Activities Of Daily Living Activities Research Articles

Database covering the prayer movements which were not available previously

Lower body implants are designed according to the boundary conditions of gait data and tested against. However, due to diversity in cultural backgrounds, religious rituals might cause different ranges of motion and different loading patterns. Especially in the Eastern part of the world, diverse Activities of Daily Living (ADL) consist of salat, yoga rituals, and different style sitting postures. A database covering these diverse activities of the Eastern world is non-existent. This study focuses on data collection protocol and the creation of an online database of previously excluded ADL activities, targeting 200 healthy subjects via Qualisys and IMU motion capture systems, and force plates, from West and Middle East Asian populations with a special focus on the lower body joints. The current version of the database covers 50 volunteers for 13 different activities. The tasks are defined and listed in a table to create a database to search based on age, gender, BMI, type of activity, and motion capture system. The collected data is to be used for designing implants to allow these sorts of activities to be performed.

Impact of frailty on risk of long-term functional decline following vascular surgery

ObjectiveFrailty is a clinical syndrome associated with slow recovery after vascular surgery. However, the degree and length of functional impairment frail patients experience after surgery is unclear. The objective of this study was to prospectively measure changes in functional status among frail and non-frail patients undergoing a spectrum of different vascular surgery procedures. MethodsPatients consented to undergo elective minor and major vascular surgery procedures at an academic medical center between May 2018 and March 2019 were prospectively identified. Prior to surgery, all patients underwent provider assessment of frailty using the validated Clinical Frailty Scale (CFS), as well as baseline assessment of functional status using the Katz Activities of Daily Living (ADL) index and the Lawton Instrumental Activities of Daily Living (iADL) index. These same instruments were used to evaluate each patient’s functional status at 2-weeks, 1-month, 1-year, and 2-year time points following surgery. Changes in iADL and ADL scores among frail (CFS ≥5) and non-frail patients were compared using paired Wilcoxon signed-rank tests and logistic regression models. ResultsA total of 126 patients were assessed before and after minor (55%) and major (45%) vascular procedures, of which 43 patients (34%) were determined to be frail prior to surgery. Frail patients were older and more likely than non-frail patients to have medical comorbidities including chronic kidney disease, chronic obstructive pulmonary disease, or diabetes (all P < .05). When compared with the non-frail cohort, frail patients had significantly lower ADL and iADL scores before surgery and experienced a greater decline in ability to independently complete ADL and iADL activities after surgery that was sustained at 2 years (P < .05 and P < .001, respectively). After risk-adjustment, frailty was associated with an increased likelihood of decline in ADLs (odds ratio, 5.4; 95% confidence interval, 1.9-15.4; P < .05) and iADLs (odds ratio, 6.3; 95% confidence interval, 2.6-15.1; P < .001) at 2 years following surgery. ConclusionsFrail patients experience a significant decline in ability to perform ADL and iADLs that persists 2 years following vascular surgery. These data highlight the degree of functional decline occurring immediately following surgery, as well as risk for long-term, sustained impairment that should be shared with frail patients before undergoing a procedure.

Outlier based Human Fall Detection using One-Class Classification

Objective: This work aims to develop a human fall detection method that is trained using data of routine movement of people only collected from accelerometer sensor to stay away from irregular fall detection model. This work also aims to analyze the effect of calculated features on the fall detection model. Methodology: In the proposed method, The fall detection model is built using one-class classification. At first, data of accelerometer sensor in three directions has been used to detect the fall events. Five feature vectors i.e. resultant, variance, standard deviation, Root Mean square, and Euclidean Norm have been calculated. These four features along with one class SVM have been used to build fall detection model in ways (1) Using only resultant features only (2) Using all calculated features. This model was trained using only activities of daily living (ADL) and tested on both daily living activities and fall activities. Findings: It is found that when the model was built using all calculated features, the sensitivity was 100% and specificity was 94.92% when mobile is in the pocket and; sensitivity was 100% and specificity was 93.61% when mobile is in handbag which is better than when the model was built using resultant features only. We have also studied the effect of individual features on this fall detection model and it is found that variance played a very important role to classify fall activities and ADL activities. Novelty - The proposed fall detection method is built using one-class classification so that the proposed model will be reliable to detect falls in real life. In the proposed work, the effect of features on the fall detection model is also analyzed. Keywords: One class classification; accelerometer; outlier detection; fall detection; Bagging classifier

