Disability In Older Adults Research Articles

Abstract 2228: Long-term trajectories of functional disability in older adults with cancer

Abstract Background: Older individuals with cancer history have lower risk of developing Alzheimer’s disease (AD). Cognitive impairment is associated with lower functioning in Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL). However, little is known about long-term IADL and ADL trajectories among individuals with cancer, hindering understanding of the underlying biological mechanisms between cancer and AD. We investigated the long-term functional disability trajectories of adults with cancer, comparing them with similarly aged individuals without a cancer diagnosis. Methods: Our study included 16,006 individuals aged 50 and older without a cancer history at baseline from the Health and Retirement Study. Biennial assessments were conducted from 1998 to 2020, including self-reported cancer status, IADL, and ADL. Linear probability models with repeated measures were used to assess IADL and ADL independence probabilities, adjusting for demographic and socioeconomic covariates. Results: Among 16,006 participants (mean [SD] baseline age, 66.1 [9.9] years; 9,169 [57.3%] female), 3,723 (23.3%) reported a cancer diagnosis during follow-up. Before cancer diagnosis, individuals who later developed cancer had a higher probability of IADL independence and experienced a slower decline in independence compared to their similarly aged counterparts who remained cancer-free. Probability of IADL independence was 0.05 lower immediately after cancer diagnosis compared to the pre-cancer phase, followed by accelerated independence losses relative to the pre-cancer period. After diagnosis, the rate of decline in probability of IADL independence remained slower for individuals with cancer than their cancer-free counterparts, but differences in the rate of decline were smaller than prior to cancer diagnosis. Similar trends were observed for ADL independence. Conclusions: We observed a decline in both IADL and ADL independence around the time of cancer diagnosis, possibly attributed to treatments. Overall, individuals with cancer experienced a more gradual loss in functional independence compared to individuals who remained cancer-free, consistent with the documented inverse association between cancer and AD. Funding information: The current research was supported by the National Cancer Institute of the National Institutes of Health (T32CA009142), T32 Training Grants from the NCI/NIH, and the National Institute on Aging (RF1AG059872). Citation Format: Gina E. Nam, Elizabeth Rose Mayeda, Zuo-Feng Zhang. Long-term trajectories of functional disability in older adults with cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2228.

Interpretable prediction models for disability in older adults with hypertension: the Chinese Longitudinal Healthy Longevity and Happy Family Study.

Older adults with hypertension have a high risk of disability, while an accurate risk prediction model is still lacking. This study aimed to construct interpretable disability prediction models for older Chinese with hypertension based on multiple time intervals. Data were collected from the Chinese Longitudinal Healthy Longevity and Happy Family Study for 2008-2018. A total of 1602, 1108, and 537 older adults were included for the periods of 2008-2012, 2008-2014, and 2008-2018, respectively. Disability was measured by basic activities of daily living. Least absolute shrinkage and selection operator (LASSO) was applied for feature selection. Five machine learning algorithms combined with LASSO set and full-variable set were used to predict 4-, 6-, and 10-year disability risk, respectively. Area under the receiver operating characteristic curve was used as the main metric for selection of the optimal model. SHapley Additive exPlanations (SHAP) was used to explore important predictors of the optimal model. Random forest in full-variable set and XGBoost in LASSO set were the optimal models for 4-year prediction. Support vector machine was the optimal model for 6-year prediction on both sets. For 10-year prediction, deep neural network in full variable set and logistic regression in LASSO set were optimal models. Age ranked the most important predictor. Marital status, body mass index, score of Mini-Mental State Examination, and psychological well-being score were also important predictors. Machine learning shows promise in screening out older adults at high risk of disability. Disability prevention strategies should specifically focus on older patients with unfortunate marriage, high BMI, and poor cognitive and psychological conditions.

The common marmoset as a translational model of age-related osteoarthritis.

