Higher Physical Functioning Research Articles

Return to work of major trauma survivors from a private level 1 trauma centre in South Africa

PurposeTrauma is known as a leading cause of mortality and injury related disability globally. In South Africa (SA) the socioeconomic burden of trauma is magnified as the working age is most affected. The aim of this study was to describe the proportion of major trauma survivors who returned to work (RTW) during a 6-month period post hospital discharge and to identify the factors associated with the RTW outcome.MethodsThis was a prospective observational cohort study involving major trauma survivors from a private level 1 trauma centre intensive care unit in SA between January and September 2022. RTW status was assessed using the Employment Questionnaire. Univariate and multivariable Cox proportional hazards regression was used in analysis.ResultsSixty-four of the 86 participants (74.4%) RTW at six months post hospital discharge. RTW had a median time of 16 weeks. After adjusting and backwards analysis, Chelsea Critical Care Physical assessment tool scores (adjusted hazard ratio (AHR), 1.06, 95% CI 1.01–1.10, p = 0.007), and not having applied/received any form of grants (AHR 2.26, 95% CI 1.35–3.77, p = 0.002) were the only factors that were associated with the RTW outcome.ConclusionThe cumulative probability of no RTW was 25.6% among participants after 24 weeks. Higher physical function at ICU discharge and not seeking any form of compensation was associated with a higher probability of RTW. This study has highlighted the complexities of RTW and the socioeconomic burden following major trauma. There is therefore a need for further studies on RTW following major trauma in SA.

Long-term health outcomes and quality of life in women with untreated pelvic floor dysfunction: a single-center cohort study

ObjectiveThis study aimed to evaluate the long-term health outcomes and quality of life (HRQoL) associated with untreated pelvic floor dysfunction (PFD) in women, and to identify key factors contributing to symptom severity.MethodsA cohort of 1,651 women aged 18 years and older with untreated PFD were recruited between June 2018 and August 2023. Data on sociodemographic, lifestyle factors, and clinical history were collected via questionnaires and clinical assessments. The Pelvic Floor Distress Inventory (PFDI-20) and Short Form-12 (SF-12) were used to assess symptom severity and HRQoL.ResultsThe study found that 56% of participants experienced urinary incontinence (UI), 52% had pelvic organ prolapse (POP), and 47% reported gynecological disorders. Sleep apnea (OR: 18.3, p < 0.001) and menopause (OR: 2.48, p < 0.001) were significantly associated with higher symptom severity, while postpartum complications had a protective effect (OR: 0.01, p < 0.001). Obesity was inversely associated with symptom severity (OR: 0.3, p < 0.001). HRQoL scores showed that 97.6% of participants had high physical functioning (mean PF: 67.36 ± 11.62), but vitality (VT) was notably lower, with 27.8% scoring below 50 (mean VT: 54.84 ± 6.60). FI (p = 0.006) and pelvic pain (p = 0.001) were linked to significantly poorer physical functioning and higher bodily pain.ConclusionUntreated PFD has a profound impact on HRQoL, especially in women with sleep apnea, menopause, and pelvic pain. Early diagnosis and intervention are critical to mitigating these effects and improving long-term outcomes. These findings highlight the urgent need for targeted public health strategies to address untreated PFD.

Facilitators and barriers to employment for people with adult-onset physical disabilities: results from a U.S.A. survey.

Employment has long been an area of concern for people with disabilities. National samples in the United States are needed to understand the experiences of people with disabilities related to employment. (1) Describe and evaluate associations between personal and health-related factors with employment after disability, and (2) describe and evaluate associations between facilitators, barriers, and work-related external factors with maintaining a longest held job after disability. We recruited a national sample of people with physical disabilities from panels assembled by a United States market research organization; by selection, 1309 were working and 491 were not. We evaluated the likelihood of employment and maintaining employment after disability onset using Poisson regression. Model 1 evaluated factors associated with employment; Model 2 evaluated factors associated with maintained employment. Model 1: Older age, decreased ability to pay bills on time, and assistive device use were associated with decreased likelihood of employment after disability onset. Non-Black minority identification, fatigue, and higher physical function were associated with increased likelihood of employment. For Model 2, the likelihood of maintaining a longest held job was associated with acquiring a disability at work, receipt of job accommodations, valuing opportunities for advancement and health benefits, having a helpful living situation, and helpful human resource attitudes. Decreased likelihood of maintaining a longest held job after disability onset was associated with job dissatisfaction and supervisors' attitudes. This work highlights opportunities for employers to focus efforts on job accommodations and support in the maintenance of employment after disability.

