Ability In Activities Of Daily Research Articles

Community rehabilitation by the trained village health volunteers on activities of daily living and quality of life in stroke survivors

Background: The number of people with disabilities resulting from strokes is increasing in Thailand. The major sequela of the disease was weakness in one side of the body that causes difficulty in activities of daily living (ADL) and poor quality of life (QOL) for stroke survivors. Community-based rehabilitation could be one of the strategies that enhances functional performance and improves QOL in these individuals. There were many disabled people in Mae Ka subdistrict, San Pa Tong District, Chiang Mai Province, where health care providers and local people were enthusiastic to take care of each other’s health in the community. Objective: The present study aimed to investigate rehabilitation outcomes in ADL and QOL of stroke participants who received rehabilitation services from trained village health volunteers (VHVs). Materials and methods: This study was a quasi-experimental research design. Subjects were recruited using purposive sampling, including 10 stroke survivors. Instruments used were 1) ADL Assessment for Occupational Therapy Clients; and 2) World Health Organization Quality of Life Assessment, Short Form-Thai version. The statistics used were descriptive, as well as the Wilcoxon Signed Ranks Test. Results: Results demonstrated that scores of basic activities of daily living (BADL) in the participants increased significantly (p<0.05) except for sexual expression. The score in the instrumental activities of daily living (IADL) was also significantly higher at post-rehabilitation than pre-intervention (p<0.05), as was the total ADL score. Stroke patients had significantly higher QOL scores after intervention than the pretest (p<0.05). Conclusion: These indicated that the community rehabilitation center at Mae Ka Subdistrict Administrative Organization, San Pa Tong District, Chiang Mai Province, run by the trained VHVs could promote ability in daily activities and improve QOL in stroke participants who come for their services.

Comparison of the clinical efficacy of all-inside arthroscopic lateral ligament augmentation procedure and Broström procedure for the treatment of chronic lateral rotational ankle instability

Objective: To compare the clinical efficacy of patients with chronic lateral rotational ankle instability(CLRAI) after all-inside arthroscopic lateral ligament augmentation procedure and Broström procedure. Methods: This is a retrospective cohort study. The clinical and imaging data of 106 CLRAI patients were collected at the Xuzhou Central Hospital from January 2021 to December 2022. The patients included 55 males and 51 females with an age of (32.6±8.2) years (range: 16 to 50 years). All patients were treated under all-inside arthroscopic, and were divided into Broström-Gould surgery group (n=54) and Broström surgery group (n=52) according to different ligament repair methods. At 3, 6, and 12 months after surgery, ankle inversion stress tests and anterior drawer tests were used to examine the stability of the ankle joint and observe gait. The American Orthopedic Foot and Ankle Society ankle hindfoot scale (AOFAS-AH) and Karlsson ankle function score (KAFS) were used to assess ankle function; Tegner score was used to assess the patient's level of exercise; the foot and ankle outcome score(FAOS)(including score of symptoms,pain,function, daily living,function, sports and recreational activities (sport); quality of life (QOL)) was used to assess the patient's daily activity ability. Comparisons of data were made using independent sample t test, repeated measures analysis of variance, LSD multiple comparison method, χ2 test or Mann-Whitney U test. Results: All operations were successfully accomplished. All incisions healed by first intention, without evidence of postoperative complications of implant rejection, ligation reaction, and nerve and vessel injury. All patients were followed up at 3, 6, and 12 months after surgery. Ankle varus stress test and anterior drawer test were negative. No evidence supporting lateral ankle instability was obtained. All patients eventually regained normal gait. No patients underwent revision surgery. Repeated measurement analysis of variance showed that AOFAS-AH, Tegner, KAFS and FAOS scores in the Brostrom-Gould group and the Brostrom group were significantly higher than those before surgery (P<0.01). The change trends of Tegner score and FAOS-sport score were significantly different between the two groups (F=18.839, P<0.01; F=8.169, P=0.005). Multiple comparisons revealed that at 3-, 6-and 12-month follow-up, the Tegner scores ((3 months: 3.7±0.5 vs. 3.3±0.5, t=-3.980, P<0.01; 6 months: 4.4±0.6 vs. 3.8±0.7, t=-4.792,P<0.01;12 months: 5.8±0.9 vs. 5.1±1.0, t=-3.889,P<0.01)), sport scores ((3 months: 82.5±3.7 vs. 79.3±3.8, LSD-t=-4.316, P<0.01; 6 months: 88.5±4.9 vs. 85.7±3.8, LSD-t=-3.312,P=0.001;12 months: 90.1±4.3 vs. 88.2±5.1, LSD-t=-2.112,P=0.037)) in the Broström-Gould surgery group were higher than those in the Broström surgery group, with statistical significances. Conclusions: Both Broström-Gould and Broström procedures under all-inside arthroscopic can make ankle stability and improve ankle function in the treatment of CLRAI. However, the former maybe shorten the time to return to exercise and achieve higher motor function.

