Annals of Geriatric Medicine and Research最新文献

Background: Nursing home residents engage in lower levels of physical activity, primarily remaining seated or lying down, except for routine activities of daily living (ADLs). Since ADLs, particularly toileting, require effort. This study investigated the relationship between physical activity and toileting activity during the daytime among older nursing home residents.

Methods: The study involved 30 participants, including a group of healthy community-dwelling older individuals and two groups of nursing home residents with independent and non-independent toileting behavior, respectively. The physical activity of participants was measured with an accelerometer, and estimated metabolic equivalents, duration, and amount of physical activity were calculated.

Results: The amount of physical activity associated with toileting was significantly higher in the independent and non-independent groups than in the community group. Moreover, the amount of non-sedentary physical activity associated with toileting positively affected the amount of non-sedentary physical activity during the daytime. These findings suggest that toileting activity can contribute significantly to the physical activity of older nursing home residents.

Conclusion: Interventions focusing on improving toileting behavior among nursing home residents may positively impact overall physical activity and functional abilities.

Background: This study aimed to develop an instrument for assessing physical functioning among adults aged 50 years or older living in the community.

Methods: Based on a review of various national health surveys and cohort studies, a 144-item bank was constructed for assessing physical functioning. Focus group interviews were conducted among adults aged 50 years or older to investigate their level of understanding of 60 selected items, followed by a pretest of the items on a nationally representative sample (n=508). The final 25-item questionnaire was tested on an independent sample (n=259) for validity and reliability based on classical test and item response theories. Predictive validity at the 6-month follow-up was tested in a separate sample (n=263).

Results: The newly developed Life Functioning (LF) scale assessed the dimensions of functional limitations, disabilities, and social activities. The scale satisfied a one-dimensionality assumption with good item fit and demonstrated criterion validity, construct validity, high internal consistency (Cronbach's alpha=0.93), and test-retest reliability (intra-class correlation coefficient=0.84; 95% confidence interval, 0.76-0.89). The LF scale comprised 25 items with a total score ranging from 0 to 100. Higher scores indicated higher levels of functioning. The LF score was significantly associated with the Physical Functioning score at 6 months.

Conclusion: The LF scale was developed to assess the physical functioning of people in their late midlife or older. Future studies should test the instrument on a national sample and evaluate its application in diverse population subgroups.

Background: The effect of sarcopenia on depressive mood during geriatric rehabilitation remains unclear. This study investigated the potential influence of sarcopenia on depressive mood among geriatric patients in a rehabilitation setting.

Methods: This observational cohort study enrolled 204 patients aged ≥65 years (mean age, 78.8±7.6 years; women, 45.1%) admitted to a rehabilitation unit between April 2020 and July 2021. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment criteria, which include low handgrip strength and muscle mass. Depressive mood was defined as a 15-item Geriatric Depression Scale score of ≥6 points. We applied logistic regression models to examine the influence of sarcopenia on depressive mood at discharge.

Results: We observed sarcopenia in 58.3% of patients. The logistic regression model showed that sarcopenia negatively influenced depressive mood at discharge (odds ratio=5.460; 95% confidence interval, 2.344-13.415). Of the 68 patients without depressive mood at admission, those with sarcopenia (n=31) had a significantly higher incidence of depressive mood at discharge compared with patients without sarcopenia (n=37) (41.9% vs. 16.2%, p=0.037).

Conclusion: Sarcopenia at admission negatively affected depressive mood at discharge from geriatric rehabilitation. Thus, early and routine assessment of sarcopenia is vital for patients undergoing geriatric rehabilitation.

Background: Impaired executive function is common in older adults. This study examined the causal relationship between the use of information and communication technology (ICT) and executive function in older adults over time.

Method: This study performed a secondary analysis of data from four waves (2016-2019) of the National Health and Aging Trends Study. A fixed-effect analysis was conducted to examine the effects of ICT on the executive function of older adults without dementia aged ≥65 years. This study analyzed data from 3,334 respondents.

Results: We observed significant positive effects of ICT use on executive function over time (standardized β=0.043-0.045; 95% confidence interval, 0.001-0.043; p<0.05).

Conclusion: The current findings support the use of ICT as a protective approach to prevent decline in executive function in community-dwelling older adults.

Background: Functional dependency may serve as a marker for positive SARC-F screen (Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) among older adults at the Emergency Department (ED). We compared functional dependency between SARC-F- (<4) and SARC-F+ (≥4) groups at the ED.

Methods: A secondary analysis of cohorts from two quasi-experimental studies among patients aged ≥65 years old presenting to the ED of a 1,700-bed tertiary hospital. We compared both groups for baseline characteristics using univariate analyses, and performed multiple linear regression to examine the association between Modified Barthel Index (MBI) and Lawton's instrumental activities of daily living (IADL) against SARC-F, and binary logistic regression to examine the associations between individual ADL domains and SARC-F+. We compared the area under receiver operating characteristic curves (AUC) to detect SARC-F+ for MBI, IADL, frailty, age, cognition and comorbidity.

