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Abstract Background Understanding the predictors of functional status can be useful for improving modifiable predictors or identifying at-risk populations. Researchers have examined the predictors of functional status in older adults, but there has not been sufficient study in this field in older adults with multiple chronic conditions, especially in Iran. Consequently, the results of this body of research may not be generalizable to Iran. Therefore, this study was conducted to determine the predictors of functional status in Iranian older adults with multiple chronic conditions. Methods In this cross-sectional study, 118 Iranian older adults with multiple chronic conditions were recruited from December 2022 to September 2023. They were invited to respond to questionnaires inquiring about their demographic and health information, basic activities of daily living (BADL) and instrumental activities of daily living (IADL), depression and cognitive status. The predictors included age, gender, marital status, education, number of chronic conditions, and depression. Descriptive and analytical statistical tests (univariate and multiple regression analysis) were used to analyze the data. Results The majority of participants were married (63.9%) and women (59.3%). Based on the results of the multiple regression analysis, age (B=-0.04, P = 0.04), depression (B=-0.12, P = 0.04), and IADL (B = 0.46, P

Background: Understanding the predictors of functional status can be useful for improving modifiable predictors or identifying at-risk populations. Researchers have examined the predictors of functional status in older adults, but there has not been sufficient study in this field in older adults with multiple chronic conditions, especially in Iran. Consequently, the results of this body of research may not be generalizable to Iran. Therefore, this study was conducted to determine the predictors of functional status in Iranian older adults with multiple chronic conditions. Methods: In this cross-sectional study, 118 Iranian older adults with multiple chronic conditions were recruited from December 2022 to September 2023. They were invited to respond to questionnaires inquiring about their demographic and health information, basic activities of daily living (BADL) and instrumental activities of daily living (IADL), depression and cognitive status. The predictors included age, gender, marital status, education, number of chronic conditions, and depression. Descriptive and analytical statistical tests (univariate and multiple regression analysis) were used to analyze the data. Results: The majority of participants were married (63.9%) and women (59.3%). Based on the results of the multiple regression analysis, age (B=-0.04, P = 0.04), depression (B=-0.12, P = 0.04), and IADL (B = 0.46, P < 0.001) were significant predictors for functional status in terms of BADL. Also, marital status (B=-0.51, P = 0.05), numbers of chronic conditions (B=-0.61, P = 0.002), and BADL (B = 0.46, P < 0.001) were significant predictors for functional status in terms of IADL. Conclusion: The findings support the predictive ability of age, marital status, number of chronic diseases, and depression for the functional status. Older adults with multiple chronic conditions who are older, single, depressed and with more chronic conditions number are more likely to have limitations in functional status. Therefore, nurses and other health care providers can benefit from the results of this study and identify and pay more attention to the high risk older adult population. [ABSTRACT FROM AUTHOR]

We used satellite-linked tags to evaluate dive behavior in offshore bottlenose dolphins (Tursiops spp.) near the island of Bermuda. The data provide evidence that bottlenose dolphins commonly perform both long (>272 s) and deep (>199 m) dives, with the deepest and longest dives being to 1,000 m and 826 s (13.8 min), respectively. The data show a relationship between dive duration and dive depth for dives longer than about 272 s. There was a diurnal pattern to dive behavior, with most dives deeper than 50 m being performed at night; deep diving began at sunset and varied throughout the night. We used the cumulative frequency of dive duration to estimate a behavioral aerobic dive limit (bADL) of around 560-666 s (9.3-11.1 min) in adult dolphins in this population. Dives exceeding the bADL spent significantly longer time in the upper-most 50 m following a dive as compared with dives less than the bADL. We conclude that the offshore ecotype off Bermuda, unlike the shallow-diving near-shore bottlenose dolphin, is a deepdiving ecotype, and may provide a useful animal model to study extreme diving behavior and adaptations. [ABSTRACT FROM AUTHOR]