Efficacy of rTMS combined with cognitive training in TBI with cognition disorder: a systematic review and meta-analysis.

Post-traumatic brain injury cognitive disorder(PTBICD) is one of the common symptoms of TBI survivors, severely limiting their life and rehabilitation progress. Repetitive transcranial magnetic stimulation (rTMS) has been shown to modulate cognition in a non-invasive manner while there are inconsistencies in previous studies. A comprehensive systematic review of rTMS treatment in patients with PTBICD is warranted. To evaluate the efficacy and safety of rTMS + cognitive training(CT) in enhancing cognitive function among PTBICD patients. A comprehensive search was conducted in PubMed, EMBASE, Cochrane Library, WOS, CNKI, Wan Fang, VIP and CBM, to identify relevant randomized controlled trials(RCTs) published before December 20, 2023. The primary outcomes measured changes in global cognitive scales, while the secondary outcomes focused on improvements in attention, memory, event-related potentials, and activities of daily living. Meta-analysis of data was carried out using Stata 14.0. Fourteen studies including 820 PTBICD patients were included. The results showed that rTMS + CT significantly improved MoCA[WMD = 3.47, 95%CI (2.56, 4.38)], MMSE[WMD = 3.79, 95%CI (2.23, 5.35)], RBMT[WMD = 1.53, 95%CI (0.19, 2.87)], LOTCA[WMD = 5.68, 95%CI (3.11, 8.24)], and promoted MBI[WMD = 7.41, 95%CI (5.90, 8.92)] as well as reduced correlated potential P300 latency[WMD = -20.77, 95%CI (-38.08, -3.45)] and amplitude[WMD = 0.81, 95%CI (0.57, 1.06)] in PTBICD compared to sham rTMS or CT, while adverse reaction ratio was higher than that of control group [RR = 1.67, 95%CI (1.00, 2.77)]. The results demonstrated that rTMS + CT can improve the cognitive function, mental state and daily activity ability of PTBICD patients. Systematic Review Registration: [PROSPERO], identifier [No. CRD42024520596].

Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study

BackgroundThe oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs).MethodsThe OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT).ResultsThe oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0–3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP.ConclusionsThis study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents.Trial registrationChiCTR2000035236 (registration date: 04/08/2020).

Meta-analysis of stereotactic hematoma removal and craniotomy hematoma removal in the treatment of hypertensive intracerebral hemorrhage in the elderly.

A large number of clinical studies suggested that surgery might be a better choice than conservative treatment for treating hypertensive intracerebral hemorrhage in the middle-aged and elderly. Stereotactic puncture can reduce the mass effect caused by hematoma, reduce the intervention of body homeostasis, reduce brain tissue damage, and improve the prognosis of patients with cerebral hemorrhage. This meta-analysis aims to evaluate the efficacy of stereotactic puncture and craniotomy in elderly patients with hypertensive intracerebral hemorrhage. A search strategy was designed to search in databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, CNKI, Wanfang database and relevant references. Literature on the efficacy and safety of different surgical methods for hypertensive cerebral hemorrhage in the middle-aged and elderly were retrieved. The search time was until August 17, 2022. Keywords included "hypertensive intracerebral hemorrhage," "stereotactic hematoma removal," "craniotomy." After the literature search, 2 researchers independently conducted literature screening, quality evaluation of included trials and data extraction. RevMan5.4 software was used to perform a Meta-analysis on the operation time, hospital stay, postoperative Glasgow Coma Scale (GCS) score, postoperative daily activity ability, postoperative complications and neurological prognosis scores included in the included studies. A total of 1988 samples were included in 9 studies. 1022 patients underwent stereotactic hematoma removal, and 968 patients underwent craniotomy hematoma removal. The orientation group had more advantages in the length of hospital stay, postoperative disability, pulmonary infection, intracranial infection and digestive tract ulcer, and the difference was statistically significant (P < .05). In addition, the length of stay (I²= 83%) of the included articles had good homogeneity (I²< 50%), and there was no significant difference between the 2 groups in operation time, postoperative GCS score, postoperative daily activity ability, and neurological prognosis score (P > .05). The meta-analysis indicate that compared to craniotomy for hematoma removal, stereotactic hematoma removal can reduce the postoperative disability rate, intracranial infection rate, lung infection rate, and digestive tract ulcer rate in middle-aged and elderly patients with hypertensive intracerebral hemorrhage.