Age-related osteoarthritis (OA) is a degenerative joint disease characterized by pathological changes in nearly every intra- and peri-articular tissue that contributes to disability in older adults. Studying the etiology of age-related OA in humans is difficult due to an unpredictable onset and insidious nature. A barrier in developing OA modifying therapies is the lack of translational models that replicate human joint anatomy and age-related OA progression. The purpose of this study was to determine whether the common marmoset is a faithful model of human age-related knee OA. Semi-quantitative microCTscoring revealed greater radiographic OA in geriatric versus adult marmosets, and the age-related increase in OA prevalence was similar between marmosets and humans. Quantitative assessments indicate greater medial tibial cortical and trabecular bone thickness and heterogeneity in geriatric versus adult marmosets which is consistent with an age-related increase in focal subchondral bone sclerosis. Additionally, marmosets displayed an age-associated increase in synovitis and calcification of the meniscus and patella. Histological OA pathology in the medial tibial plateau was greater in geriatric versus adult marmosets driven by articular cartilage damage, proteoglycan loss, and alteredchondrocyte cellularity. The age-associated increase in medial tibial cartilage OA pathology and meniscal calcification was greater in female versus male geriatric marmosets. Overall, marmosets largely replicate human OA as evident by similar 1) cartilage and skeletal morphology, 2) age-related progression in OA pathology, and 3) sex differences in OA pathology with increasing age. Collectively, these data suggest that the common marmoset is a highly translatable model ofthe naturally occurring, age-related OA seenin humans.

Framework for policymaking on self-management of health by older adults using technologies

BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, the use of information and communication technologies (ICTs) to support care management exponentially increased. Governments around the world adapted existing programs to meet the needs of patients. The reactivity of governments, however, led to changes that were inequitable, undermining groups such as older adults living with chronic diseases and disability. Policies that align with recent developments in ICTs can promote better health outcomes and innovation in care management. A framework for policymaking presents potential for overcoming barriers and gaps that exist in current policies.ObjectiveThe goal of this study was to examine how well a provisional framework for policymaking represented the interactions between various components of government policymaking on older adults’ self-management of chronic disease and disability using ICTs.MethodsThrough an online survey, the study engaged policymakers from various ministries of the government of Ontario in the evaluation and revision of the framework. The data were analyzed using simple statistics and by interpreting written comments.ResultsNine participants from three ministries in the government of Ontario responded to the questionnaire. Overall, participants described the framework as useful and identified areas for improvement and further clarification. A revised version of the framework is presented.ConclusionsThrough the revision exercise, our study confirmed the relevance and usefulness for a policymaking framework on the self-management of disease and disability of older adults’ using ICTs. Further inquiries should examine the application of the framework to jurisdictions other than Ontario considering the dissociated nature of Canadian provincial healthcare systems.

Estimating the Effect of Engagement in Community-Based Going-Out Program on Incidence Disability in Older Adults

ObjectivesAlthough going out has been reported to be associated with the incidence of disability, few studies have investigated the effect of community-based programs to promote going out on the incidence of disability. This study aimed to estimate the effects of a program fostering going-out on the incidence of disability in community-dwelling older adults. DesignLongitudinal, observational study. Setting and ParticipantsNonengaged (n = 1086) and engaged older adults (n = 1086) enrolled in the National Center for Geriatrics and Gerontology Study of Geriatric Syndrome by using a one-to-one nearest neighbor propensity score–matching scheme. MethodsAfter the baseline assessments, participants in the community-based going-out program received a specialized physical activity tracker, monitored their daily physical activity, and received personalized feedback on going out to community facilities with a system for reading the device for 12 months. Disability onset was defined as a new case of long-term care under the public insurance certification in Japan within 48 months of program completion. The absolute risk reduction and the number needed to treat for the incidence of disability were calculated for the nonengaged and engaged groups. Cox proportional hazard regression analysis, using inverse probability weighting was used to obtain the hazard ratio. ResultsDisabilities occurred in 112 individuals in the matched nonengaged group and 51 individuals in the engaged group. The absolute risk reduction was 5.67% (95% CI 3.46%-7.88%). The number needed to treat was 18 (95% CI 13-29). The hazard ratio, with the nonengaged group as the reference, was 0.49 (95% CI 0.36-0.67). Conclusions and ImplicationsThis longitudinal observational study suggested that a community-based program could prevent 1 disability in every 18 participants. This program does not require a professional instructor, only the distribution of devices and system installation, and it could be beneficial as a population-based approach to preventing disabilities.

