Decline In Functional Ability Research Articles

Sarcopenia adversely impacts clinical outcomes in patients undergoing pancreaticoduodenectomy: A systematic review and meta-analysis.

Sarcopenia is a syndrome marked by a gradual and widespread reduction in skeletal muscle mass and strength, as well as a decline in functional ability, which is associated with malnutrition, hormonal changes, chronic inflammation, disturbance of intestinal flora, and exercise quality. Pancreatoduodenectomy is a commonly employed clinical intervention for conditions such as pancreatic head cancer, ampulla of Vater cancer, and cholangiocarcinoma, among others, with a notably high rate of postoperative complications. Sarcopenia is frequent in patients undergoing pancreatoduodenectomy. However, data regarding the effects of sarcopenia in patients undergoing pancreaticoduodenectomy (PD) are both limited and inconsistent. To assess the influence of sarcopenia on outcomes in patients undergoing PD. The PubMed, Cochrane Library, Web of Science, and Embase databases were screened for studies published from the time of database inception to June 2023 that described the effects of sarcopenia on the outcomes and complications of PD. Two researchers independently assessed the quality of the data extracted from the studies that met the inclusion criteria. Meta-analysis using RevMan 5.3.5 and Stata 14.0 software was conducted. Forest and funnel plots were used, respectively, to demonstrate the outcomes of the sarcopenia group vs the non-sarcopenia group after PD and to evaluate potential publication bias. Sixteen studies encompassing 2381 patients were included in the meta-analysis. The patients in the sarcopenia group (n = 833) had higher overall postoperative complication rates [odds ratio (OR) = 3.42, 95% confidence interval (CI): 1.95-5.99, P < 0.0001], higher Clavien-Dindo class ≥ III major complication rates (OR = 1.41, 95%CI: 1.04-1.90, P = 0.03), higher bacteremia rates (OR = 4.46, 95%CI: 1.42-13.98, P = 0.01), higher pneumonia rates (OR = 2.10, 95%CI: 1.34-3.27, P = 0.001), higher pancreatic fistula rates (OR = 1.42, 95%CI: 1.12-1.79, P = 0.003), longer hospital stays (OR = 2.86, 95%CI: 0.44-5.28, P = 0.02), higher mortality rates (OR = 3.17, 95%CI: 1.55-6.50, P = 0.002), and worse overall survival (hazard ratio = 2.81, 95%CI: 1.45-5.45, P = 0.002) than those in the non-sarcopenia group (n = 1548). However, no significant inter-group differences were observed regarding wound infections, urinary tract infections, biliary fistulas, or postoperative digestive bleeding. Sarcopenia is a common comorbidity in patients undergoing PD. Patients with preoperative sarcopenia have increased rates of complications and mortality, in addition to a poorer overall survival rate and longer hospital stays after PD.

De-escalation of Disease-Modifying Therapy for People with Multiple Sclerosis Due to Safety Considerations: Characterizing 1-Year Outcomes in 25 People Who Switched from Ocrelizumab to Diroximel Fumarate.

Switching disease-modifying therapy (DMT) may be considered for relapsing-remitting multiple sclerosis (RRMS) if a patient's current therapy is no longer optimal. This was particularly important during the recent COVID-19 pandemic because of considerations around immune deficiency and impaired vaccine response associated with Bcell-depleting DMTs. This real-world, single-center study aimed to evaluate change or decline in functional ability and overall disease stability in people with RRMS who were switched from Bcell-depleting ocrelizumab (OCRE) to diroximel fumarate (DRF) because of safety concern related to the COVID-19 pandemic. Adults with RRMS were included if they had been clinically stable for ≥ 1year on OCRE. Data collected at baseline and 1year post switch included relapse rate, magnetic resonance imaging (MRI), blood work for assessment of peripheral immune parameters, the Cognitive Assessment Battery (CAB), optical coherence tomography (OCT), and patient-reported outcomes (PROs). Participants (N = 25) had a mean (SD) age of 52 (9) years, and a mean (SD) duration of 26 (8) months' treatment with OCRE before the switch to DRF. Median washout duration since the last OCRE infusion was 7months (range 4-18months). No participants relapsed on DRF during follow-up, and all remained persistent on DRF after 1year. There were no significant changes in peripheral immune parameters, other than an increase in the percentage of CD19+ cells 1year after switching (p < 0.05). Similarly, there were no significant changes in CAB, OCT, and PROs. These preliminary findings suggest that transition to DRF from OCRE may be an effective treatment option for people with RRMS who are clinically stable but may need to switch for reasons unrelated to effectiveness. Longer follow-up times on larger samples are needed to confirm these observations.

