Independence In Instrumental Activities Research Articles

DESEMPENHO FÍSICOS EM IDOSOS SEDENTÁRIOS

In the study with 30 sedentary elderly individuals between 60 and 80 years of age, physical and functional capacity tests were performed. In the 6-Minute Walk Test, the elderly individuals aged 60 to 69 years walked an average of 4 meters, while those aged 70 to 79 and 80 years walked 5 and 6 meters, respectively. In the Lawton Scale, which assesses independence in instrumental activities, most elderly individuals showed a need for help, showing that dependence increases with age. In the Katz Scale, 37% of the elderly individuals aged 60 to 69 years, 43% of those aged 70 to 79 years and 20% of those aged 80 years maintained independence in basic self-care activities.

Healthy Aging: Interaction of Cognition, Lifestyle, and Instrumental Activities of Daily Living.

Background: The increasing elderly population highlights the importance of comprehending healthy aging by examining the interactions among cognition, daily activities, and lifestyle. This study aims to address this by investigating these relationships within the World Health Organization's Healthy Aging Model. Methodology: A cross-sectional study was conducted with 178 older adults from southern Iran, representing various cognitive levels. Participants underwent assessments to measure cognitive functions, lifestyle preferences, and independence in instrumental activities of daily living (IADL) using the Mini-Mental State Examination, the Lifestyle Assessment Questionnaire for the Iranian Elderly, and the Lawton IADL Scale. Findings: The relationships between the studied variables were identified. Lower cognitive function was found to be associated with decreased engagement in IADL and less-favorable lifestyle choices. Conclusion: Integrating cognition, IADL, and lifestyle into assessments and interventions align with both the domain and process of occupational therapy, thereby enhancing well-being and promoting healthy aging in older adults.

Leveraging independence and mental fitness - keys to reducing in-hospital mortality among geriatric COVID-19 patients in the intensive care unit: A cross-sectional study in Poland.

Coronavirus disease 2019 (COVID-19) quickly reached the pandemic status, with 765.22 million confirmed cases of COVID-19 and 6.92 million COVID-19 deaths reported worldwide by May 2023. Due to its sudden and global nature, the COVID-19 pandemic has had a significant impact on the emotional and mental health of many people. A group of COVID-19 patients who frequently require intensive care are geriatric patients. The cognitive performance of these patients and their independence in instrumental activities of daily living (IADL) may be crucial to their prognosis and risk of in-hospital death. The present study aimed to assess the level of independence in activities of daily living (ADL), mental fitness, the level of fear of COVID-19, and cognitive functions to determine their impact on in-hospital mortality in geriatric COVID-19 patients. A total of 300 intensive care unit (ICU) patients with COVID-19 were included in the cross-sectional study, using the following questionnaires: the Lawton IADL scale, the Katz ADL index of independence, the fear of COVID-19 scale (FCV-19S), the abbreviated mental test score (AMTS), and the 15-item geriatric depression scale (GDS15). Patients aged 64 or below reported significantly greater independence on the IADL scale and the basic ADL scale, and showed a significantly higher level of mental fitness (Mann-Whitney U test; p = 0.001). Patient survival and in-hospital mortality were influenced by independence in basic and complex ADL. The level of independence is an important prognostic indicator for in-hospital mortality in geriatric COVID-19 patients. The higher the level of mental fitness, the higher the level of independence in basic and instrumental activities of daily living. Patients aged ≥65 years are less independent in basic and instrumental activities of daily living. Moreover, they show a significantly lower level of cognitive functions.

Fatores associados à capacidade funcional em pessoas idosas no serviço de emergência

