Heavy Housework Research Articles

Nutrition and lifestyle in relation to bone health and body weight in Croatian postmenopausal women

The objective was to investigate the association of nutrients and lifestyle modifiers with bone mineral density (BMD) and weight and/or body mass index (BMI) in 120 healthy Croatian postmenopausal women. The hip and spine BMD was assessed by Lunar Prodigy (GE Medical Systems). Nutrient assessment from 3-day records was analyzed using the US Department of Agriculture Food Composition Tables and the Croatian National Institute of Public Health database. Subjects were asked to record the consumption of alcohol, coffee, tea and mineral waters, the amount of salt added to foods and smoking habits, as well as involvement in recreational activities, walking and heavy housework. Spot urine samples were analyzed for calcium, magnesium, sodium, potassium and zinc and were normalized by creatinine. Alcohol showed statistically significant positive association with femur and spine BMD and its consumption was higher in subjects without osteoporosis. Urinary sodium/creatinine was significantly positively associated with femoral neck and trochanter BMD, while urinary calcium/creatinine was significantly negatively associated with trochanter, total femur and spine BMD. Consumption of mineral waters was inversely associated with weight/BMI and so were dietary fiber and magnesium. In conclusion, moderate alcohol consumption and urinary sodium were positively associated while urinary calcium was negatively associated with either hip and/or spine BMD. Mineral waters, higher fiber and magnesium intake were beneficial for weight/BMI in this population of apparently healthy Croatian women.

Managing Activity Difficulties at Home: A Survey of Medicare Beneficiaries

Dudgeon BJ, Hoffman JM, Ciol MA, Shumway-Cook A, Yorkston KM, Chan L. Managing activity difficulties at home: a survey of Medicare beneficiaries. Objective To describe assistance from helpers and use of assistive technology and environmental modification by community-dwelling people with difficulties in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Design Cross-sectional study using the 2004 Medicare Current Beneficiary Survey. Setting Community. Participants Nationally representative sample of 14,500 Medicare beneficiaries (mean age, 71.5y; 55% female; 49% currently married; 68% living with others; 84% white). Interventions Not applicable. Main Outcome Measures Self-reported difficulty with ADLs and IADLs; uses of help, assistive technology, and/or environmental modification. Results Difficulties were reported most frequently for heavy housework, walking, and shopping; money management, shopping, and light housework were reported as activities most often needing a helper. Walking, bathing, and toileting were activities most often needing uses of assistive technology. Bathroom modifications were the most commonly reported environmental modification. Results from a logistic regression showed that advancing age was the primary factor associated with increasing use of helpers and assistive technology or both for difficult activities. Conclusions Uses of helpers, assistive technology, and environmental modification are common but vary by type of ADL and/or IADL and age. Focused studies regarding uses of help and access to assistive technology and environmental modification appear needed to support community living. Public education about methods and types of accommodations appears needed and may substitute for or augment guidance from care providers.

Facteurs de risque obstétricaux du petit poids de naissance à terme en milieu rural sahélien

The objective of this study is to identify the obstetrical risk factors related to low birth-weight in a rural environment in the Sahel region. A cross-sectional study carried out between January 1st and December 31st, 2003, recorded and registered 1013 new born children (from full-term pregnancies) from the north-central part of Burkina Faso. The adjusted odds for ratios of low birth-weight were estimated for each obstetric and pregnancy characteristic through a multiple level logic regression analysis. After adjustment for socioeconomic variables, the following were noted as significant factors which seriously increased the risk of low birth-weight: first time pregnancy (OR = 2.8), severe vomiting (OR = 3.4), heavy housework (OR = 1.6), and agricultural labour (OR = 3.3). The existence of high risk was also present in case of women giving birth at home without any medical assistance (OR = 2.1). The number of prenatal visits does not indicate or confer any direct link to prevention of risks or positive benefit on birth-weight status. In light of these results, it is necessary to redefine the content and the procedures for pregnancy surveillance and care, including and adequate management of severe vomiting and increased public awareness on reduction of house work and manual labour for pregnant women.

