Basic Activities Of Daily Research Articles

Fear of falling in community-dwelling older adults presenting to the emergency department for minor injuries: Impact on return to the ED and future falls.

1) To characterize mild, moderate, and severe fear of falling in older emergency department (ED) patients for minor injuries, and 2) to assess whether fear of falling could predict falls and returns to the ED within 6 months of the initial ED visit. This study was part of the Canadian Emergency and Trauma Initiative (CETI) prospective cohort (2011-2016). Patients ages ≥ 65, who were independent in their basic daily activities and who were discharged from the ED after consulting for a minor injury, were included. Fear of falling was measured by the Short Falls Efficacy Scale International (SFES-I) in order to stratify fear of falling as mild (SFES-I = 7-8/28), moderate (SFES-I = 9-13/28), or severe (SFES-I = 14-28/28). Many other physical and psychological characteristics where collected. Research assistants conducted follow-up phone interviews at 3 and 6 months' post-ED visit, in which patients were asked to report returns to the ED. A total of 2,899 patients were enrolled and 2,009 had complete data at 6 months. Patients with moderate to severe fear of falling were more likely to be of ages ≥ 75, female, frailer with multiple comorbidities, and decreased mobility. Higher baseline fear of falling increased the risk of falling at 3 and 6 months (odds ratio [OR]-moderate-fear of falling: 1.63, p < 0.05, OR-severe-fear of falling 2.37, p < 0.05). Fear of falling positive predictive values for return to the ED or future falls were 7.7% to 17%. Although a high fear of falling is associated with increased risk of falling within 6 months of a minor injury in older patients, fear of falling considered alone was not shown to be a strong predictor of return to the ED and future falls.

Validation of the Mandarin Version of the Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" Among Patients in Acute Rehabilitation.

A standardized functional measure that can be used across rehabilitation care settings in Taiwan is urgently needed. To generate a Mandarin version of the Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" for patients in acute care. Mixed-methods study with a cross-sectional design. Acute care wards of three teaching hospitals in Taiwan. A sample of 231 neurological patients in acute care (62.3% female; mean age = 63.2 yr, standard deviation = 14.6). The 6-Clicks consist of three subscales: Basic Mobility, Daily Activity, and Applied Cognition. They were translated into Mandarin, and their internal consistency, test-retest reliability, interrater reliability, and convergent validity were tested. All subscales of the Mandarin version of the 6-Clicks showed good internal consistency (α = .97-.98). Test-retest and interrater reliabilities were excellent for all subscales (intraclass correlation coefficients >.8). Convergent validity was supported by strong correlations of the Basic Mobility and Daily Activity subscales with the Barthel Index (r = .73 and .72, respectively) and between the Applied Cognition subscale and the Montreal Cognitive Assessment (r = .82). Our results provide psychometric evidence supporting the use of the Mandarin version of the 6-Clicks in acute care settings in Taiwan. This study confirms the appropriateness of the use of the Mandarin version of the AM-PAC "6-Clicks" with patients in acute rehabilitation, making it a valuable addition to validated measures available for use by occupational therapists in Taiwan.

Estado cognitivo y funcionalidad para las actividades básicas en el adulto mayor institucionalizado

&lt;p&gt;&lt;strong&gt;Introducción: &lt;/strong&gt;El envejecimiento es un proceso fisiológico donde el organismo experimenta cambios de manera constante. Junto a este proceso se observa el deterioro cognitivo y disminución de la funcionalidad en las actividades básicas de la vida diaria (ABVD). &lt;strong&gt;Objetivo:&lt;/strong&gt; Conocer la relación que existe entre el estado cognitivo y la funcionalidad para las actividades básicas de la vida diaria del adulto mayor (AM) institucionalizado. &lt;strong&gt;Método:&lt;/strong&gt; Estudio transversal descriptivo, con participación de 32 adultos mayores de ambos sexos. Previo consentimiento informado, se aplicaron escalas de Mini-Mental de Folstein e Índice de Barthel. Para identificar asociación entre variables se utilizó correlación de Spearman y para identificar asociación entre género se utilizó Chi-cuadrada. Un valor de P≤ 0.05 fue establecido para identificar diferencias significativas entre ambos grupos. &lt;strong&gt;Resultados: &lt;/strong&gt;56.2% (n=18) fueron mujeres y 43.75% (n=14) hombres. Edad promedio fue 80.5 ± 8.97. El Índice de Barthel identificó que solamente 12.5% (n=4) eran independientes en tanto que 87.5% (n=28) presentaba algún grado de dependencia funcional. La escala de Folstein evidenció que 6.2% (n=2) eran normales y el resto (n=30) presentaba algun grado de deterioro cognitivo. No se evidenciaron diferencias significativas con base a género ni para funcionalidad (p=0.45) ni para deterioro cognitivo (p=0.85) respectivamente. La correlación de Spearman evidenció r = 0.66 y p = &amp;lt; 0.0001. &lt;strong&gt;Conclusión:&lt;/strong&gt; Existe asociación del estado cognitivo con la funcionalidad para las ABVD en el AM institucionalizado, determinando que a mayor deterioro cognitivo mayor será su dependencia funcional; El género no tiene influencia sobre dicha asociación.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Perceived availability of future care and depressive symptoms among older adults in China: evidence from CHARLS

