Ability Of Older Adults Research Articles

Age-related performance fatigability: a comprehensive review of dynamic tasks.

Adult aging is associated with a myriad of changes within the neuromuscular system, leading to reductions in contractile function of old adults. One of the consequences of these age-related neuromuscular adaptations is altered performance fatigability, which can limit the ability of old adults to perform activities of daily living. Whereas age-related fatigability during isometric tasks has been well characterized, considerably less is known about fatigability of old adults during dynamic tasks involving movement about a joint, which provides a more functionally relevant task compared with static contractions. This review provides a comprehensive summary of age-related fatigability during dynamic contractions, where the importance of task specificity is highlighted with a brief discussion of the potential mechanisms responsible for differences in fatigability between young and old adults. The angular velocity of the task is critical for evaluating age-related fatigability, as tasks that constrain angular velocity (i.e., isokinetic) produce equivocal age-related differences in fatigability, whereas tasks involving unconstrained velocity (i.e., isotonic-like) consistently induce greater fatigability for old compared with young adults. These unconstrained velocity tasks, which are more closely associated with natural movements, offer an excellent model to uncover the underlying age-related mechanisms of increased fatigability. Future work evaluating the mechanisms of increased age-related fatigability during dynamic tasks should be evaluated using contraction modes that are specific to the task (i.e., dynamic), rather than isometric, particularly for the assessment of spinal and supra spinal components. Advancing our understanding of age-related fatigability is likely to yield novel insights and approaches for improving mobility limitations in old adults.

Ageing, Emotion Regulation and Effectiveness of Non-Pharmaceutical Interventions

The process of ageing is usually defined in terms of physical and cognitive decline. A number of observations have been associated with the process of ageing such as, reduced productivity, a conservative nature, and a preference for tranquility. However, previous studies have reported interesting findings on increased emotional abilities among older adults which enable them to critically evaluate their life to find a meaningful purpose which thereby, accord to escalate their emotional stability. The current article describes the scope of existing literature examining emotion regulation in older adults. We first describe the emotion regulation in older adults through psycho-social perspectives. Following, we discuss the cognitive and neural correlates of emotion regulation in older adults. We then lay emphasis on the use of non-pharmaceutical interventions to enhance the quality of life including emotion regulation abilities in older adults.

Music training modulates theta brain oscillations associated with response suppression.

There is growing interest in developing training programs to mitigate cognitive decline associated with normal aging. Here, we assessed the effect of 3-month music and visual art training programs on the oscillatory brain activity of older adults using a partially randomized intervention design. High-density electroencephalography (EEG) was measured during the pre- and post-training sessions while participants completed a visual GoNoGo task. Time-frequency representations were calculated in regions of interest encompassing the visual, parietal, and prefrontal cortices. Before training, NoGo trials generated greater theta power than Go trials from 300 to 500 ms post-stimulus in mid-central and frontal brain areas. Theta power indexing response suppression was significantly reduced after music training. There was no significant difference between pre- and post-test for the visual art or the control group. The effect of music training on theta power indexing response suppression was associated with reduced functional connectivity between prefrontal, visual, and auditory regions. These results suggest that theta power indexes executive control mechanisms in older adults. Music training affects theta power and functional connectivity associated with response suppression. These findings contribute to a better understanding of inhibitory control ability in older adults and the neuroplastic effects of music interventions.

노인의 문장회상발화에서 나타난 언어적 비유창성 분석

In this study we investigated the discourse production ability of older adults by using a sentence recall task in order to examine the link between the linguistic disfluencies and cognitive functioning, and the role of linguistic disfluencies in semantic aspect of sentence recall. Fifty-six older adults (ages 63-87) performed the sentence recall task in which they read short sentences and recalled the contents aloud. Fluency and disfluency in discourse production were measured by the propositional recall as well as the frequency and types of disfluencies. The results were as follows. First, the propositional recall rate of the elderly was very low, and four types of disfluencies in utterances were frequently found. Second, the propositonal recall rate was positively correlated with the overall cognitive function, vocabulary, and reading span. Third, the rate of disfluency significantly predicted the propositonal recall performance independently after controlling for cognitive functioning. These results suggest that linguistic disfluency may play a significant role in semantic aspect of discourse production in addition to cognitive functioning. Thus, disfluent utterances could be indicative of linguistic decline due to normal as well as pathological aging.