Exploring Factors Associated with Changes in Pain and Function Following mHealth-Based Exercise Therapy for Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis and Meta-Regression

Exercise therapy is the first-line intervention recommended for those with chronic musculoskeletal pain (CMP). Smartphone technologies (mHealth) represent a feasible means for exercise prescription and individualization. This systematic review with meta-analysis aimed to identify factors associated with changes in pain and function following mHealth-based exercise therapy in patients with CMP. CINAHL (via EBSCOhost), Embase, PubMed, Scopus, and SPORTdiscus were searched from inception to February 2023. Observational and controlled clinical trials with correlation or regression analysis of factors associated with the effect of mHealth exercise interventions on pain and function were included. The risk of bias, completeness of interventions, spin of information, and certainty in the evidence were evaluated. Eight studies with 51,755 participants were included. Reduced pain intensity after intervention was associated with higher physical function: r (95% CI) = −0.55 (−0.67 to −0.41); I2 = 86%, Tau2 = 0.02; p < 0.01. Meta-regression identified the Body Mass Index (BMI), exercise dose, and completion rate as potential moderators between changes in pain and physical function following mHealth exercise therapy. No association was found between pain and anxiety: r (95% CI) = 0.15 (−0.08 to 0.37); I2 = 87%, Tau2 = 0.02; p = 0.19. Very low certainty in the evidence was observed due to serious concerns regarding the risk of bias, inconsistency, and indirectness. The limited available evidence detracts from the clinical interpretation of the findings.

Trajectories of satisfaction with work-family reconciliation among midlife employees: the role of family-related factors and quality of life.

We studied the developmental trajectories of satisfaction with work-family reconciliation (WFS) and their associations with family-related factors and quality of life measures among municipal employees. The study was based on the Helsinki Health Study of municipal employees of the City of Helsinki in 2001-02 and its follow-up surveys in 2007, 2012, and 2017. Employees aged 40-50 at baseline and working at all timepoints were analysed (n = 1681, 84% women). Growth Mixture Models were applied to identify trajectories of WFS (dissatisfied vs. satisfied). Associations of family-related and quality-of-life factors (physical functioning and emotional well-being) with the WFS trajectories were studied using log-binomial regression models, adjusting for sociodemographic and lifestyle variables. Two WFS trajectories, low (women 45%; men 53%) and high were identified. In a fully adjusted model among women, having ≥1 children aged 0-6 years was associated with increased odds of belonging to the low WFS trajectory (OR 1.52, 95% CI 1.19-1.95). Among men, having ≥1 children aged 7-18 was associated with decreased odds (0.39, 0.19-0.80). High emotional well-being was inversely associated with the low WFS trajectory among both genders (women 0.32, 0.23-0.45; men 0.20, 0.09-0.46). High physical functioning (0.59, 0.42-0.83) was inversely associated with the low WFS trajectory among women only. Less than half of the women and more than half of the men participants belonged to a low WFS trajectory, which associated with the age of children in the family and quality-of-life measures.

Association Between Dynapenia, Central Obesity, and Physical Function in Young Adults: A Cross-Sectional Study.

