Decline In Physical Function Research Articles

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.

Predictors of postoperative physical functional decline at hospital discharge in elderly patients with prolonged intensive care unit stay after cardiac surgery

BackgroundA prolonged stay in the intensive care (ICU) is associated with physical function decline following cardiac surgery. To predict physical function decline after cardiac surgery, it may be important to evaluate physical function in the ICU. ObjectivesThis study aimed to determine that physical function examination at ICU discharge was independently associated with physical functional decline at hospital discharge in elderly patients who had undergone cardiac surgery and prolonged the ICU stay. MethodsWe assessed physical function before and after cardiac surgery in elderly patients who had spent ≥72 h in the ICU in this retrospective cohort study using the short physical performance battery (SPPB). At hospital discharge, a decrease of at least 1 point on the SPPB was considered a postoperative physical functional decline. Postoperative physical functional decline at hospital discharge was predicted using multiple logistic regression. ResultsWe revealed postoperative physical functional deterioration in 28.0% of patients who spent ≥72 h in the ICU following cardiac surgery. The Medical Research Council sum score (MRC-SS) (OR: 0.96, 95% CI: 0.82–0.99) and mechanical ventilation days (OR: 1.27, 95% CI: 1.01–1.64) were independently associated with physical functional decline at hospital discharge. ConclusionsPhysical function at ICU discharge and mechanical ventilation days were predictors of postoperative physical functional decline at hospital discharge in patients. MRC-SS was more accurate in predicting postoperative physical functional decline at hospital discharge when performed at the time of ICU discharge.

The vaccination of the aged in post COVID-19 era

As human grow older, immune-senescence, inflammaging, decline in physical and cognitive functions, frailty, various comorbidities and related polypharmacy make us vulnerable to infectious diseases, which in turn accelerates aging vice versa. Immunization for the aged against vaccine-preventable diseases is being emphasized more and more. However, in reality, the effective immune response is hindered for the similar reasons, so strategies to overcome this are being taken. The goal of elderly vaccination is to reduce the severity, mortality, and burden of disease. This review introduces 2023 adult immunization guidelines of the Korean Society of Infectious Diseases including influenza, pneumococcus, varicella zoster and coronavirus disease 2019 (COVID-19), and recently licensed respiratory syncytial virus vaccination. Clinicians are required to play a role in helping client’s decisions by providing and discussing scientific information about the benefits and risks of vaccination based on an understanding of the their medico-social condition in this post-COVID-19 era.

Tooth Loss as a Predictor of Long-Term Care Requirements in the Elderly: A Study in Kobe City, Japan.

The Kobe project, which utilizes prospective data from the national health insurance system, focuses on early detection and preventive strategies through the Frail Kenshin health check-up program. Previous research has underscored the correlation between tooth loss and the decline in physical and cognitive functions. In this study, using Kobe project data, we examined the link between remaining teeth and long-term care needs in individuals aged 64-65 years, with primary and secondary objectives involving various health parameters and quality of life. We analyzed baseline data from a prospective study conducted alongside the Frail Check program for generally healthy individuals aged 64-65 yearsto examine the relationship between the number of remaining teeth and various health indicators. This study focused on citizens aged 64-65 years to identify those at risk of needing long-term care by the age of 65 years. Data from 1,530 participants were obtained, excluding eight individuals for specific reasons. At the end of the follow-up period, 41 (2.7%) individuals required supportand 15 (1.0%) needed long-term care alone. The data revealed a significant association between the number of remaining teeth and the need for long-term care or support, as demonstrated by the Cochran-Armitage trend test (p<0.001). Although trends were noted for nutrition and total Cognitive Functional Instrument Self scores, they did not reach statistical significance. Additionally, a decrease in the number of remaining teeth was significantly associated with worse European Quality of Life Five Dimensions (EQ-5D-5L) visual analog scale scores, mobility, and regular activities (p<0.001). Tooth loss indicates the potential long-term care needs of older adults. Monitoring oral health is crucial for addressing care requirements.