Impact of Syndesmotic Screw Removal on Quality of Life, Mobility, and Daily Living Activities in Patients Post Distal Tibiofibular Diastasis Repair.

Background and Objectives: While numerous studies have been conducted on syndesmotic screw management following distal tibiofibular diastasis repair, a clear consensus remains unclear. This research aims to evaluate whether the postoperative removal of syndesmotic screws leads to improved patient outcomes, specifically in quality of life, mobility, and daily living activities, and whether it offers a cost-effective solution. Materials and Methods: Patients with a history of unimalleolar or bimalleolar ankle fractures, classified according to the Danis-Weber and Lauge-Hansen systems, were included. Comprehensive evaluations were made via standardized questionnaires like the SF-36 Health Survey, HADS, and WHOQOL-BREF, distributed approximately 2 months post surgery. A total of 93 patients underwent syndesmotic screw removal while 51 retained the screws (conservative approach). Results: Patients who underwent screw removal reported superior satisfaction in mobility, with a score of 7.8, compared to 6.7 in the conservative approach (p = 0.018). Similarly, their ability to perform daily activities scored 8.1, higher than the 6.5 from the conservative cohort (p < 0.001). Pain levels were also more favorable in the screw removal group, with a score of 5.3 against 6.8 in the conservative group (p = 0.003). On the SF-36 physical domain, the screw removal group achieved a mean score of 55.9 versus 53.3 for the conservative group (p = 0.027). Notably, the HADS anxiety subscale highlighted reduced anxiety levels in the screw removal cohort with a mean score of 5.8 against 7.3 in the conservative group (p = 0.006). However, overall quality of life and recommendations to others showed no significant difference between the groups. Conclusions: Syndesmotic screw removal postoperatively leads to marked improvements in patients' mobility, daily activity abilities, and reduced postoperative pain and anxiety levels. However, overall quality of life was similar between the two approaches. The findings offer valuable insights for orthopedic decision making and patient-centered care concerning the management of syndesmotic screws after distal tibiofibular diastasis repair.

Adaptation and psychometric testing of the Turkish evaluation of daily activity questionnaire in people with rheumatoid arthritis

Purpose The aims were to translate the Evaluation of Daily Activity Questionnaire (EDAQ) into Turkish, then test validity and reliability in people with rheumatoid arthritis (RA) in Turkey. Material and Methods Phase 1: The EDAQ was forward and backward translated, culturally adapted following cognitive debriefing interviews with participants with RA (n = 10) and finalized by an expert committee. Phase 2: Participants (n = 215) completed a questionnaire including the EDAQ, Health Assessment Questionnaire (HAQ), and Short-Form 36 v1 (SF-36v1). Two weeks later, the EDAQ was again completed for test–retest reliability (n = 82:38%). Internal construct validity was assessed using Rasch analysis. Internal consistency, concurrent validity, and test–retest reliability were assessed. Results Following cultural adaptation, one item was removed, and examples increased or changed. Cronbach’s α values were 0.71 − 0.93 for all EDAQ domains, that is, acceptable to good. The EDAQ met Rasch model requirements for fit (excellent construct validity: p > 0.05). Concurrent validity was moderate to strong for most EDAQ domains with HAQ (rs 0.49–0.81) and SF-36-v1 Physical Function (rs 0.42–0.70). There was excellent test–retest reliability for all domains (ICC (2,1): 0.95–1.00). Conclusion The Turkish EDAQ is a valid, reliable measure of daily activity ability for use in practice and research with Turkish speakers with RA.