Does Social Support Moderate the Relationship Between Frailty and Functional Ability Trajectory Among Community-Dwelling Older Adults?

Functional ability is the important prerequisite to live independently and achieve aging in place, which depends on the complex interaction of intrinsic and extrinsic factors. Identifying the trends and influencing factors of functional ability would contribute to the accurate assessment and intervention of geriatric health. This study aimed to disentangle the moderating effect of 3 types of social support, namely objective support, subjective support, and support utilization, on the relationship between frailty and functional ability trajectories. This was a secondary analysis using data from a prospective 3-wave study with a sample of 777 Chinese community-dwelling older adults. Social support was assessed using the Social Support Rating scale. Frailty was assessed using the FRAIL scale. Functional ability was measured by the Lawton Instrumental Activities of Daily Living scale. Latent growth curve models were implemented to test their relationships. Objective support but not subjective support or support utilization moderated on the relationship between frailty and functional ability slope. Functional ability decline over time was buffered by objective support among robust individuals but exacerbated among (pre)frail individuals. The moderating effect of social support on the relationship between frailty and functional ability trajectory varies by support types, which reminded that social support may be a promising intervention target to maintain functional independence for frail individuals, opening up a new perspective on social support in the field of disability prevention. Effective interventions should particularly address objective support in conjunction with empowering the frail older population to optimize the trajectory of functional ability.

Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis.

Major Depressive Disorder is a long-term, recurring, and very common illness that is associated with a significant decline in functional ability. The gold-standard method of treating depression is pharmacotherapy, which involves the use of antidepressant medications either alone or in various combinations. However, approximately 30% of Major Depressive Disorder patients suffer from Treatment Resistant Depression, a more severe condition that has a profound impact on patients' lives. Our study aims to conduct the first comprehensive review and meta-analysis to assess the effectiveness and safety of adding Dialectical Behavior Therapy to antidepressant medications compared to groups using pharmacotherapy alone as an intervention for adults with Treatment Resistant Depression. We will search for publications in the following databases: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Lilacs, Web of Science, and PsycINFO. We will manually review the reference lists of the included studies to identify potentially relevant studies. There will be no restrictions on the language or publication date. Quality assessment of the included studies will be performed independently according to the Cochrane Risk of Bias instrument. To assess the certainty of the findings' body of evidence, we will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. This study aims to determine the effectiveness and safety of Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults. Ethical approval was not required as individual patient data was not obtained. Our intention is to publish the systematic review in a medical journal that offers open access upon completion of the process. PROSPERO registration number CRD42023406301. Registered on March 24, 2023.

Changes in Combined Lifestyle Risks and the Transition of Activities of Daily Living in the Elderly Population of Taiwan: Evidence from the Taiwan Longitudinal Study on Aging.

Functional ability decline occurs with age. This study aims to investigate the associations between the lifestyle factors-exercising, food consumption, and smoking-and the functional ability of the activities of daily living (ADL) by gender. The data were obtained from the Taiwan longitudinal study on aging, a national cohort study. The cross-sectional results demonstrated that the frequency of exercising was negatively associated with ADL in both men and women. Dairy products were positively associated with ADL in men. The longitudinal results illustrated that current and consistent exercising were negatively associated with changes in ADL scores over 4- and 8-year periods in both men and women. Seafood consumption was negatively associated with changes in the subsequent 4-year ADL scores. Past smoking was positively associated with changes in subsequent 4-year ADL scores in men, while current smoking was positively associated with changes in subsequent 8-year ADL scores in women. Therefore, consistent exercising, food consumption, and smoking were associated with ADL functional ability in elderly people, and the associations differed by gender. Elders exercising consistently had good ADL performance and maintained their ADL ability better, especially women. Seafood consumption decreased the risk of ADL decline, while smoking increased the risk of ADL decline.

