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2022 ◽  
Vol 8 ◽  
Author(s):  
Yingying Ke ◽  
Jun Xu ◽  
Xiaoyan Zhang ◽  
Qihao Guo ◽  
Yunxia Zhu

Background: Sarcopenia is a geriatric syndrome characterized by progressive loss of muscle mass, function and quality and associated with a range of adverse health outcomes including disability. Despite a negative correlation between muscle mass and follicle-stimulating hormone (FSH) levels in postmenopausal women, it is unclear if FSH is associated with sarcopenia and its poor outcomes, especially in older men.Methods: We used cross-sectional data from 360 men aged over 80 who participated in health check-ups to investigate correlations between serum FSH and sarcopenia, individual sarcopenia components, low physical performance (gait speed ≤ 0.8 m/s) and instrumental activities of daily living (IADL) disability. Sarcopenia and severe sarcopenia were diagnosed according to the revised definition of the European Working Group on Sarcopenia in Old People (EWGSOP2).Results: The prevalence of sarcopenia was 17.8% in this population. In binary logistic regression analysis, compared with higher FSH group, lower FSH group showed a significant reduction in the risk of low calf circumference (a surrogate for muscle mass; OR 0.308, 95% CI 0.109–0.868, P = 0.026) after adjusting potential confounders including age, waist circumference, education, exercise, associated biochemical parameters, other sex hormones and high-sensitivity C-reactive protein. The correlation between FSH and low handgrip strength was marginally significant (OR 0.390, 95% CI 0.151–1.005, P = 0.051). No associations were observed between FSH and sarcopenia, severe sarcopenia, and disability in adjusted models.Conclusion: In older men, circulating FSH was not associated with sarcopenia, sarcopenia severity, the majority of its components and adverse health outcome (IADL disability), with the exception of low calf circumference. Further work is needed to better elucidate the association of FSH and low muscle quantity by adopting more accurate measurement method of appendicular skeletal muscle mass such as DXA, CT or MRI.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 632-632
Author(s):  
Bernard Steinman ◽  
Bremen Whitlock ◽  
Casandra Mittlieder ◽  
Julie Overton ◽  
Jon Pynoos

Abstract By definition, older adults living in rural communities have fewer formal resources available to address aging-related functional needs. Supportive environments are frequently relied on in rural settings to help address this discrepancy. The purpose of this study was to assess the role of supportive housing features and home modifications in mediating the association between rurality and disability. We hypothesized that environmental supports would be more crucial in rural settings than non-rural settings. We analyzed data from the National Health and Aging Trends Study (NHATS). Variable selection was guided by the International Classification of Functioning, Disability and Health (ICF), including covariates for sociodemographics, chronic conditions, mobility functioning, and participation. A series of regression models tested mediation by environmental variables of the association between rurality (as determined by the metro/nonmetro file indicator) and ADL/IADL disability. Supportive home environments were operationalized using indicators of whether participants had access to homes from the outside without having to use stairs; presence of a bedroom, kitchen, and full bathroom with a shower or tub on the same floor; and whether bathroom fixtures had been modified with features such as grab bars. Results suggest a statistical relationship between rurality and disability that is explained in part by the presence or lack of supportive home features, and these effects were greater in rural settings. Implications are that older adults who live in rural settings can benefit greatly by supportive environments and modifications in areas of the home that are known to cause difficulty.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 260-260
Author(s):  
Melissa Lamar ◽  
Sue Leurgans ◽  
Aron Buchman ◽  
Lisa Barnes ◽  
Brittney Lange-Maia