Effects of vestibular rehabilitation training combined with anti-vertigo drugs on vertigo and balance function in patients with vestibular neuronitis: a systematic review and meta-analysis.

To investigate the effects of vestibular rehabilitation training (VRT) combined with anti-vertigo drugs on vertigo and balance function in patients with vestibular neuronitis (VN). PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, Wan Fang Data, VIP, and CBM were searched until July 13, 2023. Patients with vestibular neuronitis participated in the study. Twenty one studies including 1,415 patients were included in this review for meta-analysis. According to the Physiotherapy Evidence Database (PEDro) quality assessment, four studies received high quality (≥seven scores) and 17 studies received moderate quality (six scores). The meta-analysis showed that VRT combined with anti-vertigo drugs significantly reduced the Dizziness Handicap Inventory (DHI) score, the Vestibular Disorders Activities of Daily Living Scale (VADL) score and the Canal Paresis (CP) score, and improved the overall efficiency and the Berg Balance Scale (BBS) score, promoting vestibular evoked myogenic potentials (VEMPs) returned to normal in VN compared to simple anti-vertigo drugs or VRT alone. The results of this meta-analysis demonstrate the efficacy and safety of VRT combined with anti-vertigo drugs in patients with VN. Combined therapy can alleviate vestibular dysfunction such as vertigo and vomiting in patients, improve daily activity ability and balance ability, in addition to VRT has fewer adverse reactions, so it is extremely safe. However, there are shortcomings such as lack of long-term follow-up and different frequency and duration of treatment. Therefore, future randomized controlled trials (RCTs) with larger sample sizes and longer-term observations are needed to verify the effectiveness of VRT in combination with anti-vertigo drugs for VN.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/.

Self-efficacy, resilience and healthy ageing among older people who have an acute hospital admission: A cross-sectional study.

To examine the associations between self-efficacy, resilience and healthy ageing among older people who have an acute hospital admission. A cross-sectional study. Survey and medical record data were collected from older people on discharge from hospital. The survey measured self-efficacy with the 6-item General Self-Efficacy scale (GSE-6), resilience with the Brief Resilience Scale (BRS), and healthy ageing with the Selfie Ageing Index (SAI). Medical record data included potential confounders: co-morbidities, frailty items, previous falls and previous admission in the last 28 days. Multi-linear regression and Spearman's rank correlation coefficient were used to examine the independent associations between self-efficacy, resilience and healthy ageing. Responses were received from 143 older people (mean age 79). After adjusting for potential confounders, co-morbidities (ß = -0.08, p = 0.001) remained negatively associated with healthy ageing, while self-efficacy (ß = 0.03, p = 0.005) and resilience (ß = 0.05, p < 0.001) remained positively associated with healthy ageing (R2 = 0.243). Positive correlations were found between self-efficacy (ρ = 0.33, p < 0.01), resilience (ρ = 0.38, p < 0.001) and healthy ageing. Positive correlations were also found between self-efficacy and resilience (ρ = 0.38, p < 0.01). Those with lower self-efficacy and resilience were more likely to report reduced activities of daily living, mobility, physical activity and mood. Findings indicate that while the number of co-morbidities have negative consequences for healthy ageing among older people who are hospitalised, the promotion of self-efficacy and resilience can potentially contribute to healthy ageing within the physical and psychological domains. Nurses can promote self-efficacy, which can potentially increase resilience and help to improve self-management of chronic conditions, functional ability in daily activities, mobility and physical activity and reduce both anxiety and depressive symptoms. Participant feedback throughout the data collection process assisted in the evaluation of study methods and data interpretation. This included processes such as assessing selected tools and clarifying the meanings of healthy ageing factors.

Stable Walking Feedback Control for a Self-Balanced Lower Limb Exoskeleton for Paraplegics

Self-Balanced lower limb exoskeleton (SBLLE) is designed for rehabilitation and walking assistance for dyskinesia persons with spinal or lower limb muscle injury to regain the locomotion ability in daily activities. In this paper, an innovative feedback control strategy for a fully actuated SBLLE is presented, which helps users to walk stably without crutches or other assistive devices. Exoskeleton is approximated as a simplified center of mass (CoM) model. Based on this simplified dynamic model, the trajectory generation and walking feedback control strategy, which enhances the locomotion stability, is introduced. The proposed strategy is implemented on our exoskeleton, AutoLEE-II, and its stability and dynamic performance are demonstrated in the stable walking simulations and experiments for exoskeleton with a female subject.

