Community-dwelling Seniors Research Articles

Multi-channel EMG manifestations of upper-extremity muscle coordination imbalance among community-dwelling sarcopenic seniors

Multi-channel EMG manifestations of upper-extremity muscle coordination imbalance among community-dwelling sarcopenic seniors

Detecting muscle fatigue among community-dwelling senior adults with shape features of the probability density function of sEMG

BackgroundPhysical exercise is an important method for both the physical and mental health of the senior population. However, excessive exertion can lead to increased risks of falls, severe injuries, and diminished quality of life. Therefore, simple and effective methods for fatigue monitoring during exercise are highly desirable, particularly in community settings. The purpose of this study was to explore the possibility of real-time detection of exercise-induced fatigue using surface Electromyogram (sEMG) features, including the kurtosis and skewness of the Probability Density Function (PDF) in the community settings to solve the issues of low sensitivity and high computational complexity of commonly used sEMG features.MethodssEMG signals from six forearm muscles were recorded during hand grip tasks at 20% maximal voluntary contraction (MVC) task-to-failure contractions from 30 healthy community-dwelling elders at their respective community centers. PDF shape features of the sEMG, namely kurtosis and skewness, were computed from 25 s of non-fatigue stable phase and 25 s of fatigue data for comparison. Statistical tests were conducted to compare and test for the significance of these features. We further proposed a novel fatigue indicator, Temporal-Mean-Kurtosis (TMK) of channel-averaged kurtosis, to detect fatigue with relatively low computational complexity and adequate sensitivity in community settings. ANOVA and post-hoc analyses were performed to examine the performance of TMK.ResultsStatistically significant differences were found between the non-fatigue period and the fatigue period for both kurtosis and skewness, with increasing values when approaching fatigue. TMK was shown to be sensitive in detecting fatigue with respect to time with lower computational complexity than the Sample Entropy.ConclusionThis study investigated PDF shape features of sEMG signals during a handgrip exercise to identify muscle fatigue in older adults in community experiments. Results revealed significant changes in kurtosis upon fatigue, indicating that PDF shape features were suitable convenient detectors of muscle fatigue in community experiments. The proposed indicator, TMK, showed potential sensitivity in tracking muscle fatigue over time in community-based settings with limited computational complexity, highlighting the promise of sEMG’s PDF features in detecting muscle fatigue among the elderly.

Occurrence of Malnutrition among Seniors in Poland Depending on the Place of Residence: An Analysis of Socioeconomic and Health Risk Factors.

The aging population in Poland poses significant socioeconomic and health challenges, particularly regarding malnutrition among seniors. This study examines the impact of place of residence on the nutritional status and related health outcomes of older adults. Data were collected from 338 community-dwelling seniors and those in long-term care facilities. The results indicate that long-term care residents exhibited significantly higher frailty and depression levels and poorer nutritional status, functional fitness, gait, and balance compared to those in communities. Self-reported quality of life did not differ significantly between groups. Regardless of residence, having a family correlated with better nutritional status, quality of life, and functional fitness and lower frailty and depression levels. Malnutrition was significantly associated with reduced functional fitness across all residences, and well-nourished individuals in care facilities had lower functional fitness than those who were at home. Community-dwelling residents had significantly lower frailty levels, with frailty negatively correlating with nutritional status. Normal nutritional status was linked to higher balance and gait scores, indicating a lower fall risk, with the risk further reduced for those living in community settings. Additionally, normal nutritional status correlated with lower depression levels and higher quality of life, with malnourished individuals experiencing better quality of life in community-dwelling settings. These findings underscore the critical role of residence and family support in elderly nutrition and health outcomes.

Assessment Of Functional Fitness Outcomes In 12-week Fitness Program Intervention Based On Age Categories Among Community Dwelling Seniors

Assessment Of Functional Fitness Outcomes In 12-week Fitness Program Intervention Based On Age Categories Among Community Dwelling Seniors

Digital Technology Use in US Community-Dwelling Seniors With and Without Homebound Status

