Hearing loss and cognitive impairment are widely prevalent in individuals aged 60 years and above. Hearing loss is one of the main modifiable risk factors for dementia, emphasizing the importance for potentially mitigating cognitive decline.
Methods
This study performed a secondary analysis of the database of Survey on Health, Well-Being, and Aging in Colombia (SABE Colombia). Hearing loss and cognitive impairment were assessed by self-report and the abbreviated Folstein version of the Mini Mental State Examination validated in Latin American Spanish. Information was searched on hearing rehabilitation and access barriers. A logistic regression model was used to assess the impact factors of cognitive impairment.
Results
Among 23,694 participants, the estimated prevalence of hearing loss was 31.73 % and for cognitive impairment was 19.79 %, which is similar with global reports. A significant proportion of individuals with hearing loss (93.13 %) remain untreated. There was a statistically significant association between the presence of hearing loss and risk of cognitive impairment (p < 0.001). Older age, fewer years of education, gender (women) and affiliation to subsidized scheme/not being affiliated were also found having significant associations with cognitive impairment (p < 0.001).
Conclusions
This study offers valuable insights into cognitive impairment and hearing loss and their interrelation in Colombia, thereby assisting government authorities and health system stakeholders in making informed decisions regarding public health policies and resource allocation.
{"title":"Cognitive impairment and hearing loss in Colombian aged population","authors":"Leonardo Elías Ordóñez Ordóñez , Daniela Cerón Perdomo , Gloria Corredor-Rojas , Jorge Medina-Parra , Esther Sofía Angulo Martínez","doi":"10.1016/j.ahr.2025.100238","DOIUrl":"10.1016/j.ahr.2025.100238","url":null,"abstract":"<div><h3>Background</h3><div>Hearing loss and cognitive impairment are widely prevalent in individuals aged 60 years and above. Hearing loss is one of the main modifiable risk factors for dementia, emphasizing the importance for potentially mitigating cognitive decline.</div></div><div><h3>Methods</h3><div>This study performed a secondary analysis of the database of Survey on Health, Well-Being, and Aging in Colombia (SABE Colombia). Hearing loss and cognitive impairment were assessed by self-report and the abbreviated Folstein version of the Mini Mental State Examination validated in Latin American Spanish. Information was searched on hearing rehabilitation and access barriers. A logistic regression model was used to assess the impact factors of cognitive impairment.</div></div><div><h3>Results</h3><div>Among 23,694 participants, the estimated prevalence of hearing loss was 31.73 % and for cognitive impairment was 19.79 %, which is similar with global reports. A significant proportion of individuals with hearing loss (93.13 %) remain untreated. There was a statistically significant association between the presence of hearing loss and risk of cognitive impairment (<em>p</em> < 0.001). Older age, fewer years of education, gender (women) and affiliation to subsidized scheme/not being affiliated were also found having significant associations with cognitive impairment (<em>p</em> < 0.001)<strong>.</strong></div></div><div><h3>Conclusions</h3><div>This study offers valuable insights into cognitive impairment and hearing loss and their interrelation in Colombia, thereby assisting government authorities and health system stakeholders in making informed decisions regarding public health policies and resource allocation.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 3","pages":"Article 100238"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-22DOI: 10.1016/j.ahr.2025.100237
Jihye Kim , Yue Li , Sungchul Park , Hyunjee Kim , Yeunkyung Kim
Background
To investigate factors associated with the receipt of caregiver training among informal caregivers for people living with dementia in the community.
Methods
Using three waves of the National Health and Aging Trends Study and the National Study of Caregiving data (2015, 2017, and 2021), the sample included 2606 family/unpaid caregivers who provided care assistance to community-dwelling older adults living with dementia. We conducted a multivariate logistic regression analysis with sampling weights to examine the factors associated with the receipt of training among caregivers for people living with dementia.
Results
Findings indicated that 8.3 % of the caregivers received caregiver training. Non-Hispanic Black (odds ratio [OR], 2.02; 95 % confidence interval [CI]: 1.30–3.15) and caregivers of other races (OR, 2.94; 95 % CI: 1.57–5.49) were more likely to receive training than non-Hispanic White caregivers. Spouse of care recipient (OR, 3.11; 95 % CI: 1.32–7.30), Medicaid-enrolled caregivers (OR, 2.52; 95 % CI: 1.44–4.41), caregivers who worked in the past week (OR, 2.12; 95 % CI: 1.21–3.70), and caregivers for those who needed assistance for multiple self-care or mobility tasks (OR, 2.22; 95 % CI: 1.24–4.00) were more likely to receive caregiver training than their respective counterparts.