Effects of different dual task training on dual task walking and responding brain activation in older adults with mild cognitive impairment

The concurrent additional tasking impacts the walking performance, and such impact is even greater in individuals with mild cognitive impairment (MCI) than in healthy elders. However, effective training program to improve dual task walking ability for the people with MCI is not immediately provided. Therefore, this study aimed to determine the effects of cognitive and motor dual task walking training on dual task walking performance and the responding brain changes in older people with MCI. Thirty older adults with MCI were randomly allocated to receive 24 sessions of 45-min cognitive dual task training (CDTT, n = 9), motor dual task training (MDTT, n = 11), or conventional physical therapy (CPT, n = 10). Gait performance and brain activation during single and dual task walking, and cognitive function assessed by trail-making test (TMT-A, B) and digit span test were measured at pre-, post-test, and 1-month follow-up. Both CDTT and MDTT improved dual task walking with responding activation changes in specific brain areas. The improvements in motor dual task walking performance after both dual task trainings were significantly better than after CPT in the older adults with MCI. Both cognitive and motor dual task training were feasible and beneficial to improve dual task walking ability in older adults with MCI.Trial Registration: The trial was registered to Thai Clinical Trial Registry and the registration number is TCTR20180510002 (first registration date: 10/05/2018).

Ability of older adults to recognize cognitive changes and its relationship with mental health: a cross-sectional study

IntroductionWith rising age, the incidence of physical and mental problems increases. Physiological and social changes occur across the lifespan that can affect an individual’s health and ability. The present study was aimed to determine older adult’s ability to recognize cognitive changes and its relation with mental health status.Materials and MethodsA descriptive correlational design was used to recruit 423 older adults who were referred to health centers in Tabriz, Iran in 2019 to receive primary health care. A systematic random sampling method was used for selecting participants. Data collection tools included a demographic-social questionnaire, General Health Questionnaire for assessing mental health (with 4 subscales) and a questionnaire of ability to recognize cognitive changes (with 8 sub-scales). Data were analyzed using descriptive statistics and inferential statistics.ResultsThe mean score of mental health of the older adults was 56.35 (8.40) which shows moderately impaired mental health. The most impaired aspect of mental health detected was the social function dimension 13.20 (2.67). The average of the total ability score was 41.19 (4.78) and the physical strength dimension had the highest average of 9.08 (1.80) and the empowerment obligation dimension had the lowest average of 3.06 (1.08). There was significant relationship between dimensions of depression (r = 0.21, p < 0.001), anxiety (r = 0.1, p = 0.04) and social functioning (r = 0.17), p < 0.001) with the ability to recognize cognitive changes of the older adults.ConclusionNegative mood states and social functioning were associated with the ability to recognize cognitive changes in this population of older adults. This sample exhibited moderately impaired mental health status and relatively large burdens of untreated affective symptoms. Although causality cannot be determined with this cross-sectional design, use of social programs to keep older adults mentally active, as well as cognitive rehabilitation programs could be tested with longitudinal designs for their impact on cognitive change recognition.

Novel subgroups of functional ability in older adults and their associations with adverse outcomes

BackgroundThere is no general agreement on a standard form of functional classification in older adults and is mainly assessed by Activities of Daily Living (ADL) and/or Instrument Activity of Daily Living. A refined classification based on evaluation the limitations of intrinsic capacity, environment and social interaction, could provide a basis to predict the future disability and identify individuals with increased risk of adverse outcomes.MethodsA new functional classification among older adults aged 60 and over was conducted by latent class analysis and compared with the traditional classifications, based on the China Health and Retirement Longitudinal Study. To further investigate the scientific validity of this new classification, associations with 7-year mortality and ADLs impairments among categories were tested by using Survival curves and Cox proportional hazard models. This was followed by the confirmatory analysis related to the prospective data. Competing risk analysis was also performed to analysis the sensitivity to further support our conclusions.ResultsFive categories were identified among 5,992 older adults which gave the best fitting, yielding a significant Bootstrap Likelihood Ratio Test (p < 0.001) and Lo-Mendell-Rubin adjusted likelihood ratio test (p < 0.001), with an entropy over 0.80. The presence of five categories: “health” (34.0%), “sub-disorder status” (36.6%), “acute diseases” (10.3%), “somatic functional disorder” (7.7%), and “viability disorder” (11.4%), which matched well with the functional independence rates by the international classifications. Among them, those in “sub-disorder status” were considered as an intermediate status between disability and health. The findings also revealed that those who were in “acute disease”, “somatic functional disorders”, “health” and “sub-disorder status” had a significant lower risk of mortality and ADLs limitations than “viability disorder”. And the risks gradually increased towards the less functionally independent end of the classification. However, the distribution of characteristics among five categories were in a synchronous change, indicating a stable classification.ConclusionsA new classification representing the functional heterogeneity of older adults could effectively stratify the risk of mortality and ADLs limitations. Identifying the clusters of functional decline might be useful in predicting subsequent ageing trends, designing personalized intervention, and delaying the progression of disability and preventing its occurrence.

