Age-specific risk factors for incident disability in activities of daily living among middle-aged and elderly community-dwelling Japanese women during an 8-9-year follow up: The Hizen-Oshima study

2016 ◽  
Vol 17 (7) ◽  
pp. 1096-1101 ◽  
Author(s):  
Takuhiro Okabe ◽  
Yasuyo Abe ◽  
Yoshihito Tomita ◽  
Satoshi Mizukami ◽  
Mitsuo Kanagae ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e033691
Author(s):  
Divyamol K Sasidharan ◽  
Priya Vijayakumar ◽  
Manu Raj ◽  
Sumi Soman ◽  
Libin Antony ◽  
...  

ObjectivesThere is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence of falls and associated risk factors among free living elderly population from Kerala, India.DesignProspective cohort study with stratified random cluster sampling.SettingThe study location was Ernakulam, Kerala, India, and we collected information via house visits using a questionnaire. During the research, the subjects were followed up prospectively for 1 year by phone at intervals of 3 months and missing subjects were contacted by house visits.ParticipantsCommunity-dwelling elderly above 65 years of age.ResultsWe recruited a total of 1000 participants out of which a total of 201 (20.1%) subjects reported a fall during the follow-up. The incidence rate of falls was 31 (95% CI 27.7 to 34.6) per 100 person-years. Female sex (OR 1.48, 95% CI 1.05 to 2.10, p=0.027), movement disorders including Parkinsonism (OR 2.26, 95% CI 1.00 to 5.05, p=0.048), arthritis (OR 1.48, 95% CI 1.05 to 2.09, p=0.026), dependence in basic activities of daily living (OR, 3.49, 95% CI 2.00 to 6.09, p<0.001), not using antihypertensive medications (OR, 1.53, 95% CI 1.10 to 2.13, p=0.012), living alone during daytime (OR 3.27, 95% CI 1.59 to 6.71, p=0.001) and a history of falls in the previous year (OR, 2.25, 95% CI 1.60 to 3.15, p<0.001) predicted a fall in the following year.ConclusionsOne in five community-dwelling senior citizen fall annually and one in four who fall are prone to fall again in the following year. Interventions targeting falls among the elderly need to focus on modifiable risk factors such as living alone during daytime, movement disorders, arthritis and dependence on basic activities of daily living.


2018 ◽  
Vol 73 (1) ◽  
pp. 86-88 ◽  
Author(s):  
Lin Yang ◽  
Lee Smith ◽  
Mark Hamer

BackgroundThe aetiology of age-related sarcopenia is not known.ObjectivesTo investigate if risk of developing sarcopenia differs by gender and to identify gender-specific risk factors of incident sarcopenia in a large population-based cohort of older English adults.MethodsThe sample (n=3404; age 63.4 (SD 7.7) years; 54.1% women) comprised older community-dwelling adults recruited from the English Longitudinal Study of Ageing. Sarcopenia was defined as handgrip <26 kg in men and <16 kg in women. Handgrip strength was assessed at baseline (2004/2005) and repeated at follow-up (2012/2013). Analysed risk factors included baseline anthropometric measures, smoking, vigorous and moderate physical activity, depressive symptoms, chronic illnesses and wealth. After excluding participants with sarcopenia at baseline, multivariable logistic regressions were used to explore baseline risk factors for incident sarcopenia.ResultsDuring 8-year follow-up, 208 and 287 cases of sarcopenia were identified in men (n=1564) and women (n=1840), respectively. Women were at 20% (age adjusted OR=1.20, 95% CI 0.98 to 1.47) higher risk of developing sarcopenia than men. The inverse association between physical activity and sarcopenia risk was observed at moderate (OR=0.44, 95% CI 0.27 to 0.67) and vigorous (0.53, 95% CI 0.31 to 0.82) intensities in men and only vigorous (OR=0.44, 95% CI 0.28 to 0.68) intensity in women. Social factors, such as wealth, and chronic health conditions appeared to be more strongly associated with sarcopenia in men.ConclusionWomen are at higher risk of developing incident sarcopenia than men, and this is likely explained by a range of gender-specific risk factors.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 238-239
Author(s):  
Caitlin Pope ◽  
Tyler Bell ◽  
Brian Downer ◽  
Sadaf Milani ◽  
Lauren Roach ◽  
...  