Effects of Custom-mold Insole by Medial Heel Skive Technique on Physical Function in Flexible Flat Foot

Objectives: Flexible Flat Foot (FFF), a common foot deformity decreasing medial longitudinal arch height is often comorbid with subtalar joint pronation causing physical activity difficulties in this population. Among the orthotic insoles prescribed for improving foot function, foot orthoses with medial heel skive technique have a limited research background. The present study aimed to investigate the effects of the custom-mold insole with medial heel skive technique on physical function in FFF. Methods: Eighteen adults with FFF from the University of Social Welfare and Rehabilitation Sciences students and staff participated in this study. Custom-Mold insole with medial heel skive was fabricated for all research participants. Physical function in the activities of daily living and sports was assessed by the Foot and Ankle Ability Measure (FAAM), Activities of Daily Living (ADL) subscale (ADL-FAAM), and SPORT-FAAM questionnaires at the beginning of the study and 6 weeks after. Paired Samples t-test and nonparametric tests were used to compare the collected results. Results: After 6 weeks of using the insole with medial heel skive technique, scores in both ADL and SPORTS activities were significantly improved. Discussion: Foot function improvement was not found in all of the studies assessing foot function in flat feet after using different orthotic insoles, by different questionnaires or other systems. In this study, foot and ankle function was significantly improved per FAAM questionnaire- which had highly limited use in orthotic interventions in flat feet population- using medial heel skive technique; however, further studies are required to accentuate medial heel skive technique effect on flat feet function by comparing this technique with other positive cast modifications to control the flat foot. According to the present study results, custom-mold insole with medial heel skive may improve physical function in FFF and can be prescribed in this group.

Recognition of Bathroom Activities in Older Adults Using Wearable Sensors: A Systematic Review and Recommendations.

This article provides a systematic review of studies on recognising bathroom activities in older adults using wearable sensors. Bathroom activities are an important part of Activities of Daily Living (ADL). The performance on ADL activities is used to predict the ability of older adults to live independently. This paper aims to provide an overview of the studied bathroom activities, the wearable sensors used, different applied methodologies and the tested activity recognition techniques. Six databases were screened up to March 2020, based on four categories of keywords: older adults, activity recognition, bathroom activities and wearable sensors. In total, 4262 unique papers were found, of which only seven met the inclusion criteria. This small number shows that few studies have been conducted in this field. Therefore, in addition, this critical review resulted in several recommendations for future studies. In particular, we recommend to (1) study complex bathroom activities, including multiple movements; (2) recruit participants, especially the target population; (3) conduct both lab and real-life experiments; (4) investigate the optimal number and positions of wearable sensors; (5) choose a suitable annotation method; (6) investigate deep learning models; (7) evaluate the generality of classifiers; and (8) investigate both detection and quality performance of an activity.

The impact of pain on the course of ADL functioning in patients with dementia.

Understanding if and how pain influences activities of daily living (ADL) in dementia is essential to improving pain management and ADL functioning. This study examined the relationship between the course of pain and change in ADL functioning, both generally and regarding specific ADL functions. Participants were Dutch nursing home residents (n = 229) with advanced dementia. ADL functioning was assessed with the Katz ADL scale, and pain with the Dutch version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-D). Changes of PACSLAC-D and Katz ADL scores were computed based on the difference in scores between baseline, 3-month and 6-month follow-up. Multivariate linear regression models were used to assess the relationships between change in pain score, change in total ADL score and specific ADL item scores during follow-up. At baseline, residents had a median ADL score of 18 (interquartile range 13-22, range 6-24) and 48% of the residents were in pain (PACSLAC-D ≥ 4). Residents with pain were more ADL dependent than residents without pain. A change in pain score within the first 3 months was a significant predictor for a decline in ADL functioning over the 6-month follow-up (B = 0.10, SE = 0.05, P = 0.045), and specifically, a decline on the items 'transferring' over the 6-month follow-up and 'feeding' during the first 3 months of follow-up. Pain is associated with ADL functioning cross-sectionally, and a change in pain score predicts a decline in ADL functioning, independent of dementia severity. Awareness of (changes in) ADL activities is clearly important and might result in both improved recognition of pain and improved pain management.