Muscle strength is recognized as a key indicator of overall health and can help identify the risk of cardiometabolic disease. This study explores the relationship between low muscle strength, central obesity, and physical function among young adults. We conducted a cross-sectional study from a convenience sample of 513 adults aged 18-25. Participants' anthropometric measures such as height, weight, and circumferences of both waist and hip were measured, and body mass index (BMI) was calculated. Subjects were tested for hand grip strength (HGS) using hand dynamometry. Relative hand grip strength (RHGS) was derived by dividing maximum HGS by BMI. Physical function was assessed using a six-minute walk test. The International Physical Activity Questionnaire (IPAQ) was administered. Overweight and obesity were present in 313 (61%) of the study population. Central obesity was observed in 194 (37.8%) of the population. RHGS showed a positive association with physical function and physical activity, and a negative association was observed with BMI and waist circumference. Low RHGS was categorized as < 25th percentile by gender. The non-dynapenic non-central obese group had higher physical function (644± 124.2) than others. There was no difference in the dynapenic and central obese groups. The dynapenic central obese group had significantly lesser physical function (424.9±69.1) than all other groups in both genders. Our study supports the importance of early investigation of dynapenia, which can increase the risk of chronic disease and accelerate the development of physical limitations. Understanding how dynapenia and central obesity relate to low physical function is of growing importance in young adults, and it can play an important role in overall health.

Effect of resistance training on physical function during chemotherapy in colon cancer.

The decline of physical function during chemotherapy predicts poor quality of life and premature death. It is unknown if resistance training prevents physical function decline during chemotherapy in colon cancer survivors. This multicenter trial randomly assigned 181 colon cancer survivors receiving postoperative chemotherapy to home-based resistance training or usual care control. Physical function outcomes included the short physical performance battery, isometric handgrip strength, and the physical function subscale of the Medical Outcomes Short-Form 36-item questionnaire. Mixed models for repeated measures quantified estimated treatment differences. At baseline, participants had a mean (SD) age of 55.2 (12.8) years; 67 (37%) were 60 years or older, and 29 (16%) had a composite short physical performance battery score of no more than 9. Compared with usual care control, resistance training did not improve the composite short physical performance battery score (estimated treatment difference = -0.01, 95% confidence interval [CI] = -0.32 to 0.31; P = .98) or the short physical performance battery scores for balance (estimated treatment difference = 0.01, 95% CI = -0.10 to 0.11; P = .93), gait speed (estimated treatment difference = 0.08, 95% CI = -0.06 to 0.22; P = .28), and sit-to-stand (estimated treatment difference = -0.08, 95% CI = -0.29 to 0.13; P = .46). Compared with usual care control, resistance training did not improve isometric handgrip strength (estimated treatment difference = 1.50 kg, 95% CI = -1.06 to 4.05; P = .25) or self-reported physical function (estimated treatment difference = -3.55, 95% CI = -10.03 to 2.94); P = .28). The baseline short physical performance battery balance score (r = 0.21, 95% CI = 0.07 to 0.35) and handgrip strength (r = 0.23, 95% CI = 0.09 to 0.36) correlated with chemotherapy relative dose intensity. Among colon cancer survivors with relatively high physical functioning, random assignment to home-based resistance training did not prevent physical function decline during chemotherapy. NCT03291951.

Successful Aging and Subjective Aging: Toward a Framework to Research a Neglected Connection.

Research related to subjective aging, which describes how individuals perceive, interpret and evaluate their own aging, has substantially grown in the past two decades. Evidence from longitudinal studies shows that subjective aging predicts health, quality of life, and functioning in later life. However, the existing literature on successful aging has mostly neglected the role of subjective aging. This paper proposes an extended framework of successful aging linking subjective aging conceptually and empirically to Rowe and Kahn's (1997) three original key criteria of successful aging (i.e., avoiding disease and disability, maintaining high cognitive and physical function, and engagement with life). A particular focus is placed on subjective aging as an antecedent of successful aging. A review of the empirical subjective aging literature shows that subjective aging concepts consistently predict all three of Rowe and Kahn's criteria of successful aging. Mechanisms underlying these relations are discussed at three levels, namely psychological, behavioral, and physiological pathways. The proposed addition also takes into consideration the interconnections between subjective aging and successful aging throughout the lifespan and across historical time. Finally, we discuss the importance of facilitating successful aging through systematic interventions that support more positive views of aging at the individual and societal level.