Effect of Chronic Venous Insufficiency on Activities of Daily Living and Quality of Life: Correlation of Demographic Factors With Duplex Ultrasonography Findings

The study evaluates to what extent symptoms of chronic venous insufficiency (CVI) and functional venous incompetence as investigated using color-coded duplex ultrasonography may interfere with activities of daily living (ADLs). This study comprises a cross-sectional survey conducted in urban areas surrounding 24 Italian cities. A spontaneous sample of 5,187 subjects (4,457 women [mean age, 54 years] and 730 men [mean age, 61 years]), selected by advertising on television and in newspapers, underwent a clinical examination that included duplex ultrasonography in 3 vein segments in both legs to determine the presence and severity of venous reflux. Subjective perception of lower limb symptoms of CVI and the effect of leg problems on the ability to perform normal ADLs are assessed by means of a self-administered questionnaire. Most of the respondents have some CVI symptoms, with women being 1.5 to 3 times as likely as men to report leg symptoms. The risk of developing the most frequent subjective symptoms such as heaviness and tiredness in the legs is not statistically significantly different for younger subjects compared with older subjects. Advanced age is considered to be a relevant risk factor only for heat sensation and swollen legs. Persons living in southern Italy are at higher risk of almost all lower limb symptoms. Results of duplex ultrasonography performed on 3875 subjects show that fewer than 1 in 5 young persons, regardless of sex, manifest some degree of venous reflux (primarily mild symptoms). The risk of developing venous incompetence increases rapidly with age until it triples among subjects 50 years and older. Adjusting for all other factors, men are on average 1.5 times as likely as childless women to have venous reflux, and the risk increases in the case of family history of CVI or (among women) in the case of past pregnancies. More women than men report that their leg problems affect their ADLs. Pregnancy and living in the south contribute to a reduction in the ability to perform most heavy housework. Although milder lower limb symptoms such as evening heaviness and tiredness in the legs may begin early in life, venous reflux and related symptoms of heat sensation and swollen legs become more pronounced with age, and their severity can be disabling for those afflicted.

Domestic Physical Activity in Relationship to Multiple CVD Risk Factors

Public health recommendations emphasize regular participation in moderate intensity physical activity (at least 5 days per week, 30 minutes or more per day), including domestic activities (e.g., heavy housework). The contribution of domestic activities in improving cardiovascular disease risk remains unclear. This cross-sectional study aimed at determining the independent associations of domestic activity and other activity types with multiple cardiovascular disease (CVD) risk factors (resting pulse rate, obesity, total cholesterol, high-density lipoprotein cholesterol, blood pressure, C-reactive protein). The sample comprised of 14,836 adults (ages 16 years and over) living in households in England in 2003. Interviews assessed participation in at least moderate intensity physical activity (domestic activity, walking, and sports), and nurses measured blood pressure and took blood samples. Analyses were done in 2006. A total of 24.2% of men and 19.8% of women met the activity recommendations, dropping to a total of 17.6% and 13.0% when domestic activity was excluded. With the exception of systolic blood pressure in women, domestic activity was not related to a favorable profile of any other CVD risk factors. There was a trend for lower body mass index and waist circumference and higher high-density lipoprotein cholesterol with increased participation in walking. Sports participation was related to a favorable profile for all risk factors excluding systolic blood pressure in men and cholesterol and C-reactive protein in women. The odds of being obese (body mass index more than 30 kg/m(2)) were lower with increased participation in walking and sports. Despite its high prevalence, domestic physical activity was not associated with improvements in CVD risk factors. These results suggest that physical activity recommendations may need to focus on physical activities other than those performed in and around the household.