ObjectivesTo examine (1) the prevalence of digital technology use, including information and communication technology devices, everyday technology use, and digital health technology use among community-dwelling older adults with or without homebound status and (2) the associations of digital technology use with homebound status. DesignCross-sectional study. Setting and ParticipantsWe used the 2022 National Health and Aging Trends Study (NHATS) data that included 5510 community-dwelling older adults. MethodsDigital technology use was assessed using self-reported outcomes of the technological environment component of the NHATS, including information and communication technology devices, everyday technology use, and digital health technology use. Homebound status was measured with 4 mobility-related questions regarding the frequency, independence, and difficulties of leaving home. Survey-weighted, binomial logistic regression was used to examine the associations of 17 technological-related outcomes and homebound status. ResultsOverall, the prevalence of homebound older adults was 5.2% (95% CI, 4.4%–6.1%), representing an estimated 2,516,403 people. The prevalence of digital technology use outcomes varied according to homebound status. The prevalence of any technology used in homebound, semi-homebound, and non-homebound populations was 88.5%, 93.3%, and 98.5%, respectively. Compared with non-homebound older adults, semi-homebound older adults had lower odds of emailing (OR, 0.71; 95% CI, 0.53–0.94), using the internet for any other reason (OR, 0.70; 95% CI, 0.49–0.99), visiting medical providers (OR, 0.68; 95% CI, 0.48–0.95), and handling insurance (OR, 0.75; 95% CI, 0.56–0.99); homebound older adults had lower odds of using a phone (OR, 0.41; 95% CI, 0.28–0.59), using any everyday technology (OR, 0.58; 95% CI, 0.38–0.89), visiting medical providers (OR, 0.52; 95% CI, 0.35–0.76), and handling insurance (OR, 0.57; 95% CI, 0.38–0.86). Conclusions and ImplicationsNon-homebound older adults are more likely to use digital technology than those who are semi-homebound or homebound. Public health care providers should prioritize efforts to enhance digital inclusion to ensure that all older adults can benefit from the advantages of digital technology.

Interrater Reliability of the Home Assessment of Person-Environment Interaction (HoPE) – Cognitive Version

Aims Most older people living with a neurocognitive disorder wish to age at home, and the person-environment interaction is a key factor in helping in-home functioning. The Home Assessment of Person-Environment Interaction (HoPE) – Cognitive Version is one of the few assessment tools targeting this interaction. This study tested its interrater reliability. Methods Based on Classical Test Theory, two independent trained occupational therapists simultaneously administered the HoPE-Cognitive Version to 30 dyads (older person and their caregiver), at home. Kappa coefficients, percentages of agreement and standard errors were calculated. Results Kappa coefficients ranged from −0.053 to 1.000 (kappamean=0.415; percentage of agreementrange=50%-100%); the majority (80%) ranged from Fair to Almost Perfect. For each of the three sections of the HoPE-Cognitive Version, the kappa coefficients for the global scores ranged as follows: Section 1: from 0.143 to 0.310 (mean = 0.235); Section 2: from 0.086 to 0.842 (mean = 0.413); Section 3: from −0.053 to 1.000 (mean = 0.532). Conclusion This study documents the interrater reliability of a promising instrument for understanding the person-environment interaction of community-dwelling seniors living with neurocognitive disorders. Several low coefficients demonstrate a high percentage of agreement, according to Feinstein and Cicchetti’s paradoxes. Continuing validation of the HoPE-Cognitive Version should further support its use.

Exploring the Remediation of Behavioral Disturbances of Spatial Cognition in Community-Dwelling Senior Citizens with Mild Cognitive Impairment via Innovative Technological Apparatus (BDSC-MCI Project): Protocol for a Prospective, Multi-Center Observational Study.

Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer's disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-ε4) has been associated with both sporadic and familial late-onset AD, and patients with mild cognitive impairment (MCI) due to AD are more likely to progressively deteriorate. Spatial navigation performance will be examined on a sample of 76 community-dwelling senior citizens (25 healthy controls; 25 individuals with subjective cognitive decline (SCD); and 26 patients with MCI due to AD) via a virtual computer-based task (i.e., the AppleGame) and a naturalistic task (i.e., the Detour Navigation Test-modified version) for which a wearable device with sensors will be used for recording gait data and revealing physiological parameters that may be associated with spatial disorientation. We expect that patients with MCI due to AD and APOE-ε4 carriers will show altered SN performances compared to individuals with SCD and healthy controls in the experimental tasks, and that VR testing may predict ecological performance. Impaired SN performances in people at increased risk of developing AD may inform future cognitive rehabilitation protocols for counteracting spatial disorientation that may occur during elders' traveling to unfamiliar locations. The research protocol has been approved by the Ethics Committee of the Istituto Auxologico Italiano. Findings will be published in peer-reviewed medical journals and discussed in national and international congresses.