Fluid Cognition Among Individuals With Systemic Lupus Erythematosus.

We sought to describe fluid cognition and its correlates among individuals with systemic lupus erythematosus (SLE). Participants (n = 199) were recruited from a population-based cohort for a single study visit (October 2019 to May 2022). Fluid cognition was measured via the National Institutes of Health Toolbox Fluid Cognition Battery (including episodic memory, working memory, attention and inhibitory control, processing speed, and cognitive flexibility domains) and expressed as age-corrected standard scores (mean 100, SD 15). Potential impairment was defined as a standard score >1.5 SD below the mean. Descriptive statistics were calculated and associations of various participant characteristics with the potential fluid cognition impairment were assessed with multivariable logistic regression. Participants' mean age was 46.1 years; most were female (87.4%), Black (86.4%), and non-Hispanic (95.0%). The mean overall fluid cognition score was 87.2; of the individual domains, the participants' mean score was lowest on attention and inhibitory control (82.0). Working status (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.14-0.64) and higher self-reported physical functioning (OR 0.46, 95% CI 0.28-0.75) and physical performance (OR 0.72, 95% CI 0.59-0.87) were associated with lower odds of fluid cognition impairment; lower educational attainment was associated with higher odds (OR 3.82, 95% CI 1.67-8.75). Self-reported forgetfulness, neuropsychiatric damage, and depressive symptoms were not statistically significantly associated with potential impairment. Fluid cognition and, particularly, attention and inhibitory control were low in those with SLE relative to the general US population. Working status, higher physical functioning and performance, and higher educational attainment were associated with lower prevalence of potential impairment. Future work is needed to develop and implement interventions to help support cognition in individuals with SLE.

Mental Health Scores but not Sleep Quality are Lower in Veterans with Gulf War Illness that have Low Physical Function

PURPOSE: Gulf War Illness (GWI) is a poorly understood illness that impacts about a third of Veterans who were deployed to the Gulf Region during the 1990-1991 Gulf War (GW). GW Veterans have twice the odds of having depression compared to non-deployed Veterans. Depression and sleep quality are associated with impaired physical function, which is notable since physical activity is a modifiable health behavior that can be an effective method to reduce mild to moderate depressive symptoms and improve sleep. We hypothesize that Veterans categorized with GWI and with high physical function scores will have fewer depressive symptoms and better sleep quality compared to those with low physical function. Evaluating the connection between physical and mental health in Veterans with GWI could support behavioral health interventions intended to improve symptom management. Methods: GW Veterans were enrolled in an ongoing VA multi-site remote clinical research study and completed web-based questionnaires: the Modified Kansas questionnaire, short-form 36 (SF-36), Patient Reported Outcomes Measurement Information System (PROMIS)-Emotional Distress Anxiety and Depression, and the Pittsburgh Sleep Quality Index (PSQI). The modified Kansas was used to designate GWI based on 6 self-reported symptom domains. Symptom onset was also required within 5 years of deployment. The SF-36 assessed eight functional domains, including physical functioning measuring mobility disability. GW Ill Veterans were grouped based on the SF-36 physical function score such that those with ≤70 were considered in the poor physical function group (low) and &gt;70 were in the high physical function group (high). The PROMIS Anxiety assessed anxiety and PROMIS Depression assessed negative mood and decreased positive affect. The PSQI global score assessed sleep quality over a one-month period and ranges from 0-21 where a greater score reflects poorer sleep quality. Data were analyzed using student t-tests and linear regressions using Graphpad Prism 9. RESULTS: 63 Veterans (low group: 12 females/35 males, 60±4 years old; high group: 3 females/13 males, 59±5 years old) completed the web-based questionnaires. Anxiety and depression scores were greater in the low vs high group (Anxiety= low: 70.0±29; high: 45.4±14.0, P=0.001; Depression= low: 64.2.0±34.5; high: 41.3±14.7, P=0.01). Sleep quality (low: 12.8±4.0; high: 11.9±4.7, P=0.44) was not different between the groups. Anxiety scores (R2=0.19, P=0.0004) and depression scores (R2=0.11, P=0.007) were related to physical function, thus greater physical function was associated with lower (better) mental health scores. Sleep quality (R2=0.07, P=0.03) was related to physical function, so greater physical function was associated with better sleep quality. CONCLUSIONS: Gulf War Illness is a chronic multi-symptom condition that can be debilitating. Insight about physical function, depression and sleep symptoms could guide therapeutic approaches. The SF-36 is recommended as a core data element in GWI research and as such can provide information on the physical aspects of health. These findings suggest that depression and anxiety differ in those with low versus high physical function and that physical function is related to mental health and sleep quality. Future research should examine how GW Veterans are able to maintain their physical function to improve overall health. VA CSR&amp;D. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Cancer history and physical function in patients with cardiovascular disease.