Age-related deficits in dip-listening evident for isolated sentences but not for spoken stories

Fluctuating background sounds facilitate speech intelligibility by providing speech ‘glimpses’ (masking release). Older adults benefit less from glimpses, but masking release is typically investigated using isolated sentences. Recent work indicates that using engaging, continuous speech materials (e.g., spoken stories) may qualitatively alter speech-in-noise listening. Moreover, neural sensitivity to different amplitude envelope profiles (ramped, damped) changes with age, but whether this affects speech listening is unknown. In three online experiments, we investigate how masking release in younger and older adults differs for masked sentences and stories, and how speech intelligibility varies with masker amplitude profile. Intelligibility was generally greater for damped than ramped maskers. Masking release was reduced in older relative to younger adults for disconnected sentences, and stories with a randomized sentence order. Critically, when listening to stories with an engaging and coherent narrative, older adults demonstrated equal or greater masking release compared to younger adults. Older adults thus appear to benefit from ‘glimpses’ as much as, or more than, younger adults when the speech they are listening to follows a coherent topical thread. Our results highlight the importance of cognitive and motivational factors for speech understanding, and suggest that previous work may have underestimated speech-listening abilities in older adults.

Eigenbehaviour as an Indicator of Cognitive Abilities.

With growing use of machine learning algorithms and big data in health applications, digital measures, such as digital biomarkers, have become highly relevant in digital health. In this paper, we focus on one important use case, the long-term continuous monitoring of cognitive ability in older adults. Cognitive ability is a factor both for long-term monitoring of people living alone as well as a relevant outcome in clinical studies. In this work, we propose a new potential digital biomarker for cognitive abilities based on location eigenbehaviour obtained from contactless ambient sensors. Indoor location information obtained from passive infrared sensors is used to build a location matrix covering several weeks of measurement. Based on the eigenvectors of this matrix, the reconstruction error is calculated for various numbers of used eigenvectors. The reconstruction error in turn is used to predict cognitive ability scores collected at baseline, using linear regression. Additionally, classification of normal versus pathological cognition level is performed using a support-vector machine. Prediction performance is strong for high levels of cognitive ability but grows weaker for low levels of cognitive ability. Classification into normal and older adults with mild cognitive impairment, using age and the reconstruction error, shows high discriminative performance with an ROC AUC of 0.94. This is an improvement of 0.08 as compared with a classification with age only. Due to the unobtrusive method of measurement, this potential digital biomarker of cognitive ability can be obtained entirely unobtrusively—it does not impose any patient burden. In conclusion, the usage of the reconstruction error is a strong potential digital biomarker for binary classification and, to a lesser extent, for more detailed prediction of inter-individual differences in cognition.

Lower urinary tract symptoms and functional ability in older adults: a community-based cross-sectional study

ObjectivesFunctional ability, or the ability to live actively in older age, is essential for healthy ageing. This study assessed the association between the five types of lower urinary tract symptoms...

Information Communication Technology as Instrumental Activities of Daily Living for Aging-in-Place in Chinese Older Adults With and Without Cognitive Impairment: The Validation Study of Advanced Instrumental Activities of Daily Living Scale.

