Daily Activities Of Older Adults Research Articles

Comparing the effects of aquatic-based exercise and land-based exercise on balance in older adults: a systematic review and meta-analysis.

Balance plays a crucial role in the daily activities of older adults. Aquatic-based exercises (AE) are widely conducted as an alternative to land-based exercises (LE). Previous studies have compared AE and LE as effective ways to improve balance and have yielded inconsistent results. Therefore, this review aimed to compare the effects of AE and LE on balance function in older adults. Electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched. Randomized controlled trials published from January 2003 to June 2023 were included following predetermined criteria. Data extraction was carried out by two independent reviewers. Data synthesis was conducted using RevMan 5.3 software. The fixed-effect model or random-effect model was chosen based on the results of the heterogeneity test. Meta-analysis for the effect sizes of balance outcomes was calculated as standardized mean difference (SMD) with 95% confidence intervals (CI). The quality of the included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. This review was registered at PROSPERO CRD42023429557. A total of 29 studies involving 1486 older adults (with an average age of 66.2years) were included. Meta-analysis results indicated that AE could improve balance ability based on two tests: the Berg balance scale (BBS: SMD = 1.13, 95% CI 0.25 to 2.00, p = 0.01, I2 = 94%) and the 30-s chair stand test (30 CST: SMD = 2.02, 95% CI 0.50 to 3.54, p = 0.009, I2 = 96%). However, there were no significant differences between the AE group and the LE group in terms of the 6-min walking test (6 MWT: SMD = 0.13, 95% CI -0.16 to 0.43, p = 0.38, I2 = 62%) and time up to go test (TUGT: SMD = 0.44, 95% CI -0.44 to 0.91, p = 0.07, I2 = 85%). Older adults with different health conditions have different gains in different balance measurements after AE intervention and LE intervention. Although this was influenced by participant health status, transfer effects, sample size, and other factors, AE offers better benefits than LE for improving balance function in older adults.

Older Adults' Unmet Needs at the End of Life: A Cross-Country Comparison of the United States and England.

Objectives: This study aimed to compare the end-of-life (EOL) experiences in concentration with place of death, for older adults in the U.S. and England. Methods: Weighted comparative analysis was conducted using harmonized Health and Retirement Study and English Longitudinal Study of Ageing datasets covering the period of 2006-2012. Results: At the EOL, more older adults in the U.S. (64.14%) than in England (54.09%) had unmet needs (I/ADLs). Home was the main place of death in the U.S. (47.34%), while it was the hospital in England (58.01%). Gender, marital status, income, place of death, previous hospitalization, memory-related diseases, self-rated health, and chronic diseases were linked to unmet needs in both countries. Discussion: These findings challenge the existing assumptions about EOL experiences and place of death outcomes, emphasizing the significance of developing integrated care models to bolster support for essential daily activities of older adults at the EOL.

Oral health and oral health-related quality of life among older adults receiving home health care services: A scoping review.

To map the literature on subjective and objective oral health indicators and oral health-related quality of life (OHRQoL) in older adults receiving home health care services (HHCS). The proportion of older adults in need of HHCS will increase in the coming years. Previous studies indicate that frail and dependent older adults are at increased risk for oral diseases, due to challenges with daily oral hygiene and regular access to dental services. Four databases were searched in November 2020 for relevant literature. Search terms included a comprehensive list of terms for adults 65 years or older receiving HHCS, clinical and subjective oral health indicators, and OHRQoL. The literature was reviewed based on inclusion and exclusion criteria. Of the 3114 sources identified, 18 were included. Data on oral diseases and symptoms among older adults receiving HHCS were limited and heterogeneous. Overall, older adults often lacked some of their natural teeth and often had removable dentures that needed repair. In addition, plaque, caries, xerostomia, and chewing and swallowing problems were common among the population group. Data on OHRQoL were scarce and indicated a positive association with a higher number of present teeth, while decayed teeth, root remnants, and dry mouth had substantial negative impacts on the daily activities of older adults receiving HHCS. This scoping review show that older adults above 65 years receiving HHCS generally have poor oral health status and that there is a knowledge gap regarding their OHRQoL.