Modes of habitual physical activity influence weight loss in postmenopausal women during a 10‐week weight loss intervention

It is widely agreed that weight loss (WL) regimens are more successful when both energy restriction and increased physical activity (PA) are employed. Less is known about the effect of habitual PA in the success of WL. The Objective was to evaluate which type of habitual PA, in addition to energy restriction, is influential in WL. Participants were 36 postmenopausal women, aged (mean±SD) 56.5±3.7 y, BMI 31.4±4.6 kg/m2, who lost 4.6±3% of weight, ranging from 11.3% to 0.3%, at 10 weeks of intervention. Habitual activity was assessed by the Allied Dunbar Questionnaire for older adults. Additionally, total energy expenditure throughout two 24-hour periods, including resting/sleeping and other habitual and recreational activities was assessed as well and expressed as kcal/kg/24h (MET/24h). Multiple regression models with %WL (at 2-week periods during 10 weeks) as dependent variables and controlling for age and initial weight, revealed that heavy housework and fast walking pace had the highest influence in WL. Higher MET/24h was also significant predictor of WL at various time increments. In conclusion, in this preliminary study, we showed that even habitual activities and total energy expenditure reflecting higher overall activity could help in WL efforts. This is important in view of the typically low compliance to structured exercise protocols in WL regimens. Funded by USDA/CSREES/NRI #2004-05287

Correlates of Physical Activity in a Community Sample of Older Adults in Appalachia

Although much has been learned about the global determinants of physical activity in adults, there has been a lack of specific focus on gender, age, and urban/rural differences. In this church-based community sample of Appalachian adults (N = 1,239), the primary correlates of physical activity included age, gender, obesity, and self-efficacy. Overall, 42% of all participants and 31% of adults age 65 years or older met recommended guidelines for physical activity, which suggests that most participants do not engage in adequate levels of physical activity. Of participants who met physical activity guidelines, the most common modes of moderate and vigorous activity were walking briskly or uphill, heavy housework or gardening, light strength training, and biking. These particular activities that focus on building self-efficacy might be viable targets for intervention among older adults in rural communities.

Activities of daily living and social activities in people with multiple sclerosis in Stockholm County

Objective: To describe independence in personal and instrumental activities of daily living (ADL), and frequency of social/lifestyle activities in a population-based sample of people with multiple sclerosis in Stockholm. Design: Population-based survey. Setting: Data collection in home environment. Subjects: One hundred and sixty-six people with multiple sclerosis. Interventions: Data were collected using measurements and structured interviews. Main measures: Independence in ADL was assessed by the Barthel Index; independence in personal and instrumental ADL by the Katz Extended ADL Index; and frequency of social/lifestyle activities by the Frenchay Activities Index. Results: The mean age was 519 ± 12 years in the included 166 people with multiple sclerosis, of whom 71% (n = 118) were women. Fifty-two per cent (n = 85) were independent in personal ADL, 30% (n = 50) in instrumental ADL, and 35% (n = 57) had normal frequency of social/lifestyle activities. Most frequently affected ADL items were cleaning indoors and outdoors transportation (62%, n = 102) and the social/lifestyle items of household maintenance (59%, n = 97), walking outside (59%, n = 97), heavy housework (61%, n = 100), and gardening (68%, n = 112). Conclusions: ADL and social/lifestyle activities were affected in two-thirds of people with multiple sclerosis in Stockholm. The most affected items were items that could be classified as mobility-related and physically demanding, underlining the importance of developing and using evidence-based exercise treatments and rehabilitation to increase independence in people with multiple sclerosis in Stockholm.

