Geriatrics最新文献

Background/objective: The present study aimed to contribute to analyzing the psychometric properties of the WHO Quality of Life Scale for Older Adults (WHO-QoL-Old) in a sample of older adults in Michoacán, Mexico.

Methods: 111 older adults from Michoacán, Mexico, participated in the study. Confirmatory factor analysis (CFA) was conducted to test the fit of various models. Data analysis was performed using R Studio, considering the ordinal nature of the items in the model estimation method. Internal consistency was evaluated using the alpha coefficient (α) and McDonald's omega coefficient (ω).

Results: The CFA indicated that the six-correlated-factor model proposed theoretically showed a very good fit (χ²: 397.11, p < 0.001; CFI: 0.958; SRMR: 0.079; RMSEA: 0.079). The factors within the model demonstrated acceptable internal consistency, with an alpha coefficient ranging from 0.739 to 0.874 and an omega coefficient ranging from 0.748 to 0.882.

Conclusions: It is concluded that the WHO-QoL-Old scale presents good psychometric properties for the Mexican older adult population.

Objective: The aim of this study was to clarify the link between experiencing cerebrovascular diseases (strokes as an explicit example) and fear of falling (FOF) among middle-aged and older adults in Europe. Methods: Longitudinal data were used from wave 5 to wave 7 of the representative Survey of Health, Ageing and Retirement in Europe (SHARE). Self-reported tools were used to quantify the key variables. Fear of falling was similarly assessed using a dichotomous yes or no question, "For the past six months at least, have you been bothered by any of the health conditions on this card", with fear of falling being one of the options. It was adjusted for various sociodemographic and health-related factors. In particular, to account for unobserved heterogeneity, conditional fixed effect regressions (FE) were used. Accordingly, change in an individual's FOF status over the included waves was analysed and correlated with the reported change of all the included time-varying independent variables within the same individual, including experiencing stroke or other cerebrovascular diseases. The final analytical sample equalled n = 22.071 observations. Results: Conditional logistic FE regressions showed that the onset of a stroke or other forms of cerebrovascular disease was not associated with an increased likelihood of experiencing fear of falling (OR = 1.25, p = 0.095). However, stratified by sex, such an association was present in men (OR = 1.79, p = 0.006), though not in women (OR = 0.94, p = 0.732). Conclusions: The onset of a stroke or other cerebrovascular diseases was associated with an increased likelihood of experiencing FOF in men but not women. Efforts are required to assist older men in avoiding FOF after the onset of stroke or other cerebrovascular pathologies.

Objective: This study aims to clarify the gazing characteristics of older drivers while driving cars using a gaze analysis device. Methods: The participants included 16 older and 12 middle-aged drivers who drove cars daily. After conducting cognitive and attentional function tests, eye gaze while watching driving videos was measured using an eye tracker. Ten driving videos were prepared. In addition, a total of 34 hazard areas were analyzed. Results: The results of the gaze measurement parameters were statistically compared between the two groups. In the older group, the gaze analysis results indicated that while viewing driving videos, the search for areas close to the car was expanded. In addition, in several hazard areas, we observed a decrease in the number of drivers gazing at the driver, shortened total gazing time, delay in the timing of gazing, and decrease in the number of visits. Conclusions: Older drivers' eye movement is increased; however, it is characterized by gazing at unimportant areas, indicating an inefficient scanning pattern. Although these results do not indicate an obvious decline in driving ability among older drivers, the decline in hazard perception may become apparent in some situations. The data contain underpowered results and require revalidation in larger studies.

Background/Objectives: An association between oral function and physical fitness, including walking capacity, has been reported. However, the association between masticatory behaviors and walking ability-both of which represent patterns of movement in daily life-has not been clarified. This study aimed to investigate the association between masticatory behaviors, oral function, and walking capacity in older people. Methods: One hundred community-dwelling older people (31 men, 69 women, mean age 75.7 ± 6.3 years) were selected to participate in this study. Age, sex, masticatory behaviors, oral functions (tongue pressure, tongue-lips motor function, occlusal force, and masticatory performance), and walking capacity were assessed. Masticatory behaviors were assessed during the consumption of one rice ball (100 g) using a wearable chewing counter, and the number of chews, chewing rate, the number of chews per bite, and meal time were recorded. Walking capacity was assessed using the timed up and go test (TUG). Spearman's rank correlation coefficients were calculated to assess the strength and direction of the association. Results: Moderate negative correlations were observed between TUG time and tongue pressure and between TUG time and tongue-lips motor function (/ta/ and /ka/) (rs = -0.33, -0.21, -0.28, respectively). In addition, moderate negative correlations between TUG time and chewing rate (rs = -0.22) and between TUG time and meal time (rs = 0.33) were observed, suggesting that lower walking capacity was associated with slower chewing rate and longer meal times. Conclusions: In community-dwelling older people, declines in mastication speed and dexterity and tongue strength are associated with lower walking capacity.