Functional dependency among elderly population in a rural area of Ernakulam district, Kerala, India

Background: Elderly populations with co-morbidities and sensory impairments are more likely to be functionally dependent on their activities of daily living. Objectives of the study were to determine functional dependency among the elderly population residing in a rural area of Ernakulam district, and also to determine the factors associated with functional dependency in the study population. Methods: A community-based cross-sectional study was conducted among 200 elderly people from rural area of Ernakulam district, Kerala. A non-probability convenient sampling method was used for the study participants. A semi-structured questionnaire was used to collect information about the socio-demographic questions, medical history and history of comorbidities. Barthel’s scale assessed activities of daily living and independent activities of daily living were assessed by Lawton’s scale. The statistical test was done using statistical package for the social sciences (SPSS) version 21 and a chi-square test of significance was used to find the association of various factors with functional dependency. Results: In Barthel’s scale using ADL score, fully dependent was found to be 2.5%. In the IADL score using Lawton’s scale fully dependent was found to be 0.5% among the study participants. Among the study participants, 57.9% of females and 42.1% of males have a visual impairment, 60% of females and 40% of males have a hearing impairment, 45.5% of females and 54.5% of males have a cognitive impairment. Conclusions: Comorbidities such as diabetes mellitus, cardiovascular diseases, osteoporosis, osteoarthritis, and cognitive impairment contribute to a decline in functional abilities among older adults.

UNDERSTANDING THE LONG-TERM EFFECTS OF PUBLIC OPEN SPACE ON OLDER ADULTS’ FUNCTIONAL ABILITY AND MENTAL HEALTH

Abstract Little is known about how public open space (POS) environment quality and vitality influence older adults’ functional ability and mental health over time. POS vitality refers to the capacity of POS to accommodate a variety of users and activities. We undertook a four-year longitudinal survey of 2081 older adults in Hong Kong to investigate longitudinal relationships between POS environment quality, POS vitality, functional ability and mental health. We applied environment quality evaluation and space use behavior observation to collect data on the environment quality and vitality of POSs within the 200-m buffer area of participants’ residences. POS environment quality attributes included the number of leisure facility types, accessibility, shade, and bench quality. POS vitality attributes comprised the diversity of users and activities. We used the Chinese Lawton Instrumental Activities of Daily Living Scale to measure older adults’ functional ability and the Geriatric Depression Scale (15-item) to evaluate mental health. We applied latent growth curve models to analyze the longitudinal associations. Accessibility to POS and social interactions among users in POS were related to better functional ability and mental health among older adults at baseline. The number of leisure facility types, and social interactions among users in POS led to a slower decline in functional ability over time. However, there were no significant associations between POS and mental health over time. These findings have theoretical implications for the healthy aging research framework and practical insights for planning policies using POS as an intervention tool to facilitate older adults’ healthy aging.

Specific neuropsychiatric symptoms are associated with functional decline trajectories in Alzheimer's disease and Lewy body dementia: a five-year follow-up study.

Neuropsychiatric symptoms (NPS) are often overlooked and under-identified symptoms associated with dementia, despite their significant impact on the prognosis of individuals living with the disease. The specific role of certain NPS in functional prognosis remains unclear. To determine the association of different NPS with functional decline in people living with Alzheimer's disease (AD) or Lewy body dementia (LBD). This is an analysis of data from the Dementia Study of Western Norway (DemVest) with 196 patients included of which 111 had AD and 85 LBD. The Neuropsychiatric Inventory (NPI) and the Rapid Disability Rating Scale (RDRS-2) for activities of daily living were administered annually for 5 years. NPI total score and individual items with RDRS-2 trajectories were analyzed with linear mixed models. The LBD group exhibited higher levels of functional impairment and a greater burden of NPS at baseline. Over the 5-year follow-up, hallucinations, aggression, depression, anxiety, apathy, disinhibition, aberrant motor behavior, nighttime behavior disturbances, and abnormal eating patterns were significantly associated with the decline in functional abilities in individuals with AD, as well as irritability and aberrant motor behavior in those with LBD. These results highlight the relevance of early detection and intervention of these particularly relevant NPS, due to its potential of also impacting physical function. Better detection and management of these NPS could improve functional prognosis in people living with dementia. Specific NPS demonstrate relevant distinct associations with Longitudinal trajectories of functional decline in AD and LBD.

