COMPONENTS OF THE RISK INSTRUMENT FOR SCREENING IN THE COMMUNITY (RISC) THAT CORRELATE WITH PUBLIC HEALTH NURSES’ PERCEPTION OF RISK

2015 ◽  
pp. 1-6
Author(s):  
P. LEAHY-WARREN ◽  
R. O’CAOIMH ◽  
C. FITZGERALD ◽  
A. COCHRANE ◽  
A. SVENDROVSKI ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Mental State ◽  
Perceived Risk ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Public Health Nurses ◽  
Perception Of Risk ◽  
Caregiver Network ◽  
Community Dwelling Older Adults

Background: Functional decline and frailty are common in community-dwelling older adults, leading to an increased risk of adverse outcomes. Objective: To examine the factors that public health nurses perceive to cause risk of three adverse outcomes: institutionalisation, hospitalisation, and death, in older adults, using the Risk Instrument for Screening in the Community (RISC). Design: A quantitative, correlational, descriptive design was used. Setting and Participants: A sample of 803 community-dwellers, aged over 65 years receiving regular follow-up by public health nurses. Procedure and Measurements: Public health nurses (n=15) scored the RISC and the Clinical Frailty Scale (CFS) on patients in their caseload. We examined and compared correlations between the severity of concern and ability of the caregiver network to manage these concerns with public health nurses’ perception of risk of the three defined adverse outcomes. Results: In total, 782 RISC scores were available. Concern was higher for the medical state domain (686/782,88%) compared with the mental state (306/782,39%) and activities of daily living (595/782,76%) domains. Concern was rated as severe for only a small percentage of patients. Perceived risk of institutionalisation had the strongest correlation with concern over patients mental state,(r=0.53), while risk of hospitalisation,(r=0.53) and death,(r=0.40) correlated most strongly with concern over the medical state. Weaker correlations were found for the other domains and RISC scores. The CFS most strongly correlated with the ADL domain,(r=0.78). Conclusion: Although the prevalence of concern was high, it was mostly rated as mild. Perceived risk of institutionalisation correlated most with concern over the ability of caregiver networks to manage patients’ mental state, while risk of hospitalisation and death correlated with patients’ medical state. The findings suggest the importance of including an assessment of the caregiver network when examining community-dwelling older adults. Validation of the RISC and public health nurses’ ratings are now required.

THE COMMUNITY ASSESSMENT OF RISK INSTRUMENT: INVESTIGATION OF INTER-RATER RELIABILITY OF AN INSTRUMENT MEASURING RISK OF ADVERSE OUTCOM

2015 ◽  
pp. 1-10
Author(s):  
R.M. CLARNETTE ◽  
J.P. RYAN ◽  
E. O’ HERLIHY ◽  
A. SVENDROVSKI ◽  
N. CORNALLY ◽  
...  
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Activities Of Daily Living ◽  
Mental State ◽  
Daily Living ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Rater Reliability ◽  
Gamma Statistic ◽  
Community Dwelling Older Adults

Background: Frailty is increasingly common in community dwelling older adults and increases their risk of adverse outcomes. Risk assessment is implicit in the Aged Care Assessment Teams process, but few studies have considered the factors that influence the assessor’s decision making or explored the factors that may contribute to their interpretation of risk. Objective: to examine the inter-rater reliability of the Community Assessment of Risk Instrument (CARI), which is a new risk assessment instrument. Design: A cohort study was used. Setting and participants: A sample of 50 community dwelling older adults underwent comprehensive geriatric assessment by two raters: a geriatrician and a registered nurse. Procedure and measurements: Each participant was scored for risk by the two raters using the CARI. This instrument ranks risk of three adverse outcomes, namely i) institutionalisation, ii) hospitalisation and iii) death within the next year from a score of 1, which is minimal risk to 5, which is extreme risk. Inter-rater reliability was assessed with Gamma, Spearman correlation and Kappa statistics. Internal consistency was assessed with Cronbach’s alpha. Results: There were 30 female (mean age 82.23 years) and 20 male (mean age 81.75 years) participants. Items within domains showed good-excellent agreement. The gamma statistic was >0.77 on 6/7 Mental State items, 14/15 items in the Activities of Daily Living domain. In the Medical domain, 6/9 items had Gamma scores >0.80. The global domain scores correlated well, 0.88, 0.72 and 0.87. Caregiver network scores were 0.71, 0.73 and 0.51 for the three domains. Inter-rater reliability scores for global risk scales were 0.86 (institutionalisation) and 0.78 (death). The gamma statistic for hospitalisation was 0.29, indicative of lower inter-rater reliability. Cronbach’s alpha was 0.86 and 0.83 for the Activities of Daily Living domain, 0.51 and 0.42 for the Mental state domain and 0.23 and 0.10 for the Medical state domain. Conclusions: Overall, the instrument shows good inter-rater reliability. Poor correlations on some items relate to poor communication of clinical data and variable interpretation based on professional background. Lack of internal consistency in the medical condition domain confirms the discrete nature of these variables.