Both cancer and cardiovascular disease (CVD) cause skeletal muscle mass loss, thereby increasing the likelihood of a poor prognosis. We investigated the association between cancer history and physical function and their combined association with prognosis in patients with CVD. We retrospectively reviewed 3,796 patients with CVD (median age: 70years; interquartile range [IQR]: 61-77years) who had undergone physical function tests (gait speed and 6-minute walk distance [6MWD]) at discharge. We performed multiple linear regression analyses to assess potential associations between cancer history and physical function. Moreover, Kaplan-Meier curves and Cox regression analyses were used to evaluate prognostic associations in four groups of patients categorized by the absence or presence of cancer history and of high or low physical function. Multiple regression analyses showed that cancer history was significantly and independently associated with a lower gait speed and 6MWD performance. A total of 610 deaths occurred during the follow-up period (median: 3.1years; IQR: 1.4-5.4years). The coexistence of low physical function and cancer history in patients with CVD was associated with a significantly higher mortality risk, even after adjusting for covariates (cancer history/lowgait speed, hazard ratio [HR]: 1.93, P < 0.001; and cancer history/low6MWD, HR: 1.61, P = 0.002). Cancer history is associated with low physical function in patients with CVD, and the combination of both factors is associated with a poor prognosis.

Posttraumatic stress disorder, Veterans Health Administration use, and care-seeking among recent-era U.S. veterans.

The current study investigated the associations among probable posttraumatic stress disorder (PTSD), recent Veterans Health Administration (VHA) health care use, and care-seeking for PTSD in U.S. military veterans. Analyses were conducted among 19,691 active duty military personnel enrolled in the Millennium Cohort Study who separated from the military between 2000 and 2012 and were weighted to the 1,130,103 active duty personnel who separated across this time period. VHA utilization was identified from electronic medical records in the year before survey completion, and PTSD care-seeking and PTSD symptoms were assessed through self-report on the 2014-2016 survey; thus, the observation period regarding care-seeking and VHA use encompassed 2013-2016. Veterans with probable PTSD were more likely to use VHA services than those without probable PTSD, aOR = 1.12, 95% CI [1.01, 1.24], although the strongest association with recent VHA use was a depression diagnosis, aOR = 2.47, 95% CI [2.26, 2.70]. Among veterans with probable PTSD, the strongest predictor of care-seeking was recent VHA use compared to community care, aOR = 4.01, 95% CI [3.40, 4.74); reporting a diagnosis of depression was the second strongest predictor of PTSD care-seeking, OR = 2.99, 95% CI [2.53, 3.54]. However, the absolute number of veterans with probable PTSD who were not seeking care was approximately equivalent between veterans using VHA services and those not using VHA services. Additionally, certain groups were identified as being at risk of not seeking care, namely Air Force veterans and veterans with high physical and mental functioning despite substantial PTSD symptoms.

Changes in gait performances during walking with head movements in older adults with chronic neck pain.