BackgroundThe capability in applying information communication technology (ICT) is crucial to the functional independence of older peoples of community living nowadays. The proper assessment of individuals' capability of ICT application is the corner stone for the future development of telemedicine in our aging population.MethodsWith the recruitment of 300 participants of different functional and social background in home-living, hostel-living, and care-and-attention home living; and through assessing the ability of individuals in instrumental activities of daily living and cognitive assessments, this study aimed at capturing the content validity and construct validity of the Advanced Instrumental Activities of Daily Living (AIADL scale). In addition, this study assess the ability of older peoples in applying ICT and how the functional and social background affects their independence in aging-in-place.ResultsThe AIADL scale showed good test-retest reliability and good-to-excellent internal consistency. To determine if items of the AIADL scale measure various aspects of community living, exploratory factor analysis revealed a two-factor structure with “home living and management” and “community living”. Validity analysis with the known-groups method showed a high overall accuracy of prediction of individuals' capability of independent living in the community.ConclusionsThe AIADL scale is a valid and reliable instrument to assess the ability of older adults in handling ICT as part of their instrumental activities in daily living. The scale can reflect capability of older peoples in applying ICT. This instrument can serve as a reference in measuring readiness of individuals in receiving telemedicine and their ability of aging-in-place.

Comparing Mentalizing Abilities in Older Adults with and without Common Mental Disorders

Introduction: The concept of mentalization is of central importance not only in modern psychotherapy but also in geriatric psychotherapy. In relation to older people, deficits in some aspects of the ability to mentalize, such as the theory of mind (ToM), affect perception, and metacognitive skills, are known. However, little is known about the mentalization ability of older people with mental disorders. The aim of the present study was to investigate the mentalizing abilities of older patients with depressive and anxious symptoms. Methods: In this study, the ability to mentalize using the Mentalization Questionnaire (MZQ), the HEALTH-49 questionnaire, Trail-Making Test (executive functions), and Reading-the-Mind-in-the-eyes-test (ToM) was studied in a clinical (n = 150) and a nonclinical comparison sample of people (n = 150) in different age groups (40–54, 55–69, ≥70). The evaluation of the data was conducted with different statistical methods, especially variance and regression analyses. Results: The clinical sample of all age groups showed significantly poorer mentalizing skills than the nonclinical samples. There were large correlations to health-related aspects. Additionally, in the regression analysis, only the setting variable (clinical vs. nonclinical) had an influence on the MZQ score and neither gender, education, executive functions nor ToM had a significant influence. Age also had no effect and did not correlate with MZQ scores but did correlate negatively with ToM. Conclusions: The results show the importance of mentalization concepts for mental disorders in patients in the second half of life. There are indications of an imbalance of different aspects of mentalizing ability, especially between self- and other-related mentalizing abilities. Improving this balance could be a goal of therapeutic interventions.

Motivational Interviewing, Readiness for Change, Walking, and Functional Ability in Older Adults.

Regular exercise in older adults can slow the physical, psychological, and functional decline that is associated with aging. Understanding what may contribute to the initiation and adherence of exercise within the older adult population might help identify interventions that would successfully increase physical activity. The purpose of the current study was to determine if motivational interviewing would increase readiness for change, daily steps, and functional ability among older adult participants. The Senior Fitness Test (SFT) and pedometers were used to assess functional ability and daily steps within two groups of older adults. All participants who completed the 8-week study, on average, demonstrated an increase in daily steps as well as overall fitness. Posttest analyses revealed that the outcome for the intervention group did not exceed the control group, with the exception of the 8-foot up-and-go test, a test within the SFT that measures agility and dynamic balance (p = 0.035). One-on-one, individualized socialization sessions may have contributed to the overall improvement noted in both groups. [Journal of Gerontological Nursing, 48(3), 23-29.].