Apathy and Parkinson’s Disease Motor Phenotypes: A Preliminary Study (P6-11.014)

<h3>Objective:</h3> To investigate apathy characteristics across Parkinson’s Disease (PD) motor phenotypes using the Dimensional Apathy Scale (DAS). <h3>Background:</h3> Apathy is a common non-motor symptom of PD, characterized by decreased goal directed behavior. Apathy results in significant decline in functional abilities, caregiver burden, and increased costs of care. Motor phenotypes of PD are widely recognized (i.e., Postural Instability and Gait Difficulty [PIGD] and non-PIGD). It is unknown if distinct apathy profiles characterize motor PD phenotypes. DAS allows a multi-dimensional characterization of apathy (executive, emotional and cognitive/behavioral components) in addition to self-awareness. <h3>Design/Methods:</h3> Eighteen participants (9 women, mean age: 64.5±9.5 years) with PD were recruited at Baylor College of Medicine under an IRB approved protocol. Apathy was measured by the DAS (cut off = 28.5), completed by both, participants and caregivers. Participants were also assessed with the Movement Disorders Society’s-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and the Montreal Cognitive Assessment (MoCA). Analyses were performed for the whole cohort and clinical subgroups (PIGD and non-PIGD). Statistical analyses were done by GraphPad Prism version 9.0. <h3>Results:</h3> Seven participants were apathetic (PD-A) and 11 non-apathetic (PD-NA). There were no significant differences in age and MDS-UPDRS score between PD-A and PD-NA. The PD-A group had a significantly lower MoCA score (24.7±2.2 vs 27.4±2.5; p=0.03). In the whole cohort, there was a negative correlation between MoCA and total DAS score. DAS scores of participants and caregivers were correlated for the behavioral/cognitive and executive subscores but not for the emotional domain. Among those with PIGD-phenotype, 75% (3/4) had apathy versus 28.6% (4/14) among those with non-PIGD. <h3>Conclusions:</h3> The prevalence of apathy in the PIGD subtype was higher. Discrepancy of emotional DAS scores between participants and caregivers may suggest domain specific deficits on self-awareness. Future work in a larger population will focus on the characterization of apathy across PD subtypes. <b>Disclosure:</b> Mr. Lenka has nothing to disclose. Dr. Gazes has nothing to disclose. The institution of Dr. Vanegas-Arroyave has received research support from National Institutes of Health.

Understanding the long-term effects of public open space on older adults’ functional ability and mental health

Little is known about how public open space (POS) environment quality and vitality influence older adults' functional ability and mental health over time. POS vitality refers to the capacity of POS to accommodate a variety of users and activities. We undertook a four-year longitudinal survey of 2081 older adults in Hong Kong to investigate longitudinal relationships between POS environment quality, POS vitality, functional ability and mental health. We applied environment quality evaluation and space use behavior observation to collect data on the environment quality and vitality of POSs within the 200-m buffer area of participants' residences. POS environment quality attributes included the number of leisure facility types, accessibility, shade, and bench quality. POS vitality attributes comprised the diversity of users and activities. We used the Chinese Lawton Instrumental Activities of Daily Living Scale to measure older adults' functional ability and the Geriatric Depression Scale (15-item) to evaluate mental health. We applied latent growth curve models to analyze the longitudinal associations. Accessibility to POS and social interactions among users in POS were related to better functional ability and mental health among older adults at baseline. The number of leisure facility types, and social interactions among users in POS led to a slower decline in functional ability over time. However, there were no significant associations between POS and mental health over time. These findings have theoretical implications for the healthy aging research framework and practical insights for planning policies using POS as an intervention tool to facilitate older adults’ healthy aging.

How does social support interact with intrinsic capacity to affect the trajectory of functional ability among older adults? Findings of a population-based longitudinal study

BackgroundThe ecological model of health and ageing has proposed that functional ability (FA) is determined by the interaction between intrinsic capacity (IC) and environmental characteristics. This study empirically examined how social support, as an important social environmental resource, interacts with IC to affect FA trajectories among older adults. MethodsThis was a prospective three-wave cohort study with a sample of 775 community-dwelling older adults. Social support, IC and FA were assessed using the Social Support Rating Scale, the revised Integrated Care for Older People screening tool and the Lawton Instrumental Activities of Daily Living Scale, respectively. Latent growth curve models (LGCM) were implemented to test their relationships. ResultsFA significantly declined over 3 years, and the detrimental effect of impaired IC on the deterioration rate of FA was buffered by subjective support but was aggravated by support utilization and was not changed by objective support. FA decline among older adults with impaired IC was observed in those with low subjective support or with high support utilization but not in those with high subjective support or with low support utilization. Among older adults with intact IC, FA decline was observed in those with low support utilization but not in those with high support utilization or with low or high subjective support. ConclusionsSubjective support may prevent FA decline among older adults with impaired IC, while support utilization may benefit older adults with intact IC but may be detrimental for those with impaired IC. Social support interventions to optimize FA trajectories should improve older adults' perceptions of support and bridge the gap in support utilization among older adults with impaired IC.