Conclusions
Given the challenges of dementia caregiving and the potential beneficial effect of training, it is imperative for policy makers to promote both overall uptake rate of caregiver training and the rate among high-risk subgroups, to relieve caregiver burden and improve outcomes of both caregivers and care recipients.
{"title":"Factors associated with receipt of caregiver training among family and unpaid caregivers of people living with dementia","authors":"Jihye Kim , Yue Li , Sungchul Park , Hyunjee Kim , Yeunkyung Kim","doi":"10.1016/j.ahr.2025.100237","DOIUrl":"10.1016/j.ahr.2025.100237","url":null,"abstract":"<div><h3>Background</h3><div>To investigate factors associated with the receipt of caregiver training among informal caregivers for people living with dementia in the community.</div></div><div><h3>Methods</h3><div>Using three waves of the National Health and Aging Trends Study and the National Study of Caregiving data (2015, 2017, and 2021), the sample included 2606 family/unpaid caregivers who provided care assistance to community-dwelling older adults living with dementia. We conducted a multivariate logistic regression analysis with sampling weights to examine the factors associated with the receipt of training among caregivers for people living with dementia.</div></div><div><h3>Results</h3><div>Findings indicated that 8.3 % of the caregivers received caregiver training. Non-Hispanic Black (odds ratio [OR], 2.02; 95 % confidence interval [CI]: 1.30–3.15) and caregivers of other races (OR, 2.94; 95 % CI: 1.57–5.49) were more likely to receive training than non-Hispanic White caregivers. Spouse of care recipient (OR, 3.11; 95 % CI: 1.32–7.30), Medicaid-enrolled caregivers (OR, 2.52; 95 % CI: 1.44–4.41), caregivers who worked in the past week (OR, 2.12; 95 % CI: 1.21–3.70), and caregivers for those who needed assistance for multiple self-care or mobility tasks (OR, 2.22; 95 % CI: 1.24–4.00) were more likely to receive caregiver training than their respective counterparts.</div></div><div><h3>Conclusions</h3><div>Given the challenges of dementia caregiving and the potential beneficial effect of training, it is imperative for policy makers to promote both overall uptake rate of caregiver training and the rate among high-risk subgroups, to relieve caregiver burden and improve outcomes of both caregivers and care recipients.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 3","pages":"Article 100237"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-21DOI: 10.1016/j.ahr.2025.100236
Jing Wang , Shahrzad Siamdoust , Zhijing Xu , Catharine Mott , Brenda L. Plassman , Ruth A. Anderson , Jessica Zwerling , Bei Wu
Background
Maintaining oral health is essential for individuals with dementia, yet they often need support. We sought to identify insights gained during the recruitment process for an intervention designed to teach care partners skills to guide individuals with mild dementia in proper oral hygiene techniques and provide reminders to practice oral hygiene care.
Methods
Throughout the study, research team members from two research sites met regularly to discuss their experiences in recruiting participants. Notes from these meetings served as the basis for identifying key challenges and effective strategies.
Results
Recruitment involved direct patient engagement, collaboration with dementia research centers and community organizations, and the use of electronic health record systems, including MyChart. Recruitment coordinators connected study personnel with organizations and support groups, thereby broadening the recruitment base. Barriers to recruitment included the reduced frequency of patient visits to clinics during the COVID-19 pandemic, which limited in-person recruitment opportunities, as well as the time required to establish new relationships with non-affiliated hospitals and community organizations. Recruitment efforts successfully integrated long-standing relationships with dementia research centers and healthcare providers alongside the establishment of new partnerships with community organizations and non-affiliated hospitals.
Conclusion
Flexibility, participant-centered communication, and a multifaceted approach were critical for overcoming pandemic-related challenges and addressing recruitment barriers, ensuring diverse and well-retained participation in this study.
