA, with the low ME group as reference. Questionnaires were returned by 12,747 individuals (response rate 65.9%). The no ME group had the lowest response rate, the worst lifestyle behaviors, and the lowest social capital, but no problems with neighborhood environment. Higher-level functional capacity, especially IA, was reduced in both the high ME and no ME groups. After adjustments for age, gender, health insurance, accessibility to public facilities in their residential area, family size, body mass index, and physical and mental functioning, the prevalence ratio (PR) for impaired IA lost its significance in the high ME group (PR 0.97, 95% confidence interval 0.90-1.05), but remained significant in the no ME group (1.19, 1.08-1.31). After additional adjustments for health behaviors (i.e., health checks, smoking, fitness, and dietary variety), the PR of the no ME group was attenuated towards the null (1.08, 0.98-1.20). Community-dwelling

  17. FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

    OpenAIRE

    Michaela Dingová; Eva Králová

    2017-01-01

    Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged...

  18. Synergistic association of changes in serum uric acid and triglycerides with changes in insulin resistance after walking exercise in community-dwelling older women.

    Science.gov (United States)

    Kawamoto, Ryuichi; Katoh, Takeaki; Ninomiya, Daisuke; Kumagi, Teru; Abe, Masanori; Kohara, Katsuhiko

    2016-05-01

    Serum uric acid (SUA) and triglyceride (TG) levels are strongly correlated with insulin resistance; however, the association after a walking exercise program in community-dwelling older women has not been investigated. The present study included 100 postmenopausal women (mean ± standard deviation, 68 ± 7 years) from a rural village in Japan. The Nordic walking program of 120 min per week was performed for 12 weeks. Before and after the intervention, SUA, TG, various relevant factors and homeostasis model assessment of insulin resistance (HOMA-IR) were measured. Multivariate linear regression analysis showed that baseline TG and γ-glutamyltransferase (GGT) were significantly associated with baseline HOMA-IR. After the 12-week training program, changes in TG, SUA and GGT were significantly associated with changes in HOMA-IR. In addition to their direct associations, we observed a synergistic association between changes in TG and SUA and changes in HOMA-IR. Participants were divided into three groups (tertiles) according to changes in TG and SUA. The tertiles of changes in SUA correlated significantly with changes in HOMA-IR in participants in the tertile with the greatest decrease in TG (r = 0.525, p = 0.001), but not in the other two tertiles of change in TG (r = 0.049, p = 0.699). There was a significant interaction between SUA and TG for changes in HOMA-IR (β = 0.281, p = 0.005). These results suggest that changes in TG and SUA are synergistic factors associated with changes in insulin resistance after a 12-week walking exercise program in community-dwelling older women.

  19. [Are gait parameters related to knee pain, urinary incontinence and a history of falls in community-dwelling elderly women?].

    Science.gov (United States)

    Kim, Hunkyung; Suzuki, Takao; Yoshida, Hideyo; Shimada, Hiroyuki; Yamashiro, Yukari; Sudo, Motoki; Niki, Yoshifumi

    2013-01-01

    To examine the association between gait parameters and knee pain, urinary incontinence, and a history of falls. Comprehensive health examinations were conducted in 2009 among 971 elderly women over 70 years of age, in which the questionnaire and gait parameter results of 870 participants were analyzed. Knee pain, urinary incontinence and a history of falls were assessed through face-to-face interview surveys. Gait parameters were measured using a walk-way to assess walking speed, cadence, stride, stride length, step width, walking angle, toe angle and the differences in each parameter between the right and left foot. Multiple logistic regression analyses were performed to examine the associations between the gait parameters and knee pain, urinary incontinence and a history of falls. The elderly women with knee pain, urinary incontinence and a history of falls had slower walking speeds, smaller strides and strides length, and wider step width and walking angles. The multiple logistic regression analysis showed the walking speed to be significantly associated with mild knee pain and urinary incontinence and single a history of fall; moderate/severe knee pain was significantly associated with step width (OR=0.58, 95%CI=0.40-0.84) and walking angle (OR=1.62, 95%CI=1.30-2.01); moderate/severe urinary incontinence was significantly associated with walking speed (OR=0.97, 95%CI=0.96-0.99), walking angle (OR=1.14, 95%CI=1.02-1.26), and difference in walking angle between the right and left foot (OR=1.43, 95%CI=1.09-1.86); multiple a history of falls was significantly associated with stride length (OR=0.85, 95%CI=0.79-0.93) and the difference in walking angle between the right and left foot (OR=1.36, 95%CI=1.01-1.85). The data suggest that combining assessments of walking speed and other gait parameters may be an effective screening method for the early detection of geriatric syndromes.

  20. Adapted physical activity is beneficial on balance, functional mobility, quality of life and fall risk in community-dwelling older women: a randomized single-blinded controlled trial.

    Science.gov (United States)

    Kovács, E; Prókai, L; Mészáros, L; Gondos, T

    2013-06-01

    Exercise programmes have important role in prevention of falls, but to date, we have little knowledge about the effects of Adapted Physical Activity programme on balance of older women. The aim of this study was to investigate the effects of an Adapted Physical Activity programme on balance, risk of falls and quality of life in community-dwelling older women. This was a randomized controlled study. Community, in a local sport centre. Older women aged over 60 years. Seventy-six women were randomised to an exercise group providing Adapted Physical Activity programme for 25 weeks or a control group (in which they did not participate in any exercise programme). The one-leg stance test, Timed Up and Go test, incidence of fall and the quality of life (SF-36V2) were measured at baseline and after 25 weeks. The one-leg stance test and the Timed Up and Go test in the exercise group was significantly better than in the control group after the intervention period (P=0.005; P=0.001, respectively). The Physical Functioning, Vitality and General Health subdomains of quality of life were also significantly better in the exercise group compared to the control group (P=0.004; P=0.005; P=0.038, respectively). Relative risk was 0.40 (90% CI 0.174 to 0.920) and the number needed to treat was 5 (95% CI 2.3 to 23.3). This 25-week Adapted Physical Activity programme improves static balance, functional mobility, as well as Physical Functioning, Vitality and General Health subdomains of quality of life. Based on our results, the Adapted Physical Activity programme may be a promising fall prevention exercise programme improving static balance and functional mobility for community-dwelling older women.

  1. Race Differences: Use of Walking Speed to Identify Community-Dwelling Women at Risk for Poor Health Outcomes--Osteoarthritis Initiative Study.

    Science.gov (United States)

    Kirkness, Carmen S; Ren, Jinma

    2015-07-01

    Onset of disability, risk for future falls, frailty, functional decline, and mortality are strongly associated with a walking speed of less than 1.0 m/s. The study objective was to determine whether there were differences in slow walking speed (differences in walking speed can be attributed to age, obesity, socioeconomic factors, disease severity, or comorbidities. A cross-sectional design was used. Community-dwelling adults were recruited from Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island. Participants were 2,648 women (23% African American) who were 45 to 79 years of age and had a self-selected baseline walking speed of 20 m/s in the Osteoarthritis Initiative Study. Mixed-effects logistic regression models were used to examine racial differences in walking speed (<1.0 m/s versus ≥1.0 m/s), with adjustments for demographic factors, socioeconomic factors, disease severity, and comorbidities. Walking speed was significantly slower for African American women than for white American women (mean walking speed=1.19 and 1.33 m/s, respectively). The prevalence of a walking speed of less than 1.0 m/s in this cohort of middle-aged women was 9%; about 50% of the women with a walking speed of less than 1.0 m/s were younger than 65 years. Women with a walking speed of less than 1.0 m/s had lower values for socioeconomic factors, higher values for disease severity, and higher prevalences of obesity and comorbidities than those with a walking speed of ≥1.0 m/s. After controlling for these covariates, it was found that African American women were 3 times (odds ratio=2.9; 95% confidence interval=2.0, 4.1) more likely to have a walking speed of less than 1.0 m/s than white American women. The study design made it impossible to know whether a walking speed of less than 1.0 m/s in women who were 45 years of age or older was a predictor of future poor health outcomes. In this study, race was independently associated with a walking speed

  2. Frailty and cardiovascular risk in community-dwelling elderly: a population-based study

    Directory of Open Access Journals (Sweden)

    Ricci NA

    2014-10-01

    Full Text Available Natalia Aquaroni Ricci,1 Germane Silva Pessoa,1 Eduardo Ferriolli,2 Rosangela Correa Dias,3 Monica Rodrigues Perracini1 1Master’s and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID, São Paulo, 2Faculty of Medicine, Universidade de São Paulo (USP, Ribeirão Preto, 3Department of Physiotherapy, Universidade Federal de Minas Gerais (UFMG, Belo Horizonte, Brazil Background: Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD and the frailty syndrome in older people.Purpose: To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly.Methods: This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference ­measurement, and smoking.Results: Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4% and the lowest one was smoking (10.4%. It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher’s exact test: P=0.005; P=0.021. Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher’s exact test: P≤0.001; P≤0.001. There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement.Conclusion: Hypertension was

  3. Seasonal changes in vitamin D status among Danish adolescent girls and elderly women: the influence of sun exposure and vitamin D intake

    DEFF Research Database (Denmark)

    Andersen, Rikke; Brot, C; Jakobsen, Jette

    2013-01-01

    Background/objectives:To determine seasonal variation in vitamin D status in healthy Caucasian adolescent girls and elderly community-dwelling women living in Denmark, and to quantify the impact of sun exposure and intake on the seasonal changes in vitamin D status.Subjects/methods:A 1-year...... longitudinal observational study of 54 girls (11-13 years) and 52 women (70-75 years). The participants were examined three times (winter-summer-winter). Serum 25-hydroxyvitamin D (S-25OHD) concentration and vitamin D intake were measured at each visit. Sun exposure was measured during summer.Results:S-25OHD...... concentrations (winter, summer, winter) were median (25, 75 percentiles) 23.4 (16.5, 36.4), 60.3 (42.7, 67.7), 29.5 (22.2, 40.4) and 47.2 (27.3, 61.1), 67.3 (35.1, 79.2), 50.5 (32.7, 65.5) nmol/l for girls and women, respectively. The usual sun habits were determinant (P=0.002) for change in vitamin D status...

  4. Sarcopenia and sarcopenic obesity in Spanish community-dwelling middle-aged and older women: Association with balance confidence, fear of falling and fall risk.

    Science.gov (United States)

    Aibar-Almazán, Agustín; Martínez-Amat, Antonio; Cruz-Díaz, David; Jiménez-García, José D; Achalandabaso, Alexander; Sánchez-Montesinos, Indalecio; de la Torre-Cruz, Manuel; Hita-Contreras, Fidel

    2018-01-01

    To analyze the association of sarcopenia, obesity, and sarcopenic obesity (SO) with fear of falling (FoF) and balance confidence in a Spanish sample of middle-aged and older community-dwelling women. A total of 235 women (69.21±7.56 years) participated in this study. Body composition (bioelectrical impedance analysis), hand-grip strength, and physical performance (gait speed) were evaluated for the diagnosis of sarcopenia, obesity, and SO. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. The Activities-Specific Balance Confidence Scale (ABC) and the Falls Efficacy Scale-International (FES-I) were employed to assess FoF and balance confidence, respectively. Scores of >26 on the FES-I and risk of falling. The independent associations of sarcopenia, obesity and SO with FoF, balance confidence, and fall risk were evaluated by multivariate linear and logistic regressions, adjusting for potential confounding variables. 27.23% and 18.72% of women presented with sarcopenia and SO, respectively. Gait speed, body mass index (BMI), and fall history were independently associated with ABC score (adjusted-R 2 =0.152) and fall risk (ABC) (adjusted-R 2 =0.115). FES-I score was independently associated (adjusted-R 2 =0.193) with fall history, gait speed, BMI, and depression, which, together with obesity (BMI) and SO, remained independent factors for fall risk measured as FES-I score (adjusted-R 2 =0.243). In community-dwelling middle-aged and older Spanish women, BMI, gait speed, and fall history were independently associated with FoF, balance confidence, and fall risk. Depression was related only to FoF, and, together with obesity (BMI) and SO, was an independent predictor of fall risk as assessed by the FES-I. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Medication-related risk factors associated with health-related quality of life among community-dwelling elderly in China.

    Science.gov (United States)

    Zhang, Sha; Meng, Long; Qiu, Feng; Yang, Jia-Dan; Sun, Shusen

    2018-01-01

    Previous studies have demonstrated that medication adherence has an impact on health-related quality of life (HRQoL). However, other medication-related factors that may influence HRQoL have not been extensively studied, especially factors based on the Medication-Risk Questionnaire (MRQ), and such studies are mostly done in Western countries. Our objective was to explore risk factors associated with HRQoL among community-dwelling elderly with chronic diseases in mainland China, especially the medication-related risk factors regarding MRQ. The study was conducted in a community health service center through surveys to eligible patients. The main outcomes of HRQoL were assessed by the EuroQol-5D (EQ-5D) scale and EQ-visual analog scale (EQ-VAS). Medication-related risk factors according to MRQ associated with HRQoL were identified using a multiple linear regression. A total of 311 patients were analyzed, averaging 71.19±5.33 years, and 68.8% were female. The mean EQ-5D index was 0.72±0.09, and the mean EQ-VAS score was 71.37±11.97. The most prevalent problem was pain/discomfort, and 90.0% believed that they could take care of themselves without any problems. Sex, age, educational level, frailty, function status, and certain medication-related factors regarding MRQ were found to be significant factors impacting the HRQoL. A multivariate analysis showed that MRQ factors of polypharmacy, multimorbidity, feeling difficultly with taking medicines as prescribed, and taking medicines with narrow therapeutic index had negative impacts on the quality of life. Patient's internal characteristics and medication-related risk factors according to MRQ were associated with quality of life. The results of the MRQ is an indicator of quality of life that can identify patients who need interventions.

  6. Prevalence of falls in elderly women.

    Science.gov (United States)

    Vitor, Priscila Regina Rorato; de Oliveira, Ana Carolina Kovaleski; Kohler, Renan; Winter, Gabriele Regiane; Rodacki, Cintia; Krause, Maressa Priscila

    2015-01-01

    To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. The prevalence of falls in this sample was 32.4%. Among women fallers, 40% self-reported a high fear of falling. It is recommended that functional and resistance exercises are included in the preventive strategies for reducing risk factors for falls and its determinants in elderly women. Level of Evidence II, Prognostic-Prospective Study.

  7. Prevalence of chronic obstructive pulmonary disease in independent community-dwelling older adults: The Fujiwara-kyo study.

    Science.gov (United States)

    Yoshikawa, Masanori; Yamamoto, Yoshifumi; Tomoda, Koichi; Fujita, Yukio; Yamauchi, Motoo; Osa, Takao; Uyama, Hiroki; Okamoto, Nozomi; Kurumatani, Norio; Kimura, Hiroshi

    2017-12-01

    As the Japanese population ages, the number of older patients with chronic obstructive pulmonary disease (COPD) is expected to increase, but the prevalence of COPD in patients aged ≥80 years remains unclear. The purpose of the present study was to determine the prevalence of COPD in independent community-dwelling older adults aged ≥80 years. We investigated the prevalence of COPD in 2862 independent community-dwelling older adults (1504 men, 1358 women, mean age 77.7 ± 7.0 years) who underwent spirometry in the Fujiwara-kyo study, a study of successful aging in older adults. Those participants with airflow limitation (forced expiratory volume in 1 s/forced vital capacity dwelling older adults aged ≥80 years. However, the benefits of the spirometric screening and treatment for these patients needs to be determined. Geriatr Gerontol Int 2017; 17: 2421-2426. © 2017 Japan Geriatrics Society.

  8. An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls

    Directory of Open Access Journals (Sweden)

    Schuster Tibor

    2011-02-01

    Full Text Available Abstract Background Prevention of falls in the elderly is a public health target in many countries around the world. While a large number of trials have investigated the effectiveness of fall prevention programs, few focussed on interventions embedded in the general practice setting and its related network. In the Prevent Falls (PreFalls trial we aim to investigate the effectiveness of a pre-tested multi-modal intervention compared to usual care in this setting. Methods/Design PreFalls is a controlled multicenter prospective study with cluster-randomized allocation of about 40 general practices to an experimental or a control group. We aim to include 382 community dwelling persons aged 65 and older with an increased risk of falling. All participating general practitioners are trained to systematically assess the risk of falls using a set of validated tests. Patients from intervention practices are invited to participate in a 16-weeks exercise program with focus on fall prevention delivered by specifically trained local physiotherapists. Patients from practices allocated to the control group receive usual care. Main outcome measure is the number of falls per individual in the first 12 months (analysis by negative binomial regression. Secondary outcomes include falls in the second year, the proportion of participants falling in the first and the second year, falls associated with injury, risk of falls, fear of falling, physical activity and quality of life. Discussion Reducing falls in the elderly remains a major challenge. We believe that with its strong focus on a both systematic and realistic fall prevention strategy adapted to primary care setting PreFalls will be a valuable addition to the scientific literature in the field. Trial registration NCT01032252

  9. Reference Values and Age Differences in Body Composition of Community-Dwelling Older Japanese Men and Women: A Pooled Analysis of Four Cohort Studies.

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    Satoshi Seino

    Full Text Available To determine age- and sex-specific body composition reference values and investigate age differences in these parameters for community-dwelling older Japanese men and women, using direct segmental multi-frequency bioelectrical impedance analysis.We conducted a pooled analysis of data collected in four cohort studies between 2008 and 2012: Kusatsu Longitudinal Study, Hatoyama Cohort Study, Itabashi Cohort Study, and Kashiwa Cohort Study. The pooled analysis included cross-sectional data from 4478 nondisabled, community-dwelling adults aged 65-94 years (2145 men, 2333 women; mean age: 72.9 years in men and 72.6 years in women. Body weight, fat mass (FM, percentage FM, fat-free mass (FFM, and appendicular lean soft tissue mass were measured using the InBody 720 and 430 (Biospace Co. Ltd, Seoul, Korea. The values were then normalized by height in meters squared to determine body mass index (BMI, FM index (FMI, FFM index (FFMI, and skeletal muscle mass index (SMI.Simple means (standard deviation of BMI, percentage FM, FMI, FFMI, and SMI were 23.4 (2.9 kg/m(2, 24.9 (6.3%, 5.96 (2.09 kg/m(2, 17.4 (1.5 kg/m(2, and 7.29 (0.76 kg/m(2, respectively, in men and 22.7 (3.3 kg/m(2, 31.7 (7.1%, 7.40 (2.61 kg/m(2, 15.3 (1.2 kg/m(2, and 5.86 (0.67 kg/m(2, respectively, in women. We then calculated quartiles and quintiles for these indices after stratifying for sex and 5-year age group. FFMI and SMI decreased significantly with age in both sexes (P < 0.001 for trends, but FFMI remained constant among the women with only a 1% decrease up to age 84 years. Percentage FM increased significantly, with age (P < 0.001 in men and P = 0.045 in women for trends, but FMI was unchanged in both sexes (P = 0.147 in men and P = 0.176 in women for trends.The present data should be useful in the clinical evaluation of body composition of older Japanese and for international comparisons. The small age-related decrease in FFMI may be a noteworthy characteristic of body composition

  10. Comparison between parameters of muscle performance and inflammatory biomarkers of non-sarcopenic and sarcopenic elderly women

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    Lustosa LP

    2017-08-01

    Full Text Available Lygia Paccini Lustosa,1 Patrícia Parreira Batista,1 Daniele Sirineu Pereira,2 Leani Souza Máximo Pereira,1 Aline Scianni,1 Giane Amorim Ribeiro-Samora1 1Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, 2Physical Therapy Department, Universidade Federal de Alfenas, Alfenas, Brazil Background: Sarcopenia is a multifactorial geriatric syndrome with complex interrelationships. Increased plasma levels of inflammatory mediators increase the catabolic stimuli of the musculature, thereby causing a decrease in mass and muscular function. Objective: The objective of this study was to compare the performance of the knee extensors test (by isokinetic dynamometer and plasma levels of interleukin-6 (IL-6 and soluble receptors of tumor necrosis factor alpha (sTNFR1 between sarcopenics and non-sarcopenics community-dwelling elderly women residents of Brazil. Material and methods: The diagnosis of sarcopenia included measurements of body composition (by densitometry with dual energy source of X-ray, handgrip strength (by Jamar® dynamometer, and the usual gait velocity according to the recommendations of the European Working Group on Sarcopenia in Older People. In both sarcopenics and non-sarcopenics elderly women, we evaluated the muscle function by knee extensors test (using an isokinetic dynamometer Byodex System 4 Pro® at angular speeds of 60°/s and 180°/s and also we evaluated the plasma concentrations of IL-6 and sTNFR1. Comparisons of muscle performance between groups were carried out using mixed factorial ANOVA with post hoc Bonferroni test; sTNFR1 and IL-6 variables were analyzed by applying Mann–Whitney U test. Results: Statistical differences were observed between groups regarding muscle power (P=0.01, total work adjusted to body weight (P=0.01 at a rate of 180°/s, and plasma levels of sTNFR1 (P=0.01. Conclusion: Sarcopenic elder women showed lower performance of the lower limbs, especially at a higher speed

  11. Association of Cognitive Function and Risk for Elder Abuse in a Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Rajan, Kumar; Evans, Denis A.

    2011-01-01

    Aim This study aimed to examine the cross-sectional association between cognitive function and elder abuse. Methods The Chicago Health and Aging Project (CHAP) is a population-based study conducted in a geographically defined community (n = 8,932). We identified 238 CHAP participants who had elder abuse reported to a social services agency. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (perceptual speed), and both immediate and delayed recall of the East Boston Memory Test (episodic memory). An index of global cognitive function scores was derived by averaging the z-scores of all tests. Logistic regression models were used to assess the association of cognitive function domains and risk of elder abuse. Results After adjusting for confounders, lowest tertiles of global cognition (odd's ratio, OR 4.18, 95% confidence interval, 95% CI 2.44–7.15), MMSE (OR 2.97, 95% CI 1.93–4.57), episodic memory (OR 2.27, 95% CI 1.49–3.43) and perceptual speed (OR 2.37, 95% CI 1.51–3.73) were associated with increased risk of elder abuse. The lowest levels of global cognitive function were associated with an increased risk of physical abuse (OR 3.56, 95% CI 1.08–11.67), emotional abuse (OR 3.02, 95% CI 1.41–6.44), caregiver neglect (OR 6.24, 95% CI 2.68–14.54), and financial exploitation (OR 3.71, 95% CI 1.88–7.32). Conclusion Lower levels of global cognitive function, MMSE, episodic memory and perceptual speed are associated with an increased risk of elder abuse. PMID:22095098

  12. Prevalence of falls in elderly women

    OpenAIRE

    Vitor,Priscila Regina Rorato; Oliveira,Ana Carolina Kovaleski de; Kohler,Renan; Winter,Gabriele Regiane; Rodacki,Cintia; Krause,Maressa Priscila

    2015-01-01

    OBJECTIVE: To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. METHODS: Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. RES...

  13. Variables explaining health-related quality of life in community-dwelling older adults.

    Science.gov (United States)

    Sartor-Glittenberg, Cecelia; Lehmann, Sara; Okada, Mari; Rosen, Danielle; Brewer, Kathryn; Bay, R Curtis

    2014-01-01

    Although health-related quality of life (HRQL) has been linked to numerous factors in older adults, limited or conflicting studies have investigated variables explaining HRQL in healthy, community-dwelling older adults. The purpose of this study was to determine whether physical activity, gait speed, balance, strength, endurance, and flexibility were associated with HRQL in healthy, community-dwelling older adults. Participants of this cross-sectional, correlational research design study included residents of a senior living community, aged 60 years and older who were independent in at least unlimited household ambulation. These residents participated in tests of physical activity, gait speed, balance, strength, endurance, flexibility, and HRQL (Medical Outcomes Study Short-Form Health Survey, SF-36). The physical (PCS) and mental (MCS) component summary scores of the SF-36 were calculated. Data were collected on 84 participants (mean [SD] age = 78.6 (5.9) years, 54.8% women). Significant correlations were found between the PCS and fast gait speed (FGS) (r = 0.43; p Fullerton Advanced Balance Scale (r = 0.44; p balance, and lower body strength were associated with the PCS of the SF-36; however, FGS was the only variable that uniquely contributed to the variance in the PCS. Body mass index was associated with the MCS; however, only balance uniquely contributed to the variance in the MCS. Physical activity was not associated with the PCS or MCS. The results of this study support the assessment of FGS in community-dwelling older adults to gain insight into physical health status. Interventions directed toward FGS, balance, and BMI may contribute to optimum HRQL in this population.

  14. Physical activity level and fall risk among community-dwelling older adults.

    Science.gov (United States)

    Low, Sok Teng; Balaraman, Thirumalaya

    2017-07-01

    [Purpose] To find the physical activity level and fall risk among the community-dwelling Malaysian older adults and determine the correlation between them. [Subjects and Methods] A cross-sectional study was conducted in which, the physical activity level was evaluated using the Rapid Assessment of Physical Activity questionnaire and fall risk with Fall Risk Assessment Tool. Subjects recruited were 132 community-dwelling Malaysian older adults using the convenience sampling method. [Results] The majority of the participants were under the category of under-active regular light-activities and most of them reported low fall risk. The statistical analysis using Fisher's exact test did not show a significant correlation between physical activity level and fall risk. [Conclusion] The majority of community-dwelling Malaysian older adults are performing some form of physical activity and in low fall risk category. But this study did not find any significant correlation between physical activity level and fall risk among community-dwelling older adults in Malaysia.

  15. A reliable measure of frailty for a community dwelling older population

    Directory of Open Access Journals (Sweden)

    Fletcher Astrid

    2010-10-01

    Full Text Available Abstract Background Frailty remains an elusive concept despite many efforts to define and measure it. The difficulty in translating the clinical profile of frail elderly people into a quantifiable assessment tool is due to the complex and heterogeneous nature of their health problems. Viewing frailty as a 'latent vulnerability' in older people this study aims to derive a model based measurement of frailty and examines its internal reliability in community dwelling elderly. Method The British Women's Heart and Health Study (BWHHS cohort of 4286 women aged 60-79 years from 23 towns in Britain provided 35 frailty indicators expressed as binary categorical variables. These indicators were corrected for measurement error and assigned relative weights in its association with frailty. Exploratory factor analysis (EFA reduced the data to a smaller number of factors and was subjected to confirmatory factor analysis (CFAwhich restricted the model by fitting the EFA-driven structure to observed data. Cox regression analysis compared the hazard ratios for adverse outcomes of the newly developed British frailty index (FI with a widely known FI. This process was replicated in the MRC Assessment study of older people, a larger cohort drawn from 106 general practices in Britain. Results Seven factors explained the association between frailty indicators: physical ability, cardiac symptoms/disease, respiratory symptoms/disease, physiological measures, psychological problems, co-morbidities and visual impairment. Based on existing concepts and statistical indices of fit, frailty was best described using a General Specific Model. The British FI would serve as a better population metric than the FI as it enables people with varying degrees of frailty to be better distinguished over a wider range of scores. The British FI was a better independent predictor of all-cause mortality, hospitalization and institutionalization than the FI in both cohorts. Conclusions

  16. Muscle function-dependent sarcopenia and cut-off values of possible predictors in community-dwelling Turkish elderly: calf circumference, midarm muscle circumference and walking speed.

    Science.gov (United States)

    Akın, S; Mucuk, S; Öztürk, A; Mazıcıoğlu, M; Göçer, Ş; Arguvanlı, S; Şafak, E D

    2015-10-01

    The aim of this study was to determine the prevalence of muscle strength-based sarcopenia and to determine possible predictors. This is a cross-sectional population-based study in the community-dwelling Turkish elderly. Anthropometric measurements, namely body height, weight, triceps skin fold (TSF), mid upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC), were noted. The midarm muscle circumference (MAMC) was calculated by using MUAC and TSF measurement. Sarcopenia was assessed, adjusted for body mass index (BMI) and gender, according to muscle strength. Physical performance was determined by 4 m walking speed (WS; m/s). The receiver operating curve analysis was performed to determine cut-offs of CC, MAMC and 4 m WS. A total of 879 elderly subjects, 50.1% of whom were female, were recruited. The mean handgrip strength (HGS) and s.d. was 24.2 (8.8) kg [17.9 (4.8) female, 30.6 (7.1) male]. The muscle function-dependent sarcopenia was 63.4% (female 73.5%, male 53.2%). The muscle mass-dependent sarcopenia for CC (sarcopenia. An adequate muscle mass may not mean a reliable muscle function. Muscle function may describe sarcopenia better compared with muscle mass. The CC, MAMC and 4 m WS cut-offs may be used to assess sarcopenia in certain age groups.

  17. Elderly Adi Women of Arunachal Pradesh: "Living Encyclopedias" and Cultural Refugia in Biodiversity Conservation of the Eastern Himalaya, India

    Science.gov (United States)

    Singh, Ranjay K.; Rallen, Orik; Padung, Egul

    2013-09-01

    Elderly women of a particular socioecological system are considered to be "living encyclopedias" in biocultural knowledge systems. These women play a pivotal role in retaining and passing on biodiversity-related traditional knowledge to the next generations. Unfortunately the fast changing sociocultural values and the impact of modernity have rendered their knowledge somewhat less valuable and they are being treated as "cultural refugia." Our study on the importance of these women in the conservation of indigenous biodiversity was conducted in 14 randomly selected villages dominated by the Adi tribe of East Siang District, Arunachal Pradesh (northeast India). Data were collected from 531 women (381 elderly and 150 young to middle aged) during 2003-2008 using conventional social science methods and participatory rural appraisal. One innovative method, namely "recipe contest," was devised to mobilize Adi women of each village in order to energies them and explore their knowledge relating to traditional foods, ethnomedicines, and conservation of indigenous biodiversity. Results indicated that 55 plant species are being used by elderly Adi women in their food systems, while 34 plant species are integral parts of ethnomedicinal practices. These women identified different plant species found under multistory canopies of community forests. Elderly women were particularly skilled in preparing traditional foods including beverages and held significantly greater knowledge of indigenous plants than younger women. Lifelong experiences and cultural diversity were found to influence the significance of biodiversity use and conservation. The conservation of biodiversity occurs in three different habitats: jhum lands (shifting cultivation), Morang forest (community managed forests), and home gardens. The knowledge and practice of elderly women about habitats and multistory vegetations, regenerative techniques, selective harvesting, and cultivation practices contribute

  18. Elderly Adi women of Arunachal Pradesh: "living encyclopedias" and cultural refugia in biodiversity conservation of the Eastern Himalaya, India.

    Science.gov (United States)

    Singh, Ranjay K; Rallen, Orik; Padung, Egul

    2013-09-01

    Elderly women of a particular socioecological system are considered to be "living encyclopedias" in biocultural knowledge systems. These women play a pivotal role in retaining and passing on biodiversity-related traditional knowledge to the next generations. Unfortunately the fast changing sociocultural values and the impact of modernity have rendered their knowledge somewhat less valuable and they are being treated as "cultural refugia." Our study on the importance of these women in the conservation of indigenous biodiversity was conducted in 14 randomly selected villages dominated by the Adi tribe of East Siang District, Arunachal Pradesh (northeast India). Data were collected from 531 women (381 elderly and 150 young to middle aged) during 2003-2008 using conventional social science methods and participatory rural appraisal. One innovative method, namely "recipe contest," was devised to mobilize Adi women of each village in order to energies them and explore their knowledge relating to traditional foods, ethnomedicines, and conservation of indigenous biodiversity. Results indicated that 55 plant species are being used by elderly Adi women in their food systems, while 34 plant species are integral parts of ethnomedicinal practices. These women identified different plant species found under multistory canopies of community forests. Elderly women were particularly skilled in preparing traditional foods including beverages and held significantly greater knowledge of indigenous plants than younger women. Lifelong experiences and cultural diversity were found to influence the significance of biodiversity use and conservation. The conservation of biodiversity occurs in three different habitats: jhum lands (shifting cultivation), Morang forest (community managed forests), and home gardens. The knowledge and practice of elderly women about habitats and multistory vegetations, regenerative techniques, selective harvesting, and cultivation practices contribute

  19. Prevalence estimates of depression in elderly community-dwelling African Americans in Indianapolis and Yoruba in Ibadan, Nigeria.

    Science.gov (United States)

    Baiyewu, Olusegun; Smith-Gamble, Valerie; Lane, Kathleen A; Gureje, Oye; Gao, Sujuan; Ogunniyi, Adesola; Unverzagt, Frederick W; Hall, Kathleen S; Hendrie, Hugh C

    2007-08-01

    This is a community-based longitudinal epidemiological comparative study of elderly African Americans in Indianapolis and elderly Yoruba in Ibadan, Nigeria. A two-stage study was designed in which community-based individuals were first screened using the Community Screening Interview for Dementia. The second stage was a full clinical assessment, which included use of the Geriatric Depression Scale, of a smaller sub-sample of individuals selected on the basis of their performance in the screening interview. Prevalence of depression was estimated using sampling weights according to the sampling stratification scheme for clinical assessment. Some 2627 individuals were evaluated at the first stage in Indianapolis and 2806 in Ibadan. All were aged 69 years and over. Of these, 451 (17.2%) underwent clinical assessment in Indianapolis, while 605 (21.6%) were assessed in Ibadan. The prevalence estimates of both mild and severe depression were similar for the two sites (p=0.1273 and p=0.7093): 12.3% (mild depression) and 2.2% (severe depression) in Indianapolis and 19.8% and 1.6% respectively in Ibadan. Some differences were identified in association with demographic characteristics; for example, Ibadan men had a significantly higher prevalence of mild depression than Indianapolis men (pYoruba (p=0.0039). Prevalence of depression was similar for elderly African Americans and Yoruba despite considerable socioeconomic and cultural differences between these populations.

  20. Nutritional Status in Community-Dwelling Elderly in France in Urban and Rural Areas

    Science.gov (United States)

    Torres, Marion J.; Dorigny, Béatrice; Kuhn, Mirjam; Berr, Claudine; Barberger-Gateau, Pascale; Letenneur, Luc

    2014-01-01

    Malnutrition is a frequent condition in elderly people, especially in nursing homes and geriatric wards. Its frequency is less well known among elderly living at home. The objective of this study was to describe the nutritional status evaluated by the Mini Nutritional Assessment (MNA) of elderly community-dwellers living in rural and urban areas in France and to investigate its associated factors. Methods Subjects aged 65 years and over from the Approche Multidisciplinaire Intégrée (AMI) cohort (692 subjects living in a rural area) and the Three-City (3C) cohort (8,691 subjects living in three large urban zones) were included. A proxy version of the MNA was reconstructed using available data from the AMI cohort. Sensitivity and specificity were used to evaluate the agreement between the proxy version and the standard version in AMI. The proxy MNA was computed in both cohorts to evaluate the frequency of poor nutritional status. Factors associated with this state were investigated in each cohort separately. Results In the rural sample, 38.0% were females and the mean age was 75.5 years. In the urban sample, 60.3% were females and the mean age was 74.1 years. Among subjects in living in the rural sample, 7.4% were in poor nutritional status while the proportion was 18.5% in the urban sample. Female gender, older age, being widowed, a low educational level, low income, low body mass index, being demented, having a depressive symptomatology, a loss of autonomy and an intake of more than 3 drugs appeared to be independently associated with poor nutritional status. Conclusion Poor nutritional status was commonly observed among elderly people living at home in both rural and urban areas. The associated factors should be further considered for targeting particularly vulnerable individuals. PMID:25133755

  1. Nutritional status in community-dwelling elderly in France in urban and rural areas.

    Directory of Open Access Journals (Sweden)

    Marion J Torres

    Full Text Available Malnutrition is a frequent condition in elderly people, especially in nursing homes and geriatric wards. Its frequency is less well known among elderly living at home. The objective of this study was to describe the nutritional status evaluated by the Mini Nutritional Assessment (MNA of elderly community-dwellers living in rural and urban areas in France and to investigate its associated factors.Subjects aged 65 years and over from the Approche Multidisciplinaire Intégrée (AMI cohort (692 subjects living in a rural area and the Three-City (3C cohort (8,691 subjects living in three large urban zones were included. A proxy version of the MNA was reconstructed using available data from the AMI cohort. Sensitivity and specificity were used to evaluate the agreement between the proxy version and the standard version in AMI. The proxy MNA was computed in both cohorts to evaluate the frequency of poor nutritional status. Factors associated with this state were investigated in each cohort separately.In the rural sample, 38.0% were females and the mean age was 75.5 years. In the urban sample, 60.3% were females and the mean age was 74.1 years. Among subjects in living in the rural sample, 7.4% were in poor nutritional status while the proportion was 18.5% in the urban sample. Female gender, older age, being widowed, a low educational level, low income, low body mass index, being demented, having a depressive symptomatology, a loss of autonomy and an intake of more than 3 drugs appeared to be independently associated with poor nutritional status.Poor nutritional status was commonly observed among elderly people living at home in both rural and urban areas. The associated factors should be further considered for targeting particularly vulnerable individuals.

  2. Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community.

    Science.gov (United States)

    Burnett, Jason; Jackson, Shelly L; Sinha, Arup K; Aschenbrenner, Andrew R; Murphy, Kathleen Pace; Xia, Rui; Diamond, Pamela M

    2016-01-01

    Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.