A Proof of Principle Study Conducted by Community-Dwelling Seniors Using a Novel Passive Gait Assist System

It is vital for rehabilitating patients to perform as many task-related exercises as possible. These patients often need either force or trajectory assistance in order to perform gait. While this can be provided in the form of traditional gait rehabilitation or currently emerging robot-assisted gait training, there is a need for an affordable means to assist gait training. In this study, we present a passive gait assistance device that is composed of a spring-bar system attached to an elastic cord and a specialized shoe. The shoe has two straps attached such that both plantar and dorsiflexion torque can be applied to the user depending on the angle of the pulling force. The merit of the devices is that it is an affordable means to provide the user with gait assistance while allowing some freedom of one’s foot movement. We show that, with 20 community-dwelling seniors, our system successfully produces plantar flexion and dorsiflexion torque according to the gait cycle. Furthermore, electromyography analysis suggests that plantar flexor demand during the late stance phase and dorsiflexor demand during the swing phase are significantly reduced.

Comparison between six-week exergaming, conventional balance and no exercise training program on older adults’ balance and gait speed

Abstract We evaluated differences between a six-week exergame-training and a conventional balance training program on the balance and gait speed of older adults’ (>65 years). Forty-two healthy participants were recruited from independent living and community centers and randomized to one of three groups: exergaming balance training (EBT), conventional balance training (CBT), or control (no training). The participants completed two balance measurements (Fullerton Advanced Balance Scale (FAB) and center of pressure (COP) excursion), and gait speed at pre, post-intervention, and after a three-week follow-up. Both EBT and CBT groups improved their scores on the FAB, COP displacement, and gait speed post-intervention (p<0.05) and these changes were maintained and did not return to pre-training values after three weeks of detraining. The control group scores for FAB and gait velocity values declined (p<0.001) but not COP excursions during the study. This six-week exergame training program improved balance control and gait speed in community-dwelling seniors in a similar fashion to conventional training. Participants’ physical abilities scores improved and were maintained following three weeks of detraining. Exergame-based training therefore may be considered as an intervention that can address balance control and gait speed in older adults. As well improved scores can be maintained with transient or sporadic activity.

Health Care Access and Quality of Life of Community-Dwelling Senior Citizens in Pampanga, Philippines.

This study examined the association between healthcare access and quality of life (QOL) among senior citizens in Pampanga, Philippines. We conducted a cross-sectional study among 410 community-dwelling senior citizens aged 60 and above. Using validated scales, we assessed both healthcare access and QOL. Descriptive statistics were employed to characterize the senior citizens, and multiple linear regression was used to examine the association between healthcare access and QOL. Senior citizens, averaging 69 years old, were predominantly women, single/widowed, and with comorbidities. They reported high healthcare access (mean = 120.13) and moderate QOL (mean = 70.79). Environmental health scored highest in QOL domains, while social relationships scored lowest. Overall healthcare access was positively associated with overall QOL (B [unstandardized beta] = .22, 95% CI [confidence interval] 0.10, 0.33) and its domains. Significant associations with overall QOL were observed for accessibility (B = 1.95, 95% CI 0.98, 2.91) and affordability (B = -1.60, 95% CI -2.46, -0.74). Filipino senior citizens in Pampanga demonstrated high healthcare access and moderate QOL. The study highlights the importance of healthcare access in enhancing senior citizens' QOL, particularly regarding accessibility and affordability. Further research is needed to explore the nuanced relationships between healthcare access subscales and specific QOL domains.

ENGAGING OLDER ADULTS VIA SOCIAL MEDIA DURING A PANDEMIC: SUCCESSFUL LEARNING EXPERIENCES FOR STUDENTS AND ADULTS

Abstract The Arkansas Colleges of Health Education and the Arkansas Geriatric Education Collaborative collaborated on a project to educate senior adults about the use of assistive technologies (AT) for self-care, home management, community engagement, and leisure participation to help them live safely and independently. Occupational and physical therapy students collaborated with 10 community dwelling senior adults to research, develop, and disseminate 27 video vignettes shared via Facebook. These vignettes were developed and shown during a time when senior adults were encouraged to isolate during the pandemic. As of January 2023, the outcomes of sharing the 27 video vignettes on Facebook included: a total of 17,204 views, the most viewed was “Lighting and Magnification” at 1,000+ views, followed by “Sewing” at 992 views, the least viewed was “Fishing” at 147 views. Older adult viewers feedback included: contact with ACHE to ask how to purchase the assistive devices; sharing the information gained with their family members and others; purchase of devices; providing a resource for AT assistance for OA. Additionally, the senior adults that participated in the project reported a better understanding of the AT after presenting in the videos. In conclusion, these results indicate that creating the video vignettes and sharing them on Facebook had an extensive reach beyond the 27 individual sessions. This also demonstrated that the viewers were actively engaged as noted by their questions and comments.