BackgroundMajor concerns have arisen about the challenges facing China in providing sufficient care to its older population in light of rapid population ageing, changing family structure, and considerable rates of internal migration. At the family level, these societal changes may produce care uncertainty which may adversely influence the psychological wellbeing of older individuals. This paper applies social support and control theories to examine the relationship between perceived availability of future care and psychological wellbeing of older adults in China, and how this relationship is moderated by economic insufficiency, health vulnerability, and urban/rural context.MethodsAnalyses are based on data from the China Health and Retirement Longitudinal Study, a multi-panel nationally representative household survey of the Chinese population aged 45 years and older. Data are taken from 2013 and 2011 waves of the study, with an initial sample size around 17,000, in which around 11,000–14,000 respondents are used for our final regression model. The score of depressive symptoms was measured in both waves with the Center for Epidemiologic Studies Depression Scale (CES-D10), and perceived availability of future care was measured in 2013 by asking respondents the question “Suppose that in the future, you need help with basic daily activities like eating or dressing, do you have relatives or friends (besides your spouse/partner) who would be willing and able to help you over a long period of time (yes/no)?”ResultsMultivariate regression analysis revealed that uncertainty regarding future care support was associated with greater depressive symptoms even after controlling for factors confounded with care uncertainty such as family structure, socio- economic status, and a lagged measure of depression. Further, older adults without an anticipated source of care faced double jeopardy in their depressive symptoms if they also experienced functional limitations.ConclusionsConsidering rapid aging of the Chinese population, anticipated increases in chronic disease burden, and possible attenuation of filial care, this analysis suggests that older adults in China may increasingly face health and social conditions detrimental to their mental health. Polices that remedy these concerns should be discussed, developed and implemented.

A nationwide study on prevalence and factors associated with dynapenia in older adults: ELSI-Brazil

This study aimed to assess the prevalence and factors associated with dynapenia in a nationally representative sample of Brazilians aged 50 years and older. A cross-sectional study was performed with baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). Dynapenia was defined as low muscle strength (< 27kg for men and < 16kg for women). Explanatory variables were sociodemographic characteristics, health conditions, health behaviors and physical performance. Analyses were based on multivariate logistic regression and population attributable fractions. Among the 8,396 participants, the prevalence of dynapenia was 17.2% (16.6% among men and 17.7% among women); for those aged 65 years and older, the prevalence was 28.2% (29.1% and 27.5% among men and women, respectively). Dynapenia was positively associated with age, low gait speed, limitations in performing two or more basic daily activities, falls and self-reported chronic diseases; and negatively associated with education level, physical activity and body mass index (overweight/obese, OR = 0.26). Prevalence of dynapenia is high in Brazilian older adults. Educational skills and physical activity improvement present greater potential to reduce dynapenia in this population.

Associations between Physical Activity, Depression, and Quality of Life in Elderly: Meta-Analysis