  3. Community structure of grassland ground-dwelling arthropods along increasing soil salinities.

    Science.gov (United States)

    Pan, Chengchen; Feng, Qi; Liu, Jiliang; Li, Yulin; Li, Yuqiang; Yu, Xiaoya

    2018-03-01

    Ground-dwelling arthropod communities are influenced by numerous biotic and abiotic factors. Little is known, however, about the relative importance of vegetation structure and abiotic environmental factors on the patterns of ground-dwelling arthropod community across a wide range of soil salinities. Here, a field survey was conducted to assess the driving forces controlling ground-dwelling arthropod community in the salinized grasslands in the Hexi Corridor, Gansu Province, China. The data were analyzed by variance partitioning with canonical correspondence analysis (CCA). We found that vegetation structure and edaphic factors were at least of similar importance to the pattern of the whole ground-dwelling arthropod community. However, when all collected ground-dwelling arthropods were categorized into three trophic guilds (predators, herbivores, and decomposers), as these groups use different food sources, their populations were controlled by different driving forces. Predators and decomposers were mainly determined by biotic factors such as vegetation cover and aboveground plant biomass and herbivores by plant density and vegetation cover. Abiotic factors were also major determinants for the variation occurring in these guilds, with predators strongly affected by soil electrical conductivity (EC) and the content of fine particles (silt + clay, CS), herbivores by soil N:P, EC, and CS, and decomposers by soil EC and organic matter content (SOM). Since plant cover, density, and aboveground biomass can indicate resource availability, which are mainly constrained by soil N:P, EC, CS, and SOM, we consider that the ground-dwelling arthropod community in the salinized grasslands was mainly influenced by resource availability.

  4. The relationship between health and cognitive functioning in a sample of elderly people in the community.

    Science.gov (United States)

    Christensen, H; Jorm, A F; Henderson, A S; Mackinnon, A J; Korten, A E; Scott, L R

    1994-05-01

    The association between health status and cognitive performance was examined in a sample of 708 community dwelling elderly people aged 70 years or over. Cognitive performance declined significantly across the age groups 70-74, 75-79, 80-84, and 85-89 years on the Mini-Mental State Examination and on measures of fluid intelligence and memory, but not on measures of crystallized intelligence. Health status declined significantly across age for five of 49 past and current medical conditions, for measures of Activities of Daily Living (ADL) and for systolic blood pressure, but did not decline significantly for global self-ratings of health, diastolic blood pressure or reports of smoking. Weak but significant correlations between health and cognitive performance were found for self-reported global ratings of health and for self-reports of some physical symptoms but not for diastolic or systolic blood pressure, or for many other physical conditions. Both self- and informant-based ratings of ADL correlated with cognitive performance. Age differences remained after cognitive performance was adjusted for health variables such as ADL, self-ratings of health and current health problems. It is concluded that, at the population level, lower levels of cognitive performance in community-dwelling elderly subjects are not strongly mediated by ill health.

  5. Physical performance measures that predict faller status in community-dwelling older adults.

    Science.gov (United States)

    Macrae, P G; Lacourse, M; Moldavon, R

    1992-01-01

    Falls are a leading cause of fatal and nonfatal injuries among the elderly. Accurate determination of risk factors associated with falls in older adults is necessary, not only for individual patient management, but also for the development of fall prevention programs. The purpose of this study was to evaluate the effectiveness of clinical measures, such as the one-legged stance test (OLST), sit-to-stand test (STST), manual muscle tests (MMT), and response speed in predicting faller status in community-dwelling older adults (N = 94, age 60-89 years). The variables assessed were single-leg standing (as measured by OLST), STST, and MMT of 12 different muscle groups (hip flexors, hip abductors, hip adductors, knee flexors, knee extensors, ankle dorsiflexors, ankle plantarflexors, shoulder flexors, shoulder abductors, elbow flexors, elbow extensors, and finger flexors), and speed of response (as measured by a visual hand reaction and movement time task). Of the 94 older adults assessed, 28 (29.7%) reported at least one fall within the previous year. The discriminant analysis revealed that there were six variables that significantly discriminated between fallers and nonfallers. These variables included MMT of the ankle dorsiflexors, knee flexors, hip abductors, and knee extensors, as well as time on the OLST and the STST. The results indicate that simple clinical measures of musculoskeletal function can discriminate fallers from nonfallers in community-dwelling older adults. J Orthop Sports Phys Ther 1992;16(3):123-128.

  6. Pinyon pine mortality alters communities of ground-dwelling arthropods

    Science.gov (United States)

    Robert J. Delph; Michael J. Clifford; Neil S. Cobb; Paulette L. Ford; Sandra L. Brantley

    2014-01-01

    We documented the effect of drought-induced mortality of pinyon pine (Pinus edulis Engelm.) on communities of ground-dwelling arthropods. Tree mortality alters microhabitats utilized by ground-dwelling arthropods by increasing solar radiation, dead woody debris, and understory vegetation. Our major objectives were to determine (1) whether there were changes in...

  7. Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant.

    Science.gov (United States)

    Nyunt, Ma Shwe Zin; Chong, Mei Sian; Lim, Wee Shiong; Lee, Tih Shih; Yap, Philip; Ng, Tze Pin

    2013-01-01

    The Clinical Dementia Rating (CDR) scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI) and evaluated its reliability and validity for assessing mild cognitive impairment (MCI) and dementia among community-dwelling elderly subjects. At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE) reliability (κ 0.77-1.00 for six domains and 0.95 for global rating) and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating), good agreement (κ 0.79) with the clinical assessment status of MCI (n = 37) and dementia (n = 4) and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p reliable assessment of MCI and dementia in community-living elderly subjects without an informant.

  8. Optimizing social participation in community-dwelling older adults through the use of behavioral coping strategies.

    Science.gov (United States)

    Provencher, Véronique; Desrosiers, Johanne; Demers, Louise; Carmichael, Pierre-Hugues

    2016-01-01

    This study aimed to (1) determine the categories of behavioral coping strategies most strongly correlated with optimal seniors' social participation in different activity and role domains and (2) identify the demographic, health and environmental factors associated with the use of these coping strategies optimizing social participation. The sample consisted of 350 randomly recruited community-dwelling older adults (≥65 years). Coping strategies and social participation were measured, respectively, using the Inventory of Coping Strategies Used by the Elderly and Assessment of Life Habits questionnaires. Information about demographic, health and environmental factors was also collected during the interview. Regression analyses showed a strong relationship between the use of cooking- and transportation-related coping strategies and optimal participation in the domains of nutrition and community life, respectively. Older age and living alone were associated with increased use of cooking-related strategies, while good self-rated health and not living in a seniors' residence were correlated with greater use of transportation-related strategies. Our study helped to identify useful behavioral coping strategies that should be incorporated in disability prevention programs designed to promote community-dwelling seniors' social participation. However, the appropriateness of these strategies depends on whether they are used in relevant contexts and tailored to specific needs. Our results support the relevance of including behavioral coping strategies related to cooking and transportation in disability prevention programs designed to promote community-dwelling seniors' social participation in the domains of nutrition and community life, respectively. Older age and living alone were associated with increased use of cooking-related strategies, while good self-rated health and not living in a seniors' residence were correlated with greater use of transportation

  9. Relationship of Having Hobbies and a Purpose in Life With Mortality, Activities of Daily Living, and Instrumental Activities of Daily Living Among Community-Dwelling Elderly Adults.

    Science.gov (United States)

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2016-07-05

    This study's aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly. Prospective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853) and developing a decline in ADL (n = 1254) and IADL (n = 1162) were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression. During the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47-2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44-5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01-3.55) compared to having both hobbies and PIL. Although effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults.

  10. Prevalence and predictors of mild cognitive impairment in Xi'an: a community-based study among the elders.

    Directory of Open Access Journals (Sweden)

    Xiangni Su

    Full Text Available Mild cognitive impairment (MCI is an intermediate stage between normal cognitive function and dementia among aging individuals. This study was designed to estimate the prevalence of MCI and explore the possible risk factors including gender disparities among community-dwelling older individuals. The study was conducted in Xi'an, China. This is a cross-sectional study. A total of 815 individuals, 60 years and older were selected by stratified random cluster sampling. Cognitive function was measured using the mini-mental status examination (MMSE, the Chinese version of the Dementia Rating Scales (CDRS was used to apply the diagnostic of non-dementia, and activities of daily living (ADL and instrumental activities of daily living (IADL systems were used to functional status. The association between sociodemographic characteristics, lifestyle, history of chronic diseases and MCI were evaluated separately for men and women using the Pearson χ²-test and binary logistic regression. Of the 815 community-dwelling individuals, 145 were found to have MCI. Overall, the prevalence of MCI was 18.5%, with a prevalence of 19.6% in women (105/535, and 15.3% (40/261 in men. The results of the binary logistical regression analysis indicated that age and history of stroke were associated with MCI in men. For women, the risk factors were lower level of educational and lack of religious attendance. Results suggested that the factors capable of influencing MCI differed profoundly between older men and older women. For this reason, different preventative measures should be adopted to delay or reverse cognitive impairment among community-dwelling older men and women.

  11. Falls prediction in elderly people : A 1-year prospective study

    NARCIS (Netherlands)

    Swanenburg, Jaap; de Bruin, Eling D.; Uebelhart, Daniel; Mulder, Theo

    The aim of the present study was to determine whether force plate variables in single- and dual-task situations are able to predict the risk of multiple falls in a community-dwelling elderly population. Two hundred and seventy elderly persons (225 females, 45 males; age, 73 7 years) performed

  12. Grannies, elders, and friends: aging Aboriginal women in Toronto.

    Science.gov (United States)

    Baskin, Cyndy; Davey, Caitlin J

    2015-01-01

    Based on a research project in Toronto, Canada, this article highlights the strengths and resiliency of 12 female Aboriginal Elders and seniors as they age together. For these women, being actively involved in their families and the Aboriginal community gives them a solid grounding in who they are, what their roles are and how they contribute to the whole. Of particular significance is the support and friendship the women offer each other through their commonalities, activities, and sense of humor.

  13. A measure of fall risk behaviors and perceptions among community-dwelling older adults.

    Science.gov (United States)

    Yuen, Hon Keung; Carter, Rickey E

    2006-01-01

    Relatively little is known about the interaction between behavioral and environmental circumstances associated with falls among community-dwelling older adults. This study is designed to develop an instrument that measures community-dwelling older adults' participation in and perceptions of fall risk behaviors. Eighty-seven community-dwelling older adults aged 60 or above (mean +/- SD = 76 +/- 7.9), who had experienced at least one fall in the past 12 months, completed a questionnaire dealing with frequency of their participation in fall risk behaviors, their perceptions of these behaviors, and their fall history. Data were subjected to exploratory factor analysis. A 20-item instrument consisting of three constructs was presented as the Fall Risk Behaviors and Perceptions Scale (FRB&PS). Two of the three constructs of the instrument were de-stabilizers and non-supports, both of which measure participation in fall risk behaviors; the third was perceptions of fall risk behaviors. Internal consistency coefficient of the FRB&PS is 0.733 with a root mean square error of approximation (RMSEA) score of 0.075, which indicates an adequate model fit. Results from the stepwise regression analyses indicated that adults aged 75 and above (the old-old) participated less frequently in fall risk activities (p = 0.025), and had more knowledge about fall risks as measured by a higher perception score (p = 0.025) than those aged 60 to 75 (the young-old). Older men tended to participate more frequently in fall risk activities (p = 0.020) than older women; in addition, those older adults who are more mobile (p = 0.002) also participated more frequently in fall risk behaviors than those who are less mobile. Preliminary findings indicate that the pilot FRB&PS is a reliable and valid instrument to measure community-dwelling older adults' participation in and perceptions of fall risk behaviors. Additional psychometric validation of the FRB&PS on predicting the likelihood of falls is

  14. Falls and Fall-Related Injuries among Community-Dwelling Adults in the United States.

    Directory of Open Access Journals (Sweden)

    Santosh K Verma

    Full Text Available Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span.Nationally representative data from the National Health Interview Survey (NHIS 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004-2013. Costs of unintentional fall-related injuries were extracted from the CDC's Web-based Injury Statistics Query and Reporting System.Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+, 1.1% of middle-aged adults (45-64 and 0.7% of young adults (18-44 reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%-7% from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010.Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a greater public health benefit.

  15. Serum uric acid is more strongly associated with impaired fasting glucose in women than in men from a community-dwelling population.

    Directory of Open Access Journals (Sweden)

    Ryuichi Kawamoto

    Full Text Available Serum uric acid (SUA levels are associated with metabolic syndrome (MetS and its components such as glucose intolerance and type 2 diabetes. It is unknown whether there are gender-specific differences regarding the relationship between SUA levels, impaired fasting glucose (IFG and newly detected diabetes. We recruited 1,209 men aged 60±15 (range, 19-89 years and 1,636 women aged 63±12 (range, 19-89 years during their annual health examination from a single community. We investigated the association between SUA levels and six categories according to fasting plasma glucose (FPG level {normal fasting glucose (NFG, <100 mg/dL; high NFG-WHO, 100 to 109 mg/dL; IFG-WHO, 110 to 125 mg/dL; IFG-ADA, 100 to 125 mg/dL; newly detected diabetes, ≥126 mg/dL; known diabetes} SUA levels were more strongly associated with the different FPG categories in women compared with men. In women, the associations remained significant for IFG-WHO (OR, 1.23, 95% CI, 1.00-1.50 and newly detected diabetes (OR, 1.33, 95% CI, 1.03-1.72 following multivariate adjustment. However, in men all the associations were not significant. Thus, there was a significant interaction between gender and SUA level for newly detected diabetes (P = 0.005. SUA levels are associated with different categories of impaired fasting glucose in participants from community-dwelling persons, particularly in women.

  16. Dietary Protein Intake in Dutch Elderly People: A Focus on Protein Sources

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    Michael Tieland

    2015-11-01

    Full Text Available Introduction: Sufficient high quality dietary protein intake is required to prevent or treat sarcopenia in elderly people. Therefore, the intake of specific protein sources as well as their timing of intake are important to improve dietary protein intake in elderly people. Objectives: to assess the consumption of protein sources as well as the distribution of protein sources over the day in community-dwelling, frail and institutionalized elderly people. Methods: Habitual dietary intake was evaluated using 2- and 3-day food records collected from various studies involving 739 community-dwelling, 321 frail and 219 institutionalized elderly people. Results: Daily protein intake averaged 71 ± 18 g/day in community-dwelling, 71 ± 20 g/day in frail and 58 ± 16 g/day in institutionalized elderly people and accounted for 16% ± 3%, 16% ± 3% and 17% ± 3% of their energy intake, respectively. Dietary protein intake ranged from 10 to 12 g at breakfast, 15 to 23 g at lunch and 24 to 31 g at dinner contributing together over 80% of daily protein intake. The majority of dietary protein consumed originated from animal sources (≥60% with meat and dairy as dominant sources. Thus, 40% of the protein intake in community-dwelling, 37% in frail and 29% in institutionalized elderly originated from plant based protein sources with bread as the principle source. Plant based proteins contributed for >50% of protein intake at breakfast and between 34% and 37% at lunch, with bread as the main source. During dinner, >70% of the protein intake originated from animal protein, with meat as the dominant source. Conclusion: Daily protein intake in these older populations is mainly (>80% provided by the three main meals, with most protein consumed during dinner. More than 60% of daily protein intake consumed is of animal origin, with plant based protein sources representing nearly 40% of total protein consumed. During dinner, >70% of the protein intake originated from

  17. First Nations Women in Northern Ontario: Health, Social, and Community Priorities

    Directory of Open Access Journals (Sweden)

    Christine Simard

    2011-05-01

    Full Text Available This article reports on data from women dwelling in First Nations communities regarding (1 baseline statistics about women’s circumstances, needs, interests, and opportunities for community engagement, and 2 information about women’s present status, experience, interest, and other questions of social, economic,and health status. Two hundred twenty-six women from 35 First Nations communities completed the survey. This paper focuses on the main findings from the survey, which fall into 4 thematic areas. Theme 1 consists of demographic information as provided by participants. Theme 2 consists of social information such as housingand education. Theme 3 includes information about participants’ top community health concerns. Theme 4 examines participants’ community involvement. Use of the survey in directing women's social policy isdiscussed.

  18. Social risk factors for falls among rural Nigerian community-dwelling older adults.

    Science.gov (United States)

    Maruf, Fatai Adesina; Muonwe, Chidile; Odetunde, Marufat

    2016-06-01

    Reports on social risk factors for falls are scarce. This study explored the associations of selected sociodemographic and health variables with falls among rural Nigerian community-dwelling older adults. The present cross-sectional study involved 131 community-dwelling older adults (84 women and 47 men) recruited at an outreach center. Demographic (age, sex and marital status), social (frequency of visiting relations and friends, and number of consistent informal carers) and health (number of comorbid conditions) variables were recorded. Having fewer than two informal carers (0.26, 95% CI 0.10-0.68) was independently associated with reduced risk for falls. Visiting relations and friends less than twice per week was independently associated with greater risks for falls (3.85, 95% CI 1.42-10.46) and recurrent falls (4.86, 95% CI 1.25-18.85). The number of informal carers and frequency of social visits are risk factors for falls in older adults, and need to be taken into consideration in any strategy for fall prevention in older adults. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

  19. Diet and its relationship to sarcopenia in community dwelling Iranian elderly: a cross sectional study.

    Science.gov (United States)

    Hashemi, Rezvan; Motlagh, Ahmadreza Dorosty; Heshmat, Ramin; Esmaillzadeh, Ahmad; Payab, Moloud; Yousefinia, Mahsa; Siassi, Fereydoun; Pasalar, Parvin; Baygi, Fereshteh

    2015-01-01

    Sarcopenia is associated with frailty and disability among the elderly and imposes significant costs on health care systems. We tested whether adherence to a particular dietary pattern was associated with sarcopenia among the elderly in a district of Tehran, Iran. We used a semiquantitative Food Frequency Questionnaire to assess the dietary intake of 300 randomly-selected elderly men and women (at least 55 y old) living in the sixth district of Tehran; and the dietary patterns of the subjects were obtained using principal component analysis. We performed a logistic regression to measure the effect of adherence to each dietary pattern on the odds of sarcopenia. Subjects in the highest tertile of the Mediterranean dietary pattern, characterized by a higher consumption of olive oil, fruits, vegetables, fish, and nuts, had a lower odds ratio for sarcopenia than those in the lowest tertile (OR = 0.42; 95% CI = 0.18-0.97; P for trend = 0.04). In contrast, adherence to the Western dietary pattern, characterized by a high consumption of sugar, soy, and fast foods, was not associated with sarcopenia (OR = 0.51; 95% CI = 0.21-1.24; P for trend = 0.13). Similarly, adherence to the Mixed dietary pattern, characterized by a high consumption of animal proteins, potatoes, and refined grains, did not affect the odds of sarcopenia (OR = 1.45; 95% CI = 0.66-3.19; P for trend = 0.95). This study suggests that adherence to the Mediterranean diet is associated with lower odds of sarcopenia among the Iranian elderly. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Associations Between Geriatric Syndromes and Mortality in Community-Dwelling Elderly: Results of a National Longitudinal Study in Taiwan.

    Science.gov (United States)

    Huang, Chi-Chang; Lee, Jenq-Daw; Yang, Deng-Chi; Shih, Hsin-I; Sun, Chien-Yao; Chang, Chia-Ming

    2017-03-01

    Although geriatric syndromes have been studied extensively, their interactions with one another and their accumulated effects on life expectancy are less frequently discussed. This study examined whether geriatric syndromes and their cumulative effects are associated with risks of mortality in community-dwelling older adults. Data were collected from the Taiwan Longitudinal Study in Aging in 2003, and the participant survival status was followed until December 31, 2007. A total of 2744 participants aged ≥65 years were included in this retrospective cohort study; 634 died during follow-up. Demographic factors, comorbidities, health behaviors, and geriatric syndromes, including underweight, falls, functional impairment, depressive condition, and cognitive impairment, were assessed. Cox proportional hazard regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the probability of survival according to the cumulative number of geriatric syndromes. The prevalence of geriatric syndromes increased with age. Mortality was significantly associated with age ≥75 years; male sex; ≤6 years of education; history of stroke, malignancy; smoking; not drinking alcohol; and not exercising regularly. Geriatric syndromes, such as underweight, functional disability, and depressive condition, contributed to the risk of mortality. The accumulative model of geriatric syndromes also predicted higher risks of mortality (N = 1, HR 1.50, 95% CI 1.19-1.89; N = 2, HR 1.69, 95% CI 1.25-2.29; N ≥ 3, HR 2.43, 95% CI 1.62-3.66). Community-dwelling older adults who were male, illiterate, receiving institutional care, underweight, experiencing a depressive condition, functionally impaired, and engaging in poor health behavior were more likely to have a higher risk of mortality. The identification of geriatric syndromes might help to improve comprehensive care for community-dwelling older adults. Copyright © 2016 AMDA – The Society for

  1. Prevalence of idiopathic normal-pressure hydrocephalus in the elderly population of a Japanese rural community

    International Nuclear Information System (INIS)

    Hiraoka, Kotaro; Meguro, Kenichi; Mori, Etsuro

    2008-01-01

    The prevalence of idiopathic normal-pressure hydrocephalus (NPH) in a community was investigated by retrospective analysis of data from a previous community-based study of 170 randomly selected elderly residents aged 65 years or older. Magnetic resonance (MR) images of the subjects were reviewed for the specific structural features of idiopathic NPH, i.e. ventricular enlargement and narrow cerebrospinal fluid (CSF) space at high convexity and high midline areas. The clinical features of idiopathic NPH, gait disturbance, urinary incontinence, and cognitive impairment, were evaluated on the basis of records of the subjects' neurological examinations, a health questionnaire, the Mini-Mental State Examination, and Clinical Dementia Rating. Thirteen of the 170 subjects showed lateral ventricular enlargement greater than 0.3 on Evans' index. Five subjects (2.9%) demonstrated both ventricular enlargement and narrow CSF space at the high convexity/midline. All five subjects with these MR imaging signs had cognitive impairment, one had gait disturbance, and one had urinary incontinence. The present study found 2.9% of community-dwelling elderly subjects showed radiological and clinical features consistent with idiopathic NPH. (author)

  2. Urinary Incontinency in Elderly Women and the Potential Risk Factors: A Cohort Study among the Elderly Women of Amirkola

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    E Moudi

    2017-02-01

    Full Text Available BACKGROUND AND OBJECTIVE: Urinary incontinence is a common health problem among elderly population, particularly elderly women, and it is necessary to identify the different risk factors that cause urinary incontinence. The present study was designed to assess this problem among elderly women in Babol and the risk factors associated with it. METHODS: In this cross-sectional study, 590 elderly women over 60 years old in Amirkola were studied using census method. The required data were collected using standard checklists and questionnaires. Any form of involuntary withdrawal of urine, wetting the pad or underwear was considered urinary incontinence. FINDINGS: In this study, the mean age of subjects was 68.2 ± 6.8 years and 194 out of 590 women (32.9% had urinary incontinence. The marital status (OR: 0.64 (CI-95% =0.42-0.98, p=0.04, constipation history (OR: 1.63 (CI-95% =0.11-2.39, p=0.01 and use of corticosteroid drugs (OR: 1.7 (CI-95% =1.01-2.95, p=0.05 were directly related to urinary incontinence after matching with other risk factors. However, urinary incontinence in elderly women was not related to factors such as age, obesity, education, number of children, chronic diseases like diabetes, blood pressure and respiratory disorders. CONCLUSION: According to the results of this study, one third of elderly women in Babol suffer from urinary incontinence and unmarriedness, constipation history, and use of corticosteroid drugs increase the possibility of this condition, which necessitates the need for more attention to this problem and its risk factors that have significant emotional effects on elderly women.

  3. Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During Multitasking.

    Science.gov (United States)

    Johansson, Jonas; Nordström, Anna; Nordström, Peter

    2016-06-01

    As 90% of fractures are caused by falls, and as fractures are more common in elderly women than in elderly men, a better understanding of potential sex differences in fall rates and underlying mechanisms is needed. The purpose of this study was to determine whether women are more prone than men to falling, and to evaluate whether the risk of falling is associated with variations in gait patterns. The cohort for this prospective observational study consisted of 1390 community-dwelling men and women aged 70 years, examined in a health survey between July 2012 and November 2014. Gait patterns were measured using a computerized walkway system during normal-speed, fast-speed, and dual-task trials. Triaxial accelerometers were used to collect objective data on physical activity, and self-reported fall data were collected by telephone 6 and 12 months after examination. Incident low-energy falls were defined as unexpected events in which participants came to rest on the ground. During the follow-up period, 148 study participants (88 women, 60 men; P = .01) reported falls. After adjusting for multiple confounders, including objective measures of physical activity, socioeconomic factors, cardiovascular disease, and cognitive function, the odds ratio for falling in women was 1.49 (95% confidence interval [CI] 1.02-2.19). Variations in gait pattern were significantly (20%-40%) increased in fallers compared with nonfallers during the dual-task trial for step width, step length, stride length, step time, stance time, stride velocity, and single support time (all P women showed 15% to 35% increased variability in all of these gait parameters during the dual-task trial compared with men (all P women were at greater risk of falls compared with their male counterparts. This increased risk was associated with increased variation in gait pattern during dual-task activities, and may contribute to women's greater fracture risk compared with men. Copyright © 2016 AMDA – The

  4. Skin hydration and lifestyle-related factors in community-dwelling older people.

    Science.gov (United States)

    Iizaka, Shinji

    2017-09-01

    This study aimed to investigate skin hydration status of the lower legs by comparing several methods and examining lifestyle-related factors in community-dwelling older people. A cross-sectional study was conducted in three community settings in Japan from autumn to winter. Participants were older people aged ≥65 years (n=118). Skin hydration status of the lower legs was evaluated by stratum corneum hydration using an electrical device, clinical symptoms by an expert's observation and the visual analogue scale. Lifestyle factors of skin care were evaluated by a self-administered questionnaire. The mean age of participants was 74.4 years and 83.9% were women. Stratum corneum hydration was significantly correlated with clinical scores by an expert's observation (rho=-0.46, Pskin, 57.5% showed low stratum corneum hydration. Hospitalization in the past year (b=-9.4, P=0.008), excessive bathing habits (b=-4.6, P=0.014), and having an outdoor hobby (b=-5.7, P=0.007) were negatively associated, and diuretics (b=11.5, P=0.002) and lotion-type moisturizer use (b=4.6, P=0.022) were positively associated with stratum corneum hydration. Stratum corneum hydration measurements show an adequate association with observation-based evaluation by an expert, but poor agreement with subjective evaluation in community-dwelling older people. Hospitalization experience and lifestyle factors are associated with skin hydration. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Relationship of Having Hobbies and a Purpose in Life With Mortality, Activities of Daily Living, and Instrumental Activities of Daily Living Among Community-Dwelling Elderly Adults

    Directory of Open Access Journals (Sweden)

    Kimiko Tomioka

    2016-07-01

    Full Text Available Background: This study’s aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai with mortality and a decline in the activities of daily living (ADL and instrumental ADL (IADL among the community-dwelling elderly. Methods: Prospective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853 and developing a decline in ADL (n = 1254 and IADL (n = 1162 were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression. Results: During the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47–2.94, decline in ADL (odds ratio 2.74; 95% CI, 1.44–5.21, and decline in IADL (odds ratio 1.89; 95% CI, 1.01–3.55 compared to having both hobbies and PIL. Conclusions: Although effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults.

  6. A cross-sectional study on health and physical functioning in relation to coping strategies among community-dwelling, ethnically diverse older women

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    Zarankin Keren

    2010-03-01

    Full Text Available Abstract Background Although empirical evidence is available on the coping-health link in older age, research on this topic is needed with non-clinical samples of ethnically diverse older women. To contribute to filling such a research gap, we tested whether these women's general health and functional limitations were associated with specific coping strategies (selected for their particular relevance to health issues and with known health-related demographics, i.e., age, ethnicity, income, and married status. Methods In this cross-sectional study, respondents were recruited at community facilities including stores and senior centers. The sample consisted of 180 community-dwelling women (age 52-98 screened for dementia; 64% of them reported having an ethnic minority status. The assessment battery contained the Mini-Cog, a demographics list, the Brief COPE, and the Medical Outcome Study 36-Item Short-Form Health Survey. Results Hierarchical multiple regression analyses showed that older women who used behavioral disengagement and, to a smaller degree, self-distraction as a form of coping reported lower levels of general health. The opposite was the case for positive reframing and, to a lesser degree, substance use. Moreover, lower income was related to worse general health and (together with more advanced age physical functioning. None of the coping strategies achieved significance in the physical functioning model. Conclusions These cross-sectional findings need corroboration by longitudinal research prior to developing related clinical interventions. Based on the initial evidence provided herein, clinicians working with this population should consider establishing the therapeutic goal of increasing the use of positive reframing while diminishing behavioral disengagement.

  7. Asymptomatic bacteriuria among elderly and middle-aged rural community-dwellers in South-Western Nigeria

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    Olowe OA

    2013-07-01

    Full Text Available OA Olowe,1 OB Makanjuola,1 KO Olabiyi,1 PO Akinwusi,2 CO Alebiosu,2 MA Isawumi,3 MB Hassan,3 EO Asekun-Olarinmoye,4 WO Adebimpe,4 TA Adewole5 1Department of Medical Microbiology and Parasitology, 2Department of Medicine, 3Department of Ophthalmology, 4Department of Community Medicine, 5Department of Biochemistry, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria Abstract: Asymptomatic bacteriuria in elderly individuals has been well described in institutionalized settings, but to a lesser extent in the community. The purpose of this study was to determine the pathogens responsible for asymptomatic bacteriuria in elderly and middle-aged individuals in Alajue-Ede, South-Western Nigeria, and to identify any associated factors. Mid-stream urine samples were collected from apparently healthy elderly and middle-aged volunteers who were participating in community health screening. Samples were processed and bacterial isolates were identified following standard procedures. In total, 128 volunteers (48 men, 76 women participated in the study. Twenty-eight (22.6% urinary pathogens were isolated, comprising Klebsiella species in five (17.9%, Pseudomonas aeruginosa in one (3.6%, Escherichia coli in 19 (67.9%, and Proteus species in three (10.7% cases. Women were identified as being at higher risk of asymptomatic bacteriuria, and the prevalence also increased with increasing age in men. The elderly in this community have a high prevalence of asymptomatic bacteriuria, and screening for comorbid medical conditions may be of benefit. Keywords: asymptomatic bacteriuria, urinary pathogens, elderly, urinary tract infection

  8. Fall risk in an active elderly population

    DEFF Research Database (Denmark)

    Læssøe, Uffe; Hoeck, Hans C.; Simonsen, Ole

    2007-01-01

    risk can be assessed by testing balance performance. In this study a test battery of physiological parameters related to balance and falls was designed to address fall risk in a community dwelling elderly population. RESULTS: Ninety-four elderly males and females between 70 and 80 years of age were...... assessment in which the physiological performance is evaluated in relation to the activity profile of the individual. Udgivelsesdato: 2007-null...

  9. Effect of cold indoor environment on physical performance of older women living in the community

    DEFF Research Database (Denmark)

    Lindemann, Ulrich; Oksa, Juha; Skelton, Dawn A

    2014-01-01

    performance of older women. DESIGN: cross-sectional experimental study with two test conditions. SETTING: movement laboratory in a climate chamber. SUBJECTS: eighty-eight community-dwelling, cognitively unimpaired older women (mean age 78 years). METHODS: participants were exposed to moderately cold (15°C...

  10. Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.

    Science.gov (United States)

    2008-01-01

    (LTC) home. Urinary incontinence is a health problem that affects a substantial proportion of Ontario's community-dwelling seniors (and indirectly affects caregivers), impacting their health, functioning, well-being and quality of life. Based on Canadian studies, prevalence estimates range from 9% to 30% for senior men and nearly double from 19% to 55% for senior women. The direct and indirect costs associated with UI are substantial. It is estimated that the total annual costs in Canada are $1.5 billion (Cdn), and that each year a senior living at home will spend $1,000 to $1,500 on incontinence supplies. Interventions to treat and manage UI can be classified into broad categories which include lifestyle modification, behavioural techniques, medications, devices (e.g., continence pessaries), surgical interventions and adjunctive measures (e.g., absorbent products). The focus of this review is behavioural interventions, since they are commonly the first line of treatment considered in seniors given that they are the least invasive options with no reported side effects, do not limit future treatment options, and can be applied in combination with other therapies. In addition, many seniors would not be ideal candidates for other types of interventions involving more risk, such as surgical measures. It is recognized that the terms "senior" and "elderly" carry a range of meanings for different audiences; this report generally uses the former, but the terms are treated here as essentially interchangeable. Behavioural interventions can be divided into 2 categories according to the target population: caregiver-dependent techniques and patient-directed techniques. Caregiver-dependent techniques (also known as toileting assistance) are targeted at medically complex, frail individuals living at home with the assistance of a caregiver, who tends to be a family member. These seniors may also have cognitive deficits and/or motor deficits. A health care professional trains the

  11. Structural Equation Modeling to Assess Discrimination, Stress, Social Support, and Depression among the Elderly Women in South Korea.

    Science.gov (United States)

    Lee, Hung Sa; Kim, Chunmi

    2016-09-01

    The purpose of this study was to find the relationship and conceptual model of discrimination, stress, support, and depression among the elderly in South Korea. This was a cross-sectional descriptive study involving 207 community-dwelling elders. Data were collected through questionnaires from May 5 to May 31, 2014 in community senior centers, and analyzed using descriptive statistics, t test, analysis of variance, Scheffé test, and structural equation modeling. There were significant effects of discrimination on stress, support on stress and stress on depression. Moreover, there were two significant indirect effects observed between discrimination and depression, and between support and depression. For each indirect effect, the mediating factor was stress. Additionally, there was no direct effect between discrimination and depression or support. This study found that social support and discrimination had indirect effects on depression through stress. More specifically, decreased stress led to a reduction of depression. Therefore, social support based on a thorough understanding of stress is very important for caring elderly who are depressive. Copyright © 2016. Published by Elsevier B.V.

  12. Developing Self-Expression and Community among South African Women with Persona Doll Making

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    Garcia, Dorothy Yumi

    2014-01-01

    Township-dwelling Black South African women must cope with an array of traumatizing stressors that stunt individual voice and diminish the creation of supportive female communities. At issue was the capacity of women under these conditions to thrive as individuals and contributing members of society, thus the rationale for this project study. The…

  13. Study of Health and Social Indicators of Elderly Women in Iran

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    Marzieh Shirazi Khah

    2012-03-01

    Full Text Available Objectives: by reducing the fertility rate and Improve health& social conditions in Iran, increases the statistics of population older women also follow the whole population of seniors. So that in two decades than has increased the population of elderly women to total female population of 3 percent to 4.1 percent in the recent census in 2006 to 7 percent and is expected that increasing continues this trend the next decades. Global statistics show that significantly more elderly woman than elderly men in most countries, developed and developing, But according to the Statistical Center of Iran shows that during 1976-2006 has increased in every decade the number of elderly women in Iran Due to improved health services, social and economic, but has reduced the population of elderly women than elderly men This happened while usually Is less life expectancy in men than women .therefore In this paper we study the population status, health, education, family status, employment, quality of life and isolation of elderly women in Iran and We review different reasons than elderly women than elderly men in gender. Methods & Materials: This study is a descriptive-analytical study and a library that was used in the Statistics Center of Iran as the country's census is the most documented. In addition, we search for related database in English and Persian, including pubmed, medline, ISI and Web site World Health Organization and Scientific Information Database To obtain demographic and social information about the Iranian elderly population. Also took advantage of the views of experts to analyze the findings gerontology, epidemiology and sociology on gender differences in the elderly population in Iran. Result: With a deep look at the situation of elderly women from different dimensions, including physical health, psychological-psychological, familial, social and... Understand that Despite the efforts and improvements in health status, social and economic in

  14. Magnitude and Correlates of Anemia in Elderly Women of a Resettlement Colony of Delhi.

    Science.gov (United States)

    Singh, Tulika; Nagesh, S; Ray, T K

    2018-01-01

    Anemia of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life of elderly women. Despite its clinical importance, anemia in the elderly women is underrecognized. The objective of this study was to assess the magnitude and correlates of anemia in elderly women of a resettlement colony of Delhi. A community-based, cross-sectional study for the duration of 1 year was conducted among 512 geriatric women (≥60 years). Demographic characteristics, dietary assessment, and behavioral risk factors were determined by interview, and the participants underwent physical examination followed by hemoglobin estimation by HemoCue. Anemia was defined using the WHO criteria of hemoglobin <12 g/dl. Chi-square test was employed to study the association between sociodemographic factors and anemia followed by multivariate regression analysis. The prevalence of anemia was 79.9% according to the WHO criteria of hemoglobin <12 g/dl in females. Age, education, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, history of worm infestation, and body mass index (BMI) were significantly associated with anemia on univariate analysis. In multivariate analysis, age, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, and BMI were significant explanatory variables for anemia. Our study points out high prevalence of and some of the major factors associated with anemia in elderly women. The need of the hour is to include our elderly women under the gamut of National Anemia Prophylaxis Program.

  15. Falls and Fall-Related Injuries among Community-Dwelling Adults in the United States

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    Verma, Santosh K.; Willetts, Joanna L.; Corns, Helen L.; Marucci-Wellman, Helen R.; Lombardi, David A.; Courtney, Theodore K.