Background: This study provides a detailed examination of older Veterans with traumatic brain injury (TBI) and dementia and their caregivers, focusing on Veterans' demographic, clinical, functional, safety risk, and behavioral characteristics and caregivers' demographic, clinical, and care-related characteristics and well-being.

Methods: Veterans' caregivers (N = 110) completed a telephone-based survey.

Results: Veterans averaged eight comorbid health conditions, with over 60% having chronic pain, hypertension, post-traumatic stress disorder, or depression. Caregivers reported helping with an average of three activities of daily living, with the highest percentages of Veterans needing assistance with grooming, dressing, and bathing. Almost all Veterans needed assistance with shopping, cooking, medication management, housework, laundry, driving, and finances. Veterans averaged two safety risks, the most common being access to dangerous objects, access to a gun, and not being able to respond to emergency situations. Although Veterans averaged 14 behavioral concerns, caregivers reported that their family needs relating to TBI were generally met or partly met, and they voiced confidence in their ability to respond to behaviors and control their upsetting thoughts. Caregivers' mean burden score was severe, while mean depression and anxiety scores were mild. Caregivers reported an average of 10.5 h per day providing care and 20.1 h per day on duty.

Conclusions: The findings demonstrate the increased presence of impairments, safety risks, and behavioral issues in Veterans with comorbid TBI and dementia, as well as increased impacts on families' burdens and care provision requirements. Clinicians should be alert for and educate TBI patients and caregivers on the warning signs of post-TBI dementia and its associated functional, behavioral, and safety risk profile, as well as challenges related to caregiver well-being. Healthcare policymakers must consider the increased caregiver demands associated with comorbid TBI and dementia, as well as the need for expanded long-term support and services.

Background: GaitSmart (GS) is a sensor-based digital medical device that can be used with the integrated app vGym to provide a personalised rehabilitation programme for older people undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study aimed to determine whether the GS intervention used in the rehabilitation of older people undergoing THA or TKA is potentially cost-effective compared to the current standard of care (SoC).

Methods: Decision-analytic modelling was conducted to estimate the cost-effectiveness over a seventeen-week time horizon from an NHS perspective. UK clinical and cost data from the GaitSmart randomised clinical trial was used to obtain the input parameters, and a sensitivity analysis was performed to address uncertainties.

Results: Over a seventeen-week time horizon, GS incurred cost savings of GBP 450.56 and a 0.02 gain in quality-adjusted life years (QALYs) compared to the SoC. These results indicate that GS is the dominant intervention because the device demonstrated greater effectiveness and lower costs. Probabilistic sensitivity analyses confirm the robustness of our results.

Conclusions: GS appears to offer short-term efficiency benefits and demonstrates cost-effectiveness for the improvement in gait in people undergoing THA or TKA, compared to the SoC.

Background/objectives: Sarcopenia is a muscular disease characterized by loss of muscular strength and function, affecting mainly women, and associated with increased mortality risk. The aim of this study was to compare active women with inactive women of different age groups regarding muscle mass, strength, and muscle quality.

Methods: This study included 147 women (85 runners and 62 inactive), divided into <50 and ≥50 years old. Participants were evaluated for knee flexor and extensor peak torque (PT), body composition, and training habits.

Results: For knee extensor muscles, there was an age group effect (F(2.146) = 40.5; p < 0.001) on absolute PT (Nm); an age group effect (F(2.146) = 44.1; p < 0.001) and a physical activity group effect (F(2.146) = 113.0; p < 0.001) on PT adjusted by body mass (Nm/kg); and an age group effect (F(2.146) = 36.9; p < 0.001) and a physical activity group effect (F(2.146) = 6.1; p = 0.014) on PT adjusted by lean mass (Nm/kgLM). There was no interaction effect.

Conclusion: In both age groups, active women had greater strength and higher muscle quality than inactive women, but the difference in strength, muscle mass, and muscle quality between younger and older women were the same among runners and inactive women.

