Independence Of Older Persons Research Articles

Prediction of Upper-Body Power During the Seated Medicine Ball Throw in Older Women.

Parrino, RL, Strand, KL, San Ly, A, Barry, SS, Liscano, JA, Trebotich, L, Martin-Diala, C, Martin, E, and Signorile, JF. Prediction of Upper-body power during the seated medicine ball throw in older women. J Strength Cond Res XX(X): 000-000, 2022-Upper-body power, the product of muscular strength and movement velocity, is a core measure used by clinicians and researchers alike, to assess functional independence in older persons. Nevertheless, the evaluation of upper-body power is often impractical due to prohibitive cost, as well as space, equipment, and technical demands. Therefore, this study was designed to establish a predictive equation for upper-body peak power (PPUB) using the seated medicine ball throw (SMBT). Thirty-five older women (75.2 6.4y) completed the SMBT and pneumatic resistance chest press peak power (CPPP) testing. A stepwise multiple regression was used to produce a predictive model using CPPP to assess PPUB. The model included SMBT distance (SMBTD) and medicine ball mass (MBMass) as significant predictors (PPUB[W] = 96.719·SMBTD [m] + 37.164·MBMass [kg]-104.499; r = 0.752; SEE = 41.41 W; p < 0.001). The performance of this model was confirmed through a cross-validation analysis using 70% (n = 23; r = 0.709; p < 0.001) and 30% (n = 12; r = 0.823; p < 0.001) of the sample. Reliability was confirmed using intraclass correlation, coefficient of variation, standard error of measurement, and Bland-Altman analyses for both MBMass. This model provides an easily accessible and reliable tool, using SMBTD and MBMass, for predicting PPUB in older women as a marker of quality of life, functional independence, and ability to complete activities of daily living.

The Effect of Physical Exercise on Frail Older Persons: A Systematic Review.

Physical exercise is one of the most effective non-pharmacological interventions aimed to improve mobility and independence in older persons. The effect of physical exercise and the most effective type of exercise in frail older persons remain undefined. This systematic review examines the effectiveness of physical exercise on frail older persons. Seven databases were search for randomized control trials which assessed the effect of exercise on participants who were identified as being frail using specific and validated criteria. Nine articles were reviewed from eight studies, from which seven used a validated definition of frailty. Based on the articles analyzed in our systematic review, the evidence suggests that exercise has a positive effect on various measures used to determine frailty including cognition, physical functioning, and psychological wellbeing. Some studies revealed that exercise may prevent or delay the onset of frailty which can enhance quality of life in older adults. Despite the evidence for exercise interventions in frail older adults, it appears that there is no clear guidance regarding the most effective program variables. The reviewed studies were generally long in duration (≥6 months) with sessions lasting around 60 minutes performed three or more times per week, including multicomponent exercises. In conclusion, although exercise interventions appear to be effective in managing the various components of frailty and preventing/delaying the onset of frailty, the most effective exercise program in this population remains unidentified.

Aging, the Central Nervous System, and Mobility in Older Adults: Neural Mechanisms of Mobility Impairment.

Mobility is crucial for successful aging and is impaired in many older adults. We know very little about the subtle, subclinical age-related changes in the central nervous system (CNS) that mediate mobility impairment. A conference series focused on aging, the CNS, and mobility was launched. The second conference addressed major age-associated mechanisms of CNS-mediated mobility impairment. Speakers and conference attendees recommended key areas for future research, identified barriers to progress, and proposed strategies to overcome them. Priorities identified for future research include (a) studying interactions among different mechanisms; (b) examining effects of interventions targeting these mechanisms; (c) evaluating the effect of genetic polymorphisms on risks and course of age-related mobility impairment; and (d) examining the effect of age on CNS repair processes, neuroplasticity, and neuronal compensatory mechanisms. Key strategies to promote research include (a) establish standard measures of mobility across species; (b) evaluate the effect of aging in the absence of disease on CNS and mobility; and (c) use advanced computational methods to better evaluate the interactions between CNS and other systems involved in mobility. CNS is a major player in the process, leading to mobility decline with aging. Future research in this area has the potential to prolong independence in older persons. Better interactions among disciplines and shared research paradigms are needed to make progress. Research priorities include the development of innovative approaches to integrate research on aging, cognition, and movement with attention to neurovascular function, neuroplasticity, and neurophysiological reserve.