Development of a weighted scoring model for social activities to predict disability incidents among older Japanese adults

BackgroundSocial activities contribute to health improvements in older adults, but methods for evaluating these activities are not yet established. We developed a scoring model for social activity, weighted by specific activities, to assess the association between disability incidence in older adults and social activities. MethodsData were obtained from Japan's National Center for Geriatrics and Gerontology Study of Geriatric Syndromes (NCGG-SGS). Social activity was evaluated across 16 domains. Disability was determined using data extracted from Japan's long-term care insurance system. ResultsData from 4998 older adults were analyzed; among them, 422 (8.4 %) developed a disability within 35 months (Interquartile range: 32-39). The Cox proportional hazards model was used to assess 16 domains of social activity. The results yielded risk factors for disability incidence in six social activity domains: work, travel, hobbies, babysitting, family caregiving, and events. The coefficients for these activities were assigned weights of 3, 3, 2, 1, 1, and 1, respectively. The weighted social activity scoring model significantly improved the ability to predict disability incidence when the number of social activities in which individuals participated was considered (social activity score: area under the curve [AUC] 0.691, 95 % confidence interval [CI] 0.664–0.717; number of social activities: AUC 0.681, 95 % CI 0.654–0.707, P = 0.042). ConclusionsThe composite score derived from the weighted social activity scoring model serves as a valuable tool due to its enhanced predictability, which complements established background factors associated with the incidence of disability in older adults.

Cognitive frailty and its association with disability among Chinese community-dwelling older adults: a cross-sectional study

BackgroundThere are a variety of determinants that are key to functional disability of older adults. However, little is known regarding the relationship between cognitive frailty and disability among older people. The aims of this study were to examine the associations between cognitive frailty and its six components with instrumental activities of daily living (IADL) functioning in community-dwelling older adults.MethodsA total of 313 community-dwelling older adults (aged ≥ 65 years) were recruited from eight community centers in central China. Cognitive frailty was operationalized using the Mini-Mental State Examination for the evaluation of cognitive status and the Fried criteria for the evaluation of physical frailty. The outcome was functional disability assessed by the IADL scale. The association between cognitive frailty, as well as its components, and IADL limitations was identified by conducting binary logistic regression analysis.ResultsThe prevalence of cognitive frailty was 8.9% in this study. The results showed that cognitive frailty (OR = 22.86) and frailty without cognitive impairment (OR = 8.15) were associated with IADL limitations. Subdimensions of cognitive frailty, exhaustion, weakness, low physical activity and cognitive impairment components were independently associated with IADL limitations.ConclusionCognitive frailty was associated with a higher prevalence of disability. Interventions for improving cognitive frailty should be developed to prevent IADL disability among community-dwelling older adults in China.

Opioid reduction and enhanced recovery in orthopaedic surgery (OREOS): a protocol for a feasibility randomised controlled trial in patients undergoing total knee arthroplasty

BackgroundKnee arthritis is a leading cause of limited function and long-term disability in older adults. Despite a technically successful total knee arthroplasty (TKA), around 20% of patients continue to have persisting pain with reduced function, and low quality of life. Many of them continue using opioids for pain control, which puts them at risk for potential long-term adverse effects such as dependence, overdose and risk of falls. Although persisting pain and opioid use after TKA have been recognised to be important issues, individual strategies to decrease their burden have limitations and multi-component interventions, despite their potential, have not been well studied. In this study, we propose a multi-component pathway including personalized pain management, facilitated by a pain management coordinator. The objectives of this pilot trial are to evaluate feasibility (recruitment, retention, and adherence), along with opioid-free pain control at 8 weeks after TKA.MethodsThis is a protocol for a multicentre pilot randomised controlled trial using a 2-arm parallel group design. Adult participants undergoing unilateral total knee arthroplasty will be considered for inclusion and randomised to control and intervention groups. Participants in the intervention group will receive support from a pain management coordinator who will facilitate a multicomponent pain management pathway including (1) preoperative education on pain and opioid use, (2) preoperative risk identification and mitigation, (3) personalized post-discharge analgesic prescriptions and (4) continued support for pain control and recovery up to 8 weeks post-op. Participants in the control group will undergo usual care. The primary outcomes of this pilot trial are to assess the feasibility of participant recruitment, retention, and adherence to the interventions, and key secondary outcomes are persisting pain and opioid use.DiscussionThe results of this trial will determine the feasibility of conducting a definitive trial for the implementation of a multicomponent pain pathway to improve pain control and reduce harms using a coordinated approach, while keeping an emphasis on patient centred care and shared decision making.Trial registrationProspectively registered in Clinicaltrials.gov (NCT04968132).