Background: The aging process is associated with a greater prevalence of long-term health problems. One of them is a significant increase in problems including mental health problems in the elderly demographic. The World Health Organization (WHO) estimates that about one in every ten elderly people suffer from depress­ion, which is a factor that can reduce the of life (QOL) of the elderly. QOL can be concep­tualized as a set of harmonious satis­factions that individuals get in their daily lives by taking into account the physical, psycho­logical and social aspects of life. Good QOL for the elderly can be interpreted as feeling better in carrying out basic daily activities (Activity of Daily Living/ ADLs) properly and living inde­pen­dently. One of the aspects that play an import­ant role in improving the of life of the elderly is activity. This study aims to determine the average strength of the relation­ship between activity and depression and of life in the elderly based on the results of previous research. Subjects and Method: This study is a syste­matic review and meta-analysis using a design. The articles used in this study were obtained from several databases including PubMed, Google Scholar, Springerlink, and Sciencedirect. The articles used in this study are those published from 2010-2020. The arti­cle search was carried out by considering the eligibility criteria defined using the PICO model. P: Male and female aged ≥ 60 years, I: Physical C: sedentary behavior O: Depression and Quality of Life. The keywords to search for articles were as follows: physical activity, quality of elder­ly, cross-sectional and adjusted odds ratio. The articles included in this study are full text articles with a study design. Articles were collected using PRISMA flow dia­grams and analyzed using the Review Manager 5.3 application. Results: A total of 16 articles were reviewed in this study. The meta-analysis showed that phy­sical activity can reduce the risk of depression in the elderly (aOR= 0.72; 95% CI= 0.52 to 1.00; p<0.001). The meta-analysis also showed that activity can improve the of life of the elderly (aOR= 1.25; 95% CI= 1.05 to 1.48; p<0.001). Conclusion: Physical activity can reduce the risk of depression and can improve the of life among elderly. Keyword s : depression, of life, elderly, Correspondence: Fatchurrohmah Ines Prabandari. Masters Pro­gram in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: inesfatchur@gmail.com. Journal of Epidemiology and Public Health (2020), 05(04): 420-434 https://doi.org/10.26911/jepublichealth.2020.05.04.04

Prevalence of SARS-CoV-2 in Household Members and Other Close Contacts of COVID-19 Cases: A Serologic Study in Canton of Vaud, Switzerland

Background: Understanding community-based SARS-CoV-2 transmission is crucial to inform public health decisions. Research on SARS-CoV-2 transmission within households and other close settings using serological testing is scarce.Methods: We invited COVID-19 cases diagnosed between February 27 and April 1, 2020 in canton of Vaud, Switzerland, to participate, along with household members and other close contacts. Anti-SARS-CoV-2 IgG antibodies were measured using a Luminex immunoassay. We estimated factors associated with serological status using generalized estimating equations.Findings: Overall, 219 COVID-19 index cases, 302 household members, and 69 other close contacts participated between May 4 and June 27, 2020. More than half of household members (57·2%, 95%CI 49·7-64·3) had developed a serologic response to SARS-CoV-2, while 19·0% (95%CI 10·0-33·2) of other close contacts were seropositive. After adjusting for individual and household characteristics, infection risk was higher in household members aged 65 or more than in younger adults (aOR 3·63, 95%CI 1·05-12·60), and in those not strictly adhering to simple hygiene rules like hand washing (aOR 1·80, 95%CI 1·02-3·17). The risk was lower when more than 5 people outside home were met during the semi-confinement, compared to none (aOR 0·35, 95%CI 0·16-0·74). The individual risk of household members to be seropositive was lower in large households (22% less per each additional person).Interpretation: We find that, during semi-confinement, household members of a COVID-19 case were at very high risk of getting infected, 3 times more than close contacts outside home. This highlights the need to provide clear messages on specific protective measures applicable at home. For elderly couples, who were especially at risk, providing them external support for daily basic activities is essential.Funding: Center for Primary Care and Public Health (Unisanté), Canton of Vaud, Leenaards Foundation, Fondation pour l'Université de Lausanne. SerocoViD is part of Corona Immunitas coordinated by SSPH+.Declaration of Interests: We declare no competing interests.Ethics Approval Statement: The Cantonal Ethics Committee of Vaud, Switzerland (ID 2020-00887) approved the protocol.

Activity Limitations and Depressive Symptoms Among Older Couples: The Moderating Role of Spousal Care.

Limitations in performing basic daily activities, as well as spousal caregiving that arises from activity limitations, are important factors that have ramifications for mental health among couples. The objective of this study was to investigate the interplay of these factors by focusing on whether the associations between activity limitations and depressive symptoms among coupled-individuals were moderated by receipt and provision of spousal care. Longitudinal household data from the Health and Retirement Study (2004-2014; dyad N = 6,614) were analyzed to estimate within-person associations between one's own and spousal activity limitations, receipt and provision of spousal care, and depressive symptoms. Findings showed a consistent link between one's own activity limitations and depressive symptoms for both spouses, whereas spousal activity limitations were associated with depressive symptoms for wives only. We also found moderating effects of spousal care in the link between one's own and spousal activity limitations and depressive symptoms. Receipt and provision of activities of daily living-related assistance may contextualize the association between activity limitations and depressive symptoms among older coupled-individuals in a direction that could alleviate or aggravate the risk of depression.