{"title":"Insights from recruiting individuals with mild dementia and care partners for a multi-site oral hygiene intervention","authors":"Jing Wang , Shahrzad Siamdoust , Zhijing Xu , Catharine Mott , Brenda L. Plassman , Ruth A. Anderson , Jessica Zwerling , Bei Wu","doi":"10.1016/j.ahr.2025.100236","DOIUrl":"10.1016/j.ahr.2025.100236","url":null,"abstract":"<div><h3>Background</h3><div>Maintaining oral health is essential for individuals with dementia, yet they often need support. We sought to identify insights gained during the recruitment process for an intervention designed to teach care partners skills to guide individuals with mild dementia in proper oral hygiene techniques and provide reminders to practice oral hygiene care.</div></div><div><h3>Methods</h3><div>Throughout the study, research team members from two research sites met regularly to discuss their experiences in recruiting participants. Notes from these meetings served as the basis for identifying key challenges and effective strategies.</div></div><div><h3>Results</h3><div>Recruitment involved direct patient engagement, collaboration with dementia research centers and community organizations, and the use of electronic health record systems, including MyChart. Recruitment coordinators connected study personnel with organizations and support groups, thereby broadening the recruitment base. Barriers to recruitment included the reduced frequency of patient visits to clinics during the COVID-19 pandemic, which limited in-person recruitment opportunities, as well as the time required to establish new relationships with non-affiliated hospitals and community organizations. Recruitment efforts successfully integrated long-standing relationships with dementia research centers and healthcare providers alongside the establishment of new partnerships with community organizations and non-affiliated hospitals.</div></div><div><h3>Conclusion</h3><div>Flexibility, participant-centered communication, and a multifaceted approach were critical for overcoming pandemic-related challenges and addressing recruitment barriers, ensuring diverse and well-retained participation in this study.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 3","pages":"Article 100236"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-15DOI: 10.1016/j.ahr.2025.100235
Lihua Shu , Xiaoling Yin , Xiangzhu Zhu , Jing Zhao , Xinqing Deng , Yevheniy Eugene Shubin , Harvey J. Murff , Reid M. Ness , Chang Yu , Martha J. Shrubsole , Qi Dai
Background
Traditional Chinese medicine (TCM) has guided generations of practice on disease treatment and health maintenance. The TCM principles include the framework of body constitution. However, no study has assessed the body constitution in US population.
Methods
This is an ancillary study of the Personalized Prevention of Colorectal Cancer Trial which was conducted in US during 2012–2016. 191 white participants were evaluated for body constitution type using a self-administered Traditional Chinese Medicine Questionnaire (English version). The body constitution subtypes and cardiovascular disease (CVD) risk were assessed.
Results
Fifty-seven (29.8 %) were identified as balanced constitution (BC), while Blood-stasis (17.3 %), Qi-deficient (13.6 %), and inherited-special constitutions (10.5 %) were the pre-eminent pathologic subtypes. Additional analyses investigated the relationship between CVD risk and body constitution subtypes. No major types of TCM body constitution were associated with the general cardiovascular risk score and other CVD biomarkers.
Conclusions
It is important to understand the underlying mechanisms contributing to the differences by population, which may not only help to understand the underlying mechanism for TCM, but also help to identify novel factors or mechanisms for CVD risk, prevention and treatment.
{"title":"Associations between traditional Chinese medicine body constitution and cardiovascular disease risk in a white population","authors":"Lihua Shu , Xiaoling Yin , Xiangzhu Zhu , Jing Zhao , Xinqing Deng , Yevheniy Eugene Shubin , Harvey J. Murff , Reid M. Ness , Chang Yu , Martha J. Shrubsole , Qi Dai","doi":"10.1016/j.ahr.2025.100235","DOIUrl":"10.1016/j.ahr.2025.100235","url":null,"abstract":"<div><h3>Background</h3><div>Traditional Chinese medicine (TCM) has guided generations of practice on disease treatment and health maintenance. The TCM principles include the framework of body constitution. However, no study has assessed the body constitution in US population.</div></div><div><h3>Methods</h3><div>This is an ancillary study of the Personalized Prevention of Colorectal Cancer Trial which was conducted in US during 2012–2016. 191 white participants were evaluated for body constitution type using a self-administered Traditional Chinese Medicine Questionnaire (English version). The body constitution subtypes and cardiovascular disease (CVD) risk were assessed.</div></div><div><h3>Results</h3><div>Fifty-seven (29.8 %) were identified as balanced constitution (BC), while Blood-stasis (17.3 %), Qi-deficient (13.6 %), and inherited-special constitutions (10.5 %) were the pre-eminent pathologic subtypes. Additional analyses investigated the relationship between CVD risk and body constitution subtypes. No major types of TCM body constitution were associated with the general cardiovascular risk score and other CVD biomarkers.</div></div><div><h3>Conclusions</h3><div>It is important to understand the underlying mechanisms contributing to the differences by population, which may not only help to understand the underlying mechanism for TCM, but also help to identify novel factors or mechanisms for CVD risk, prevention and treatment.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 3","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-12DOI: 10.1016/j.ahr.2025.100234
Sophie Edwards , Marc Evans , Craig Ritchie , Julie Hviid Hahn-Pedersen , Mei Sum Chan , Benjamin D Bray , Alice Clark , Christian Ahmad Wichmann , Dominic Trepel
Background
Multimorbidity (having two or more comorbidities), is common among people with dementia and associated with lower survival and increased healthcare use. We aimed to identify comorbidity clusters in people living with Alzheimer’s disease (AD) dementia in the UK, describe comorbidity-cluster prevalence and patterns, and estimate associations of clusters with healthcare resource utilisation (HCRU) and costs.