Effect of long-term care insurance in a pilot city of China: Health benefits among 12,930 disabled older adults

BackgroundThe surge of disabled older people have brought enormous burdens to society. The aim of this study was to examine the impact of long-term care insurance (LTCI) implementation on mortality and changes in physical ability among disabled older adults. MethodsThis was a prospective observational study based on data from the government-led LTCI program in a pilot city of China from 2017 to 2021. Administrative data included the application survey of activities of daily living (ADL), the baseline characteristics and all-cause mortality. Return visit surveys of ADL were conducted between August 2021 and December 2021. A regression discontinuity model was used to analyze the impact of LTCI on mortality. ResultsA total of 12,930 individuals older than 65 years were included in this study, and 10,572 individuals were identified with severe disability and participated in the LTCI program. LTCI implementation significantly reduced mortality by 5.10 % (95 % CI, -9.30 % to -0.90 %) and extended the survival time by 33.74 days (95 % CI, 13.501 to 53.970). The ADL scores of the LTCI group dropped by 2.5 points on average, while the ADL scores of those did not participated in LTCI dropped by 25.0 points. The heterogeneity analysis revealed that the impact of LTCI on mortality reduction was more significant among females, individuals of lower age, those who were married, cared for by family members, and who lived in districts with rich care resources. ConclusionsLTCI implementation had a favorable impact on the mortality and physical ability of participants.

Regional disparity in age-related disability: toward healthy aging in Indonesia

Purpose: Maintaining functional ability and minimizing age-related disability of older adults are required to promote healthy aging. A supportive physical and social environment, in addition to individual variables, has a role in reducing the risk of age-related disability. Infrastructure development differs between Java-Bali and outer Java-Bali regions. This study aims to determine the extent to which the disability of older adults in Java-Bali and outer Java-Bali regions. 
 Methods: This study is cross-sectional, using data from the 2020 National Socio-Economic Survey (SUSENAS) with 122.344 Indonesian older adults aged 60 and over. Disability is the outcome variable. The explanatory variable is regional disparity (Java-Bali and outer Java-Bali regions), which refers to where the older adults live. In addition, the control variables include age, sex, marital status, educational level, employment status, leisure activity, household wealth status, and self-rated health status (SRHS). A multivariate logistic regression statistical analysis is performed. 
 Results: The outer Java-Bali region has a slightly greater prevalence of older adults with age-related disability than the Java-Bali region, with 28.8 and 22.9 percent, respectively. However, older adults living in the outer Java-Bali region are 1.63 times more likely (OR 1.63; 95% CI (1.58-1.68)) to have disability than those living in the Java-Bali region. Other socio-demographic variables are significantly associated with age-related disability. 
 Conclusion: Living in the Java-Bali region increases the risk of age-related disability. Infrastructure development in the outer Java-Bali region needs to be improved so that older adults can experience healthy aging.

Do urinary and double incontinence predict changes in living arrangements and mobility in older women after hip fracture? – a 1-year prospective cohort study

BackgroundContinence problems are known to be associated with disability in older adults. Costs of disability and resulting need for more supported living arrangements are high after a hip fracture. The aim was to examine pre-fracture urinary incontinence (UI) and double incontinence (DI, concurrent UI and fecal incontinence) as predictors of changes in mobility and living arrangements in older female hip fracture patients in a 1-year follow-up.MethodsStudy population comprised 1,675 female patients aged ≥ 65 (mean age 82.7 ± 6.8) sustaining their first hip fracture between 2007–2019. Data on self-reported pre-fracture continence status was collected. The outcomes were declined vs. same or improved mobility level and need for more assisted vs same or less assisted living arrangements 1-year post-fracture. Separate cohorts of 1,226 and 1,055 women were generated for the mobility and living arrangements outcomes, respectively. Age- and multivariable-adjusted logistic regression models were used to determine the associations of UI, DI, and other baseline characteristics with the outcomes.ResultsOf the patients, 39% had declined mobility or more assisted living arrangements at 1-year follow-up. Adjusting for age, both pre-fracture UI and DI were associated with changes in mobility and living arrangements. In the multivariable analysis, UI (OR 1.88, 95% CI 1.41–2.51) and DI (1.99, 95% CI 1.21–3.27) were associated with decline in mobility level while only DI (OR 2.40, 95% CI 1.22–4.75) remained associated with the need for more assisted living arrangements.ConclusionsBoth pre-fracture UI and DI in older women are risk factors for declining mobility level, but only DI for more supported living arrangements 1-year post-hip fracture. UI likely develops earlier in life and might not necessarily be strongly associated with the onset or increasing disability in later years. DI may indicate more marked vulnerability and burden to patients as well as to formal and informal caregivers.