Predicting catastrophic decline in mobility among older people

to investigate the associations between chronic health conditions, psychosocial and environmental factors and catastrophic decline in mobility among older people. longitudinal cohort. national sample living in private households. nine hundred and ninety-nine adults aged > or = 65 years at initial interview, of which 786 agreed to take part in a follow-up survey 12 months later, and 531 responded to the questionnaire. catastrophic decline in mobility: inability to do any of the three activities of daily living items-walking 400 yards, climbing up and down stairs or steps and getting on a bus-having been capable of independently doing all three one year earlier. similar annual rates of catastrophic decline were reported for men and women: 4.8 [95% confidence interval (CI) 2.7-8.3] and 4.6% (2.4-8.6), respectively. Strong associations were found between catastrophic decline and age > 70 years, hearing problems and health deterioration, odds ratio (OR) 3.7 (95% CI 1.1-11.8), 2.8 (1.1-7.3) and 4.3 (1.2-14.7), respectively. Poor perceptions of health, loss of control and feeling fearful also appeared to be important: below average summary psychological status, OR 6.5 (1.9-22.3). Inability to do heavy housework, carry heavy shopping or bend to cut own toenails, indicating poor functional reserve capacity, was strongly associated with decline, OR 6.8 (2.2-20.8). psychosocial factors are as strongly associated with catastrophic decline as deterioration in health status. Interventions to reduce the risk of catastrophic decline may require management of psychosocial problems as well as health condition components.

Cognitive Functioning as a Predictor of Functional Disability in Later Life

The contribution of cognitive functioning on multiple levels of functional disability and mortality over two years as well as individual activities of daily living (ADLs) and instrumental activities of daily living (IADLs) tasks, in a sample of older U.S. adults was examined. A total of 4,077 U.S. adults (1,493 males and 2,584 females) aged > or =70 years (mean = 76.35 years) from the Second Longitudinal Study of Aging (1997/1998-1999/2000) were examined using an adapted Telephone Interview of Cognitive Status (TICS), ADLs, and IADLs. Multivariate logistic regression investigated cognition as a predictor of five mutually exclusive levels of functional disability. People with the lowest level of cognition had greater odds of mortality at follow-up (adjusted odds ratio [AOR] = 2.86, 95% confidence interval [CI] = 1.94-4.20), ADL and IADL disability (AOR = 1.58, 95% CI = 1.15-2.16), ADL disability (AOR = 1.83, 95% CI = 1.27-2.64), or IADL disability (AOR = 1.22, 95% CI = 0.86-1.71) than those who were disability-free. Cognitive functioning was not predictive of individual ADL tasks but was predictive of the IADL tasks of preparing meals, shopping for groceries, managing money, telephone use, light housework, and medications but not heavy housework. Persons with lower levels of cognitive functioning were more likely to die or become disabled than those with higher levels of cognition. Changes in cognitive functioning might serve as an early indicator of neurologic and medical factors.

S.14.05 Metabolic side effects of antipsychotics

Background: When second-generation antipsychotics (SGAs), also called atypical antipsychotics, were introduced in the 1990s, early research suggested that these drugs offered better tolerability and adherence than first-generation antipsychotics (FGAs), or typical antipsychotics. This presumably would reduce the need for hospital services. However, health research to test this hypothesis has focused mostly on psychiatric readmissions.Objective: The objective of this study was to compare rates of all-cause hospitalization among patients receiving different classes of antipsychotics (SGAs, FGAs, both, or neither) in a large, all-ages sample of both institutionalized and noninstitutionalized Medicare beneficiaries.Methods: We examined the 2005 Medicare Current Beneficiary Survey Cost and Use file for 11,236 survey participants. Antipsychotic utilization was characterized in terms of class: FGA (ie, chlorpromazine, fluphenazine, haloperidol, loxapine, perphenazine, thiothixene, thioridazine, or trifluoperazine) or SGA (ie, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, or ziprasidone). Hospitalization was defined in terms of whether a Medicare beneficiary was admitted to the hospital for any reason in 2005, and was measured in terms of the number of hospital visits. In our final model, we included the following confounding variables: disability status (≥1 limitation in activities of daily living), Rosow-Breslau impairment score (difficulty with walking, stooping, crouching, kneeling, or doing heavy housework), cognitive impairment (diagnosis of Alzheimer's disease or memory loss that interfered with daily activity), and health behavior variables (body mass index and smoking status).Results: A total of 3.5% of Medicare beneficiaries (1.3 million) filled ≥1 prescription for an antipsychotic medication in 2005. Controlling for demographic, socioeconomic, health, and disability variables, SGA-only users were more than twice as likely (odds ratio [OR] = 2.2 [95% CI, 1.7–2.9]) and combination users were more than 6 times as likely (OR = 6.3 [95% CI, 2.4–16.2]) as nonusers to be hospitalized. The odds of FGA users being hospitalized were not significantly different from nonusers (OR = 1.4 [95% CI, 0.7–2.8]).Conclusions: This analysis yielded provocative, but by no means conclusive, evidence that SGAs as a class are not necessarily superior to FGAs in mitigating patient's use of hospital services under real-world conditions. Systematic analysis of this relationship with a large, multiple-year sample of Medicare beneficiaries is warranted.

