Search

Background: Static and dynamic balance skills can be related to the activities of daily living (ADL) in children with non‐syndromic intellectual disabilities, and the type of balance skills affecting ADL can differ depending on the domain of ADL (self‐care, mobility, and social function). Methods: The ADL capabilities of 66 children with intellectual disabilities were assessed using the Pediatric Evaluation of Disability Inventory (PEDI) and were examined in relation to static and dynamic balance skills. Results: Significant positive correlations were found between the one‐leg standing and PEDI (r =.841 for self‐care, r =.700 for mobility, and r =.760 for social function). Our analysis showed that static balance skills affected self‐care, dynamic balance skills affected mobility, and intelligence quotient affected social function. Conclusions: Improving balance skills is important for enhancing ADL capabilities, and the type of balance skills that need enhancement vary based on the domain of ADL. [ABSTRACT FROM AUTHOR]

Aim: Life-space mobility (LSM) restriction is a serious issue among older adults using home-visit rehabilitation (HR). This study evaluated physical function, transportation, and other factors not comprehensively tested in previous studies and examined factors associated with the restriction of LSM among older adults using HR. Methods: This cross-sectional multi-center study recruited 88 HR users (49 men, 39 women, mean age 79.0 [-7.8] years) living in urban and rural areas from August to October 2020. We administered the Life-Space Assessment (LSA), the Self-Efficacy Scale on Going out among community-dwelling Elderly (SEGE), grip strength, a 30-s chair stand test, Bedside Mobility Scale, Functional Independence Measure, Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE) test. Participants were divided into two groups based on the cut-off value of the LSA scores. In the logistic regression analysis, the dependent variable was LSA scores =30, and the independent variables were measured based on objective evaluation items and adjusted for confounding factors (age, sex, and frequency of use of day-care services). Results: Restriction of LSM was significantly associated with FAI (odds ratio [OR] = 0.817, 95% confidence interval [CI] = 0.706-0.945), HACE facilitators (OR = 1.558, 95% CI = 1.168-2.079), and living alone (OR = 12.822, 95% CI = 1.202-136.716). Conclusion: Restriction of LSM is associated with environmental factors, such as assistive devices and household composition, and ability to engage in instrumental activities of daily living. Our findings indicate a great need for focusing on these factors among home-care older adults receiving HR. [ABSTRACT FROM AUTHOR]

Aim: Chronic kidney disease (CKD) is an important public health problem. Recently, CKD has been found to be associated with poor physical functioning in community‐dwelling elderly individuals. However, the physical functioning of non‐dialysis (ND) patients with advanced CKD treated by nephrologists is unknown. Methods: Patients with ND‐CKD stage G3b‐5 who participated in a nationwide Reach‐J CKD cohort study were included in this study. Physical functioning and physical activity were assessed by the Katz Index, Lawton‐Body instrumental activities of daily living (IADL) scale, and Rapid Assessment of Physical Activity questionnaire of the international CKD Outcomes and Practice Patterns Study (CKDopps) questionnaires. Dichotomies between good and poor physical functioning and physical activity scores were explored. Results: Among 1628 patients, 84.3% had good physical functioning. Poor physical functioning was more common with older age (p <.001), higher CKD stage (p <.05), and comorbid conditions such as diabetes (p <.001), cardiovascular disease (p <.05), cerebrovascular disease (p <.001), and cancer (non‐skin) (p <.05). Forty percent of the patients were inactive. Physical inactivity was more common with older age (p <.001) and higher CKD stage (p <.001). Conclusion: A minority, but sizeable proportion of patients with advanced CKD treated by nephrologists in Japan have some disability in ADLs/IADLs. Nephrologists need to routinely assess the physical functioning and physical activity of patients with advanced CKD to provide individualized guidance and comprehensive support to these patients for their daily life. SUMMARY AT A GLANCE: Among non‐dialysis stage G3b‐5 subjects, poor physical functioning was more common with older age, higher CKD stage, and comorbid conditions such as diabetes, cardiovascular disease, cerebrovascular disease, and cancer (non‐skin). The study stressed the need for nephrologists to routinely assess the physical functioning and physical activity of patients with advanced CKD to provide individualized guidance and comprehensive support for their daily life. [ABSTRACT FROM AUTHOR]