Methods
This was a cohort study using Discover dataset (electronic health records from approximately 2.8 million North-West London residents). We identified individuals with AD dementia using diagnostic codes, and estimated HCRU and total healthcare costs (including primary and hospital-based care). Individuals were grouped based on comorbidity profile using k-medoids clustering. Multivariable modelling was used to estimate associations between comorbidity clusters and healthcare costs.
Results
Among 18,116 individuals with AD dementia, eight comorbidity clusters were identified. The three highest-cost clusters incurred mean costs per patient year(ppy) of £6355, £5560, and £5284 respectively. The highest-cost cluster had a high burden of comorbidities with the most prevalent: frailty (83.2 %), hypertension (81.8 %), type 2 diabetes mellitus (81.4 %), and chronic kidney disease (69.7 %). Costs in the three highest-cost clusters were 1.7 to 2.0 times higher than the lowest-cost cluster (mean cost £3160ppy), which featured the lowest overall comorbidity burden. The lowest median survival times were in the two highest-cost clusters. Cluster membership was strongly associated with costs even after adjusting for a wide range of demographic and clinical factors. Compared with the lowest-cost cluster the average marginal increases in costs for the clusters ranged between £1072 (95 %CI:£478-£1666) and £3531ppy (95 %CI: £2850-£4212).
Conclusions
HCRU and costs in individuals with AD dementia show notable differences, with a large proportion of costs attributable to a minority of individuals with multiple comorbidities (particularly cardiometabolic diseases and frailty). Health systems should ensure initiatives to improve timely diagnosis and treatment of people with AD taking account of the high multimorbidity prevalence in this population.
{"title":"The associations between multimorbidity, healthcare resource utilisation and costs in individuals with Alzheimer's disease dementia","authors":"Sophie Edwards , Marc Evans , Craig Ritchie , Julie Hviid Hahn-Pedersen , Mei Sum Chan , Benjamin D Bray , Alice Clark , Christian Ahmad Wichmann , Dominic Trepel","doi":"10.1016/j.ahr.2025.100234","DOIUrl":"10.1016/j.ahr.2025.100234","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity (having two or more comorbidities), is common among people with dementia and associated with lower survival and increased healthcare use. We aimed to identify comorbidity clusters in people living with Alzheimer’s disease (AD) dementia in the UK, describe comorbidity-cluster prevalence and patterns, and estimate associations of clusters with healthcare resource utilisation (HCRU) and costs.</div></div><div><h3>Methods</h3><div>This was a cohort study using Discover dataset (electronic health records from approximately 2.8 million North-West London residents). We identified individuals with AD dementia using diagnostic codes, and estimated HCRU and total healthcare costs (including primary and hospital-based care). Individuals were grouped based on comorbidity profile using k-medoids clustering. Multivariable modelling was used to estimate associations between comorbidity clusters and healthcare costs.</div></div><div><h3>Results</h3><div>Among 18,116 individuals with AD dementia, eight comorbidity clusters were identified. The three highest-cost clusters incurred mean costs per patient year(ppy) of £6355, £5560, and £5284 respectively. The highest-cost cluster had a high burden of comorbidities with the most prevalent: frailty (83.2 %), hypertension (81.8 %), type 2 diabetes mellitus (81.4 %), and chronic kidney disease (69.7 %). Costs in the three highest-cost clusters were 1.7 to 2.0 times higher than the lowest-cost cluster (mean cost £3160ppy), which featured the lowest overall comorbidity burden. The lowest median survival times were in the two highest-cost clusters. Cluster membership was strongly associated with costs even after adjusting for a wide range of demographic and clinical factors. Compared with the lowest-cost cluster the average marginal increases in costs for the clusters ranged between £1072 (95 %CI:£478-£1666) and £3531ppy (95 %CI: £2850-£4212).</div></div><div><h3>Conclusions</h3><div>HCRU and costs in individuals with AD dementia show notable differences, with a large proportion of costs attributable to a minority of individuals with multiple comorbidities (particularly cardiometabolic diseases and frailty). Health systems should ensure initiatives to improve timely diagnosis and treatment of people with AD taking account of the high multimorbidity prevalence in this population.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-11DOI: 10.1016/j.ahr.2025.100233
Lijing Chen , Huanzhi Zhu , Jing Wang , Rongrong Lu , Jing Tian , Bei Wu , Jing Chu , Juan Li
Background
More than half of stroke survivors suffer from movement disorders after receiving routine rehabilitation treatment. Evidence suggests that virtual reality (VR)-based robotic training for lower limb rehabilitation is a promising approach for improving motor function recovery.