Abstract Objective To relate sociodemographic, economic and clinical variables and having or not having a caregiver, risk for falls and perception of the risk for falls with the functional capacity of older adults in an Emergency Department. Methods Analytical cross-sectional study of 197 older adults conducted in the Emergency Department between September 2019 and March 2020. A questionnaire with sociodemographic, economic and clinical information was applied, as well as the instruments: Falls Risk Awareness Questionnaire, Morse Falls Scale, Katz Index and Lawton Scale. The Kruskal Wallis test was used to compare the Katz Index and the Lawton Scale, and the Spearman correlation coefficient was used to associate the Morse Falls Scale with continuous variables. The Mann-Whitney test and the Kruskal Wallis test were used to associate the Falls Risk Awareness Questionnaire with the categorical variables. Results Illiterate patients (p<0.0001) with lower income (p=0.0446) had a lower score on the Katz Index, that is, they presented a higher percentage of totally dependent people. Divorced older adults (p=0.0004) without a caregiver (p<0.0001) had a higher score on the Lawton Scale, that is, a greater degree of independence. The greater perception of risk for falls (p=0.0403) was associated with less independence for instrumental activities of daily living. The low risk for falls (p<0.0001) was associated with greater independence for instrumental activities of daily living. There was no association between perceived risk for falls (p=0.2693) and risk for falls (p=0.4984) with the Katz Index. Conclusion Lower education and income were associated with dependence for activities of daily living. Being divorced and not having a caregiver were associated with independence in instrumental activities of daily living. There was no association between the perception of risk for falls and the risk for falls with activities of daily living. The greater perception of risk for falls was associated with less independence, and the low risk for falls was associated with greater independence for instrumental activities of daily living.

Associations between potentially inappropriate prescribing and increased number of medications with postdischarge health outcomes among geriatric rehabilitation inpatients: RESORT study.

Older adults are vulnerable to medication-related harm mainly due to high use of medications and inappropriate prescribing. This study aimed to investigate the associations between inappropriate prescribing and number of medications identified at discharge from geriatric rehabilitation with subsequent postdischarge health outcomes. RESORT (REStORing health of acutely unwell adulTs) is an observational, longitudinal cohort study of geriatric rehabilitation inpatients. Potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) were measured at acute admission, and at admission and discharge from geriatric rehabilitation, using Version 2 of the STOPP/START criteria. In total, 1890 (mean age 82.6 ±8.1years, 56.3% female) were included. The use of at least 1 PIM or PPO at geriatric rehabilitation discharge was not associated with 30-day and 90-day readmission and 3-month and 12-month mortality. Central nervous system/psychotropics and fall risk PIMs were significantly associated with 30-day hospital readmission (adjusted odds ratio [AOR] 1.53; 95% confidence interval [CI] 1.09-2.15), and cardiovascular PPOs with 12-month mortality (AOR 1.34; 95% CI 1.00-1.78). Increased number of discharge medications was significantly associated with 30-day (AOR 1.03; 95% CI 1.00-1.07) and 90-day (AOR 1.06; 95% CI 1.03-1.09) hospital readmissions. The use and number of PPOs (including vaccine omissions) were associated with reduced independence in instrumental activities of daily living scores at 90-days after geriatric rehabilitation discharge. The number of discharge medications, central nervous system/psychotropics and fall risk PIMs were significantly associated with readmission, and cardiovascular PPOs with mortality. Interventions are needed to improve appropriate prescribing in geriatric rehabilitation patients to prevent hospital readmission and mortality.

Memory performance mediates the relationship between depression and independence in instrumental activities of daily living among community-dwelling older adults: Evidence from the China Family Panel Study.

Our objective was to examine the link between depression and independence in the instrumental activities of daily living (IADLs) and to explore the mediating role of memory performance through a cross-sectional analysis of a nationally representative sample of community-dwelling older adults in China. In total, 3730 respondents age ≥ 60 (51.7% males) from the 2020 survey of the China Family Panel Study (CFPS) constituted the study sample. Their depressive symptoms, memory performance, and independence in the IADLs were measured. Based on the descriptive statistics, bivariate correlation analysis and bootstrapping mediation analysis were conducted. As hypothesized, independence in the IADLs was negatively related to depression, while it was positively associated with memory performance. Moreover, after controlling for demographic factors, memory performance was demonstrated to be a partial mediator between depression and independence in the IADLs. These findings support the development of clinical interventions which prevent disability or maintain the physical functioning of older adults through alleviating depression and enhancing memory performance.