ObjectiveAs the global population ages, disability among the elderly presents unprecedented challenges for healthcare systems. However, limited research has examined whether dietary interventions like tea consumption may alleviate and prevent disability in older adults. As an important dietary therapy, the health benefits of tea drinking have gained recognition across research disciplines. Therefore, this study aimed to investigate the association between tea drinking habits and disability levels in the elderly Chinese population.MethodsLeveraging data from the 2008 to 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, we disaggregated tea drinking frequency and activities of daily living (ADL) measures and deployed fixed-effect ordered logit models to examine the tea-disability association for the first time. We statistically adjusted for potential confounders and conducted stratified analyses to assess heterogeneity across subpopulations.ResultsMultivariable fixed-effect ordered logistic regression suggested tea drinking has protective effects against ADL disability. However, only daily tea drinking was associated with lower risks of basic activities of daily living (BADL) disability [odds ratio (OR) = 0.61; 95% confidence interval (CI), 0.41–0.92] and lower levels of instrumental activities of daily living (IADL) disability (OR = 0.78; 95% CI, 0.64–0.95). Stratified analyses indicated heterogeneous effects across age and income groups. Daily tea drinking protected against BADL (OR = 0.26 and OR = 0.28) and IADL disability (OR = 0.48 and OR = 0.45) for adults over 83 years old and high-income households, respectively.ConclusionWe found that drinking tea almost daily was protective against disability in elderly people, warranting further research into optimal dosages. Future studies should utilize more rigorous causal inference methods and control for confounders.

IntroductionPrevalence of functional limitations (FLs) and disabled activities of daily living (ADL) cause heavy burdens to the health of the older people. Stratified by gender, this study aimed to explore the effects of FL and ADL on the mortality of the older people in China, and the mechanism was then discussed.MethodsWe used survey data of a prospective 10-year cohort (2008–2018), from the China Longitudinal Healthy Longevity Survey (CLHLS). The primary outcome was all-cause mortality, and Independent variables included FL, basic ADL (BADL), and instrumental ADL (IADL). Covariates involved socio-demographic characteristics, health-related behaviors, and health status of the participants in the CLHLS project.ResultsThere were 967 (19.20%) male and 2,235 (32.36%) female older people performed functional limitations, and their survival time was 60.98 (SE = 0.66) and 55.19 (SE = 0.55) months, respectively. Old adults with FL had significantly poorer survival than the ones without (Log-rank test, P < 0.001). Weibull regression suggested that FL (P < 0.001), abnormal BADL (P < 0.001) and IADL (P < 0.001) were negatively associated with the survival of the older people. Further analysis showed that BADL and IADL performed significantly mediating roles in the relation of FL and survival time in old adults; additionally, for female older people, BADL also exhibited a significant moderating role in the effect of FL on survival.ConclusionsPrevalence of FL was serious among the older people in China, especially for the women. Disabilities of BADL and IADL and FL were negatively associated with the survival time of the older people in China. Regarding the effect of FL on survival, BADL and IADL performed significantly mediating roles, and the moderating role of BADL existed only for the female. These suggested evidence to implement strategies to maintain health in the older people.

Objective: As the global population ages, disability among the elderly presents unprecedented challenges for healthcare systems. However, limited research has examined whether dietary interventions like tea consumption may alleviate and prevent disability in older adults. As an important dietary therapy, the health benefits of tea drinking have gained recognition across research disciplines. Therefore, this study aimed to investigate the association between tea drinking habits and disability levels in the elderly Chinese population., Methods: Leveraging data from the 2008 to 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, we disaggregated tea drinking frequency and activities of daily living (ADL) measures and deployed fixed-effect ordered logit models to examine the tea-disability association for the first time. We statistically adjusted for potential confounders and conducted stratified analyses to assess heterogeneity across subpopulations., Results: Multivariable fixed-effect ordered logistic regression suggested tea drinking has protective effects against ADL disability. However, only daily tea drinking was associated with lower risks of basic activities of daily living (BADL) disability [odds ratio (OR) = 0.61; 95% confidence interval (CI), 0.41-0.92] and lower levels of instrumental activities of daily living (IADL) disability (OR = 0.78; 95% CI, 0.64-0.95). Stratified analyses indicated heterogeneous effects across age and income groups. Daily tea drinking protected against BADL (OR = 0.26 and OR = 0.28) and IADL disability (OR = 0.48 and OR = 0.45) for adults over 83 years old and high-income households, respectively., Conclusion: We found that drinking tea almost daily was protective against disability in elderly people, warranting further research into optimal dosages. Future studies should utilize more rigorous causal inference methods and control for confounders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ma, Zhu, Hong, Zhao and Li.)