    2016-01-01

    Introduction Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Methods Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004–2013. Costs of unintentional fall-related injuries were extracted from the CDC’s Web-based Injury Statistics Query and Reporting System. Results Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45–64) and 0.7% of young adults (18–44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%–7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Conclusions Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a

  16. Willingness to use and pay for options of care for community-dwelling older people in rural Vietnam

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    Van Hoi Le

    2012-02-01

    Full Text Available Abstract Background The proportion of people in Vietnam who are 60 years and over has increased rapidly. The emigration of young people and impact of other socioeconomic changes leave more elderly on their own and with less family support. This study assesses the willingness to use and pay for different models of care for community-dwelling elderly in rural Vietnam. Methods In 2007, people aged 60 and older and their family representatives, living in 2,240 households, were randomly selected from the FilaBavi Demographic Surveillance Site. They were interviewed using structured questionnaires to assess dependence in activities of daily living (ADLs, willingness to use and to pay for day care centres, mobile care teams, and nursing centres. Respondent socioeconomic characteristics were extracted from the FilaBavi repeated census. Percentages of those willing to use models and the average amount (with 95% confidence intervals they are willing to pay were estimated. Multivariate analyses were performed to measure the relationship of willingness to use services with ADL index and socioeconomic factors. Four focus group discussions were conducted to explore people's perspectives on the use of services. The first discussion group was with the elderly. The second discussion group was with their household members. Two other discussion groups included community association representatives, one at the communal level and another at the village level. Results Use of mobile team care is the most requested service. The fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than do the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require that services be free-of-charge is two to three times higher than the proportion willing to pay full cost. Households are willing to pay more than the elderly for day care and nursing

  17. Elderly women and stress. Does marriage make a difference?

    Science.gov (United States)

    Preston, D B; Dellasega, C

    1990-04-01

    Although studies of gender differences in the stress/health relationship of elderly persons have been done, few have examined the combined affect of marital status and gender on health. The experience of stress may affect elderly married women differently than elderly unmarried women. The purpose of this study was to explore the differential effects of stress on elderly married women and to identify interventions that could be used in gerontological nursing practice to promote effective coping. Roy's theory is used to explain the effects of stress on elderly women and to suggest nursing interventions. According to Roy, individuals respond to stressors in four behavioral modes: physiological, self-concept, role performance, and interdependency. The results of this study indicate that, of the four groups studied in this sample, the married women were in poorest health and the most vulnerable to stress.

  18. Urinalysis requests on the elderly residing in the Auckland community: tick box requesting?

    Science.gov (United States)

    Upton, Arlo; McEwan, M; Williamson, Deborah

    2016-01-29

    Urinalysis for microscopy and culture is one of the most frequently requested tests for microbiology laboratories, particularly from elderly patients. This study sought to describe the clinical appropriateness of urinalysis from community-dwelling elderly patients and subsequent antibiotic prescription. Demographic, laboratory, and antibiotic prescription data were collected on all samples submitted from patients ≥ 70 years during August 2014 to Labtests Auckland. In addition, clinical data were collected by questionnaire from a subgroup of 200 patients. During August 2014, approximately 7% of the Auckland population aged ≥ 70 years had urinalysis submitted. Urine dipstick was not routinely performed before specimen submission, particularly from patients living at home rather than a long-term care facility, and nearly 50% of samples were not cultured due to absence of pyuria. Escherichia coli was isolated from 23% of female and 7% of male specimens. E. coli isolates from our cohort were less susceptible to all antibiotics tested against compared with all E. coli isolated from all urines in 2014. Clinical indications were absent in 40% of the subgroup of patients. Antibiotic prescription within 7 days of urinalysis was common (36%). This study highlights the frequency of urinalysis testing among the elderly residing in the community. Clinical indications are often absent, and treatment of asymptomatic bacteriuria is likely to be contributing to excessive antibiotic prescription in this group of patients.

  19. Socio-demographic, behavioral and functional characteristics of groups of community and institutionalized elderly Quechua Indians of Peru, and their association with nutritional status.

    Science.gov (United States)

    Fortunato, Laura; Drusini, Andrea G

    2005-06-01

    Socio-demographic, behavioral, functional and anthropometric data for groups of elderly Quechua Indians of Peru were used to investigate the effects of gender and lifestyle patterns on nutritional status. Two community-dwelling samples were selected for study, representative of divergent lifestyles in terms of their combination of socio-economic, demographic and cultural contexts, plus an ad-hoc sample of institutionalized individuals with controlled food intake and reduced physical activity. Results suggest that differences in socio-demographic, behavioral and functional characteristics exist between the sexes and across settings (low- vs. highland) and lifestyles (institutionalized vs. community-dwelling; semi-urban vs. rural). These factors are likely to be related to diverging dietary and physical activity patterns, and have considerable effects on the nutritional status of the respondents.

  20. The relationship between geriatric depression and health-promoting behaviors among community-dwelling seniors.

    Science.gov (United States)

    Chang, Chyong-Fang; Lin, Mei-Hsiang; Wang, Jeng; Fan, Jun-Yu; Chou, Li-Na; Chen, Mei-Yen

    2013-06-01

    People older than 65 years old account for about 10.9% of Taiwan's total population; it is also known that the older adults experience a higher incidence of depression. Public health nurses play an important role in promoting community health. Policymaking for community healthcare should reflect the relationship between health-promoting behavior and depression in community-dwelling seniors. Therefore, the encouragement of healthy aging requires strategic planning by those who provide health promotion services. This study was designed to elicit the health-promoting behaviors of community seniors and investigate the relationship between geriatric depression and health-promoting behaviors among seniors who live in rural communities. We used a cross-sectional, descriptive design and collected data using a demographic information datasheet, the Health Promotion for Seniors and Geriatric Depression Scale short forms. The study included 427 participants. Most were women; mean age was 75.8 years. Most were illiterate; roughly half engaged in a limited number of health-promoting activities. The Geriatric Depression Scale score was negatively associated with health-promoting behavior. Social participation, health responsibility, self-protection, active lifestyle, and total Health Promotion for Seniors score all reached statistical significance. Multivariate analysis indicated that geriatric depression and physical discomfort were independent predictors of health-promoting behavior after controlling the confounding factors. Participants practiced less than the recommended level of health-promoting behaviors. We found a negative correlation between the geriatric depression score and health-promoting behavior. Results can be referenced to develop strategies to promote healthy aging in the community, especially with regard to promoting greater social participation and increased activity for community-dwelling older adults experiencing depression.

  1. The effect of social relationships on survival in elderly residents of a Southern European community: a cohort study

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    Otero Angel

    2007-08-01

    Full Text Available Abstract Background Comparative evidence regarding the effects of social relationships on mortality in Mediterranean communities will increase our knowledge of their strengths and the ways in which they influence longevity across cultures. Men and women may benefit differently from social relationships because of cultural differences in gender roles. Psychosocial mechanisms such as social support, which may explain the effects of social networks, may also vary by culture. Methods Detailed information on the social relationships of a representative sample of 1,174 community-dwelling older adults was collected in Leganés, a city in central Spain. Mortality over a 6-year follow-up period was ascertained. Information on socio-demographic, health and disability variables was also collected. Cox proportional hazards models were fitted separately for men and women and for the combined sample. Results Having a confidant was associated with a 25% (95% CI 5–40% reduction in the mortality risk. The hazard ratio for lack of social participation was 1.5 (95% CI 1.3–1.7. Being engaged in meaningful roles protected against mortality, while receipt of emotional support did not affect survival. These results were comparable for men and women. Having contact with all family ties was associated with reduced mortality only in men. Structural aspects of social networks make a unique contribution to survival, independently of emotional support and the role played in the lives of significant others. Conclusion In this elderly Southern European population, the beneficial effects of social networks, social participation, engagement in the life of significant others and having a confidant call for public policies that foster intergenerational and community exchanges.

  2. The effect of social relationships on survival in elderly residents of a Southern European community: a cohort study

    Science.gov (United States)

    Rodriguez-Laso, Angel; Zunzunegui, Maria Victoria; Otero, Angel

    2007-01-01

    Background Comparative evidence regarding the effects of social relationships on mortality in Mediterranean communities will increase our knowledge of their strengths and the ways in which they influence longevity across cultures. Men and women may benefit differently from social relationships because of cultural differences in gender roles. Psychosocial mechanisms such as social support, which may explain the effects of social networks, may also vary by culture. Methods Detailed information on the social relationships of a representative sample of 1,174 community-dwelling older adults was collected in Leganés, a city in central Spain. Mortality over a 6-year follow-up period was ascertained. Information on socio-demographic, health and disability variables was also collected. Cox proportional hazards models were fitted separately for men and women and for the combined sample. Results Having a confidant was associated with a 25% (95% CI 5–40%) reduction in the mortality risk. The hazard ratio for lack of social participation was 1.5 (95% CI 1.3–1.7). Being engaged in meaningful roles protected against mortality, while receipt of emotional support did not affect survival. These results were comparable for men and women. Having contact with all family ties was associated with reduced mortality only in men. Structural aspects of social networks make a unique contribution to survival, independently of emotional support and the role played in the lives of significant others. Conclusion In this elderly Southern European population, the beneficial effects of social networks, social participation, engagement in the life of significant others and having a confidant call for public policies that foster intergenerational and community exchanges. PMID:17678536

  3. Elder abuse telephone screen reliability and validity.

    Science.gov (United States)

    Buri, Hilary M; Daly, Jeanette M; Jogerst, Gerald J

    2009-01-01

    (a) To identify reliable and valid questions that identify elder abuse, (b) to assess the reliability and validity of extant self-reported elder abuse screens in a high-risk elderly population, and (c) to describe difficulties of completing and interpreting screens in a high-need elderly population. All elders referred to research-trained social workers in a community service agency were asked to participate. Of the 70 elders asked, 49 participated, 44 completed the first questionnaire, and 32 completed the duplicate second questionnaire. A research assistant administered the telephone questionnaires. Twenty-nine (42%) persons were judged abused, 12 (17%) had abuse reported, and 4 (6%) had abuse substantiated. The elder abuse screen instruments were not found to be predictive of assessed abuse or as predictors of reported abuse; the measures tended toward being inversely predictive. Two questions regarding harm and taking of belongings were significantly different for the assessed abused group. In this small group of high-need community-dwelling elders, the screens were not effective in discriminating between abused and nonabused groups. Better instruments are needed to assess for elder abuse.

  4. Health-related quality of life of elderly living in the rural community and homes for the elderly in a district of India. Application of the short form 36 (SF-36) health survey questionnaire.

    Science.gov (United States)

    Varma, G R; Kusuma, Y S; Babu, B V

    2010-08-01

    The present investigation aimed to assess the health-related QoL (HRQoL) of elderly people living in two settings: (i) rural community and (ii) homes for the elderly in a district of South India. The data are drawn from elderly (>60 years of age) sampled from both settings. The short form 36-item health survey (SF-36) was administered to all respondents. The average scores for several domains, including total physical health, total mental health and overall health (total SF-36 score) were around 50, which can be interpreted as a moderate level of health-related QoL. Residents living in a home for the elderly scored better in all domains except for role-physical and role-emotional. Though univariate analysis revealed some associations between characteristics of elderly SF-36 scores, the multiple regression analysis indicated that working status yields a significant but negative coefficient for total SF-36 score among community dwelling elderly. The elderly report that their lives are better when they are staying in homes for the elderly. Hence, despite the socio-economic conditions, provision of a better and conducive environment by setting up more charity-based homes for the elderly may be one of the options for relative betterment of the QoL of the elderly, particularly those who are socially and economically deprived. Finally, the study warrants the need of normative values of SF-36 for various population groups in India.

  5. Acceptance and use of health information technology by community-dwelling elders.

    Science.gov (United States)

    Fischer, Shira H; David, Daniel; Crotty, Bradley H; Dierks, Meghan; Safran, Charles

    2014-09-01

    With the worldwide population growing in age, information technology may help meet important needs to prepare and support patients and families for aging. We sought to explore the use and acceptance of information technology for health among the elderly by reviewing the existing literature. Review of literature using PubMed and Google Scholar, references from relevant papers, and consultation with experts. Elderly people approach the Internet and health information technology differently than younger people, but have growing rates of adoption. Assistive technology, such as sensors or home monitors, may help 'aging in place', but these have not been thoroughly evaluated. Elders face many barriers in using technology for healthcare decision-making, including issues with familiarity, willingness to ask for help, trust of the technology, privacy, and design challenges. Barriers must be addressed for these tools to be available to this growing population. Design, education, research, and policy all play roles in addressing these barriers to acceptance and use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Effect of a self-care program on oxidative stress and cognitive function in an older Mexican urban-dwelling population.

    Science.gov (United States)

    Sánchez-Rodríguez, M A; Arronte-Rosales, A; Mendoza-Núñez, V M

    2009-11-01

    To determine the effect of a self-care program on oxidative stress (OxS) and cognitive function in an older, Mexican, urban-dwelling population. A longitudinal and pre-experimental study was carried out in a sample of 79 older healthy, urban-dwelling individuals residing in Mexico City, (62 females and 17 males), of which 71 of them (59 women and 12 males) complied with the entire self-care program. We measured OxS, cognitive function, the Nagi Disability Scale of physical task functioning, and Instrumental Activities of Daily Living (IADL) prior to and after 2 years of intervention with an active aging program. All older persons adopted healthy, self-care-based lifestyles according to the active aging program to which they were trained, which was associated with a statistically significant improvement of OxS and cognitive function markers on comparing pre- and post-community intervention data. Our findings suggest that self-care-based healthy lifestyles programs can improve the oxidative stress and cognitive function in urban-dwelling elderly population.

  7. Evidence-Based Approaches to Remedy and Also to Prevent Abuse of Community-Dwelling Older Persons

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    Donna M. Wilson

    2011-01-01

    Full Text Available Elder abuse is a global issue, with an estimated 4–10% of older persons in Canada abused each year. Although Canadian legislation has been created to prevent and punish the abuse of older persons living in nursing homes and other care facilities, community-dwelling older persons are at greater risk of abuse. This paper highlights the importance of evidence-based actions targeted at three determinants of health: (a personal health practices and coping skills, (b social support networks, and (c social environments. Two research studies are profiled as case studies that illustrate the ready possibility and value of two specific types of actions on community-based older-person abuse. This paper argues for the immediate and widespread adoption of these evidence-based measures and for additional empirical evidence to guide the correction of underreporting of abuse, raise awareness of its serious nature, and increase options to not only stop it but ultimately prevent it.

  8. Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.

    Science.gov (United States)

    Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-Ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi

    2018-01-01

    To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.Cross-sectional study between 2011 and 2013.Community in which residents voluntarily attended a health examination.We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P fear of falling.The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.

  9. eGFRs from Asian-modified CKD-EPI and Chinese-modified CKD-EPI equations were associated better with hypertensive target organ damage in the community-dwelling elderly Chinese: the Northern Shanghai Study

    Directory of Open Access Journals (Sweden)

    Ji H

    2017-08-01

    Full Text Available Hongwei Ji,1,* Han Zhang,1,* Jing Xiong,1 Shikai Yu,1 Chen Chi,1 Bin Bai,1 Jue Li,2 Jacques Blacher,3 Yi Zhang,1,* Yawei Xu1,* 1Department of Cardiology, Shanghai Tenth People’s Hospital, 2Department of Prevention, Tongji University School of Medicine, Shanghai, People’s Republic of China; 3Paris Descartes University, AP-HP, Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France *These authors contributed equally to this work Background: With increasing age, estimated glomerular filtration rate (eGFR decline is a frequent manifestation and is strongly associated with other preclinical target organ damage (TOD. In literature, many equations exist in assessing patients’ eGFR. However, these equations were mainly derived and validated in the population from Western countries, which equation should be used for risk stratification in the Chinese population remains unclear, as well as their comparison. Considering that TOD is a good marker for risk stratification in the elderly, in this analysis, we aimed to investigate whether the recent eGFR equations derived from Asian and Chinese are better associated with preclinical TOD than the other equations in elderly Chinese.Methods: A total of 1,599 community-dwelling elderly participants (age >65 years in northern Shanghai were prospectively recruited from June 2014 to August 2015. Conventional cardiovascular risk factors were assessed, and hypertensive TOD including left ventricular mass index (LVMI, carotid–femoral pulse wave velocity (cf-PWV, carotid intima-media thickness (IMT, ankle–brachial index (ABI and urine albumin to creatinine ratio (UACR was evaluated for each participant. Participant’s eGFR was calculated from the Modification of Diet in Renal Disease (MDRD, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI, Chinese-abbreviated MDRD (c-aMDRD, Asian-modified CKD-EPI (aCKD-EPI equation and Chinese-modified CKD-EPI (cCKD-EPI equation.Results: In multivariate

  10. Spinal sagittal balance substantially influences locomotive syndrome and physical performance in community-living middle-aged and elderly women.

    Science.gov (United States)

    Muramoto, Akio; Imagama, Shiro; Ito, Zenya; Hirano, Kenichi; Ishiguro, Naoki; Hasegawa, Yukiharu

    2016-03-01

    Spinal sagittal imbalance has been well known risk factor of decreased quality of life in the field of adult spinal deformity. However, the impact of spinal sagittal balance on locomotive syndrome and physical performance in community-living elderly has not yet been clarified. The present study investigated the influence of spinal sagittal alignment on locomotive syndrome (LS) and physical performance in community-living middle-aged and elderly women. A total of 125 women between the age of 40-88 years (mean 66.2 ± 9.7 years) who completed the questionnaires, spinal mouse test, physical examination and physical performance tests in Yakumo study were enrolled in this study. Participants answered the 25-Question Geriatric Locomotive Function Scale (GLFS-25), the visual analog scale (VAS) for low back pain (LBP), knee pain. LS was defined as having a score of >16 points on the GLFS-25. Using spinal mouse, spinal inclination angle (SIA), thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sacral slope angle (SSA), thoracic spinal range of motion (TSROM), lumbar spinal range of motion (LSROM) were measured. Timed-up-and-go test (TUG), one-leg standing time with eyes open (OLS), and maximum stride, back muscle strength were also measured. The relationship between spinal sagittal parameters and GLFS-25, VAS and physical performance tests were analyzed. 26 people were diagnosed as LS and 99 were diagnosed as non-LS. LBP and knee pain were greater, physical performance tests were poorer, SIA were greater, LLA were smaller in LS group compared to non-LS group even after adjustment by age. SIA significantly correlated with GLFS-25, TUG, OLS and maximum stride even after adjustment by age. The cutoff value of SIA for locomotive syndrome was 6°. People with a SIA of 6° or greater were grouped as "Inclined" and people with a SIA of less than 6° were grouped as "Non-inclined". 21 people were "Inclined" and 104 were "Non-inclined". Odds ratio to fall in LS of

  11. The health benefits following regular ongoing exercise lifestyle in independent community-dwelling older Taiwanese adults.

    Science.gov (United States)

    Wang, Ching-Yi; Yeh, Chih-Jung; Wang, Chia-Wei; Wang, Chun-Feng; Lin, Yen-Ling

    2011-03-01

    To examine the effect of regular ongoing exercise lifestyle on mental and physical health in a group of independent community-dwelling Taiwanese older adults over a 2-year period. 197 older adults (mean age 72.5 years; 106 men and 91 women) who were independent in walking, instrumental and basic activities of daily living completed the baseline and a 2-year follow-up assessment. Older adults regularly performing exercises during the 2-year study period were grouped into regular exercise group; otherwise in the irregular exercise group. Baseline and follow-up assessments included a face-to-face interview and a battery of performance tests. The regular exercise group showed significantly less depression (P = 0.03) and tended to regress less on the performance tests (P = 0.025-0.410) across 2 years compared to the irregular exercise group. Regular exercise is important for maintaining or even improving mental and functional health, even for independent community-dwelling older adults. © 2010 The Authors. Australasian Journal on Ageing © 2010 ACOTA.

  12. [Medication use among community-dwelling older Icelanders. Population-based study in urban and rural areas].

    Science.gov (United States)

    Sigurdardottir, Arun K; Arnadottir, Solveig Asa; Gunnarsdottir, Elín Díanna

    2011-12-01

    To describe medication use among older community-dwelling Icelanders by collecting information on number of medicine, polypharmacy (>5 medications), and medications by ATC categories. Moreover, to explore the relationship between medication use and various influential factors emphasizing residency in urban and rural areas. Population-based, cross-sectional study. Participants were randomly selected from the National registry in one urban (n=118) and two rural (n=68) areas. 1) ≥ 65 years old, 2) community-dwelling, 3) able to communicate verbally. Information on medication use was obtained from each person's medication list and interviews. A questionnaire and five standardized instruments were used to assess the potential influencing factors. On average, participants used 3.9 medications and prevalence of polypharmacy was 41%. Men used 3.5 medications on average and women 4.4 (p=0.018). Compared to rural residents, urban residents had fewer medical diagnoses, better mobility, less pain, and fewer depressive symptoms. By controlling for the effects of these variables, more medications were associated with urban living (pbetter scores on health assessments.

  13. Exploring factors associated with sexual activity in community-dwelling older adults.

    Science.gov (United States)

    Killinger, Kim A; Boura, Judith A; Diokno, Ananias C

    2014-01-01

    Sexuality is an important, yet often overlooked, aspect of successful aging. The current article explores potential relationships between sexual activity in older adults and marital status, health, mobility, urinary incontinence, and caffeine and alcohol use, as well as sexual desire and erectile function in women and men, respectively. A survey was mailed to community-dwelling older adults 60 and older. Of 242 respondents (79% ages 60 to 74, 53% male), 159 (65.7%) were sexually active. A higher proportion of sexually active adults were married (p = 0.0005), had better health (p = 0.0003), and drank alcohol (p = 0.007). A lower proportion of sexually active adults had urinary incontinence (p = 0.006). Similar proportions of men and women were sexually active (62.8% and 68.2%, respectively; p = 0.38). Sexually active women had better sexual desire scores (p Sexually active men had better mobility (p = 0.012) and erectile function (p sexually active men had incontinence (p sexual health in older adults. Copyright 2014, SLACK Incorporated.

  14. Magnitude and Correlates of Anemia in Elderly Women of a Resettlement Colony of Delhi

    Directory of Open Access Journals (Sweden)

    Tulika Singh

    2018-01-01

    Full Text Available Background: Anemia of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life of elderly women. Despite its clinical importance, anemia in the elderly women is underrecognized. Objectives: The objective of this study was to assess the magnitude and correlates of anemia in elderly women of a resettlement colony of Delhi. Materials and Methods: A community-based, cross-sectional study for the duration of 1 year was conducted among 512 geriatric women (≥60 years. Demographic characteristics, dietary assessment, and behavioral risk factors were determined by interview, and the participants underwent physical examination followed by hemoglobin estimation by HemoCue. Anemia was defined using the WHO criteria of hemoglobin <12 g/dl. Chi-square test was employed to study the association between sociodemographic factors and anemia followed by multivariate regression analysis. Results: The prevalence of anemia was 79.9% according to the WHO criteria of hemoglobin <12 g/dl in females. Age, education, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, history of worm infestation, and body mass index (BMI were significantly associated with anemia on univariate analysis. In multivariate analysis, age, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, and BMI were significant explanatory variables for anemia. Conclusion: Our study points out high prevalence of and some of the major factors associated with anemia in elderly women. The need of the hour is to include our elderly women under the gamut of National Anemia Prophylaxis Program.

  15. Aromatherapy: does it help to relieve pain, depression, anxiety, and stress in community-dwelling older persons?

    Science.gov (United States)

    Tang, Shuk Kwan; Tse, M Y Mimi

    2014-01-01

    To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (Paromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.

  16. Factors Associated with Choking During Meals; a Risk Indicator for Repetitive Fevers in The Elderly Community

    Directory of Open Access Journals (Sweden)

    Takeshi Nishiyama

    2017-04-01

    Full Text Available Background: Choking during meals is a common symptom in the elderly, however the factors associated with it have not been fully clarified. In this study, we examined the factors associated with choking during meals. Methods: The oral health status and practices that promote oral health conditions was surveyed in 1305 community dwelling elderly using a self-administered questionnaire. Eight items including satisfaction with their oral condition, denture fit, chewing ability, tooth brushing frequency, dental visits, exercises to train muscles for chewing and swallowing, choking during meals, and repetitive fever were selected for analysis. Results: 25.1% of the subjects experienced choking during meals, which was significantly associated with repetitive fever occurrence. Differences in satisfaction levels with their oral condition, denture fit, chewing ability, and tooth brushing frequency were observed between groups with and without choking. Age, satisfaction level, and chewing ability were significantly associated with choking during meals. Conclusions: This study demonstrated that choking during meals is a risk indicator for repetitive fever in the elderly living in community settings. Poor chewing ability and dissatisfaction with their oral condition were risk factors associated with choking. These results suggest that training the elderly to eat efficiently and safely and improving oral conditions is necessary for those who suffer from choking during meals to prevent repetitive fever.

  17. Cognitive impairment in elderly women

    DEFF Research Database (Denmark)

    Rasmussen, Henrik Berg; Bagger, Yu Z; Tankó, László B

    2006-01-01

    BACKGROUND: A variety of factors contribute to the development of cognitive impairment in elderly people. Previous studies have focused upon a single or a few risk factors. In this study we assessed and compared the significance of a wide variety of potential risk factors for cognitive impairment...... in postmenopausal women. METHODS: A total of 208 pairs of elderly women (mean age = 73.2 years) were examined in a cross-sectional case-control study. Each pair consisted of a case (with impaired cognition) and a control subject matched by age and educational status. Cognitive functions were determined using...

  18. Aging in community and local NGOs: Empowering marginalized older women in South Korea.

    Science.gov (United States)

    Yang, Yunjeong

    2017-10-23

    This article is based on an embedded case study of selected older people's self-help groups in urban South Korea, which aim to assist community-dwelling older adults, particularly poor and marginalized women, to age in their community and remain active and contributing members. The study highlights the importance of the role and capacity of nongovernmental organizations (NGOs) as partner organizations. Implications are important for other aging societies, particularly in Asia, where older women have been often confined by patriarchal oppression.

  19. Physical frailty predicts incident depressive symptoms in elderly people: prospective findings from the Obu Study of Health Promotion for the Elderly.

    Science.gov (United States)

    Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Yoshida, Daisuke; Anan, Yuya; Tsutsumimoto, Kota; Uemura, Kazuki; Liu-Ambrose, Teresa; Park, Hyuntae; Lee, Sanyoon; Suzuki, Takao

    2015-03-01

    The purpose of this study was to determine whether frailty is an important and independent predictor of incident depressive symptoms in elderly people without depressive symptoms at baseline. Fifteen-month prospective study. General community in Japan. A total of 3025 community-dwelling elderly people aged 65 years or over without depressive symptoms at baseline. The self-rated 15-item Geriatric Depression Scale was used to assess symptoms of depression with a score of 6 or more at baseline and 15-month follow-up. Participants underwent a structural interview designed to obtain demographic factors and frailty status, and completed cognitive testing with the Mini-Mental State Examination and physical performance testing with the Short Physical Performance Battery as potential predictors. At a 15-month follow-up survey, 226 participants (7.5%) reported the development of depressive symptoms. We found that frailty and poor self-rated general health (adjusted odds ratio 1.86, 95% confidence interval 1.30-2.66, P Examination, Short Physical Performance Battery, and Geriatric Depression Scale scores at baseline. Our findings suggested that frailty and poor self-rated general health were independent predictors of depressive symptoms in community-dwelling elderly people. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  20. Resilience in Rural Community-Dwelling Older Adults

    Science.gov (United States)

    Wells, Margaret

    2009-01-01

    Context: Identifying ways to meet the health care needs of older adults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps older adults adjust to the hardships associated with aging. Rural community-dwelling older adults often face unique challenges such…

  1. Effects of Improvement on Selective Attention: Developing Appropriate Somatosensory Video Game Interventions for Institutional-Dwelling Elderly with Disabilities

    Science.gov (United States)

    Chen, Shang-Ti; Chiang, I-Tsun; Liu, Eric Zhi-Feng; Chang, Maiga

    2012-01-01

    The purpose of this study was to develop appropriate somatosensory video game interventions on enhancing selective attention of institutional-dwelling elderly with disabilities. Fifty-eight participants aged 65[approximately]92 were recruited and divided into four groups, 4-week and 8-week experimental and two control groups, for evaluating the…

  2. Frailty as a Risk Factor for Falls Among Community Dwelling People: Evidence From a Meta-Analysis.

    Science.gov (United States)

    Cheng, Mei-Hsun; Chang, Shu-Fang

    2017-09-01

    This study was conducted to investigate the relationships between different frailty stages and the fall incidence rates of community-dwelling older adults. The differences between various frailty indicators regarding assessment accuracy of the fall incidence rates of community-dwelling elders were also analyzed. Finally, the relationship between frailty and recurrent falls was explored. This study comprised a systematic literature review and meta-analysis. Two researchers independently examined and extracted the related literature. The key search terms included frailty, frail, fall, older people, older, geriatric, and senior. The literature sampling period was from January 2001 to December 2016. The quality of each paper was assessed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases of the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and MEDLINE were used to conduct a systematic literature search by using the random effect mode to analyze the compiled papers. A total of 102,130 community-dwelling older adults ≥65 years of age and 33,503 older adults who had experienced a fall were compiled to investigate the relationship between frailty and falls. The meta-analysis results revealed that compared with robust older adults, frail older adults demonstrated the greatest risk for falls, followed by prefrail older adults. Furthermore, the use of different frailty indicators to predict the fall incidence rates of older adults yielded nonsignificantly different outcomes. In short, studies of either cardiovascular health or osteoporotic fracture indicators are effective for predicting the risk for falls in older people. Finally, this study confirmed that compared with robust older adults, frail older adults were more likely to experience recurrent falls. Frailty is a crucial healthcare topic of people with geriatric syndromes. Frail older adults are

  3. Association between butyrylcholinesterase K variant and mild cognitive impairment in the Thai community-dwelling patients.

    Science.gov (United States)

    Pongthanaracht, Natsalil; Yanarojana, Somchai; Pinthong, Darawan; Unchern, Supeenun; Thithapandha, Amnuay; Assantachai, Prasert; Supavilai, Porntip

    2017-01-01

    To study the association of the butyrylcholinesterase K variant (BChE-K) and the plasma BChE activity with mild cognitive impairment (MCI) in Thai community-dwelling patients. One hundred patients diagnosed with MCI and 100 control subjects were recruited from the community-dwelling setting in Bangkok, Thailand. The genotype and allele distributions of the BChE-K were determined by polymerase chain reaction and subsequent DNA sequencing. The BChE activity was measured in plasma according to the Ellman's method. The BChE-K allele frequencies in the Thai community-dwelling patients were in accordance with other ethnics. The BChE-K allele frequency in the control subjects (12%) was higher than that of MCI patients (5.5%), suggesting a protective role of BChE-K for MCI in the Thai community-dwelling patients. The BChE-K homozygotes were significantly associated with lower BChE activity. Our results suggested that the BChE-K may be implicated as a protective factor for MCI in the Thai community-dwelling patients, although a further study with a large sample size is warranted to confirm this.

  4. Effects of Lutein/Zeaxanthin Supplementation on the Cognitive Function of Community Dwelling Older Adults: A Randomized, Double-Masked, Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Billy R. Hammond

    2017-08-01

    Full Text Available Background: High levels of xanthophyll carotenoids lutein (L and zeaxanthin (Z in the central nervous system have been previously correlated with improved cognitive function in community-dwelling older adults. In this study, we tested the effects of supplementing L and Z on older men and women with a range of baseline cognitive abilities.Objective: The purpose of this study was to determine whether or not supplementation with L+Z could improve cognitive function in community-dwelling, older adults.Design: Double-masked, randomized, placebo-controlled trial. A total of 62 older adults were randomized into groups receiving either 12 mg L+Z or a visually identical placebo. Data from 51 participants (M = 73.7 years were available for analysis. Retinal L+Z levels (macular pigment optical density, MPOD were measured psychophysically using heterochromatic flicker photometry as a biomarker of cortical L+Z levels. Cognitive function was measured using the CNS Vital Signs computerized test platform.Results: Participants receiving the active L+Z supplement had statistically significant increases in MPOD (p < 0.03 and improvements in complex attention (p < 0.02 and cognitive flexibility domains (p < 0.04, relative to participants taking the placebo. A trend was also seen for the executive function domain (p = 0.073. In male participants only, supplementation yielded improved composite memory (p = 0.04.Conclusions: Supplementation with L+Z improved cognitive function in community-dwelling, older men and women.

  5. Albumin levels and cause-specific mortality in community-dwelling older adults.

    Science.gov (United States)

    Wu, Chen-Yi; Hu, Hsiao-Yun; Huang, Nicole; Chou, Yi-Chang; Li, Chung-Pin; Chou, Yiing-Jenq

    2018-04-09

    To investigate the association between serum albumin levels and cause-specific mortality among community-dwelling older adults. This cohort study was based on data obtained from the government-sponsored Annual Geriatric Health Examination Program for the older adults in Taipei City between 2006 and 2010. The study sample consisted of 77,531 community-dwelling Taipei citizens (≥65 years old). Mortality was determined by matching the participants' medical records with national death files. Serum albumin levels were categorized into dwelling older adults had a mean albumin level of 4.3 g/dL, which significantly reduced by age. Compared to albumin levels ≥4.4 g/dL, mildly low albumin levels (4.2-4.3 g/dL) were associated with an increased mortality risk (hazard ratio [HR]: 1.16, 95% confidence interval [CI]: 1.05-1.28 for all-cause mortality), and albumin levels dwelling older adults, and mortality risk increased as the albumin level decreased. Copyright © 2017. Published by Elsevier Inc.

  6. Transformation of dwelling culture based on riverine community in Musi River Palembang

    Science.gov (United States)

    Wicaksono, Bambang; Siswanto, Ari; Kusdiwanggo, Susilo; Anwar, Widya Fransiska Febriati

    2017-11-01

    Palembang City development since the Palembang Darussalam Sultanate era to the reformation era has impact on the living culture community, less of the raft houses, houses on stilts transformed into a terraced house, and the house became the dominant land. Dwelling Culture oriented on transformation of river become land-oriented. The development has leaving identity, character, and potential of the riverine architecture and dwelling life of river. The goals of study are to describe a case and revealing the meaning of dwelling cultural transformation in Musi River society from the process of cultural acculturation and investigate the architectural aspect from the form of house and modes of dwelling through the structuralism approach. The data collection is conducted qualitatively by using data collection techniques such as observation, interview, literature study, whereas the method of analysis, is a method that is done through Levi-Strauss structuralism approach that identifies all the elements of community thought in a systematic procedure. The results showed the structure behind the orientation, position, shape, and layout of dwelling revealed through the meanings in it. It means, the change and development from cultural acculturation process which oriented in the land dwelling, based on structure thinking of Palembang society.

  7. Life-space mobility and dimensions of depressive symptoms among community-dwelling older adults.

    Science.gov (United States)

    Polku, Hannele; Mikkola, Tuija M; Portegijs, Erja; Rantakokko, Merja; Kokko, Katja; Kauppinen, Markku; Rantanen, Taina; Viljanen, Anne

    2015-01-01

    To examine the association between life-space mobility and different dimensions of depressive symptoms among older community-dwelling people. Cross-sectional analyses of baseline data of the 'Life-Space Mobility in Old Age' cohort study were carried out. The participants were community-dwelling women and men aged 75-90 years (N = 848). Data were gathered via structured interviews in participants' home. Life-space mobility (the University of Alabama at Birmingham (UAB) Life-Space Assessment - questionnaire) and depressive symptoms (Centre for Epidemiological Studies Depression Scale, CES-D) were assessed. Other factors examined included sociodemographic factors, difficulties walking 500 m, number of chronic diseases and the sense of autonomy in participation outdoors (subscale of Impact on Participation and Autonomy questionnaire). Poorer life-space mobility was associated with higher prevalence of different dimensions of depressive symptoms. The associations were partially mediated through walking difficulties, health and the sense of autonomy in participation outdoor activities. Poorer life-space mobility interrelates with higher probability for depressive symptoms, thus compromising older adults' mental wellbeing. A focus on older adults' life-space mobility may assist early identification of persons, who have elevated risk for depressive symptoms. The association between life-space mobility and depressive symptoms should be studied further utilizing longitudinal study designs to examine temporality and potential causality.

  8. The relationship between serum IGF-1, handgrip strength, physical performance and falls in elderly men and women.

    Science.gov (United States)

    Van Nieuwpoort, Caroline; Vlot, Mariska; Schaap, Laura; Lips, Paul; Drent, Madeleine

    2018-05-22

    Human aging is accompanied by a decrease in growth hormone secretion and serum IGF-1 levels. Also, loss of muscle mass, strength and impairment of physical performance, ending in a state of frailty, are seen in elderly. We aimed to investigate whether handgrip strength, physical performance and recurrent falls are related to serum IGF-1 levels in community dwelling elderly. Observational cohort study (cross-sectional and prospective). We studied the association between IGF-1 and handgrip strength, physical performance and falls in participants of the Longitudinal Aging Study Amsterdam. 1292 participants were included (633 men, 659 women). Serum IGF-1 levels were divided into quartiles (IGF-1-Q1 to IGF-1-Q4). Data on falls were collected prospectively for a period of three years. All analyses were stratified for age and physical activity and adjusted for relevant confounders. Men with a low physical activity score in IGF-1-Q1 and IGF-1-Q2 of the younger age group had a lower handgrip strength compared to IGF-1-Q4. In younger more active males in IGF-1-Q2 physical performance was worse. Recurrent fallers were less prevalent in older, low active males with low IGF-1 levels. In females, recurrent fallers were more prevalent in older, more active females in IGF-1-Q2. IGF-1 quartile may predict changes in handgrip strength and physical performance in men and women. Our results indicate that lower IGF-1 levels are associated with lower handgrip strength and worse physical performance, but less recurrent fallers especially in men. Associations were often more robust in IGF-1-Q2. Future studies on this topic are desirable.

  9. Prospective Studies of Risk Factors Associated with Type 2 Diabetes, Cardiovascular Disease, and Mortality in Elderly Women

    DEFF Research Database (Denmark)

    Møller, Katrine Dragsbæk

    and novel risk factors and their relation to ageing, disease, and mortality in elderly Danish women. The studies are epidemiological in their character and based on data from the Prospective Epidemiological Risk Factor (PERF) study, a community-based cohort study on 5,855 elderly Danish women enrolled......The world’s population is ageing. With an increased life expectancy across the globe, more people will live into old age. Women outlive men averagely by four years, warranting an increased focus on healthy ageing in women. The demographic shift resulting in an increased fraction of elder...... individuals has given rise to concerns about whether the extra life years added are spent in good health or with disease conditions resulting in high impacts on health care systems, socioeconomic relations and on the individual level. The World Health Organization predicts the burden of non...