Association of objectively measured physical activity with incidence disability in older adults with/without social isolation

PurposeThis study aimed to investigate association between objectively measured physical activities with incidence disability in older adults with and without social isolation. MethodsThis 5-year longitudinal observational study used a population-based study from a sub-cohort of the National Center for Geriatrics and Gerontology Study of Geriatric Syndrome. In Japan, Incident disability is defined as a new case of public insurance certification for long-term care. As participants, we enrolled 5,257 community-dwelling older adults aged ≥ 70 years. The Participants on whom incomplete baseline physical activity assessments were performed; who required long-term care; had a history of dementia, Parkinson's disease, stroke, or depression; who lacked independence in basic ADL; who had Mini-Mental State Examination scores; or who had missing measurements; were excluded. Thus, 2,071 participants were included. ResultsOf the participants, 1,183 non-socially isolated participants had 151 (4.3%) cases of disability, while socially isolated participants had 150 (13%) cases. Cox proportional-hazards regression analysis presented the adjusted hazard ratio (HR) and 95% confidence interval (95%CI) of daily steps and low-intensity and moderate-to-vigorous physical activities—0.62(0.43–0.89), 0.84(0.60–1.18), 0.62(0.43–0.89) in participants with social isolation, and 0.58(0.40–0.85), 0.86(0.60–1.24), 0.70(0.49–1.01) in those with social isolation. ConclusionsDaily steps were significantly associated with a decreased risk of incidence disability, regardless of social isolation. These results suggest the greater importance of daily physical activity than its specific intensity in socially isolated older adults.

Do older adults with disability face home care poverty? Evidence from China

ABSTRACT Home care poverty is the inability of older people to access adequate home care services and their unmet needs for home care. With the increasing number of older adults (60 years old and above) with disability in China, the Chinese government pays more and more attention to home care. In this case, it is of great significance to explore whether older adults with the disability face home care poverty and its influencing factors. The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2018 were utilized. SPSS 22.0 was used as a data analysis tool to conduct descriptive statistics and multiple logistic regression analysis on the sample (n = 1932). The study found that in 2018, 48.0% of older adults with disability faced home care poverty. Multiple logistic regression results showed that degree of disability, age, rural and non-eastern regions, income poverty, family caregiver, and reluctant caregivers were positive factors that increased the risk of home care poverty in disabled older adults (p < .05). But care duration, care expenditure, social pensions insurance, community daily life care and community medical services are the positive factors to eliminate the home care poverty for older adults with disability (p < .05). In order to solve the problem of home care poverty of older adults with disability, based on the research conclusions, the study proposed to establish a long-term care insurance system, formulate supportive policies for family caregivers or their families, and establish a wide variety of community care services.

Exploration of the factors influencing hearing disability in older adults of China: a nested case-control study.

As two line trends - aging disability and disability aging - continue to emerge, hearing disability is becoming increasingly prevalent among older adults in china. This study aimed to investigate the incidence of hearing disability among older adults and identify the various factors contributing to its development. In this matched nested case-control study, data from the China Health and Retirement Longitudinal Study from 2011 to 2018 were analyzed. A total of 4,523 older adults were recruited from a national sample database, of which 1,094 individuals were eligible for inclusion in the hearing disability cohort, while 3,429 older adults who had not been diagnosed with hearing disability were considered non-hearing disability controls. Hearing disability was assessed by a self-reported question. These controls were matched to hearing disability cases in a 1:1 ratio based on age and sex. The logistic regression models were used to find out various factors of hearing disability in the target population. Totally 1,094 individuals (24.14%) developed hearing disability during the follow-up period. After 1:1 matching, 2,182 subjects were included in the study, with 1,091 cases in the case group. Factors that influenced the incidence of hearing disability in older adults included annual per capita household income (OR = 0.985, p = 0.003), cognitive function (OR = 0.982, p = 0.015), depression level (OR = 1.027, p < 0.001), somatic mobility (OR = 0.946, p = 0.007), history of kidney disease (OR = 1.659, p < 0.001), history of asthma (OR = 1.527, p = 0.008), history of accidental injuries (OR = 1.348, p = 0.015), whether there is a place for recreational and fitness activities in the community (OR = 0.672, p < 0.001), and whether there is a health service center/health center in the community (OR = 0.882, p = 0.006). The incidence of hearing disabilities among older adults in China is high. The protective and risk factors that contribute to the incidence of disability should be fully considered in the care of older adults.