BARRIERS AND FACILITATORS OF PALLIATIVE CARE FOR ADULT HEART FAILURE PATIENTS: INTEGRATIVE REVIEW

Introduction: Heart failure (HF) patients usually experience symptoms such as dyspnea, tiredness, cognitive impairment, and pain. Those symptoms contribute to a decline in physical functioning and a limitation in their ability to do their daily tasks. Palliative care (PC) is crucial for people with HF because it focuses on improving the quality of life and can reduce symptoms and improve function. Qatar aims to introduce PC services for adult patients with HF. Objective: This integrative review aims to investigate the barriers, facilitators, and the outcomes to the provision of palliative care among adult patients with HF. Methods: Whittemore and KnafI’s framework guided this integrative review. Using three databases, twenty (n=20) peer-reviewed articles, published between 2011 and 2022, were included in the integrative review. The Mixed Methods Appraisal Tool was used to assess the quality of these articles. The data was then extracted and thematically analyzed before being synthesized. Results: The barriers, facilitators, and outcomes of providing PC services to individuals with HF were identified from the perspectives of patients, healthcare providers, and healthcare organizations. Conclusion: Gaining a comprehensive understanding of these barriers, facilitators, and outcomes associated with providing PC services to adults with HF is central for the effective implementation of such services for this patient population in Qatar. Keywords: heart failure, palliative care, barriers, facilitators

Functional decline during the COVID-19 pandemic among U.S. military veterans: Results from the National Health and Resilience in Veterans Study.

The coronavirus disease-2019 pandemic has contributed to widespread social and economic stressors, along with substantial health problems, including loss of life. To date, however, relatively few studies have examined the prevalence and correlates of declines in mental and physical functioning in U.S. military veterans, an older and potentially vulnerable segment of the U.S. adult population. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative, longitudinal study of 3078 veterans. Veterans were surveyed prior to the pandemic (pre-pandemic) and 1year later during the height of the pandemic (peri-pandemic). Multivariable analyses were conducted to identify risk and protective variables associated with pre-to-peri pandemic declines in self-reported physical and mental functioning. The prevalence of veterans who experienced functional decline (≥0.5 standard deviation reductions) pre-to-peri-pandemic was 18.1% (N=541) for physical functioning and 18.3% (N=547) for mental functioning. Older age, greater adverse childhood experiences (ACEs), and pandemic-related posttraumatic stress symptoms were the strongest correlates of physical functional decline, while greater ACEs, loneliness, pandemic-related posttraumatic and social restriction stress symptoms, and lower protective psychosocial characteristics were the strongest correlates of mental functional decline. Although the majority of U.S. Veterans showed functional maintenance or improvement 1year into the pandemic, nearly one-in-five experienced a decline in physical or mental functioning. Results could help inform identification of veterans who may be at risk for functional decline during large-magnitude stressors, such as national or global pandemics.

A peer-volunteer led active ageing programme to prevent decline in physical function in older people at risk of mobility disability (Active, Connected, Engaged [ACE]): study protocol for a randomised controlled trial

BackgroundThe Active Connected Engaged [ACE] study is a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial [RCT] with an internal pilot phase. The ACE study incorporates a multi-level mixed methods process evaluation including a systems mapping approach and an economic evaluation. ACE aims to test the effectiveness and cost-effectiveness of a peer-volunteer led active ageing intervention designed to support older adults at risk of mobility disability to become more physically and socially active within their communities and to reduce or reverse, the progression of functional limitations associated with ageing.Methods/designCommunity-dwelling, older adults aged 65 years and older (n = 515), at risk of mobility disability due to reduced lower limb physical functioning (Short Physical Performance Battery (SPPB) score of 4–9 inclusive) will be recruited. Participants will be randomised to receive either a minimal control intervention or ACE, a 6-month programme underpinned by behaviour change theory, whereby peer volunteers are paired with participants and offer them individually tailored support to engage them in local physical and social activities to improve lower limb mobility and increase their physical activity. Outcome data will be collected at baseline, 6, 12 and 18 months. The primary outcome analysis (difference in SPPB score at 18 months) will be undertaken blinded to group allocation. Primary comparative analyses will be on an intention-to-treat (ITT) basis with due emphasis placed on confidence intervals.DiscussionACE is the largest, pragmatic, community-based randomised controlled trial in the UK to target this high-risk segment of the older population by mobilising community resources (peer volunteers). A programme that can successfully engage this population in sufficient activity to improve strength, coordination, balance and social connections would have a major impact on sustaining health and independence.ACE is also the first study of its kind to conduct a full economic and comprehensive process evaluation of this type of community-based intervention. If effective and cost-effective, the ACE intervention has strong potential to be implemented widely in the UK and elsewhere.Trial registrationISRCTN, ISRCTN17660493. Registered on 30 September 2021.Trial Sponsor: University of Birmingham, Contact: Dr Birgit Whitman, Head of Research Governance and Integrity; Email: researchgovernance@contacts.bham.ac.uk.Protocol Version 5 22/07/22.