O envelhecimento populacional no Brasil vem acompanhado pelo aumento das doenças crônicas não-transmissíveis, dentre elas as demências, que produzem grande impacto entre os indivíduos acometidos e seus familiares. Este estudo é parte do Estudo SABE (Saúde, Bem-Estar e Envelhecimento na América Latina e Caribe). A amostra foi composta pelos idosos que obtiveram 12 ou menos pontos no MEEM (Mini Exame do Estado Mental) e 6 ou mais no Questionário de Pfeffer para Atividades Funcionais (QPAF). A combinação desses instrumentos indica maior especificidade para a medida de declínio cognitivo mais grave, sugerindo a presença de demência ou outros transtornos associados. Os objetivos deste estudo são apresentar os resultados do SABE no que se refere ao desempenho de atividades de vida diária e aos arranjos domiciliares dos idosos com declínio cognitivo no Município de São Paulo e verificar de que forma esses arranjos contribuem para suprir as demandas assistenciais desses idosos com dependência. A limitação funcional ocorre principalmente em relação às atividades instrumentais de vida diária (AIVD). A maioria reside em arranjos domiciliares com presença de filhos, mas há uma parcela considerável que mora só. A ajuda oferecida pela maioria dos arranjos domiciliares chega muitas vezes a 100% em AIVD, porém nas atividades básicas de vida diária (ABVD) só entre os casais esse índice é alcançado mostrando que a demanda assistencial tem sido atendida em sua maioria, permitindo a análise de que no idoso com declínio cognitivo, a evidência mais acentuada da limitação apresentada é um fator que desencadeia maior oferta de ajuda.The aging of the Brazilian population is concomitant along with increases in chronic non-transmittable diseases. Among these diseases are dementias, which have a great impact on individuals affected by cognitive decline and their families. This study forms part of the "SABE Study" (Health, Wellbeing and Aging in Latin America and the Caribbean). The sample was composed of elderly people who presented scores of 12 or less in the Mini Mental State Examination (MMSE) and 6 or more in the Pfeffer Functional Activity Questionnaire (PFAQ. The combination of these two instruments showed higher specificity for measuring more severe cognitive decline that suggested the presence of dementia and other associated disturbances. The objectives of this study were to present the results from SABE relating to performance in activities of daily living and domestic arrangements among elderly people with cognitive decline in the municipality of São Paulo, and to investigate how these arrangements contributed towards meeting the care needs of these dependent elderly people. The functional limitation was mainly related to instrumental activities of daily living (IADL). A majority of these elderly people were living within living arrangements involving the presence of their children; however, a considerable proportion were living alone. The help made available through the living arrangements often reached 100% of the IADL. However, among the basic activities of daily living (ADL), 100% was only reached in arrangements in which only the couple were living together. This showed that the demand for care was met in most cases, thus allowing the conclusion that, among elderly people with cognitive decline, the strongest evidence of the limitations presented is the factor that triggers greater offer of help.