A Pilot Study of Machine Learning–Based Algorithms to Assist Integrated Care for Older Community-Dwelling Adults

As life expectancy increases, there is a growing consensus on the development of integrated care encompassing the health and daily activities of older adults. In recent years, although the demand for machine learning applications in healthcare has increased, only a few studies have implemented machine learning-based systems in integrated care for older adults owing to the complex needs of older adults and the coarseness of the available data. Our study aims to explore the possibility of implementing machine learning decision-support algorithms in the integrated care of older community-dwelling adults. Our experiment uses secondary data based on the community-based integrated service model. Such data were collected from 511 older adults through 162 assessment items in which tailored services were selected from 18 available services. We implemented four machine learning models: decision tree, random forest, K-nearest neighbors, and multilayer perceptron. The area under the receiver operating characteristic curve results of the four models were decision tree = 0.89, K-nearest neighbors = 0.88, random forest = 0.93, and multilayer perceptron = 0.88. The results suggest that machine learning-based decision-assisting algorithms can improve the quality of tailored services for integrated care with intensive involvement of face-to-face tasks by reducing the simple, repetitive tasks of care managers.

Aging Living at Home: Residential Satisfaction among Active Older Adults Based on the Perceived Home Model.

Background: Housing plays an important role in the aging process and health. The house and its nearby environment host most of the daily activities of older adults. Residential satisfaction (RS) has been relegated to physical issues such as accessibility. However, RS is also constituted by older adults’ perceptions about housing. This study analyzes the perceived home that develops RS in older adults. Methods: A random sample of 714 participants aged 50 to 84 (mean = 65; SD = 0.98) were used. Participants lived in ordinary housing in southern Spain. Scales measure perceptions of RS, meaning, functionality and belief of control over the home. Results: Analyses were performed using structural equation models to evaluate the dependence relationships between the different perceptions evaluated. We observe a direct influence of internal control on usability (β = 0.84) and perceived meanings (β = 0.49). However, external control shows a negative influence on the meaning of home (β = −0.14). Perceived usability (β = 0.68) and meaning (β = 0.32) positively influence RS. Conclusion: Perceptions of meaning, functionality and RS itself depend on internal housing-related control beliefs. Active older adults with higher internal control perceived their home fit better to the need of everyday life and improve RS.

Fear of falling is as important as multiple previous falls in terms of limiting daily activities: a longitudinal study

BackgroundFear of falling and previous falls are both risk factors that affect daily activities of older adults. However, it remains unclear whether they independently limit daily activities accounting for each other.MethodsWe used the data from Round 1 (Year 1) to Round 5 (Year 5) of the National Health and Aging Trends Study. We included a total of 864 community-dwelling participants who provided data on previous falls, fear of falling and limited activities from Year 1 to Year 5 and had no limited daily activities at Year 1 in this study. Previous falls and fear of falling were ascertained by asking participants how many falls they had in the past year and whether they had worried about falling in the last month. Limited daily activities included any difficulties with mobility (e.g., going outside), self-care (e.g., eating), and household activities (e.g., laundering). Generalized estimation equation models were used to examine whether previous falls and fear of falling independently predicted development of limited daily activities adjusting covariates.ResultsParticipants were mainly between 65 and 79 years old (83 %), male (57 %), and non-Hispanic White (79 %). Among participants who had multiple falls in Year 1, 19.1-31 %, 21.4-52.4 %, and 11.9-35.7 % developed limitations in mobility, self-care, and household activities during Year 2 to Year 5, respectively. Among those who had fear of falling in Year 1, 22.5-41.3 %, 30.0-55.0 %, and 18.8-36.3 % developed limitations in mobility, self-care, and household activities during Year 2 to Year 4, respectively. Fear of falling independently predicted limitations in mobility (Incidence rate ratio [IRR]: 1.79, 95 % CI: 1.44, 2.24), self-care (IRR: 1.25, 95 % CI: 1.08, 1.44) and household activities (IRR: 1.39, 95 % CI: 1.08, 1.78) after adjusting for previous falls and covariates. Multiple previous falls independently predicted limitations in mobility (IRR: 1.72, 1.30, 2.27), self-care (IRR: 1.40, 95 % CI: 1.19, 1.66) and household activities (IRR: 1.36, 95 % CI: 1.01, 1.83) after adjusting fear of falling and covariates.ConclusionsFear of falling seems to be as important as multiple previous falls in terms of limiting older adults’ daily activities.