Economic valuation of informal care: The conjoint measurement method applied to informal caregiving

This paper reports the results of the application of the conjoint measurement method (CM) to determine a monetary value of informal care. Compared to the normally recommended valuation methods, like the opportunity cost method and proxy good method, CM is probably better able to capture the heterogeneity of informal care. We developed a survey in which informal caregivers were asked to rate four different hypothetical informal caregiving situations, which differed with respect to care hours, care tasks and monetary compensation. Data were obtained from postal surveys. A total of 135 pairs of informal caregivers and care recipients with rheumatoid arthritis (RA) from the Netherlands returned a completed survey and were used in the analysis. Informal caregivers require an extra compensation of 1.00 euro per hour for providing one additional hour of the same informal care task (meaning that from the seventh to the eighth hour, they require 8 euro). For providing two extra hours of care, they require 2.00 euro compensation per hour. The relative valuation of informal care tasks is very diverse. Respondents require a compensation of 13.43 euro per hour for switching from providing light housework to personal care and 0.56 euro per hour for switching from providing personal care to heavy housework. Though CM is sometimes regarded as cognitively complex, 70% of the respondents were able and willing to evaluate the hypothetical caregiving scenarios. Elderly respondents especially had more difficulty with the method. In sum, CM is seen as a promising alternative for existing methods to determine a monetary value of informal care. The presented valuations of informal care can be incorporated in the numerator of a cost–effectiveness ratio in economic evaluations of health care.

Further Evidence for the Importance of Subclinical Functional Limitation and Subclinical Disability Assessment in Gerontology and Geriatrics

The objectives of this work were to determine the prevalence of self-reported subclinical status for functional limitation and disability at baseline and assess their independent effects on the onset of functional limitation and disability 1-2 years later. Nine hundred ninety-eight African American men and women 49-65 years old in St. Louis, MO, received comprehensive in-home evaluations at baseline and two annual telephone follow-ups. Outcome measures included walking a half-mile, climbing steps, stooping-crouching-kneeling, lifting or carrying 10 lbs., and doing heavy housework. The baseline prevalence of subclinical status was 26.4% for walking a half-mile, 26.8% for climbing steps, 39.0% for stooping-crouching-kneeling, 29.1% for lifting or carrying 10 lbs., and 22.7% for doing heavy housework. The adjusted odds ratios for the task-specific subclinical status measure at baseline on developing difficulty 1-2 years later were 1.68 (p < .05) for walking a half-mile, 4.46 (p < .001) for climbing steps, 2.48 (p < .001) for stooping-crouching-kneeling, 2.51 (p < .001) for lifting or carrying 10 lbs., and 2.22 (p < .001) for doing heavy housework. Performance tests (tandem stand, chair stands, and preferred gait speed) did not have consistent independent effects on the onset of functional limitation or disability. The subclinical status measures were the main predictors of the onset of difficulty in all tasks and functions 1-2 years later. Interventions to reduce frailty should focus on self-reported subclinical status as an early warning system.