Chronic neck pain (CNP) can lead to altered gait which is worse when combined with head movement. Gait parameters for indicating speed and symmetry have not been thoroughly investigated in older adults with CNP. This study aimed to compare gait performance in term of speed and symmetry in older adults with and without CNP during walking with head movement. Fifty young older adults, consisting of 36 healthy controls without neck pain (OLDs) and 14 older adults with CNP, participated in the study. Participants completed the Neck Disability Index and Activities-specific Balance Confidence Scale. The 10-Meter Walk Test (10MWT) was used to assess gait performance. Participants were instructed to walk at preferred speed under three different head movement patterns: no head movement (NM), horizontal head movement (HM), and vertical head movement (VM). The Inertial Measurement Unit was used to capture gait performance, and its software was used to analyze gait variables; gait speed, Locomotor Rehabilitation Index (LRI), gait asymmetry index, Phase Coordination Index (PCI). The CNP group reported moderate neck pain with mild disability in activities of daily living, and less balance confidence than the OLD group (p < 0.05). The CNP group showed significantly slower gait speed and lower LRI during walking with both the HM and VM (p < 0.05), which corresponded to lower stride length and cadence. The gait asymmetry index in the CNP group was significantly higher than the OLD group during walking with VM (p < 0.05), whereas the PCI was significantly higher than the OLD group during walking with both HM and VM (p < 0.05). Chronic neck pain affects both speed and symmetry when walking with head movement. Gait parameters in this study could be implemented to identify changes in speed and symmetry of gait in older adults with CNP who have mild disability and high physical functioning.

Printed smart devices for anti-counterfeiting allowing precise identification with household equipment

Counterfeiting has become a serious global problem, causing worldwide losses and disrupting the normal order of society. Physical unclonable functions are promising hardware-based cryptographic primitives, especially those generated by chemical processes showing a massive challenge-response pair space. However, current chemical-based physical unclonable function devices typically require complex fabrication processes or sophisticated characterization methods with only binary (bit) keys, limiting their practical applications and security properties. Here, we report a flexible laser printing method to synthesize unclonable electronics with high randomness, uniqueness, and repeatability. Hexadecimal resistive keys and binary optical keys can be obtained by the challenge with an ohmmeter and an optical microscope. These readout methods not only make the identification process available to general end users without professional expertise, but also guarantee device complexity and data capacity. An adopted open-source deep learning model guarantees precise identification with high reliability. The electrodes and connection wires are directly printed during laser writing, which allows electronics with different structures to be realized through free design. Meanwhile, the electronics exhibit excellent mechanical and thermal stability. The high physical unclonable function performance and the widely accessible readout methods, together with the flexibility and stability, make this synthesis strategy extremely attractive for practical applications.

Impact of daily physical therapy over 2 weeks on spinal mobility including objective electronic measurements and function in patients with axial spondyloarthritis.

Patients with axial spondyloarthritis (axSpA) are often compromised by impaired function and mobility. The standardized 2-week inpatient program 'multimodal rheumatologic complex treatment' (MRCT) was designed for patients with axSpA. The Epionics SPINE (ES) is an objective tool validated to assess mobility. To investigate the impact of MRCT on physical function and mobility including range of motion (RoM) and kinematics (RoK). Single-center interventional, observational trial. Patients with axSpA presenting with high disease activity and impaired physical function were consecutively recruited to undergo MRCT. Assessments performed before (V1) and after (V2) the intervention included Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis functional index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), the ankylosing spondylitis physical performance index (ASPI), the Short Physical Performance Battery (SPPB), and ES measurements. At baseline, the 80 patients included had: BASDAI 5.5 ± 1.5, BASFI 5.6 ± 2.0, BASMI 4.2 ± 1.8, SPPB 13.8 ± 1.8, and ASPI 37.3 ± 18.1 s. Clinically relevant improvements between V1 versus V2 were noted for BASFI, BASMI, and all other assessments (p < 0.001), and also for ES measures of RoK (all p < 0.003) and RoM (all p < 0.04), while a positive trend was seen for flexion and extension (RoM). There was no significant effect of changes in medication (all p > 0.05). The 2-weeks MRCT was associated with definite improvements of function and mobility. Importantly, the effect of this extensive physical activity was confirmed by using the ES as an objective tool to assess spinal mobility. The ES demonstrated for the first time that the RoK of spinal mobility can significantly improve related to an exercise intervention. Ethical Committee: Ruhr-Universität (reference-number: 19-6735-BR).