Occupational performance issues in older adults with subjective cognitive decline

Purpose To describe and categorize difficulties in daily activities of older adults with subjective cognitive decline (SCD) compared to individuals with mild cognitive impairment (MCI). Methods Deductive quantitative content analysis was used to classify reported issues in the performance of meaningful daily activities, in older adults with SCD (n = 67; age= 70 ± 6.3) or MCI (n = 42; age= 72 ± 6.6). The occupational performance issues were identified using the Canadian Occupational Performance Measure, a semi-structured interview, and categorised using the International Classification of Functioning, Disability and Health (ICF). Results Both groups identified issues in all nine ICF “Activities and Participation” domains, with no significant group effects on seven of them. The most frequently affected “Activities and Participation” domains in both groups were “Self-care” (e.g. exercise and diet); “Community, social and civic life” (e.g. social-leisure activities); and "General tasks and demands” (e.g. time management). Over 90% of the issues in both groups were described in the context of difficulties in “Mental functions” (e.g. memory and higher-level cognitive functions). Conclusions Older adults with SCD, although independent, identified a variety of daily activities that they are not performing satisfactorily, remarkably similar in nature to the occupational performance issues described by older adults with MCI. Implications for Rehabilitation Older adults with SCD identified difficulties in performing social and leisure activities, maintaining healthy lifestyle behaviours, and managing multiple daily tasks. The daily challenges described by older adults with SCD are similar in nature to those identified by those with MCI. Older adults with SCD and MCI describe their daily challenges are related not only to memory problems, but also to executive dysfunction. Interventions for older adults with SCD should aim to improve self-identified problems in everyday functioning.

Age score for assessing motor function in Chinese older men

Background and objective: Motor performance plays an important role in daily activities for older adults. The purpose of the study was to construct a method for measuring physical fitness age that can be used to assess motor performance in elderly men and to verify its validity. Methods: Four items of physical fitness including grip strength, balancing on one leg with eyes open, 30 s chair stand test and 6 min walk test were selected and measured in a random order. Principal component analysis was employed to build physical fitness age based on motor performance variables from 94 elderly men with a mean age of 71.20 ± 5.05 years. Physical fitness age = 115.516-0.652 × grip strength - 0.142 × balancing on one leg with eyes open - 0.839 × 30 s chair stand - 0.061 × 6 min walk distance + 0.541 × chronological age. Results: Validation test from 13 men with exercise habit and 12 men without exercise habit showed that the physical fitness age in the exercised adults was significantly lower than its chronological age (63.91 ± 5.40 vs. 70.92 ± 4.17, P < 0.001), while no significant difference was observed between physical fitness age and chronological age in the elderly without exercise habits (71.23 ± 7.49 vs. 70.83 ± 5.19, P = 0.646). Conclusion: Physical fitness age is a valid indicator to evaluate and monitor motor performance. Participation in physical exercise may lower the physical fitness age by improving motor performance.

Interventions Within the Scope of Occupational Therapy Practice to Improve Performance of Daily Activities for Older Adults With Low Vision: A Systematic Review.

The prevalence of low vision increases with age. Low vision has detrimental effects on older adults' independence. To identify the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in daily activities for older adults with low vision. Literature published between 2010 and 2017 was searched in CINAHL, Cochrane Databases, MEDLINE, OTseeker, and PsycINFO. The authors screened and appraised studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Studies were eligible if the participants' mean age was 55 yr or older, the level of evidence was Level III or higher, the intervention was within the scope of occupational therapy practice, and the outcome measures assessed the performance of daily activities. Fourteen studies met the review criteria. Three intervention themes were identified: low vision rehabilitation services (n = 6), self-management approach (n = 6), and tango (n = 2). Moderate evidence was found for low vision rehabilitation services. Low evidence was found for using the self-management approach or adding the self-management approach to existing low vision rehabilitation services. Low evidence was found for tango. This systematic review supports the use of low vision rehabilitation services as an effective approach. Occupational therapy practitioners are encouraged to be part of multidisciplinary teams that offer comprehensive low vision evaluations and multicomponent services. Low vision rehabilitation that offers multidisciplinary services, including occupational therapy, is effective in promoting independence among older adults with low vision.