Methods
A pilot open-label randomized controlled trial was conducted to explore the feasibility and preliminary effects of VR-based robotic training for lower limb rehabilitation in stroke patients with hemiplegia. We enrolled 42 stroke patients with hemiplegia, 21 received VR-based robotic training for lower limb rehabilitation and conventional rehabilitation treatment as the intervention, and 21 only received conventional rehabilitation treatment as the control.
Results
Forty participants completed the trial. We found a statistically significant difference in lower limb motor function scores from baseline to week 4 between the intervention and control group (mean difference (MD): 6.5 vs 3.3, p<0.001). At week 4, participants in the intervention group demonstrated significant enhancements in balancing function, walking ability, activities of daily living, and quality of life (p<0.05). However, the intervention group did not show a significant improvement in global cognitive function compared to the control group (MD: 3.8 vs 3.7, p = 0.873). No adverse events were observed during the trial.
Conclusion
The VR-based robotic training for lower limb rehabilitation showed promise in improving motor function, activities of daily living, and quality of life in stroke patients with hemiplegia. These preliminary findings support the feasibility of this approach and highlight the need for large-scale studies to validate its effectiveness.
超过一半的中风幸存者在接受常规康复治疗后出现了运动障碍。有证据表明，基于虚拟现实（VR）的机器人下肢康复训练是改善运动功能恢复的一种有前途的方法。方法通过开放标签随机对照试验，探讨基于vr的机器人训练在脑卒中偏瘫患者下肢康复中的可行性及初步效果。我们招募了42例脑卒中偏瘫患者，其中21例接受基于vr的机器人下肢康复训练和常规康复治疗作为干预，21例仅接受常规康复治疗作为对照组。结果40名参与者完成了试验。我们发现干预组和对照组从基线到第4周的下肢运动功能评分有统计学显著差异（平均差异（MD）： 6.5 vs 3.3, p<0.001）。在第4周，干预组的参与者在平衡功能、行走能力、日常生活活动和生活质量方面表现出显著的增强（p<0.05）。然而，与对照组相比，干预组在整体认知功能方面没有显着改善（MD: 3.8 vs 3.7, p = 0.873）。试验期间未观察到不良事件。结论基于vr的机器人下肢康复训练可改善脑卒中偏瘫患者的运动功能、日常生活活动和生活质量。这些初步发现支持了这种方法的可行性，并强调需要进行大规模研究来验证其有效性。
{"title":"Virtual reality-based robotic training for lower limb rehabilitation in stroke patients with Hemiplegia: A pilot study","authors":"Lijing Chen , Huanzhi Zhu , Jing Wang , Rongrong Lu , Jing Tian , Bei Wu , Jing Chu , Juan Li","doi":"10.1016/j.ahr.2025.100233","DOIUrl":"10.1016/j.ahr.2025.100233","url":null,"abstract":"<div><h3>Background</h3><div>More than half of stroke survivors suffer from movement disorders after receiving routine rehabilitation treatment. Evidence suggests that virtual reality (VR)-based robotic training for lower limb rehabilitation is a promising approach for improving motor function recovery.</div></div><div><h3>Methods</h3><div>A pilot open-label randomized controlled trial was conducted to explore the feasibility and preliminary effects of VR-based robotic training for lower limb rehabilitation in stroke patients with hemiplegia. We enrolled 42 stroke patients with hemiplegia, 21 received VR-based robotic training for lower limb rehabilitation and conventional rehabilitation treatment as the intervention, and 21 only received conventional rehabilitation treatment as the control.</div></div><div><h3>Results</h3><div>Forty participants completed the trial. We found a statistically significant difference in lower limb motor function scores from baseline to week 4 between the intervention and control group (mean difference (MD): 6.5 vs 3.3, <em>p</em><0.001). At week 4, participants in the intervention group demonstrated significant enhancements in balancing function, walking ability, activities of daily living, and quality of life (<em>p</em><0.05). However, the intervention group did not show a significant improvement in global cognitive function compared to the control group (MD: 3.8 vs 3.7, <em>p</em> = 0.873). No adverse events were observed during the trial.</div></div><div><h3>Conclusion</h3><div>The VR-based robotic training for lower limb rehabilitation showed promise in improving motor function, activities of daily living, and quality of life in stroke patients with hemiplegia. These preliminary findings support the feasibility of this approach and highlight the need for large-scale studies to validate its effectiveness.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-05DOI: 10.1016/j.ahr.2025.100232
Jananee Myooran , Faiyaz Rahman , Dennis Cordato , Danielle Ní Chróinín
Background
Cognitive impairment is a common sequela of ischaemic stroke, especially in older patients who are often predisposed to both delirium and dementia. Despite this, factors associated with cognitive impairment post-stroke are poorly evaluated in everyday clinical practice, including associated risk factors, the impact of reperfusion therapies on risk of post-stroke cognitive impairment, and effects on mortality and morbidity.