Introduction: Prevalence of functional limitations (FLs) and disabled activities of daily living (ADL) cause heavy burdens to the health of the older people. Stratified by gender, this study aimed to explore the effects of FL and ADL on the mortality of the older people in China, and the mechanism was then discussed., Methods: We used survey data of a prospective 10-year cohort (2008-2018), from the China Longitudinal Healthy Longevity Survey (CLHLS). The primary outcome was all-cause mortality, and Independent variables included FL, basic ADL (BADL), and instrumental ADL (IADL). Covariates involved socio-demographic characteristics, health-related behaviors, and health status of the participants in the CLHLS project., Results: There were 967 (19.20%) male and 2,235 (32.36%) female older people performed functional limitations, and their survival time was 60.98 (SE = 0.66) and 55.19 (SE = 0.55) months, respectively. Old adults with FL had significantly poorer survival than the ones without (Log-rank test, P < 0.001). Weibull regression suggested that FL ( P < 0.001), abnormal BADL ( P < 0.001) and IADL ( P < 0.001) were negatively associated with the survival of the older people. Further analysis showed that BADL and IADL performed significantly mediating roles in the relation of FL and survival time in old adults; additionally, for female older people, BADL also exhibited a significant moderating role in the effect of FL on survival., Conclusions: Prevalence of FL was serious among the older people in China, especially for the women. Disabilities of BADL and IADL and FL were negatively associated with the survival time of the older people in China. Regarding the effect of FL on survival, BADL and IADL performed significantly mediating roles, and the moderating role of BADL existed only for the female. These suggested evidence to implement strategies to maintain health in the older people., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gao, Du, Cai and Hu.)

This study investigated the association between physical functioning and activities of daily living (ADL) of elderly people, taking into account the role of cognitive, psychological, and social factors. We administered physical, cognitive, psychological, and social instruments to investigate the level of basic and instrumental activities of daily living (BADL and IADL). The analysis showed that physical functioning was the only individual factor that was significantly linked with the level of BADL and IADL. This study underlines that physical functioning is the main individual characteristic directly associated with the level of BADL and IADL in old age. [ABSTRACT FROM AUTHOR]

The article discusses the principles of Assessment evaluating the degree of dependence among people with disabilities who require care by another person. It compares previous legislation and the current legislative framework and discusses possible proposal for changes in the assessment system, which is based on the Activity of Daily Living (ADL below) with respect to the basal and instrumental activities. [ABSTRACT FROM AUTHOR]

Purpose: Using the Activity Card Sort (ACS), we derived a measure of lifestyle-adjusted function and examined the distribution of this measure and its correlates in a community sample of older adults at risk for disability transitions. Design and Methods: Participants in the Sources of Independence in the Elderly project (n = 375) completed the ACS using a Q-sort (successive pile sort procedure), in which respondents sorted 39 nonbasic activities of daily living (non-BADL) and noninstrumental activities of daily living (non-IADL) tasks into four categories: “never performed,” “used to but no longer perform,” “hard to do,” and “easy to do.” Lifestyle-adjusted function was defined as the number reported easy/(number easy + number hard + number no longer performed). Results: Respondents reported that they found it easy to perform about 60% of the activities they ever performed. However, people reporting BADL and IADL disability found it easy to perform only 32% of these activities. Lower extremity performance and depressive symptoms were significant independent correlates of lifestyle-adjusted function in models that controlled for sociodemographic and clinical status. The same 2 correlates were significant in models that excluded people with self-reported BADL or IADL disability. Implications: Because this measure eliminates activities never performed, it can be considered “lifestyle adjusted.” Its ability to identify differences in competency among people who do not report BADL or IADL disability suggests that it may be a useful addition to functional assessment. [ABSTRACT FROM PUBLISHER]

This paper is based on a survey among 435 Czech households caring for a dependent senior in the family to inquire into the conditions and circumstances of caring for seniors in the family. The concept of 'care as a labour of love' (Graham) is contrasted with the concept of the 'defamilisation of care' (Glenn) and 'social rights for elderly care' (Fine). The author finds that more demanding family care, measured as the level of IADL or BADL, is reflected in a growing number of hours spent on family care. The author shows the significant differences in the psychological and financial burden experienced by primary caregivers in relation to how demanding the level of care required is. The article presents evidence of the existence of `collective family care' in situations where demanding personal care for a senior is required. The participation of other family members in providing care for a senior in situations of demanding personal care demonstrates some features of family cohesion. [ABSTRACT FROM AUTHOR]