Abstract Given the hypothesized bidirectional association between functional and cognitive decline, further characterization of the temporal association between the two is needed, especially in Latinx samples as they are the most rapidly growing demographic in the United States and at greater risk for Alzheimer’s disease. This study assessed bidirectional associations between instrumental activities of daily living (IADL) difficulty and cognition in older Puerto Rican adults. Participants included 2,840 community-dwelling adults (60+ years) without cognitive impairment who completed baseline and a four-year follow-up in the Puerto Rican Elderly: Health Conditions (PREHCO) project. At each wave, cognition (using the Mini-Mental Cabán) and self-reported IADL difficulty (a sum score of 10 everyday tasks) were measured. Covariates included age, gender, education, comorbidities, and depressive symptoms. Bidirectional associations were tested using a path model with concurrent and cross-lagged paths between cognition and IADL difficulty adjusting for covariates. Lower baseline cognition related to more baseline IADL difficulty (B=-0.08, SE=0.02, p&lt;.001). Cognitive decline at follow-up related to greater IADL difficulty at follow-up (B=-0.06, SE=0.02, p=.012). Looking at cross-lagged associations, greater baseline IADL difficulty associated with more cognitive decline at follow-up (B=-0.10, SE=0.04, p=.012). However, baseline cognition was not significantly associated with change in IADL difficulty at follow-up (B=-0.003, SE=0.02, p=.869). Findings support the growing body of literature that IADL difficulties can predict future cognitive decline in samples of community-dwelling older adults. More research into both functional and cognitive decline in Latinx samples will provide a more generalizable view of aging.


2019 ◽  
Vol 60 (1) ◽  
pp. 101-111 ◽  
Author(s):  
Xiaoling Xiang ◽  
Jieling Chen ◽  
MinHee Kim

Abstract Background and Objectives The purpose of this study was to examine the trajectories of homebound status in older adults and to investigate the risk factors in shaping the pattern of these trajectories. Research Design and Methods The study sample was a nationally representative sample of Medicare beneficiaries aged 65 and older (N = 7,607) from the National Health and Aging Trends Study (Round 1–Round 7). Homebound state was defined as never or rarely went out the home in the last month. Homebound trajectories were identified using an enhanced group-based trajectory modeling that accounted for nonrandom attrition. Multinomial logistic regression was used to examine risk factors of homebound trajectories. Results Three trajectory groups were identified: the “never” group (65.5%) remained nonhomebound; the “chronic” group were largely persistently homebound (8.3%); and the “onset” group (26.2%) had a rapid increase in their risk of being homebound over the 7-year period. The following factors increased the relative risk for being on the “onset” and “chronic” versus the “never” trajectory: older age, Hispanic ethnicity, social isolation, past or current smoking, instrumental activities of daily living limitations, probable dementia, and use of a walker or wheelchair. Male sex and living alone were associated with a lower risk of being on the “chronic” trajectory, whereas depression and anxiety symptoms, chronic conditions, and activities of daily living limitations increased the risk. Discussion and Implications The progression of homebound status among community-dwelling older adults followed three distinct trajectories over a 7-year period. Addressing social isolation and other risk factors may prevent or delay the progression to homebound state.


Blood ◽  
2012 ◽  
Vol 119 (3) ◽  
pp. 692-695 ◽  
Author(s):  
Andrew M. Evens ◽  
Irene Helenowski ◽  
Erika Ramsdale ◽  
Chadi Nabhan ◽  
Reem Karmali ◽  
...  

AbstractWe investigated a recent (January 1999 to December 2009) cohort of 95 elderly Hodgkin lymphoma subjects. At diagnosis, median age was 67 years (range, 60-89 years), whereas 61% had significant comorbidity, 26% were unfit, 17% had a geriatric syndrome, and 13% had loss of activities of daily living. Overall response rate to therapy was 85%, whereas incidence of bleomycin lung toxicity was 32% (with associated mortality rate, 25%). With 66-month median follow-up, 2-year and 5-year overall survival were 73% and 58%, respectively (advanced-stage, 63% and 46%, respectively). Most International Prognostic Score factors were not prognostic on univariate analyses, whereas Cox multivariate regression identified 2 risk factors associated with inferior overall survival: (1) age more than 70 years (2.24; 95% CI, 1.16-4.33, P = .02) and (2) loss of activities of daily living (2.71; 95% CI, 1.07-6.84, P = .04). Furthermore, a novel survival model based on number of these risk factors (0, 1, or 2) showed differential 2-year OS of 83%, 70%, and 13%, respectively (P < .0001) and 5-year OS of 73%, 51%, and 0%, respectively (P < .0001).


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 589-589
Author(s):  
Anton Schönstein ◽  
Hans-Werner Wahl ◽  
Michael Denkinger ◽  
Dhayana Dallmeier ◽  
Dietrich Rothenbacher ◽  
...  

Abstract Subjective views on aging (VoA; e.g., subjective age, attitude toward own aging “ATOA”) are regarded as important biopsychosocial markers of aging but their antecedents are not entirely clear. Besides general risk factors (depression, cognition, activities of daily living), we compared multiple disease groups to establish connections between specific morbidities and risk for negative VoA. Data was drawn from the ActiFE-Ulm study for which a representative sample of community-dwelling older people (65-90 years) was recruited. Follow-ups were conducted 7.7 years (median) after recruitment (T2; N=526). Self-reported depression at T1 was the strongest general risk-factor for negative VoA at follow-up (both subjective age and ATOA). Back pain predicted negative ATOA, whereas rheumatism was associated to both negative ATOA and older subjective age. We conclude that diseases are differentially associated with VoA. Further, mental health problems such as depression seem to be of higher importance for VoA as compared to other factors.


