Search

Objective: Longitudinal studies investigating the link between social support and functional decline are limited among the oldest old. Thus, the aim of this study was to examine whether changes in social support are associated with functional decline among the oldest old longitudinally using panel regression models. Methods: Longitudinal data from 3 waves (waves 7, 8, and 9) of a multicenter prospective cohort study covering primary care patients aged ≥85 years were used. In the analytical sample, n equaled 624 individuals. The validated Lawton and Brody Instrumental Activities of Daily Living (IADL) scale and the well-established Barthel Index (ADL) were used to quantify functional status. The psychometrically sound Lubben Social Network Scale was used to measure social support. Several potential confounders such as age, marital status, cognitive decline, or depressive symptoms were included in the fixed effects (FE) regression models. Results: Linear FE regressions showed that a decrease in social support is associated with functional decline (IADL: β = 0.03, p < 0.05; ADL: β = 0.27, p < 0.05) in men but not in women. With IADL as outcome measure, the interaction term (sex × social support) achieved statistical significance (p < 0.01). With regard to covariates, functional decline (IADL and ADL) was consistently associated with increasing age, an increase in the number of chronic conditions (except for women [ADL]), and cognitive decline (except for men [ADL]). Furthermore, functional decline (ADL) was associated with an increase in depressive symptoms. Discussion: Our findings highlight the meaning of social support for functional status among the oldest old. Finding ways to sustain social support in highest age may be a promising approach in order to postpone functional decline. [ABSTRACT FROM AUTHOR]

Introduction. Painful periods is one of the utmost general gynaecological disorders of adolescence. Therefore, the main aim of the study was to identify the prevalence of primary dysmenorrhoea and its effect on instrumental activities of daily living among females from Pakistan. Methods. An observational cross-sectional study with a sample of 161 females was organized at University of Lahore, Gujrat Campus, Pakistan, between October 2019 and March 2020. The participants’ age ranged between 18 and 36 years. Their body mass index was calculated through weight and height. The data were collected by using WaLIDD score (working ability, location, intensity, days of pain, dysmenorrhoea), visual analogue scale, and Lawton Instrumental Activities of Daily Living scale. Pearson correlation coefficient was used to evaluate the correlation between different variables. The data were analysed with the SPSS statistical software, version 20.0. Results. Out of the 161 participants, 60.87% had moderate dysmenorrhoea, while mild and severe dysmenorrhoea was reported in 7.45% and 31.68%, respectively. Most females (62.11%) exhibited instrumental activities of daily living disability, while 37.89% had no disability. The results revealed that there were statistically significant associations between dysmenorrhoea and instrumental activities of daily living (p = 0.003). Significance was assumed at p < 0.05. Conclusions. Dysmenorrhoea had a statistically significant effect on instrumental activities of daily living (p = 0.003) [ABSTRACT FROM AUTHOR]

This study explored the proliferation of stressors that contribute to depression in grandparents who are caregivers of an adult child with a long-term illness and their grandchildren. The data were drawn from Wave 4 of the Cape Area Panel Study in South Africa and subjected to linear regression analysis to predict depression in these older adults. We found evidence that the combination of primary and secondary care leads to a proliferation of stressors as these older adults experienced higher levels of depression, lower income, and greater food insecurity. Providing financial help to others and declining health also contributed to an increase in depression. [ABSTRACT FROM AUTHOR]

This study investigated the successful aging among men with various chronic health conditions. A cohort of 303 male participants (50 men with high blood pressure, 32 with cardiac disease, 30 with diabetes mellitus, 23 with the prostate gland, and 39 with other diseases) were included in the study. Successful aging scale (SAS), independence in activities of daily living scale (ADLs), instrumental activities of daily living scale (IADLs), satisfaction with life scale (SLs) were performed. SLs was positively associated with SAS (R =.287;r2 =.083;p⩽.001), healthy lifestyle habits (HLH) (R =.046;r2 =.014;p⩽.001), struggle against difficulties (SAD) (R =.307;r2 =.094;p⩽.001), and IADLs (R =.156;r2 =.024;p⩽.001). Age was negatively associated with IADL (R =.247;r2 =.061;p⩽.001). Age was unassociated with SAS or the components (HLH;SAD). Monthly income was positively associated with SLs (R =.409;r2 =.167;p⩽.001). Education was positively associated with SAD (R =.230;r2 =.053;p⩽.001), HLH (R =.237;r2 =.056;p⩽.001), SLs (R =.190;r2 =.036;p⩽.001), and SAS (R =.252;r2 =.064;p⩽.001). The SAS with its components was valid and reliable [χ2:92,485; χ2/df:2.371; SRMR:.099; RMSEA:.067; NNFI:.926; IFI:.937; CFI:936; GFI:.916; AGFI:.916]. SLs and education had a positive effect on SAS, and its components (HLH, SAD). The SAS was proved with validity and reliability. [ABSTRACT FROM AUTHOR]