Spatial variations and influencing factors of Cumulative Health Deficit Index of elderly in China

BackgroundWith the acceleration of aging and urbanization, how to make cities more age-friendly has become a hot topic. During the long-term demographic transition, the health of the elderly has become an important consideration in urban planning and management. The health of the elderly is a complex issue. However, previous studies have mainly focused on the health defects related to disease incidence, loss of function, mortality, etc., yet a comprehensive evaluation of health status is lacking. The Cumulative Health Deficit Index (CHDI) is a composite index that combines psychological and physiological indicators. Health deficits can reduce the quality of life of the elderly and increase the burden on families, cities and even society, so it is indispensable to understand the individual factors and regional factors that affect CHDI. The research on the spatial differentiation of CHDI and its driving factors can provide scientific geographic information basis for the construction of age-friendly cities and healthy city planning. It also has great significance in narrowing the differences in the health status among regions and reducing the overall burden of the country.MethodsThis research analyzed a nationwide dataset, the China Longitudinal Aging Social Survey in 2018 conducted by the Renmin University of China, which contained 11,418 elderly aged 60 years and older from 28 provinces/municipalities/autonomous regions that represent 95% of the population in mainland China. The Cumulative Health Deficit Index (CHDI) was the first time constructed using the entropy-TOPSIS method to evaluate the health status of the elderly. Entropy-TOPSIS is to quantify the importance of each indicator by calculating the entropy value to improve the reliability and accuracy of the results and avoid the influence of previous researchers’ subjective assignments and model assumptions on the results. The selected variables include physical health 27 indicators (self-rated health, basic mobility assessment, daily activity ability, disease and treatment) and mental health 36 indicators (cognitive ability, depression and loneliness, social adjustment, and filial piety concept). The research used the Geodetector methods (factor detection and interaction detection) that combined individual and regional indicators to analyze the spatial variation characters and reveal the driving factors of CHDI.ResultsThe weight of mental health indicators (75.73) is three times that of physical health indicators (24.27), and its composition formula is: CHDI value = (14.77% disease and treatment + 5.54% daily activity ability + 2.14% health self-assessment + 1.81% basic mobility assessment) + (33.37% depression and loneliness + 25.21% cognitive ability + 12.46% social adjustment + 4.7% filial piety). Individual CHDI was more associated with age and was more evident in females than males. CHDI average values show the distribution trend of Hu Line (HL) in the geographic information graph that the CHDI in West HL regions are lower than in the East HL regions. The highest CHDI cities are in Shanxi, Jiangsu, and Hubei, whereas the lowest CHDI cities are Inner Mongolia, Hunan and Anhui. The geographical distribution maps of the 5-levels of CHDI levels show very different CHDI classification levels among the elderly in the same region. Further, the top three influential factors are personal income, empty nest, aged 80+, and regional factors also obviously affect CHDI values, such as the proportion participating in insurance, population density, and GDP. The two different factors in individual and regional factors all show a two-factor interaction effect, and enhancement or nonlinear enhancement. The top three ranks are personal income ∩ quality of air (0.94), personal income ∩ GDP (0.94), and personal income ∩ urbanization rate (0.87).ConclusionsCHDI is a subjective and objective comprehensive index, and mental indicators are primary factors. Thus attaching importance to the psychological care of the elderly is the key to building a healthy aging society. The large individual heterogeneity and spatial differentiation of CHDI in the elderly were demonstrated by map visualization. The analysis of the influencing factors of CHDI by the Geodetector method proves that spatial differentiation is mainly affected by individual economic and social security factors, but also by the interaction with regional factors such as quality of air, GDP, and urbanization rate. This research fills a gap in the elderly health status in the field of spatial geography. The results can provide empirical evidence for policymakers to take measures according to local conditions to improve the health status of the elderly according to regional differences in physical and mental conditions. It also plays a guiding role for the country in balancing regional economic development, promoting healthy and sustainable urban development, and creating age-friendly cities.

Pulsed Radiofrequency and Platelet Rich Plasma in Degenerative Joint Arthritis: Two Case Reports and Literature Analyses.

