scholarly journals Participant characteristics and intervention effects of a program to improve the physical function in community-dwelling frail elderly subjects

2013 ◽  
Vol 50 (6) ◽  
pp. 804-811 ◽  
Author(s):  
Chikako Kato ◽  
Remi Fujita ◽  
Kunio Ida
2014 ◽  
Vol 44 (6) ◽  
pp. 1571-1578 ◽  
Author(s):  
Loes C.M. Bertens ◽  
Johannes B. Reitsma ◽  
Yvonne van Mourik ◽  
Jan-Willem J. Lammers ◽  
Karel G.M. Moons ◽  
...  

It is uncertain whether screening of older persons for chronic obstructive pulmonary disease (COPD) is worthwhile because the effects on patient management and prognosis are unknown.We aimed to assess the short-term consequences of detecting COPD in frail elderly subjects with dyspnoea, considering pulmonary drug use, hospitalisations and all-cause mortality.Community-dwelling frail elderly subjects, aged 65 years and older, with dyspnoea, participating in a screening study on COPD and heart failure were included. Final diagnoses were assigned by an expert panel based on all data from the screening strategy, including spirometry. Follow-up data were collected from the general practitioners.Of the 386 patients, 84 (21.8%) were received a new diagnosis of COPD. Overall, changes in pulmonary drug prescription during 6 months of follow-up were infrequent (n = 53, 13.7%; among new cases of COPD, 15 (17.9%) out of 84). Of all participants, 25.9% were hospitalised in the first year of follow-up, with the highest rate in patients with newly detected COPD (32.1%).Many new cases of COPD could be detected by screening frail elderly subjects with dyspnoea, but the impact on patient management seems limited. Our study underlines the importance of obtaining follow-up data to assess the true impact of a (screen-detected) diagnosis of COPD on patient management and outcome.


2009 ◽  
Vol 103 (2) ◽  
pp. 289-294 ◽  
Author(s):  
Sachiko Izawa ◽  
Hiromi Enoki ◽  
Yoshihisa Hirakawa ◽  
Mitsunaga Iwata ◽  
Jun Hasegawa ◽  
...  

Although anthropometric parameters have been extensively studied regarding their relationship to physical function status, the association between these parameters and the activity of daily living (ADL) function remains controversial. We investigated whether BMI or mid-upper arm circumference (AC) is an indication of variation in the physical functioning of the frail elderly. The present study was a prospective cohort analysis of 543 community-dwelling frail elderly. Data included the participants' demographic characteristics, basic ADL, comorbidity and anthropometric measurements at baseline and at 2-year follow-up. Logistic regression models were used to investigate the association between ADL status and anthropometric measurements during the study period. Among the 543 participants, 418 maintained or improved their ADL status, while 125 showed an ADL decline during the study period. Multivariate logistic regression analysis showed that BMI and AC levels or ADL status at baseline were not independent predictors of the loss of ADL function or the decline in these anthropometric measurements during the study period, respectively. However, the decline in BMI and AC levels and the loss of ADL function were associated with each other during the study period. There is an association between the negative changes in anthropometric measurements during the follow-up period and the decline in ADL function during a 2-year follow-up in community-dwelling frail elderly.


Author(s):  
Chisato Hayashi ◽  
Soshiro Ogata ◽  
Tadashi Okano ◽  
Hiromitsu Toyoda ◽  
Sonoe Mashino

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 194-195
Author(s):  
Kaiyuan Hua ◽  
Sheng Luo ◽  
Katherine Hall ◽  
Miriam Morey ◽  
Harvey Cohen