The problems experienced by patients with cancer and their needs for palliative care

To investigate the problems that patients experience and their met- and unmet needs for professional help. This information is necessary to tailor palliative care to patient needs. Patients (n=94) with disseminated cancer completed a validated checklist with 90 potential problems and needs for palliative care (PNPC questionnaire). On average, patients experienced 37 problems (range 0-68) and required more professional attention for eight problems (range 0-71). The five most prevalent problems were: fatigue, heavy housework, coping with the unpredictability of the future, fear of metastases, and frustrations because I can do less than before. The five issues most in need of extra attention were: informational needs, coping with the unpredictability of the future, fear of metastases, fear of physical suffering, and difficulties remembering what was told (during consultations). Younger patients experienced more social, psychological, and financial problems. Some 10% of patients expressed a multitude of problems and needs. While patients with metastasized cancer experienced a wide variety of problems, they asked for more support for only a few specific problems. Evidently, "problems" are not synonymous with unmet needs. Therefore, not only problems but also needs for care should be assessed. A structural need for support to cope with fears of suffering and loss of autonomy was found. Ten percent of patients expressed a multitude of problems and needs and might benefit either from psychological counseling or better palliative care.

The relationship between sensory impairment and functional independence among elderly.

BackgroundIt has been well established that increasing age is associated with decreasing functional ability in older adults. It is important to understand the specific factors that affect instrumental activities of daily living (IADL) and functional independence among older adults with sensory disabilities.MethodsNationally representative sample of adults aged 55 years and older with seeing or hearing disabilities were categorised into three sensory classifications: "Seeing Disabled but Hearing Abled" (SD-HA), "Hearing Disabled but Seeing Abled" (HD-SA), and both "Seeing and Hearing Disabled" (SD-HD). The additional category of "Seeing Disabled and/or Hearing Disabled" (SD and/or HD) was created to calculate the total of all individuals from the above categories who either had a seeing or hearing disability or both sensory disabilities. Respondents were asked to indicate whether they received assistance in performing seven IADL and their level of functional independence.ResultsThe most common factors that affect IADL were heavy chores, grocery shopping and housework. Individuals with both seeing and hearing disabilities (SD-HD) reported having the most IADL restrictions, followed by individuals with only seeing disabilities (SD-HA) and only hearing disabilities (HD-SA). Individuals with severe sensory disabilities were generally more likely to report IADL restrictions and less likely to have decision-making control and be happy with their lives. In each sensory classification, females aged 55–64 years and 65 years and older reported more IADL restrictions than males.ConclusionBoth seeing and hearing disabilities have a significant impact on restricting an individual's IADL.

Further evidence for the agreement between patients with stroke and their proxies on the Frenchay Activities Index

To determine item, subscale and total score agreement on the Frenchay Activities Index (FAI) between stroke patients and proxies six months after discharge from rehabilitation. Prospective study design. Fifty patient-proxy pairs, interviewed separately, in the patient's residence. Modified FAI using 13 items. Individual FAI items, subscales and total score agreement as measured by weighted kappa and intraclass correlation coefficients (ICC). Excellent agreement was found for the total FAI (ICC 0.87, 95% confidence interval (CI) 0.78-0.93), and domestic (ICC 0.85, 95% CI 0.73-0.91) and outdoor (ICC 0.87, 95% CI 0.78-0.95) subscales, with moderate agreement found for the work/leisure subscale (ICC 0.63, 95% CI 0.34-0.78). For the individual FAI items, good, moderate, fair and poor agreement was found for five, three, four and one item, respectively. The best agreement was for objective items of preparing meals, washing-up, washing clothes, shopping and driving. The poorest agreement was for participation in hobbies, social outings and heavy housework. Scoring biases associated with patient or proxy demographic characteristics were found. Female proxies, and those who were spouses, scored patients lower on domestic activities; male patients, and those who were younger, scored themselves higher on outdoor activities and higher patient FIM scores were positively correlated with higher FAI scores. While total and subscale agreement on the FAI was high, individual item agreement varied. Proxy scores should be used with caution due to bias.