(1) Background: Osteoarthritis (OA) is a debilitating joint disease. The are several therapies available for OA. According to current knowledge, the combination of Platelet-Rich Plasma (PRP) and Pulsed Radiofrequency (PRF) can be applied in the treatment of pain of nociceptive origin due to peripheral tissue damage. (2) Methods: We performed a narrative review identifying the articles by searching electronic databases. A retrospective analysis of patients with OA treated with PRF and PRP in "Vito Fazzi" Hospital (Lecce, Italy) was performed. (3) Results: A total of four publications on the use of PRP and PRF in degenerative joint arthritis were included in our review. In our experience, two patients with OA were treated with PRP and PRF after unsuccessful conservative treatment. Patient pain score, daily activity ability, active range of activity, and muscle strength improved after treatment. Patients reported a higher level of satisfaction. No major adverse events were reported. (4) Conclusions: The goal of the combined application of the two treatments is to make full use of the analgesic effect of PRF and the repairing effect of PRP. At present, the therapeutic potential of PRP and PRF in OA remains unmet.

Estimating bidirectional transition and post‐reversion of mild cognitive impairment

AbstractBackgroundThe natural trajectory of reversion from MCI to normal cognition (NC) and the cognitive pattern post‐reversion have been poorly explored in the existing literature. The main goals of this study were as follows: (1) to quantitatively predict bidirectional transitions of MCI (reversion to NC and progression to dementia); (2) to explore patterns of future cognitive changes post‐reversion; and (3) to estimate the effects of selected covariates on transition probabilities in the course of cognitive loss.MethodThe National Alzheimer’s Coordinating Center database was funded by a National Institute on Aging/National Institutes of Health grant (U24 AG072122). Data for this study comprised 24,220 observations from 6,651 participants with an MCI diagnosis at study entry during at least two visits between June 2005 and February 2021. Defining NC and MCI as transient states and dementia as an absorbing state, we explored the fate of MCI and future cognitive changes post‐reversion using the continuous‐time, multi‐state Markov model, which provides information on the transition probability between multiple states, hazard ratio, mean sojourn time, and total length of stay over 15 years.ResultTransition intensity of re‐progression to MCI for post‐reversion was 0.3168, 2.48 times greater than the progression from MCI to dementia or reversion from MCI to NC. For the post‐reversion participants, the chance of progressing to dementia increased by 2% per year. participants who re‐progressed to MCI had an approximately 40% probability of reversing to NC again over the 15‐year period. participants stayed in the post‐reversion NC state for 3.2667 years (range 2.9349–3.6360) and in the MCI state for 1.7605 years (range 1.5134–2.0480) before progressing to dementia. Age, cognitive function, daily activity ability, and depressive symptoms were significant predictors of progression to dementia.ConclusionThere were distinct transition dynamics between amnesic MCI (aMCI) and nonamnesic (naMCI). The post‐reversion participants remained at increased risk of re‐progression to MCI or progression to dementia in the long term. Findings in this study can serve as valuable references for relevant research and healthcare professionals to help understand the natural history of cognitive loss and create proactive plans and targeted interventions.

Transcranial Direct Current Stimulation for Global Cognitive Functioning and Ability in Daily Life Activities in Poststroke Cognitive Impairment: A Systematic Review and Meta-analysis.

The aim of the study is to determine the efficacy of transcranial direct current stimulation on global cognition and ability in daily life activities of patients with poststroke cognitive impairment. Nine electronic databases were searched from their respective inceptions through January 2022. We included the randomized controlled trials that used transcranial direct current stimulation for poststroke cognitive impairment and included at least one global cognitive function or ability in daily life activities outcome indicators. Two reviewers appraised the risks of bias through the Cochrane Collaboration's tool and performed the meta-analysis. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Twenty-two studies (1198 participants) were included. Most studies had no significant bias in the quality of the methodology. Meta-analyses found that compared with the control group, transcranial direct current stimulation increased Montreal cognitive assessment, Mini-mental state examination, Loewenstein occupational therapy cognitive assessment, total effective rate of cognition, modified Barthel Index, and decreased P300 latency (all P < 0.05). These results showed transcranial direct current stimulation can improve cognitive function and ability in daily life activities in poststroke cognitive impairment. The transcranial direct current stimulation may have a significant rehabilitation effect on global cognitive functioning and ability in daily life activities of patients with poststroke cognitive impairment.