Independência funcional de pessoas idosas com perturbações mentais: um estudo num serviço de psicogeriatria em Portugal

Functional dependency in older persons increases the need of social and health care. However the vast literature on functional independency has rarely focused on older people with mental disorders. This study examines functional independency in older persons (≥65 years old) with mental disorders. This is a cross‐sectional and retrospective study; data were obtained from clinical processes at the psychogeriatric unit of the Hospital Magalhães Lemos, Porto, Portugal. The sample comprises 157 participants. Functional independence was assessed with EASYCare (Elderly Assessment System); mental disorders were obtained from the clinical diagnosis. Main findings suggest four groups according to functional in/dependency: independent (44.7%), light dependent, (36.8%), moderate dependent (13.2%) and severe dependent (5.3%). Functional independence in older persons with mental disorders is relevant for social and health services to plan programs that promote autonomy and well‐being.

European project on osteoarthritis: design of a six-cohort study on the personal and societal burden of osteoarthritis in an older European population

BackgroundOsteoarthritis (OA), the most common form of arthritis, is a major contributor to functional impairment and loss of independence in older persons. The European Project on OSteoArthritis (EPOSA) is a collaborative study involving six European cohort studies on ageing. This project focuses on the personal and societal burden and its determinants of osteoarthritis. This paper describes the design of the project, and presents some descriptive analyses on selected variables across countries.Methods/designEPOSA is an observational study including pre-harmonized data from European cohort studies (Germany, Italy, the Netherlands, Spain, Sweden and the United Kingdom) on older community-dwelling persons aged 65 to 85 years. In total, 2942 persons were included in the baseline study with a mean age of 74.2 years (SD 5.1), just over half were women (51,9%). The baseline assessment was conducted by a face-to-face interview followed by a clinical examination. Measures included physical, cognitive, psychological and social functioning, lifestyle behaviour, physical environment, wellbeing and care utilisation. The clinical examination included anthropometry, muscle strength, physical performance and OA exam. A follow-up assessment was performed 12–18 months after baseline.DiscussionThe EPOSA study is the first population-based study including a clinical examination of OA, using pre-harmonized data across European countries. The EPOSA study provides a unique opportunity to study the determinants and consequences of OA in general populations of older persons, including both care-seeking and non care-seeking persons.

Editorial: Clinical and Biological Markers of Sarcopenia: Where Are We?

Sarcopenia, defined as muscle wasting and weakness with aging, is common and associated with disability (1). Substantial potential exists to prolong active life expectancy and functional independence in older persons through interventions designed to prevent or treat sarcopenia. However, a major barrier to the implementation of trials to prevent and treat sarcopenia is the continued lack of consensus on inclusion and exclusion criteria, baseline assessment tools and end point assessments. For this reason, the work presented here on behalf of the International Working Group on Sarcopenia is another major step forward (2). The authors have consolidated multiple sources of information to summarize the current status of proposed clinical definitions and to identify candidate markers of muscle function, muscle mass and circulating factors that might suggest mechanisms or biological confounders. The authors found strong agreement regarding the key indicators of muscle function, including physical performance measures, muscle strength measures and indicators of functional disability. This strong agreement can potentially serve to guide those involved trial development and regulatory oversight.

Musculoskeletal Pain Is Associated With Incident Mobility Disability in Community-Dwelling Elders