Background and aims: There are few studies on the functional outcome of patients with supratentorial (STS) and infratentorial stroke (ITS). They lead to conflicting conclusions and do not define the role of motor deficits on functional recovery of STS and ITS patients. We wished to investigate this. Methods: The study was carried out on 90 consecutive patients admitted to our Rehabilitation Department with clinical evidence of acute cerebrovascular accident. Neuroimaging data, clinical evidence, and the National Institute of Health Stroke Scale (NIH) were used to select two groups of patients: 1) 45 patients with supratentorial stroke lesion (STS group), 2) 45 patients with infratentorial stroke lesion (ITS group). The STS group included patients with hemiparesis, and the ITS group patients with ataxia. Patients were evaluated through the NIH, Fugl-Meyer scale, Klockgether score, CIRS, Trunk Control Test (TCT), Lindmark scale, Barthel index, and Katz index, at both admission and discharge. Results: At admission, there were no differences between the STS and ITS groups in disability or average Barthel, Lindmark and Katz scores. At discharge, the Katz index average scores were significantly higher (p=0.000) and disability was lower (p=0.002) in ITS patients. The efficiency in Lindmark, Barthel and Katz scores of group ITS was significantly greater than that of STS patients (p=0.03, p=0.030 and p=0.000, respectively). The final Katz score was correlated (Spearman rank method) with initial TCT (p=0.000), onset to admission interval (p=0.019) and initial NIH (p=0.044) in the STS group. Final BADL score was correlated only with initial TCT (p=0.000) in the ITS group. Conclusions: Our data seem to indicate that STS has a worse rehabilitative prognosis than ITS, and that hemiparesis is more difficult to rehabilitate than ataxia. [ABSTRACT FROM AUTHOR]

Abstract: This study longitudinally examined the relationships between the specific domains of cognitive performance and functional decline among the community elderly. The study population was 119 men and 194 women aged 70–84 at baseline, who were examined at both baseline and in a 4-year follow-up survey. Katz''s Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) were used for measuring the functional capacities of basic activities of daily living (BADL) and higher-level competence, respectively. For the purpose of analyses, declines in each subscale of functional capacity during the follow-up period were used as outcome variables; and specific domains of cognitive performances, including information processing speed, executive function, orientation, and episodic memory at baseline, were used as independent variables. Multiple logistic regression analyses, adjusted for the potential confounders, showed that information processing speed and orientation were associated independently and inversely with BADL decline, and that information processing speed and executive function were related independently and inversely to higher-level competence decline. These results suggested that information processing speed and orientation are reliable predictors for decline in BADL, and information processing speed and executive function are also reliable predictors for decline in higher-level competence among the community elderly. [Copyright &y& Elsevier]

Aim: Residential greenness exposure is associated with many health outcomes, including obesity, cardiovascular disease, and mental disorders. However, few studies have assessed the effects of greenness exposure on activities of daily living (ADL). This study evaluated the relationship between greenness and ADL among elderly residents with long-term care insurance (LTCI) in Shanghai, China.Methods: We conducted a cross-sectional survey using stratified random sampling among elderly residents with LTCI in six districts of Shanghai in August 2018. We quantitatively assessed residential greenness using satellite-derived normalized difference vegetation index (NDVI) values with 250-, 500-, and 1000-m buffers around each participant's residential address. We calculated the walk score to assess neighborhood walkability. Physical function was assessed using basic ADL (BADL) and instrumental ADL (IADL). We performed binary logistic regression and restricted cubic splines with R software.Results: The study participants were 1067 adults with a mean age of 82.40 years (standard deviation, 7.68 years). The mean NDVI value was 0.311. In the fully adjusted model, being in the highest-tertile NDVI500-m had a significant protective effect on BADL mild to none disability (odds ratio, 2.143; 95% confidence interval, 1.489-3.084) compared with participants in the lowest-tertile NDVI500-m. Restricted cubic spline showed a non-linearity association between NDVI values and BADL and IADL mild to none disability.Conclusions: Our results indicate the importance of residential greenness exposure to physical function-especially for BADL disability. Well-designed longitudinal studies are needed to confirm our findings and investigate the underlying mechanisms. [ABSTRACT FROM AUTHOR]