Relation of chair rising ability to activities of daily living and physical activity in Parkinson\u2019s disease

BackgroundMany persons living with Parkinson’s disease (PD) have difficulty rising from a chair. Impaired ability to perform the chair rise may be associated with low physical activity levels and reduced ability to perform activities of daily living (ADL).MethodsCross-sectional analysis was performed in 88 persons with PD to study the association of chair rising ability with ADL and physical activity.ResultsWe found that the participants who pushed themselves up from the chair had more severe PD, higher motor impairment and more comorbidity than those who rose from a chair normally. The Unified Parkinson’s Disease Rating Scale ADL (UPDRS-ADL), Schwab and England Activities of Daily Living Scale (SE-ADL) and the Physical Activity Scale for the Elderly (PASE) scores for the participants who pushed themselves up to rise (17.20 ± 7.53; 76.67 ± 13.23; 46.18 ± 52.64, respectively) were significantly poorer than for those who rose normally (10.35 ± 3.79; 87.64 ± 8.30; 112.90 ± 61.40, respectively) (all p < .05). Additionally, PASE scores were significantly poorer for participants who pushed themselves up to rise compared to those who rose slowly (95.21 ± 60.27) (p < .01). Pushing up to rise from a chair was a significant predictor of UPDRS-ADL (β = .357; p < .001; R2 = .403), SE-ADL (β = −.266; p = .009; R2 = .257) and PASE (β = −.250; p = .016; R2 = .162).ConclusionsAbility to rise from a chair was associated with ADL limitation and physical activity in persons with PD. Poor ability to rise from a chair may prevent persons from living independently and engaging in physical activity.

Human Fall Detection Using Efficient Kernel and Eccentric Approach

Unintentional human falls are a very crucial problem in elderly people. If the fall goes unnoticed or undetected, it can lead to severe injuries and can even lead to death. Detecting falls as early as possible is very important to avoid severe physical injurious and mental trauma. The objective of this paper is to design the fall detection model using data of daily living activities only. In the proposed fall detection model, an eccentric approach with SVM based one-class classification is used. For the pre-processing step, fast fourier transformation has been applied to the data and seven features have been calculated using the preprocessed ADL dataset that has been calculated from the dataset of ADL (activities of daily living) activities acquired from the smartphones. An enhancement of the chi-square kernel-based support vector machine has been proposed here for classifying ADL activities from fall activities. Using the proposed algorithm, 98.81% sensitivity and 98.65% specificity have been achieved. This fall detection model achieved 100% accuracy on the FARSEEING dataset.

Activities of Daily Living and Associated Costs in the Most Widespread Neurodegenerative Diseases: A Systematic Review.

Nowadays, the population is rapidly ageing because of increasing life expectancy and decreasing birth rates. Thus, the purpose of this systematic review is to prepare a comprehensive overview which identifies the activities of daily living (ADLs) that are gradually reduced among patients with dementia, as well as explore the therapies applied in relation to dementia and how they effectively improve the quality of life (QoL) of patients and caregivers. Furthermore, we aim to summarise the ADL activities influenced by therapies and examine the treatment costs and care for patients so that recommendations for research and development (R&D) can be made to improve both the QoL of people with dementia and cost-saving measures. The research focuses on four selected neurodegenerative diseases: Alzheimer, Parkinson, vascular dementia, and amyotrophic lateral sclerosis. Therefore, the peer-reviewed English written articles from 2014 to 2019 were searched between September 1 and December 13, 2019. Twenty-seven papers were included in the analysis. The results show that essential assistance occurs in connection with activities: eating, drinking, dressing, bathing, personal hygiene, use of the toilet, and transport. By contrast, shopping or cleaning is not addressed as much. A lower ability to take care of oneself is connected with poor patient health and higher social care costs because the patient requires care from external sources, such as home aid or nurse visits. The challenge that remains is to shift new knowledge from scientific disciplines and connect it with the needs of patients to remove legitimate barriers and increase the acceptance of new solutions by popularisation. Additionally, regarding the burden on caregivers, it would be appropriate to promote this area of education and employment so that family members can use formal caregivers, ensuring them free time and much-needed rest.