The impact of influenza on the ability to work, volunteer and provide care: results from an online survey of Canadian adults 50 years and older

BackgroundInfluenza is associated with a decline in functional abilities among Canadian older adults, although specific impacts on daily life have not been fully explored.MethodsIn August 2019 and May 2020, we conducted surveys of Canadian adults 50-64 years and 65 years and older through an online market research platform. The survey included questions about the impact of diagnosed influenza or self-reported influenza-like-illness (ILI) on working, volunteering and caregiving.ResultsWe surveyed 1006 adults in the 50-64 year age group about the 2018/19 season and 1001 about the 2019/20 season. In the 65 years and older age group, we surveyed 3548 and 3500 individuals about the 2018/19 and 2019/20 influenza seasons, respectively. In each season, nearly two-thirds of individuals 50-64 years with influenza/ILI were employed; 51.7% reported absenteeism in 2018/19 and 53.6% in 2019/20. Of the 20% of individuals 65 years and older who were employed, 47.0% of those with influenza/ILI were absent while ill in 2018/19 (39.8% in 2019/20). In 2018/2019, 29.6% of respondents 50-64 years old with influenza/ILI identified as volunteers (29.3% in 2019/2020). In both seasons, nearly half were unable to do so while ill. Of the 164 (32.7%) individuals 65 years and older who volunteered during the 2018/19 season, 80 (48.8%) did not while ill; 224 (37.3%) respondents volunteered in the 2019/20 season, and half were absent while ill. Of those 50-64 years with influenza/ILI, 97 (42.2%) and 57 (22.2%) were caregivers in 2018/19 and 2019/20, respectively. In 2018/19 and 2019/20, 40 (41.2%) and 28 (49.1%) caregivers were unable to provide care when ill, respectively. Of those with influenza/ILI in the 65 years and older age group, 123 (24.6%) and 162 (27.0%) were caregivers in 2018/19 and 2019/20, respectively. In 2018/19, 18 (14.6%) caregivers with influenza/ILI did not provide care while ill (42 [25.9%] in 2019/20).DiscussionIn Canadian older adults, influenza and ILI had notable impacts on ability to volunteer and provide care across two recent seasons. Optimization of influenza prevention in this population may yield important societal benefits.

Differential effects of calorie restriction and rapamycin on age-related molecular and functional changes in skeletal muscle.

Aging is a multifactorial process associated with progressive degradation of physiological integrity and function. One of the greatest factors contributing to the deleterious effects of aging is the decline of functional ability due to loss of muscle mass, strength, and function, a condition termed sarcopenia. Calorie restriction (CR) has consistently been shown to extend lifespan and delay the onset and progression of various age-related diseases, including sarcopenia. Additional anti-aging interventions that are receiving scientific attention are CR mimetics. Of these pharmacological compounds, rapamycin has shown similar CR-related longevity benefits without the need for diet restrictions. To investigate the potential role of rapamycin as an anti-sarcopenic alternative to CR, we conducted a study in male and female C57BL/6J mice to assess the effects of rapamycin on age-related gene expression changes in skeletal muscle associated with loss of muscle mass, strength, and function, relative to control. We hypothesize that the effects of rapamycin will closely align with CR with respect to physical function and molecular indices associated with muscle quality. Our results indicate CR and rapamycin provide partial protection against age-related decline in muscle, while engaging uniquely different molecular pathways in skeletal muscle. Our preclinical findings of the therapeutic potential of rapamycin or a CR regimen on geroprotective benefits in muscle should be extended to translational studies towards the development of effective strategies for the prevention and management of sarcopenia.