In this study, we investigated the effect of regular walking and its combination with manual techniques/resistance exercise. The position of the shoulder girdle was assessed using the acromion-wall distance (AD). The intervention took place twice a week for 4 weeks. A total of 88 seniors over the age of 60 successfully completed the study. The results showed a statistically significant improvement of AD in the left shoulder within the group that underwent walking combined with resistance exercise. The remaining groups did not show any statistically significant change in AD.

Background: The world population is rapidly aging; therefore, it is necessary to respond to this challenge in time. One of the typical involutional signs of old age is a hunched posture combined with a forward position of the shoulder girdle. This posture negatively impacts various bodily functions, postural stability, and strain on the musculoskeletal system.

Objectives: We aimed to evaluate the effect of walking and walking combined with manual therapy/resistance exercise on scapular positioning in healthy elderly individuals.

Methods: Participants of experimental groups underwent a 4-week training session that involved walking and manual techniques/resistance training applied 2x/week. Participants of the control group maintained their usual daily habits.

Results: Our results showed statistically significant improvement in scapular positioning of the left shoulder in participants who underwent regular walking combined with resistance exercise training.

Conclusions: These results suggest that regular walking combined with resistance training, when properly dosed, may beneficially influence scapular positioning in healthy elderly individuals.

Background/Objectives: This retrospective study focused on the role of Dopamine Transporter (DAT) scans in diagnosing Parkinson's Disease (PD) in older adults with cognitive impairment (CI). Methods: We retrospectively analyzed brain imaging of 6483 individuals aged 60 and above with CI. Among these, 297 underwent a DAT scan, with 189 testing positive and 89 starting dopamine therapy. In contrast, 173 patients exhibited PD-associated structural changes on CT or MRI without receiving DAT scans or treatment. Results: Of these patients, 50 (29%) experienced falls. This points towards a potential missed diagnosis of PD, which can respond to therapy in the early stages. Conclusions: Our results suggest that providers may overlook subtle signs of parkinsonism in patients with CI, resulting in symptoms worsening and treatment delay. Since CI is often first brought to the attention of PCPs, our findings call for an increased effort to inform PCPs of the role of DAT scans in aiding the diagnosis of dopamine deficiency states. By understanding PD-related structural changes seen on brain imaging and using a DAT scan to confirm dopamine deficiency, treatment for PD or related states might be started earlier or a timely referral made to a specialist, reducing patient disability and improving their quality of life.

Introduction: Obesity is a chronic, relapsing, and progressive disease. The issue of obesity affects 50 to 80% of patients who have been diagnosed with breast cancer. The aim of this study is to assess the scale of the problem of obesity among breast cancer survivors (BCS) older than 60 years, evaluate their physical fitness, and study the relationship between the occurrence of obesity and levels of fitness among breast cancer survivors. The relationship between fitness and sociodemographic factors has also been analyzed.

Materials and methods: This original epidemiological clinical study included a cohort of 88 female breast cancer survivors treated in 2022 in Holycross Cancer Center, Kielce, Poland. A questionnaire involving demographic information and medical data was utilized. The Senior Fitness Test (SFT) battery has been used to assess the physical fitness of the patients. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were also analyzed.

Results: More than 70% of the studied breast cancer survivors were classified as overweight or obese, according to BMI and WC indices. Depending on the SFT trial, the regression coefficients indicated worse results in participants who were older, lived in urban areas, were professionally active, less educated, and had higher obesity indices. The analysis of the relationship between obesity indices and fitness components revealed that all obesity indices were significantly associated with lower body flexibility (BMI p = 0.0118, WC p = 0.0092, WHR p = 0.0364, WHtR p = 0.0095). Upper body flexibility was significantly correlated with BMI indices (p = 0.0091, p = 0.0193) and WHtR (p = 0.0095). Agility and balance were significantly associated with WC (p = 0.0193), WHR (p = 0.098), and WHtR (p = 0.0095). Lower body strength was significantly correlated with the WHR index (p = 0.0487). Significant differences were found in upper body strength depending on the WHtR category.

Conclusions: In the studied group of breast cancer survivors, there is a high prevalence of overweight and obesity. With increasing obesity rates, older age, and lower education levels, physical activity measured by the SFT decreases. Living in urban areas and being professionally active also predispose to lower physical activity levels. As obesity indices increase, physical fitness decreases in trials assessing upper and lower body strength, upper and lower body flexibility, as well as agility and dynamic balance.