Identifying mobility disability risk factors may facilitate development of interventions promoting functional independence in older persons. We tested the hypothesis that musculoskeletal pain is associated with first occurrence of severe mobility disability. In a prospective observational study at 40 community-based sites, 759 older Catholic clergy in the Rush Religious Orders Study without baseline dementia, stroke, Parkinson's disease, or severe performance-based mobility disability (defined as gait speed less than or equal to 0.4 m/s) and at least one follow-up mobility evaluation were evaluated over a mean of 8.5 (SD = 3.8) years. All participants were queried about musculoskeletal pain in the year before baseline and underwent annual assessment of mobility. Using a proportional hazards model adjusted for age, sex, and education, the hazard for incident severe mobility disability was greater for participants reporting pain in the year before baseline (odds ratio = 1.47, 95% confidence interval = 1.17-1.85). Results were unchanged after adjusting for self-reported mobility disability, gait speed, depressive symptoms, body mass index, physical activity, chronic medical conditions, and analgesic use. Compared with no report of musculoskeletal pain, musculoskeletal pain in one or two areas was associated with a 30% greater hazard for incident disability (odds ratio = 1.31, 95% confidence interval = 1.00-1.70). Musculoskeletal pain in three or more areas was associated with an 80% greater hazard for incident disability (odds ratio = 1.80, 95% confidence interval = 1.31-2.47). In participants without baseline self-reported mobility disability (n = 486), musculoskeletal pain was associated with greater hazard for incident self-reported mobility disability (odds ratio = 1.38, 95% confidence interval = 1.11-1.73). In older persons, musculoskeletal pain is associated with incident mobility disability.

Hearing loss impacts on the use of community and informal supports

the aim of this study is to estimate the cross-sectional and longitudinal impact of hearing loss on use of community support services and reliance on non-spouse family/friends among older people. Blue Mountains Hearing Study participants (n = 2,956) were assessed for hearing impairment by audiologists in sound-treated booths. Participants were classified as hearing impaired if PTA(0.5-4)( )(kHz) >25 dB HL. Use of services and non-spouse family/friend support was assessed cross-sectionally. Incident use was assessed among survivors at the 5-year follow-up (n = 1,457). a significant cross-sectional association between hearing loss (>25 dB HL) and use of community support services was observed after adjusting for age, sex, living status, self-rated poor health, self-reported hospital admissions, disability in walking and best-corrected visual impairment [odds ratio (OR) 2.12, 95% confidence interval (CI) 1.15-3.90]. Participants with hearing loss who never used a hearing aid were twice as likely to use formal supports as participants without hearing loss (multivariate-adjusted OR 2.25, 95% CI 1.19-4.24). Hearing loss increased the incident need for non-spouse family/friend support or community services (multivariate-adjusted OR 1.49, 95% CI 1.02-2.18). after adjusting for confounding factors, hearing impairment negatively impacted on the independence of older persons by increasing reliance on community or family support.

Effect of Arthritis in Middle Age on Older‐Age Functioning

To examine whether symptomatic arthritis in middle age predicts the earlier onset of functional difficulties (difficulty with activities of daily living (ADLs) and walking) that are associated with loss of independence in older persons. Prospective longitudinal study. The Health and Retirement Study, a nationally representative sample of persons aged 50 to 62 at baseline who were followed for 10 years. Seven thousand five hundred forty-three subjects with no difficulty in mobility or ADL function at baseline. Arthritis was measured at baseline according to self-report. The primary outcome was time to persistent difficulty in one of five ADLs or mobility (walking several blocks or up a flight of stairs). Difficulty with ADLs or mobility was assessed according to subject interview every 2 years. Analyses were adjusted for other comorbid conditions, body mass index, exercise, and demographic characteristics. Twenty-nine percent of subjects reported arthritis at baseline. Subjects with arthritis were more likely to develop persistent difficulty in mobility or ADL function over 10 years of follow-up (34% vs 18%, adjusted hazard ratio (HR)=1.63, 95% confidence interval (CI)=1.43-1.86). When each component of the primary outcome was assessed separately, arthritis was also associated with persistent difficulty in mobility (30% vs 16%, adjusted HR=1.55, 95% CI=1.41-1.71) and persistent difficulty in ADL function (13% vs 5%, adjusted HR=1.85, 95% CI=1.58-2.16). Middle-aged persons who report a history of arthritis are more likely to develop mobility and ADL difficulties as they enter old age. This finding highlights the need to develop interventions and treatments that take a life-course approach to preventing the disabling effect of arthritis.