PHYSICAL ACTIVITY SURVEILLANCE

The 1996 Surgeon General's Report on Physical Activity and Health emphasized the health-related benefits of moderate-intensity physical activities (PA), such as heavy yard work, brisk walking, and housework. Prior to this, vigorous intensity PA (e.g., running, aerobic sports) was recommended for cardiovascular health. Given the public health focus on lifestyle activities, traditional surveillance systems with an emphasis on vigorous intensity sports are not able to determine how many Americans are achieving a level of PA to ensure health benefits. PURPOSE To determine the prevalence and epidemiology of health-related PA levels in U.S adults using a new instrument designed to capture a broad range of activities. METHODS Data were obtained in 2001 from a population-based randomdigit-dialed telephone survey administered to adults. Survey questions assessed PA while at work and during leisure time. RESULTS The study population included 83,684 men and 121,456 women. About 45% of adults were active at recommended levels (men 48%; women 43%) and only 16% reported no leisure-time PA. As expected, the prevalence of recommended levels of PA decreased as age increased and the prevalence of recommended activity was higher among whites compared to Blacks or Hispanics. Differences were noted by educational level with recommended levels of PA increasing as educational level increased. At work, 9% reported heavy activity, 14% reported mostly standing and walking, 39% reported mostly sitting and 38% were unemployed. Among men reporting heavy labor, over 50% were active at the recommended level in their non-working hours. CONCLUSION Broadening the definition of PA to include moderate-intensity activities increased the prevalence of recommended activity to 45%, suggesting that over half the population is still at risk for poor health outcomes due to physical inactivity.

Social and medical risk indicators for 8-year mortality in a Swedish urban elderly population

The aim of this study was to identify and evaluate social and medical risk indicators for mortality in an urban elderly population. Altogether 217 subjects (144 women and 73 men, mean age 78 years, range 69–96 years of age) participated in an examination 1990/91. Eighty-eight persons (55 women and 33 men) had died, and 129 subjects (89 women and 40 men) were alive January 1, 1999. Several risk indicators were found and those with the highest statistical explanatory power to predict mortality were: tremor, inability for heavy housework, a pathological second heart sound, low triceps skinfold, low diastolic blood pressure and decreased appetite. A multivariate model (MVM) utililizing both social and medical risk indicators, and a clinical model (CM) based on the judgement of a registered nurse identified 49 and 34%, respectively, of those who died during the 8-year period ( n=88). A third risk group, the intervention group, comprising individuals selected by either the MVM or CM models, identified 56% of those who died. The latter procedure could be used to define risk groups for mortality in future intervention studies. The combination of social and medical risk indicators in MVM, and a CM might be used in studies with larger sample sizes in order to increase the knowledge in this field.

Vigorous Physical Activity and Fall Occurrence

The purpose of this study was to examine whether vigorous physical activity, defined as sports, heavy housework, or a job that involves physical labor, is associated with falls, falls with a serious injury, broken hip, and fall frequency. This study uses the Health and Retirement Study (HRS) database survey developed by the University of Michigan to examine the relationship of key attribute variables (in addition to vigorous physical activity) associated with falls. The sample consisted of 11,226 older Americans age 65 to 106. A Logit and Tobit regression analysis indicated that vigorous physical activity is negatively associated with falls and falls with a serious injury, broken hip, and fall frequency. Although the study does not differentiate which component of vigorous physical activity (i.e., sports, heavy housework, or a job that involves physical labor) it does indicate that those who participate in these activities are less likely to be associated with fall-related consequences.

Health and Social Profile of Older Adults With MS: Findings From Three Studies

Currently in the United States, approximately 45% of people with multiple sclerosis (MS) are older than 55. The majority of these people can expect to live as long as their age peers. This paper provides a health and social profile of 440 older adults with MS (mean age, 64) using data from three separate studies conducted in Canada and the United States. The majority of participants were women, married, living with at least one other person, and reporting that their income was adequate to meet their needs. The most common symptoms reported included fatigue, problems with balance, and weakness. Participants had the most difficulty with doing heavy housework, making a hot meal, managing finances, and bathing. Overall, most participants reported their health as poor. Comparing these findings to existing literature suggests important health differences between younger and older people with MS, and between older adults with and without MS, that may not be sufficiently recognized by existing services. (Int J MS Care. 2002; 4: 139–143, 148–151)