scholarly journals How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Grainne Vavasour ◽  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Daniel Kelly
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Gait Speed ◽  
Outcome Measurement ◽  
Wearable Sensors ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Ageing Population ◽  
Application Development ◽  
Community Dwelling Older Adults

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

scholarly journals The Relationship between Chronotype, Physical Activity and the Estimated Risk of Dementia in Community-Dwelling Older Adults

2020 ◽  
Vol 17 (10) ◽  
pp. 3701
Author(s):  
Ngeemasara Thapa ◽  
Boram Kim ◽  
Ja-Gyeong Yang ◽  
Hye-Jin Park ◽  
Minwoo Jang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Community Dwelling ◽  
Daily Physical Activity ◽  
Estimated Risk ◽  
Community Dwelling Older Adults ◽  
The Relationship ◽  
State Examination

Our study examined the association between chronotype, daily physical activity, and the estimated risk of dementia in 170 community-dwelling older adults. Chronotype was assessed with the Horne–Östberg Morningness–Eveningness Questionnaire (MEQ). Daily physical activity (of over 3 METs) was measured with a tri-axial accelerometer. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to measure the estimated risk of dementia. The evening chronotype, low daily physical activity, and dementia were positively associated with each other. The participants with low physical activity alongside evening preference had 3.05 to 3.67 times higher estimated risk of developing dementia, and participants with low physical activity and morning preference had 1.95 to 2.26 times higher estimated risk than those with high physical activity and morning preference. Our study design does not infer causation. Nevertheless, our findings suggest that chronotype and daily physical activity are predictors of the risk of having dementia in older adults aged 70 years and above.

Mini-Mental State Examination performance in frail, pre-frail, and non-frail community dwelling older adults in Ermelino Matarazzo, São Paulo, Brazil

2012 ◽  
Vol 24 (11) ◽  
pp. 1725-1731 ◽  
Author(s):  
Cláudia Rodrigues Monteiro Macuco ◽  
Samila Satler Tavares Batistoni ◽  
Andrea Lopes ◽  
Meire Cachioni ◽  
Deusivânia Vieira da Silva Falcão ◽  
...  
Keyword(s):  
Older Adults ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Sao Paulo ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
São Paulo ◽  
Frail Older Adults ◽  
Community Dwelling Older Adults ◽  
State Examination

ABSTRACTBackground: Frailty in older adults is a multifactorial syndrome defined by low metabolic reserve, less resistance to stressors, and difficulty in maintaining organic homeostasis due to cumulative decline of multiple physiological systems. The relationship between frailty and cognition remains unclear and studies about Mini-Mental State Examination (MMSE) performance and frailty are scarce. The objective was to examine the association between frailty and cognitive functioning as assessed by the MMSE and its subdomains.Methods: A cross-sectional population-based study (FIBRA) was carried out in Ermelino Matarazzo, a poor subdistrict of the city of São Paulo, Brazil. Participants were 384 community dwelling older adults, 65 years and older who completed the MMSE and a protocol to assess frailty criteria as described in the Cardiovascular Health Study (CHS).Results: Frail older adults had significantly worse performance on the MMSE (p < 0.001 for total score). Linear regression analyses showed that the MMSE total score was influenced by age (p < 0.001), education (p < 0.001), family income (p < 0.001), and frailty status (p < 0.036). Being frail was associated more significantly with worse scores in Time Orientation (p < 0.004) and Immediate Memory (p < 0.001).Conclusions: Our data suggest that being frail is associated with worse cognitive performance, as assessed by the MMSE. It is recommended that the assessment of frail older adults should include the investigation of their cognitive status.

scholarly journals The Relationship Between Frailty and Depression, Quality of Life, Disability, and Hospitalization Among Community-Dwelling Older Adults

2020 ◽  
Author(s):  
Audai A. Hayajneh ◽  
Hanan Hammouri ◽  
Eman S. Al-Satari ◽  
Debra C. Wallace ◽  
Mohammad Rababa
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Outcomes ◽  
Secondary Analysis ◽  
Depression Scale ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
High Prevalence ◽  
Community Dwelling Older Adults