COMPARATIVE CORRELATIONS OF FUNCTIONAL AND TASK-SPECIFIC TESTS WITH PERCEIVED FUNCTIONALITY IN THE FRAIL

Functional Activities of Daily Living (ADL) performance declines with age. These declines must be quantified to allow proper exercise prescription. PURPOSE The purpose of this study was to determine if a task-specific (TS) test would have a stronger correlation with self-perceived functionality than traditional functional tests (FT) in the frail elderly. METHOD Residents of an assisted living facility (n = 14, average age = 85.8) completed a self-rated instrumental activities of daily living (IADL) scale before physical testing to establish a perceived functionality score. 3 FTs were performed: 1) the functional reach test (REACH); 2) the 30-sec chair stand (CS); and 3) the 8-ft up-and-go (UG). In addition, a timed object manipulation, where participants transferred 5 one-gallon jugs (8.4 lbs) from a low shelf (mid-patellar height) to a high shelf (acromial height) was used as a TS test of IADL. Self-perceived functionality scores were correlated to all test outcomes independently using a Pearson¡−s Product Moment correlation and tested for significance using a two-tailed, t-test (alpha < 0.01). RESULTS No significant correlations were seen between scores of self-perceived functionality and REACH (r = 0.53), CS (r = 0.60), or UG (r = −0.53). However, there was a significant correlation between self-perceived functionality and performance on the TS test (r = −0.72). CONCLUSION These preliminary data indicate the importance of using TS tests to diagnose levels of independence in older persons. Our object manipulation task was the only test that significantly correlated with the perceived IADL scale. This result suggests that testing with emphasis on IADL task-specificity should be employed to provide precise diagnosis of needs before exercise prescription in frail individuals.

Medical and long-term care costs when older persons become more dependent.

Loss of independence in older persons places considerable financial burden on them, their families, and the health care system. This study estimated the additional medical and long-term care costs that occur during the year when older persons make the transition to dependency at home or move to a nursing home.

Promoting Independence in Older Persons Through the Internet

New communication technologies provide hope for promoting independence in older persons. Today the Internet provides opportunities to socialize with others, participate in educational and spiritual activities, and assist with some of the instrumental activities of daily living. This is important in terms of quality of life for older persons as well as reducing expenditures for long-term care. This article discusses the growth in use of the Internet by the elderly and evaluates its ability to meet both various general needs of the population as well as needs specific to older persons.

Systematic Replication of an Intervention Designed to Increase Attendance at Nutrition Sites for the Elderly

Nutritional and social well-being are important factors in the health and independence of older persons. In previous research, Bunck and Iwata (1978) effectively increased attendance at a nutrition site serving the elderly using a combination of prompting and reinforcement procedures. This study provides a systematic replication of their intervention procedures at two senior meal sites. Findings from this study, however, resulted in no increase in attendance. Thus, further applied research is still needed to identify effective methods for increasing attendance in community-based nutrition and health promotion programs.

Humanitarian Issues: Implications for Policy

Community support services represent an important resource for older persons. Their significance will grow as the older population increases in size in the North American Region. It is essential for the well-being of society that an adequate array of services for older persons be developed. Community support services must be provided in sensitive and personalized ways—and must respect the dignity and integrity of older persons. Community support services promote the independence of older persons; they prevent or defer recourse to more expensive and less personally desirable forms of caring services, such as nursing homes and geriatric services. Therefore, community support services may be said to have supportive, preventive and rehabilitative functions and to play an integrative role in terms of family and community life.

A family therapy model for preserving independence in older persons: Utilization of the family of procreation

Abstract This paper presents a family therapy model that utilizes the Bowen theory systems framework with the aged. Instead of seeking out the family of orientation, however, which is less significant to older family members who have fewer living siblings and parents, the framework is adapted to the family of procreation, which takes on increased importance in the lives of the elderly. A discussion of the older family member is followed by a brief explanation of the theoretical framework. The major thrust of the paper provides a description of the course of family therapy with the aged using this model. Included are the goals and outcomes of therapy, strategies for re-relating with other family members, and roles of the therapist and client. Research issues are discussed briefly. The expected outcomes of this model are the creation of more satisfying intergenerational relationships and the preservation and enhancement of independence for the aged.