Predictivity of daily gait speed using tri-axial accelerometers for two-year incident disability among Japanese older adults

Gait speed is an important indicator of functional decline in older adults. Recently, daily gait speed has been assessed using accelerometers. However, it is unclear whether this parameter can predict the decline in functional abilities. This study investigates whether daily gait speed can be a predictor of incident disability risk as well as in-laboratory gait speed. A sample of 1860 older adults (Male: 728, Female: 1132; 70.1 ± 6.2 years) were instructed to wear accelerometers on the waist. The association between daily gait speed for two weeks and incident disability during a two-year period was analyzed by using the cut-off value for screening prefrailty in the previous study (106.3 cm/s). Furthermore, the associations with in-laboratory gait speed (cut-off value: 100 cm/s), number of steps (cut-off value: 6342.2 steps/day), and incident disability were also analyzed. Cox proportional hazards analysis showed a significant hazard ratio of low daily gait speed (HR, 2.97; p = 0.02) comparable to that of low in-laboratory gait speed (HR: 2.53; p = 0.01). Conversely, the number of steps had no significant association with incident disability (HR: 1.99; p = 0.12). These results suggest that daily gait speed can be a predictor of incident disability risk in older adults.

Sexual and Reproductive Health in Women with Pulmonary Hypertension: A Qualitative Study

Pulmonary arterial hypertension (PAH) is a devastating disease characterized by elevation in pulmonary artery pressure causing progressive symptoms: shortness of breath, fatigue, and a decline in functional ability. Research on the impact of PAH on sexual and reproductive health was sparse. The aim of this study is to explore sexual and reproductive health of women with PAH in relation to their illness experience. Twenty-five women with PAH participated in semistructured interviews. A thematic analysis was conducted on the transcripts using the ATLAS.ti software. Four main themes were identified: illness experience, intimate relationship, sexuality, and attitudes toward pregnancy. Results showed that illness changed women’s self-perception, couples’ relationship, sexuality, and the idea of an eventual pregnancy. The relationship with the partner was usually indicated as an important resource, whereas communication with health care professionals was a critical but also potential key resource for the future. Results point to the need for intervention strategies to support women with PAH and help them make aware choices. Moreover, intervention strategies may inform health care interventions and policies for tackling the challenges posed by this illness.

Soft tissue coverage of lower extremity defects: pearls and pitfalls in the chronic wound population

The incidence of chronic lower extremity (LE) wounds continues to increase. Lower limb amputations are associated with increased cardiovascular exertion, further decline in functional ability, and higher mortality rates. As such, there has been a shift towards limb salvage modalities. These include local debridement with advanced wound care, revascularization, bony reconstruction, and soft tissue reconstruction. Perioperative planning for soft tissue reconstruction requires careful consideration of several factors, including patient comorbidities, wound size and location, exposed underlying structures, and in the case of possible free flap, patency of donor and recipient vessels. This article reviews the perioperative factors that should be considered in preparation for successful soft tissue reconstruction of the LE.

The Relationship between Functional Status and Social, Emotional and Family Loneliness among Older Adults in Pontian

Life at mature age is perceived to be very challenging and mostly influenced by the ageing process and negative changes that increase the risk of functional abilities. The most enormous thing to achieve is to live independently with less help from others to achieve an optimum quality of life. Methods: This is a community-based cross-sectional survey conducted among 414 community-dwelling older adults in Pontian District aiming to identify the functional status and examine the relationship between functional status and three types of loneliness. The Pfeffer Functional Activities Questionnaire was used to measure the level of functional status. Loneliness was measured with the short form of the Social and Emotional Loneliness Scale for Adults. The Statistical Package for Social Science Ver.26 for Windows was used to analyse all of the data.The results of this study show that the mean (+SD) age is 71.4 (+2.0). The majority of respondents perceived good health status and no deterioration in functional status. 8.2% of respondents experienced deterioration in functional status. Of these, 32.6% of respondents experienced social loneliness, 39.9% experienced emotional loneliness, and 9.2% experienced family loneliness. The results also revealed a significant relationship between functional status and social loneliness (p = 0.02). In conclusion, the majority of respondents are independent enough to perform functional activities, and less than half of them have experienced social, emotional, or family loneliness. Social loneliness was linked to a decline in functional ability in older adults. This research could aid in the care of older adults who live independently and freely in the community.