Telehealth to Address Health Promotion & Social Isolation in Community Dwelling Seniors During a Public Health Emergency

In 2020, the Covid-19 pandemic led to a public health emergency and dramatic physical and social lockdown for many of society’s most vulnerable people. This mixed methods study examined the feasibility and value of delivering health promotion occupational therapy through an online video platform to community dwelling seniors over the age of 65. Four stand-alone sessions were designed to introduce health promotion and aging in place to 10 community dwelling seniors. The sessions were designed to allow seniors to engage in informative, interactive activities offering a chance to share their lived experiences. Seniors embraced new technology and benefited from therapeutic recommendations in their homes. Qualitative and quantitative results support the adaptation of telehealth as a permanent benefit for community dwelling seniors and offers the potential to reach a broader audience, reduce barriers to access care, and optimize safety in the home.

Relationship between Visual Functioning, Balance, and Fear of Falling among Community-dwelling seniors with Cataract

Relationship between Visual Functioning, Balance, and Fear of Falling among Community-dwelling seniors with Cataract

Effects of Auricular Acupressure Therapy on Psychological Factors, Sleep Quality, and Salivary Cortisol Levels in South Korean Older Adults in the Community: A Single-blind, Randomized Controlled Trial

Purpose: This study aimed to investigate the effects of auricular acupressure (AA) therapy on psychological factors, sleep quality, and salivary cortisol levels in community-dwelling older adults. Methods: This was a single-blind, randomized, placebo-controlled comparative pretest-posttest study that applied AA for three weeks. The experimental group received AA on the shenmen, sympathetic, subcortical, and adrenal areas, while the control group received acupuncture in four areas along the helix. Nineteen participants were assigned to the experimental group and 21 to the control group. All participants were community-dwelling seniors aged 65 years or older who had an Insomnia Severity Index score of 8 or higher and experienced psychological stress. Depression, anxiety, and stress were measured using the Korean version of the Depression Anxiety Stress Scale for psychological factors, and the Korean version of the Pittsburgh Sleep Quality Index and morning salivary cortisol levels were measured to evaluate sleep quality. Results: Statistically significant differences were observed between the groups for depression (t=5.56, <i>p</i><.001), anxiety (t=3.53, <i>p</i>=.001), and stress (t=3.55, <i>p</i>=.001). The PSQI (t=4.72, <i>p</i><.001) and salivary cortisol levels (z=-4.21, <i>p</i><.001) showed statistically significant differences between the groups. Conclusion: AA demonstrated its effectiveness as an intervention for addressing complex symptoms in community-dwelling older adults. It was found to alleviate depression, anxiety, and stress, enhance sleep quality, and reduce salivary cortisol levels.

Needs and influence factors of medical-nursing-pension of disabled elderly.

As the population ages, the incidence of disabled elderly persons increases, and the need for medical-nursing-pension services among disabled senior persons increases. The purpose of this study is to determine the needs and affecting factors of disabled elderly living in community homes in Nanning, Guangxi, China. The study utilized the descriptive comparative cross-sectional study. Stratified random sampling was utilized, based on inclusion and exclusion criteria, a total of 168 disabled elderly were randomly selected and investigated using a self-designed questionnaire which included basic nursing services domain, professional nursing services domain, rehabilitative nursing services domain, living nursing services domain, and spiritual nursing services domain. The t test, one-way ANOVA, and multivariate logistic regression were used to determine the influencing factors of medical-nursing-pension demands for community-dwelling disabled elderly. Majority of impaired seniors have a moderate to high-level of demand for medical-nursing-pension services. Age (t = 2.369, 95% confidence interval [CI]: 0.673-7.414), educational level (t = -16.946, 95% CI: -31.247 to -24.726), monthly income (t = -16.273, 95% CI: -22.104 to -17.320), economic source (t = 8.891, 95% CI: 16.850-26.470), time spent disabled (t = -11.151, 95% CI: -31.845 to -22.264), living with children (t = 10.852, 95% CI: 24.491-35.521), and medical insurance participation (t = 4.556, 95% CI: 9.032-22.848) all influence the demand for medical-nursing-pension services for disabled seniors in the community (P = .05). Majority of community-dwelling impaired seniors have a moderate to high demand for medical-nursing-pension services. Relevant departments and community nurses should pay increased attention to the elderly who are older, have a low educational level, a low monthly income, have an economic source of pension from their own, have been disabled for long period of time, are single, and do not have children, to improve the health care system for disabled elderly by implementing more personalized home visits in medical-nursing-pension on health education about oxygen inhalation and wound dressing.