Revisión sobre la efectividad de la terapia en espejo en el proceso de rehabilitación de miembros superiores en pacientes con accidente cerebrovascular

Introducción: La afección en extremidades superiores posterior a un accidente cerebrovascular se considera la más frecuente y esta deja secuelas a corto, mediano y largo plazo que intervienen en el desarrollo de actividades básicas cotidianas o de la vida diaria en el usuario como bañarse, vestirse, peinarse, entre otras. la terapia en espejo pretende ayudar a que esta rehabilitación sea más fácil creando una ilusión visual del miembro afectado como si estuviese sano, Objetivo: verificar Mediante la revisión de bibliografía la efectividad de la terapia en espejo en el proceso de rehabilitación de miembros superiores en pacientes con accidente cerebrovascular. Método: se hizo una revisión de literatura de 47 artículos relacionados con la terapia en espejo y el proceso de rehabilitación en miembros superiores, teniendo en cuenta publicaciones en inglés y español en las bases de datos Pubmed, Elsevier, Science Direct, Dialnet, Medline basándonos en los últimos 10 años. Resultados: Los estudios mostraron que la terapia en espejo es efectiva en el proceso de rehabilitación motora en miembros superiores en pacientes con accidente cerebrovascular siempre y cuando se combine con terapias complementarias y su periodo de rehabilitación sea extenso Conclusión: La terapia en espejo es considerada efectiva por la intervención de las neuronas espejo en el proceso de aprendizaje la cual en compañía de otros medios ayuda a la pronta recuperación de la movilidad del paciente con accidente cerebrovascular, mejorando así el desarrollo de sus actividades básicas cotidianas contribuyendo a una mejora en su calidad de vida.

Long-term functional outcomes after traumatic popliteal artery injury: A 20-year experience.

Traumatic popliteal arterial injury (TPAI) is associated with a risk of both limb loss and long-term morbidity due to prolonged ischemia and the often-associated musculoskeletal injuries. Long-term functional outcome following this injury has not been adequately studied. We evaluated patients with TPAI to determine if there was an improvement in functional outcome over time. We hypothesized that both the initial severity of ischemia and the associated injuries limited the ability of patients to improve functional outcome. Patients with TPAI for 20 years were identified. All patients had at least a 2-year follow-up. Functional outcomes were measured using the Boston University Activity Measure for Post-Acute Care to assess basic mobility (BM) and daily activity (DA). Multiple linear regression, adjusted for age, severity of injury and shock, operative complexity, associated injuries, ischemic time, and length of follow-up were used to identify predictors of functional outcome after TPAI. A total of 214 patients were identified: 123 penetrating (57%) and 91 blunt (43%). Overall mortality was 1.9% (all in-hospital), and amputation occurred in 10%. Of the 210 survivors, follow-up was obtained in 145 patients (69%). Median follow-up was 9.2 years (interquartile range, 5.7-15.7 years). Mean Activity Measure for Post-Acute Care scores for BM and DA were 78 and 75, respectively, both signifying mild impairment (normal, >84). Multiple linear regression failed to identify increasing length of follow-up as a predictor of improved functional outcomes. Only age, lower extremity fracture, and ischemic time were identified as predictors of decreased BM and DA. Increasing age, lower extremity fracture, and prolonged ischemic time worsened long-term functional outcomes. Functional outcome did not improve over time, suggesting that maximal recovery may be achieved within the first 2 years postinjury. Thus, early and effective revascularization remains the only potentially modifiable risk factor for improving functional outcomes following TPAI. Prognostic, level III.