The lived experience of bathing adaptations in the homes of older adults and their carers (BATH-OUT): A qualitative interview study.

The onset of disability in bathing may be followed by disability in other daily activities for older adults. A bathing adaptation usually involves the removal of a bath or inaccessible shower and replacement with a level, easy access shower. The purpose is to remove the physical environmental barriers and restore older adults’ ability to bathe safely and/or independently. The aim of this study was to explore the views and experiences of older adults and their carers who had received a bathing adaptation in order to examine how the adaptation had affected them and identify mechanisms of impact and outcomes from their perspectives. The study was nested within a feasibility Randomised Controlled Trial (RCT) (BATH‐OUT) conducted within one local authority housing adaptations service in England. Semi‐structured interviews were completed between 21 December 2016 and 19 August 2017 with 21 older adults and five carer participants of the feasibility RCT. Interview participants were purposively sampled on living arrangement and gender. Interviews were audio‐recorded, transcribed verbatim and analysed in seven stages using framework analysis. Findings were presented thematically. Five themes were identified: ease of use; feeling safe; feeling clean; independence, choice and control; and confidence and quality of life. The removal of the physical barriers in the bathroom led to older adults re‐mastering the activity of bathing, having an improved sense of physical functioning which gave a sense of ‘freedom’. This appeared to impact a range of areas contributing to a wider sense of increased confidence consistent with constructs underpinning social care‐related quality of life. We suggest that future research should examine housing adaptations from a person–environment fit approach, and that timely restoration of bathing ability is especially important as it can affect confidence and perceived competence in other areas of daily living.

Monitoring Methods of Human Body Joints: State-of-the-Art and Research Challenges.

The world’s population is aging: the expansion of the older adult population with multiple physical and health issues is now a huge socio-economic concern worldwide. Among these issues, the loss of mobility among older adults due to musculoskeletal disorders is especially serious as it has severe social, mental and physical consequences. Human body joint monitoring and early diagnosis of these disorders will be a strong and effective solution to this problem. A smart joint monitoring system can identify and record important musculoskeletal-related parameters. Such devices can be utilized for continuous monitoring of joint movements during the normal daily activities of older adults and the healing process of joints (hips, knees or ankles) during the post-surgery period. A viable monitoring system can be developed by combining miniaturized, durable, low-cost and compact sensors with the advanced communication technologies and data processing techniques. In this study, we have presented and compared different joint monitoring methods and sensing technologies recently reported. A discussion on sensors’ data processing, interpretation, and analysis techniques is also presented. Finally, current research focus, as well as future prospects and development challenges in joint monitoring systems are discussed.

Examining daily activity routines of older adults using workflow

We evaluated the value of workflow analysis supported by a novel visualization technique to better understand the daily routines of older adults and highlight their patterns of daily activities and normal variability in physical functions. We used a self-reported activity diary to obtain data from six community-dwelling older adults for 14 consecutive days. Workflow for daily routine was analyzed using the EventFlow tool, which aggregates workflow information to highlight patterns and variabilities. A total of 1453 events were included in the data analysis. To demonstrate the patterns and variability of each individual’s daily activities, participant activity workflows were visualized and compared. The workflow analysis revealed great variability in activity types, regularity, frequency, duration, and timing of performing certain activities across individuals. Also, when workflow approach was applied to spatial information of activities, the analysis revealed the ability to provide meaningful data on individuals’ mobility in different levels of life spaces from home to community. Results suggest that using workflows to characterize the daily activities of older adults will be helpful for clinicians and researchers in understanding their daily routines and preparing education and prevention strategies tailored to each individual’s activity level. This tool also has the potential to be integrated into consumer informatics technologies, such as patient portals or personal health records, so that consumers may be encouraged to become actively involved in monitoring and managing their health.