Relationships between housing and health for older private renters: evidence from a pilot study in Australia

Increasing numbers of older people seek to age at home in their community in western countries including Australia. Whilst this aligns with community aged care policy, the nature and suitability of their housing to enable ageing in place, receives less policy attention. The increasing representation of older tenants in the private rental market, with limited resources and precarious tenure highlights the need to understand ageing in place in a privately rented home. This study aimed to explore the relationships between housing accessibility, financial status, health, and independence for older Australians renting privately. Home visits were conducted with 27 older adults, where the SF8, ADL Staircase, the Housing Enabler, the Financial Capability Questionnaire, and the 30:40 indicator of housing stress were completed. This preliminary research found that older private renters lived in inaccessible homes, with high scores on the Housing Enabler (mean = 185) indicating poor access. Inaccessible housing was correlated with worse physical health, lower perceived independence, less independence in instrumental activities of daily living, and activities of daily living being difficult to perform. Older tenants living with higher levels of financial disadvantage were also found to be less independent and have poorer mental health. The research reveals important policy implications for community aged care, housing, and social security, including removing barriers to enable free and easy access to home modifications for older renters experiencing financial disadvantage. Future research should examine a nationally representative, diverse sample of owners, private renters, and social housing tenants to further understand the influence of the home environment, including tenure, on the health and well-being of older adults as they age in place.

Assessing independence in activities of individuals affected by leprosy

Background The abilities required to perform the fundamental physical needs of an individual and instrumental activities required for independent living in a community are reduced in individuals affected by leprosy, due to various medical and psychological factors. Objective To assess basic life activities, identify critical sociodemographic factors influencing these and ascertain opportunities to improve the independence levels of individuals affected by leprosy. Material and methods A survey of 71 participants was conducted from a residential leprosy facility in Srinagar, in the Jammu and Kashmir region of northern India, between 2019–2020. Data were collected via face-to-face interviews of individuals affected by leprosy who were asked questions about sociodemography. The standardised instruments Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) were used. Statistical methods, t-test, ANOVA, correlation and multivariant regression were used to analyse the data. Results Among the entire sample (n = 71), 3% of study participants showed complete independence in basic activities and 1% of study participants showed complete independence in instrumental activities. For activities of daily living, dependency was found in physical ambulation (8%), grooming (10%) and bathing (13%). In instrumental activities of daily living, dependency was found in shopping (18%), food preparation (24%), responsibility for own medication (34%) and ability to use a phone (34%). Statistically, a significant correlation was recorded between disease categories, age, employment, and activity independence. Conclusion This study concludes that individuals affected by leprosy are severely constrained in carrying out basic and instrumental activities. Dependency increases with age and level of disability. However, being in some kind of employment increases independence levels in both activities of daily living and instrumental activities of daily living; marriage increases independence in activities of daily living, but not in instrumental activities.

Exploring Care Service Use Among Latino LGBTQ+ Caregivers of Persons Living with Alzheimer’s Disease and Related Dementias

AbstractBackgroundLatino and lesbian, gay, bisexual, transgender or queer (LGBTQ+) adults are both growing populations at increased risk of Alzheimer’s disease and related dementias (ADRD). The increased prevalence in ADRD among these populations requires caregiving that is often met by informal caregivers. Yet, very little is known about the experiences of informal ADRD caregivers who identify as both Latino and LGBTQ+.MethodWe examined differences in sociodemographic characteristics, caregiving characteristics, and use of caregiver support services between English‐proficient Latino and non‐Latino LGBTQ+ ADRD caregivers recruited via social media (n = 286; Latino n = 103).ResultLatino caregivers identified as gay (45%), lesbian (24%), bisexual (20%), and queer/other (11%). Sixty‐one percent identified as cisgender (not transgender) women, 39% cisgender men, and 19% identified as transgender. On average, Latino caregivers were younger (36 vs. 38 years old), reported a lower percentage of individuals who completed a college degree (36% vs. 51%), a higher income (64% vs. 50%), and a lower percentage of being married or partnered (44% vs 63%). Latino caregivers were in their caregiving roles for seven months less than non‐Latino caregivers, and reported a greater (8% vs. 6%) presence and severity of behavioral symptoms of distress (e.g., agitation, disrupted sleep) among their care recipients living with ADRD. Latino caregivers indicated their care recipients had less dependence in activities of daily living (1.3 vs. 1.8) and more independence in instrumental activities of daily living (5.1 vs. 4.2). Latino caregivers also reported lower use of respite services (38% vs. 51%), transportation services (37% vs. 53%), and making home modifications (34% vs. 71%) for their care recipients living with ADRD.ConclusionFindings indicate Latino and non‐Latino LGBTQ+ ADRD informal caregivers differed in sociodemographic characteristics, length of time caregiving, and the presence and severity of behaviors and functioning levels of their care recipients living with ADRD. Latino caregivers utilized caregiver support services to a lesser degree than non‐Latino caregivers. More research is needed to understand ways to address the needs and better serve this growing population.