  10. Minor positive effects of health-promoting senior meetings for older community-dwelling persons on loneliness, social network, and social support

    Directory of Open Access Journals (Sweden)

    Gustafsson S

    2017-11-01

    Full Text Available Susanne Gustafsson,1,2 Helene Berglund,1,3 Joel Faronbi,1,4 Emmelie Barenfeld,1,2,5 Isabelle Ottenvall Hammar1,2 1Frail Elderly Research Support Group (FRESH, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, 2Gothenburg University Centre for Ageing and Health (AgeCap, 3Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; 4Department of Nursing Science, College of Health Science, Obafemi Awolowo University, Ile-Ife, Nigeria; 5Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden Objective: The aim of this study was to evaluate the 1-year effect of the health-promoting intervention “senior meetings” for older community-dwelling persons regarding loneliness, social network, and social support.Methods: Secondary analysis of data was carried out from two randomized controlled studies: Elderly Persons in the Risk Zone and Promoting Aging Migrants’ Capabilities. Data from 416 participants who attended the senior meetings and the control group at baseline and the 1-year follow-up in the respective studies were included. Data were aggregated and analyzed with chi-square test and odds ratio (OR to determine the intervention effect.Results: The senior meetings had a positive effect on social support regarding someone to turn to when in need of advice and backing (OR 1.72, p=0.01. No positive intervention effect could be identified for loneliness, social network, or other aspects of social support.Conclusion: Health-promoting senior meetings for older community-dwelling persons have a minor positive effect on social support. The senior meetings might benefit from a revision to reinforce content focused on loneliness, social network, and social support. However, the modest effect could also depend on the lack of accessible social resources to meet participants’ identified needs, a possible hindrance for a

  11. Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Ryu, Mikyung; Jo, Jaeseong; Lee, Yunhwan; Chung, Yoon-Sok; Kim, Kwang-Min; Baek, Weon-Chil

    2013-11-01

    this study examined the association of physical activity with sarcopenia and sarcopenic obesity among the community-dwelling Korean elderly. subjects consisted of 2,264 aged 65 years or older in the 2008-09 Korea National Health and Nutrition Examination Survey. Sarcopenia was defined as 2 SD below the mean of the appendicular skeletal muscle/weight for healthy young adults. Obesity was defined as waist circumference ≥ 90 cm for men and ≥ 85 cm for women. Levels of physical activity were classified using the metabolic equivalent task method. the prevalence of sarcopenia was 12.1% in men and 11.9% in women. Among those with sarcopenia, obesity was prevalent in 68.3% of men and 65.0% of women. Adjusting for all covariates, compared with those with low physical activity, men who engaged in moderate and high activity were 38% and 74%, respectively, less likely to have sarcopenia (Ptrend women, the relationship between physical activity and sarcopenia was not significant. For sarcopenic obesity, men participating in moderate [odds ratio (OR) = 0.47; 95% confidence interval (CI) 0.26-0.87] and high (OR = 0.27; 95% CI: 0.12-0.60) physical activity, compared with low activity, had significantly lower risk (Ptrend = 0.001). In women, high physical activity was associated with a lower risk of sarcopenic obesity (OR = 0.43; 95% CI: 0.22-0.86). physical activity is associated with a reduced risk of sarcopenia and sarcopenic obesity in older Korean adults. There were gender differences in the relationship, with stronger associations observed in men than in women.

  12. Assessing the Risk of Sarcopenia in the Elderly: The Mini Sarcopenia Risk Assessment (MSRA) Questionnaire.

    Science.gov (United States)

    Rossi, A P; Micciolo, R; Rubele, S; Fantin, F; Caliari, C; Zoico, E; Mazzali, G; Ferrari, E; Volpato, S; Zamboni, M

    2017-01-01

    to validate the MSRA questionnaire proposed as prescreening tool for sarcopenia, in a population of community-dwelling elderly subjects. observational study. community dwelling elderly subjects. 274 community dwelling elderly subjects, 177 women and 97 men, aged 66-78 years. Based on EWGSOP diagnostic criteria subjects were classified as sarcopenic and non-sarcopenic. The Mini Sarcopenia Risk Assessment (MSRA) questionnaire, is composed of seven questions and investigates anamnestic and nutritional characteristics related to risk of sarcopenia onset (age, protein and dairy products consumption, number of meals per day, physical activity level, number of hospitalizations and weight loss in the last year). 33.5% of the study population, were classified as sarcopenic. With the 7-item MSRA score, subjects with a score of 30 or less, had a 4-fold greater risk of being sarcopenic than subjects with a score higher than 30 (OR:4.20;95% CI:2.26-8.06); area under the ROC curve was 0.786 (95% CI:0.725-0.847). In a logistic regression, considering as dependent variable the probability of being sarcopenic, and as independent variables the 7 items of the questionnaire, two items (number of meals and milk and dairy products consumption) showed non-significant diagnostic power. A 5-item score was then derived and the area under the ROC curve was 0.789 (95% IC:0.728-0.851). Taking into account the cost of false positive and false negative costs and the prevalence of sarcopenia, the "optimal" threshold of the original MSRA score (based on 7 items) is 30, with a sensitivity of 0.804 and a specificity of 0.505, while the "optimal" threshold of the MSRA score based on 5 items, is 45, with a sensitivity of 0.804 and a specificity of 0.604. this preliminary study shows that the MSRA questionnaire is predictive of sarcopenia and can be suggested as prescreening instrument to detect this condition. The use of a short form of the MSRA questionnaire improves the capacity to identify

  13. Comparison of 2 Different Exercise Approaches: Tai Chi Versus Otago, in Community-Dwelling Older Women.

    Science.gov (United States)

    Son, Nam-Kuk; Ryu, Young Uk; Jeong, Hye-Won; Jang, Young-Hwan; Kim, Hyeong-Dong

    2016-01-01

    Regular exercise can delay age-related risk factors and can maintain or improve physical health and activity in older adults leading to a decrease in fall risk. The purpose of this study was to compare 2 different interventions for fall prevention, tai chi (TC) and Otago, by examining lower extremity strength, balance, and spatiotemporal gait parameters in community-dwelling older women. We performed a randomized trial in which subjects were assigned to 1 of 2 groups: the TC group (n = 21; age, 72.8 ± 4.7 years, range: 65-83 years), which participated in a modified Sun-style TC exercise program; and the Otago group (n = 24; age, 71.5 ± 3.6 years, range: 65-79 years), which participated in the Otago exercise program. The Timed Up and Go (TUG) test, functional reach (FR) test, one-leg standing (OLS) test, 5 times sit-to-stand test (5×STS), 30-second sit-to-stand (30s STS) test, and gait parameters (gait velocity, step length, step width, stride time, and cadence) were measured before and after the intervention. Both groups showed statistically significant improvements in balance (TUG and OLS tests), lower extremity strength (5×STS and 30s STS tests), and spatiotemporal gait parameters, except for step width and step length (P fall prevention.

  14. Fall risk in community-dwelling elderly cancer survivors: a predictive model for gerontological nurses.

    Science.gov (United States)

    Spoelstra, Sandra; Given, Barbara; von Eye, Alexander; Given, Charles

    2010-02-01

    The aim of this predictive study was to test a structural model to establish predictors of fall risk in elderly cancer survivors. An aging and nursing model of care was synthesized and used to examine the Minimum Data Set for 6,912 low-income older adult participants in a community setting in the midwestern United States. Data analysis established relationships among fall risk and age, race/ethnicity, history of a previous fall, depression, pain, activities of daily living, instrumental activities of daily living, incontinence, vision, and cognitive status. Factors leading to fall risk can direct nursing activities that have the potential to prevent falls, thus improving older adults' quality of life. Copyright 2010, SLACK Incorporated.

  15. Gender differences in positive life orientation among the nursing home elders in China: A cross-sectional study.

    Science.gov (United States)

    Jin, Cheng; Zheng, Zhibo; Xian, Wei; Bai, Ming; Jin, Liying; Li, Yuting; Yang, Xiufei; Sheng, Yang; Ai, Wensi; Liu, Hongbo

    2017-09-01

    Life orientation among the nursing home elders would differ from those of community-dwelling elders due to the different living environment, but may have greater differences in gender. This study was designed to investigate the positive life orientation and explore the potential risk factors including gender disparities among nursing home elders in China. This cross-sectional study was conducted in Northeast China. Two steps cluster sampling procedure were chosen. Basic activities of daily living (BADL) and instrumental activities of daily living (IADL) systems were used to estimate the functional status. Positive life orientation was measured using the six-question life orientation scale (LOS). 2512 nursing home elders were enrolled in the study. The mean age of the participants was 73.14±6.746years. Of the 1308 men and 1204 women, 14.9% had a positive life orientation in women and 16.1% in men. Higher level of education, independent in BADL and IADL were related to positive life orientation both in men and women. Age and BMI were also found to be significantly associated with positive life orientation in men (OR=0.587, 1.132, respectively). For women, the influence of income and vision on positive life orientation was also significant (OR=1.967, 1.926, respectively). The positive life orientation was higher in men than women. The gender-specific differences contribute to take more effective measures to improve the positive life orientation. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Association between butyrylcholinesterase K variant and mild cognitive impairment in the Thai community-dwelling patients

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    Pongthanaracht N

    2017-05-01

    Full Text Available Natsalil Pongthanaracht,1 Somchai Yanarojana,1 Darawan Pinthong,1 Supeenun Unchern,1 Amnuay Thithapandha,1 Prasert Assantachai,2 Porntip Supavilai11Department of Pharmacology, Faculty of Science, 2Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandObjective: To study the association of the butyrylcholinesterase K variant (BChE-K and the plasma BChE activity with mild cognitive impairment (MCI in Thai community-dwelling patients.Methods: One hundred patients diagnosed with MCI and 100 control subjects were recruited from the community-dwelling setting in Bangkok, Thailand. The genotype and allele distributions of the BChE-K were determined by polymerase chain reaction and subsequent DNA sequencing. The BChE activity was measured in plasma according to the Ellman’s method.Results: The BChE-K allele frequencies in the Thai community-dwelling patients were in accordance with other ethnics. The BChE-K allele frequency in the control subjects (12% was higher than that of MCI patients (5.5%, suggesting a protective role of BChE-K for MCI in the Thai community-dwelling patients. The BChE-K homozygotes were significantly associated with lower BChE activity.Conclusion: Our results suggested that the BChE-K may be implicated as a protective factor for MCI in the Thai community-dwelling patients, although a further study with a large sample size is warranted to confirm this.Keywords: butyrylcholinesterase K variant, butyrylcholinesterase activity, mild cognitive impairment, Thai community-dwelling patients

  17. Epidemiological profile of elderly women with burning mouth symptoms

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    Maria Vieira de Lima Saintrain

    2011-09-01

    Full Text Available Objective: To determine the epidemiological profile of elderly women with burning mouth symptoms. Methods: A cross sectional, quantitative, exploratory and descriptive study conducted in two phases: a determining the prevalence of burning mouth symptoms among 263 elderly women aged between 60 and 83 years who attended six public municipal community centers in Fortaleza-CE, Brazil, b defining the epidemiological profile of respondents with burning mouth symptoms, through the variables: self-reported diseases, salivary flow, use of medications, dental prosthesis and oral hygiene habits. Data were organized by the Statistical Package for Social Sciences - SPSS version 15. Results: The prevalence of burning mouth symptoms in the group was 19% (n=50. Of these, 41 (82.0% reported the manifestation of the symptoms as a scalding sensation. Regarding the occurrence, the most referred sites were: tongue (48%; n=24 and gums (22%; n=11. Among elderly women, 24 (48.0% had daily symptoms. Regarding self-reported diseases and habits: 80.0% cited cardiovascular diseases, 74.0% (n=37 musculoskeletal illness and 62.0% (n=31 neurological disorders, besides 56.0% (n=28 present reduction of salivary flow; 70.0% (n=35 took medication, 66.0% (n=33 were users of dental prosthesis and 18.0% (n=9 did not brush their teeth. Conclusions: The prevalence of burning mouth symptoms in this group was 19%; scalding sensation was the main manifestation of the symptom and the tongue was the site of major symptomatology. The epidemiological profile of symptomatic elderly was distinguished by self-reported diseases and habits such as cardiovascular, musculoskeletal and neurological disorders, in addition to reduced salivary flow, as well as the use of medications and dental prosthesis.

  18. Self-Management Group Exercise Extends Healthy Life Expectancy in Frail Community-Dwelling Older Adults.

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    Yamada, Minoru; Arai, Hidenori

    2017-05-15

    Preventing frailty and its adverse health outcomes is crucial in countries with a large elderly population, such as Japan. Since the long-term care insurance (LTCI) system was launched, the number of certified older adults with LTCI service requirement has continued to increase. This is a serious problem, because the LTCI service requirement certification is equivalent to disability. The aim of this study was to evaluate the effect of a self-management group intervention on new LTCI service requirement certifications in community-dwelling older adults in Japan. We analyzed the cohort data from a prospective study. In this study, we recruited community-dwelling adults aged 65 years and older who were independent in a city in Kyoto prefecture in 2012. The subjects in the participation group (n = 1620) attended 60-min group training sessions once or twice every two weeks from December 2012 to December 2016. The exercise sessions consisted of mild-intensity aerobic exercise, mild strength training, flexibility and balance exercises, and cool-down activities. These exercise classes were facilitated by well-trained volunteer staff. The outcome measure was the number of new LTCI requirement certifications during a four-year follow-up period. During the four-year follow-up period, 247 subjects (15.2%) in the participation group and 334 (20.6%) in the control group were newly certified for LTCI service requirements. The hazard ratio for new LTCI service requirements in the participation group compared with the control group was 0.73 (95% CI = 0.62-0.86) in the four-year follow-up period. These results indicate the usefulness of self-management group exercise to reduce the incidence of disability in older adults. Thus, increasing self-management group activities in each community should be encouraged.

  19. Síndrome da fragilidade no idoso comunitário com osteoartrite Frailty syndrome in the community-dwelling elderly with osteoarthritis

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    Rita de Cássia Corrêa Miguel

    2012-06-01

    Full Text Available OBJETIVO: Caracterizar e comparar idosos comunitários com osteoartrite (OA de joelhos e/ou quadris, com enfoque na síndrome da fragilidade. MéTODO: Estudo transversal com avaliação de características sociodemográficas, comorbidades, medicamentos, depressão, antropometria, quedas, dor, rigidez, função, fragilidade e avaliação subjetiva da saúde em idosos com OA de joelhos e/ou quadris a partir de subamostra do estudo sobre fragilidade em idosos brasileiros (FIBRA. RESULTADOS: A amostra final foi composta de 58 idosos (74 ± 5,50 anos, como segue: 17 (29,31% não frágeis, 28 (48,28% pré-frágeis e 13 (22,41% frágeis. O número de medicamentos foi maior no grupo frágil em comparação ao não frágil (7,00 ± 2,00 e 4,00 ± 2,00, respectivamente; P = 0,001. O Índice de Massa Corporal foi menor nos idosos não frágeis em comparação aos pré-frágeis e frágeis (média de 27,00 ± 4,50 kg/m², 30,00 ± 4,00 kg/m² e 34,00 ± 8,00 kg/m², respectivamente; P = 0,018. Depressão foi mais prevalente no grupo frágil. Em relação à saúde comparada ao ano anterior, houve diferença: 64,3% dos pré-frágeis e 46,2% dos frágeis acreditavam que sua saúde piorou; entre os não frágeis, 52,9% consideraram que a saúde permaneceu igual (P = 0,016. Quanto ao nível de atividade em relação ao ano anterior, pré-frágeis e frágeis relataram que houve piora (P = 0,010. Quanto à função e à autoeficácia para quedas, os frágeis mostraram-se piores que os demais (P = 0,023 e 0,017, respectivamente. Os outros itens avaliados não apresentaram diferenças significativas entre os grupos. CONCLUSÃO: Idosos com OA e fragilidade usam maior número de medicamentos, são mais obesos e mais deprimidos, têm pior percepção da saúde e do nível de atividade em relação ao ano anterior e pior autoeficácia para quedas e para função física.OBJECTIVE: To characterize and compare community-dwelling elderly with knee and/or hip osteoarthritis

  20. Comparison of two balance training programs on balance in community dwelling older adults

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    Shefali Walia

    2016-09-01

    Full Text Available Impaired balance has been associated with an increased risk for falls and a resulting increase in the mortality rate of elder people. Thus, balance-training interventions have an important place in fall prevention. This study was designed with the purpose of identifying the appropriate balance-training program for community dwelling elderly adults with an active lifestyle. A sample of 70 elderly adults were randomly allocated into two groups: group 1 (n=35 received general balance and mobility exercise; group 2 (n=35 received specific balance strategy training. The intervention consisted of 5 sessions/week for 4 weeks. The outcome measures were Timed up and go test (TUGT and Berg balance scale (BBS. An inter-group (2-way mixed model analysis of co-variance and intra-group (repeated measures analysis was done to find the change in balance scores. After the intervention, the TUGT scores in group 1 were, mean=10.38 s, standard deviation (SD=1.59 s and in group 2 were, mean=9.27 s, SD=1.13 s. Post training, BBS scores for group 1 were, mean=54.69, SD=1.13, and for group 2 were, mean=55.57, SD =0.56. There was a significant group × time effect for TUGT and BBS score. All the subjects showed significant changes in balance scores after balance training interventions. The subjects who participated in the specific balance-strategy training significantly improved their functional mobility, as shown on the TUGT, compared to the general training group.

  1. Related factors of cognitive impairment in community-dwelling older adults in Beijing Longitudinal Study of Aging.

    Science.gov (United States)

    Han, Rui; Tang, Zhe; Ma, Lina

    2018-04-09

    To investigate the prevalence and related factors of cognitive impairment in community-dwelling older residents in Beijing, China. This is a cross-sectional study. A total of 2017 older individuals aged ≥ 60 years from Beijing Longitudinal Study of Aging were included in this study. Information on demographic characteristics, life style, chronic disease and geriatric syndromes was collected. Cognitive function was assessed by Mini-Mental State Examination. The prevalence of cognitive impairment was 13.6% in community-dwelling older residents in Beijing. The prevalence of cognitive impairment was higher in women than it was in men and in rural areas than it was in urban areas, and increased with age. Logistic regression showed that older age [odds ratio (OR) = 1.496-3.033, P cognitive impairment. The prevalence of cognitive impairment among the older adults in Beijing was high. More attention should be paid to the identification of and intervention for factors influencing cognitive impairment, and health education should be carried out to improve the quality of life of the older adults.

  2. Depression and social networks in community dwelling elders: a descriptive study.

    Science.gov (United States)

    Wilby, Frances

    2011-04-01

    Social isolation and inadequate social support have been identified as correlates of depression in older adults, although the relationship between depression and social isolation is not entirely understood (Dorfman et al., 1995). This study was conducted to describe the social networks of depressed older adults living in the community and to compare the social networks of depressed and nondepressed individuals, thus adding to the body of knowledge regarding social networks, older adults, and depression. The sample consisted of 91 respondents aged 65 and older who were randomly selected using the voter registry. About 27% (25) respondents reported significant levels of depressive symptomology as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). All respondents completed semistructured interviews that included questions about social contacts with family and others during the prior week. All participants reported social contact with family and friends during this period. In this sample, depressed elders were not socially isolated. They were more likely to report contacts with friends than those who were not depressed, and equally likely to report involvement in volunteer activities. Their likelihood of seeking social support was also comparable. Results emphasize the importance of peer relationships and suggest that, in some groups of older adults, social isolation may not be a hallmark of depressive symptoms.

  3. Baseline and changes in serum uric acid independently predict 11-year incidence of metabolic syndrome among community-dwelling women.

    Science.gov (United States)

    Kawamoto, R; Ninomiya, D; Kasai, Y; Senzaki, K; Kusunoki, T; Ohtsuka, N; Kumagi, T

    2018-02-19

    Metabolic syndrome (MetS) is associated with an increased risk of major cardiovascular events. In women, increased serum uric acid (SUA) levels are associated with MetS and its components. However, whether baseline and changes in SUA predict incidence of MetS and its components remains unclear. The subjects comprised 407 women aged 71 ± 8 years from a rural village. We have identified participants who underwent a similar examination 11 years ago, and examined the relationship between baseline and changes in SUA, and MetS based on the modified criteria of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP) III report. Of these subjects, 83 (20.4%) women at baseline and 190 (46.7%) women at follow-up had MetS. Multiple linear regression analysis was performed to evaluate the contribution of each confounding factor for MetS; both baseline and changes in SUA as well as history of cardiovascular disease, low-density lipoprotein cholesterol, and estimated glomerular filtration ratio (eGFR) were independently and significantly associated with the number of MetS components during an 11-year follow-up. The adjusted odds ratios (ORs) (95% confidence interval) for incident MetS across tertiles of baseline SUA and changes in SUA were 1.00, 1.47 (0.82-2.65), and 3.11 (1.66-5.83), and 1.00, 1.88 (1.03-3.40), and 2.49 (1.38-4.47), respectively. In addition, the combined effect between increased baseline and changes in SUA was also a significant and independent determinant for the accumulation of MetS components (F = 20.29, p baseline MetS. These results suggested that combined assessment of baseline and changes in SUA levels provides increased information for incident MetS, independent of other confounding factors in community-dwelling women.

  4. Opinions of dentists on the barriers in providing oral health care to community-dwelling frail older people: a questionnaire survey.

    Science.gov (United States)

    Bots-VantSpijker, Pieternella C; Bruers, Josef J M; Bots, Casper P; Vanobbergen, Jacques N O; De Visschere, Luc M J; de Baat, Cees; Schols, Jos M G A

    2016-06-01

    The aim of this study was to investigate to what extent dentists in the Netherlands experience barriers in providing oral health care to community-dwelling older people. As most publications on the barriers in providing oral health care to older people consist of surveys on oral health care in care homes, it was decided to investigate the barriers dentists experience in their own dental practices while providing oral health care to community-dwelling frail older people. A representative sample of 1592 of the approximately 8000 dentists in the Netherlands aged 64 or younger were invited to respond to a questionnaire online. The dentists were asked to respond to 15 opinions concerning oral healthcare provision to community-dwelling frail older people aged 75 years or more who experience problems in physical, psychological and social areas, as well as possible financial problems. The total response rate was 37% (n = 595; male=76%; average age 49). The majority of those who responded agreed that the reimbursement of oral health care to older people is poor. Two thirds of those who responded (66%) agreed that there are limited opportunities to refer the frail and elderly with complex oral healthcare problems to a colleague with specific knowledge and skills. Dentists experienced barriers in two domains; a lack of knowledge and practical circumstances. It was concluded that the dentist's gender, age, year of graduation and the number of patients aged 75 years or more treated weekly were in some respect, related to the barriers encountered. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  5. Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant

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    Ma Shwe Zin Nyunt

    2013-10-01

    Full Text Available Background: The Clinical Dementia Rating (CDR scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI and evaluated its reliability and validity for assessing mild cognitive impairment (MCI and dementia among community-dwelling elderly subjects. Method: At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE Results: The CDR-NI scores (0, 0.5, 1 showed good internal consistency (Crohnbach's a 0.83-0.84, inter-rater reliability (κ 0.77-1.00 for six domains and 0.95 for global rating and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating, good agreement (κ 0.79 with the clinical assessment status of MCI (n = 37 and dementia (n = 4 and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p Conclusion: Owing to the protocol of the interviews, assessments and structured observations gathered during the two visits, CDR-NI provides valid and reliable assessment of MCI and dementia in community-living elderly subjects without an informant.

  6. Normative scores on the Berg Balance Scale decline after age 70 years in healthy community-dwelling people: a systematic review.

    Science.gov (United States)

    Downs, Stephen; Marquez, Jodie; Chiarelli, Pauline

    2014-06-01

    What is the mean Berg Balance Scale score of healthy elderly people living in the community and how does it vary with age? How much variability in Berg Balance Scale scores is present in groups of healthy elderly people and how does this vary with age? Systematic review with meta-analysis. Any group of healthy community-dwelling people with a mean age of 70 years or greater that has undergone assessment using the Berg Balance Scale. Mean and standard deviations of Berg Balance Scale scores within cohorts of elderly people of known mean age. The search yielded 17 relevant studies contributing data from a total of 1363 participants. The mean Berg Balance Scale scores ranged from 37 to 55 out of a possible maximum score of 56. The standard deviation of Berg Balance Scale scores varied from 1.0 to 9.2. Although participants aged around 70 years had very close to normal Berg Balance Scale scores, there was a significant decline in balance with age at a rate of 0.7 points on the 56-point Berg Balance Scale per year. There was also a strong association between increasing age and increasing variability in balance (R(2) = 0.56, p balance deficits, as measured by the Berg Balance Scale, although balance scores deteriorate and become more variable with age. Copyright © 2014. Published by Elsevier B.V.

  7. The impact of community-acquired pneumonia on the health-related quality-of-life in elderly.

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    Mangen, Marie-Josée J; Huijts, Susanne M; Bonten, Marc J M; de Wit, G Ardine

    2017-03-14

    The sustained health-related quality-of-life of patients surviving community-acquired pneumonia has not been accurately quantified. The aim of the current study was to quantify differences in health-related quality-of-life of community-dwelling elderly with and without community-acquired pneumonia during a 12-month follow-up period. In a matched cohort study design, nested in a prospective randomized double-blind placebo-controlled trial on the efficacy of the 13-valent pneumococcal vaccine in community-dwelling persons of ≥65 years, health-related quality-of-life was assessed in 562 subjects hospitalized with suspected community-acquired pneumonia (i.e. diseased cohort) and 1145 unaffected persons (i.e. non-diseased cohort) matched to pneumonia cases on age, sex, and health status (EQ-5D-3L-index). Health-related quality-of-life was determined 1-2 weeks after hospital discharge/inclusion and 1, 6 and 12 months thereafter, using Euroqol EQ-5D-3L and Short Form-36 Health survey questionnaires. One-year quality-adjusted life years (QALY) were estimated for both diseased and non-diseased cohorts. Separate analyses were performed for pneumonia cases with and without radiologically confirmed community-acquired pneumonia. The one-year excess QALY loss attributed to community-acquired pneumonia was 0.13. Mortality in the post-discharge follow-up year was 8.4% in community-acquired pneumonia patients and 1.2% in non-diseased persons (p pneumonia patients, compared to non-diseased persons, but differences in health-related quality-of-life between radiologically confirmed and non-confirmed community-acquired pneumonia cases were not statistically significant. Community-acquired pneumonia was associated with a six-fold increased mortality and 16% lower quality-of-life in the post-discharge year among patients surviving hospitalization for community-acquired pneumonia, compared to non-diseased persons. ClinicalTrials.gov, NCT00812084 .

  8. Relationship between functional vision and balance and mobility performance in community-dwelling older adults.

    Science.gov (United States)

    Aartolahti, Eeva; Häkkinen, Arja; Lönnroos, Eija; Kautiainen, Hannu; Sulkava, Raimo; Hartikainen, Sirpa

    2013-10-01

    Vision is an important prerequisite for balance control and mobility. The role of objectively measured visual functions has been previously studied but less is known about associations of functional vision, that refers to self-perceived vision-based ability to perform daily activities. The aim of the study was to investigate the relationship between functional vision and balance and mobility performance in a community-based sample of older adults. This study is part of a Geriatric Multidisciplinary Strategy for the Good Care of the Elderly project (GeMS). Participants (576) aged 76-100 years (mean age 81 years, 70 % women) were interviewed using a seven-item functional vision questionnaire (VF-7). Balance and mobility were measured by the Berg balance scale (BBS), timed up and go (TUG), chair stand test, and maximal walking speed. In addition, self-reported fear of falling, depressive symptoms (15-item Geriatric Depression Scale), cognition (Mini-Mental State Examination) and physical activity (Grimby) were assessed. In the analysis, participants were classified into poor, moderate, or good functional vision groups. The poor functional vision group (n = 95) had more comorbidities, depressed mood, cognition decline, fear of falling, and reduced physical activity compared to participants with moderate (n = 222) or good functional vision (n = 259). Participants with poor functional vision performed worse on all balance and mobility tests. After adjusting for gender, age, chronic conditions, and cognition, the linearity remained statistically significant between functional vision and BBS (p = 0.013), TUG (p = 0.010), and maximal walking speed (p = 0.008), but not between functional vision and chair stand (p = 0.069). Poor functional vision is related to weaker balance and mobility performance in community-dwelling older adults. This highlights the importance of widespread assessment of health, including functional vision, to prevent balance impairment and maintain

  9. 'No more strangers': Investigating the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling aboriginal women in northern Australia.

    Science.gov (United States)

    Josif, Cathryn M; Barclay, Lesley; Kruske, Sue; Kildea, Sue

    2014-03-01

    to describe the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling Aboriginal women transferred to a regional centre in northern Australia for maternity care and birth. a mixed method design within a Participatory Action Research approach was used. Qualitative findings are presented here. Data for this paper were collected from semi-structured interviews, field notes and observations and analysed thematically. the 'top end' of the Northern Territory of Australia. a total of 66 participants included six MGP midwives, two Aboriginal Health Workers and one Senior Aboriginal Woman working in the new model; eight hospital midwives; 34 Department of Health staff, three staff from other agencies; and 12 remote dwelling Aboriginal women who used the service. the study generated one overarching theme, it's not a perfect system but it's changing. This encompassed improvements to the services evident to all participants. Core themes related to the previous maternity service which was described as the arduous journey, the new model was seen as a new way of working and a resultant very different journey occurred for Aboriginal women using the service. there was a dissonance between the previous culture of maternity services and the woman centred focus of the new model. Over 12 months initial resistance to the new model diminished and it became highly valued. The transfer of information between the regional service and remote community health centres improved as did the safety and quality of care. Aboriginal women can access continuity of carer in the regional centre for the first time and reported a more positive experience with maternity services. The new model appears to have changed the cultural responsiveness of the regional maternity service; and care provided for remote dwelling women within this service. The qualitative findings inform others seeking to implement a similar model of care for remote

  10. Elderly Men Have Low Levels of Anti-Müllerian Hormone and Inhibin B, but with High Interpersonal Variation: A Cross-Sectional Study of the Sertoli Cell Hormones in 615 Community-Dwelling Men

    Science.gov (United States)

    Chong, Yih Harng; Dennis, Nicola A.; Connolly, Martin J.; Teh, Ruth; Jones, Gregory T.; van Rij, Andre M.; Farrand, Stephanie; Campbell, A. John; MLennan, Ian S.

    2013-01-01

    The Sertoli cells of the testes secrete anti-Müllerian hormone (Müllerian inhibiting Substance, AMH) and inhibin B (InhB). AMH triggers the degeneration of the uterine precursor in male embryos, whereas InhB is part of the gonadal-pituitary axis for the regulation of sperm production in adults. However, both hormones are also putative regulators of homeostasis, and age-related changes in these hormones may therefore be important to the health status of elderly men. The levels of AMH in elderly men are unknown, with limited information being available about age-related changes in InhB. We have therefore used ELISAs to measure Sertoli cell hormone levels in 3 cohorts of community-dwelling men in New Zealand. In total, 615 men were examined, 493 of which were aged 65 or older. Serum AMH and InhB levels inversely correlated with age in men older than 50 years (p<0.001) but not in the younger men. A minority of elderly men had undetectable levels of AMH and InhB. The variation in hormone levels between similarly aged men increased with the age of men. AMH and InhB partially correlated with each other as expected (r = 0.48, p<0.001). However, the ratio of the two Sertoli hormones varied significantly between men, with this variation increasing with age. Elderly men selected for the absence of cardiovascular disease had AMH levels similar to those of young men whereas their InhB levels did not differ from aged-matched controls. These data suggests that Sertoli cell number and function changes with age, but with the extent and nature of the changes varying between men. PMID:23940675

  11. Maintenance of exercise-induced benefits in physical functioning and bone among elderly women.

    Science.gov (United States)

    Karinkanta, S; Heinonen, A; Sievänen, H; Uusi-Rasi, K; Fogelholm, M; Kannus, P

    2009-04-01

    This study showed that about a half of the exercise-induced gain in dynamic balance and bone strength was maintained one year after cessation of the supervised high-intensity training of home-dwelling elderly women. However, to maintain exercise-induced gains in lower limb muscle force and physical functioning, continued training seems necessary. Maintenance of exercise-induced benefits in physical functioning and bone structure was assessed one year after cessation of 12-month randomized controlled exercise intervention. Originally 149 healthy women 70-78 years of age participated in the 12-month exercise RCT and 120 (81%) of them completed the follow-up study. Self-rated physical functioning, dynamic balance, leg extensor force, and bone structure were assessed. During the intervention, exercise increased dynamic balance by 7% in the combination resistance and balance-jumping training group (COMB). At the follow-up, a 4% (95% CI: 1-8%) gain compared with the controls was still seen, while the exercise-induced isometric leg extension force and self-rated physical functioning benefits had disappeared. During the intervention, at least twice a week trained COMB subjects obtained a significant 2% benefit in tibial shaft bone strength index compared to the controls. A half of this benefit seemed to be maintained at the follow-up. Exercise-induced benefits in dynamic balance and rigidity in the tibial shaft may partly be maintained one year after cessation of a supervised 12-month multi-component training in initially healthy elderly women. However, to maintain the achieved gains in muscle force and physical functioning, continued training seems necessary.

  12. Documentation of daily sit-to-stands performed by community-dwelling adults.

    Science.gov (United States)

    Bohannon, Richard W; Barreca, Susan R; Shove, Megan E; Lambert, Cynthia; Masters, Lisa M; Sigouin, Christopher S

    2008-01-01

    No information exists about how many sit-to-stands (STSs) are performed daily by community-dwelling adults. We, therefore, examined the feasibility of using a tally counter to document daily STSs, documented the number of daily STSs performed, and determined if the number of STSs was influenced by demographic or health variables. Ninety-eight community-dwelling adults (19-84 years) agreed to participate. After providing demographic and health information, subjects used a tally counter to document the number of STSs performed daily for 7 consecutive days. All but two subjects judged their counter-documented STS number to be accurate. Excluding data from these and two other subjects, the mean number of STSs for subjects was 42.8 to 49.3, depending on the day. The number was significantly higher on weekdays than weekends. No demographic or health variable was significantly related to the number of STSs in univariate or multivariate analysis. In conclusion, this study suggests that a tally counter may be a practical aid to documenting STS activity. The STS repetitions recorded by the counter in this study provide an estimate of the number of STSs that community-dwelling adults perform daily.

  13. Frailty as a Predictor of Future Falls Among Community-Dwelling Older People: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kojima, Gotaro

    2015-12-01

    Although multiple longitudinal studies have investigated frailty as a predictor of future falls, the results were mixed. Thus far, no systematic review or meta-analysis on this topic has been conducted. To review the evidence of frailty as a predictor of future falls among community-dwelling older people. Systematic review of literature and meta-analysis were performed using 6 electronic databases (Embase, Scopus, MEDLINE, CINAHL Plus, PsycINFO, and the Cochrane Library) searching for studies that prospectively examined risk of future fall risk according to frailty among community-dwelling older people published from 2010 to April 2015 with no language restrictions. Of 2245 studies identified through the systematic review, 11 studies incorporating 68,723 individuals were included in the meta-analysis. Among 7 studies reporting odds ratios (ORs), frailty and prefrailty were significantly associated with higher risk of future falls (pooled OR = 1.84, 95% confidence interval [95% CI] = 1.43-2.38, P dwelling older people despite various criteria used to define frailty. The future fall risk according to frailty seemed to be higher in men than in women. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  14. Perceived Effectiveness of Elder Abuse Interventions in Psychological Distress and the Design of Culturally Adapted Interventions: A Qualitative Study in the Chinese Community in Chicago

    Directory of Open Access Journals (Sweden)

    XinQi Dong

    2013-01-01

    Full Text Available This qualitative study examines US Chinese older adults’ views on the perceived effectiveness, challenges, and cultural adaptations of elder abuse interventions to psychological distress in the Chinese community in Chicago. A community-based participatory research approach was implemented to partner with the Chinese community. A total of 37 community-dwelling Chinese older adults (age 60+ participated in focus group discussions. Data analysis was based on grounded theory framework. Our findings suggest that older adults perceived social support, empowerment, and community-based interventions design as most effective to promote psychological well-being of victims. The perceived preferences were similar between elder abuse victims and non-victims. Strategies to culturally adapt evidence-based interventions were proposed with respect to nurturing filial piety values, familial integrations, and increased independence. Research and educational outreach initiatives were also discussed. This study has wide policy and practice implications for designing and deploying interventions to reduce psychological distress with respect to elder abuse outcome. Cultural relevancy of health interventions is important in the context of the Chinese communities. Collective federal, state, and community efforts are needed to support the culturally appropriate design and implementation of interventions suitable for the needs of the Chinese older adults.

  15. The Association between Total Protein and Vegetable Protein Intake and Low Muscle Mass among the Community-Dwelling Elderly Population in Northern Taiwan

    Directory of Open Access Journals (Sweden)

    Ru-Yi Huang

    2016-06-01

    Full Text Available Sarcopenia, highly linked with fall, frailty, and disease burden, is an emerging problem in aging society. Higher protein intake has been suggested to maintain nitrogen balance. Our objective was to investigate whether pre-sarcopenia status was associated with lower protein intake. A total of 327 community-dwelling elderly people were recruited for a cross-sectional study. We adopted the multivariate nutrient density model to identify associations between low muscle mass and dietary protein intake. The general linear regression models were applied to estimate skeletal muscle mass index across the quartiles of total protein and vegetable protein density. Participants with diets in the lowest quartile of total protein density (<13.2% were at a higher risk for low muscle mass (odds ratio (OR 3.03, 95% confidence interval (CI 1.37–6.72 than those with diets in the highest quartile (≥17.2%. Similarly, participants with diets in the lowest quartile of vegetable protein density (<5.8% were at a higher risk for low muscle mass (OR 2.34, 95% CI 1.14–4.83 than those with diets in the highest quartile (≥9.4%. Furthermore, the estimated skeletal muscle mass index increased significantly across the quartiles of total protein density (p = 0.023 and vegetable protein density (p = 0.025. Increasing daily intakes of total protein and vegetable protein densities appears to confer protection against pre-sarcopenia status.