An analytical investigation of body parts more susceptible to aging and composition changes using statistical hypothesis testing

In recent years, age-related changes in body composition in the elderly are attracting attention. This is associated with a decline in physical functions and an increased risk of disease development. In general, age-related changes in body composition can be minimized with appropriate exercise. However, there are no studies that investigate body parts susceptibility to aging and changes in body composition of those parts. Therefore, devising exercise programs and advising daily life while taking these into account becomes difficult. This study aims to identify body parts that are more susceptible to aging and their body composition changes. The body composition was obtained with a Direct Segmental Multi-frequency Bioelectrical Impedance Analysis using InBody770 in 8 male elderly patients who had been shortly hospitalized. Statistical hypothesis testing was used to determine whether site-specific body composition changed significantly between hospital discharge and 1 year, 1 year and 2 years, and hospital discharge and 2 years. The results showed that Lean body mass, Total Body Water, Intracellular Water, Extracellular Water in the right arm; Lean body mass and Total Body Water in the left arm and trunk are more sensitive to aging.

Effects of Cross-Training Exercise Program to Improve Health-related Physical Fitness for University Students in Guangdong

Background and Aim: Health-related physical fitness test is beneficial to the health-related physical fitness of college students. According to the researcher's survey, most students do not have an awareness of daily physical exercise, which leads to a decline in physical function and health-related physical fitness scores. The purpose of this paper is to study the effect of cross-training programs on improving college students' health-related physical fitness, to improve college students' health-related physical fitness scores by constructing an 8-week cross-training program, and to encourage students to actively participate in extracurricular physical exercise to promote health-related physical fitness and to form the awareness of lifelong sports. The results of this study show that cross-training can improve students' health-related physical fitness performance and that even after only 4 weeks of cross-training, students' health-related physical fitness performance can still make significant progress. Materials and Methods: The study involves Guangdong Province Foreign Language and Arts Vocational College of Catering and Tourism College 2022 students, the total number of grades 710 people, health-related physical fitness scores failed 66 people, using G-Power in 66 students to calculate the sample size of 28 students (14 male，14 female) aged between 18-22 years old. The research procedure started with anthropometric measurements: height, weight, BMI, body fat percentage, etc. Subsequently, cross-training was performed. Tests included: cardiorespiratory endurance, muscular strength, muscular endurance, and flexibility. The experiment lasted for eight weeks, with five one-hour training sessions per week. Subjects underwent Health-related physical fitness tests in the first, fourth, and eighth weeks. Results: The 8-week cross-training program reduced students' BMI and body fat percentage, and improved students' health-related physical fitness grades and physical fitness. The student's health-related physical fitness grades failed in the first week, improved significantly in the fourth week (67 points), and the average score in the eighth week (75 points) improved even more significantly. Conclusion: Constructing a cross-training program had a significant effect on improving cardiorespiratory endurance, muscular strength, muscular endurance, and flexibility in college students. It also increased their BMI and body fat percentage. It was concluded that an 8-week cross-training program decreased students' BMI and body fat levels while increasing muscle mass and improving health-related physical fitness scores, and students showed significant improvement in fitness scores in week 4 and even more significant improvement in week eight. Considering the positive effects of training on physical function and fitness, it is recommended that extracurricular sports be promoted so that more people can exercise in their spare time.