Methods
A literature review was conducted, using PubMed and EMBASE databases. 62 articles were included in the review.
Results
The review demonstrated several risk factors for cognitive impairment in patients with ischaemic stroke. Patient related factors include age, race, atrial fibrillation, diabetes and pre-stroke cognition. Stroke-related factors include extensive, multi-territorial infarcts. Only endovascular thrombectomy improved cognitive outcomes post stroke. Post stroke cognitive impairment is associated with greater risk of institutionalization, depression, delirium, stroke recurrence and mortality.
Conclusion
Moving forward, utilizing cognition as a primary outcome in trials, as well as exploring the impact of post-stroke cognition on patients is essential. Therefore, further research is required to delineate the relationship between ischaemic stroke and post-stroke cognitive impairment.
{"title":"Cognitive outcomes following ischaemic stroke: a narrative review","authors":"Jananee Myooran , Faiyaz Rahman , Dennis Cordato , Danielle Ní Chróinín","doi":"10.1016/j.ahr.2025.100232","DOIUrl":"10.1016/j.ahr.2025.100232","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is a common sequela of ischaemic stroke, especially in older patients who are often predisposed to both delirium and dementia. Despite this, factors associated with cognitive impairment post-stroke are poorly evaluated in everyday clinical practice, including associated risk factors, the impact of reperfusion therapies on risk of post-stroke cognitive impairment, and effects on mortality and morbidity.</div></div><div><h3>Methods</h3><div>A literature review was conducted, using PubMed and EMBASE databases. 62 articles were included in the review.</div></div><div><h3>Results</h3><div>The review demonstrated several risk factors for cognitive impairment in patients with ischaemic stroke. Patient related factors include age, race, atrial fibrillation, diabetes and pre-stroke cognition. Stroke-related factors include extensive, multi-territorial infarcts. Only endovascular thrombectomy improved cognitive outcomes post stroke. Post stroke cognitive impairment is associated with greater risk of institutionalization, depression, delirium, stroke recurrence and mortality.</div></div><div><h3>Conclusion</h3><div>Moving forward, utilizing cognition as a primary outcome in trials, as well as exploring the impact of post-stroke cognition on patients is essential. Therefore, further research is required to delineate the relationship between ischaemic stroke and post-stroke cognitive impairment.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-23DOI: 10.1016/j.ahr.2025.100231
Miriam R. Elman , Ana R. Quiñones , Gail J. McAvay , Brent Vander Wyk , Corey L. Nagel , Heather G. Allore
Background
Racial and ethnic health disparities are persistent in the United States. The accumulation of chronic conditions and mortality are important contributors to these observed inequities.
Methods
We assessed the contribution of coexisting conditions to mortality among Hispanic, non-Hispanic White, and non-Hispanic Black older adults born in the United States. We used nationally-representative data from the Health and Retirement Study (HRS) from 1998–2020 (n = 10,430). Estimates for the absolute additive contributions of nine chronic conditions using a longitudinal extension of the average attributable fraction (LE-AAF) were derived from survey-weighted multivariable discrete survival models adjusted for sociodemographic and health characteristics.
Results
Death occurred in 42.2 % (95 % confidence interval [CI]=37.4, 47.0) of Hispanic, 42.7 % (95 % CI=41.7, 44.2) of White, and 46.4 % (95 % CI=42.7, 50.1) of Black respondents. The eight conditions increasing the risk of death contributed 73.9 % (95 % CI=50.7, 100.0) of mortality events among Hispanic respondents, 66.2 % (95 % CI=48.9, 81.5) among Black respondents, and 57.7 % (95 % CI=52.1, 62.5) among White respondents. Dementia had the strongest association with mortality with an adjusted odds ratio of 3.23 for Hispanic (95 % CI=1.90, 5.49), 3.14 for White (95 % CI=2.61, 3.78), and 2.11 for Black (95 % CI=1.63, 2.73) respondents. The development and progression of cancer malignancies contributed most to mortality for White adults. In contrast, hypertension, contributed most to mortality for Hispanic and Black adults.
Conclusions
Hispanic, Black, and White Americans differed in the prevalence and incidence of chronic conditions, as well as their association with mortality. Together, these conditions resulted in contributions to mortality that varied substantially.