  16. Religious well-being in noninstitutionalized elderly women.

    Science.gov (United States)

    Zorn, C R; Johnson, M T

    1997-01-01

    Spirituality is recognized as an important component of health care practice with elderly people. Yet, discussion of the role it plays in elderly women on a day-to-day basis is minimal, and it is frequently not addressed in quality-of-life studies in this population. The purposes of this study were to describe the level of religious well-being and selected characteristics of religiosity in a sample of 114 non-institutionalized, largely rural elderly women (Mdn age = 75), as well as to identify the relationship between selected factors and the level of religious well-being. Descriptive research revealed a high level of religious well-being among the participants and significant positive correlation between religious well-being and the variables of social support and hope (p hope emerged as the single significant predictor of religious well-being (p religious activities, highly rated the value or influence of religious beliefs in their lives, and identified that religious beliefs become increasingly important with age. Conducting a comprehensive assessment and implementing focused interventions associated with religious well-being will strengthen the scope of health care practice for elderly women.

  17. Aging and Identity: Meanings of Elderly Women

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    Irani Iracema de Lima Argimon

    2012-06-01

    Full Text Available This paper presents the results of a survey that focus on reflections on the construction of identity in elderly women. Interviews were conducted by semi-structured form with six elderly women and the data were analyzed based on the Comprehensive Review of Phenomenological Base. Not reduce the subject to biological, genetic, social allows us to develop these projects and achievements in this time of life where the experience can lead to a better well-being and quality of life.

  18. Novel use of the Wii Balance Board to prospectively predict falls in community-dwelling older adults.

    Science.gov (United States)

    Kwok, Boon-Chong; Clark, Ross A; Pua, Yong-Hao

    2015-06-01

    The Wii Balance Board has received increasing attention as a balance measurement tool; however its ability to prospectively predict falls is unknown. This exploratory study investigated the use of the Wii Balance Board and other clinical-based measures for prospectively predicting falls among community-dwelling older adults. Seventy-three community-dwelling men and women, aged 60-85years were followed-up over a year for falls. Standing balance was indexed by sway velocities measured using the Wii Balance Board interfaced with a laptop. Clinical-based measures included Short Physical Performance Battery, gait speed and Timed-Up-and-Go test. Multivariable regression analyses were used to assess the ability of the Wii Balance Board measure to complement the TUG test in fall screening. Individually, the study found Wii Balance Board anteroposterior (odds ratio 1.98, 95% CI 1.16 to 3.40, P=0.01) and mediolateral (odds ratio 2.80, 95% CI 1.10 to 7.13, p=0.03) sway velocity measures predictive of prospective falls. However, when each velocity measure was adjusted with body mass index and Timed-Up-and-Go, only anteroposterior sway velocity was predictive of prospective falls (odds ratio 2.21, 95% CI 1.18 to 4.14). A faster anteroposterior velocity was associated with increased odds of falling. Area-under-the-curves for Wii Balance Board sway velocities were 0.67 and 0.71 for anteroposterior and mediolateral respectively. The Wii Balance Board-derived anteroposterior sway velocity measure could complement existing clinical-based measures in predicting future falls among community-dwelling older adults. Australian New Zealand Clinical Trials Registry number: ACTRN12610001099011. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Level of physical activity in men and women with chronic stroke.

    Science.gov (United States)

    Vahlberg, Birgit; Bring, Annika; Hellström, Karin; Zetterberg, Lena

    2018-04-16

    Community-dwelling stroke survivors generally show low levels of physical activity (PA). An improved understanding of the factors influencing participation in PA after stroke is imperative to improve levels of PA. Furthermore, gender differences in PA have received little attention in stroke research. The objective of this study was to examine gender differences in PA, physical functioning and psychological factors and the association between these factors and PA in men and women 1-3-year post-stroke. A total of 187 community-dwelling individuals with stroke (65-85 years old, 29% women) were included in a secondary analysis based on data from a cross-sectional study. The exclusion criteria were severe cognitive or language dysfunction or dementia. The level of PA was measured by the Physical Activity Scale for the Elderly. Physical function included balance, walking speed and mobility. Psychological factors included depression, health-related quality of life and fall-related self-efficacy. Falls and fear of falling were each measured with a single question. There were no significant differences in PA levels between men and women. In multiple regression analyses, walking speed (p men, and balance (p = 0.038) was associated with PA in women. The results indicate that strategies to increase PA levels 1-3-year post-stroke could be improved by considering gender-specific factors.

  20. Neighborhood attributes security and solidarity promote the well-being of community-dwelling older people in the Netherlands.

    Science.gov (United States)

    Cramm, Jane M; Nieboer, Anna P

    2014-07-01

    To determine whether the neighborhood attributes solidarity and security positively affect the well-being of community-dwelling older people in the Netherlands after accounting for individual characteristics, and to test if a higher level of security in combination with a stronger sense of neighborhood solidarity results in a higher level of well-being. The study sample for the cross-sectional study consisted of 869 out of 2212 (39% response rate) independently-living older adults (aged >70 years) in 92 neighborhoods of Rotterdam. We fitted a hierarchical random-effects model to account for the structure of the study design: 869 older people (level 1) nested in 92 neighborhoods (level 2) in 10 districts (level 3). Neighborhood security and solidarity among neighbors varied significantly among the 10 districts. Univariate analyses showed that education, income, neighborhood security and solidarity within neighborhoods (all P ≤ 0.001) were significantly related to the well-being of community-dwelling older people. Multilevel analyses showed neighborhood security and solidarity within neighborhoods predicted the well-being of community-dwelling older people. Furthermore, a positive interaction effect was found between neighborhood security and solidarity within neighborhoods, and well-being of community-dwelling older people. Neighborhood security and solidarity among neighbors are important for the well-being of community-dwelling older people. Furthermore, neighborhoods with high levels of perceived security in combination with stronger solidarity among neighbors are especially beneficial to the well-being of community-dwelling older people. © 2013 Japan Geriatrics Society.

  1. Breast cancer in elderly women – perspective of geriatricians

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    Thaís Cano Miranda

    2008-03-01

    Full Text Available Breast cancer is one of the neoplasms with highest incidence andprevalence among women. Elderly women are frequently excludedfrom clinical trials and very few prospective data on this age groupare collected. In this article, we reviewed some aspects of this typeof cancer in the elderly population. Although elderly women arefrequently spared of full doses of toxic treatments, some data suggest that there is significantly higher benefit when normal-dose therapy is well tolerated. The current review suggests that chronological age by itself should not be a criterion to withhold chemotherapy. Due to heterogeneity in the geriatric population, prospective studies are necessary to address global geriatric assessment.

  2. A survey of foot problems in community-dwelling older Greek Australians

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    Menz Hylton B

    2011-10-01

    Full Text Available Abstract Background Foot problems are common in older people and are associated with impaired mobility and quality of life. However, the characteristics of foot problems in older Australians for whom English is a second language have not been evaluated. Methods One hundred and four community-dwelling people aged 64 to 90 years with disabling foot pain (according to the case definition of the Manchester Foot Pain and Disability Index, or MFPDI were recruited from four Greek elderly citizens clubs in Melbourne, Australia. All participants completed a Greek language questionnaire consisting of general medical history, the Medical Outcomes Study Short-Form 36 (SF-36 questionnaire, the MFPDI, and specific questions relating to foot problems and podiatry service utilisation. In addition, all participants underwent a brief clinical foot assessment. Results The MFPDI score ranged from 1 to 30 (median 14, out of a total possible score of 34. Women had significantly higher total MFPDI scores and MFPDI subscale scores. The MFPDI total score and subscale scores were significantly associated with most of the SF-36 subscale scores. The most commonly reported foot problem was difficulty finding comfortable shoes (38%, and the most commonly observed foot problem was the presence of hyperkeratotic lesions (29%. Only 13% of participants were currently receiving podiatry treatment, and 40% stated that they required more help looking after their feet. Those who reported difficulty finding comfortable shoes were more likely to be female, and those who required more help looking after their feet were more likely to be living alone and have osteoarthritis in their knees or back. Conclusions Foot problems appear to be common in older Greek Australians, have a greater impact on women, and are associated with reduced health-related quality of life. These findings are broadly similar to previous studies in English-speaking older people in Australia. However, only a small

  3. [Association of the physical activity of community-dwelling older adults with transportation modes, depression and social networks].

    Science.gov (United States)

    Tsunoda, Kenji; Mitsuishi, Yasuhiro; Tsuji, Taishi; Yoon, Ji-Yeong; Muraki, Toshiaki; Hotta, Kazushi; Okura, Tomohiro

    2011-01-01

    The purpose of this study was to cross-sectionally examine the relationships among leisure, household and occupational physical activity with the frequency of going out by various transportation modes, depression and social networks in older adults. We randomly selected a total of 2,100 community-dwelling adults aged 65 to 85 years of age from the Basic Resident Register. Of these, 340 people were the subjects of this study. The scales of measurement used were the Physical Activity Scale for the Elderly, the Lubben Social Network Scale (LSNS) and the Geriatric Depression Scale (GDS). In a regression model, leisure-time physical activity significantly correlated with frequency of going out by bicycle (β=0.17) and LSNS score (β=0.17). Household physical activity and occupational physical activity were significantly correlated with LSNS score (β=0.21) and frequency of going out by motor vehicle (β=0.25), respectively. For total physical activity, in the 3 above-mentioned activities a significant correlation was observed among frequency of going out by bicycle (β=0.10), by motor vehicle (β=0.23), GDS score (β=-0.16) and LSNS score (β=0.23). These results indicate that the frequency of going out by bicycle and by motor vehicle were significant factors to predict leisure and occupational physical activity. Furthermore, social networks appear to be important determiners in leisure and household physical activity in community-dwelling older adults.

  4. [Systematic review of fall-related factors among the house-dwelling elderly in Japan].

    Science.gov (United States)

    Ueno, Megumi; Kawai, Sachio; Mino, Tairai; Kamoshita, Hiroshi

    2006-01-01

    Fall-related factors and individual characteristics of the elderly who have had fall are necessary to develop practical fall prevention programs, and life support management. However, no nation-wide meta-analysis of the fall-related factors of elderly has been performed in Japan. To conduct a meta-analysis concerning fall-related factors among the house-dwelling elderly in Japan. Japana Centra Revuo Medicina, version 3 (systematic literature search system for Japanese literature), and Pub Med (a service of the National Library of Medicine) from January 1994 to December 2003. Study search terms included the following: retrograde case-control, prospective cohort, and retrospective cohort study with falls. Search terms included older adults (60 years and over), falls and humans. Thirty-two fall-related factors were meta-analyzed. Among 32 fall-related factors, only nine factors were statistically proven to be related to falls. These factors were female gender, age over 70 years old, fall experience, past history of cerebrovascular disease, grip strength, knee extensor strength, one foot standing time with eyes open, one foot standing time with eyes closed, and skinfold thickness (female). Eleven factors: presence of a spouse, past medical history of hypertension, complaints of dizziness, numbness of the extremities, 10 meter maximum walking velocity, tendency to stumble, use of supportive equipment, standing postural sway. sitting trunk flexion, skinfold thickness (male), and body mass index, were not statistically proven to be related to falls. More studies are necessary to determine the efficacy of fall-related factors among the Japanese elderly.

  5. Measurement and visualization of face-to-face interaction among community-dwelling older adults using wearable sensors.

    Science.gov (United States)

    Masumoto, Kouhei; Yaguchi, Takaharu; Matsuda, Hiroshi; Tani, Hideaki; Tozuka, Keisuke; Kondo, Narihiko; Okada, Shuichi

    2017-10-01

    A number of interventions have been undertaken to develop and promote social networks among community-dwelling older adults. However, it has been difficult to examine the effects of these interventions, because of problems in assessing interactions. The present study was designed to quantitatively measure and visualize face-to-face interactions among elderly participants in an exercise program. We also examined relationships among interactional variables, personality and interest in community involvement, including interactions with the local community. Older adults living in the same community were recruited to participate in an exercise program that consisted of four sessions. We collected data on face-to-face interactions of the participants by using a wearable sensor technology device. Network analysis identified the communication networks of participants in the exercise program, as well as changes in these networks. Additionally, there were significant correlations between the number of people involved in face-to-face interactions and changes in both interest in community involvement and interactions with local community residents, as well as personality traits, including agreeableness. Social networks in the community are essential for solving problems caused by the aging society. We showed the possible applications of face-to-face interactional data for identifying core participants having many interactions, and isolated participants having only a few interactions within the community. Such data would be useful for carrying out efficient interventions for increasing participants' involvement with their community. Geriatr Gerontol Int 2017; 17: 1752-1758. © 2017 Japan Geriatrics Society.

  6. Impact of Blunted Perception of Dyspnea on Medical Care Use and Expenditure, and Mortality in Elderly People

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    Satoru eEbihara

    2012-07-01

    Full Text Available Dyspnea is an alarming symptom responsible for millions of patient visits each year. Poor perception of dyspnea might be reasonably attributed to an inappropriately low level of fear and inadequate earlier medical treatment for both patients and physicians, resulting in subsequent intensive care. This study was conducted to evaluate medical care use and cost, and mortality according to the perception of dyspnea in community-dwelling elderly people. We analyzed baseline data from a community-based Comprehensive Geriatric Assessment (CGA in 2002. The perception of dyspnea in 479 Japanese community-dwelling elderly people with normal lung function was measured in August 2002. The sensation of dyspnea during breathing with a linear inspiratory resistance of 10, 20 and 30 cmH2O/L/s was rated using the Borg scale. According to the perception of dyspnea, we divided the elderly into tertiles and compared all hospitalizations, out-patient visits, costs and death through computerized linkage with National Health Insurance (NHI beneficiaries claims history files between August 2002 and March 2008. In-patient hospitalization days and medical care costs significantly increased with the blunted perception of dyspnea, resulting in an increase in total medical-costs with blunted perception of dyspnea. With low perception group as reference, the hazard ratios of all cause mortality were 0.65 (95%CI 0.23-1.89 for intermediate perception group and 0.31(0.10-0.97 for high perception group, indicating the mortality rate also significantly increased with the blunted perception of dyspnea after multivariates adjustment (p=0.04. The blunted perception of dyspnea is related to hospitalization, large medical costs and all-cause mortality in community-dwelling elderly people. These findings provide a rational for preventing serious illness with careful monitoring of objective conditions in the elderly.

  7. Sex differences in the risk profile and male predominance in silent brain infarction in community-dwelling elderly subjects. The Sefuri brain MRI study

    International Nuclear Information System (INIS)

    Takashima, Yuki; Mori, Takahiro; Hashimoto, Manabu; Yuzuriha, Takefumi; Yao, Hiroshi; Miwa, Yoshikazu; Sasaguri, Toshiyuki; Uchino, Akira

    2010-01-01

    Although brain infarction is more common in men, the male predominance of silent brain infarction (SBI) was inconsistent in the earlier studies. This study was to examine the relationship between sex differences in the risk profile and SBI. We conducted a population-based, cross-sectional analysis of cardiovascular risk factors and SBI on MRI. We asked all the female participants about the age at natural menopause and parity. SBI was detected in 77 (11.3%) of 680 participants (266 men and 414 women) with a mean age of 64.5 (range 40-93) years. In the logistic analysis, age (odds ratio (OR)=2.760/10 years, 95% confidence interval (CI)=2.037-3.738), hypertension (OR=3.465, 95% CI=1.991-6.031), alcohol intake (OR=2.494, 95% CI=1.392-4.466) and smoking (OR=2.302, 95% CI=1.161-4.565) were significant factors concerning SBI. Although SBI was more prevalent among men, this sex difference disappeared on the multivariate model after adjustment for other confounders. In 215 women aged 60 years or older, age at natural menopause, early menopause, duration of menopause, number of children and age at the last parity were not significantly associated with SBI after adjustment for age. Hypertension and age were considered to be the major risk factors for SBI in community-dwelling people. Male predominance in SBI was largely due to higher prevalence of alcohol habit and smoking in men than in women in our population. (author)

  8. Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.

    LENUS (Irish Health Repository)

    Barry, P J

    2012-02-03

    BACKGROUND: In appropriate prescribing is a significant and persistent problem in elderly people, both in hospital and the community and has been described in several countries in Europe and also the USA. The problem of inappropriate prescribing has not been quantified in the Republic of Ireland. The most commonly used criteria for the identification of inappropriate prescribing are the Beers\\' criteria [both independent of diagnosis (ID) and considering diagnosis (CD) - 2003 version]. The Beers\\' criteria ID includes 48 different categories of either single medications or multiple medications of a similar class identified as inappropriate prescriptions and the Beers\\' criteria CD contains 19 different categories containing possible drug-disease interactions. A second tool, the improved prescribing in the elderly tool (IPET) has also been validated and used in hospital and community studies and has 14 categories of either explicitly contraindicated medications or possible drug-disease interactions. OBJECTIVES: The primary aim of the study is to measure the incidence of inappropriate prescribing among older community-dwelling individuals presenting to an acute hospital in the Republic of Ireland. A secondary aim of this study was also therefore to compare the efficacy of the above two tools in identifying inappropriate prescribing. METHODS: A prospective, consecutive observational cohort study was carried out over a 4-month period. The setting was an urban-based university hospital acute geriatric medicine assessment unit. Subjects in this study (n = 350) were consecutively screened on admission to hospital (mean age = 80.3 +\\/- 6.1 years) and all patients had both Beers\\' criteria ID and CD and IPET applied to their list of prescription drugs on admission, cross-referenced with their list of current active medical diagnosis. RESULTS: The results of the study identified a high rate of inappropriate prescribing among this population of community-dwelling

  9. Stories of pain and health by elderly Pakistani women in Norway.

    Science.gov (United States)

    Sverre, Beate Lie; Solbrække, Kari Nyheim; Eilertsen, Grethe

    2014-11-01

    This ethnographic study investigates the stories of elderly Pakistani women living in Norway. Migration studies indicate that elderly migrant women are passive, ill victims caught in a marginalized position due to age, ethnicity and gender, and thus have little access to opposition and agency. To broaden the picture it is necessary to develop an innovative approach to understand what is implicated in the process of migration. The importance of considering life conditions that surrounds potential health promotion behaviors of immigrants is stressed by several researchers. However, up to now limited research guided by this perspective has been done in Norway. Therefore, this study explored how elderly Pakistani women in Norway promote their health and well-being through some distinct social interactions. The intention is to bring awareness to how health, even by so-called disadvantaged social groups, may take place. These practices are important to take into consideration when developing health-promoting policies for elderly immigrants. An ethnographic study of 15 Pakistani women, aged 53-75, was carried out in a multisided fieldwork in Oslo using participant observation and ethnographic interviews. The analytical approach was inspired by the constructivist theoretical framework of narrative ethnography. The elderly Pakistani women in Norway construct stories of living in-between cultures and experiences of acculturative stress caused by being elderly, immigrants and women. However, this analysis also suggests that through distinct social relationships, primarily in the context of a voluntary organization, elderly Pakistani women do health by the way they interact and construct a repertoire of social identities. The healing practices taking place among elderly Pakistani women may counteract the negative health outcomes associated with age, migration and gender implications for immigrant health-promoting policy in Norway may be to increase the establishment and

  10. Prevalence of and Risk Factors for Elder Abuse and Neglect in the Community: A Population-Based Study.

    Science.gov (United States)

    Burnes, David; Pillemer, Karl; Caccamise, Paul L; Mason, Art; Henderson, Charles R; Berman, Jacquelin; Cook, Ann Marie; Shukoff, Denise; Brownell, Patricia; Powell, Mebane; Salamone, Aurora; Lachs, Mark S

    2015-09-01

    To estimate past-year prevalence and identify risk and protective factors of elder emotional abuse, physical abuse, and neglect. Cross-sectional, population-based study using random-digit-dial sampling and direct telephone interviews. New York State households. Representative (race, ethnicity, sex) sample (N = 4,156) of English- or Spanish-speaking, community-dwelling, cognitively intact individuals aged 60 and older. The Conflict Tactics Scale was adapted to assess elder emotional and physical abuse. Elder neglect was evaluated according to failure of a responsible caregiver to meet an older adult's needs using the Duke Older Americans Resources and Services (OARS) scale. Caseness thresholds were based on mistreatment behavior frequencies and elder perceptions of problem seriousness. Past-year prevalence of elder emotional abuse was 1.9%, of physical abuse was 1.8%, and of neglect was 1.8%, with an aggregate prevalence of 4.6%. Emotional and physical abuse were associated with being separated or divorced, living in a lower-income household, functional impairment, and younger age. Neglect was associated with poor health, being separated or divorced, living below the poverty line, and younger age. Neglect was less likely in older adults of Hispanic ethnicity. Elder abuse and neglect are common problems, with divergent risk and protective factor profiles. These findings have direct implications for public screening and education and awareness efforts designed to prevent elder mistreatment. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  11. THE EFFECTS OF OTAGO EXERCISE PROGRAMME FOR FALL PREVENTION IN ELDERLY PEOPLE

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    Nancy N. Patel

    2015-08-01

    Full Text Available Background: The ‘Otago exercise programme’ (OEP is a strength and balance retraining programme designed to prevent falls in older people living in the community. The aim of this study was to find the effects of Otago exercise programme for fall prevention in community dwelling elderly people. Method: The sample comprised 30 community dwelling elderly around sinhgad road, pune (out of 30, 4 were dropouts aged over 60 years both male and female falling under moderate fall risk measured by Tinetti Performance Oriented Mobility Assessment. The intervention consisted mainly strength and balance training. Intervention was done for 1 hr every day, 5 days per week for 6weeks. Outcome measure assessment was done pre, 3rd week and post intervention. Pre and post comparison of following three outcome measures was done. Outcome measures: Tinetti Performance Oriented Mobility Assessment, 10RM and Chair stand test. Result: Paired t-test was done. Results of p value for 10RM (p value = 0.00, Tinetti performance oriented mobility assessment (p value = 0.00 and chair stand test (p value = 0.01 was found to be highly significant. Out of 26 subjects with moderate risk of fall pre intervention, 24 subjects showed low risk of fall during post intervention assessment of Tinetti Performance Oriented Mobility Assessment. Conclusion: The Otago exercise programme is significantly effective increasing strength of lower limb and improving in balance, gait and therefore ultimately preventing fall in community dwelling Indian elder people. Hence, Otago exercise protocol can be used in day to day clinical practice and also as a home exercise program.

  12. Evaluation of an osteoporosis and fall risk intervention program for community-dwelling elderly. A quasi-experimental study of behavioral modifications.

    Science.gov (United States)

    Grahn Kronhed, Ann-Charlotte; Blomberg, Carina; Löfman, Owe; Timpka, Toomas; Möller, Margareta

    2006-06-01

    Osteoporosis and fall fractures are increasing problems amongst the elderly. The aim of this study was to explore whether combined population-based and individual interventions directed at risk factors for osteoporosis and falls result in behavioral changes in an elderly population. A quasi-experimental design was used for the study. Persons aged >or=65 years were randomly selected in the intervention and control community. An intervention program was managed from the primary health care center and delivered to the community. Health education was designed to increase awareness of risk factors for the development of osteoporosis and falling. Questionnaires about lifestyle, health, previous fractures, safety behavior and physical activity level were distributed at baseline in 1989 and at the follow-ups in 1992 and 1994 in both communities. There was a difference of 17.7% between the dual intervention (receiving both population-based and individual interventions) and the control samples regarding the self-reported use of shoe/cane spikes, and a difference of 20.5% regarding the reported "moderate level" of physical activity in 1994. There was an increase in the number of participants in the dual intervention sample who, at baseline, had not reported equipping their homes with non-slip mats and removing loose rugs but who did report these changes in 1994. The increase in the reported use of shoe/cane spikes in the dual intervention sample was observed mainly for the period 1992-1994. A public health intervention model, including both population-based and individual interventions, can contribute to behavioral changes in the prevention of falls and changed physical activity patterns amongst elderly people.

  13. Arriving old: A qualitative study of elder refugee women's self-perceptions of the first year of resettlement.

    Science.gov (United States)

    Dubus, Nicole

    2018-01-01

    This qualitative study examines eight elder women's experiences of resettling with their family and the protective factors that enhanced their resiliency. The implications for social work include the need to assess elder refugees' strengths, resilience, pre-resettlement functioning instead of services that might encourage integration into the dominant culture and community, and that the refugee experience is a lifelong experience that shapes and informs various stages of life.

  14. Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents

    Science.gov (United States)

    Son, Kyeong Min; Cho, Nam H.; Lim, Seung Hun

    2013-01-01

    Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact. PMID:23678258

  15. Effectiveness of a new standardised Urinary Continence Physiotherapy Programme for community-dwelling older women in Hong Kong.

    Science.gov (United States)

    Leong, B S; Mok, Nicola W

    2015-02-01

    To examine the effectiveness of a standardised Urinary Continence Physiotherapy Programme for older Chinese women with stress, urge, or mixed urinary incontinence. A controlled trial. Six elderly community health centres in Hong Kong. A total of 55 women aged over 65 years with mild-to-moderate urinary incontinence. Participants were randomly assigned to the intervention group (n=27) where they received eight sessions of Urinary Continence Physiotherapy Programme for 12 weeks. This group received education about urinary incontinence, pelvic floor muscle training with manual palpation and verbal feedback, and behavioural therapy. The control group (n=28) was given advice and an educational pamphlet on urinary incontinence. There was significant improvement in urinary symptoms in the intervention group, especially in the first 5 weeks. Compared with the control group, participants receiving the intervention showed significant reduction in urinary incontinence episodes per week with a mean difference of -6.4 (95% confidence interval, -8.9 to -3.9; t= -5.3; PIncontinence Impact Questionnaire Short Form modified Chinese (Taiwan) version. The subjective perception of improvement, measured by an 11-point visual analogue scale, was markedly better in the intervention group (mean, 8.7; standard deviation, 1.0; 95% confidence interval, 8.4-9.1) than in the control group (mean, 1.4; standard deviation, 0.7; 95% confidence interval, 1.2-1.7; t=33.9; Ptreatment satisfaction in the intervention group was 9.5 (standard deviation, 0.8) as measured by an 11-point visual analogue scale. This study demonstrated that the Urinary Continence Physiotherapy Programme was effective in alleviating urinary symptoms among older Chinese women with mild-to-moderate heterogeneous urinary incontinence.

  16. Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training.

    Science.gov (United States)

    Jørgensen, Martin Grønbech

    2014-01-01

    weeks of biofeedback-based Nintendo Wii training on static postural balance, mechanical lower limb muscle function, and functional performance in 58 community-dwelling older adults. Additionally, the study investigated the participant motivation for this type of training (Exergaming). Marked improvements in maximal leg muscle strength, rapid force capacity and functional performance were observed following the period of biofeedback-based Nintendo Wii training. Unexpectedly, static bilateral postural balance remained unaltered following the period of intervention. The study participants perceived the Nintendo Wii training as enjoyable and highly motivating, which suggests that this type of exercise may be successfully implemented at senior citizens' centers and/or in the home of the elderly. The results presented in this thesis suggest that strict control of time-of-day is an important methodological aspect when evaluating postural balance in older adults, and an assessment protocol using the Nintendo Wii-Balance Board is reproducible and valid. Biofeedback-based Nintendo Wii exercise intervention appeared unsuccessful in improving static bilateral postural balance, most likely due to a test ceiling effect in the selected outcome measures, but the intervention elicited marked positive changes in various key risk factors associated to fall accidents. Notably, Wii based biofeedback exercise was perceived by the older adults as a highly motivating type of training.

  17. Identifying Balance and Fall Risk in Community-Dwelling Older Women: The Effect of Executive Function on Postural Control

    OpenAIRE

    Muir-Hunter, Susan W.; Clark, Jennifer; McLean, Stephanie; Pedlow, Sam; Van Hemmen, Alysia; Montero Odasso, Manuel; Overend, Tom

    2014-01-01

    Purpose: The mechanisms linking cognition, balance function, and fall risk among older adults are not fully understood. An evaluation of the effect of cognition on balance tests commonly used in clinical practice to assess community-dwelling older adults could enhance the identification of at-risk individuals. The study aimed to determine (1) the association between cognition and clinical tests of balance and (2) the relationship between executive function (EF) and balance under single- and d...

  18. Identifying community healthcare supports for the elderly and the factors affecting their aging care model preference: evidence from three districts of Beijing

    Directory of Open Access Journals (Sweden)

    Tianyang Liu

    2016-11-01

    Full Text Available Abstract Background The Chinese tradition of filial piety, which prioritized family-based care for the elderly, is transitioning and elders can no longer necessarily rely on their children. The purpose of this study was to identify community support for the elderly, and analyze the factors that affect which model of old-age care elderly people dwelling in communities prefer. Methods We used the database “Health and Social Support of Elderly Population in Community”. Questionnaires were issued in 2013, covering 3 districts in Beijing. A group of 1036 people over 60 years in age were included in the study. The respondents’ profile variables were organized in Andersen’s Model and community healthcare resource factors were added. A multinomial logistic model was applied to analyze the factors associated with the desired aging care models. Results Cohabiting with children and relying on care from family was still the primary desired aging care model for seniors (78 %, followed by living in institutions (14.8 % and living at home independently while relying on community resources (7.2 %. The regression result indicated that predisposing, enabling and community factors were significantly associated with the aging care model preference. Specifically, compared with those who preferred to cohabit with children, those having higher education, fewer available family and friend helpers, and shorter distance to healthcare center were more likely to prefer to live independently and rely on community support. And compared with choosing to live in institutions, those having fewer available family and friend helpers and those living alone were more likely to prefer to live independently and rely on community. Need factors (health and disability condition were not significantly associated with desired aging care models, indicating that desired aging care models were passive choices resulted from the balancing of family and social caring resources

  19. Quality Indicators for In-Hospital Pharmaceutical Care of Dutch Elderly Patients Development and Validation of an ACOVE-Based Quality Indicator Set

    NARCIS (Netherlands)

    Wierenga, Peter C.; Klopotowska, Joanna E.; Smorenburg, Susanne M.; van Kan, Hendrikus J.; Bijleveld, Yuma A.; Dijkgraaf, Marcel G.; de Rooij, Sophia E.

    2011-01-01

    Background: In 2001, the ACOVE (Assessing Care Of Vulnerable Elders) quality indicators (QIs) were developed in the US to measure the quality of care of vulnerable elderly patients. However, the ACOVE QI set was developed mainly to assess the overall quality of care of community-dwelling vulnerable

  20. Decline in Physical Function and Risk for Elder Abuse Reported to Social Services in a Community-Dwelling Population of Older Adults

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Evans, Denis

    2012-01-01

    Objectives Elder abuse is an important public health and human rights issue and is associated with increased morbidity and mortality. This study aimed to examine the longitudinal association between decline in physical function and the risk for elder abuse. Design Prospective population-based study Setting Geographically defined community in Chicago. Participants Chicago Health and Aging Project (CHAP) is a population-based study (N=6,159), and we identified 143 CHAP participants who had elder abuse reported to social services agency from 1993–2010. Participants The primary independent variable was objectively assessed physical function using decline in physical performance testing (Tandem stand, measured walk and chair stand). Secondary independent variables were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcomes were reported and confirmed elder abuse and specific subtypes of elder abuse (physical, psychological, caregiver neglect and financial exploitation). Logistic regression models were used to assess the association of decline in physical function measures and risk for elder abuse. Results After adjusting for potential confounders, every 1 point decline in physical performance testing (OR, 1.13(1.06–1.19)), Katz impairment (OR, 1.29(1.15–1.45)), Nagi impairment (OR, 1.30(1.13–1.49)) and Rosow Breslau impairment (OR, 1.42(1.15–1.74)) were associated with increased risk for elder abuse. Lowest tertiles of physical performance testing (OR, 4.92 (1.39–17.46), highest tertiles of Katz impairment (OR, 3.99 (2.18–7.31), Nagi impairment (OR, 2.37 (1.08–5.23), and Rosow Breslau impairment (2.85 (1.39–5.84) were associated with increased risk for elder abuse. Conclusion Decline in objectively assessed physical function and self-reported physical function are associated with increased risk for elder abuse. PMID:23002901

  1. Perceptions of Elder Abuse From Community-Dwelling Older Persons and Professionals Working in Western Switzerland.

    Science.gov (United States)

    Roulet Schwab, Delphine; Wangmo, Tenzin

    2017-09-01

    Older persons' perspectives regarding elder abuse remain little studied. However, definitions of elder abuse and effective prevention strategies require adaptation to the needs and cultures of targeted populations. This study explored the views of older persons and professionals to evaluate their converging and diverging perspectives toward elder abuse and its prevention. The study employed a qualitative approach where six focus groups were held in Western Switzerland (the French-speaking part of the country). Four focus groups with 25 older persons from varying socioeconomic backgrounds, and the other two focus groups were carried out with 16 professionals working in the field of elder abuse prevention. For the focus groups, we used the technique of free associations to begin the discussions and vignette-like statements to explore participants' attitudes toward elder abuse. These were followed by open-ended questions. The transcripts from the focus groups were analyzed thematically and resulted in four main themes: (a) varied associations of the term "abuse," (b) judging elder abuse situations in terms of abuse and severity, (c) self-identification with elder abuse, and (d) prevention of elder abuse. Study findings demonstrated that older persons hold views that are partly different from the views of professionals. Furthermore, perceptions of older persons could be stratified based on the socioeconomic status of the participants. These diverging perspectives reflect the heterogeneity of the senior citizen population and highlight the need for research cognizant of these differences. The results of this study provide strategies for improved targeting of preventive measures, underline the importance of integrating the perspectives of older persons, and reveal the need to expand the commonly accepted definitions of elder abuse so that they better reflect the affected individuals.

  2. Multicomponent Program to Reduce Functional Decline in Frail Elderly People : A Cluster Controlled Trial

    NARCIS (Netherlands)

    Ruikes, Franca G. H.; Zuidema, Sytse U.; Akkermans, Reinier P.; Assendelft, Willem J. J.; Schers, Henk J.; Koopmans, Raymond T. C. M.

    2016-01-01

    Background: The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. Methods: We

  3. Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial

    NARCIS (Netherlands)

    Ruikes, F.G.; Zuidema, S.U.; Akkermans, R.P.; Assendelft, W.J.; Schers, H.J.; Koopmans, R.T.

    2016-01-01

    BACKGROUND: The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. METHODS: We

  4. Construct validity of the Groningen Frailty Indicator established in a large sample of home-dwelling elderly persons: Evidence of stability across age and gender.

    Science.gov (United States)

    Peters, L L; Boter, H; Burgerhof, J G M; Slaets, J P J; Buskens, E

    2015-09-01

    The primary objective of the present study was to evaluate the validity of the Groningen Frailty Indicator (GFI) in a sample of Dutch elderly persons participating in LifeLines, a large population-based cohort study. Additional aims were to assess differences between frail and non-frail elderly and examine which individual characteristics were associated with frailty. By December 2012, 5712 elderly persons were enrolled in LifeLines and complied with the inclusion criteria of the present study. Mann-Whitney U or Kruskal-Wallis tests were used to assess the variability of GFI-scores among elderly subgroups that differed in demographic characteristics, morbidity, obesity, and healthcare utilization. Within subgroups Kruskal-Wallis tests were also used to examine differences in GFI-scores across age groups. Multivariate logistic regression analyses were performed to assess associations between individual characteristics and frailty. The GFI discriminated between subgroups: statistically significantly higher GFI-median scores (interquartile range) were found in e.g. males (1 [0-2]), the oldest old (2 [1-3]), in elderly who were single (1 [0-2]), with lower socio economic status (1 [0-3]), with increasing co-morbidity (2 [1-3]), who were obese (2 [1-3]), and used more healthcare (2 [1-4]). Overall age had an independent and statistically significant association with GFI scores. Compared with the non-frail, frail elderly persons experienced statistically significantly more chronic stress and more social/psychological related problems. In the multivariate logistic regression model, psychological morbidity had the strongest association with frailty. The present study supports the construct validity of the GFI and provides an insight in the characteristics of (non)frail community-dwelling elderly persons participating in LifeLines. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Identifying balance and fall risk in community-dwelling older women: the effect of executive function on postural control.

    Science.gov (United States)

    Muir-Hunter, Susan W; Clark, Jennifer; McLean, Stephanie; Pedlow, Sam; Van Hemmen, Alysia; Montero Odasso, Manuel; Overend, Tom

    2014-01-01

    The mechanisms linking cognition, balance function, and fall risk among older adults are not fully understood. An evaluation of the effect of cognition on balance tests commonly used in clinical practice to assess community-dwelling older adults could enhance the identification of at-risk individuals. The study aimed to determine (1) the association between cognition and clinical tests of balance and (2) the relationship between executive function (EF) and balance under single- and dual-task testing. Participants (24 women, mean age of 76.18 [SD 16.45] years) completed six clinical balance tests, four cognitive tests, and two measures of physical function. Poor balance function was associated with poor performance on cognitive testing of EF. In addition, the association with EF was strongest under the dual-task timed up-and-go (TUG) test and the Fullerton Advanced Balance Scale. Measures of global cognition were associated only with the dual-task performance of the TUG. Postural sway measured with the Standing Balance Test, under single- or dual-task test conditions, was not associated with cognition. Decreased EF was associated with worse performance on functional measures of balance. The relationship between EF and balance was more pronounced with dual-task testing using a complex cognitive task combined with the TUG.