SUCCESSFUL AGING AMONG OLDER PERSONS IN VIET NAM

Abstract The present study aims to explore the prevalence and correlates of successful ageing among Vietnamese older persons. Data used for this study is from the baseline survey of the Longitudinal Study of Ageing and Health in Viet Nam (LSAHV). LSAHV is a nationally representative survey of older persons aged 60 and above in 2018-19 with 6,050 respondents. Face-to-face interviews were conducted using structured questionnaires and tablets. Rowe and Kahn’s definition was used to study successful ageing among older persons in Viet Nam. Study sample size was 4,370 older persons. Logistic regression was employed to examine the association of sociodemographic and lifestyle factors with successful aging among older persons. The prevalence of Vietnamese older persons meeting criteria of successful ageing was 16.2% at the time of baseline survey. The percentage of older persons reporting no major diseases, no disability, high cognitive function, high physical function, and engagement with life was 35.0%, 88.5%, 55.1%, 77.9%, and 79.7%, respectively. Logistic regression analysis showed that older persons who were younger, male, having higher education level, and often doing physical exercise were likely to be successful agers. The prevalence of successful ageing was quite low among Vietnamese older people. More health interventions, successful ageing guidelines, and health care services should be provided for older persons to improve successful ageing status. It is necessary to study successful ageing to improve well-being of older persons becaise Viet Nam is currently experiencing a rapid population ageing.

THE ROLE OF WISDOM IN ADAPTING TO LATE-LIFE SPOUSAL LOSS

Abstract Death of one’s spouse is normative but one of life’s most challenging events (Carr et al., 2001). Wisdom involves compassion, tolerance for uncertainty and reflection, so may be particularly useful in dealing with spousal loss. Past research has related personal wisdom to well-being and life satisfaction in general (Ardelt, 2019). Almost no research, however, has examined wisdom as a resource in the context of bereavement. We (1) expected that higher wisdom would predict better grief adaptation in widowed older adults and, (2) explored whether wisdom effects might be moderated by older adults’ physical status. Participants (N = 54, Mage = 81; SD = 7.57, 62.3% female) completed the Brief Wisdom Screening Scale (Glück et al., 2013) and two assessments of grief adaptation: Inventory of Complicated Grief (Prigerson et al., 1995) and Integration of Stressful Life Experiences (Holland et al., 2011). Hierarchical regression, F(2, 51) = 4.25, p &amp;lt;.05, showed greater wisdom, β = -.27, t(52) = -2.061, p &amp;lt; .05 and higher physical functioning (β = -.27) both predict lower symptoms of complicated grief, with no moderation. A second regression, F(2,51) = 4.44, p &amp;lt; .055, showed a similar trend with greater wisdom associated with better integration of loss, β = .46, t(52) = 1.96, p = .055. Though preliminary, these findings suggest wisdom may serve as a resource for individuals facing loss in later life. Results are discussed in terms of theoretical models (Glück &amp; Bluck, 2013) identifying reciprocal relations between wisdom development and life challenges.