10.P. Workshop: Mental health of older people

Abstract Due to a general health deterioration, decline in functional ability, accumulated stressful events related to loss and bereavement, and unfavorable socio-economic circumstances, older adults are known to be vulnerable to the development of mental health problems, sometimes leading to serious mental disorders. Approximately 20% of adults aged 60 and over, suffer nowadays from a mental or neurological disorder. This problem is possibly even more distinct in the context of the recent Covid-19 pandemic where health protecting measurements like restricting physical and social contact, disproportionally affect the mental health of older people who are already at higher risk of social isolation and loneliness. However, according to the WHO, mental health impairment in older people is still a highly under-identified, and under-estimated public health issue, often surrounded by shame and stigma, which hinders an adequate mental health promoting approach in this population. This workshop wants to contribute to new findings in the role that certain factors can play in protecting and promoting the mental health of older people. Research during circumstances of a crisis, like the Covid-19 pandemic, may reveal new insights in this context, although the long-term effects are not yet clear, and longstanding factors may not be overlooked. Dr Sunwoo Lee (Czech Republic) performed a large survey about mental health of older adults in 27 European countries and will discuss the important role that resilience and optimism can play in promoting mental health in older adults in the midst of a pandemic crisis. Dr. Cynthia Engels (France) investigated changes in daily activities and mental health of older adults during the lockdown period in France. She will report about the most important changes found and what it meant for peoples' wellbeing and social contacts. Prof. Patricia De Vriendt (Belgium) further focused on the daily activities of older men and women during the Covid lockdown in Belgium and discovered a significant gender difference in the extent to which they succeed to engage in meaningful activities during this crisis. She will discuss how crucial this meaning in activities is for older adults to maintain in good mental health. Finally, Prof. Jutta Lindert (Germany and US) will share the rather surprising findings of a large nationwide study in the United States among older adults showing how daily discrimination is related to impaired cognitive functioning in older men and women. She points to the importance of reducing discrimination, especially when the Covid-crisis is behind us, as an important factor in supporting mental health in this older population. Key messages Resilience, optimism and meaningful activities are important factors in mental health promotion for older adults. Discrimination has a negative impact on older adults' cognitive function.

Neighbourhood physical environment, intrinsic capacity, and 4-year late-life functional ability trajectories of low-income Chinese older population: A longitudinal study with the parallel process of latent growth curve modelling.

BackgroundKnowledge of how intrinsic capacity (IC) and neighbourhood physical environment shape functional ability (FA) trajectories in later life remains understudied. We investigated four-year trajectories of IC and their impact on FA trajectories and the association between neighbourhood physical environment and FA trajectories among community-dwelling older adults in Hong Kong, China.MethodsWe conducted a four-wave longitudinal study from 2014 to 2017 in Hong Kong with 2,081 adults aged 65 and above. FA was assessed by The Chinese Lawton Instrumental Activities of Daily Living Scale. We used cognition, affect, locomotion, sensory capacity, and vitality to capture the multiple domains of IC. Neighbourhood physical environment attributes included green space, land use diversity, and availability of facilities, assessed within 200- and 500-meter buffers of respondents’ homes. We used the parallel process of latent growth curve model.FindingsIC (Unstandardized coefficient, β = −0.02, p<0.001) and FA (β = −0.20, p<0.001) each decreased significantly over time. Individuals with declines in IC experienced a faster decline in FA over time. Green space within a 200-meter buffer (β = 1.15, p = 0.023), the number of leisure (β = 0.03, p = .0.043) and public transport (β = 0.08, p = .0.003) facilities within a 500-meter buffer slowed the rate of FA decline.InterpretationThe level of FA decreased over time in later life. Changes in IC shaped FA trajectories. Increased residential green space and the number of leisure and public transport facilities in the neighbourhood may help slow FA decline over time.FundingThe Hong Kong Housing Society.

Neuropsychiatric symptoms associated with family caregiver burden and depression.

ABSTRACTAlzheimer's disease (AD) is a progressive and degenerative condition affecting several cognitive areas, with a decline in functional abilities and behavioral changes.Objective:To investigate the association between neuropsychiatric symptoms in older adults with AD and caregiver burden and depression.Methods:A total of 134 family caregivers of older people diagnosed with AD answered a questionnaire with sociodemographic data and questions concerning the care context, neuropsychiatric symptoms, caregiver burden, and depressive symptoms.Results:Results revealed that 95% of older adults had at least one neuropsychiatric symptom, with the most common being: apathy, anxiety, and depression. Among the 12 neuropsychiatric symptoms investigated, 10 were significantly associated with caregiver burden, while 8 showed significant correlations with depressive symptoms.Conclusions:Neuropsychiatric symptoms were related to caregiver burden and depressive symptoms. In addition to the older adult with AD, the caregiver should receive care and guidance from the health team to continue performing quality work.