2020 ◽  
Author(s):  
Francisco Cegri ◽  
Francesc Orfila ◽  
Rosa M Abellana ◽  
María Pastor-Valero

Abstract BackgroundFrailty in older adults is a common multidimensional clinical entity, a state of vulnerability to stressors that increases the risk of adverse outcomes such as functional decline, institutionalization or death. The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. MethodsA prospective cohort study was conducted in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). The cohort was made up of 616 individuals. Data collection included a baseline multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, and the Central Registry of Catalonia for mortality. A prognostic index for a HC and NH at eight years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine–Gray regression models were used. Results At baseline, mean age was 76.4 years and 55.5% were women. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of Daily Living, number of prescriptions, and the presence of social risk.ConclusionsPrognostic models based on comprehensive geriatric assessments can predict the need for the commencement of HC and NH admission in community-dwelling older adults. Our findings underline the necessity to measure functional capacity, mobility, number of prescriptions, and social aspects of older adults in primary healthcare centers. In such a setting they can be offered longitudinal holistic assessments so as to benefit from preventive actions in order to remain independent in the community for as long as possible.


2017 ◽  
Vol 70 (9-10) ◽  
pp. 277-282
Author(s):  
Jelena Pavlovic ◽  
Maja Racic ◽  
Divna Kekus ◽  
Mile Despotovic ◽  
Sandra Jokovic ◽  
...  

Introduction. Falls and fall-related injuries are common in the geriatric population and may be associated with significant morbidity and mortality. The aim of this study was to determine differences in the incidence of falls and risk factors for falls between the community-dwelling and institutionalized elderly people. Material and Methods. The cross sectional study was conducted in the period from May 1, 2015 to December 1, 2015, including 300 community-dwelling elderly people and 110 nursing home residents. The research instruments were a sociodemographic questionnaire, Mini nutritional assessment, Katz index, and Lawton scale. Results. During the previous 12 months, at least one fall was reported in 17.1% of the total number of respondents. The incidence of falls was higher among nursing home residents (c2 = 13.550; p = 0.001). The risk factors for falls were multifactorial. Community-dwelling elderly suffered from urinary incontinence more frequently compared to nursing home residents (p = 0.004), but a significantly worse nutritional status was found in community-dwelling elderly people (p < 0.001). Assistance in basic activities of daily living was required by 3.9% of nursing home residents, and 8.3% of community-dwelling elderly people (p < 0.001). Statistically significant difference was not found in the performance of instrumental activities of daily living (p < 0.145). Conclusion. The incidence of falls was higher in nursing home residents. Risk factors for falls in both examined groups were visual and hearing impairments, urinary incontinence, use of 3 medications per day, damaged functional status, and malnutrition. Prevention of falls requires modification of environmental hazards, reduction of risk factors, their evaluation and strategy implementation.


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018942 ◽  
Author(s):  
Siri Høivik Storeng ◽  
Erik R Sund ◽  
Steinar Krokstad

ObjectivesTo investigate factors associated with the need for assistance in basic and instrumental activities of daily living in Norwegian elderly.DesignProspective cohort study.SettingThe Nord-Trøndelag Health Study (HUNT), a large population-based health survey in Norway.Participants5050 individuals aged 60–69 years old at baseline in HUNT2 (1995–1997) who also participated in HUNT3 (2006–2008) were included in the study. 676/693 individuals were excluded in the analyses due to missing outcomes.OutcomesNeeding assistance in one or more basic or instrumental activities of daily living reported in HUNT3.ResultsIn adjusted multinomial logistic regression analyses, poor self-rated health and depression were the strongest risk factors for needing assistance in one or more basic activities of daily living in HUNT3, with ORs of 2.13 (1.35 to 3.38) and 1.58 (0.91 to 2.73). Poor self-rated health and poor life satisfaction were the strongest risk factors for needing assistance in one or more instrumental activities of daily living in HUNT3, with ORs of 2.30 (1.93 to 2.74) and 2.29 (1.86 to 2.81), respectively. Excessive sitting time, short or prolonged sleeping time, and physical inactivity seemed to be the most important lifestyle risk factors for basic/instrumental activities of daily living (ADL/IADL) disability. The studied factors were, in general, greater risk factors for mortality during follow-up than for ADL/IADL disability. Smoking was the strongest risk factor for mortality during follow-up and non-participation in HUNT3. Smoking and low social participation were the strongest risk factors for non-participation in HUNT3.ConclusionsSubjective health perception, life satisfaction and depression were the strongest risk factors for needing assistance in one or more basic/instrumental activities of daily living later in life. These factors could be possible targets for prevention purposes.


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