Associations of cardiorespiratory fitness and moderate-to-vigorous physical activity with latent cognitive abilities in older adults

It has been demonstrated that physical activity has a small but positive effect on cognition in old age, which suggests that it may be possible to alter the trajectory of age-related cognitive decline. However, our understanding of which aspects of physical activity that are important for modifying cognition remains incomplete. Adopting an exploratory approach in a sample of 115 healthy older adults (65–75 years), the present cross-sectional study used structural equation modelling to investigate the dissociable associations of physical activity (moderate-to-vigorous activity, derived from 7-day accelerometry) and cardiorespiratory fitness (VO2 max, derived from maximal treadmill ergometer test) with multiple latent cognitive abilities (working memory, episodic memory, spatial and verbal reasoning). The results showed a significant positive association between fitness and working memory, when physical activity was statistically controlled for, and a positive association of similar point magnitude between physical activity and episodic memory, when fitness was statistically controlled for, although the latter association did not reach statistical significance. The results add to the foundation for a more careful investigation of the dissociable associations of moderate-to-vigorous physical activity and fitness with cognition in old age, and encourages future research to test the hypothesis that cardiorespiratory fitness benefits working memory via general cerebrovascular effects on grey matter volume, whilst moderate-to-vigorous physical activity benefits episodic memory via effects on neuroplastic processes.

A simplified method for evaluating swallowing ability and estimating malnutrition risk: A pilot study in older adults.

The aim of this pilot study was to develop a Thai-version of a simple swallowing questionnaire, called the T-SSQ, and to evaluate the association between malnutrition risk and swallowing ability, determined objectively by tongue strength and subjectively by the T-SSQ. Sensitivity analysis was also performed to determine which swallowing indices better estimate malnutrition in older adults. This cross-sectional study comprised two phases: Phase I, development and cross-cultural translation of the T-SSQ; and Phase II, application of the T-SSQ in 60 older adults. In Phase I, content and face validity of the T-SSQ was evaluated by 10 experts and 15 older adults. In Phase II, the convergent validity of the T-SSQ was evaluated by determining its association with objective tongue strength. Nutritional status was evaluated using the Thai-version of the Mini-Nutritional Assessment. Covariates included sociodemographic characteristics, and oral and health-related status. Adjusting for covariates, the associations between the two swallowing indices and malnutrition risk were determined using multivariable regression analyses. A cut-off value for low tongue strength was determined using a receiver operating characteristic (ROC) curve, and sensitivity analysis between the swallowing indices and malnutrition risk was performed. The T-SSQ comprised 4-items of common signs and symptoms of a swallowing problem. Its content and face validity were verified. Older adults were considered as having a swallowing problem when at least one item was reported. Convergent validity of the subjective index was shown by significantly different tongue strength values between the participants with and without a swallowing problem (p for independent t-test = 0.014). Based on the highest area under the ROC curve, an 18-kPa cut-off value was chosen to classify low tongue strength. Having a swallowing problem and low tongue strength was significantly associated with malnutrition risk. The positive predictive value of the subjective swallowing index was 1.8-fold higher than objective tongue strength. Self-reported swallowing problems determined by the T-SSQ can be used as a subjective index for evaluating swallowing ability in older adults. Subjective swallowing problems and objective tongue strength were associated with malnutrition risk. However, the T-SSQ estimated malnutrition risk better than the objective index.

Standing, Transition, and Walking Ability in Older Adults: The Case for Independently Evaluating Different Domains of Mobility Function

Background: Independent mobility is a complex behavior that relies on the ability to walk, maintain stability, and transition between postures. However, guidelines for assessment that details what elements of mobility to evaluate and how they should be measured remain unclear. Methods: Performance on tests of standing, sit-to-stand, and walking were evaluated in a cohort of 135 complex, comorbid, and older adults (mean age 87 ± 5.5 years). Correlational analysis was conducted to examine the degree of association for measures within and between mobility domains on a subset of participants (n = 83) able to complete all tasks unaided. Participants were also grouped by the presence of risk markers for frailty (gait speed and grip strength) to determine if the level of overall impairment impacted performance scores and if among those with risk markers, the degree of association was greater. Results: Within-domain relationships for sit-to-stand and walking were modest (rho = 0.01–0.60). Associations either did not exist or relationships were weak for measures reflecting different domains (rho = −0.35 to 0.25, p > 0.05). As expected, gait speed differed between those with and without frailty risk markers (p < 0.001); however, balance and sit-to-stand measures did not (p ≥ 0.05). Conclusions: This study highlights the need to independently evaluate different mobility domains within an individual as a standard assessment approach. Modest within-domain relationships emphasize the need to account for multiple, unique control challenges within more complex domains. These findings have important implications for standardized mobility assessment and targeted rehabilitation strategies for older adults.