Abstract Discrimination is linked to poor health outcomes, but most studies examine young or midlife populations. We assessed associations between discrimination and disability in African Americans. The Detroit Areas Study Everyday Discrimination Scale quantified experiences of interpersonal mistreatment. Separate Cox-proportional hazards models tested the associations between baseline discrimination and incident mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) disability, adjusting for age, sex, education, BMI, smoking, depressive symptoms, and vascular diseases. At baseline, 441, 674, and 469, participants were initially free of mobility, ADL, and IADL disability, respectively, and 257, 185, and 269 new cases of mobility, ADL, and IADL disability were observed over approximately 8.5 years. Discrimination was associated with higher risk of ADL disability (hazard ratio: 1.03 per 1-point higher discrimination score, 95% confidence interval: 1.00-1.06) but no other disability type. Everyday discrimination is associated with risk of ADL disability.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Qiu Ting Kee ◽  
Mohd Harimi Abd Rahman ◽  
Norliza Mohamad Fadzil ◽  
Zainora Mohammed ◽  
Suzana Shahar

Abstract Objective Near visual impairment (VI) is a common disability in an aging population. Near vision is crucial in activity of daily living including reading, smartphone and computer use and meal preparation. This study was conducted to determine the association between near visual acuity (VA) and contrast sensitivity (CS) with activity of daily living (ADL) among visually impaired older adults. Results A total of 208 participants aged  ≥  60 were recruited from the population-based longitudinal study on neuroprotective model for healthy longevity. Habitual near VA and CS were measured using Lighthouse near VA chart and Pelli-Robson CS chart, respectively. Lawton instrumental activities of daily living (IADL) was used to assess ADL. There are 41.8% participants with near visual impairment and 28.7% among them had IADL disability. Independent t test showed significant lower mean IADL score among visually impaired participants [t(206)  =  2.03, p  =  0.04]. IADL score significantly correlated with near VA (r  =   − 0.21, p  =  0.05) but not with CS (r  =   − 0.14, p = 0.21). Near VA (B  =   − 0.44, p  =  0.03) and age (B  =   − 0.07, p  =  0.01) significantly predicted IADL. The findings show poorer VA renders higher IADL disability, which may necessitate interventions to improve ADL among visually impaired older adults.


Author(s):  
Hyungchul Park ◽  
Jihye Lim ◽  
Ji Yeon Baek ◽  
Eunju Lee ◽  
Hee-Won Jung ◽  
...  

(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV criteria were used to identify patients with clinically defined constipation, while sarcopenia was defined by the Asian Working Group for Sarcopenia consensus. The cohort was classified into three groups: no constipation, self-reported constipation only, and clinically defined constipation. (3) Results: The presence of constipation was associated with sarcopenia and slow gait speed (p < 0.001). After adjustment for possible covariates, the association with sarcopenia attenuated, while that for slow gait speed persisted. In terms of geriatric parameters, both groups with clinically defined and self-reported constipation had a higher burden of cognitive impairment, IADL disability, and lower QOL scores (p < 0.05) compared with those without constipation. (4) Conclusions: Sarcopenia and slow gait speed associated with constipation in community-dwelling older adults. Individuals with self-reported constipation symptoms alone showed comparable sarcopenic and geriatric burden to those with clinically defined constipation. Clinical suspicion for possible co-existing sarcopenia is warranted in older patients with constipation.


2021 ◽  
Author(s):  
Keigo Nanjo ◽  
Takashi Ikeda ◽  
Naoko Nagashio ◽  
Tomoko Sakai ◽  
Tetsuya Jinno