Quality of life related to functional dependence, family functioning and social support in older adults.

to determine the relationship between quality of life and functional dependence, family functioning and social support in older adults in northeastern Mexico. this is a quantitative, descriptive and analytical study, with 205 older adults. The Barthel Index, Lawton and Brody Scale, APGAR test, Multidimensional Scale of Perceived Social Support and WHOQOL-BREF were applied. the physical, psychological and social dimensions of quality of life are related to functional capacity, family functioning and social support (p< 0.05). Functional capacity and social support predict physical and psychological quality of life. Basic activities, family function and social support predict social quality of life. Instrumental activities and social support predict environmental quality of life. quality of life depends on functional independence, family function and positive perceived health. Independence in basic activities and adequate social support improve physical quality of life. Being independent in basic activities and social support improve psychological quality of life. When presenting a decrease in independence in instrumental activities, perceived quality of life decreases.

Functional capacity, risk of falling and chronic pain in older adults during the COVID-19 pandemic: a telemonitoring study

OBJECTIVE: To compare active and sedentary older adults regarding functional capacity, risk of falling, and chronic pain in a population assisted by telemonitoring during the pandemic lockdown. METHODS: This analytical, cross-sectional study included 104 older adults who were telemonitored during the COVID-19 lockdown by a team from a Brazilian Unified Health System outpatient clinic specializing in geriatrics and gerontology. A structured interview was used to collect data. Following normality testing with the Shapiro-Wilk test, Student’s t-test was used for group comparisons. Associations were analyzed using the χ2 test, and the odds ratio was calculated in a 2x2 table of sedentarism and falls in the last six months. The data were analyzed using SPSS version 26.0, with p ≤ 0.05 considered significant. RESULTS: The 57 active older adults had a lower rate of continuous medication use (24.84 vs 27.62%), fewer falls (50 vs 32.11%), less pain (12.31 vs 3.83%), and greater independence in basic activities of daily living (44.39 vs 26.46%). CONCLUSIONS: Older adults who were physically active in the midst of social distancing had better functional capacity in basic activities of daily living, fewer falls, and less pain than their sedentary peers. Independence in instrumental activities of daily living did not differ significantly between the groups.

Frailty and depression predict instrumental activities of daily living in older adults: A population-based longitudinal study using the CARE75+ cohort.

To evaluate if depression contributes, independently and/or in interaction with frailty, to loss of independence in instrumental activities of daily living (ADL) in older adults with frailty. Longitudinal cohort study of people aged ≥75 years living in the community. We used multi-level linear regression model to quantify the relationship between depression (≥5 Geriatric Depression Scale) and frailty (electronic frailty index), and instrumental activities of daily living (Nottingham Extended Activities of Daily Living scale; range: 0-66; higher score implies greater independence). The model was adjusted for known confounders (age; gender; ethnicity; education; living situation; medical comorbidity). 553 participants were included at baseline; 53% were female with a mean age of 81 (5.0 SD) years. Depression and frailty (moderate and severe levels) were independently associated with reduced instrumental activities of daily living scores. In the adjusted analysis, the regression coefficient was -6.4 (95% CI: -8.3 to -4.5, p<0.05) for depression, -1.5 (95% CI: -3.8 to 0.9, p = 0.22) for mild frailty, -6.1 (95% CI: -8.6 to -3.6, p<0.05) for moderate frailty, and -10.1 (95% CI: -13.5 to -6.8, p<0.05) for severe frailty. Moreover, depression interacted with frailty to further reduce instrumental activities of daily living score in individuals with mild or moderate frailty. These relationships remained significant after adjusting for confounders. Frailty and depression are independently associated with reduced independence in instrumental activities of daily living. Also, depression interacts with frailty to further reduce independence for mild to moderately frail individuals, suggesting that clinical management of frailty should integrate physical and mental health care.