{"title":"Contribution of chronic conditions to mortality: Differences by race and ethnicity","authors":"Miriam R. Elman , Ana R. Quiñones , Gail J. McAvay , Brent Vander Wyk , Corey L. Nagel , Heather G. Allore","doi":"10.1016/j.ahr.2025.100231","DOIUrl":"10.1016/j.ahr.2025.100231","url":null,"abstract":"<div><h3>Background</h3><div>Racial and ethnic health disparities are persistent in the United States. The accumulation of chronic conditions and mortality are important contributors to these observed inequities.</div></div><div><h3>Methods</h3><div>We assessed the contribution of coexisting conditions to mortality among Hispanic, non-Hispanic White, and non-Hispanic Black older adults born in the United States. We used nationally-representative data from the Health and Retirement Study (HRS) from 1998–2020 (<em>n</em> = 10,430). Estimates for the absolute additive contributions of nine chronic conditions using a longitudinal extension of the average attributable fraction (LE-AAF) were derived from survey-weighted multivariable discrete survival models adjusted for sociodemographic and health characteristics.</div></div><div><h3>Results</h3><div>Death occurred in 42.2 % (95 % confidence interval [CI]=37.4, 47.0) of Hispanic, 42.7 % (95 % CI=41.7, 44.2) of White, and 46.4 % (95 % CI=42.7, 50.1) of Black respondents. The eight conditions increasing the risk of death contributed 73.9 % (95 % CI=50.7, 100.0) of mortality events among Hispanic respondents, 66.2 % (95 % CI=48.9, 81.5) among Black respondents, and 57.7 % (95 % CI=52.1, 62.5) among White respondents. Dementia had the strongest association with mortality with an adjusted odds ratio of 3.23 for Hispanic (95 % CI=1.90, 5.49), 3.14 for White (95 % CI=2.61, 3.78), and 2.11 for Black (95 % CI=1.63, 2.73) respondents. The development and progression of cancer malignancies contributed most to mortality for White adults. In contrast, hypertension, contributed most to mortality for Hispanic and Black adults.</div></div><div><h3>Conclusions</h3><div>Hispanic, Black, and White Americans differed in the prevalence and incidence of chronic conditions, as well as their association with mortality. Together, these conditions resulted in contributions to mortality that varied substantially.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-15DOI: 10.1016/j.ahr.2025.100230
Anyah Prasad , Anthony P. Nunes , Bill M. Jesdale , Natalia N. Nielsen , Catherine E. Dubé , Deborah S. Mack , Kate L. Lapane
Background
Social engagement is an important determinant of health in older adults. Skin ulcers may adversely impact social engagement among nursing home residents. This study sought to quantify the differential associations between pressure and stasis ulcers and social engagement among long-stay US nursing home residents.
Methods
Cross-sectional, nationally representative data was obtained from the Minimum Data Set 2.0 on US nursing home residents aged ≥ 50 years with an annual assessment between Oct 1, 2009 and Sept 30, 2010. Adjusted prevalence ratios (aPR) of low social engagement among residents with the four stages of pressure and stasis ulcers and 95 % confidence intervals (CI) were estimated from multivariable Poisson models using a generalized estimating equation approach to account for residents nested within nursing homes.
Results
Among the 771,634 residents, 4.5 % had pressure ulcers, and 1.1 % had stasis ulcers. The presence of pressure ulcers, regardless of the stage, was associated with an increased risk of low social engagement (stage 1 aPR: 1.05 (95 % CI: 1.03–1.07); stage 4 aPR: 1.07 (95 % CI: 1.05–1.08)). Residents with stage 1 to 3 stasis ulcers were less likely than those without any skin ulcers to have low social engagement. In contrast, those with stage 4 stasis ulcers had an increased prevalence of low social engagement (aPR: 1.10 (95 % CI: 1.06–1.14)).
Conclusion
Social engagement should be monitored and addressed in residents with skin ulcers. Since pressure and stasis ulcers have different etiologies and treatment modalities, they should be considered separately in the empirical work on their association with social engagement.