Higher physical activity levels during hospitalization may benefit the life-space mobility, defined as the ability to move within environments that expand from one's home to the greater community, of stroke survivors following their discharge. This study aimed to evaluate the relationship between physical activity levels during rehabilitation hospitalization and life-space mobility among stroke survivors three months after their discharge. We recruited 84 stroke survivors as prospective participants from four convalescent rehabilitation hospitals. Physical activity levels during hospitalization were assessed using pedometers with a three-axis accelerometer, and their average step count over 14 consecutive days prior to discharge was used as the representative set of values. Pedometers were placed on the participant's waist or wrist on the non-paretic side. The Life-Space Assessment (LSA), a validated self-reporting measure for assessing community mobility, was implemented three months following participant discharge from rehabilitation hospitals via a mail-in survey method. To determine the relationship between the participants' level of physical activity during hospitalization and the LSA score following discharge, we performed multivariate regression analysis. A total of 75 participants (89.3%) completed the post-discharge survey and were therefore included in the analysis. The multiple regression analysis, controlled for age, balance function, walking endurance, fear of falling, and functional status, revealed that daily step counts were significantly associated with the LSA score three months after discharge (β = 0.241, p =.026). Physical activity levels during hospitalization were significantly associated with the life-space mobility of stroke survivors following discharge. [ABSTRACT FROM AUTHOR]

Background: Understanding the physical and mental changes in community‐dwelling elderly people is very important during the coronavirus disease 2019 (COVID‐19) pandemic when considering preventive measures. The purpose of this study was to clarify the changes of physical function and anxiety for activities of daily living in community‐dwelling older adults, focusing on locomotor function during the COVID‐19 pandemic. Methods: The study participants were 127 older people who participated in successive surveys, in the summers of 2019 and again in 2020, after the state of emergency. The Locomo 25 questionnaire, Geriatric Depression Scale‐15 (GDS‐15) questionnaire, medical history, and number of people living together were self‐reported. The Locomo 25 covers six aspects of physical pain, movement‐related difficulty, usual care, daily activity, social activities, and anxiety. Results: The paired samples t‐test revealed that Locomo 25 total scores in 2020 were significantly higher than those in 2019. The GDS‐15 score showed no significant difference. The comparison of scores for each item of the Locomo 25 revealed significantly higher scores in 2020 on Q21 ('difficult to perform sports activity', P = 0.0021), Q22 ('restricted from meeting own friends', P < 0.001), Q23 ('restricted from joining social activities', P < 0.001), Q24 ('anxious about falling in own house', P = 0.0023), and Q25 ('anxious about being unable to walk in the future', P = 0.0016). Conclusions: About 2 months after declaration of the first state of emergency due to the COVID‐19 pandemic in Japan, social activity was severely restricted. Older adults showed almost no changes in body pain and locomotive disabilities, but increases in their anxieties about walking ability and falling were remarkable. [ABSTRACT FROM AUTHOR]

Background and Purpose: Most patients become physically inactive after vertebral compression fracture and thus need help for early mobilization. This study sought to investigate the effect of early rehabilitation on activities of daily living in patients following acute vertebral compression fracture. Methods: We conducted this retrospective cohort study with a hospital-based database created by the Japan Medical Data Center and comprising data from a Diagnosis Procedure Combination survey from more than 100 acute care hospitals across Japan. Data of consecutive inpatients hospitalized because of thoracic and/or lumbar compression fractures from 2014 to 2018 were extracted. We compared characteristics and outcomes between patients who underwent early rehabilitation (early rehabilitation group) and those who did not undergo rehabilitation (no rehabilitation group). The primary outcome measure was Barthel Index improvement. Results: After applying exclusion criteria, a total of 8493 eligible patients with acute vertebral compression fracture were included in this study. The unadjusted data showed significantly greater Barthel Index improvement (72.5% vs 60.3, P <.001) and a higher rate of discharge to home (82.9% vs 77.4, P <.001) among patients in the early rehabilitation group compared with the no rehabilitation group. After adjustment by propensity score analysis, significant between-group differences were found. Conclusion: Early rehabilitation could possibly be a feasible alternative for maintenance of the Barthel Index in patients with acute vertebral compression fracture. [ABSTRACT FROM AUTHOR]