Aging and Functional Health Literacy: A Population-based Study

To investigate functional health literacy and its associated factors among older adults drawn from a disadvantaged area.Cross-sectional epidemiologic study.Population-based cohort randomly selected from the voter registration lists.Individuals aged 65+ (N=1066).The Short Test of Functional Health Literacy in Adults (S-TOFHLA); demographics; self-rated health; number of prescription drugs; modified Center for Epidemiologic Studies- Depression scale; Mini-Mental State Examination; Wechsler Test of Adult Reading; Clinical Dementia Rating; cognitive domain composite scores; independence in Instrumental Activities of Daily Living and medication management; health services utilization (emergency/urgent care visits and hospitalizations).Low (inadequate or marginal) S-TOFHLA scores were obtained by 7.04% of the sample. In unadjusted analyses, participants with low S-TOFHLA scores were significantly more likely than those with higher scores to be older, male, non-White, with lesser education and lower household income, to have lower scores on the Wechsler Test of Adult Reading, the Mini-Mental State Examination, and all cognitive domains; to be more dependent in Instrumental Activities of Daily Living and be taking more prescription drugs. In a multiple regression model including all covariates, only older age, male sex, and lower reading level were independently associated with inadequate or marginal S-TOFHLA scores.In a population-based sample of older adults, low functional health literacy was associated with age, sex, education, and reading ability. Basic functional health literacy is essential for understanding health information and instructions. Clinicians should formally or informally assess health literacy in their older patients to ensure effective communication and enhance health outcomes.

A-035 What Make Them Tick? The Clock Drawing Test and Correlations Between Cognitive and Functional Abilities

Abstract Objective The Clock Drawing Test (CDT) is among the most researched cognitive measures and is frequently used to screen for neurocognitive disorders (NCDs). No study to date has investigated the relationship between qualitative errors on the CDT and independence in instrumental activities of daily living (IADLs) or discrete cognitive abilities. Therefore, this study sought to evaluate the correlations between qualitative errors on the CDT and IADL status as well as performance in individual cognitive domains. Method Data were retrospectively collected from patients seen at an outpatient clinic in eastern Massachusetts, including 16 healthy controls, 22 patients with mild NCD, and 35 patients with major NCD. Analyses were performed between qualitative errors on the CDT and patients’ scores on the Lawton IADL Scale, Mattis Dementia Rating Scale-2 (DRS-2), Digit Span Forward and Backward, Trail Making Test (TMT), and the Boston Naming Test (BNT). Results IADL scores were moderately correlated with CDT error types. DRS-2 scores were strongly correlated commission of qualitative errors. Strong to very strong correlations were observed between TMT parts A &amp; B scores and all qualitative error types. BNT performance was strongly correlated with conceptual deficits and spatial/planning errors. Digit Span Forward and Backward scores showed low correlations with all CDT errors. Conclusions Functional status appears only moderately correlated with commission of various CDT errors; however, several cognitive measures showed high correlation with various CDT error types. These findings suggest that certain qualitative errors may be indicative of cognitive impairments warranting further workup. Clinical implications and future directions are discussed.

Life-space mobility in dementia patients and family caregivers: A dyadic approach.

Given that most dementia care is provided at home by family caregivers, caregivers' health and outdoor activities may influence persons with dementia (PWDs)' mobility. At the same time, PWDs' functional deterioration and mobility changes might affect mobility behaviours in their caregivers. The aims of this pilot study were to examine the relationship of PWD's life-space mobility (LSM) with their caregiver's LSM and to investigate the role of caregiver and PWD characteristics in determining the level of LSM in both PWDs and caregivers. A cross-sectional survey was conducted with 26 caregivers providing dementia care at home. Caregivers were used as proxy for assessing sociodemographic, clinical and physical function in PWDs. Caregivers' sociodemographic characteristics, LSM, social support, depressive symptoms, caregiving burden and preparedness for caregiving were measured. The level of LSM in caregivers was correlated with the PWD's LSM level. Caregivers who perceived high levels of social support and readiness for caregiving tended to report high levels of LSM. PWDs' age and independence in instrumental activities of daily living were correlated with caregivers' LSM. The study findings suggest that the caregiver's LSM influenced and was affected by the PWD's LSM. This underscores the need for additional research that examines the role of caregivers' psychosocial and physical health on PWDs' mobility and the context of dementia care and its influences on how dementia care dyads decide and participate in mobility behaviours. The findings of this pilot study will be helpful in identifying a target for interventions designed to delay the onset of mobility disability and maintain and improve social participation in PWDs. To minimise the effects of mobility limitations in PWDs, it is critical to examine their mobility issues from multilevel perspectives, including their caregiver's LSM levels and characteristics that have implications for both research and clinical practice.