P2261The impact of a short-term cardiac rehabilitation program on activities of daily living in elderly patients with chronic heart failure

Abstract Introduction A high proportion of elderly patients with Chronic Heart Failure (CHF) experience dyspnea and fatigue during the activities of daily living (ADLs). Purpose We aimed to determine 1) the VO2 peak of some basic ADLs comparing it to VO2 peak at CardioPulmonary Exercise Test (CPET) and 2) the effects of 3-week inpatient cardiac rehabilitation program on ADLs' performance. Methods At entry and at the end of a 20-day cardiac rehabilitation program patients performed an ADL-test consisting of five task-related ADL activities and two time-related ADL activities while wearing a metabolimeter mobile device (K5, Cosmed). Task-related activities were: 1) to put on and take off socks, shoes and jacket (ADL 1); 2) to fold eight towels (ADL 2); 3) to put 6 bottles on a shelve (ADL 3); 4) to make a bed (ADL 4); 5) to go up and down 1-floor stairs (ADL 5). Time-related ADL activities were: 1) to sweep the floor for 4 minutes (ADL 6) and 2) to walk for six minute (6MWT). Metabolic load, oxygen uptake, ventilation, heart rate and symptom of dyspnea were computed for each ADL. During the program, patients performed a CPET. Results Fifty-six CHF patients [89% men; age 72±6 years; Ejection Fraction (EF) 38±12%; 66% with EF&lt;40%] were enrolled. At entry, the least demanding ADL [expressed as proportion of peak oxygen uptake (VO2 peak) reached at CPET] was ADL 3 with 53,14±18.53%, while the most challenging was the 6MWT with 116.81±34.48%. Forty-two (75%) patients reached the VO2peak of CPET during 6MWT. After rehabilitation, there was a significant decrease in the time required to perform the task-related activities (ADL 1–5) [from 382.25±114.90 to 354.48±116.92 seconds, p=0.0175] and a significant increase in the distance covered during 6MWT [from 421.35±81.64 to 448.84±89.69 meters, p=0.000]. Moreover, following rehabilitation a significant decrease of heart rate in ADL1, ADL 3 and ADL 5 and a significant decrease of dyspnea in ADL 5, ADL 6 and 6MWT was recorded. Conclusion A comprehensive cardiac rehabilitation program can improve ADL performance due to the change of some physiological variables during effort. Further studies about the role of dedicated rehabilitation program (i.e. occupational rehab) are necessary.

Comparative Study of Different Approaches for Modeling and Analysis of Activities of Daily Living

In recent years, automatic human activity recognition has drawn much attention. On one hand, this is due to the rapid proliferation and cost degradation of a wide variety of sensing hardware, which resulted in the tremendous explosion of activity data. On the other hand there are urgent growing and pressing demands from many application areas such as: in-home health monitoring especially for the elderly, smart cities, safe driving by monitoring and predicting driver’s behavior, healthcare applications, entertainment, assessment of therapy, performance evaluation in sports, etc. In this paper we focus on activities of daily living (ADL), which are routine activities that people tend to do every day without needing assistance. We have used a public dataset of acceleration data collected with a wrist-worn accelerometer for 14 different ADL activities. Our objective is to perform an extensive comparative study of the predictive power of several paradigms to model and classify ADL activities. To the best of our knowledge, almost all techniques for activity recognition are based on methods from the machine learning literature (particularly, supervised learning). Our comparative study widens the scope of techniques that can be used for automatic analysis of human activities and provides a valuation of the relative effectiveness and efficiency of a potentially myriad pool of techniques. We apply four different paradigms for the analysis and classification of daily living activities: (1) techniques based on supervised machine learning, (2) techniques based on estimating the empirical distribution of the time series data and use measure-theoretic techniques to estimate the dissimilarity between two distributions, (3) techniques based on statistical analysis using goodness-of-fit tests, and (4) techniques based on measuring the dissimilarity between two time signals. We used several evaluation metrics including confusion matrices, overall accuracy, sensitivity and specificity for each activity, and relative computational performance. One of the main conclusions from our analysis is that the simplest techniques, for example, using empirical discrete distributions as models, have almost the best performance in terms of both accuracy and computational efficiency.