Indicação do Uso do Cateter de St. Reed no Tratamento da Dor Lombar Crônica

Introdução: A dor lombar crônica é uma patologia de alta morbidade, sendo associada à limitação das atividades básicas diárias e aumento do estresse psicológico. Há diversas linhas de tratamento que podem ser propostas, variando de fármacos até procedimento cirúrgico. Para os casos refratários, uma alternativa é a aplicação de esteroides com o cateter St. Reed. Objetivos: Descrever as indicações do uso do cateter de St. Reed para o tratamento da dor lombar crônica. Métodos: Foi realizada busca de artigos nas bases de dados PubMed (9) e UptoDate (2) através das palavras-chave: “low back pain”, “chronic pain” e “treatment failure”. Resultados: A dor lombar causada por hérnia de núcleo pulposo e estenose espinhal sem resposta ao tratamento conservador, tem como opção a aplicação de corticoide via cateter St. Reed. As vantagens são: falta de necessidade de anestesia geral, rápida recuperação e curto período de internação. As contraindicações são infecções no local, gravidez e doença mental. Estudos apontam que a aplicação alivia os sintomas, além de ser tratamento com baixos riscos de complicações e resolutividade em casos refratários. Conclusão: o uso deste cateter é uma opção para casos refratários de hérnia de disco com radiculopatia, dor discogênica e estenose espinhal.

Receptor-Interacting Protein Kinase 1 (RIPK1) as a Potential Therapeutic Target: An Overview of Its Possible Role in the Pathogenesis of Alzheimer's Disease

Alzheimer's Disease (AD) is an age-dependent neurodegenerative disorder, the most common type of dementia that is clinically characterized by the presence of beta-amyloid (Aβ) extracellularly and intraneuronal tau protein tangles that eventually leads to the onset of memory and cognition impairment, development of psychiatric symptoms and behavioral disorders that affect basic daily activities. Current treatment approved by the U.S Food and Drug Administration (FDA) for AD is mainly focused on the symptoms but not on the pathogenesis of the disease. Recently, receptor-interacting protein kinase 1 (RIPK1) has been identified as a key component in the pathogenesis of AD through necroptosis. Furthermore, genetic and pharmacological suppression of RIPK1 has been shown to revert the phenotype of AD and its mediating pathway is yet to be deciphered. This review is aimed to provide an overview of the pathogenesis and current treatment of AD with the involvement of autophagy as well as providing a novel insight into RIPK1 in reverting the progression of AD, probably through an autophagy machinery.

Current role of the collagenase Clostridium histolyticum in Dupuytren's disease treatment.

Collagenase Clostridium histolyticum (CCH) is a recent treatment for Dupuytren disease, which is a fibroproliferative disorder that leads to progressive, persistent digital flexion contracture that interferes with basic daily activities. While CCH has changed the treatment of this hand disorder, numerous concerns have to be analyzed. Our purpose is to assess the current status of this medical treatment. Literary review based on a manual search on PubMed, Web of Science, and Google Academic. Pharmacoeconomic analyses support the use of CCH, but long-term studies showing that it should be favored over conventional surgery or other treatments are lacking. Treatment decisions, therefore, must be guided by current data, which include a 5-year recurrence rate of 47%. Complications following CCH treatment are also a controversial topic, as rates of over 90% have been reported, although most of the complications are mild and self-limiting. A definition and classification of CCH-related complications is sorely needed. If we exclude adverse effects that could be considered inherent to the mechanisms of action of CCH, then the complication rate would be similar to rates reported for other techniques. Although CCH is becoming an increasingly popular treatment for Dupuytren disease, the potential applications of this modality, are much higher than currently believed, for more disorders characterized by excessive fibrosis. Currently, the administration of this treatment is promising although long-term studies are necessary to see the real role that this drug can play in both Dupuytren's disease and other fibrotic disorders.

Síndromes asociados a intoxicación por organofosforados: abordaje médico y fisioterapéutico en cuidado crítico

Introducción: el artículo reporta un caso clínico de intento suicida de un paciente con síndrome intermedio a causa de intoxicación por organofosforados. Para ello se analizó la historia clínica, los exámenes complementarios y el estudio electromiográfico, y se realizó revisión no sistemática de la literatura. Presentación del caso: se describe un caso diagnosticado en la unidad de cuidado intensivo, el cual presentó trastornos neuromotores, requerimiento de soporte ventilatorio con destete difícil y extubación fallida, así como el tratamiento médico y fisioterapéutico instaurado. Dentro del manejo de la intoxicación por organofosforados se incluye la descontaminación del tóxico, administración de atropina y pralidoxima, diagnóstico oportuno del síndrome intermedio y la prescripción de ejercicio terapéutico. El paciente recibió manejo interdisciplinario, logrando liberación de su condición crítica, pero con persistencia de debilidad muscular proximal; sin embargo, con el ejercicio alcanzó recuperación funcional de sus actividades básicas cotidianas. Conclusión: el panorama mundial de las intoxicaciones por sustancias químicas muestra que son causa de morbilidad y discapacidad importante. Los organofosforados son los plaguicidas más frecuentemente involucrados. Los síntomas y signos clínicos de este tipo de intoxicaciones se clasifican en manifestaciones colinérgicas, el síndrome intermedio y la neuropatía retardada.