  6. Identifying Balance and Fall Risk in Community-Dwelling Older Women: The Effect of Executive Function on Postural Control

    Science.gov (United States)

    Clark, Jennifer; McLean, Stephanie; Pedlow, Sam; Van Hemmen, Alysia; Montero Odasso, Manuel; Overend, Tom

    2014-01-01

    ABSTRACT Purpose: The mechanisms linking cognition, balance function, and fall risk among older adults are not fully understood. An evaluation of the effect of cognition on balance tests commonly used in clinical practice to assess community-dwelling older adults could enhance the identification of at-risk individuals. The study aimed to determine (1) the association between cognition and clinical tests of balance and (2) the relationship between executive function (EF) and balance under single- and dual-task testing. Methods: Participants (24 women, mean age of 76.18 [SD 16.45] years) completed six clinical balance tests, four cognitive tests, and two measures of physical function. Results: Poor balance function was associated with poor performance on cognitive testing of EF. In addition, the association with EF was strongest under the dual-task timed up-and-go (TUG) test and the Fullerton Advanced Balance Scale. Measures of global cognition were associated only with the dual-task performance of the TUG. Postural sway measured with the Standing Balance Test, under single- or dual-task test conditions, was not associated with cognition. Conclusions: Decreased EF was associated with worse performance on functional measures of balance. The relationship between EF and balance was more pronounced with dual-task testing using a complex cognitive task combined with the TUG. PMID:24799756

  7. Costs of Malnutrition in Institutionalized and Community-Dwelling Older Adults: A Systematic Review.

    Science.gov (United States)

    Abizanda, Pedro; Sinclair, Alan; Barcons, Núria; Lizán, Luis; Rodríguez-Mañas, Leocadio

    2016-01-01

    The aim of this study was to assess health economics evidence published to date on malnutrition costs in institutionalized or community-dwelling older adults. A systematic search of the literature published until December 2013 was performed using standard literature, international and national electronic databases, including MedLine/PubMed, Cochrane Library, ISI WOK, SCOPUS, MEDES, IBECS, and Google Scholar. Publications identified referred to the economic burden and use of medical resources associated with malnutrition (or risk of malnutrition) in institutionalized or community-dwelling older adults, written in either English or Spanish. Costs were updated to 2014 (€). A total of 9 studies of 46 initially retrieved met the preestablished criteria and were submitted to thorough scrutiny. All publications reviewed involved studies conducted in Europe, and the results regarding the contents of all the studies showed that total costs associated with malnutrition in institutionalized and community-dwelling older adults were considerably higher than those of well-nourished ones, mainly due to a higher use of health care resources (GP consultations, hospitalizations, health care monitoring, and treatments). Interventions to reduce the prevalence of malnutrition, such as the use of oral nutritional supplements, showed an important decrease in-hospital admissions and medical visits. Malnutrition is associated with higher health care costs in institutionalized or community-dwelling older adults. The adoption of nutritional interventions, such as oral nutritional supplements, may have an important impact in reducing annual health care costs per patient. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  8. Elder Abuse: Systematic Review and Implications for Practice.

    Science.gov (United States)

    Dong, Xin Qi

    2015-06-01

    This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. © 2015, Copyright the Author Journal compilation © 2015, The American Geriatrics Society.

  9. The average cost of pressure ulcer management in a community dwelling spinal cord injury population.

    Science.gov (United States)

    Chan, Brian C; Nanwa, Natasha; Mittmann, Nicole; Bryant, Dianne; Coyte, Peter C; Houghton, Pamela E

    2013-08-01

    Pressure ulcers (PUs) are a common secondary complication experienced by community dwelling individuals with spinal cord injury (SCI). There is a paucity of literature on the health economic impact of PU in SCI population from a societal perspective. The objective of this study was to determine the resource use and costs in 2010 Canadian dollars of a community dwelling SCI individual experiencing a PU from a societal perspective. A non-comparative cost analysis was conducted on a cohort of community dwelling SCI individuals from Ontario, Canada. Medical resource use was recorded over the study period. Unit costs associated with these resources were collected from publicly available sources and published literature. Average monthly cost was calculated based on 7-month follow-up. Costs were stratified by age, PU history, severity level, location of SCI, duration of current PU and PU surface area. Sensitivity analyses were also carried out. Among the 12 study participants, total average monthly cost per community dwelling SCI individual with a PU was $4745. Hospital admission costs represented the greatest percentage of the total cost (62%). Sensitivity analysis showed that the total average monthly costs were most sensitive to variations in hospitalisation costs. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

  10. Rural-Urban Differences in Preventable Hospitalizations among Community-Dwelling Veterans with Dementia

    Science.gov (United States)

    Thorpe, Joshua M.; Van Houtven, Courtney H.; Sleath, Betsy L.; Thorpe, Carolyn T.

    2010-01-01

    Context: Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care. Purpose: We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia. Methods: Medicare…

  11. Interleukin-6 and C-Reactive Protein Levels and 9-Year Cognitive Decline in Community-Dwelling Older Women: The Women's Health and Aging Study II.

    Science.gov (United States)

    Palta, Priya; Xue, Qian-Li; Deal, Jennifer A; Fried, Linda P; Walston, Jeremy D; Carlson, Michelle C

    2015-07-01

    Elevated inflammation is a proposed mechanism relating chronic diseases to cognitive dysfunction. The objective of this study was to test the hypothesis that greater levels of inflammation, as measured by the proinflammatory cytokine interleukin-6 (IL-6) and C-reactive protein, are associated with faster rates of cognitive decline among cognitively intact community-dwelling older women. We analyzed 336 women from the Women's Health and Aging Study II. Cognitive assessments were performed at baseline and every 18-36 months, and included the following domains: immediate and delayed memory (Hopkins Verbal Learning Test), psychomotor speed (Trail Making Test, Part A), and executive function (Trail Making Test, Part B). Aggregate measures of IL-6 and C-reactive protein, based on the average from visits one and two, were analyzed categorically. Random effects models were employed to test the relationship between tertiles of each inflammatory marker and changes in cognitive domain scores over 9 years. Moderate and high levels of IL-6 predicted early declines in psychomotor speed by 1.0 connection/min per year. There were no differences in baseline scores or rates of change across tertiles of IL-6 in memory or executive function. No differences were observed across tertiles of C-reactive protein for all cognitive domains. Higher levels of serum IL-6 were associated with greater declines in psychomotor speed over 9 years. This finding could suggest that elevated IL-6 may result in microvascular changes that may lead to damage of myelin sheaths that line neuronal axons, leading to decreased neuron propagation and impaired processing speed; however, mechanistic studies are needed to evaluate these hypotheses. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Relationship of socioeconomic status with health behaviors and self-perceived health in the elderly: A community-based study, Turkey.

    Science.gov (United States)

    Simsek, Hatice; Doganay, Sinem; Budak, Refik; Ucku, Reyhan

    2014-10-01

    The purpose of the present study was to determine the effects of socioeconomic status on health behaviors and perceived health. The present cross-sectional study included 2947 community-dwelling older adults aged 65 years and older. Dependent variables were health behaviors and self-perceived health. The independent variable was socioeconomic status. In men, the risk of unhealthy diet was higher among the uneducated group (OR 4.48) and among those with poor/very poor economic status (OR 3.31). Additionally, in men, having poor/very poor self-perceived health was found to be 3.50-fold significantly higher among the uneducated group than the secondary school and higher-educated group. Lower education level and lower social class were found to be protective factors for smoking in women. In women, the risk of unhealthy diet was found to be 1.54- and 2.18-fold significantly higher, respectively, among those who graduated from primary school and uneducated. There was also a relationship between poor/very poor economic status and unhealthy diet among elderly women (OR 2.80). In women, the risk of physical inactivity was found to be 1.98-fold significantly higher in the uneducated group and 1.79-fold significantly higher in those with poor/very poor economic status, 0.33-fold significantly lower in skilled employees/white collar workers. With regard to self-perceived health status, education level and perceived economic status were significantly related to poor/very poor health status in women (OR 2.09 and OR 4.08, respectively). In older men and women, lower socioeconomic status increases the risk of unhealthy diet and poor health perception. In older women, lower socioeconomic status is a protective factor for smoking, but it also increases physical inactivity. © 2013 Japan Geriatrics Society.

  13. Elder Abuse in American Indian Communities

    Science.gov (United States)

    Anisko, Briana

    2009-01-01

    Although the many American Indian tribes of the United States are unique in their own customs, languages, and histories, a common thread throughout their traditions and cultural lifestyles is that they are of a culture that reveres the elder in their communities. Elders are the carriers of the culture/history; they are the storytellers, holders of…

  14. Association between gait abnormality and malnutrition in a community-dwelling elderly population.

    Science.gov (United States)

    Misu, Shogo; Asai, Tsuyoshi; Doi, Takehiko; Sawa, Ryuichi; Ueda, Yuya; Saito, Takashi; Nakamura, Ryo; Murata, Shunsuke; Sugimoto, Taiki; Yamada, Minoru; Ono, Rei

    2017-08-01

    Malnutrition is common in older adults, and contributes to the risk of falls and functional impairment. Gait performance also contributes to falls and functional impairment; however, the association between malnutrition and gait performance remains unclear. The purpose of the present study was to investigate the association between malnutrition risk and gait performance. The study participants included 204 community-dwelling older adults with a mean age of 73.4 ± 4.3 years. Nutritional status was evaluated using the short version of the Mini-Nutritional Assessment. A score of 11 points was used as the cut-off, and the participants were categorized into two groups: ≤11, malnutrition-risk group; and ≥12, well-nourished group. Gait performance was assessed by gait speed and walking smoothness. Walking smoothness was quantified by harmonic ratios (HR), which were derived from vertical (VT), mediolateral (ML) and anteroposterior trunk accelerations, recorded during over-ground walking. Skeletal muscle mass index, handgrip strength and physical functions were also measured. HR in the ML direction was significantly lower in the malnutrition-risk group than the well-nourished group (P = 0.002); however, no differences between the two groups were observed in gait speed or HR in the VT and anteroposterior directions. The relationship between malnutrition and HR in the ML direction was independent of skeletal muscle mass index, handgrip strength, physical function, gait speed, and other confounders (P malnutrition is related to decreased walking smoothness in the ML direction, suggesting that nutritional status affects lateral trunk control during walking. Geriatr Gerontol Int 2017; 17: 1155-1160. © 2016 Japan Geriatrics Society.

  15. Teeth and physical fitness in a community-dwelling 40 to 79-year-old Japanese population

    Directory of Open Access Journals (Sweden)

    Inui A

    2016-06-01

    Full Text Available Akinari Inui,1 Ippei Takahashi,2 Kaori Sawada,2 Akimoto Naoki,2 Toshirou Oyama,1 Yoshihiro Tamura,1 Toshiyuki Osanai,1 Anna Satake,1 Shigeyuki Nakaji,2 Wataru Kobayashi1 1Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, 2Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki City, Aomori Prefecture, Japan Purpose: Decline in the number of teeth and physical fitness begins from 40 years of age; however, several epidemiological studies have identified relationships between oral conditions and physical performance parameters in community-dwelling elderly population. The aim of this study was to validate the relationship between the muscle mass and its function and oral conditions (number of teeth and dental occlusion after 40 years of age in a community-dwelling population in Japan.Materials and methods: The subjects comprised of 552 volunteers (198 males and 354 females, 40–79 years who participated in the Iwaki Health Promotion Project in 2013. Multiple linear regression analyses were performed with the measures of the muscle mass and its function as objective variables and the measures of the number of teeth, age, body mass index, medical history, serum albumin concentration, smoking status, habitual alcohol intake, marital status, education levels, and exercising habits as explanatory variables. The relationships between the Eichner index and the muscle mass and its function were analyzed using analysis of covariance, with adjustment for confounding factors.Results: After adjusting for confounding factors, the number of teeth was shown to be an independent risk factor for the timed 10 m walk test (in females and the skeletal muscle mass of the whole body (in males. The results also revealed that the timed 10 m walk test was significantly correlated with the Eichner index (Classes A and C in females were correlated.Conclusion: This cross-sectional study on a

  16. Vitamin D intake and status in Irish elderly women and adolescent girls

    DEFF Research Database (Denmark)

    McCarthy, D.; Collins, A.; O’Brien, M.

    2006-01-01

    Aim To assess vitamin D status during summer and winter in Irish girls and elderly women, and to estimate vitamin D intake in these two age-groups. Methods Ambulatory free-living, elderly Irish women (aged 70-76 years; n = 43) and girls (aged 11-13 years; n = 17) were recruited. Fasting serums we...... collected during August/ September 2002 and February/March 2003 and analysed for 25 (OH) D by HPLC. Results Mean daily intakes of vitamin D were 4.6 mu g and 2.1 mu g in elderly women and girls, respectively Serum 25 (OH) D was significantly lower (P......Aim To assess vitamin D status during summer and winter in Irish girls and elderly women, and to estimate vitamin D intake in these two age-groups. Methods Ambulatory free-living, elderly Irish women (aged 70-76 years; n = 43) and girls (aged 11-13 years; n = 17) were recruited. Fasting serums were...

  17. Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Ping; Hao, Qiukui; Hai, Shan; Wang, Hui; Cao, Li; Dong, Birong

    2017-09-01

    The aim of this systematic review and meta-analysis was to examine the association between sarcopenia and all-cause mortality among community-dwelling older people. A systematic review was performed using three electronic databases (EMBASE, MEDLINE and the Cochrane Library) to identify prospective cohort studies from January 2009 to February 2017 examining sarcopenia as a predictor of all-cause mortality among community-dwelling older people. We conducted a pooled analysis of mortality associated with sarcopenia, and subgroup analyses based on measurements of muscle mass and length of follow-up by employing a random-effects model. Sensitivity analyses were performed evaluate the cause of high heterogeneity. In addition, methodological quality, heterogeneity and publication bias were evaluated. Of 1703 studies identified, 6 studies incorporating 7367 individuals were included in the meta-analysis for all-cause mortality. The pooled hazard ratios (HRs) of all-cause mortality from the combination of included studies suggested participants with sarcopenia had a significantly higher rate of mortality (pooled HR 1.60, 95%CI 1.24-2.06, I 2 =27.8%, p=0.216) than participants without sarcopenia. The subgroup analysis for length of follow-up suggested studies with a follow-up period of less than 5 years found a higher risk of all-cause mortality (pooled HR 2.09, 95%CI 1.21-3.60) than studies with a follow-up period of 5 years or more (pooled HR 1.52, 95%CI 1.14-2.01). A subgroup of anthropometric measures was found to identify higher mortality risks (pooled HR 2.26, 95%CI 1.30-3.92) than a subgroup of dual-energy x-ray (DXA) absorptiometry (pooled HR 1.82, 95%CI 1.04-3.18) factors or a subgroup of bioelectrical impedance analysis (BIA) factors (pooled HR 1.31, 95%CI 1.15-1.49). Sarcopenia is a predictor of all-cause mortality among community-dwelling older people. Therefore, it is important to diagnose sarcopenia and to intervene, in order to reduce mortality rates in the

  18. Protein Intake and Distribution in Relation to Physical Functioning and Quality of Life in Community-Dwelling Elderly People: Acknowledging the Role of Physical Activity

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    Dominique S. M. ten Haaf

    2018-04-01

    Full Text Available Increasing total protein intake and a spread protein intake distribution are potential strategies to attenuate sarcopenia related loss of physical function and quality of life. The aim of this cross-sectional study was to investigate whether protein intake and protein intake distribution are associated with muscle strength, physical function and quality of life in community-dwelling elderly people with a wide range of physical activity. Dietary and physical activity data were obtained from two studies (N = 140, age 81 ± 6, 64% male, with the following outcome measures: physical functioning (Short Physical Performance Battery (SPPB, comprising balance, gait speed and chair rise tests, handgrip strength and quality of life (EQ-5D-5L. Protein intake distribution was calculated for each participant as a coefficient of variance (CV = SD of grams of protein intake per main meal divided by the average total amount of proteins (grams of the main meals. Based on the CV, participants were divided into tertiles and classified as spread, intermediate or pulse. The average total protein intake was 1.08 ± 0.29 g/kg/day. Total protein intake was not associated with outcome measures using multivariate regression analyses. Individuals with a spread protein diet during the main meals (CV < 0.43 had higher gait speed compared to those with an intermediate diet (CV 0.43–0.62 (β = −0.42, p = 0.035, whereas a spread and pulse protein diet were not associated with SPPB total score, chair rise, grip strength and Quality-Adjusted Life Year (QALY. The interaction of higher physical activity and higher total protein intake was significantly associated with higher quality of life (β = 0.71, p = 0.049. While this interaction was not associated with SPPB or grip strength, the association with quality of life emphasizes the need for a higher total protein intake together with an active lifestyle in the elderly.

  19. Timed Up and Go test, atrophy of medial temporal areas and cognitive functions in community-dwelling older adults with normal cognition and mild cognitive impairment.

    Science.gov (United States)

    Kose, Yujiro; Ikenaga, Masahiro; Yamada, Yosuke; Morimura, Kazuhiro; Takeda, Noriko; Ouma, Shinji; Tsuboi, Yoshio; Yamada, Tatsuo; Kimura, Misaka; Kiyonaga, Akira; Higaki, Yasuki; Tanaka, Hiroaki

    2016-12-01

    This study aimed to ascertain if performance on the Timed Up and Go (TUG) test is associated with indicators of brain volume and cognitive functions among community-dwelling older adults with normal cognition or mild cognitive impairment. Participants were 80 community-dwelling older adults aged 65-89years (44 men, 36 women), including 20 with mild cognitive impairment. Participants completed the TUG and a battery of cognitive assessments, including the Mini-Mental State Examination (MMSE), the Logical Memory I and II (LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and the Trail Making Test A and B (TMT-A, TMT-B). Bilateral, right- and left-side medial temporal area atrophy as well as whole gray and white matter indices were determined with the Voxel-based Specific Regional Analysis System for Alzheimer's Disease. We divided participants into three groups based on TUG performance: "better" (≤6.9s); "normal" (7-10s); and "poor" (≥10.1s). Worse TMT-A and TMT-B performance showed significant independent associations with worse TUG performance (Pareas were significantly independently associated with worse TUG performance (Parea atrophy in community-dwelling older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Dynamic Microsimulation Model of Impoverishment among Elderly Women in Japan

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    Inagaki, Seiichi

    2018-03-01

    The increasing poverty rate for elderly women is a growing concern in Japan and is generally due to their lifestyle changes and the public pension system based on the pre-1980s (old) lifestyle. At that time, women were expected to get married and become homemakers. Therefore, the public pension system is generous for married women and widows but not for never-married and divorced women. Using a dynamic microsimulation model, the Integrated Analytical Model for Household Simulation (INAHSIM), previous research has shown that poverty rates for elderly people will increase significantly in the future due to changes in nuptiality behavior after the 1980s. However, this approach is an indirect method, and the mechanism of impoverishment remains unclear. This study uses the same dynamic microsimulation model but attempts a more direct approach to interpret the effects of these behavioral changes on poverty rates for elderly women. Specifically, under the baseline scenario, it makes future projections on key distributions related to poverty by marital status and illustrates how they will face the poverty problem. It shows the future projections of (1) the distribution of pension amounts by gender and marital status, (2) poverty rates for elderly women by marital status, and (3) poverty rates for elderly people by gender. After the 1980s in Japan, the marriage rate decreased and the divorce rate increased significantly. Nevertheless, society still suffers from wage inequality between men and women. As a result, the number of never-married or divorced women will increase and these women will receive poor pension benefits due to an unfavorable public pension system. In addition, they have a higher risk of living in a single-person household because they have no or very few children. In the end, they will face the risk of poverty and raise the overall poverty rate.

  1. Dynamic Microsimulation Model of Impoverishment Among Elderly Women in Japan

    Directory of Open Access Journals (Sweden)

    Seiichi Inagaki

    2018-03-01

    Full Text Available The increasing poverty rate for elderly women is a growing concern in Japan and is generally due to their lifestyle changes and the public pension system based on the pre-1980s (old lifestyle. At that time, women were expected to get married and become homemakers. Therefore, the public pension system is generous for married women and widows but not for never-married and divorced women. Using a dynamic microsimulation model, the Integrated Analytical Model for Household Simulation (INAHSIM, previous research has shown that poverty rates for elderly people will increase significantly in the future due to changes in nuptiality behavior after the 1980s. However, this approach is an indirect method, and the mechanism of impoverishment remains unclear. This study uses the same dynamic microsimulation model but attempts a more direct approach to interpret the effects of these behavioral changes on poverty rates for elderly women. Specifically, under the baseline scenario, it makes future projections on key distributions related to poverty by marital status and illustrates how they will face the poverty problem. It shows the future projections of (1 the distribution of pension amounts by gender and marital status, (2 poverty rates for elderly women by marital status, and (3 poverty rates for elderly people by gender. After the 1980s in Japan, the marriage rate decreased and the divorce rate increased significantly. Nevertheless, society still suffers from wage inequality between men and women. As a result, the number of never-married or divorced women will increase and these women will receive poor pension benefits due to an unfavorable public pension system. In addition, they have a higher risk of living in a single-person household because they have no or very few children. In the end, they will face the risk of poverty and raise the overall poverty rate.

  2. The impact of asymptomatic vertebral fractures on quality of life in older community-dwelling women: the São Paulo Ageing & Health Study

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    Jaqueline B. Lopes

    2012-12-01

    Full Text Available OBJECTIVES: The aim of this study was to investigate the impact of asymptomatic vertebral fractures on the quality of life in older women as part of the Sao Paulo Ageing & Health Study. METHODS: This study was a cross-sectional study with a random sample of 180 women 65 years of age or older with or without vertebral fractures. The Quality of Life Questionnaire of the European Foundation for Osteoporosis was administered to all subjects. Anthropometric data were obtained by physical examination, and the body mass index was calculated. Lateral thoracic and lumbar spine X-ray scans were obtained to identify asymptomatic vertebral fractures using a semi-quantitative method. RESULTS: Women with asymptomatic vertebral fractures had lower total scores [61.4(15.3 vs. 67.1(14.2, p = 0.03] and worse physical function domain scores [69.5(20.1 vs. 77.3(17.1, p = 0.02] for the Quality of Life Questionnaire of the European Foundation for Osteoporosis compared with women without fractures. The total score of this questionnaire was also worse in women classified as obese than in women classified as overweight or normal. High physical activity was related to a better total score for this questionnaire (p = 0.01. Likewise, lower physical function scores were observed in women with higher body mass index values (p<0.05 and lower physical activity levels (p,0.05. Generalized linear models with gamma distributions and logarithmic link functions, adjusted for age, showed that lower total scores and physical function domain scores for the Quality of Life Questionnaire of the European Foundation for Osteoporosis were related to a high body mass index, lower physical activity, and the presence of vertebral fractures (p<0.05. CONCLUSION: Vertebral fractures are associated with decreased quality of life mainly physical functioning in older community-dwelling women regardless of age, body mass index, and physical activity. Therefore, the results highlight the importance

  3. Sex differences in subjective and actigraphic sleep measures: A population-based study of elderly persons

    NARCIS (Netherlands)

    Berg, J.F. van den; Miedema, H.M.E.; Tulen, J.H.M.; Hofman, A.; Neven, A.K.; Tiemeier, H.

    2009-01-01

    Study Objectives: To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons. Design: Cross-sectional study. Setting: The study was embedded in the Rotterdam Study, a population-based study. Participants: Nine hundred fifty-six

  4. Relationship between frailty and respiratory function in the community-dwelling elderly Estudo da relação entre fragilidade e função respiratória em idosos comunitários

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    Maycon S. Pegorari

    2013-02-01

    Full Text Available OBJECTIVE: To evaluate the impact of frailty on respiratory function in a community- dwelling elderly. METHOD: 51 community-dwelling elderly were evaluated (mean age of 73±6 years, being 29 men (56.7% and 22 women (43.3%. We collect the following variables: sociodemographic characteristics, frailty phenotype, pulmonary function test and assessment of the respiratory muscles using an analog manometer. The statistical analysis was performed using the Kolmogorov and Smirnov tests, one-way ANOVA, Paired Student's t-test and Pearson correlation coefficient (pOBJETIVO: Avaliar o impacto da fragilidade sobre a função respiratória em idosos comunitários. MÉTODO: Foram avaliados 51 idosos comunitários (73±6 anos, sendo 29 homens (56,7% e 22 mulheres (43,3%, por meio de aspectos sociodemográficos, fenótipo de fragilidade, prova de função pulmonar e manovacuometria analógica para os músculos respiratórios. Procedeu-se à análise estatística com os testes Kolmogorov e Smirnov, ANOVA one-way, t de Student Pareado e Coeficiente de Correlação de Pearson (p<0,05. RESULTADOS: Não houve diferenças significativas entre os grupos frágeis (GF=9,8%, pré-frágeis (GP=47,1% e não frágeis (GN=43,1% em relação aos dados antropométricos, demográficos e espirométricos. Para as pressões inspiratórias e expiratórias máximas (PImáx e PEmáx, observaram-se diferenças entre os três grupos, sendo essas pressões significativamente menores no GF e no GP, quando comparados ao GN. Em relação aos valores obtidos e previstos, o GF e o GP apresentaram diferença significativa (p=0,004. O GP apresentou, nas PImáx e PEmáx, correlações positivas com os valores da força de preensão palmar (r=0,7. O GN apresentou, na PEmáx, correlação positiva com os valores de nível de atividade física (r=0,7. CONCLUSÕES: O estudo evidenciou que as pressões respiratórias máximas podem decrescer de acordo com a condição de fragilidade entre os idosos

  5. Metabolic Syndrome and 16-year Cognitive Decline in Community-Dwelling Older Adults

    Science.gov (United States)

    McEvoy, Linda K.; Laughlin, Gail A.; Barrett-Connor, Elizabeth; Bergstrom, Jaclyn; Kritz-Silverstein, Donna; Der-Martirosian, Claudia; von Mühlen, Denise

    2012-01-01

    PURPOSE To determine whether metabolic syndrome is associated with accelerated cognitive decline in community-dwelling older adults. METHODS Longitudinal study of 993 adults (mean 66.8 ± 8.7 years) from the Rancho Bernardo Study. Metabolic syndrome components, defined by 2001 NCEP-ATP III criteria, were measured in 1984–87. Cognitive function was first assessed in 1988–92. Cognitive assessments were repeated approximately every four years, for a maximum 16-year follow-up. Mixed-effects models examined longitudinal rate of cognitive decline by metabolic syndrome status, controlling for factors plausibly associated with cognitive function (diabetes, inflammation). RESULTS Metabolic syndrome was more common in men than women (14% vs. 9%, p=0.01). In women, metabolic syndrome was associated with greater executive function and long term memory decline. These associations did not differ by inflammatory biomarker levels. Diabetes did not alter the association of metabolic syndrome with long-term recall but modified the association with executive function: metabolic syndrome was associated with accelerated executive function decline in diabetic women only. Metabolic syndrome was not related to rate of decline on any cognitive measure in men. CONCLUSIONS Metabolic syndrome was a risk factor for accelerated cognitive decline, but only in women. Prevention of metabolic syndrome may aid in maintenance of cognitive function with age. PMID:22285865

  6. Moderating effect of intrinsic religiosity on the relationship between depression and cognitive function among community-dwelling older adults.

    Science.gov (United States)

    Foong, Hui Foh; Hamid, Tengku Aizan; Ibrahim, Rahimah; Haron, Sharifah Azizah

    2018-04-01

    Research has found that depression in later life is associated with cognitive impairment. Thus, the mechanism to reduce the effect of depression on cognitive function is warranted. In this paper, we intend to examine whether intrinsic religiosity mediates the association between depression and cognitive function. The study included 2322 nationally representative community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, cognitive function, depression and intrinsic religiosity. A four-step moderated hierarchical regression analysis was employed to test the moderating effect. Statistical analyses were performed using SPSS (version 15.0). Bivariate analyses showed that both depression and intrinsic religiosity had significant relationships with cognitive function. In addition, four-step moderated hierarchical regression analysis revealed that the intrinsic religiosity moderated the association between depression and cognitive function, after controlling for selected socio-demographic characteristics. Intrinsic religiosity might reduce the negative effect of depression on cognitive function. Professionals who are working with depressed older adults should seek ways to improve their intrinsic religiosity as one of the strategies to prevent cognitive impairment.

  7. Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults

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    Christopher W. Frames

    2018-05-01

    Full Text Available Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI ranging from 18 to 63 kg/m2, using a force plate and an inertial measurement unit affixed at the sternum. Participants’ fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance.

  8. Subjective cognitive decline and fall risk in community-dwelling older adults with or without objective cognitive decline.

    Science.gov (United States)

    Shirooka, Hidehiko; Nishiguchi, Shu; Fukutani, Naoto; Tashiro, Yuto; Nozaki, Yuma; Aoyama, Tomoki

    2018-05-01

    The association between subjective cognitive decline and falls has not been clearly determined. Our aim was to explore the effect of subjective cognitive decline on falls in community-dwelling older adults with or without objective cognitive decline. We included 470 older adults (mean age 73.6 ± 5.2; 329 women) living in the community and obtained data on fall history directly from the participants. Subjective cognitive decline was assessed using a self-administered question. Objective cognitive function was measured using the Mini-Mental State Examination. Statistical analyses were carried out separately for participants with objective cognitive decline and those without. A multiple logistic regression analysis showed that, among participants without objective cognitive decline, subjective cognitive decline was positively associated with falls [OR 1.91; 95% confidence interval (CI) 1.17-3.12; p = 0.01). Conversely, among participants with objective cognitive decline, subjective cognitive decline was negatively associated with falls (OR 0.07; 95% CI 0.01-0.85, p = 0.04). The result suggests that the objective-subjective disparity may affect falls in community-dwelling older adults. The presence of subjective cognitive decline was significantly positively associated with falls among cognitively intact older adults. However, among their cognitively impaired peers, the absence of subjective cognitive decline was positively associated with falls.

  9. Relationships among symptom severity, coping styles, and quality of life in community-dwelling women with urinary incontinence: a multiple mediator model.

    Science.gov (United States)

    Xu, Dongjuan; Liu, Nana; Qu, Haili; Chen, Liqin; Wang, Kefang

    2016-01-01

    To investigate the relationships among symptom severity, coping styles, and quality of life (QOL) in community-dwelling women with urinary incontinence (UI). A total of 592 women with UI participated in this cross-sectional study. Bivariate Pearson's correlation was used to examine the correlations between symptom severity, coping styles, and QOL. Multivariate regression models and Sobel tests were used to test the mediating effect of coping styles. Additionally, a multiple mediator model was used to examine the mediating role of coping styles collectively. All regression models were adjusted for age, education, marital status, income, duration of UI, and type of UI. Participants tended to use avoidant and palliative coping styles and not use instrumental coping style. Avoidant and palliative coping styles were associated with poor QOL, and partially mediated the association between symptom severity and QOL. Nearly 73% of the adverse effect of symptom severity on QOL was mediated by avoidant and palliative coping styles. The use of avoidant and palliative coping styles was higher with more severe urine leakage, and QOL tended to be poorer. Coping styles should be addressed in UI management. It may be of particular value to look closely at negative coping styles and implement education and training of patients in improving their coping skills related to managing UI, which will in turn improve their QOL.

  10. Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly.

    Science.gov (United States)

    Shinkov, Alexander; Borissova, Anna-Maria; Dakovska, Lilia; Vlahov, Jordan; Kassabova, Lidia; Svinarov, Dobrin; Krivoshiev, Stefan

    2016-02-23

    To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.

  11. Community-Acquired Pneumonia: a Comparison between elderly and nonelderly patients

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    S. Jafari

    2006-08-01

    Full Text Available Background: Community-acquired pneumonia could be a life-threatening condition especially in elderly patients. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We compared the clinical and paraclinical profiles in elderly and nonelderly patients with community-acquired pneumonias. Methods: In this cross-sectional study, seventy nine patients who were hospitalized with community acquired pneumonia over a period of one year were included. Patients' medical records were reviewed; and data related to comorbid conditions, signs and symptoms, laboratory and radiographic findings were gathered using a checklist. Results: The clinical features, laboratory parameters and complications from pneumonia were almost similar in 41 elderly (group I, age ≥65years and 38 young (group II, age<65years subjects. Delirium was seen more in elderly group (p=0.05. The average body temperature and pulse rate were significantly higher in nonelderly group. Sixty one percent of elderly patients and 21% of young patients have Po2 less than 60 (p=0.02. Smoking (29.1%, neurological disturbances (19%, congestive heart failure (15.2%, chronic obstructive pulmonary disease and diabetes mellitus (13.9% were associated comorbidities in both groups. In non elderly group, immune compromise and IV drug use were more common as underlying comorbid conditions. Two of three mortalities were due to elder patients. Conclusion: Community acquired pneumonia could have more serious clinical and abnormal laboratory features in the elderly than younger patients. Mortality rate may be higher in older patients. Comorbid conditions are frequently seen in both elderly and nonelderly patients with community acquired pneumonia, but IV drug use and immune compromise are more frequent in nonelderly patients.

  12. Comparisons of social interaction and activities of daily living between long-term care facility and community-dwelling stroke patients.

    Science.gov (United States)

    Yoon, Jeong-Ae; Park, Se-Gwan; Roh, Hyo-Lyun

    2015-10-01

    [Purpose] This study was conducted to compare the correlation between social interaction and activities of daily living (ADL) between community-dwelling and long-term care facility stroke patients. [Subjects and Methods] The Subjects were 65 chronic stroke patients (32 facility-residing, 33 community-dwelling). The Evaluation Social Interaction (ESI) tool was used to evaluate social interaction and the Assessment of Motor and Process Skills (AMPS) measure was used to evaluate ADL. [Results] Both social interaction and ADL were higher in community-dwelling than facility-residing stroke patients. There was a correlation between ESI and ADL for both motor and process skills among facility-residing patients, while only ADL process skills and ESI correlated among community-dwelling patients. In a partial correlation analysis using ADL motor and process skills as control variables, only process skills correlated with ESI. [Conclusion] For rehabilitation of stroke patients, an extended treatment process that combines ADL and social activities is likely to be required. Furthermore, treatment programs and institutional systems that can improve social interaction and promote health maintenance for community-dwelling and facility-residing chronic stroke patients are needed throughout the rehabilitation process.

  13. Association of Sarcopenic Obesity with Higher Serum High-Sensitivity C-Reactive Protein Levels in Chinese Older Males--A Community-Based Study (Taichung Community Health Study-Elderly, TCHS-E.

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    Chuan-Wei Yang

    Full Text Available The prevalence of obesity and sarcopenia is high among the elderly. The simultaneous occurrence of these two disorders results in sarcopenic obesity. Research suggests that inflammation has an important role in the pathogenesis of obesity and sarcopenia. This study explores the impact of sarcopenic obesity on inflammatory markers, including interleukin-6 (IL-6, high-sensitivity C-reactive protein (hs-CRP, and tumor necrosis factor-alpha (TNF-α. This study is a community-based cross-sectional study. The study sample consisted of 844 community-dwelling people aged 65 years and older (448 men and 396 women. Sarcopenia was characterized by low muscle mass (skeletal muscle index < 6.87 and 5.46 kg/m2 for men and women, respectively, and obesity was characterized by excess body fat (body fat percentage greater than the 60th percentile of the study sample by sex [27.82% in men and 37.61% in women]. Older individuals identified with sarcopenic obesity were those who had both sarcopenia and obesity. Inflammatory markers such as IL-6, hs-CRP, and TNF-α were measured. The prevalence rates of obesity only, sarcopenia only, and sarcopenic obesity were 32.94%, 11.85%, and 7.23%, respectively. No difference was observed in the serum levels of IL-6 and TNF-α among the four groups of combined sarcopenia and obesity status. After multivariate adjustment, the serum hs-CRP levels in the obesity only and in the sarcopenic obesity groups were 0.14 and 0.16 mg/dL among males, respectively, which were significantly higher than that in the normal group (P=0.012 and 0.036. Our results provide evidence that obesity and sarcopenic obesity are associated with increased levels of serum hs-CRP among males.

  14. Effects of exercise and milk fat globule membrane (MFGM supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial.

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    Hunkyung Kim

    Full Text Available To investigate the combined and separate effects of exercise and milk fat globule membrane (MFGM supplementation on frailty, physical function, physical activity level, and hematological parameters in community-dwelling elderly Japanese women.A total of 131 frail, elderly women over 75 years were randomly assigned to one of four groups: exercise and MFGM supplementation (Ex+MFGM, exercise and placebo (Ex+Plac, MFGM supplementation, or the placebo group. The exercise group attended a 60-minute training program twice a week for three months, and the MFGM group ingested 1g of the MFGM supplement in pill form, daily for 3 months. The primary outcome measure was change in frailty status based on Fried's frailty phenotype. Secondary outcome measures included body composition, physical function and hematological parameters, and interview survey components assessing lifestyle factors. Participants were followed for 4 months post-intervention.Significant group × time interactions were observed for usual walking speed (P = 0.005, timed up & go (P<0.001, and insulin-like growth factor-binding protein 3/insulin-like growth factor 1 ratio (P = 0.013. The frailty components revealed that weight loss, exhaustion, low physical activity, and slow walking speed were reversed, but low muscle strength did not significantly changed. Frailty reversal rate was significantly higher in the Ex+MFGM (57.6% than in the MFGM (28.1% or placebo (30.3% groups at post-intervention (χ2 = 8.827, P = 0.032, and at the follow-up was also significantly greater in the Ex+MFGM (45.5% and Ex+Plac (39.4% groups compared with the placebo (15.2% group (χ2 = 8.607, P = 0.035. The exercise+MFGM group had the highest odds ratio (OR for frailty reversal at post-intervention and follow-up (OR = 3.12, 95% confidence interval (CI = 1.13-8.60; and OR = 4.67, 95% CI = 1.45-15.08, respectively.This study suggests that interventions including exercise and nutrition can improve frailty status

  15. The Relationship between Health Literacy and Physical Activity Level of Elderly Women in the City of Urmia

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    Friborz Fathi

    2017-06-01

    Full Text Available Background and objective: Health Literacy refers to cognitive and social skills which determine the motivation and knowledge intended for people to obtain information and access to understand and using them to promote and keeping fitness. Regular physical activity is necessary for human. The purpose of this study was to investigate the relationship between Health Literacy and physical activity level of elderly women in the of Urmia city. Methods: In this descriptive – correlation study of 120 elderly women of Urmia were selected. In Order to collect data, two questionnaire Functional Health Literacy of TOFHLA adults   and a physical activity questionnaire of Baekce was used. It was used SPSS software and one-sample T- test, and it was also conducted Pearson correlation and stepwise regression. Results: of 30% of the elderly had adequate Health Literacy 38/34 had inadequate health literacy and 31/64 had cross-border Health Literacy. Correlations were positive and significant correlation between adequate Health Literacy and physical activity were cross-border health physical activity in respectively. One-sample T-Tak results showed that the level Health Literacy in both access and reading in elderly women is higher than the average level in Urmia. Stepwise regression analysis showed that adequate health and cross-border Health Literacy can account for more than 80 percent of their sporting activities. Conclusion:  In order to promote physical activity levels of elderly women it should be improved their health literacy. By planning and designing useful training in the field of Health Literacy programs tailored to the elderly it can be done effective step to develop literacy skills in community health and physical health of elderly. Paper Type: Research Article

  16. Poor Appetite and Dietary Intake in Community-Dwelling Older Adults

    NARCIS (Netherlands)

    van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

    2017-01-01

    BACKGROUND/OBJECTIVES: Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling

  17. Incidence, Risk Factors, and the Protective Effect of High Body Mass Index against Sarcopenia in Suburb-Dwelling Elderly Chinese Populations.