Training older adults with low vision to use a computer tablet: A feasibility study

Introduction The purpose of this feasibility study was to investigate the potential use of a computer tablet as a low vision device to facilitate performance of and satisfaction with daily activities for older adults with low vision. Method A repeated measures design was used to measure outcomes. Four older adult women with low vision completed 10 weekly sessions of group training in tablet use. The feasibility of this research method and intervention was examined by evaluating recruitment capability, data collection procedures, outcome measures, intervention procedures, resources, and preliminary responses to intervention. Results The four participants were all women, with a mean age of 74.25 years (68–81). Visual acuity ranged from 20/160 to 20/4000. Mean change in performance and satisfaction on the Canadian Occupational Performance Measure were 3.45 and 3.65, respectively. Daily tablet use increased from 15 minutes at pretest to 3 hours at posttest to 4.5 hours at follow-up. Conclusion Group training in computer tablet use for older adults with low vision shows promise to improve performance and satisfaction in a variety of daily activities. With appropriate resources, the research method is feasible for a larger study examining this community-based intervention for older adults with low vision.

Older adults utilize less efficient postural control when performing pushing task

The ability to maintain balance deteriorates with increasing age. The aim was to investigate the role of age in generation of anticipatory (APA) and compensatory (CPA) postural adjustments during pushing an object. Older (68.8±1.0years) and young adults (30.1±1.4years) participated in the experiment involving pushing an object (a pendulum attached to the ceiling) using both hands. Electrical activity of six leg and trunk muscles and displacements of the center of pressure (COP) were recorded and analyzed during the APA and CPA phases. The onset time, integrals of muscle activity, and COP displacements were determined. In addition, the indexes of co-activation and reciprocal activation of muscles for the shank, thigh, and trunk segments were calculated. Older adults, compared to young adults, showed less efficient postural control seen as delayed anticipatory muscle onset times and delayed COP displacements. Moreover, older adults used co-activation of muscles during the CPA phase while younger subjects utilized reciprocal activation of muscles. The observed diminished efficiency of postural control during both anticipatory and compensatory postural adjustments observed in older adults might predispose them to falls while performing tasks involving pushing. The outcome provides a background for future studies focused on the optimization of the daily activities of older adults.

Start-Up Time and Walking Speed in Older Adults Under Loaded Conditions During Simulated Road Crossing

Background/Study Context: The safety of older pedestrians in road crossing has received considerable attention but previous studies measure gait characteristics only under unloaded conditions. The aim of this study was to investigate the start-up time and walking speed under loaded conditions that reflect daily activities of older adults in Singapore.Methods: Thirty-two older adults (age (SD) = 69.4 (7.0) years) and 20 young controls (age (SD) = 23.1 (2.0) years) walked under four conditions: (1) unloaded, (2) pushing a stroller loaded with 10 kg, (3) pulling a shopping cart loaded with 15 kg, and (4) carrying two shopping bags each loaded with 2 kg. Start-up time was determined from video recordings and walking speed measured using timing gates. A mixed-model analysis of variance (ANOVA; age by walking condition) with repeated measures was applied.Results: Start-up times were slower in the stroller and shopping cart conditions compared with the unloaded and shopping bags conditions. Loading reduced walking speed, with the shopping cart being the slowest, followed by the stroller and then the shopping bags. A significant interaction was found, with young controls reducing their speeds more substantially while handling the stroller/cart than older participants.Conclusion: Loading caused a compromise in start-up time and walking speed. The start-up time was slower when pushing a stroller or pulling a shopping cart but remained unaffected by carrying shopping bags. Speed was reduced under all loaded conditions, with a greater effect in young than older participants when handling a stroller or shopping cart.