PSYCOEDUCATION OF YOUNG MOTHER TO REDUCE ANXIETY OF HYPERTENSIVE ELDERLY IN PUTON VILLAGE WORKING AREA OF CUKIR HEALTH CENTER

The elderly are a vulnerable age group, where in this phase a person tends to experience a decline in both physical and mental function and thus requires assistance to fulfill daily life activities. Health problems such as high blood pressure (hypertension), diabetes (diabetes mellitus/DM), heart disease, etc. can cause the elderly to be unable to carry out activities and fulfill their daily needs, thus requiring long-term care (PJP). A systematic program is needed to care for the elderly so that their needs can be met, prevent complications, and maintain optimal quality of life for the elderly. At the stage of development of the elderly, individuals experience setbacks both physically, psychologically and socially. Dependence on other people, especially family, becomes very high. Therefore, specific and appropriate assistance is needed to help the elderly carry out their activities optimally and not cause worse conditions or complications. Efforts that have been made to prevent and control hypertension in the elderly include providing psychoeducation to young mothers accompanying the elderly. Bearing in mind that in Puton Village the incidence of hypertension is still high and many people complain of experiencing anxiety due to hypertension. This community service activity was carried out for 1 week starting from the coordination stage to the evaluation. Based on the results of community service, participants understand more about anxiety in elderly people with hypertension so that they can reduce anxiety in elderly people with hypertension and increase the knowledge and ability of young mothers in caring for the elderly at home

Abstract 17131: Association of Objectively Measured Sleep With 6-minute Walk Distance in Older Adults

Background: Decline in physical function in older adults is associated with higher risk of cardiovascular diseases. While disturbances in sleep may contribute to declines in physical function with aging, prior research is limited by the use of subjective sleep measures. Hypothesis: Older adults with sleep disturbance will have impaired functional capacity measured via 6-minute walk test. Aim: This study aimed to examine the association between objectively measured sleep parameters and 6-minute walk distance (6MWD), a marker of functional capacity, in a diverse sample of older adults aged ≥55 years. Methods: This analysis included 96 participants who were enrolled in the Disparities in Sleep and Cognitive Outcomes (DISCO) study, a prospective cohort study of older adults with objective measurement of sleep and functional capacity. Sleep duration (minutes), efficiency (%), and fragmentation (%) were measured using 7 days-wrist actigraphy. Sleep stages including non-REM stage 3 (N3) duration (minutes) and REM duration (minutes) were measured using an overnight home sleep monitor. Total distance (meters) completed in 6-minutes was the primary outcome. Covariates included age, sex, race, ethnicity, body mass index, smoking status, and pain/ inflammation. Linear regression models were used for analysis. Results: Mean age of participants was 69.1 ± 5.4 years (range 56-82 years), 69.8% were women, 72% were White and 97% were Non-Hispanic/Latino. The average 6MWD was 495.6 ± 87 meters. Sleep duration, N3 duration, and REM duration were not statistically associated with total distance walked. In the fully adjusted models, higher sleep efficiency was associated with higher total 6MWD (p&lt;0.001), and greater sleep fragmentation was associated with lower total 6MWD (p=0.016) (see Table 1). Conclusions: Less favorable sleep quality, as indicated by lower sleep efficiency and more fragmented sleep, was associated with poorer functional capacity in older adults.

Abstract 16118: Vitamin D3 Significantly Decreases Vascular Stiffness, Improving Cognitive Impairment and Sarcopenia in a Frail, Elderly Population From Buenos Aires, Argentina