{"title":"Differential associations of the stages of pressure and stasis ulcers and social engagement among nursing home residents","authors":"Anyah Prasad , Anthony P. Nunes , Bill M. Jesdale , Natalia N. Nielsen , Catherine E. Dubé , Deborah S. Mack , Kate L. Lapane","doi":"10.1016/j.ahr.2025.100230","DOIUrl":"10.1016/j.ahr.2025.100230","url":null,"abstract":"<div><h3>Background</h3><div>Social engagement is an important determinant of health in older adults. Skin ulcers may adversely impact social engagement among nursing home residents. This study sought to quantify the differential associations between pressure and stasis ulcers and social engagement among long-stay US nursing home residents.</div></div><div><h3>Methods</h3><div>Cross-sectional, nationally representative data was obtained from the Minimum Data Set 2.0 on US nursing home residents aged ≥ 50 years with an annual assessment between Oct 1, 2009 and Sept 30, 2010. Adjusted prevalence ratios (aPR) of low social engagement among residents with the four stages of pressure and stasis ulcers and 95 % confidence intervals (CI) were estimated from multivariable Poisson models using a generalized estimating equation approach to account for residents nested within nursing homes.</div></div><div><h3>Results</h3><div>Among the 771,634 residents, 4.5 % had pressure ulcers, and 1.1 % had stasis ulcers. The presence of pressure ulcers, regardless of the stage, was associated with an increased risk of low social engagement (stage 1 aPR: 1.05 (95 % CI: 1.03–1.07); stage 4 aPR: 1.07 (95 % CI: 1.05–1.08)). Residents with stage 1 to 3 stasis ulcers were less likely than those without any skin ulcers to have low social engagement. In contrast, those with stage 4 stasis ulcers had an increased prevalence of low social engagement (aPR: 1.10 (95 % CI: 1.06–1.14)).</div></div><div><h3>Conclusion</h3><div>Social engagement should be monitored and addressed in residents with skin ulcers. Since pressure and stasis ulcers have different etiologies and treatment modalities, they should be considered separately in the empirical work on their association with social engagement.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Assessing quality of life (QOL) in individuals with Alzheimer's disease (AD) is particularly challenging due to the subjective nature of the concept and the cognitive deficits associated with the condition. This study aimed to translate the AD-Related QOL (ADRQL) questionnaire into Persian and rigorously evaluate its reliability and validity in this population.
Methods
This cross-sectional methodological study was conducted between March 2021 and August 2022, involving 220 patients diagnosed with AD according to DSM-IV criteria, along with their primary caregivers. The Persian version of the ADRQL (P-ADRQL) and the QOL in Late-Stage Dementia (QUALID) scales were used to collect data, allowing for a thorough assessment of QOL across multiple domains.
Results
The P-ADRQL demonstrated excellent psychometric properties, with an overall Cronbach's alpha of 0.92, indicating strong internal consistency. This suggests that the items reliably measure the construct of QOL in patients with AD. Additionally, test-retest analysis revealed consistent scores across all subscales, confirming the stability of caregiver assessments over time. Significant correlations between P-ADRQL and QUALID further supported the convergent validity of the instrument, affirming its ability to measure QOL in alignment with established dementia assessment tools.
Conclusion
The P-ADRQL is a robust and reliable instrument for evaluating QOL in older Iranian adults with AD. Its strong psychometric properties ensure accurate and consistent assessments, addressing a critical need within Iran's healthcare system.
{"title":"Validity and reliability of the Persian version of Alzheimer's disease-related quality of life (P-ADRQL) questionnaire among older Iranian adults","authors":"Masoud Gharib , Jafar Hajghani , Hamed Cheraghmakani , Vahid Rashedi","doi":"10.1016/j.ahr.2025.100229","DOIUrl":"10.1016/j.ahr.2025.100229","url":null,"abstract":"<div><h3>Background</h3><div>Assessing quality of life (QOL) in individuals with Alzheimer's disease (AD) is particularly challenging due to the subjective nature of the concept and the cognitive deficits associated with the condition. This study aimed to translate the AD-Related QOL (ADRQL) questionnaire into Persian and rigorously evaluate its reliability and validity in this population.</div></div><div><h3>Methods</h3><div>This cross-sectional methodological study was conducted between March 2021 and August 2022, involving 220 patients diagnosed with AD according to DSM-IV criteria, along with their primary caregivers. The Persian version of the ADRQL (P-ADRQL) and the QOL in Late-Stage Dementia (QUALID) scales were used to collect data, allowing for a thorough assessment of QOL across multiple domains.</div></div><div><h3>Results</h3><div>The P-ADRQL demonstrated excellent psychometric properties, with an overall Cronbach's alpha of 0.92, indicating strong internal consistency. This suggests that the items reliably measure the construct of QOL in patients with AD. Additionally, test-retest analysis revealed consistent scores across all subscales, confirming the stability of caregiver assessments over time. Significant correlations between P-ADRQL and QUALID further supported the convergent validity of the instrument, affirming its ability to measure QOL in alignment with established dementia assessment tools.</div></div><div><h3>Conclusion</h3><div>The P-ADRQL is a robust and reliable instrument for evaluating QOL in older Iranian adults with AD. Its strong psychometric properties ensure accurate and consistent assessments, addressing a critical need within Iran's healthcare system.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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