Elder abuse and associated factors in eastern romania.

This article explores elder abuse in a hospitalised population. We wanted to identify details related to psychological and emotional abuse in the older population in our region and to determine the importance of the Elderly Abuse Suspicion Index (EASI© ) in comprehensive geriatric assessments. This cross-sectional study conducted between March 2015 and May 2016 included 386 consecutive hospitalised patients over 65 years of age. All patients underwent a geriatric assessment, data were collected about their medical history, and the EASI© was administered to each. The main outcome was identifying the presence, the type of abuse and the factors associated with abuse. There were 21.5% of patients who suffered any form of abuse. Women were more frequently abused than men. Emotional abuse was the most common (60.2%) followed by neglect (53%) and physical abuse (22.91%); sexual abuse was absent in our study group. The abused patients had an impaired cognitive function (P = 0.034). They were also malnourished (P ≤ 0.001) and depressed (P = 0.001). The presence of peripheral artery disease, stroke, pneumonia, chronic kidney disease, musculoskeletal diseases and anxiety correlated with the presence of abuse. No statistically significant correlation was found between the degree of independence in instrumental activities of daily living and the presence of abuse (r = 0.105, P = 0.051). EASI is a tool for detecting elder abuse and should be included in the standard geriatric assessment to prevent ageism. The number of abused elderly patients is significant, and the multiple factors associated with abuse are diverse.

Trajectories of daytime sleepiness and their associations with dementia incidence.

Several studies have associated daytime sleepiness with risk of dementia, but it is unknown whether longstanding and emerging daytime sleepiness equally signal a risk of dementia, and whether other health factors explain these associations. In a prospective, population-based epidemiologic study, we (i) assessed associations of daytime sleepiness trajectories over 10 years with dementia incidence and (ii) examined whether selected health characteristics attenuated these associations. Using latent group-based trajectory analysis we categorized participants into three groups: (i) no daytime sleepiness (n=959, 49.2%), (ii) emerging daytime sleepiness (n=342, 17.5%) and (iii) persistent daytime sleepiness (n=650, 33.3%). Compared with no daytime sleepiness, emerging and persistent daytime sleepiness were similarly associated with greater incident dementia risk (respective hazard ratios [95% confidence intervals] were 2.2 [1.3, 3.5] and 1.9 [1.2, 3.1]). Baseline blood pressure, body mass index, chronic disease diagnoses and symptoms of depression did not attenuate these associations. In contrast, lack of independence in instrumental activities of daily living attenuated the daytime sleepiness-dementia association by approximately 17%-21%. These findings suggest that persistent and emerging daytime sleepiness may signal a risk of dementia. However, the underlying mechanisms remain unclear. Further studies should investigate whether and how pathways to sleepiness, functional impairment and dementia pathophysiology interrelate and manifest together over time.

Velocidade do alcance em tarefas de atenção e memória: validação do teste como marcador funcional na população geriátrica