Introduction: Aging is the leading risk factor for multiple chronic diseases especially cardio and cerebrovascular and for a decline in physical and mental function. Progressive stiffening arterial wall, cognitive impairment and sarcopenia are hallmarks of aging. Due to the pleiotropic actions that have been discovered in vitamin D (VD), which include vascular ,muscular and cognitive effects, we hypothesized that VD3 supplementation might decrease vascular stiffness and could have beneficial effect on mental status and sarcopenia in a frailty elderly population. Methods: We randomized 42 residents (78±6.5 yo; 24 females) from a public geriatric institution, to receive either 100,000 IU of VD3 or placebo (P) every 15 days for 6 months. Arterial stiffness (AS) was evaluated through central systolic pressure (cSYS), central pulse pressure (cPP), and the augmentation index (AIx) a measure of systemic AS derived from the ascending aortic pressure waveform; using Uscom® device. Cognitive function was evaluated using the Clock-Drawing Test (CDT), which is simple and effective for this population. Skeletal muscle strength/sarcopenia, were assess with the up and go test (UGT), muscle strength with hydraulic dynamometer, body mass index (BMI) and mini-nutritional assessment (MNA) test. Results: VD group showed a statistically significant decrease in AS vs P. VD Δ cSYS -12.3 mmHg, Δ cPP -6.7 mmHg mmHg and Δ AIx -17.8 %, for all three parameters: p&lt;0.05. The CDT score improved in VD group (4.3 to 5.9, p &lt;0.05) but there were no statistically significant differences in P group. Muscle strength in VD group improved significantly (from 15.1±9.4 to 18.7±3.8 Kg force/cm 2 , p&lt;0.05) vs no difference in P group. UGT improved with statistical significance in both VD and P group. The BMI and the MNA test were also favorable for VD group although they did not reach statistical significance. Conclusions: Vitamin D3 6-months supplementation improved vascular compliance by decreasing arterial stiffness, improved cognitive performance and sarcopenia indicators in this frail elderly people. Although this was a preliminary study, a larger number of patients studies should be conducted to validated these findings and to consider VD3 supplementation in this population.

Abstract 19098: Physical Activity is Associated With Better Quality of Life and Perceived Health

Background: People living with coronary heart disease (CHD) experience decline in physical and social functioning, contributing to poor quality of life (QOL) and perceived health. Evidence shows that physical activity in the adult population is associated with improved QOL and better perceived health, but little is known about its benefits for community-dwelling older adults with chronic CHD. Hypothesis: Engagement in the self-care activity of physical activity is strongly related to better perceived health and QOL. Objective: Describe the association between physical activity and perceived health and QOL among older adults with long-standing CHD (&gt;20 years). Methods: In this cross-sectional study, 20-year follow-up survey data were collected from 126 survivors from the Heart and Soul prospective cohort study of people living with CHD. To identify variables associated with perceived health and QOL, we utilized nested ordinal logistic regression models (four-level model). Results: The mean age for 126 surveyed survivors was 80.9 ± 9.1 years; 71.8% (n=94) were males, less than half being physically active (47.3%, n=62) and 23.7% had heart failure. Analysis adjusted for socioeconomic status (SES), physical activity, and activities of daily living (ADL) revealed a positive association between physical activity and perceived health ( aOR =2.316, p =.023) and a strong association with QOL ( aOR =2.070, p =.046). The QOL adjusted model found heart failure diagnosis was associated with lower QOL ( aOR= .431, p &lt;.033). Conclusions: Physical activity was positively associated with perceived health and QOL among older adults with CHD, even after adjusting for SES, physical activity levels, and ADL suggesting that engagement in self-care activities such as physical activity is associated improve the overall perceived health and QOL of individuals with CHD. Furthermore, the study highlighted the impact of heart failure on QOL, even after adjusting for physical activity. These findings underscore the need for interventions and programs to promote physical activity among older adults with CHD and targeted interventions in managing heart failure.

Evaluation of symptom severity, tolerability, and physical function in the I-SPY2 trial.