Abstract Background: Frailty syndrome is characterized by a decline in physiological and psychological reserve that leads to poor health outcomes. Objectives: The current study explored frailty and its impacts on health outcomes among older adults in close-knit Jordanian communities. Methods: A secondary analysis (N=109) of community-dwelling older adults aged 60 years or over was conducted. The Arabic version of the culturally adapted Tilburg Frailty Indicator, the Geriatric Depression Scale, the Montreal Cognitive Assessment, the SF-36 Quality of Life survey, and disability self-reports were used. Results: Despite Jordanian communities being very close-knit, the results indicated a high prevalence of frailty (78%) and depression (38%) and poor outcomes of cognitive dysfunction and low quality of life among the participating older adults. Further, the prevalence of frailty was found to be 4.2 times higher among females than males and 7.2 times higher among single older adults than married older adults. Conclusion: A high prevalence of frailty and its related adverse outcomes was found among older adults in Jordan.

scholarly journals Reply to Comment on Nakai, Y.; Makizako, H.; Kiyama, R.; Tomioka, K.; Taniguchi, Y.; Kubozono, T.; Takenaka, T.; Ohishi, M. Association between Chronic Pain and Physical Frailty in Community-Dwelling Older Adults. Int. J. Environ. Res. Public Health 2019, 16, 1330, doi:10.3390/ijerph16081330

2019 ◽  
Vol 17 (1) ◽  
pp. 175
Author(s):  
Yuki Nakai ◽  
Hyuma Makizako ◽  
Ryoji Kiyama ◽  
Kazutoshi Tomioka ◽  
Yoshiaki Taniguchi ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Chronic Pain ◽  
Missing Data ◽  
Community Dwelling ◽  
Dementia Diagnosis ◽  
Physical Frailty ◽  
Exclusion Processes ◽  
Diagnosis Of Dementia ◽  
Community Dwelling Older Adults

Seven participants had a diagnosis of dementia; the number of excluded participants differed based on different exclusion processes, and there was missing data of one participant with a dementia diagnosis [...]

scholarly journals Automatic Quantification of Tandem Walking Using a Wearable Device: New Insights Into Dynamic Balance and Mobility in Older Adults

2020 ◽  
Vol 76 (1) ◽  
pp. 101-107
Author(s):  
Natalie Ganz ◽  
Eran Gazit ◽  
Nir Giladi ◽  
Robert J Dawe ◽  
Anat Mirelman ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Dynamic Balance ◽  
Principal Component ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Sensor Data ◽  
Quiet Standing ◽  
Mobility Disability ◽  
Community Dwelling Older Adults

Abstract Background Wearable sensors are increasingly employed to quantify diverse aspects of mobility. We developed novel tandem walking (TW) metrics, validated these measures using data from community-dwelling older adults, and evaluated their association with mobility disability and measures of gait and postural control. Methods Six hundred ninety-three community-dwelling older adults (age: 78.69 ± 7.12 years) wore a 3D accelerometer on their lower back while performing 3 tasks: TW, usual-walking, and quiet standing. Six new measures of TW were extracted from the sensor data along with the clinician’s conventional assessment of TW missteps (ie, trip other loss of balance in which recovery occurred to prevent a fall) and duration. Principal component analysis transformed the 6 new TW measures into 2 summary TW composite factors. Logistic regression models evaluated whether these TW factors were independently associated with mobility disability. Results Both TW factors were moderately related to the TW conventional measures (r &lt; 0.454, p &lt; .001) and were mildly correlated with usual-walking (r &lt; 0.195, p &lt; .001) and standing, postural control (r &lt; 0.119, p &lt; .001). The TW frequency composite factor (p = .008), but not TW complexity composite factor (p = .246), was independently associated with mobility disability in a model controlling for age, sex, body mass index, race, conventional measures of TW, and other measures of gait and postural control. Conclusions Sensor-derived TW metrics expand the characterization of gait and postural control and suggest that they reflect a relatively independent domain of mobility. Further work is needed to determine if these metrics improve risk stratification for other adverse outcomes (eg, falls and incident disability) in older adults.

scholarly journals Frailty in community-dwelling older adults: association with adverse outcomes

2017 ◽  
Vol Volume 12 ◽  
pp. 1003-1011 ◽  
Author(s):  
Sergio Sánchez-Garcí­a ◽  
Carmen García-Peña ◽  
Antoni Salvà-Casanovas ◽  
Rosalinda Sánchez-Arenas ◽  
Víctor Granados-García ◽  
...  
Keyword(s):  
Older Adults ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Associations between frailty trajectories and frailty status and adverse outcomes in community‐dwelling older adults

2021 ◽  
Author(s):  
Alejandro Álvarez‐Bustos ◽  
Jose Antonio Carnicero‐Carreño ◽  
Juan Luis Sanchez‐Sanchez ◽  
Francisco Javier Garcia‐Garcia ◽  
Cristina Alonso‐Bouzón ◽  
...  
Keyword(s):  
Older Adults ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Frailty Status ◽  
Community Dwelling Older Adults
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