Fall detection and human activity classification using wearable sensors and compressed sensing

The fall of elderly patients is still a critical medical issue since it can cause irreversible bone injuries due to the elderly bones weakness. To mitigate the likelihood of the occurrence of a fall, continuously tracking the patients with balance and health issues has been envisaged, despite being unpractical. To address this problem, we propose an efficient automatic fall detection system which is also fitted for the detection of different activities of daily living (ADL). The system relies on a wearable Shimmer device, to transmit some inertial signals via a wireless connection to a computer. Aiming at reducing the size of the transmitted data and minimizing the energy consumption, a compressive sensing (CS) method is applied. In this perspective, we started by creating our dataset from 17 subjects performing a set of movements, then three distinct systems were investigated: one which detects the presence or the absence of the fall, a second which detects static or dynamic movements including the fall, and a third which recognizes the fall and six other ADL activities. In the acquisition and classification steps, first only the data collected by the accelerometer are exploited, then a mixture of the accelerometer and gyroscope measurements are taken into consideration. The two configurations are compared and the resulting system incorporating CS capabilities is shown to achieve up to 99.8% of accuracy.

An investigation of factors influencing the participation of stroke survivors in social and leisure activities

Objective: Participation restrictions are serious problems that stroke survivors experience while reintegrating into family, work, community, and social situations after participating in rehabilitation programs. The purpose of this study was to explore the factors affecting participation in activities of daily living (ADL), as well as social and leisure activities of individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: The study involved 96 participants who were diagnosed with a first stroke 6 months before the study (58 men, 38 women; 60.3±14.3 years). The Berg Balance Scale, Modified Barthel Index, Manual Function test, and Activity Card Sort were used to assess static and dynamic balance function, upper limb function, level of independence, and their level of participation within the community. A regression analysis was used to identify the influence of factors affecting participation in ADL, social and recreational activities. Results: The Activity Card Sort scores were significantly affected by the Manual Function test and Modified Barthel Index scores (p<0.05). Participation in leisure activities was affected by the level of independence. Participation in social activities was affected by the balance function and level of independence of the participants. Conclusions: The results of this study have shown that participation restrictions are affected by upper limb function, balance function, and the level of independence in individuals with hemiparetic stroke.

Do nursing staff encourage functional activity among nursing home residents? A cross-sectional study of nursing staff perceived behaviors and associated factors

BackgroundNursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors.MethodsIn this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors.ResultsNursing staff perceived that household activities (mean 4.1 (scale range 1–9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged.ConclusionsAccording to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.

Trends in activities of daily living disability in a large sample of community-dwelling Chinese older adults in Hong Kong: an age-period-cohort analysis

BackgroundTo examine the trends in activities of daily living (ADL) disability in older Chinese adults in Hong Kong between 2001 and 2012.MethodsUsing data from the Elderly Health Centres (EHCs) of...

Disability Among Veterans: Analysis of the National Survey of Veterans (1997-2001).

This manuscript assesses whether the Veterans Administration Rating System (VADR) correlates with self-reported activities of daily living (ADL) used in the National Survey of Veterans and likelihood of employment. Veterans' disability benefits are determined based on a single-index standardized rating scheme, measured at time of discharge. The primary aim of this study was to assess how this single-index rating of disability for veterans compares to multidimensional measures of disability (ADL and instrumental activities of daily living [IADL]). The relationship between disability ratings and labor market outcomes such as job search behavior and the likelihood of being employed was assessed. Successful labor market reintegration requires both physical/mental well-being, we examined the extent that VADR can capture the relationship between job market behavior and measures of mental/physical health. Kernel regression estimates were obtained of the likelihood of working/looking for work. Mean numbers of IADL and ADL difficulties and medical conditions were positively associated with VADR (p-trend < 0.001). An inverse relationship was observed with VADR and predicted probability of working (p-trend < 0.001). The combination of >4 ADL/IADL deficits and mental health diagnosis increased the likelihood of not working. The probability of not working correlated with VADR when VADR was greater than 40%.

Impact of Functional Capacity on Nutritional Status of Hospitalized Elderly in Qazvin, Iran