A network analysis of anxiety and depression symptoms in Chinese disabled elderly

BackgroundMental health is an essential dimension of healthy aging. The number and severity of disabled elderly in China show an increasing tendency year by year. Due to their impaired ability of daily activities, reduced social participation and reduced self-care ability, they are more prone to depression and anxiety. MethodWe included 2131 individuals aged 65 and older from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017–2018). We used the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the Generalized Anxiety Disorder scale-7 (GAD-7) to assess depression and anxiety, respectively. The structure of depressive and anxiety symptoms was characterized using “Expected Influence” and “Bridge Expected Influence” as centrality indices in the symptom network. Network stability was tested using a case-dropping bootstrap procedure. Finally, a Network Comparison Test (NCT) was conducted to examine whether network characteristics differed by gender. ResultsNetwork analysis revealed that nodes CESD3 (Felt sadness), GAD2 (Uncontrollable worry), and GAD4 (Trouble relaxing) were the primary symptoms of the anxiety-depression network. Anxiety and depression were united by the symptoms of CESD9 (Could not get going), GAD1 (Nervousness or anxiety), CESD10 (Sleep quality), and GAD4 (Trouble relaxing). Additionally, Gender did not significantly affect the network structure. ConclusionCentral symptoms (e.g., felt sadness, uncontrollable worry and trouble relaxing) and key bridge symptoms (e.g., could not get going, nervousness and anxiety) in the depressive and anxiety symptoms network may be used as potential targets for intervention among disabled elderly who is at risk for or suffer from depressive and anxiety symptoms.

Anxiety subtypes in rural ischaemic stroke survivors: A latent profile analysis.

To determine the potential profile classes of anxiety reported by ischaemic stroke survivors in rural China, and to explore the characteristics of patients having different types of post-stroke anxiety. A cross-sectional survey. A cross-sectional survey was conducted by using convenience sampling to collect data from 661 ischaemic stroke survivors in rural Anyang city, Henan Province, China, from July 2021 to September 2021. The parameters included in the study were the socio-demographic characteristics, self-rating anxiety scale (SAS), self-rating depression scale (SDS) and the Barthel index of daily activity ability. Potential profile analysis was done to recognize subgroups of post-stroke anxiety. The Chi-square test was performed to explore the characteristics of individuals with different types of post-stroke anxiety. The model fitting indices of stroke survivors supported three classes of anxiety models which were as follows: (a) Class 1, low-level, stable group (65.3%, N=431); (b) Class 2, moderate-level, unstable group (17.9%, N=118) and (c) Class 3, high-level, stable group (16.9%, N=112). The risk factors associated with post-stroke anxiety were female patients, lower levels of education, living alone, lower monthly household income, other chronic diseases, impaired daily activity ability and depression. This study identified three different subgroups of post-ischaemic stroke anxiety and their characteristics in patients in rural China. This study has significance in providing evidence for the development of targeted intervention measures to reduce negative emotions in different subgroups of post-stroke anxiety patients. In this study, the researchers arranged the time of questionnaire collection with the village committee in advance, gathered the patients to the village committee for face-to-face questionnaire survey and collected the household data of the patients with mobility difficulties.

The association between sense of coherence and health outcomes among community-dwelling older adults: a systematic review

Abstract Objective: The objective of this study was to systematically review evidence of the association between the sense of coherence (SOC) and health outcomes in community-dwelling older adults. Methods: Six databases, including PubMed, Web of Sciences, Scopus, CINAHL Plus with full text (EBSCO), OVID, and the Cochrane Library, were thoroughly searched. The checklist developed by the Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used to assess the quality of the relevant studies. Results: Twenty-nine studies were included in this review. Generally, higher SOC levels are associated with better physical health (less symptom reporting, better functional status, less disability, better daily activity ability, less pain, better sleep quality, and better oral health) and better psychological health (less perceived stress, more positive self-perception of aging, less depression, and less posttraumatic stress reaction) in older adults. Higher SOC levels are also correlated with greater preventive/self-management behaviors ability, subjective well-being, adjustment to aging later in life, cumulative survival, quality of life, life satisfaction, and self-perceived health. Higher SOC levels are a vital mediators or moderators of health in older adults. Conclusions: The SOC is a protective factor for the health of community-dwelling older adults. Interventions targeting improvement in SOC levels should be developed and implemented to facilitate active aging in older adults.