    Science.gov (United States)

    Han, P; Zhao, J; Guo, Q; Wang, J; Zhang, W; Shen, S; Wang, X; Dong, R; Ma, Y; Kang, L; Fu, L; Jia, L; Han, X; He, Z; Bao, Y; Wang, L; Niu, K

    2016-01-01

    Few studies have explored the risk factors of sarcopenia in certain cohorts. The objective of this study was to examine the incidence of sarcopenia and associated factors over a 1-year period in an elderly Chinese suburban population. This study was conducted on 356 Chinese suburb-dwelling participants aged ≥60 years, for whom detailed information regarding sociodemographics, behavioral characteristics, and medical conditions had been documented. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. Sarcopenia incidence was documented after one year of follow-up, and correlated with several possible factors. At baseline, 64 (9.7%) of the initial 657 participants had sarcopenia. The prevalence of sarcopenia was 10.4% after one year. Between baseline and 1-year follow-up, 13 of the participants without sarcopenia at baseline had developed sarcopenia. After multivariate adjustments, it was found that the incidence of sarcopenia increased with age and high body mass index (BMI) is associated with less incidence of sarcopenia. Incidence was also higher among women. We found sarcopenia incidence increased with age, and women were more likely to have sarcopenia. A higher BMI is also associated with a lower incidence of sarcopenia. Maintaining a healthy weight could be beneficial in the prevention of sarcopenia.

  18. Does self-reported sleep quality predict poor cognitive performance among elderly living in elderly homes?

    Science.gov (United States)

    Amer, Motassem S; Hamza, Sarah A; El Akkad, Rania M; Abdel Galeel, Yamen I I

    2013-01-01

    Sleep complaints are common among elderly, especially institutionalized elderly, as they experience poorer sleep quality and higher use of sedative hypnotics, when compared to community-dwelling elderly. Recent findings suggest that there may be a relationship between poor quality of sleep and cognitive deficits. This study aimed at studying the relation between sleep quality and cognitive performance in older adults living in elderly homes. 100 elderly living in an elderly home in El Mansoura, Egypt, were recruited in this study, 50 cases with subjective poor quality of sleep and 50 controls with subjective good quality of sleep as assessed by Pittsburgh sleep quality index (PSQI). Each participant went through comprehensive geriatric assessment (CGA), including geriatric depression scale (GDS), assessment of cognitive function by mini mental state examination (MMSE). 52% of poor sleepers showed impaired MMSE, while only 24% of good sleepers had impaired MMSE. Both orientation and (attention and calculation) were more affected (P = 0.027 and 0.035, respectively). Linear correlation coefficient between PSQI and different variables revealed significant negative correlation with total MMSE score, attention and calculation. Poor quality of sleep is related to cognitive impairment among elderly living in elderly homes and this problem should be taken in consideration among this group of elders.

  19. Systematic Literature Review of Randomized Control Trials Assessing the Effectiveness of Nutrition Interventions in Community-Dwelling Older Adults

    Science.gov (United States)

    Bandayrel, Kristofer; Wong, Sharon

    2011-01-01

    Objective: Nutrition interventions may play an important role in maintaining the health and quality of life in community-dwelling older adults. To the authors' knowledge, no systematic literature review has been conducted on the effectiveness of nutrition interventions in the community-dwelling older adult population. Design: Systematic literature…

  20. Seeking "a place where one belongs": elderly Korean immigrant women using day care services in Japan.

    Science.gov (United States)

    Lee, Kumsun; Herrera C, Lourdes R; Lee, Setsuko; Nakamura, Yasuhide

    2012-10-01

    The study examined the subjective life experiences of elderly first-generation Korean women living in Japan and investigated their adjustment to the local Japanese community. The study group comprised 14 elderly Korean women residents at a Korean-oriented, insurance-based, day services center in midwestern Japan. They were interviewed in depth, and the data were analyzed using the modified grounded theory approach. The study designated the core category as "conservation of ethnic identity" and identified five subcategories: (a) loneliness, (b) returning to one's homeland culture, (c) physical decline as a result of aging, (d) family ties, and (e) a place where one belongs. The results elucidated that although the participants had adapted to Japanese culture, they were strongly influenced by the memories of their hometowns and wished to return to their homeland. The study suggests that elderly immigrants need day care support that provides an environment where they can enjoy their culture.

  1. Does smart home technology prevent falls in community-dwelling older adults: a literature review.

    Science.gov (United States)

    Pietrzak, Eva; Cotea, Cristina; Pullman, Stephen

    2014-01-01

    Falls in older Australians are an increasingly costly public health issue, driving the development of novel modes of intervention, especially those that rely on computer-driven technologies. The aim of this paper was to gain an understanding of the state of the art of research on smart homes and computer-based monitoring technologies to prevent and detect falls in the community-dwelling elderly. Cochrane, Medline, Embase and Google databases were searched for articles on fall prevention in the elderly using pre-specified search terms. Additional papers were searched for in the reference lists of relevant reviews and by the process of 'snowballing'. Only studies that investigated outcomes related to falling such as fall prevention and detection, change in participants' fear of falling and attitudes towards monitoring technology were included. Nine papers fulfilled the inclusion criteria. The following outcomes were observed: (1) older adults' attitudes towards fall detectors and smart home technology are generally positive; (2) privacy concerns and intrusiveness of technology were perceived as less important to participants than their perception of health needs and (3) unfriendly and age-inappropriate design of the interface may be one of the deciding factors in not using the technology. So far, there is little evidence that using smart home technology may assist in fall prevention or detection, but there are some indications that it may increase older adults' confidence and sense of security, thus possibly enabling aging in place.

  2. Poor nutritional status is associated with a higher risk of falling and fracture in elderly people living at home in France: the Three-City cohort study.

    Science.gov (United States)

    Torres, M J; Féart, C; Samieri, C; Dorigny, B; Luiking, Y; Berr, C; Barberger-Gateau, P; Letenneur, L

    2015-08-01

    Falling and fractures are a public health problem in elderly people. The aim of our study was to investigate whether nutritional status is associated with the risk of falling or fracture in community-dwelling elderly. Poor nutritional status was significantly associated with a higher risk of both falling and fractures. Nutrition could play a role to prevent falls and fractures. The purpose of this study is to investigate whether a poor nutritional status is associated with the risk of falling and of fracture in community dwelling elderly. Baseline nutritional status of participants was assessed using the Mini Nutritional Assessment (MNA). After a follow-up of 12 years, 6040 individuals with available data for falls and 6839 for fracture were included. People who presented the outcomes at baseline were excluded. Cox models were used to evaluate the associations between nutritional status and the risks of fall or fracture. The frequency of poor nutritional status (MNA ≤ 23.5), at baseline, was respectively 12.0% in the "fall study sample" and 12.8% in the "fracture study sample." Incident fall and fracture over 12 years were reported in 55.8 and 18.5% of the respective samples, respectively. In multivariate models controlled for sociodemographic data and several baseline health indicators, poor nutritional status was significantly associated with a higher risk of falling (hazard ratio (HR) = 1.66, 95% confidence interval (95% CI) 1.35-2.04 in men and HR = 1.20, 95% CI 1.07-1.34 in women) and with a higher risk of fracture (HR = 1.28, 95% CI 1.09-1.49). Poor nutritional status was associated with a higher risk of both falling and fractures in French elderly community-dwellers. Early screening and management of the nutritional status may be useful to reduce the frequency of these events in older people.

  3. Effect of Cyber-Golfing on Balance Amongst the Elderly in Hong Kong: A Pilot Randomised Trial

    Directory of Open Access Journals (Sweden)

    Daniel H.K. Chow

    2015-12-01

    Conclusion: The results of this study suggest that cyber-golfing might be an alternative to golfing, which is capable of enhancing balance ability amongst community-dwelling elderly. The potential of exergaming as a clinical tool for geriatric rehabilitation was discussed.

  4. Influence of sarcopenia and functionality indicators on the frailty profile of community-dwelling elderly subjects: a cross-sectional study.

    Science.gov (United States)

    Viana, Joana U; Silva, Silvia L A; Torres, Juliana L; Dias, João M D; Pereira, Leani S M; Dias, Rosângela C

    2013-01-01

    Frailty and sarcopenia are frequent conditions in the elderly and are related to inactivity and functionality. However, little is known about the influence of the sarcopenia indicators on the frailty profile or their functional implications. To evaluate whether the indirect indicators of sarcopenia and functionality influence the frailty profile in elderly subjects. This was a cross-sectional study with 53 elderly subjects recruited by an active search in a secondary health care service. The indirect indicators of sarcopenia were body mass index (BMI), gait speed, Mini-Nutritional Assessment (MNA), Human Activity Profile (HAP), and handgrip strength. Frailty was characterized according to Fried's Frailty Phenotype. Functional capacity was assessed according to the Short Physical Performance Battery (SPPB). Physical activity level was assessed by HAP. Data were analyzed by analysis of variance (ANOVA) and multiple regression. Overall, 75.5% of the subjects were women, with a mean age of 76.72 (±5.89) years; 15.1% were frail and 54.7% pre-frail; and the level of physical activity was the most prevalent indicator of sarcopenia. Significant differences (psarcopenia indicators were associated with functional capacity and geriatric depression score. The level of physical activity and gait speed appeared to be the most relevant factors in the development of frailty in the study sample, which may have functional implications.

  5. Reference values and age and sex differences in physical performance measures for community-dwelling older Japanese: a pooled analysis of six cohort studies.

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    Satoshi Seino

    Full Text Available OBJECTIVES: To determine age- and sex-specific reference values for six physical performance measures, i.e. hand-grip strength, one-legged stance, and gait speed and step length at both usual and maximum paces, and to investigate age and sex differences in these measures among community-dwelling older Japanese adults. METHODS: We conducted a pooled analysis of data from six cohort studies collected between 2002 and 2011 as part of the Tokyo Metropolitan Institute of Gerontology-Longitudinal Interdisciplinary Study on Aging. The pooled analysis included cross-sectional data from 4683 nondisabled, community-dwelling adults aged 65 years or older (2168 men, 2515 women; mean age: 74.0 years in men and 73.9 years in women. RESULTS: Unweighted simple mean (standard deviation hand-grip strength, one-legged stance, usual gait speed, usual gait step length, maximum gait speed, and maximum gait step length were 31.7 (6.7 kg, 39.3 (23.0 s, 1.29 (0.25 m/s, 67.7 (10.0 cm, 1.94 (0.38 m/s, and 82.3 (11.6 cm, respectively, in men and 20.4 (5.0 kg, 36.8 (23.4 s, 1.25 (0.27 m/s, 60.8 (10.0 cm, 1.73 (0.36 m/s, and 69.7 (10.8 cm, respectively, in women. All physical performance measures showed significant decreasing trends with advancing age in both sexes (all P<0.001 for trend. We also constructed age- and sex-specific appraisal standards according to quintiles. With increasing age, the sex difference in hand-grip strength decreased significantly (P<0.001 for age and sex interaction. In contrast, sex differences significantly increased in all other measures (all P<0.05 for interactions except step length at maximum pace. CONCLUSION: Our pooled analysis yielded inclusive age- and sex-specific reference values and appraisal standards for major physical performance measures in nondisabled, community-dwelling, older Japanese adults. The characteristics of age-related decline in physical performance measures differed between sexes.

  6. Perceived loneliness and general cognitive status in community-dwelling older adults: the moderating influence of depression.

    Science.gov (United States)

    Lam, Charlene L M; Yu, Junhong; Lee, Tatia M C

    2017-09-01

    The relationship between depression, loneliness, and cognitive functioning among the elderly is not well understood in the literature. In the present study, we tested the moderating influence of depressive symptoms on loneliness and cognitive functioning. We recruited 100 community-dwelling older adults in Hong Kong. Demographic information, perceived loneliness, depressed mood, and general cognitive status were assessed. Results indicated that married participants reported lower levels of perceived loneliness (t (96) = 2.26, p = .03). We found a significant moderating effect of depressive symptoms on the relationship between perceived loneliness and general cognitive status (B = -.05, p = .002). Perceived loneliness correlated negatively with general cognitive status only in participants with higher levels of depressed mood (B = -.16, p = .01). Together, these findings suggest that perceived loneliness combined with depressed mood is related to poorer general cognitive status in older adults. The implications of these findings are discussed.

  7. Association of Psychosocial Conditions, Oral Health, and Dietary Variety with Intellectual Activity in Older Community-Dwelling Japanese Adults.

    Science.gov (United States)

    Tomioka, Kimiko; Okamoto, Nozomi; Kurumatani, Norio; Hosoi, Hiroshi

    2015-01-01

    This study examined the factors related to intellectual activity in community-dwelling elderly persons. Self-administered questionnaires mailed to all people aged ≥65 years in a dormitory suburb in Japan (n = 15,210). The response rate was 72.2%. Analytical subjects (n = 8,910) were those who lived independently and completely answered questions about independent and dependent variables and covariates. Independent variables included psychosocial conditions (i.e., social activities, hobbies, and a sense that life is worth living (ikigai)), oral health (i.e., dental health behaviors and oral function evaluated by chewing difficulties, swallowing difficulties, and oral dryness), and dietary variety measured using the dietary variety score (DVS). A dependent variable was intellectual activity measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Covariates included age, gender, family structure, pensions, body mass index, alcohol, smoking, medical history, self-rated health, medications, cognitive function, depression, and falling. Logistic regression was used to estimate the odds ratio (OR) for poor intellectual activity. Poor intellectual activity was reported by 28.9% of the study population. After adjustment for covariates and independent variables, poor intellectual activity was significantly associated with nonparticipation in social activities (OR = 1.90, 95%CI = 1.61-2.24), having neither hobbies nor ikigai (3.13, 2.55-3.84), having neither regular dental visits nor daily brushing (1.70, 1.35-2.14), the poorest oral function (1.61, 1.31-1.98), and the lowest DVS quartile (1.96, 1.70-2.26). These results indicate that psychosocial conditions, oral health, and dietary variety are independently associated with intellectual activity in elderly persons. The factors identified in this study may be used in community health programs for maintaining the intellectual activity ability of the elderly.

  8. Association of Psychosocial Conditions, Oral Health, and Dietary Variety with Intellectual Activity in Older Community-Dwelling Japanese Adults.

    Directory of Open Access Journals (Sweden)

    Kimiko Tomioka

    Full Text Available This study examined the factors related to intellectual activity in community-dwelling elderly persons.Self-administered questionnaires mailed to all people aged ≥65 years in a dormitory suburb in Japan (n = 15,210. The response rate was 72.2%. Analytical subjects (n = 8,910 were those who lived independently and completely answered questions about independent and dependent variables and covariates. Independent variables included psychosocial conditions (i.e., social activities, hobbies, and a sense that life is worth living (ikigai, oral health (i.e., dental health behaviors and oral function evaluated by chewing difficulties, swallowing difficulties, and oral dryness, and dietary variety measured using the dietary variety score (DVS. A dependent variable was intellectual activity measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Covariates included age, gender, family structure, pensions, body mass index, alcohol, smoking, medical history, self-rated health, medications, cognitive function, depression, and falling. Logistic regression was used to estimate the odds ratio (OR for poor intellectual activity.Poor intellectual activity was reported by 28.9% of the study population. After adjustment for covariates and independent variables, poor intellectual activity was significantly associated with nonparticipation in social activities (OR = 1.90, 95%CI = 1.61-2.24, having neither hobbies nor ikigai (3.13, 2.55-3.84, having neither regular dental visits nor daily brushing (1.70, 1.35-2.14, the poorest oral function (1.61, 1.31-1.98, and the lowest DVS quartile (1.96, 1.70-2.26.These results indicate that psychosocial conditions, oral health, and dietary variety are independently associated with intellectual activity in elderly persons. The factors identified in this study may be used in community health programs for maintaining the intellectual activity ability of the elderly.

  9. Association of Psychosocial Conditions, Oral Health, and Dietary Variety with Intellectual Activity in Older Community-Dwelling Japanese Adults

    Science.gov (United States)

    Tomioka, Kimiko; Okamoto, Nozomi; Kurumatani, Norio; Hosoi, Hiroshi

    2015-01-01

    Background This study examined the factors related to intellectual activity in community-dwelling elderly persons. Methods Self-administered questionnaires mailed to all people aged ≥65 years in a dormitory suburb in Japan (n = 15,210). The response rate was 72.2%. Analytical subjects (n = 8,910) were those who lived independently and completely answered questions about independent and dependent variables and covariates. Independent variables included psychosocial conditions (i.e., social activities, hobbies, and a sense that life is worth living (ikigai)), oral health (i.e., dental health behaviors and oral function evaluated by chewing difficulties, swallowing difficulties, and oral dryness), and dietary variety measured using the dietary variety score (DVS). A dependent variable was intellectual activity measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Covariates included age, gender, family structure, pensions, body mass index, alcohol, smoking, medical history, self-rated health, medications, cognitive function, depression, and falling. Logistic regression was used to estimate the odds ratio (OR) for poor intellectual activity. Results Poor intellectual activity was reported by 28.9% of the study population. After adjustment for covariates and independent variables, poor intellectual activity was significantly associated with nonparticipation in social activities (OR = 1.90, 95%CI = 1.61–2.24), having neither hobbies nor ikigai (3.13, 2.55–3.84), having neither regular dental visits nor daily brushing (1.70, 1.35–2.14), the poorest oral function (1.61, 1.31–1.98), and the lowest DVS quartile (1.96, 1.70–2.26). Conclusion These results indicate that psychosocial conditions, oral health, and dietary variety are independently associated with intellectual activity in elderly persons. The factors identified in this study may be used in community health programs for maintaining the intellectual activity ability of the

  10. Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

    OpenAIRE

    Makino, Keitaro; Ihira, Hikaru; Mizumoto, Atsushi; Shimizu, Kotaro; Ishida, Toyoaki; Furuna, Taketo

    2015-01-01

    [Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ? 4.1?years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older...

  11. Pelvic Floor Morphometric Differences in Elderly Women with or without Urinary Incontinence.

    Science.gov (United States)

    Fradet, Sarah; Morin, Mélanie; Kruger, Jennifer; Dumoulin, Chantale

    2018-01-01

    Purpose: Urinary incontinence (UI) affects as many as 50% of women aged 60 years and older, but UI pathophysiology, specifically in elderly women, remains unclear. A better understanding of morphometric differences between continent and urinary incontinent elderly women is needed to improve the effectiveness of conservative treatment approaches. We hypothesized that morphometric differences in the pelvic floor muscles (PFM) among elderly women with and without UI could be observed using three- and four-dimensional (3D/4D) transperineal ultrasound (TPU) imaging. Method: A total of 40 elderly women (20 women with and 20 women without UI), with a mean age of 67.10 (SD 4.94) years, participated in the study. This was a case-control study in which TPU images were taken under three conditions: rest, maximal voluntary contraction (MVC), and Valsalva. Independent t -tests were conducted to compare measurements between the groups. Results: The study revealed statistically significant differences between the groups. At rest, the levator hiatal area and transverse diameter were bigger, and the PFM position was lower in the incontinent group. During MVC, all axial plane parameters were bigger in the incontinent group. In the sagittal plane, PFM position was again lower in the incontinent group. During Valsalva, the anorectal angle was wider in the women with incontinence. Conclusion: PFM morphometric differences were present and were observed using 3D/4D TPU imaging in elderly women with and without UI.

  12. Practical consensus recommendations regarding the management of hormone receptor positive early breast cancer in elderly women

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    Govind Babu

    2018-01-01

    Full Text Available Breast cancer is a leading cause of death among women, and its incidence increases with age. Currently the treatment of breast cancer in older patients is almost identical to their younger counterparts. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists regarding the management of early breast cancer specifically in elderly women.

  13. Topical Decolonization Does Not Eradicate the Skin Microbiota of Community-Dwelling or Hospitalized Adults

    Science.gov (United States)

    Hogan, Patrick G.; Wallace, Meghan A.; Deych, Elena; Shannon, William; Warren, David K.

    2016-01-01

    Topical antimicrobials are often employed for decolonization and infection prevention and may alter the endogenous microbiota of the skin. The objective of this study was to compare the microbial communities and levels of richness and diversity in community-dwelling subjects and intensive care unit (ICU) patients before and after the use of topical decolonization protocols. We enrolled 15 adults at risk for Staphylococcus aureus infection. Community subjects (n = 8) underwent a 5-day decolonization protocol (twice daily intranasal mupirocin and daily dilute bleach-water baths), and ICU patients (n = 7) received daily chlorhexidine baths. Swab samples were collected from 5 anatomic sites immediately before and again after decolonization. A variety of culture media and incubation environments were used to recover bacteria and fungi; isolates were identified using matrix-assisted laser desorption ionization–time of flight mass spectrometry. Overall, 174 unique organisms were recovered. Unique communities of organisms were recovered from the community-dwelling and hospitalized cohorts. In the community-dwelling cohort, microbial richness and diversity did not differ significantly between collections across time points, although the number of body sites colonized with S. aureus decreased significantly over time (P = 0.004). Within the hospitalized cohort, richness and diversity decreased over time compared to those for the enrollment sampling (from enrollment to final sampling, P = 0.01 for both richness and diversity). Topical antimicrobials reduced the burden of S. aureus while preserving other components of the skin and nasal microbiota. PMID:27671074

  14. The physical capabilities underlying timed "Up and Go" test are time-dependent in community-dwelling older women.

    Science.gov (United States)

    Coelho-Junior, Hélio José; Rodrigues, Bruno; Gonçalves, Ivan de Oliveira; Asano, Ricardo Yukio; Uchida, Marco Carlos; Marzetti, Emanuele

    2018-04-01

    Timed 'Up and Go' (TUG) has been widely used in research and clinical practice to evaluate physical function and mobility in older adults. However, the physical capabilities underlying TUG performance are not well elucidated. Therefore, the present study aimed at investigating a selection of physical capacities underlying TUG performance in community-dwelling older women. Four hundred and sixty-eight apparently healthy older women independent to perform the activities of daily living (mean age: 65.8 ± 6.0 years) were recruited from two specialized healthcare centers for older adults to participate in the study. Volunteers had their medical books reviewed and underwent evaluations of anthropometric data as well as physical and functional capacities. Pearson's correlation results indicate that TUG performance was significantly associated with upper (i.e., handgrip strength) and lower (i.e., sit-to-stand) limb muscle strength, balance (i.e., one-leg stand), lower limb muscle power (i.e., countermovement jump), aerobic capacity (i.e., 6-minute walk test), and mobility (i.e., usual and maximal walking speeds). When the analyses were performed based on TUG quartiles, a larger number of physical capabilities were associated with TUG >75% in comparison with TUG <25%. Multiple linear regression results indicate that the variability in TUG (~20%) was explained by lower limb muscle strength (13%) and power (1%), balance (4%), mobility (2%), and aerobic capacity (<1%), even after adjusted by age and age plus body mass index (BMI). However, when TUG results were added as quartiles, a decrease in the impact of physical capacities on TUG performance was determined. As a whole, our findings indicate that the contribution of physical capabilities to TUG performance is altered according to the time taken to perform the test, so that older women in the lower quartiles - indicating a higher performance - have an important contribution of lower limb muscle strength, while

  15. Focus groups as a tool to collect data in a community informatics project involving elderly rural women

    CSIR Research Space (South Africa)

    Smith, R

    2015-11-01

    Full Text Available The main purpose of the extended project is to identify and investigate the aspects that will encourage elderly women in rural areas to use the ICT platform, and to determine what the physical design, content and applications should look like...

  16. Muscle quality, aerobic fitness and fat mass predict lower-extremity physical function in community-dwelling older adults.

    Science.gov (United States)

    Misic, Mark M; Rosengren, Karl S; Woods, Jeffrey A; Evans, Ellen M

    2007-01-01

    Muscle mass, strength and fitness play a role in lower-extremity physical function (LEPF) in older adults; however, the relationships remain inadequately characterized. This study aimed to examine the relationships between leg mineral free lean mass (MFLM(LEG)), leg muscle quality (leg strength normalized for MFLM(LEG)), adiposity, aerobic fitness and LEPF in community-dwelling healthy elderly subjects. Fifty-five older adults (69.3 +/- 5.5 years, 36 females, 19 males) were assessed for leg strength using an isokinetic dynamometer, body composition by dual energy X-ray absorptiometry and aerobic fitness via a treadmill maximal oxygen consumption test. LEPF was assessed using computerized dynamic posturography and stair ascent/descent, a timed up-and-go task and a 7-meter walk with and without an obstacle. Muscle strength, muscle quality and aerobic fitness were similarly correlated with static LEPF tests (r range 0.27-0.40, p < 0.05); however, the strength of the independent predictors was not robust with explained variance ranging from 9 to 16%. Muscle quality was the strongest correlate of all dynamic LEPF tests (r range 0.54-0.65, p < 0.001). Using stepwise linear regression analysis, muscle quality was the strongest independent predictor of dynamic physical function explaining 29-42% of the variance (p < 0.001), whereas aerobic fitness or body fat mass explained 5-6% of the variance (p < 0.05) depending on performance measure. Muscle quality is the most important predictor, and aerobic fitness and fat mass are secondary predictors of LEPF in community-dwelling older adults. These findings support the importance of exercise, especially strength training, for optimal body composition, and maintenance of strength and physical function in older adults.

  17. Walking Recovery after a Hip Fracture: A Prospective Follow-Up Study among Community-Dwelling over 60-Year Old Men and Women

    Directory of Open Access Journals (Sweden)

    Anu Salpakoski

    2014-01-01

    Full Text Available Purpose. Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture. Methods. A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery, and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes during follow-up. Association between walking trajectories and potential determinants was analysed with a logistic regression model. Results. Two trajectories, No-to-minor-difficulty and Catastrophic, were found. Thirty-eight percent of the participants ended up in the Catastrophic trajectory for walking outdoors and 67% for 500 meters. Multivariate logistic regression analysis revealed that use of walking aid and indoor falls before fracture and prolonged pain were independently associated with catastrophic decline in both primary outcomes: difficulty in walking outdoors and 500 meters. Conclusions. A large proportion of community-dwelling older people recovering from hip fracture experienced catastrophic decline in outdoor walking. Acknowledging recovery prognoses at early stage enables individualized rehabilitation.

  18. Behavioral symptoms in community-dwelling elderly Nigerians with dementia, mild cognitive impairment, and normal cognition.

    Science.gov (United States)

    Baiyewu, Olusegun; Unverzagt, Fred W; Ogunniyi, Adesola; Smith-Gamble, Valerie; Gureje, Oye; Lane, Kathleen A; Gao, Sujuan; Hall, Kathleen S; Hendrie, Hugh C

    2012-09-01

    Few studies have examined the neuropsychiatric status of patients with dementia and cognitive impairment in the developing world despite the fact that current demographic trends suggest an urgent need for such studies. To assess the level of neuropsychiatric symptoms in community-dwelling individuals with dementia, cognitive impairment no dementia and normal cognition. Subjects were from the Ibadan site of Indianapolis-Ibadan Dementia Project with stable diagnoses of normal cognition, cognitive impairment, no dementia/mild cognitive impairment (CIND/MCI), and dementia. Informants of subjects made ratings on the neuropsychiatric inventory and blessed dementia scale; subjects were tested with the mini mental state examination. One hundred and eight subjects were included in the analytic sample, 21 were cognitively normal, 34 were demented, and 53 were CIND/MCI. The diagnostic groups did not differ in age, per cent female, or per cent with any formal education. The most frequent symptoms among subjects with CIND/MCI were depression (45.3%), apathy (37.7%), night time behavior (28.3%), appetite change (24.5%), irritability (22.6%), delusions (22.6%), anxiety (18.9%), and agitation (17.0%). Depression was significantly more frequent among the CIND/MCI and dementia (44.1%) groups compared with the normal cognition group (9.5%). Distress scores were highest for the dementia group, lowest for the normal cognition group, and intermediate for the CIND/MCI group. Significant neuropsychiatric symptomatology and distress are present among cognitively impaired persons in this community-based study of older adults in this sub-Saharan African country. Programs to assist family members of cognitively impaired and demented persons should be created or adapted for use in developing countries. Copyright © 2012 John Wiley & Sons, Ltd.

  19. Predicting delay to treatment of urinary incontinence among urban community-dwelling women in China

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    Chen Wu

    2015-03-01

    Conclusion: Women who were older, had lower subjective UI severity, and who reported only stress or urgency UI tended to delay treatment longer; such patients should be targeted for health education and intervention regarding UI in urban communities.

  20. Assertive community treatment for elderly people with severe mental illness.

    Science.gov (United States)

    Stobbe, Jolanda; Mulder, Niels C L; Roosenschoon, Bert-Jan; Depla, Marja; Kroon, Hans

    2010-10-19

    Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. The Netherlands National Trial Register NTR1620.

  1. Interventions to improve social determinants of health among elderly ethnic minority groups: a review.

    Science.gov (United States)

    Pool, Michelle S; Agyemang, Charles O; Smalbrugge, Martin

    2017-12-01

    Like the European general population, ethnic minorities are aging. In this group, important social determinants of health (social participation, social isolation and loneliness) that lead to negative health outcomes frequently occur. Interventions targeting these determinants may decrease negative health outcomes. The goal of this article was to identify effective interventions that improve social participation, and minimise social isolation and loneliness in community dwelling elderly ethnic minorities. An electronic database (PubMed) was systematically searched using an extensive search strategy, for intervention studies in English, French, Dutch of German, without time limit. Additional articles were found using references. Articles were included if they studied an intervention aimed to improve social participation or minimise social isolation or loneliness and were focusing on community dwelling elderly ethnic minorities. Data regarding studies characteristics and results were extracted. Six studies (three randomized controlled trials, three non-controlled intervention studies) were included in the review. All studies were group-based interventions and had a theoretical basis. Five out of six studies showed improvement on a social participation, -isolation or loneliness outcome. Type of intervention included volunteering-, educational- and physical activities. In three studies active participation of the participant was required, these interventions were not more effective than other interventions. Some interventions improved the included social determinants of health in community dwelling elderly ethnic minorities. Investment in further development and implementation of these interventions may help to improve social determinants of health in these populations. It is necessary to evaluate these interventions in the European setting. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. Life space and mental health: a study of older community-dwelling persons in Australia.

    Science.gov (United States)

    Byles, Julie E; Leigh, Lucy; Vo, Kha; Forder, Peta; Curryer, Cassie

    2015-01-01

    The ability of older people to mobilise within and outside their community is dependent on a number of factors. This study explored the relationship between spatial mobility and psychological health among older adults living in Australia. The survey sample consisted of 260 community-dwelling men and women aged 75-80 years, who returned a postal survey measuring spatial mobility (using the Life Space Questionnaire) and psychological health (using the SF36 Health Related Quality of Life Profile). From the Life Space Questionnaire, participants were given a life-space score and multinomial regression was used to explore the potential effect of mental health on life-space score. The study found a significant association between mental health and life space. However, gender, physical functioning, and ability to drive were most strongly associated with the extent of life space and spatial mobility. Compared to men, older women are more likely to experience less spatial mobility and restricted life space, and hence are more vulnerable to social isolation. Mental health and life space were associated for the older people in this study. These findings have important implications for health policy and highlight the need to support older persons to maintain independence and social networks, and to successfully age in place within their community. This study also highlights the utility of the Life Space Questionnaire in terms of identifying older persons at risk of poorer mental health.

  3. Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults †.

    Science.gov (United States)

    Frames, Christopher W; Soangra, Rahul; Lockhart, Thurmon E; Lach, John; Ha, Dong Sam; Roberto, Karen A; Lieberman, Abraham

    2018-05-24

    Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m², using a force plate and an inertial measurement unit affixed at the sternum. Participants' fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance.

  4. Developing a falls prevention program for community-dwelling stroke survivors in Singapore: client and caregiver perspectives.

    Science.gov (United States)

    Xu, Tianma; O'Loughlin, Kate; Clemson, Lindy; Lannin, Natasha A; Dean, Catherine; Koh, Gerald

    2017-12-25

    Drawing on the perspectives of stroke survivors, family members and domestic helpers, this study explores participants' experiences of self-perceived fall risk factors after stroke, common fall prevention strategies used, and challenges to community participation after a fall. Semi-structured interviews were conducted in Singapore with community-dwelling stroke survivors with a previous fall (n = 9), family caregivers (n = 4), and domestic helpers (n = 4) who have cared for a stroke survivor with a previous fall. Purposive sampling was used for recruitment; all interviews were audio-recorded with permission and transcribed. Thematic analysis was conducted using NVivo (v10) software. All participants shared their self-perceived intrinsic and extrinsic fall risk factors and main challenges after a fall. For stroke participants and family caregivers, motivational factors in developing safety strategies after a previous fall(s) include social connectedness, independent living and community participation. For family caregivers and domestic helpers, the stroke survivor's safety is their top priority, however this can also lead to over-protective behavior outside of the rehabilitation process. Reducing the risk of falls in community-dwelling stroke survivors seems to be more important than promoting community participation among caregivers. The study findings highlight that a structured and client-centered fall prevention program targeting stroke survivors and caregivers is needed in Singapore. Implications for rehabilitation Falls after stroke can lead to functional decline in gait and mobility and restricted self-care activities. Community-dwelling stroke survivors develop adaptive safety strategies after a fall and want to be socially connected. However, caregivers see the safety of the stroke survivors as their top priority and demonstrate over-protective behaviors. Fall prevention programs for community-dwelling stroke survivors should target both stroke

  5. Frailty and incident depression in community-dwelling older people: results from the ELSA study.

    Science.gov (United States)

    Veronese, Nicola; Solmi, Marco; Maggi, Stefania; Noale, Marianna; Sergi, Giuseppe; Manzato, Enzo; Prina, A Matthew; Fornaro, Michele; Carvalho, André F; Stubbs, Brendon

    2017-12-01

    Frailty and pre-frailty are two common conditions in the older people, but whether these conditions could predict depression is still limited to a few longitudinal studies. In this paper, we aimed to investigate whether frailty and pre-frailty are associated with an increased risk of depression in a prospective cohort of community-dwelling older people. Four thousand seventy-seven community-dwelling men and women over 60 years without depression at baseline were included from the English Longitudinal Study of Ageing. Frailty status was defined according to modified Fried's criteria (weakness, weight loss, slow gait speed, low physical activity and exhaustion) and categorized as frailty (≥3 criteria), pre-frailty (1-2 criteria) or robustness (0 criterion). Depression was diagnosed as ≥4 out of 8 points of Center for Epidemiologic Studies Depression Scale, after 2 years of follow-up. Over a 2-year follow-up, 360 individuals developed depression. In a logistic regression analysis, adjusted for 18 potential baseline confounders, pre-frailty (odds ratio (OR) = 0.89; 95% confidence interval (CI), 0.54-1.46; p = 0.64) and frailty (OR = 1.22; 95% CI, 0.90-1.64; p = 0.21) did not predict the onset of depression at follow-up. Among the criteria included in the frailty definition, only slow gait speed (OR = 1.82; 95% CI, 1.00-3.32; p = 0.05) appeared to predict a higher risk of depression. Among older community dwellers, frailty and pre-frailty did not predict the onset of depression during 2 years of follow-up, when accounting for potential confounders, whilst slow gait speed considered alone may predict depression in the older people. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  6. [The life of elderly women living alone].

    Science.gov (United States)

    Kim, Chunmi; Ko, Moon Hee; Kim, Moon Jeong; Kim, Joohyun; Kim, Hee Ja; Moon, Jin Ha; Baek, Kyoung Seon; Son, Haeng-Mi; Oh, SangEun; Lee, YoungAe; Choi, Jung-Sook

    2008-10-01

    This study aimed to uncover the fundamental nature of living alone in female elderly. The phenomenological research approach developed by van Manen was adopted. The theme was 'taking a firm stand alone on the edges of life'. The composition elements of living alone experienced by elderly women were as follows: 1) Corporeality: participants perceived their bodies by their health status. Unhealthy participants were suffering with diseases and dependant on other persons, while healthy participants were free from family responsibility and kept on moving. 2) Spatiality: participants felt both freedom and loneliness while they stayed home. 3) Relationality: participants felt pity and yearning for their bereaved husband and sometimes talked to his picture. According to their children's filial piety, participants were pleased or displeased. However, they incessantly devoted themselves to their children. 4) Temporality: participants considered the rest of their life as extra-time which was proceeding to death, and tried to keep themselves busy before they died. A nurse should understand the multifarious aspects of elderly women's life, and then intervene to consolidate their strengths for self-supporting the final years of life.