Objective To investigate the association between psychological factors related to pain and instrumental activities of daily living (IADL) disability in older adults with knee osteoarthritis (OA). Design A cross-sectional study. Setting Outpatients at a general hospital in Japan. Participants: One hundred seventy-nine (N=179) patients with knee OA and aged => 65years. Interventions Not applicable. Main Outcome Measure: Six-item short form of the pain catastrophizing scale (PCS-6) and four-item short form of the pain self-efficacy questionnaire (PSEQ-4) were used to assess the psychological status related to pain. IADL status was assessed using eight activity items. Participants selected able, need help, or unable depending on their abilities to perform these IADL activities. If they chose need help or unable to perform, for at least one item, we defined them as disabled. Results Of all participants, 88 (49.1%) showed disability in conducting IADL. Binary logistic regression analysis with the dependent variable as IADL disabled or not and PCS-6 and PSEQ-4 as independent variables were performed. Age, sex, pain intensity, depressive symptoms, usual gait speed (UGS), and isometric knee extension strength were included as covariates in the logistic regression model. Only PSEQ-4 (odds ratio (OR)=0.90, 95% confidence interval (95%CI)=0.82-0.99, p=0.02) was a significant independent variable for psychological factors related to pain. PCS-6 was not a significant variable (OR=1.06, 95%CI=0.94-1.19, p=0.13). Sex (OR=0.38, 95%CI=0.15-0.96, p=0.04) and UGS (OR=0.13, 95%CI=0.02-0.72, p=0.02) were significantly independent variables. Conclusion Our study showed the importance of assessing self-efficacy related to pain using the PSEQ-4 to determine the presence of IADL disability in older adults with knee OA.


Author(s):  
Michelle L Chan ◽  
Chloe W Eng ◽  
Paola Gilsanz ◽  
Rachel A Whitmer ◽  
Dan Mungas ◽  
...  

Abstract Objective Cognitive functioning is associated with instrumental activities of daily living (IADL) performance among older adults. The present study examines potential differences in the prevalence of IADL difficulty and association with cognition across diverse groups. Methods Participants included 455 non-Hispanic Whites, 395 Blacks, 370 Asians, and 296 Latinos age ≥65 without a current dementia diagnosis from the Kaiser Healthy Aging and Diverse Life Experience cohort. Participants self-reported IADL functioning and cognition was measured across episodic memory and executive functioning. Results Older age, male gender, and being Black were associated with more IADL difficulties. Executive functioning showed a stronger association with IADL than memory, and it was independent of health status whereas memory was not. In joint models including both cognitive domains, executive functioning remained a significant predictor of IADL difficulty, but memory did not. Results for both cognitive domains were attenuated with self-rated health added to the joint model. These relationships did not significantly differ across racial/ethnic groups Conclusions Our study supports previous work suggesting that Black older adults are at increased risk for IADL disability. This is the first study we are aware of that examined the association between specific cognitive domains and IADL performance across multiple racial/ethnic groups. Findings indicate that cognitive functioning has similar associations with self-reported IADL disability across diverse groups, and that executive functioning plays a particularly important role in IADL disability among older adults without dementia; however, health status largely attenuates the relationship between IADL difficulty and cognition.


2021 ◽  
Vol 9 (B) ◽  
pp. 975-982
Author(s):  
Abdullah Alhalafi ◽  
Maysoon Al-Amoud ◽  
Reema Aldahman ◽  
Eman Abd-Ellatif ◽  
Doaa Omar

BACKGROUND: The burden of disability among the older population is increasing as older people grow with significant social and economic negative impacts. AIM: This study examines functional disability and its associated risk factors among older Saudi citizens attending primary health-care centers (PHCCs) in Riyadh city. METHODS: This descriptive cross-sectional study was carried out on 504 older Saudi citizens aged ≥60 years who attended a PHCC in Riyadh city between December 2019 and May 2020. Interviewer-administered questionnaire was used to assessing the disability in activities of daily living (ADL) and instrumental activities of daily living (IADL) using the Katz Index and Lawton scale. RESULTS: The prevalence of ADL and IADL disability among participants was 24.6% and 58.5%, respectively. Smoking (p = 0.019), dyslipidemia (p = 0.018), rheumatoid arthritis (p = 0.028), history of falls (p = 0.014), and an emergency visit (p = 0.049) were risk factors associated with ADL disability. Predictors of IADL disability were advanced age (p = 0.004), being female (p = 0.029), and the need for a caregiver (p = 0.000). The need for homecare was positively associated with ADL dependency (p = 0.008) and IADL dependency (p = 0.003). Furthermore, regular physical activity was a protective factor against ADL functional disabilities (p = 0.002) and IADL functional disabilities (p = 0.000). CONCLUSION: This study found a high prevalence of ADL and IADL disability among elderly Saudis. Disability was associated with several sociodemographic and health status factors. The findings of this study highlight the priority of effective and targeted preventive interventions for disability.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Adriana Milazzo