Background: Lack of independence and unwanted dependence on others for activities of daily living (ADL) and decreased functional capacity affect nutritional status of the elderly. Objectives: The aim of this study was to determine the impact of functional capacity on malnutrition status in hospitalized elderly patients in the Qazvin city of Iran. Patients and Methods: This cross sectional study was conducted on patients 60 years or older hospitalized in two teaching hospitals of Qazvin, Iran, from May to October 2011. The nutritional status was assessed using the mini nutritional assessment (MNA) questionnaire. Functional capacity of the elderly was assessed using self-report questionnaires of ADL and Instrumental Activities of Daily Living (IADL). Data were analyzed using the Chi-square test and logistic regression analysis. Results: Of the 322 participant, 171 (53.1%) were male. The mean age was 70.36 ± 7.8 years. Based on MNA, 96 patients (29.8%) had normal nutritional status, 138 (42.9%) were at risk of malnutrition and 43 (13.4%) had malnutrition. Dependency on ADL and IADL was significantly associated with malnutrition and risk of malnutrition. In the logistic regression analysis, IADL was associated with malnutrition (OR: 1.19, 95% CI: 1.07 - 1.33; P < 0.001). Conclusions: Risk of malnutrition as well as reduced functional ability was high among the hospitalized elderly of Qazvin. Nutritional status assessment of older adults is necessary, particularly when they are admitted to hospitals.

Smart Home Strategies for User-Centered Functional Assessment of Older Adults

Successful aging, independence and capacity for aging in place involves the maintenance and preservation of individuals’ physical, mental and social well-being. Elderly people need to maintain the capacity to perform both activities of daily living (ADL) and instrumental activities of daily living (IADL). Advances in Smart Home technologies are increasingly able to provide embedded assessments of an individual’s functional ability in his/her home on a moment-to-moment, daily, and longitudinal basis. To date, in-situ functional assessment systems and research have focused to a greater extent on the advancement of technologies rather than the multi-faceted needs and experiences of users, however the success of any technology depends more on the users than the technology itself. This paper presents strategies for user-centric approaches to identify the technical and design challenges of developing, deploying, and using functional assessment systems in homes occupied by senior citizens. Case studies involved 4 healthy older adults (aged 65+), and examined the home deployment of smart home systems and interfaces aimed at assessment of a combination of ADL and IADL activities. Pre- and post-activity interviews were used to better understand issues related to desire, privacy, technological acceptance, suitability, and need fulfillment/support. The results inform strategies for user-centered functional assessment and assistive technology design and implementation, providing information capture, analysis, and delivery of in-home functional assessment that has the potential to support aging in place.

Functional gain following knee replacement in patients aged 75 and older: a prospective follow-up study.

The aim of this prospective follow-up study was to analyze which patient characteristics predict better functional ability, as well as improvement in the ability, following knee replacement in the aged. The focus was on the impact of specific comorbidities and radiologic data. Knee osteoarthritis patients aged≥75years (n=167) scheduled for knee replacement answered to a questionnaire asking about performance in the activities of daily living (ADL) before the operation, and 1year afterwards. Radiologic data were evaluated from the latest radiographs, and comorbidity data from patient records. The primary outcome was a sum score indicating how many ADLs (out of 10) the patient was able to perform without difficulty. The factors associated with ADL performance were analyzed with adjustment for age, gender, Charlson's comorbidity index and Kellgren-Lawrence score. Knee replacement resulted in improved performance in almost all the analyzed ADL activities. Except for cardiac diseases, the effect of the analyzed comorbidities on ADL performance was not significant. Older patients and women attained lower final functional ability than younger patients and men, but improved similarly. In more progressed osteoarthritis, the final ability was lower, but the improvement gained was greater. Comorbidity, age, or more progressed osteoarthritis should not be considered an impediment to knee replacement. Even though the final functional ability may be lower in some, the improvement gained by surgery is similar regardless of comorbidity, and was more pronounced in more progressed disease.

The effect of obesity on incidence of disability and mortality in Mexicans aged 50 years and older.

To examine the effect of obesity on incidence of disability and mortality among non-disabled older Mexicans at baseline. The sample included 8 415 Mexicans aged ≥ 50 years from the Mexican Health and Aging Study (2001 -2012), who reported no limitations in activities of daily living (ADLs) at baseline and have complete data on all covariates. Sociodemographics, smoking status, comorbidities, ADL activities, and body mass index (BMI) were collected. The lowest hazard ratio (HR) for disability was at BMI of 25 to < 30 (HR = 0.97;95% confidence interval [CI], 0.85-1.12).The lowest HR for mortality were seen among participants with BMIs 25 to < 30 (HR = 0.85; 95%CI, 075-0.97), 30 to < 35 (HR = 0.86; 95 %CI, 0.72-1.02), and > 35 (HR = 0.92; 95 %CI, 0.70-1.22). Mexican older adults with a BMI of 25 to < 30 were at less risk for both disability and mortality.