Prevalence and correlates of disability in older adults, Ghana: evidence from the Ghana 2021 Population and Housing Census

BackgroundAlthough there are studies on disabilities in older persons, most of these studies have been carried out in developed countries. Hence, there are limited studies on disability in older adults in sub-Saharan Africa, including Ghana. The few studies that have examined the prevalence and correlates of disability in older adults used survey data for their analyses. To contribute to addressing this knowledge gap that has arisen, this study used a national census, the 2021 Ghana Population and Housing Census, to examine the prevalence and correlates of disability in older adults in Ghana.MethodsThe 2021 Ghana Population and Housing Census data was used for this study. A sample size of 197,057 Ghanaians aged 60 years and above was used for this study. The Washington Group questions on disability were used to measure disability by asking older adults about their difficulties in performing the six domains of disability (physical, sight, intellectual, hearing, self-care, and speech). A multinomial logistic regression housed in STATA was used to analyse the correlates of disability in older adults in Ghana. A p-value less than 0.05 was used for statistical significance.ResultsThe results show that slightly more than one-third (38.4%) of the older adults were disabled. In terms of the number of disabilities in older adults, 16.9% had one disability condition, while 2.4% had six disability conditions. Also, 9.4% had two disability conditions. Older adults who were females, aged 70–79 years and 80 years and above, resided in rural areas, with primary, JHS/Middle, SHS, unaffiliated with religion, ever married and never married, unemployed, and belonged to the middle and rich households were more likely to have a disability condition. Also, older adults residing in the Middle and Northern zones, having no health insurance, and using clean cooking fuel were less likely to have a disability condition.ConclusionsThe results show that socio-demographic and household factors were associated with disability in older adults in Ghana. Hence, policymakers and researchers should target these factors when designing appropriate policies, programmes, and interventions to improve the wellbeing of older adults.

Counter-narratives of active aging: Disability, trauma, and joy in the age-friendly city

Dominant narratives about late life promote active aging, while anti-aging ones mobilize tropes of decline and irrelevance. In contrast, counter-narratives raise questions that spark new conversations about the promising practices that could foster more age-friendly cities. In this article, we describe our feminist and ethnographic approach to interviews and digital storytelling that aim to amplify the voices of marginalized older adults living with disability, violence, and colonialism, and share findings from this endeavor. We discuss the interviews with, and stories shared, by two disabled older adults - an Indigenous woman and a white paraplegic man - and the aging futures their counter-stories suggest. These stories reveal these participants' ongoing struggles to create meaning in their lives, and how their relationships to the physical, cultural, and social environment of the city, including its supports and services, can both support and hinder this becoming.

The association between sarcopenia and functional disability in older adults.