Sex differences in Japanese patients with ruptured aortic aneurysms

ObjectiveThis study aimed to assess the sex differences in clinical presentation and outcomes of Japanese patients with ruptured aortic aneurysm (rAA) using a large nationwide claims-based database in Japan. MethodsWe identified patients hospitalized in certified teaching hospitals in Japan with rAA between April 1, 2012, and March 31, 2015. Patients' characteristics and in-hospital outcomes were compared between men and women. The Barthel index was used for evaluating functional status at discharge by examining the ability to perform basic daily activities. ResultsOf 7086 eligible patients, 32.3% (2291/7086) were women. Women were older than men (81.9 years vs 76.1 years; P < .001), had higher prevalence of coma at admission (33.2% vs 25.2%; P < .001), and were less likely to undergo emergency operation including endovascular aneurysm repair (35.7% vs 51.1%; P < .001). The unadjusted mortality rate (62.5% vs 52.0%; P < .001) and Barthel index at discharge (78.7 vs 86.1; P < .001) were significantly worse in women than in men. However, multilevel mixed-effect logistic regression analyses showed that female sex itself was not an independent predictor for in-hospital death (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.78-1.04; P = .17). Older age, coma at admission, and vasopressor use were detected as independent predictors for in-hospital death. The same results were confirmed for each rupture site. Stratified analyses showed that older women (threshold, 80 years; OR, 0.81; 95% CI, 0.66-0.98; P = .028) and those who underwent emergency operation (OR, 0.75; 95% CI, 0.61-0.93; P = .009) showed significantly better outcomes than men. ConclusionsIn a univariate analysis, female patients with rAA showed worse mortality than men because of their older age, more severe clinical presentation, and low emergency operation rate. However, after adjustment for covariates, female sex itself was not associated with increased mortality.

Mapping critical cortical hubs and white matter pathways by direct electrical stimulation: an original functional atlas of the human brain

ObjectiveThe structural and functional organization of brain networks subserving basic daily activities (i.e. language, visuo-spatial cognition, movement, semantics, etc.) are not completely understood to date. Here, we report the first probabilistic cortical and subcortical atlas of critical structures mediating human brain functions based on direct electrical stimulation (DES), a well-validated tool for the exploration of cerebral processing and for performing safe surgical interventions in eloquent areas. MethodsWe collected 1162 cortical and 659 subcortical DES responses during testing of 16 functional domains in 256 patients undergoing awake surgery. Spatial coordinates for each functional response were calculated, and probability distributions for the entire patient cohort were mapped onto a standardized three-dimensional brain template using a multinomial statistical analysis. In addition, matching analyses were performed against prior established anatomy-based cortical and white matter (WM) atlases. ResultsThe probabilistic maps for each functional domain were provided. The topographical analysis demonstrated a wide spatial distribution of cortical functional responses, while subcortical responses were more restricted, localizing to known WM pathways. These DES-derived data showed reliable matching with existing cortical and WM atlases as well as recent neuroimaging and neurophysiological data. ConclusionsWe present the first integrated and comprehensive cortical-subcortical atlas of structures essential for humans’ neural functions based on highly-specific DES mapping during real-time neuropsychological testing. This novel atlas can serve as a complementary tool for neuroscientists, along with data obtained from other modalities, to improve and refine our understanding of the functional anatomy of critical brain networks.

Associations of alcohol consumption status with activities of daily living among older adults in China