Abstract Background. Functional decline in conjunction with low levels of physical activity has implications for health risks in older adults. Previous studies have examined the associations between accelerometry-derived activity and physical function, but most of these studies reduced these data into average means of total daily physical activity (e.g., daily step counts). A new method of analysis “functional data analysis” provides more in-depth capability using minute-level accelerometer data. Methods. A secondary analysis of community-dwelling adults ages 30 to 90+ residing in southwest region of North Carolina from the Physical Performance across the Lifespan (PALS) study. PALS assessments were completed in-person at baseline and one-week of accelerometry. Final analysis includes 669 observations at baseline with minute-level accelerometer data from 7:00 to 23:00, after removing non-wear time. A novel scalar-on-function regression analysis was used to explore the associations between baseline physical activity features (minute-by-minute vector magnitude generated from accelerometer) and baseline physical function (gait speed, single leg stance, chair stands, and 6-minute walk test) with control for baseline age, sex, race and body mass index. Results. The functional regressions were significant for specific times of day indicating increased physical activity associated with increased physical function around 8:00, 9:30 and 15:30-17:00 for rapid gait speed; 9:00-10:30 and 15:00-16:30 for normal gait speed; 9:00-10:30 for single leg stance; 9:30-11:30 and 15:00-18:00 for chair stands; 9:00-11:30 and 15:00-18:30 for 6-minute walk. Conclusion. This method of functional data analysis provides news insights into the relationship between minute-by-minute daily activity and health.


Author(s):  
Ottavia Eleonora Ferraro ◽  
Antonio Guaita ◽  
Simona Villani

Abstract Backgrounds and aims Health trajectories in aging, rather than single time-point assessments, could be early indicators of the onset of conditions such as dementia. The aim of this study was to identify different aging trajectories and to investigate their influence on the cumulative incidence of dementia. Methods We evaluated data referring to 993 elders from the InveCe.Ab study cohort. All subjects were free from dementia at baseline and re-assessed on at least one other occasion thereafter. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), physical function using the Walking Speed Test (WST), and disability on the basis of the Activities of Daily Living (ADL) score. To describe the different courses of the three outcomes combined, the Group-Based Trajectory Model (GBTM) method was applied. We looked for differences in age, gender, education, ApoE-e4 carrier status and obesity, and then investigated the influence of the observed trajectories on the incidence of dementia. Results Three trajectories were identified: a “good” scenario was observed in 703 (70.2%) individuals, who showed substantially stable cognitive and physical function and no disability; an “intermediate” scenario in 248 subjects (25.5%), who recorded a longer walking time, lower MMSE score, and a one-point higher ADL score; and a “severe” scenario in 42 elders (4.3%), who recorded declines in all the outcomes. Female gender, obesity and low education were most represented in the “severe” group. ApoE-e4 carrier status showed no difference between groups. The estimated cumulative incidence of dementia was higher in the “severe” (37%) than in the “intermediate” (7%) and “good” (< 1%) scenarios. Conclusions Using simple measurements, we built different aging trajectories, and observed that the worst performers had the highest incidence of dementia. Better knowledge of trajectories of aging would be useful for preventive interventions aimed at promoting healthier aging.


2021 ◽  
Vol 10 (7) ◽  
pp. 1352
Author(s):  
Sandra Agyapong-Badu ◽  
Martin B. Warner ◽  
Dinesh Samuel ◽  
Vasiliki Koutra ◽  
Maria Stokes

A novel approach to ageing studies assessed the discriminatory ability of a combination of routine physical function tests and novel measures, notably muscle mechanical properties and thigh composition (ultrasound imaging) to classify healthy individuals according to age and gender. The cross-sectional study included 138 community-dwelling, self-reported healthy males and females (65 young, mean age ± SD = 25.7 ± 4.8 years; 73 older, 74.9 ± 5.9 years). Handgrip strength; quadriceps strength; respiratory peak flow; timed up and go; stair climbing time; anterior thigh tissue thickness; muscle stiffness, tone, elasticity (Myoton technology), and self-reported health related quality of life (SF36) were assessed. Stepwise feature selection using cross-validation with linear discriminant analysis was used to classify cases based on criterion variable derived from known effects of age on physical function. A model was trained and features selected using 126 cases with 0.92 accuracy (95% CI = 0.86–0.96; Kappa = 0.89). The final model included five features (peak flow, timed up and go, biceps brachii elasticity, anterior thigh muscle thickness, and percentage thigh muscle) with high sensitivity (0.82–0.96) and specificity (0.94–0.99). The most sensitive novel biomarkers require no volition, highlighting potentially useful tests for screening and monitoring effects of interventions on musculoskeletal health for vulnerable older people with pain or cognitive impairment.


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