Abstract Background This study aims to analyse the distribution characteristics of ideal cardiovascular health (ICH) metrics status of the oldest-old and centenarians, and also to explore the relationships with disability and quality of life. Methods 1002 centenarians and 798 oldest-old were included in the analysis. ICH, disability and quality of life were assessed according to standard methods. Results The median number of ICH metrics among centenarians and oldest-old were 4 (4-5) and 3(3-5) respectively. The highest proportion of ICH metrics at ideal levels were glucose (90.2%), BMI (89.8%), and smoking (89.4%), the lowest proportion of ICH metrics at ideal level was blood pressure (8.3%). The disability rates of BADL and IADL decreased with the number of ICH metrics. BADL disability changed from 100.0% to 73.2%, and the IADL disability rate dropped from 100% to 80.0%. BADL disability rate decreased from 45.0% to 25.3% and IADL disability decreased from 100.0% to 57.1% among the oldest-old. The EQ-5D vas, EQ-5D score showed increasing trend along with the number of ICH metrics (p &lt; 0.05). Compared with centenarians who had only 0-2 ICH metrics, the ORs for BADL disability were 0.82, 0.66, 0.52, 0.44, and the ORs for IADL disability were 0.74, 0.65, 0.58, 0.41 for those with 3, 4, 5, ≥6 ICH metrics. Conclusions ICH metrics of centenarians and oldest-old were at a relatively good level, and there was a strong and independent inverse relationship between ICH metrics with both disability and lower quality of life. Key messages This was the first survey about the distribution of ICH metrics and association with both disability and quality of life based on elderly aged over 80 years old. The results highlighted the importance of cardiovascular prevention even at 80 years and over, which made up for the evidence gap based on this age group.


Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Yanan Qiao ◽  
Siyuan Liu ◽  
Guochen Li ◽  
Yanqiang Lu ◽  
Ying Wu ◽  
...  

<b><i>Background and Objectives:</i></b> Few studies have investigated the bidirectional relationship between disability and multimorbidity, which are common conditions among the older population. Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) and the Survey of Health, Ageing and Retirement in Europe (SHARE), we aimed to investigate the bidirectional relationship between disability and multimorbidity. <b><i>Methods:</i></b> The activities of daily living (ADLs) and the instrumental activities of daily living (IADLs) scales were used to measure disability. In stage I, we used multinomial logistic regression to assess the longitudinal association between ADL/IADL disability and follow-up multimorbidity. In stage II, binary logistic regression was used to evaluate the multimorbidity effect on future disability. <b><i>Results:</i></b> Compared with those free of disability, people with disability possessed ascending risks for developing an increasing number of diseases. For ADL disability, the odds ratio (OR) (95% confidence interval [CI]) values of developing ≥4 diseases were 4.10 (2.58, 6.51) and 6.59 (4.54, 9.56) in CHARLS and SHARE; for IADL disability, the OR (95% CI) values were 2.55 (1.69, 3.84) and 4.85 (3.51, 6.70) in CHARLS and SHARE. Meanwhile, the number of diseases at baseline was associated, in a dose-response manner, with future disability. Compared with those without chronic diseases, participants carrying ≥4 diseases had OR (95% CI) values of 4.82 (3.73, 6.21)/4.66 (3.65, 5.95) in CHARLS and 3.19 (2.59, 3.94)/3.28 (2.71, 3.98) in SHARE for developing ADL/IADL disability. <b><i>Conclusion:</i></b> The consistent findings across 2 national longitudinal studies supported a strong bidirectional association between disability and multimorbidity among middle-aged and elderly adults. Thus, tailored interventions should be taken to prevent the mutual development of disability and multimorbidity.


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