369 Background: Patient-reported outcomes (PROs) are a valuable component to understand treatment tolerability and toxicity. We have implemented an electronic system for monitoring PROs and quality of life (QOL) for patients enrolled in the I-SPY2 trial, a phase II trial evaluating the effect of novel neoadjuvant therapies for breast cancer. We associated patient demographic factors with symptoms, decline in physical function (PF), and tolerability to treatment. Methods: Study population for this analysis includes 259 enrolled patients receiving combinations of experimental immunotherapy and chemotherapy. Patients completed PRO-CTCAE/PROMIS/FACT surveys reflecting symptom severity, symptom frequency, tolerability of drug, and physical function at baseline through follow up (12 months). CTCAE 5.0 was collected weekly at these timepoints to assess adverse events (AE). Odds ratio and regularized multi-variate regression was used to evaluate early symptoms predictive of a clinically significant decline in PF from baseline to post-treatment follow-up. Results: Of 259 patients, 160 (58%) were White, 13 (5%) were Asian, 26 (10%) were African American (AA), and 25 (9.3%) were Hispanic. 25% of all patients had a clinically significant decline in PF between baseline and pre-surgery/follow-up. Symptom predictors of decline included high frequency of diarrhea and severity of joint pain. African American (AA) patients had higher severity of joint pain than White patients (OR = 14.9, P &lt; 0.05). Within the first 12 weeks of treatment, AA patients and non-white (NW) patients were more likely to report severe vomiting than White patients (OR =13.22 and 12.72, P&lt; 0.05 and P&lt; 0.03 respectively). Overall, patients that reported lower tolerance to therapy had higher grade of AE. While patients with low-grade adverse events were less bothered by their side effects at follow-up, higher grade adverse events such as hypothyroidism impacted distress levels by more than double. Conclusions: Among I-SPY2 participants, when higher grade of symptoms is persistent through follow up, it impacts physical function and tolerability even after end of therapy. Our study can allow physicians to be more diligent in active and post treatment monitoring. Clinical trial information: NCT01042379 .

Chemotherapy-Related Toxic Effects and Quality of Life and Physical Functioning in Older Patients

Although older patients are at increased risk of developing grade 3 or higher chemotherapy-related toxic effects, no studies, to our knowledge, have focused on the association between toxic effects and quality of life (QOL) and physical functioning. To investigate the association between grade 3 or higher chemotherapy-related toxic effects and QOL and physical functioning over time in older patients. In this prospective, multicenter cohort study, patients aged 70 years or older who were scheduled to receive chemotherapy with curative or palliative intent and a geriatric assessment were included. Patients were treated with chemotherapy between December 2015 and December 2021. Quality of life and physical functioning were analyzed at baseline and after 6 months and 12 months. Common Terminology Criteria for Adverse Events grade 3 or higher chemotherapy-related toxic effects. The main outcome was a composite end point, defined as a decline in QOL and/or physical functioning or mortality at 6 months and 12 months after chemotherapy initiation. Associations between toxic effects and the composite end point were analyzed with multivariable logistic regression models. Of the 276 patients, the median age was 74 years (IQR, 72-77 years), 177 (64%) were male, 196 (71%) received chemotherapy with curative intent, and 157 (57%) had gastrointestinal cancers. Among the total patients, 145 (53%) had deficits in 2 or more of the 4 domains of the geriatric assessment and were classified as frail. Grade 3 or higher toxic effects were observed in 94 patients (65%) with frailty and 66 (50%) of those without frailty (P = .01). Decline in QOL and/or physical functioning or death was observed in 76% of patients with frailty and in 64% to 68% of those without frailty. Among patients with frailty, grade 3 or higher toxic effects were associated with the composite end point at 6 months (odds ratio [OR], 2.62; 95% CI, 1.14-6.05) but not at 12 months (OR, 1.09; 95% CI, 0.45-2.64) and were associated with mortality at 12 months (OR, 3.54; 95% CI, 1.50-8.33). Toxic effects were not associated with the composite end point in patients without frailty (6 months: OR, 0.76; 95% CI, 0.36-1.64; 12 months: OR, 1.06; 95% CI, 0.46-2.43). In this prospective cohort study of 276 patients aged 70 or older who were treated with chemotherapy, patients with frailty had more grade 3 or higher toxic effects than those without frailty, and the occurrence of toxic effects was associated with a decline in QOL and/or physical functioning or mortality after 1 year. Toxic effects were not associated with poor outcomes in patients without frailty. Pretreatment frailty screening and individualized treatment adaptions could prevent a treatment-related decline of remaining health.