  7. Accuracy of Timed Up and Go Test for screening risk of falls among community-dwelling elderly Acurácia do Timed Up and Go Test para rastrear risco de quedas em idosos da comunidade

    Directory of Open Access Journals (Sweden)

    Tiago S. Alexandre

    2012-10-01

    Full Text Available OBJECTIVE: To determine the accuracy of the Timed Up and Go Test (TUGT for screening the risk of falls among community-dwelling elderly individuals. METHOD: This is a prospective cohort study with a randomly by lots without reposition sample stratified by proportional partition in relation to gender involving 63 community-dwelling elderly individuals. Elderly individuals who reported having Parkinson's disease, a history of transitory ischemic attack, stroke and with a Mini Mental State Exam lower than the expected for the education level, were on a wheelchair and that reported a single fall in the previous six months were excluded. The TUGT, a mobility test, was the measure of interested and the occurrence of falls was the outcome. The performance of basic activities of daily living (ADL and instrumental activities of daily living (IADL was determined through the Older American Resources and Services, and the socio-demographic and clinical data were determined through the use of additional questionnaires. Receiver Operating Characteristic Curves were used to analyze the sensitivity and specificity of the TUGT. RESULTS: Elderly individuals who fell had greater difficulties in ADL and IADL (pOBJETIVO: Determinar a acurácia do Timed Up and Go Test (TUGT para rastrear risco de quedas em idosos da comunidade. MÉTODO: Trata-se de um estudo de coorte prospectivo com amostra sorteada aleatoriamente, sem reposição e estratificada por partilha proporcional em relação ao sexo de 63 idosos da comunidade. Excluíram-se idosos com doença de Parkinson, ataque isquêmico transitório, acidente vascular encefálico, Miniexame do Estado Mental inferior ao considerado normal de acordo com a escolaridade, movimentação exclusiva por cadeira de rodas e relato de uma queda nos seis meses anteriores à primeira entrevista. O TUGT, um teste de mobilidade, foi a medida testada, e o desfecho, a ocorrência de queda. Mensuraram-se atividades básicas (ABVD e

  8. Suicide attempts by elderly women - from a gender perspective.

    Science.gov (United States)

    Meneghel, Stela Nazareth; Moura, Rosylaine; Hesler, Lilian Zielke; Gutierrez, Denise Machado Duran

    2015-06-01

    This article analyzes the presence of gender inequality and violence in the lives of elderly women who have attempted suicide. This survey is part of a qualitative research study developed in twelve municipal regions in Brazil with high levels of suicide, and is coordinated by Claves-Fiocruz. Information was obtained by means of semi-structured interviews with thirty-two women from a sampling of fifty-nine elderly women with a history of attempted suicide. It was decided not to identify the interviewees, and to construct a narrative based on events that have occurred in the lives of all these women. The study was based on the women's life cycle (infancy, youth, adult life and old age) to see if gender inequality had been an issue in each of these phases. The inequalities began in infancy with differentiated gender upbringing; these continued during their youth and with their sexual initiation, marriage and maturity these continued during their adult life through acts of violence committed by their partners and/ or other family members which culminates in old age, when they are deprived of their independence and have lost ties, possessions and points of reference. These lives permeated with violence result in a feeling of emptiness and unworthiness, and lead many elderly women to view death as their only solution.

  9. Particularities of community- acquired pneumonia in the elderly.

    Science.gov (United States)

    Kwas, Hamida; Habibech, Sonia; Zendah, Ines; Khattab, Amel; Ghédira, Habib

    2017-02-01

    Acute community-acquiredpneumonia in olderadults has averysevereprognosiswith a mortality rate whichcanreach 10%. Knowing the clinical, etiological, therapeutic and progressive features of thisdiseasecan help to establish management rulesthatcanimprove the prognosis. The aim of ourstudywas to compare the community-acquiredpneumonia profile in olderadults and youngerthem. Retrospective comparative studyincluding patients hospitalized for community-acquiredpneumonia. Two groups of patients weredefined: group 1 subjectsagedbetween 18 and 64 years and group 2 subjectsaged 65 years and older. The meanage of elderlywas 76±6,18. COPD was five times more common in group 2 (p = 0.0001). Symptomsweredifferent in the two groups withpredominance of dyspnea in the group of elderly. Prognosisfactors scores (PSI and CURB_65) in elderlywerehighercompared to youngersubjects. Sputum culture wascontributory in third cases in both groups. Pseudomonas aeruginosawas the mostcommonpathogenidentified in the elderly. Empiricaltreatmentwas the mostprescribed in both groups. Evolution was more favorable in group 1 (p = 0.006). Complications, hospitalization in ICU and delay of recoveryweremostcommon in the group 2. Our studyconfirmedsomecharacteristics of community-acquiredpneumonia in elderly; it has mostlyrevealed the importance of microbiological tests in this population.

  10. Emergency Department Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults

    Science.gov (United States)

    Sawyer, Patricia; Kennedy, Richard; Williams, Courtney; Brown, Cynthia J.

    2016-01-01

    Background The rise in emergency department (ED) utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to positively impact the care of older adults. Symptoms have been associated with ED utilization, however, it remains unclear if symptoms are the primary reason for ED utilization. Purpose Describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department. Examine the differences in self-reported symptoms among those who utilized the emergency department, and those who did not. Procedures A prospective longitudinal design was used. The sample included 403 community-dwelling older adults 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. Main Findings Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance, and fair/poor well-being were significantly associated with ED utilization. Conclusions Several symptoms were common among this cohort of older adults. However, there were no significant differences in the types of symptoms reported by older adults who utilized the emergency department compared to those who did not use the emergency department. Based on these findings, symptoms among community-dwelling older adults may not be the primary reason for ED utilization. PMID:28131350

  11. Classifying MCI Subtypes in Community-Dwelling Elderly Using Cross-Sectional and Longitudinal MRI-Based Biomarkers

    Directory of Open Access Journals (Sweden)

    Hao Guan

    2017-09-01

    Full Text Available Amnestic MCI (aMCI and non-amnestic MCI (naMCI are considered to differ in etiology and outcome. Accurately classifying MCI into meaningful subtypes would enable early intervention with targeted treatment. In this study, we employed structural magnetic resonance imaging (MRI for MCI subtype classification. This was carried out in a sample of 184 community-dwelling individuals (aged 73–85 years. Cortical surface based measurements were computed from longitudinal and cross-sectional scans. By introducing a feature selection algorithm, we identified a set of discriminative features, and further investigated the temporal patterns of these features. A voting classifier was trained and evaluated via 10 iterations of cross-validation. The best classification accuracies achieved were: 77% (naMCI vs. aMCI, 81% (aMCI vs. cognitively normal (CN and 70% (naMCI vs. CN. The best results for differentiating aMCI from naMCI were achieved with baseline features. Hippocampus, amygdala and frontal pole were found to be most discriminative for classifying MCI subtypes. Additionally, we observed the dynamics of classification of several MRI biomarkers. Learning the dynamics of atrophy may aid in the development of better biomarkers, as it may track the progression of cognitive impairment.

  12. Does smart home technology prevent falls in community-dwelling older adults: a literature review

    Directory of Open Access Journals (Sweden)

    Eva Pietrzak

    2014-04-01

    Full Text Available Background: Falls in older Australians are an increasingly costly public health issue, driving the development of novel modes of intervention, especially those that rely on computer-driven technologies. Objective: The aim of this paper was to gain an understanding of the state of the art of research on smart homes and computer-based monitoring technologies to prevent and detect falls in the community-dwelling elderly. Method: Cochrane, Medline, Embase and Google databases were searched for articles on fall prevention in the elderly using pre-specified search terms. Additional papers were searched for in the reference lists of relevant reviews and by the process of ‘snowballing’. Only studies that investigated outcomes related to falling such as fall prevention and detection, change in participants’ fear of falling and attitudes towards monitoring technology were included. Results: Nine papers fulfilled the inclusion criteria. The following outcomes were observed: (1 older adults’ attitudes towards fall detectors and smart home technology are generally positive; (2 privacy concerns and intrusiveness of technology were perceived as less important to participants than their perception of health needs and (3 unfriendly and age-inappropriate design of the interface may be one of the deciding factors in not using the technology. Conclusion: So far, there is little evidence that using smart home technology may assist in fall prevention or detection, but there are some indications that it may increase older adults’ confidence and sense of security, thus possibly enabling aging in place.

  13. Macronutrient intake and inadequacies of community-dwelling older adults, a systematic review

    NARCIS (Netherlands)

    Borg, ter S.J.; Verlaan, S.; Mijnarends, D.; Schols, J.M.G.A.; Groot, de C.P.G.M.; Luiking, Y.C.

    2015-01-01

    Background: Anorexia of ageing may predispose older adults to under-nutrition and protein energy malnutrition. Studies, however, report a large variation in nutrient inadequacies among community-dwelling older adults. Summary: This systematic review provides a comprehensive overview of the energy

  14. Relative and Absolute Reliability of Timed Up and Go Test in Community Dwelling Older Adult and Healthy Young People

    Directory of Open Access Journals (Sweden)

    Farhad Azadi

    2014-01-01

    Full Text Available Objectives: Relative and absolute reliability are psychometric properties of the test that many clinical decisions are based on them. In many cases, only relative reliability takes into consideration while the absolute reliability is also very important. Methods & Materials: Eleven community-dwelling older adults aged 65 years and older (69.64±3.58 and 20 healthy young in the age range 20 to 35 years (28.80±4.15 using three versions of Timed Up and Go test were evaluated twice with an interval of 2 to 5 days. Results: Generally, the non-homogeneity of the study population was stratified to increase the Intra-class Correlation Coefficient (ICC this coefficient in elderly people is greater than young people and with a secondary task is reduced. In This study, absolute reliability indices using different data sources and equations lead to in more or less similar results. At general, in test–retest situations, the elderly more than the young people must be changed to be interpreted as a real change, not random. The random error contribution is slightly greater in elderly than young and with a secondary task is increased.It seems, heterogeneity leads to moderation in absolute reliability indices. Conclusion: In relative reliability studies, researchers and clinicians should pay attention to factors such as homogeneity of population and etc. As well as, absolute reliability beside relative reliability is needed and necessary in clinical decision making.

  15. Lifecourses, pensions and poverty among elderly women in Belgium

    DEFF Research Database (Denmark)

    Peeters, Hans; Tavernier, Wouter De

    2015-01-01

    , family history and pension regulations can provide greater insight into the mechanisms that produce poverty among elderly women in Belgium. To that end, we make use of register data on some 9,000 women aged 65-71. Data on the poverty risk of these women is linked to career and family data, spanning over...... 45 years. We find that pension policy can indeed account for the higher poverty risk of some groups of elderly women (e.g. divorcees) as compared to others (e.g. widows). Similarly, pension policy can, to a large extent, directly or indirectly explain how previous lifecourse events, such as marital...... dissolution or childbirth, affect old-age poverty risk. However, our study also reveals some unexpected findings. Most notably, pension regulations fail to account for the beneficial situation of married women. Indeed, our analyses suggest that capital (income) may prove more decisive than pension rights...

  16. FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

    Directory of Open Access Journals (Sweden)

    Michaela Dingová

    2017-03-01

    Full Text Available Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged from data analysis: development of the fear of falling, feared consequences of falling, activities curtailment, fall prevention behavior and meaning of social support in daily life. The fear of falling was described as a negative experience, directly linked to fall consequences such as physical injury, incapacitation, loss of autonomy, fear of dependence and experience of humiliating conditions. To maintain a certain level of independence in daily life, the participants chose to avoid falls by activity curtailment, organizing their lives more carefully and getting support from others. Conclusion: All participants identified that they had discovered their fear of falling after experiencing falls. The fear of falling was associated with feared consequences of a potential fall and had an impact on their daily life. The participant also mentioned other contributors to their fear of falling, including ill health and aging. Keywords: Fear of falling, older adults, perceived consequences of falls, daily life.

  17. CBO Richtlijn Preventie van valincidenten bij ouderen: Wat kunnen verpleeghuizen hiermee? [How can nursing homes make use of the guideline: Prevention of fall incidents in the elderly by the Dutch Institute for Healthcare Improvement (CBO)?

    NARCIS (Netherlands)

    Neyens, J.C.L.; Dijcks, B.P.J.; Kinkelder, A.de; Graafmams, W.C.; Schols, J.M.G.A.

    2005-01-01

    Fall incidents occur frequently in the community dwelling elderly and even more in the institutionalised elderly. Fall-related research data indicate positive effects of a multifactorial intervention targeted on prevention of falls and fall-related injuries. In November 2004 the guideline

  18. Nonparetic Knee Extensor Strength Is the Determinant of Exercise Capacity of Community-Dwelling Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Wei-Te Wang

    2014-01-01

    Full Text Available Objective. To investigate the relationship among walking speed, exercise capacity, and leg strength in community dwelling stroke subjects and to evaluate which one was the leading determinant factor of them. Design. This is a descriptive, cross-sectional study. Thirty-five chronic stroke patients who were able to walk independently in their community were enrolled. Walking speed was evaluated by using the 12-meter walking test. A maximal exercise test was used to determine the stroke subjects’ exercise capacity. Knee extensor strength, measured as isokinetic torque, was assessed by isokinetic dynamometer. Results. The main walking speed of our subjects was 0.52 m/s. Peak oxygen uptake (VO2 peak was 1.21±0.43 L/min. Knee extensor strength, no matter whether paretic or nonparetic side, was significantly correlated to 12-meter walking speed and exercise capacity. Linear regression also showed the strength of the affected knee extensor was the determinant of walking speed and that of the nonparetic knee extensor was the determinant of exercise capacity in community dwelling stroke subjects. Conclusions. Walking speed and peak oxygen uptake were markedly decreased after stroke. Knee extensor strength of nonparetic leg was the most important determinant of exercise capacity of the community-dwelling stroke subjects. Knee extensor strengthening should be emphasized to help stroke patient to achieve optimal community living.

  19. Nonparetic knee extensor strength is the determinant of exercise capacity of community-dwelling stroke survivors.

    Science.gov (United States)

    Wang, Wei-Te; Huang, Ling-Tzu; Chou, Ya-Hui; Wei, Ta-Sen; Lin, Chung-Che

    2014-01-01

    To investigate the relationship among walking speed, exercise capacity, and leg strength in community dwelling stroke subjects and to evaluate which one was the leading determinant factor of them. This is a descriptive, cross-sectional study. Thirty-five chronic stroke patients who were able to walk independently in their community were enrolled. Walking speed was evaluated by using the 12-meter walking test. A maximal exercise test was used to determine the stroke subjects' exercise capacity. Knee extensor strength, measured as isokinetic torque, was assessed by isokinetic dynamometer. The main walking speed of our subjects was 0.52 m/s. Peak oxygen uptake (VO₂ peak) was 1.21 ± 0.43 L/min. Knee extensor strength, no matter whether paretic or nonparetic side, was significantly correlated to 12-meter walking speed and exercise capacity. Linear regression also showed the strength of the affected knee extensor was the determinant of walking speed and that of the nonparetic knee extensor was the determinant of exercise capacity in community dwelling stroke subjects. Walking speed and peak oxygen uptake were markedly decreased after stroke. Knee extensor strength of nonparetic leg was the most important determinant of exercise capacity of the community-dwelling stroke subjects. Knee extensor strengthening should be emphasized to help stroke patient to achieve optimal community living.

  20. The Longitudinal Elderly Person Shadowing Program: Outcomes from an Interprofessional Senior Partner Mentoring Program

    Science.gov (United States)

    Basran, Jenny F. S.; Dal Bello-Haas, Vanina; Walker, Doreen; MacLeod, Peggy; Allen, Bev; D'Eon, Marcel; McKague, Meredith; Chopin, Nicola S.; Trinder, Krista

    2012-01-01

    The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults.…

  1. Health Related Quality of Life and Its Socio-Demographic Determinants among Iranian Elderly People: a Population Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Karimollah Hajian-Tilaki

    2017-03-01

    Full Text Available Introduction: In the stage of demographic transition, the rate of elderly is increasing and their health condition is a matter of concern. Thus, the objective of this study was to investigate the health related quality of life (QoL and the associated socio-demographic determinants among Iranian elderly people. Methods: We conducted a cross-sectional study with a representative samples of 750 elderly people whom community dwelling in urban area of Babol, in the north of Iran. In a household survey, the demographic data were collected and the health related QoL was assessed with a validated standard short form questionnaire (SF-36. The multiple linear regression analysis was performed to determine the demographic characteristics in predicting QoL using SPSS ver 13. Results: The overall mean (SD scores of QoL was 62.4(17.2 for men and 51.2 (17.9 for women. The mean scores of QoL in all dimensions in men had significantly higher than women. The adjusted regression coefficient of gender, age, educational level, being couple were significant on overall scores of QoL. Aging is inversely associated while male gender and education at high school or higher and being couple are positively associated in prediction of overall scores of QoL. Conclusion: The findings indicate that the health related QoL is rather poor in old people particular in women, elderly with low education level and being single. Therefore, healthcare policy makers should consider an urgent health interventional program among elderly people at present stage of demographic transition with emphasis on high risk demographic profiles.

  2. Influence of sarcopenia and functionality indicators on the frailty profile of community-dwelling elderly subjects: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Joana U. Viana

    2013-08-01

    Full Text Available BACKGROUND: Frailty and sarcopenia are frequent conditions in the elderly and are related to inactivity and functionality. However, little is known about the influence of the sarcopenia indicators on the frailty profile or their functional implications. OBJECTIVE: To evaluate whether the indirect indicators of sarcopenia and functionality influence the frailty profile in elderly subjects. METHOD : This was a cross-sectional study with 53 elderly subjects recruited by an active search in a secondary health care service. The indirect indicators of sarcopenia were body mass index (BMI, gait speed, Mini-Nutritional Assessment (MNA, Human Activity Profile (HAP, and handgrip strength. Frailty was characterized according to Fried's Frailty Phenotype. Functional capacity was assessed according to the Short Physical Performance Battery (SPPB. Physical activity level was assessed by HAP. Data were analyzed by analysis of variance (ANOVA and multiple regression. RESULTS: Overall, 75.5% of the subjects were women, with a mean age of 76.72 (±5.89 years; 15.1% were frail and 54.7% pre-frail; and the level of physical activity was the most prevalent indicator of sarcopenia. Significant differences (p<0.05 were observed in both the physical activity level and gait speed between the non-frail and pre-frail groups and between the non-frail and frail groups. In addition, some sarcopenia indicators were associated with functional capacity and geriatric depression score. CONCLUSION: The level of physical activity and gait speed appeared to be the most relevant factors in the development of frailty in the study sample, which may have functional implications.

  3. Drug-related problems among community-dwelling older adults in mainland China.

    Science.gov (United States)

    Yang, Jiadan; Meng, Long; Liu, Yu; Lv, Liping; Sun, Shusen; Long, Rui; Shan, Xuefeng; Song, Jie; Qiu, Feng

    2018-04-01

    Background Little is known about the extent of drug-related problems (DRPs) in community-dwelling older adult patients with chronic diseases in mainland China. Setting A medication therapy review service at a community health center in Chongqing, China. Objective To identify and categorize DRPs along with pharmacists' recommendations in addressing the DRPs identified. Method The study was conducted between May 2015 and July 2016. A total of 102 community-dwelling older adults were included. MTR was carried out by clinical pharmacists. DRPs and pharmacotherapy recommendations were recorded and analyzed. Main outcome measure The number of drug-related problems and main problem categories. Results The average age of patients was 69.4 years. Patients took an average of 6.3 medications. A total of 489 DRPs were identified (mean of 4.8 per patient). The most common category was under-treated (27.8%) followed by over- or under-dose (18.8%) and monitoring (17.8%). The number of medications taken was the significant associated factor for DRPs. Pharmacists made 526 recommendations to address the DRPs (mean of 1.1 recommendations per DRP). Primary care providers accepted 68.1% of these recommendations, and implemented 60.9% of them. Conclusion The prevalence of DRPs among studied patient population was high. Pharmacists may play a vital role in addressing the DRPs and optimize pharmacotherapy through MTR service located in community health centers.

  4. The Effect of Selective Hata Yoga Training on Balance of Elderly Women

    Directory of Open Access Journals (Sweden)

    Sepideh Jannati

    2011-01-01

    Full Text Available Objectives: The aim of current study was to determine the effects of Hata yoga training on dynamic and static balances of elderly women in Mashhad. Methods and Materials: The present study enjoys the semi-experimental design. The statistical population of the study, which has been carried out in 2009, were elderly women of Mashhad who were voluntarily invited to participate in the research. 29 healthy elderly women aged 56-72 years old have been selected who haven’t had any disease history during the last one year such as: advanced osteoporosis, hip replacement, glaucoma, Parkinson’s disease, common occurrences of dizziness, or any surgery. Before and after doing the Hata yoga training program which was performed in 3- sessions of 1- hour during 8 weeks Dynamic and static balances were evaluated by fall risk test and postural stability test respectively by Biodex Balance System. Finally data were analyzed by using Variance analysis (GLM-repeated measures and Dependent T-test and the significance of results was α=0.05. Results: The effects of 24 sessions of Hata yoga training were significant on static balance: overall (P=0.001, anterior-posterior (P=0.002, medial-lateral (P=0.006 and dynamic balance of elderly women (P=0.00. Conclusion: Considering the positive influence of Hata yoga training on dynamic and static balances, it is concluded that Hata yoga training has led to the improvement muscle strength among elderly women particularly endurance and strength of muscles in lower extremity and may increase the efficiency of neuro- motor system and improve somatosensory of muscles and joints by ameliorating the existed balance and decreasing fall risk in elderly women.

  5. Statin Use and Decline in Gait Speed in Community-Dwelling Older Adults

    DEFF Research Database (Denmark)

    Lo-Ciganic, W. H.; Perera, S.; Gray, S. L.

    2015-01-01

    ObjectivesTo examine the association between statin use and objectively assessed decline in gait speed in community-dwelling older adults. DesignLongitudinal cohort study. SettingHealth, Aging and Body Composition (Health ABC) Study. ParticipantsTwo thousand five participants aged 70-79 at baseli...

  6. [Muscle and bone health as a risk factor of fall among the elderly. Kaigoyobou and prevention of falling].

    Science.gov (United States)

    Obuchi, Shuichi

    2008-06-01

    Kaigoyobou, prevention of long-term care use, is a comprehensive approach, including physical, nutritional, and social, to maintain independent living in the elderly. Prevention of falling is one useful method of Kaigoyobou. From literature review, post-fall syndrome should be primarily eliminated in the elderly since falling rate of the elderly with the falling history reported significantly greater falling rate than the other community dwelling elderly. The ability to avoid falling when they trip or slip during walking may be the most important physical function needed to be intervened. In order to train elderly person successfully, nutritional intervention need to be considered into fall prevention program.

  7. Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome.

    Science.gov (United States)

    Christian, Rose C; Dumesic, Daniel A; Behrenbeck, Thomas; Oberg, Ann L; Sheedy, Patrick F; Fitzpatrick, Lorraine A

    2003-06-01

    Polycystic ovary syndrome (PCOS), a common endocrine disorder of reproductive-aged women, is associated with multiple risk factors for coronary heart disease (CHD), such as diabetes mellitus, dyslipidemia, visceral obesity, and hypertension. However, premature coronary atherosclerosis has not been demonstrated in PCOS women. Electron beam computed tomography (EBCT) noninvasively measures coronary artery calcium (CAC), a marker for coronary atherosclerosis. We measured CAC by EBCT in 30- to 45-yr-old premenopausal PCOS women and compared the results to CAC in 1) recruited normal ovulatory volunteers matched for age and weight to the PCOS cohort, and 2) community-dwelling women of similar age in an extant coronary calcium database. Healthy, community-dwelling, ovulatory controls (n = 71) were matched by age and body mass index (BMI) to PCOS women (n = 36). Women with diabetes or known CHD were excluded. Subjects underwent EBCT scanning, oral glucose tolerance testing, and CHD risk factor assessment. PCOS women had significantly higher levels of serum total and low density lipoprotein cholesterol and testosterone levels than matched controls. PCOS and control women were obese and had a greater mean BMI than community-dwelling women (33 kg/m(2) for PCOS vs. 31 kg/m(2) for control; P PCOS women (39%) than in matched controls (21%; odds ratio, 2.4; P = 0.05) or community-dwelling women (9.9%; odds ratio, 5.9; P PCOS women than in obese or nonobese women of similar age. PCOS women are at increased risk for atherosclerosis and should be targeted for primary prevention of CHD.

  8. Assertive community treatment for elderly people with severe mental illness

    Directory of Open Access Journals (Sweden)

    Mulder Niels CL

    2010-10-01

    Full Text Available Abstract Background Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. Methods We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.. If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. Discussion This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects

  9. Evaluation of Sarcopenia in Elderly Women of China

    Directory of Open Access Journals (Sweden)

    Lufang Chen

    2017-09-01

    Conclusion: Our findings suggested that both aging and menopause contributes to the decline of muscle strength and physical function rather primarily than the loss of muscle mass in the process of sarcopenia in Chinese older women. Hand-grip strength criteria is more sensitive to diagnose sarcopenia in elderly women of China.

  10. The Effect of Narrative Reminiscence on Happiness of Elderly Women.

    Science.gov (United States)

    Yousefi, Zahra; Sharifi, Khadijeh; Tagharrobi, Zahra; Akbari, Hossien

    2015-11-01

    Happiness has a considerable impact on elderly quality of life. Reminiscence therapy can be an effective intervention in increasing the positive emotions among elderly. This study was performed to investigate the effect of reminiscence therapy on Iranian elderly women's happiness. This randomized clinical trial conducted on 32 elderly women (census sampling) attending the jahandidegan daycare elderly center IN Gorgan city, Iran, in 2013. Happiness scores of 4 phases were measured: before, the third session, the sixth session and one month after the intervention. Three instruments were used in this study including a demographic questionnaire, the mini mental state examination test, and Oxford happiness questionnaire. The intervention group participated in six sessions of narrative group reminiscence that were held in three consecutive weeks, two sessions per week. The control group was also participated in six sessions of group discussions that were held in three consecutive weeks, two sessions per week. Data analysis was performed the chi-square, independent t-test, Paired t-test. From a total of 32 elderly women, 29 cases completed the study. No significant differences were found between the two groups in terms of demographic characteristics. The mean happiness scores before the intervention between the two groups were not significantly different (P = 0.824). Comparison of the mean happiness scores of the intervention group in the four measurement times revealed a significant difference only after the third and sixth sessions (P = 0.03), and no significant difference was found between the mean happiness scores of the control group in the four measurement times. The elderly participating in the matched group sessions can be effective in increasing positive emotions.

  11. The effectiveness of Pilates on balance and falls in community dwelling older adults.

    Science.gov (United States)

    Josephs, Sharon; Pratt, Mary Lee; Calk Meadows, Emily; Thurmond, Stephanie; Wagner, Amy

    2016-10-01

    The purpose of this study was to determine whether Pilates is more effective than traditional strength and balance exercises for improving balance measures, balance confidence and reducing falls in community dwelling older adults with fall risk. Thirty-one participants with fall risk were randomly assigned to the Pilates group (PG) or the traditional exercise group (TG). Both groups participated in 12 weeks of exercise, 2 times/week for 1 h. There was significant improvement in the Fullerton Advanced Balance Scale for both the PG (mean difference = 6.31, p Pilates and traditional balance programs are effective at improving balance measures in community dwelling older adults with fall risk, with the Pilates group showing improved balance confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. The effects of strength training on cognitive performance in elderly women.

    Science.gov (United States)

    Smolarek, André de Camargo; Ferreira, Luis Henrique Boiko; Mascarenhas, Luis Paulo Gomes; McAnulty, Steven R; Varela, Karla Daniele; Dangui, Mônica C; de Barros, Marcelo Paes; Utter, Alan C; Souza-Junior, Tácito P

    2016-01-01

    Aging is a degenerative process marked by recognized functional, physiological, and metabolic impairments, such as dynapenia and diminished cognitive capacity. Therefore, the search for innovative strategies to prevent/delay these physiological and cognitive disorders is essential to guarantee the independence and life quality of an elderly population. The aim of this work is to verify the effect of a 12-week resistance exercise program on the general physical aptitude and cognitive capacities of elderly and sedentary women. Twenty-nine women (65.87±5.69 years) were divided into two groups. The control group was composed of eight elderly women who met the same inclusion criteria of the study and the strength training group was composed of 29 elderly women who were subjected to a resistance exercise program defined by 12 upper and lower limb exercises combined in 3×10 repetitions with 1-minute interval between repetitions and two resting minutes between exercises (three times/week). Weight loads were fixed between 60% and 75% of the apparent 1 repetition maximum, which was estimated by the test of 10 maximum repetitions. The direct curl was performed for upper body strength evaluation with 2.3 kg dumbbells for 30 seconds, whereas the chair test was used for lower body evaluation (total sit-stand movements in 30 seconds). The cognitive capacities of subjects were evaluated by "The Montreal Cognitive Assessment" questionnaire. After 12 weeks, the elderly group showed significant increases in the average upper body strength (58%), lower body strength (68%), and cognitive capacity (19%). The present study demonstrated that regular resistance exercises could provide significant gains on the upper and lower body strength concomitant to positive improvements on cognitive capacities of elderly women, bringing enhanced life quality.

  13. International classification of function, disability and health framework for fall risk stratification in community dwelling older adults

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    Majumi M. Noohu

    2017-05-01

    Full Text Available Falls is an important cause for mortality and morbidity in older adults. The fall risk assessment is an integral component of fall prevention in older adults. The international classification of function, disability and health (ICF can be an ideal comprehensive model for fall risk assessment. There is lack of information relating ICF and fall risk assessment in community dwelling older adults. In this study we tried to assess the fall risk using different domains of ICF using various clinical tools. A total of 255 subjects were recruited through convenient sampling method from geriatric clinic (OPD of All India Institute of Medical Sciences, New Delhi. The study was single session cross-section design. The body mass index (BMI, grip strength, depression score (Geriatric depression scale:short form; GDS-S and co morbidities were used to assess body function and structure domain, timed up and go (TUG, Berg balance scale (BBS and elderly fall screening test (EFST scores were used for activity domain, selfreported cause of fall, medications and uses of assistive device for environmental factors. Then the association of body function and structure, activity and environmental factors were determined with falls. There was an association of fall in analysis in subjects with no fall and one or more falls for, BMI, grip strength (kg, GDS-S score, no. of co morbidities, chronic pain, TUG, BBS, TUG (s, BBS, EFST, slip/trip, walking cane, hypoglycemic and antihypertensives medications (unadjusted and adjusted odds ratio.The diabetes, and hyper tension showed association for adjusted odds ratio only. In subjects with one fall and more than one fall, TUG, BBS, EFST, GDS-S score, NSAIDS and antidepressants use showed a significant association with fall (unadjusted and adjusted odds ratio. The ICF may be used in routine for fall risk assessment in community dwelling older adults.

  14. Association of day length and weather conditions with physical activity levels in older community dwelling people.

    Directory of Open Access Journals (Sweden)

    Miles D Witham

    Full Text Available Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people.We analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical Activity Cohort Scotland. We correlated seven day triaxial accelerometry data with daily weather data (temperature, day length, sunshine, snow, rain, and a series of potential effect modifiers were tested in mixed models: environmental variables (urban vs rural dwelling, percentage of green space, psychological variables (anxiety, depression, perceived behavioural control, social variables (number of close contacts and health status measured using the SF-36 questionnaire.547 participants, mean age 78.5 years, were included in this analysis. Higher minimum daily temperature and longer day length were associated with higher activity levels; these associations remained robust to adjustment for other significant associates of activity: age, perceived behavioural control, number of social contacts and physical function. Of the potential effect modifier variables, only urban vs rural dwelling and the SF-36 measure of social functioning enhanced the association between day length and activity; no variable modified the association between minimum temperature and activity.In older community dwelling people, minimum temperature and day length were associated with objectively measured activity. There was little evidence for moderation of these associations through potentially modifiable health, environmental, social or psychological variables.

  15. Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

    Science.gov (United States)

    Uthaikhup, Sureeporn; Prasert, Romchat; Paungmali, Aatit; Boontha, Kritsana

    2015-01-01

    Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold heat pain responses. The pain measures were assessed over the cervical spine and at a remote site, the tibialis anterior muscle. Results Elders with chronic neck pain had lower pressure pain threshold over the articular pillar of C5-C6 and decreased cold pain thresholds over the cervical spine and tibialis anterior muscle when compared with controls (p pain thresholds and suprathreshold heat pain responses (p > 0.05). Conclusion The presence of pain hypersensitivity in elderly women with chronic neck pain appears to be dependent on types of painful stimuli. This may reflect changes in the peripheral and central nervous system with age. PMID:26039149

  16. Serum betaine is inversely associated with low lean mass mainly in men in a Chinese middle-aged and elderly community-dwelling population.

    Science.gov (United States)

    Huang, Bi-Xia; Zhu, Ying-Ying; Tan, Xu-Ying; Lan, Qiu-Ye; Li, Chun-Lei; Chen, Yu-Ming; Zhu, Hui-Lian

    2016-06-01

    Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3·2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all Pwomen (P=0·016). Each sd increase in serum betaine was associated with increases in LM% of 0·609 (whole body), 0·811 (trunk), 0·422 (limbs), 0·632 (arms) and 0·346 (legs) in men and 0·350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17 % (whole body) and 14 % (trunk) in women and 23 % (whole body), 28 % (trunk), 22 % (arms) and 26 % (percentage skeletal muscle index) in men with each sd increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men.

  17. [Effects on salivation, xerostomia and halitosis in elders after oral function improvement exercises].

    Science.gov (United States)

    Kim, Young Jin; Park, Kyung Min

    2012-12-01

    The purpose of this study was to investigate effects of Oral Function Improvement Exercises on salivation, xerostomia and halitosis in elderly people. The participants in the study were 48 female community-dwelling elders in D city. The Oral Function Improvement Exercises were given 3 times a week, for a total of 24 times from August to October 2011. Spitting method, Visual Analogue Scale, and halimeter (mBA-21) were used to evaluate the effects of Oral Function Improvement Exercises on salivation, xerostomia, and halitosis. The data were analyzed using χ²-test and t-test with the SPSS program. The experimental group had significantly better salivation, and less xerostomia and halitosis than the control group. The results indicate that Oral Function Improvement Exercises were effective for salivation, xerostomia and halitosis in the elders. Therefore, it was suggested that Oral Function Improvement Exercise are applicable in a community nursing intervention program to improve the quality of life for elders.

  18. A study of the relationship between depression symptom and physical performance in elderly women

    OpenAIRE

    Lee, Yang Chool

    2015-01-01

    Depression is a general public health problem; there is an association between regular exercise or vigorous physical activity and depression. Physical activity has positive physical, mental, and emotional effects. The purpose of this study was to examine the relationship between depression symptom and physical performance in elderly women. A total of 173 elderly women aged 65 to 80 participated in this study. We evaluated elderly women using the 6-min walk, grip-strength, 30-sec arm curl, 30-...

  19. Life-Space Predicts Health Care Utilization in Community-Dwelling Older Adults.

    Science.gov (United States)

    Kennedy, Richard E; Williams, Courtney P; Sawyer, Patricia; Lo, Alexander X; Connelly, Kay; Nassel, Ariann; Brown, Cynthia J

    2017-09-01

    To determine whether decline in life-space mobility predicts increased health care utilization among community-dwelling older adults. Health care utilization (number of emergency department [ED] visits and hospitalizations) was self-reported during monthly interviews among 419 community-dwelling African American and non-Hispanic White adults aged 75 years and older in The University of Alabama at Birmingham (UAB) Study of Aging II. Life-space was measured using the UAB Life-Space Assessment. Generalized estimating equations were used to examine associations of life-space at the beginning of each interval with health care utilization over the 1-month interval. Overall, 400 participants were followed for 36 months. A 10-point decrease in life-space was associated with 14% increased odds of an ED visit and/or hospitalization over the next month, adjusting for demographics, transportation difficulty, comorbidity, and having a doctor visit in the last month. Life-space is a practical alternative in predicting future health care utilization to performance-based measures, which can be difficult to incorporate into clinical or public health practice.

  20. Comparison of caregivers', residents', and community-dwelling spouses' opinions about expressing sexuality in an institutional setting.

    Science.gov (United States)

    Gibson, M C; Bol, N; Woodbury, M G; Beaton, C; Janke, C

    1999-04-01

    Opinions regarding the appropriateness of elderly residents' sexual behaviors in a chronic care hospital and how to respond to inappropriate behaviors were surveyed. Study participation was open to all staff (N = 1,205), eligible residents (N = 182) and community-dwelling spouses (N = 103). Participation rates were 40% (residents), 42% (spouses), 34% (nursing staff), 50% (allied health staff), and 22% (support staff). Staff completed the questionnaire independently, while residents and spouses were offered self-completion or a structured interview. Almost all selected the interview. Residents and spouses were less tolerant than staff of residents' masturbating, engaging in sexual relationships, viewing sexual materials, and making sexual approaches to staff. Privacy was the primary determinant of appropriateness for behaviors for all groups. Staff and spouses were more likely to endorse counseling when behaviors were perceived as inappropriate than residents. Nurses endorsed counseling less frequently than allied health professionals and support staff. Nurses were more likely to have been approached sexually by a resident. Differences of opinion are interpreted in terms of cohort influences on values and contextual influences on behavior.