Remote monitoring and assessment of daily activities in the home environment

Background/PurposeQuantitative analysis of daily activities measured by home monitoring systems can be helpful to assess objectively the health-related living behavior and functional ability of older adults. Advances in sensors and telecommunication technologies have prompted the concept and development of implementing diverse sensors and intelligent algorithms to monitor human/environment interactions. This paper presents the remote monitoring and assessment of daily activities of older adults living alone at home, assuming that comprehensive profiles of daily activities at home can be captured by using simple and low-cost sensors in a less diverse modality. MethodsA passive home monitoring system with a minimal set of sensing modalities, namely human infrared and electric current, was developed and used for continuous and unobtrusive monitoring of daily activities of an elderly woman for over 6 months. Four movement detectors were deployed in different indoor locations to detect active movements, and an appliance usage detector detected television use. A set of activity features that measure the intensity, regularity and abnormalities of activity patterns is defined and demonstrated to quantify the characteristics and rhythms of daily activities of the subject. ResultsDifferent rhythms of daily activities can be estimated from different locations at home, and distinct behaviors were shown between weekdays and holidays. Unusual activities have been detected by the system, too. The system setup did not require modification of home furnishings that could obstruct the subject's daily living or cause any discomfort or displeasure to the subject. ConclusionThis study suggests that daily activities of an older adult living alone at home can be measured by means of low-cost sensors in a less-diverse sensor modality, and daily rhythms can be quantified with a simple estimation method. The activity features developed in this study are built into a home telehealth system for telecare applications.

Neighbourhood influences on participation in activities among older adults with chronic health conditions

We examined the relationships between perceptions of neighbourhood characteristics and satisfaction with participation in everyday activities among 248 older adults with chronic health conditions in Hamilton, Ontario, Canada. We used a cross-sectional survey to collect data regarding neighbourhood characteristics, social support, social network size, and individual characteristics. Path analysis showed that fewer neighbourhood problems directly predict higher levels of satisfaction with participation. Neighbourhood cohesion indirectly predicts participation by predicting social support, which predicts participation. Neighbourhood safety indirectly predicts participation by predicting increased social cohesion and neighbourhood amenities may influence participation similarly. Changes to neighbourhood characteristics have the potential to facilitate participation in daily activities for older adults with chronic health conditions.

Falls among Koreans 45 years of age and older: incidence and risk factors

The aim of the study was to determine the incidence of falls according to age and risk factors among Korean adults 45 years of age and older. Falling is a known critical incident that results in injuries and limits the daily activities of older adults. The 2006 Korean Longitudinal Study of Aging, a publicly available database, was used for this study, which was conducted in 2006 with a total of 10,254 respondents. The variables used in this study were selected from the demographic and health sections of the larger study. The overall incidence of any type of fall was 4.0%, and the incidence of injurious falls tended to increase with increasing age; however, people below 65 years of age had a greater proportion of injurious falls than any of the older adult groups. All types of falls were more likely to occur among older adults and those with arthritis, visual deficits, cognitive impairments and depression. In addition, older age, visual deficits, weak grip, cognitive impairment and depression were key risk factors for falls requiring treatment and those resulting in difficulties in activities of daily living. Falls resulting in hip fractures occurred more frequently among women, people with visual deficits and those with depression. Future assessments of the incidence and risk factors for falls and studies of fall interventions should begin with younger age groups, namely those 45 years of age and older.

Perceived difficulty in everyday technology use among older adults with or without cognitive deficits

This study's purpose was comparing perceived relevance of and difficulty in use of everyday technology such as remote controls, cell phones, and microwave ovens, in older adults with/without cognitive deficits. Three groups included 157 participants; 34 had mild-stage dementia, 30 had mild cognitive impairment (MCI), and 93 lacked known cognitive impairments. Data were collected in structured interviews with the Everyday Technology Use Questionnaire (ETUQ). Analyses revealed that participants with no known cognitive deficits (Group 3) considered a higher proportion of technologies relevant to their life situation than participants with mild-stage dementia (Group 1) and those with MCI (Group 2). Furthermore, participants with no known cognitive deficits reported the lowest mean level of perceived difficulty in everyday technology use, followed by those with MCI and those with mild-stage dementia. All three groups differed significantly (p <0.01; p <0.001) in perceived difficulty using technology, indicating that measurement of perceived difficulty in everyday technology use may sensitively detect changes resulting from MCI/dementia. Findings indicate that perceived difficulty in using everyday technology increases in people with MCI and is accentuated in mild-stage dementia. This calls for increased attention to these issues when assessing functional ability in daily activities of older adults with possible MCI/dementia, and for further research.