Background With the rapid growth of the elderly population and public health challenges in China, concerns arise related to disability associated with activities of daily living (ADLs) and alcohol consumption status. This study assesses the relationships of alcohol consumption status with basic daily activities among Chinese older adults. Methods A total of 5,133 participants aged 60 years or above from three waves of the Chinese Longitudinal Healthy Longevity Survey (2009, 2012, and 2014) were analyzed. Independent ADL items included bathing, dressing, toileting, indoor moving, continence, and feeding (without others’ assistance). Multilevel ordered logistic regression model estimation was used to examine the results of total scores based on the Katz index. Multilevel logistic regression models also were estimated to study each index item separately to examine differences across each of the six ADLs. Additional confirmatory factor analysis (CFA) was performed to examine the validity of the index. Results Preliminary CFA showed that most items had good factor loadings (>0.700), except for continence (0.256) and feeding (0.481). Based on the ordered regression model, former (AOR = 0.412, 95% CI: 0.294, 0.579, p < 0.001) and non-alcohol consumption (AOR = 0.598, 95% CI: 0.447, 0.800, p < 0.001) were negatively associated with the total score. Non-alcohol consumption status was negatively associated with ADL items separately (all ps < 0.05), with the exceptions of continence and feeding. Conclusion Alcohol consumption may be associated with Chinese older adults’ better ADLs. However, further clinical or experimental trials are needed to examine the impact of alcohol consumption on older adults’ ADLs.

Social Care and Gender: Who Cares for Dependent Adults in Spain?

Care work encompasses a series of tasks of distinct social and economic importance; however, it has not been a traditional object of study in Economics. The main objective of this article is to analyze the factors that intervene in informal care work in Spain. To approach this, an econometric analysis will be conducted using the National Health Survey (ENS as its Spanish acronym) carried out by the Instituto Nacional de Estadística (INE) of Spain. The results show that, in Spain, dependent adults do not receive the institutional support they need to perform basic daily activities. In fact, practically all of the care they receive is informal. This article will demonstrate that, within the household, women are responsible for informal care work whenever a family member is in need of such services. Our research shows that this is a consistent pattern regardless of the carer’s personal characteristics and level of education as well as the characteristics of the dependent adult living in the household. These findings reveal the necessity of reorienting public policies in order to help reduce gender inequalities caused by this socio-economic reality.

How do impairments in cognitive functions affect activities of daily living functions in older adults?

The assessment of daily living activities could provide information about daily functions and participation restrictions to develop intervention strategies. The purposes of this study were to assess the scores of the Barthel Index (BI) and Lawton Instrumental Activities of Daily Living (IADL) scale in older adults with cognitive impairment and to explore the different effects that levels of cognitive functions have on changes in IADL functions. We recruited 31 participants with dementia, 36 with mild cognitive impairment (MCI), and 35 normal controls (NCs) from the neurology outpatient department of a regional hospital. The results of the demographic and clinical characteristics through the Lawton IADL scale, BI, Quick Mild Cognitive Impairment (Qmci) screen, Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE), were collected on the same day and compared with the Kruskal–Wallis test, Wilcoxon rank-sum test, Fisher’s exact test, and a multiple linear regression analysis, as appropriate. In the BI, bathing was the most discriminating activity to differentiate patients with MCI and dementia; in the Lawton IADL scale, medication responsibility and shopping were the most discriminating activities to differentiate NCs and patients with MCI, and patients with MCI and dementia, respectively. In addition, the predictors of changes in Lawton IADL scale scores were the problem-solving score of the Clinical Dementia Rating scale, a Qmci score of > 20.4 and an age of ≤ 81.2 years, a MoCA score of < 9.4 and an age of > 81.2 years, and the MMSE score and an age of > 81.2 years. This study adds to the evidence that the description of basic and instrumental daily activities is integrated in older adults with cognitive impairment. Notably, the Qmci is the most significant predictor of changes in IADL function for “young” older adults, as are the MoCA and MMSE for “old” older adults.

The challenges and experiences of stroke patients and their spouses in Blantyre, Malawi.

This was a qualitative exploratory study design. We conveniently selected 18 participants. Half of the population comprised patients and the other half spouses. Data were collected through in-depth interviews and focus group discussions and were analysed using thematic content analysis. Stroke patients were found to be challenged by lack of mobility and failure to perform basic functional activities such as walking and feeding using the affected hand, which resulted in sudden dependence on the spouse for basic self-care and daily activities. In consequence, spouses were burdened by care-giving responsibilities while, on the other hand, most participants had limited access to rehabilitation and health services at the grassroots level. Moreover, congestion and lack of privacy were shown to exist at the Kachere Rehabilitation Centre due to inadequate space. This study has managed to show some of the problems that stroke patients and spouses experience during and after rehabilitation. There is a need for early and adequate intervention to address functional limitations and facilitate return to work. Spouses should be made to understand the condition of their partner and educated regarding possible implications of the same. In addition, social and psychological support should form an inseparable part of the therapy. Stroke support groups and association could be considered as a way of enhancing social support and awareness.