AIM: To validate the reaching speed during attention and memory tasks as a functional indicator in the geriatric population.METHODS: Institutionalized elderly living in 4 Portuguese institutions were characterized by their functional profile, with the following variables: (i) cognition; (ii) independence in basic daily living activities; (iii) independence in instrumental activities of daily living; (iii) grip strength, (iv) diagnosis of depression; (v) upper limb sensorimotor function; (vi) executive functions. All these instruments underwent a linking process with the International Classification of Functioning and Health. The sample was divided into four functional groups considering the values below and above the mean range of reaching speed in attention tasks (Group 1 - G1, Group 2 - G2) and the range of RS in memory tasks (Group 3 - G3, Group 4 - G4). Characterization of the sample groups was performed using descriptive statistical measures of the ICFqualifiers and the difference between groups (G1 / G2 and G3 / G4) was tested using t-tests for independent samples.RESULTS: The results showed significant differences between low- and high profile groups in RS tasks (p &lt;0.05), identifying the following priority intervention areas in institutionalized elderly: d6. Domestic life, d1. Learning and knowledge application, d4. Mobility, d5. Self-care and d8. Significant areas of life. Older adults with reaching speed in attention tasks &lt;0.06m/s or &lt;0.07m/s in memory tasks tend to have moderate to severe disability in Mobility and Self Care and severe/complete inability to participate in Household tasks.CONCLUSION: This study was an important contribution to the validation of reaching speed (a test for upper limb function) during attention and memory tasks as a functional indicator, enabling elderly functional evaluation in a large spectrum, including non-ambulate elderly people.

Association of diet quality and physical activity with healthy ageing in the French NutriNet-Santé cohort.

A growing number of studies have explored overall health during ageing in a holistic manner by investigating multidimensional models of healthy ageing (HA). However, little attention has been given to the role of adherence to national nutrition guidelines in that context. This study aimed to investigate the prospective association between adherence to the French nutrition guidelines and HA. The authors analysed data from 21 407 participants of the NutriNet-Santé study with a median baseline age of 55·6 years (2009-2014) and initially free of major chronic diseases. HA was defined as not developing major chronic disease, no depressive symptoms, no function-limiting pain, independence in instrumental activities of daily living, good physical, cognitive and social functioning, as well as good self-perceived health. Adherence to guidelines of the French Nutrition and Health Programme (Programme National Nutrition Santé or PNNS) was measured via the PNNS Guideline Score (PNNS-GS), using baseline data from repeated 24-h dietary records and physical activity questionnaires. After a median follow-up of 5·7 years, 46·3 % of participants met our HA criteria. Robust-error-variance Poisson regression revealed that higher PNNS-GS scores, reflecting higher adherence to nutrition recommendations (including both diet and physical activity guidelines), were associated with a higher probability to age healthily (relative riskquartile 4 v. quartile 1 = 1·17 (95 % CI 1·12, 1·22)). Supplementary analyses revealed that this association may, to a small part, be mediated by weight status. The results suggest that high adherence to the French national nutrition recommendations may be linked to better overall health throughout ageing.

Borrelia burgdorferi as a risk factor for Alzheimer's dementia and mild cognitive impairment.

To determine the association of Borrelia burgdorferi infection with Alzheimer's disease or mild cognitive impairment (MCI) in older adults. Case-control study. Patients older than 60years, both sexes, were included. Three groups were created: with probable Alzheimer's disease cases with NINCDS-ADRDA criteria, MCI cases in those not meeting NINCDS-ADRDA criteria for dementia, but who had an abnormal cognitive evaluation and independence in instrumental activities of daily living (IADL), cognitively healthy controls were diagnosed with normal cognitive evaluation and independence in IADL were identified in the community. Western blot IgG against B. burgdorferi in serum was done in all the participants. Non-conditional logistic regression was applied to estimate the association of Alzheimer's disease or MCI and seropositive to B. burgdorferi. Thirty-eight patients with Alzheimer's disease, mean age of 75.6 ± 3.4years, 69% were females, education 8.3 ± 4.8years. 39 patients with MCI, mean age of 72.2 ± 6.8years, 85% were females, education 11.2 ± 4.2years. A total of 11/38 (29%) were positive to B. burgdorferi with Alzheimer's disease, 9/39 (23%) with MCI, and 11/108 (10%) of controls. In patients with Alzheimer's disease, an adjusted odds ratio (aOR) = 3.65 (95% CI 1.2-11.1) adjusted for education and a history of cerebrovascular disease (CVD) was estimated, and in patients with MCI an aOR = 3.2 (95% CI 1.1-9.1) for a history of diabetes mellitus and CVD was estimated. In our study, there was an increased risk of Alzheimer's disease and MCI in seropositive IgG patients to B. burgdorferi.