Functional status of community-dwelling older adults after inpatient rehabilitation

Background/aims: Factors that influence functional ability in older adults after rehabilitation are not well understood. The aim of this study was to investigate how older people function in their community after being discharged from inpatient rehabilitation. Methods A cross-sectional study was undertaken of community-dwelling older adults (n=86, 75 ± 6 years) discharged from rehabilitation in the previous 12 months. Basic functional independence was assessed using the Functional Independence Measure and complex functional independence was assessed using the Frenchay Activities Index. Multiple regression analyses were conducted to assess any association between predetermined factors and function. Results Functional Independence Measure scores and physical activity levels after being discharged accounted for 50% of the variance in basic function (R2=0.50, F=40.75, P&lt;0.001). Frenchay Activities Index scores, physical activity, age, sex and migrant status accounted for 68% of variance in complex function (R2=0.68, F=29.75, P&lt;0.001). Conclusions Clinicians are encouraged to implement strategies to improve function at discharge from rehabilitation and to promote physical activity among older people at risk of poor function following rehabilitation.

Effects of Community-Based MotoTiles Exercise on Balance Ability in Older Adults

Effects of Community-Based MotoTiles Exercise on Balance Ability in Older Adults

The Relationship between Functional Status and Social, Emotional and Family Loneliness among Older Adults in Pontian

Life at mature age is perceived to be very challenging and mostly influenced by the ageing process and negative changes that increase the risk of functional abilities. The most enormous thing to achieve is to live independently with less help from others to achieve an optimum quality of life. Methods: This is a community-based cross-sectional survey conducted among 414 community-dwelling older adults in Pontian District aiming to identify the functional status and examine the relationship between functional status and three types of loneliness. The Pfeffer Functional Activities Questionnaire was used to measure the level of functional status. Loneliness was measured with the short form of the Social and Emotional Loneliness Scale for Adults. The Statistical Package for Social Science Ver.26 for Windows was used to analyse all of the data.The results of this study show that the mean (+SD) age is 71.4 (+2.0). The majority of respondents perceived good health status and no deterioration in functional status. 8.2% of respondents experienced deterioration in functional status. Of these, 32.6% of respondents experienced social loneliness, 39.9% experienced emotional loneliness, and 9.2% experienced family loneliness. The results also revealed a significant relationship between functional status and social loneliness (p = 0.02). In conclusion, the majority of respondents are independent enough to perform functional activities, and less than half of them have experienced social, emotional, or family loneliness. Social loneliness was linked to a decline in functional ability in older adults. This research could aid in the care of older adults who live independently and freely in the community.

Walking meditation versus balance training for improving balance abilities among older adults with history of fall: A randomized controlled trial

Objective To investigate improvement in balance abilities compared between walking meditation and balance training among older adults with history of fall. Interventions Walking meditation or mindfulness meditation whilst standing and moving (n = 35) or balance training (n = 33) 20–30 min/day, 5–7 days/week for 24 weeks was performed at home. Main outcomes The primary outcomes were dynamic balance abilities as assessed by Timed Up and Go test (TUGT), and static balance as assessed by Functional Reach Test (FRT) and Single Leg Stance Test (SLST). The secondary outcomes were quality of life as measured by the EuroQOL 5-dimensions 5-levels (EQ-5D-5L), and mental health as evaluated by the Thai Geriatric Mental Health Assessment Tool-15 (TGMHA-15). All outcomes were assessed at baseline, 6 months, and 9 months. Self-reported compliance, adverse events, and patient satisfaction were recorded at 6 and 9 months. Results The mean age was 69 years (range: 60–85). No significant difference was observed between groups for the 3 primary outcome measures. The mean difference (95% confidence interval) between groups was −0.48 (-1.40, 0.44) for TUGT, −1.11 (-3.66, 1.45) for FRT, and 0.82 (-5.03, 6.67) for SLST. The EQ-5D-5L and TGMHA-15 also showed no significant difference between groups. Most participants were in good compliance with the exercise protocol (48.3–68.0%), and no serious adverse events were reported. Conclusion Our results showed walking meditation to be comparable to balance training for improving balance abilities in older adults with history of fall. Walking meditation may be considered an alternative treatment for improving balance abilities in this patient population.