Latent transition analysis to explore patterns of physical functional decline among older adults in China: A national 6-year longitudinal study

Background and aimsMultiple limitations often co-occur and accumulate, leading to subsequent function decline. However, there is a scarcity of longitudinal studies examining the progression of physical function among the general population of older adults in China. This study aimed to define typical physical function status and its change, which were characterized by the coexistence and accumulation of diverse limitations targeting a Chinese sample of older adults. MethodsThis study used the three recent public data waves of the Chinese Longitudinal Healthy Longevity Survey during a 6-year follow-up period. 9765 individuals who were over 65 and participated in the 2011 survey were included. Latent transition analysis was used to identify the latent physical function status and explore the transition of older adults among different latent statuses. ResultsSeven latent statuses of physical function were identified, with visual impairment and related limitations being particularly prevalent among older adults. Upper limb mobility appeared to be a differentiated indicator of physical functional status. Physical function decline mainly started with the limitations in squatting, carrying weights and walking, then to the status with intact upper limb mobility and hearing function only, or converted directly into the latter, then to complete dysfunction. ConclusionsOur findings suggest some indicative limitations and critical steps in the process of functional decline among older adults. These results may provide insight for researchers and policymakers to develop tailored preventive and rehabilitation care and provide support for physically limited elderly according to their latent status and course of functional decline.

2129P Feasibility of a virtual exercise program to mitigate decline in physical function for advanced lung cancer patients

2129P Feasibility of a virtual exercise program to mitigate decline in physical function for advanced lung cancer patients

Neurological Soft Signs and Social Cognition in Patients with Schizophrenia: the Missing Link

Schizophrenia is a debilitating mental disorder characterised by a pronounced decline in mental, physical, and social functioning. Our study aims to investigate the relationship between the socio-cognitive and the subtle motor and sensory symptoms of schizophrenia, which are, respectively, represented by facial emotion recognition deficits (FERD) and neurological soft signs (NSS). Thus, we assessed 60 patients diagnosed with schizophrenia. FERD was measured with the “Averaged Karolinska Directed Emotional Faces” set, and NSS was assessed with the Neurological Evaluation Scale. A strong and significant negative correlation was found between the NSS total score and the FERD total score (r = –0.7, p &lt; 0.001). There was also a significant negative correlation between several of the subscores of both instruments. The results show that impaired social cognition is significantly associated with soft neurological disturbances in patients suffering from schizophrenia. Taken together, this reinforces the notion that schizophrenia is characterised by dysfunction and disconnection of a complex cerebral network, which can probably be influenced by psychosocial and physical nonpharmacological therapeutic interventions.

Senescent cells as new pharmacological targets for age-related diseases and anti-aging therapy

Aging is a natural process leading to decline in physical function, reducing ability to adjust to everyday organismal stress and increased frailty. Recent studies of the mechanism of aging have brought attention to naturally occurring senescent cells in different organs throughout the body. This natural process of senescence is caused by cell cycle arrest due to cellular damage, which protects cells from apoptosis, while stimulating the production and secretion of different senescent associated secretory phenotypes (SASPs) causing low grade chronic inflammation. Emerging studies show that by targeting and eliminating these cells with a new class of senolytic drugs in old animals we can improve a variety of health conditions including reduction of inflammation, improvement of insulin sensitivity and metabolic status, increase of bone mineral density and enhanced physical function together with extended overall longevity. Ongoing clinical trials using Desatanib and Quarcetin (D+Q) and other classes of senolytic drugs indicate high translational potentials in targeting and clearing senescent cells to cure some age-related diseases; however, more in depth studies have to be completed to incorporate these therapies in general healthy elderly populations for safe anti-aging intervention.

Fall Detection Method Based on Convolutional Neural Network

With the improvement of people's living standards and social medical conditions, the average life expectancy is gradually lengthening, and the proportion of the elderly in the global population is also growing. China is a big country with a large population, and the problem of population aging is becoming increasingly prominent and severe. When elderly people live alone at home without others to care for them, falls become the most common and dangerous phenomenon due to the decline of physical function and the influence of certain diseases. Therefore, rapid, efficient and accurate identification and judgment of human falls are of great significance, which can effectively alleviate the threat to the life and health of the elderly and the social medical burden of falls. This paper mainly carried out a fall detection method based on convolutional neural networks, aiming to improve the accuracy of human fall detection through the natural advantages of convolutional neural networks in image recognition, and provide better solutions for medical monitoring and elderly care.