Results: SARC-F+ patients were older (86.4±7.6 years), predominantly female (71.5%) and frail (73.9%), more dependent on walking aids (77.2%), and had lower premorbid MBI (median 90.0 [interquartile range 71.0-98.0]) and IADL (4.0 [2.0-5.0]) (both p<0.001). MBI (β=-0.07, 95% confidence interval [CI] -0.086 to -0.055) and IADL (β=-0.533, 95% CI -0.684 to -0.381) were significantly associated with SARC-F. Dependency in finances (odds ratio [OR]=14.7, 95% CI 3.57-60.2, p<0.001), feeding (OR=12.4, 95% CI 1.45-106, p=0.022), and stair-climbing (OR=10.49, 95% CI 4.96-22.2, p<0.001) were the top three functional items associated with SARC-F. MBI (AUC=0.82, 95% CI 0.77-0.84) and IADL (AUC=0.78, 95% CI 0.72-0.84) showed superior discrimination for SARC-F+ compared to other measures (AUC=0.58-0.70).

Conclusion: Functional dependency is strongly associated with positive SARC-F screen among older adults at the ED. This highlights the need for increased vigilance, especially in the presence of dependency in relevant domains such as managing finances, feeding, and stair-climbing.

Background: This study aimed to survey knowledge and perceptions of social prescribing (SP) amongst health and community care workers, and is a cross-sectional online survey conducted in November 2023.

Methods: The survey on basic demographics, awareness, knowledge, and practices of SP was completed by 123 health and community care workers.

Results: The mean age of respondents was 39.0 years. Nearly two-thirds had heard of SP. A lower proportion of acute hospital doctors (55.6%) and nurses (56.8%) had heard of SP compared with primary and subacute care doctors (75.0%). The majority agreed that SP benefits patients' mental health and reduces healthcare utilization. Primary care physicians, community nurses, and active ageing centres were the top three professionals selected as most responsible for SP by survey respondents. The most commonly cited barriers to SP were seniors' reluctance (63.4%), lacking knowledge on how to refer (59.3%), lack of time (44.7%), and cost to seniors (44.7%).

Conclusion: Overall, health and community care workers demonstrated positive attitudes toward SP and were keen to refer patients for SP. However, additional efforts are needed to improve knowledge about how to refer to and provide training on SP.

Background: Gait speed is associated with a higher prevalence of balance disorders in older adults residing at high altitudes. This study investigated this association in older adults from 12 high-altitude Andean Peruvian communities.

Methods: We performed a secondary data analysis from an analytical cross-sectional study of adults >60 years of age, residing in 12 high-altitude Andean Peruvian communities, enrolled between 2013 and 2019. The exposure and outcome variables were gait speed (categorized in tertiles), and balance disorders (defined as a functional reach value of ≤20.32 cm), respectively. We built generalized linear models of the Poisson family with a logarithmic link function and robust variances, and estimated crude prevalence ratios (cPR) and adjusted prevalence ratios (aPR) with 95% confidence intervals (CIs).

Results: We analyzed 418 older adults; 38.8% (n=162) were male, and the mean age was 73.2±6.9 years. The mean gait speed and functional reach were 0.66±0.24 m/s and 19.9±6.48 cm, respectively. In the adjusted regression model, the intermediate (aPR=1.88; 95% CI, 1.39-2.55; p<0.001) and low (aPR=2.04; 95% CI, 1.51-2.76; p<0.001) tertiles of gait speed were associated with a higher prevalence of balance disorders.

Conclusion: The intermediate and low tertiles of gait speed were associated with a higher prevalence of balance disorders among older adult residents of 12 high-altitude Andean communities. We recommend further research on the behavior of this association to propose interventions for these vulnerable groups and reduce the impact of geriatric conditions.

Dynapenia and multimorbidity are common health problems affecting older adults. However, few studies have systematically reviewed the association between dynapenia and multimorbidity. Therefore, this systematic review aimed to provide a comprehensive overview of studies on the association between these conditions. We searched four electronic databases for relevant articles published in July 2023. The main inclusion criteria were the following: a description of dynapenia, which indicates loss of muscle strength, and a description of multimorbidity with two or more chronic diseases. Five studies met these inclusion criteria. In all five of these studies, the participants were community-dwelling older adults. All the studies showed an association between dynapenia and multimorbidity. The prevalence of dynapenia and multimorbidity ranged from 16% to 25.9%. The results of our systematic review demonstrated that dynapenia in older adults increases the risk of multimorbidity. We propose that interventions and reversible changes in dynapenia can prevent multimorbidity. (PROSPERO Registration No. CRD42023443282).

Background: The association between physical frailty and performance in different cognitive domains in the absence of cognitive disorders is poorly understood. Hence, we aimed to explore the associations between frailty levels based on the Fried Physical Frailty Phenotype and performance of different cognitive domains. We also aimed to examine the associations between cognitive function and each criterion in the Fried Frailty Scale using the same cognitive domains in a non-dementia population aged 60-96 years.

Methods: This cross-sectional study included 4,329 participants aged 60-96 years, drawn from the "Good Aging in Skåne" population study. Frailty indices included handgrip strength, physical endurance, body mass index (BMI), physical activity, and walking speed. Cognitive function was assessed across eight domains: episodic memory, processing speed, semantic memory, verbal fluency, working memory, attention, executive function, and visual perception. We constructed adjusted multiple linear regression models for each cognitive domain, with the frailty levels as the independent variable. Likewise, we constructed linear regression models with each cognitive domain as the dependent variable and frailty criteria as independent variables.

Results: Physical frailty was associated with poor performance in episodic memory, processing speed, semantic memory, verbal fluency, working memory, attention, and executive functions (p<0.001 for all associations). Weaker hand grip strength was independently associated with poorer performance in all cognitive domains (p < 0.015).

Conclusion: Higher levels of frailty were associated with poorer performance in all cognitive domains except visual perception. Describing frailty by considering cognitive functioning may provide a better understanding of frailty.