Quality of life of patients with primary open-angle glaucoma, primary angle closure glaucoma, and pseudoexfoliation glaucoma in Central Serbia

Background/Aim. Impaired vision resulting from glaucoma can have deleterious effects on both physical and mental health. This study aims to examine the adverse im-pacts of primary open-angle glaucoma (POAG), primary angle closure glaucoma (PACG), and pseudoexfoliation glaucoma (PEG) on the quality of life (QoL) in Central Serbia. Methods. This research, designed as a cross-sectional study, included 102 patients treated for POAG, PACG, or PEG. The patients were divided into three groups (POAG, PACG, and PEG) based on the type of glaucoma they suffered from and were monitored for six months. The data on the QoL were obtained with the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Using the appropriate algorithm, the total NEI VFQ-25 scores were calculated for each group. Results. The questionnaire showed that scores for general vision were significantly lower in the PEG group than in the other two groups (PEG: 61.1 ? 12.6; POAG: 71.6 ? 17.9; PACG: 75.7 ? 11.6), p &lt; 0.001. General health, eye pain, distance vision, social functioning, peripheral vision, reduced ability in daily activities, and dependence on others were also statistically significantly lower in the PEG group. The highest value of near vision was recorded for the POAG group (76.2 ? 21.2). The highest mean value in glaucomatous visual field defect was recorded in the PEG group (14.5 ? 3.6 dB). Conclusion. This research has demonstrated that the QoL is significantly lower in patients suffering from PEG compared to those suffering from POAG and PACG. Concerning the general health of patients, eye pain, distance vision, as well as the domain of social and everyday functioning, the lowest scores for individual areas of examination according to the NEI VFQ-25 were recorded in PEG patients. The results indicate that serious measures should be taken in order to improve the QoL of glaucoma patients.

Description of the Independency of the Elderly in Fulfilling Daily Living (ADL) Activities at the Cinta Kasih Tzu Chi Cengkareng Flat

Elderly people (elderly) experience a decrease in physical condition which affects the decline in activity, health and independency. Objective of this study to see an overview of the level of independency of the elderly in fulfilling the ability of daily activities (ADL). The research was conducted on the elderly at Tzu Chi Cengkareng Flat, West Jakarta during January-March 2022 with a survey method research design with a cross-sectional approach to 103 elderly people. Collecting data by direct interviews. Descriptive analysis to explain the characteristics of the independency of the elderly. The elderly in the Cengkareng Tzu Chi Love Flat are aged between 60-74 years, 97 people (94.2%), more than 75 years, 6 people (5.8%), female, 57 (55.3%) more than men. 46 (44.7%), more did not work 70 (68.0%) than those who worked 33 (32.0%) and had comorbidities, 62 people (60.2%) were elderly who had comorbidities. Of the 103 elderly, 101 (98.1%) had high independency and 2 (1.9%) had low independency. Conclusion the elderly in the Tzu Chi Love Flat, are able to meet their daily needs without the help of other family members, more than 50% of the elderly are categorized as having high independency.

Health shocks, basic medical insurance and common prosperity: Based on the analysis of rural middle-aged and elderly groups.

Health is a major part of human welfare. The index system of common prosperity was constructed for middle-aged and elderly people in rural areas. Besides, the impart of health shocks and rural basic medical insurance on common prosperity was explored. The data for this study came from China Health and Retirement Longitudinal Survey (CHARLS) in 2013, 2015, and 2018. The finding shows that health shocks hindered the improvement of the common prosperity of the middle-aged and elderly in rural areas, among which daily activities produced the greatest negative effect. The heterogeneity analysis shows that health shocks have a stronger negative effect on the common prosperity of low-income groups than that of high-income ones. The shock of daily activity ability has the greatest influence on the middle-aged and elderly between 45 and 55 years old. However, acute health shocks have a strong negative effect on those aged above 56. The mechanism analysis shows that rural basic medical insurance can alleviate the health shocks to middle-aged and elderly people, but the effect is limited. In general, low-income groups benefit more. Therefore, China should speed up the promotion of the Healthy China Strategy and the reform of the rural basic medical insurance system, and prompt changes from an inclusive to a targeted policy to provide more precise safeguards for vulnerable groups.