Sarcopenia is associated with functional disability in older adults. However, no consistent conclusions have been reached considering the differences in the measurement and criteria of sarcopenia. We aimed to examine the association between sarcopenia status and functional disability based on China Health and Retirement Longitudinal Study (CHARLS). A nationally representative longitudinal study. Participants aged at least 60 years old from the CHARLS 2015y were included. Sarcopenia was assessed according to the Asian Working Group for Sarcopenia 2019 algorithm. The outcomes of this study were basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The logistic regression model was conducted to analyze the cross-sectional and longitudinal associations between sarcopenia status and ADLs and IADLs disability. In the cross-sectional study, 37.2% of the 6893 participants were defined as having sarcopenia. Any form of sarcopenia was associated with ADLs and IADLs disability. During three years of follow-up, 786 (16.5%) participants developed new-onset ADLs disability, and 980 (22.5%) participants developed new-onset IADLs disability. Compared with the no-sarcopenia, participants with possible sarcopenia (OR: 1.62, 95%CI: 1.34-1.95), sarcopenia (OR: 1.58, 95%CI: 1.18-2.11), or total sarcopenia (OR: 1.58, 95%CI: 1.34-1.88) had a higher risk of ADLs disability. While, the risk of IADLs disability for participants with possible sarcopenia (OR: 1.68, 95%CI: 1.41-2.00), sarcopenia (OR: 1.87, 95%CI: 1.40-2.51), or total sarcopenia (OR: 1.71, 95%CI: 1.45-2.00) was still significantly increased. With statistical interaction between sarcopenia status and residence or sex in ADLs and IADLs disability, older adults in urban, with ORs ranging from 2.14 to 2.44, were at a higher risk of functional disability than those in rural. Possible sarcopenia was associated with a much higher risk of ADLs disability (OR: 1.68, 95%CI: 1.26-2.25) in males and a higher risk of IADLs disability (OR: 1.98, 95%CI: 1.56-2.52) in females. Sarcopenia was associated with an increased risk of ADLs and IADLs disability among older Chinese adults. Even possible sarcopenia still significantly impacted ADLs and IADLs disability, and this association varied by sex and residence.

Temporal Muscle Thickness Predicts Mortality and Disability in Older Adults Diagnosed with Mild Dementia

Temporal Muscle Thickness Predicts Mortality and Disability in Older Adults Diagnosed with Mild Dementia

The Association Between Family Support and Changes in Self-Rated Health Among Chinese Older Adults: How Living Arrangements Moderate the Association?

ObjectivesThe study intends to investigate the association between family support and older adult health as well as the interaction between family support and living arrangements on their health. DesignCross-sectional study. Setting and ParticipantsSamples included in the final analysis (N = 11,430) come from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). MethodsMultiple logistic regression analysis was used to analyze the associations between family supports, multiplicative interaction of family supports and living arrangements, and self-rated health change. Subgroup analysis on disabled older adults was supplemented. ResultsOlder adult individuals who received functional support, provided financial support, and had frequent emotional communication with their children in the past year reported better self-rated health. Moreover, having frequent emotional communication with children could bring better self-rated health for the older adults living with spouses and children (ORbetter vs same = 2.765, P < .01) and empty nesters who lived without children (ORbetter vs same = 1.551, P < .05). Conclusions and ImplicationsOur findings imply that functional support and emotional support may play an increasingly important role in the health of Chinese older individuals. The interaction between emotional support and 2 living arrangements mentioned above is relevant to better health of older individuals. We advocate for culturally tailored Age-Friendly Communities augmenting the geriatric health care framework. While bolstering social support for seniors, prioritizing fundamental needs is paramount for those with disabilities.

ESTIMATING THE EFFECTS OF A POTENTIAL VACCINE FOR CYTOMEGALOVIRUS ON DISABILITIES AMONG OLDER ADULTS IN THE US

Abstract Cytomegalovirus (CMV) infection has been identified as contributing to the development several aging-related diseases, such as disabilities. However, the development of CMV vaccines has been slow, particularly of those targeting older individuals. With few studies that have investigated the potential effects of a CMV vaccine on disabilities among older adults, we aim to study such effects on mobility disabilities by tasks. We use longitudinal data from the Health and Retirement Study (HRS) from 2016 to 2020 to quantify what proportion of disabilities could be prevented in the United States with a viable CMV vaccine. The analytic sample includes N=5,855 individuals aged 65 or above. Under the assumption that a hypothetical vaccine would shift CMV levels from seropositive to seronegative, we construct a binary indicator based on the continuous IgG antibody measure of serum CMV. Using a novel logistic regression-based approach that allows adjustment for continuous age, we estimate attributable fractions (AF) to seropositive CMV levels for five dichotomous outcomes about difficulty with activities of daily living (ADLs), including walking across a room, dressing, bathing, eating, getting in and out of bed, and using the toilet, and stratify the analyses by sex and race/ethnicity. The findings will implicate the potential impact of a vaccine for CMV on mobility disability in older adults, laying the groundwork for future studies to examine the impact of vaccines on disabilities at different time points with varying efficacy levels among the elderly.