Effects Of A 12-week Fitness Intervention On Functional Fitness Outcomes For Community Dwelling Seniors

Effects Of A 12-week Fitness Intervention On Functional Fitness Outcomes For Community Dwelling Seniors

Factors influencing fall in the community-dwelling elderly: Data from the 2020 national survey of older people: A secondary analysis study

Purpose: This study was performed to identify the factors influencing fall in the community-dwelling elderly using the raw data of the 2020 national older Koreans data. Methods: The study included 9,920 community-dwelling seniors aged 65 years and older. The data were analyzed by using a complex sampling design univariate logistic regression analysis. Results: Although the subjects of this study were 9,920 people, it can be generalized to 7,617,710 people because it is a probability sample using the stratified systematic sampling with cluster plots. As a result of this study, the fall rate of community-dwelling elderly was 6.4% and the weighted percentage was 7.1%. Satisfaction with economic status, number of chronic diseases, use of medical facilities, smoking, limitation of lower muscle strength, decreased visual acuity, limitation of daily living function, and housing type were identified as factors influencing fall in older people dwelling in the community. Conclusion: Based on the variables identified in this study, it is necessary for nurses to select high-risk groups for fall and to actively develop and implement nursing intervention to prevent fall.

The Role of Physical Activity and Community Engagement in Understanding Mental Health Among Community-Dwelling Seniors.

Caregivers and health practitioners are often looking for good intervention techniques to help community-living older adults to improve their mental health. This study examined the relationship between physical activity and community engagement and their effect on mental well-being among older men and women. Data from National Health and Aging Trends Study from the years 2018 to 2020 were used to explore and test the posited relationships. Partial least-squares structural equation modeling was used to test the developed model that focused on the relationships among physical activity and mental well-being when controlling for demographics in older adults. Social interactions added importance to well-being among older men and women. Physical activity factors and community engagement all together have a positive impact on an older adults' mental well-being. This study provides statistically significant empirical evidence that older adults who are physically active and involved in the community exhibit greater mental well-being than those who isolate themselves.

The Role of Physical Activity and Community Engagement in Understanding Mental Health Among Community-Dwelling Seniors.

The Role of Physical Activity and Community Engagement in Understanding Mental Health Among Community-Dwelling Seniors.

Physiotherapy Can Help Recover Functional Status in Community-dwelling Seniors Assessed in Emergency Departments for Minor Injuries

Background: Around 75% of seniors seeking treatment for injuries in Emergency Departments (ED) are discharged home with minor injuries that put them at risk of functional decline in the following months. Objectives: To 1) describe seniors’ characteristics using or not physiotherapy services following ED visits for minor injuries and 2) examine their functional status according to physiotherapy use. Methods: Secondary data analyses of the Canadian Emergency Team Initiative cohort study. Participants were 65 years and older, discharged home after consulting EDs for minor injuries and assessed three times: ED, 3- and 6-months. Physiotherapy use was recorded as yes/no. Functional status was measured using the Older American Resources Scale (OARS). Multivariate linear regressions were used to examine change in OARS scores over time, accounting for confounders. Results: Among the 2169 participants, 565 (26%) received physiotherapy, and 1604 (74%) did not. Physiotherapy users were more likely females (71% vs. 64%), more educated, and less cognitively impaired. The overall change in OARS at 6 months was -0.31/28 points (95% CI: -0.55; -0.28) with no difference across groups after adjustment. Subgroup analyses among frail seniors showed that physiotherapy users maintained their function while non-users lost clinically significant function (-0.02 vs. -1.26/28 points, p = 0.03). Among the severely injured (Injury Severity Scale ≥ 5), physiotherapy users’ results were higher by almost 1/28 points (p = 0.03) compared to non-users. Conclusion: These results suggest that among seniors discharged home after consulting the ED for minor injuries, the frail and severely injured may benefit from being systematically referred to physiotherapy services.