Data-driven subgrouping of youths with depression reveals that resilience is associated with higher physical functioning despite high symptom burden in the Texas Youth Depression and Suicide Research Network (TX-YDSRN)

BackgroundThe Patient-Reported Outcomes Measurement Information System (PROMIS) measure, which assesses past week status of seven domains (physical function mobility, anxiety, depressive symptoms, fatigue, peer relationships, pain interference, and pain intensity), represents a new paradigm using patient-reported outcomes. We used a data-driven approach with PROMIS to identify subgroups of youths receiving depression treatment. MethodsYouths (n = 721) enrolled in the Texas Youth Depression and Suicide Research Network who completed the PROMIS were analyzed. Latent class analyses (LCAs) identified subgroups and compared their baseline clinical/sociodemographic features. ResultsCompared to population norms, our sample had worse than average physical function, anxiety, depression, fatigue, and pain interference. Using LCA, four subgroups were identified: 1) lower symptom severity and higher physical functioning (14.6 %); 2) higher symptom burden, higher pain interference/intensity, and lower physical functioning (52.7 %); 3) higher symptom burden, higher pain interference/intensity, but with higher physical functioning (9.2 %); and 4) higher symptom burden, but lower physical functioning and pain interference/intensity (23.6 %). Group 3 demonstrated higher resilience than Group 2. In contrast, Group 2 had higher anxiety than Group 4. LimitationsIndividuals may have different symptom profiles due to the observational nature of the study. Replication of these subgroups may be difficult, as future samples may differ in these characteristics. Further work may demonstrate the stability of these groups. ConclusionsA data-driven analysis identified a small but significant subgroup with high physical functioning despite high symptom burden and pain, and this group reported higher resilience. Resilience-enhancing interventions may help improve functional outcomes in depressed youth.

Physical function decline predictors in nursing home residents using new national quality indicators.

To determine the predictors of physical function (PF) decline among nursing home residents using items from the Long-term care Information system For Evidence (LIFE), a system launched in 2021 to ensure the quality of long-term care. The LIFE data of 1648 residents from 45 nursing homes in Japan were retrospectively collected in July 2021 (T0) and January 2022 (T1), including demographics, PF assessed by the Barthel index (BI), nutrition and oral health, and cognitive function. The Dementia Behavior Disturbance scale was used to assess the frequency of certain behaviors, such as "waking at midnight." The predictors of PF decline, defined as a decrease ≥5 in the BI score at T1 compared with that at T0, were determined using mixed-effects logistic regression analyses. PF at T0 was classified into high (>60 BI) and low (≤60 BI) groups. The participants' mean age was 87.2 ± 7.1 years, and 45.3% experienced PF decline. The significant predictors of PF decline were age ≥ 90 years, body mass index <18.5 kg/m2 , dementia diagnosis, moderate and severe cognitive impairments, not vocalizing reciprocal exchanges at will, always "waking at midnight," and high PF at T0. The LIFE items predicted PF decline among nursing home residents, suggesting that LIFE data can be used to ensure the quality of long-term care. Geriatr Gerontol Int 2024; 24: 123-132.

Patient Characteristics Associated with Sexual Interest and Activity Among Adults with Spina Bifida

ObjectiveWe sought to identify factors associated with sexual interest and activity among adults with spina bifida and to describe the sexual profile of those who were sexually active. Sexual health of adults with spina bifida is often neglected and current knowledge on the topic is limited. MethodsAn anonymous web-based survey was advertised and administered between March 2018 and September 2018 and participants 16 years and older with spina bifida were included in this study. Respondents were asked about sexual interest, activity, and function using the validated Patient-Reported Outcomes Measurement Information System Sexual Function Profile.Bivariate and multivariable models with ordinal logistic regression were fitted to evaluate predictors of sexual interest and sexual function. ResultsOf the 261 respondents with a self-reported diagnosis of spina bifida (mean age of 38.5 years), 73.2% noted at least a little bit of interest in sexual activity. In multivariate analysis, women were less likely to report higher sexual interest than men (OR=0.53, 95% CI 0.31–0.92, p=0.03) whereas those with higher physical functioning were more likely to have higher sexual interest (OR=1.04, CI 1.01–1.07, p=0.03). Just less than half of respondents (46.4%) were sexually active in the past 30 days, and those with a VP shunt were less likely to engage in sexual activity compared to those without (OR=0.36, 95% CI 0.19–0.68; p<0.01). ConclusionsThe mismatch between sexual interest and sexual activity highlights the importance of exploring issues related to sexual health when counseling adult patients with spina bifida.