During the last three decades, Japan has become one of the world's top countries for longevity, and the increase in average life expectancy is accompanied by a sharp rise in older population 65 years of age and above to ∼28%. This study aimed to examine the changes in major health-related measures, including a physical constitution, physical function, and functional capacity of community-dwelling Japanese older people in the last decade. From the data of 13 longitudinal cohort studies on aging conducted in Japan with a total of 13,441 older subjects, this study analyzed the changes in six indices that are related to health and functioning of the older people; height, weight, body mass index, walking speed, grip strength, and instrumental activity of daily living, between 2007 (±2 years) and 2017 (±2 years). Comparison of data for the two periods between subjects matched for age group and gender evidently showed better health status and a slower decline in most of the health-related measures in 2017 compared to a decade ago. The results of this study indicate that the phenomenon of "rejuvenation" is occurring among the new generation of Japanese older adults, and the importance of this older population as a social resource in the super-aged society should be reacknowledged. [ABSTRACT FROM AUTHOR]

• Cognitive health is essential for the healthy life of older people. • We compared the venue and home-visit surveys in a sample of urban older people. • Rate of cognitive decline measured by the MMSE was higher in the home-visit survey. • Participants in the home visit-survey could be more difficult in their daily lives. • Home-visit surveys can help increase the representativeness of older people. We conducted surveys in older people at a venue and in home-visits, and compared cognitive and health status between the two groups to assess their cognitive and everyday functioning. Among 7,614 persons aged 70 years and older living in an urban area, 5,430 responded to a mail survey for sociodemographic characteristics and self-rated questionnaires including the Geriatric Depression Scale-short form (GDS-15). Of these, 1,360 agreed to attend a venue survey, and 693 agreed to take a home-visit survey. Trained nurses examined participants' blood pressure, medical history, and daily functions using the dementia assessment sheet for community-based integrated care system (DASC-21), and tested their cognitive function using the Mini-Mental State Examination (MMSE). Of 2,053 participants, 2,020 (venue: 1,352; home-visit: 668) completed the MMSE. Median MMSE scores for the venue and home-visit groups were 28 and 26 points, respectively, with 130/1,352 (9.6%) and 205/668 (30.7%) participants below the traditional 23/24 cutoff score. The home-visit group had lower mobility, lower frequency of going out, poorer mental health, and lower independence in instrumental daily activities. Notably, 39.9% and 43.7% of the venue and home-visit groups lived alone, respectively. In this sample of urban older people, the rate of cognitive decline detected using the MMSE was three times higher in the home-visit group than in the venue group. Home-visit participants were more likely to have difficulty in physical, cognitive, and everyday functioning, suggesting they have a greater need for daily living support to continue living in the community. [ABSTRACT FROM AUTHOR]

• Older adults generally do not report ADL limitation until 77 years old, and mobility limitation occurs at a various age in Taiwan and Japan. • Older adults generally do not face serious disability until 85 or 86 years old in Taiwan or Japan, respectively. • The speed of disability with age for older adults Taiwan was faster than Japan in ADL and IADL limitation, but not in mobility. Disability development using age as the axis was void in the literature. Identification of the age trajectory of disability development across populations enables preparation for aging-related policies when conducting cross-national comparisons. This study compared three indicators of the development of physical disability in populations of Taiwan and Japan. Data comprised two nationally representative panel surveys (1) the Taiwan Longitudinal Study on Aging (N = 3,037) in 1996–2011 and (2) the National Survey of the Japanese Elderly in 1996–2012 (N = 1,974). Older adults (65+) were examined longitudinally. Activities of daily living (ADL), instrumental activities of daily living (IADL), and mobility disability development during aging were analyzed using multilevel models. After age standardization, Japan reported higher prevalence rate of ADL disability (14.95% vs. 9.65%) but lower IADL (19.30% vs. 30.36%) and mobility disability (36.07% vs. 49.82%) as compared with Taiwan. ADL limitation occur (ADL limitation>=1) at the age of 77.9 and 77.2 for populations in Japan and Taiwan, respectively. Populations reached three ADL limitations at the age of 86.7 and 85.0 in Japan and in Taiwan, respectively. IADL limitation occur (IADL limitation>=1) at the age of 79.1 and 74.5 for populations in Japan and Taiwan, respectively. Mobility limitation occur (Mobility limitation>=1) at the age of 70.7 and 65.3 for populations in Japan and Taiwan, respectively. Older adults generally do not report ADL limitation until 77 and do not face serious disability until 85 or 86 in Taiwan or Japan, respectively. Mobility limitation occurs at a various age in different countries. [ABSTRACT FROM AUTHOR]