Background/Objective: The Everyday Technology Use Questionnaire (ETUQ), which evaluates the perceived relevance of and the perceived ability in everyday technology (ET) use, has demonstrated acceptable psychometric properties in Swedish studies of older adults. The aim of this study was to examine the reliability and validity of the ETUQ in a Japanese context in older Japanese adults. Methods: A sample of older Japanese adults (n = 164) including persons with (n = 32) and without (n = 132) cognitive impairment was interviewed with the ETUQ, including original items (ETs) and added Japanese context-specific items. Data were analyzed using a Rasch measurement model. Results: The analysis demonstrated acceptable functioning of the rating scale, internal scale validity, person response validity, and person-separation reliability of the Japanese ETUQ according to the Rasch model. However, evidence supporting unidimensionality in the Japanese ETUQ was not consistent in this sample. The added Japanese items did not significantly change the estimated individual person measures of perceived ability to use ET. Conclusion: The Japanese ETUQ seems to be a sensitive tool to evaluate perceived ability in ET use among elderly people in Japan with and without cognitive impairment. Therefore, it could be used in research and clinical practice.

Objectives Preexisting cognitive impairment is a predictor of cognitive decline after ischemic stroke, but evidence in intracerebral hemorrhage ( ICH) is limited. We aimed to determine the prevalence of premorbid cognitive impairment in patients with ICH. Materials and Methods We included patients with acute ICH. Pre- ICH cognitive impairment was determined based on the results of the Informant Questionnaire on Cognitive Decline in the Elderly ( IQCODE) that uses information from close relatives. Patients were assessed as having been cognitively impaired with an IQCODE score of ≥3.44; an IQCODE ≥4.00 indicated pre- ICH dementia. CT and MRI images were reviewed to determine the extent of white matter lesions and to measure the radial width of the temporal horn as marker of brain atrophy. We investigated differences of cardiovascular risk factors and imaging data between patients with and without pre- ICH cognitive impairment using correlation analyses, uni- and multivariable regression models. Functional neurological state was assessed using the modified Rankin Scale ( mRS). The mRS was dichotomized at the level of 3, and a premorbid mRS of 0-2 was considered as functional independency. Results Among the 89 participants, median age was 70 years (interquartile range 58-78) and 52 (58.4%) were male. IQCODE indicated pre- ICH cognitive impairment in 18.0% (16 of 89), and 83.1% were functionally independent before ICH. Cognitive impairment was associated with a premorbid mRS≥3 (chi squared test, P=0.009). In multivariable analysis, prior stroke/transient ischemic attack ( OR 18.29, 95%- CI 1.945-172.033, P=.011) and hematoma volume ( OR 0.90, 95%- CI 0.812-0.991, P=.033) were independently associated with pre- ICH cognitive impairment. Conclusions In conclusion, cognitive impairment frequently precedes ICH. A higher frequency of cerebrovascular events suggests a role of vascular processes in the development of cognitive impairment before ICH. [ABSTRACT FROM AUTHOR]

Background/Aims: Diagnosing dementia is challenging in many primary care settings, given the limited human resources and the lack of current diagnostic tools. With this in mind, a primary care-based cohort was established in the Aveiro district of Portugal. Methods: A total of 568 participants were evaluated using cognitive tests and APOE genotyping. Results: The findings revealed a dementia prevalence of 12%. A strong correlation between increasing Clinical Dementia Rating (CDR) scores and education was clearly evident. Other highly relevant risk factors were activities of daily living (ADL), instrumental ADL, aging, depression, gender, the APOE ε4 allele, and comorbidities (depression as well as gastrointestinal, osteoarticular, and neurodegenerative diseases). A hitherto unreported, significant correlation between gastrointestinal disease and high CDR score was clearly observable. Conclusions: This study shows the merit of carrying out a dementia screening on younger subjects. Significantly, 71 subjects in the age group of 50-65 years were flagged for follow-up studies; furthermore, these cases with a potentially early onset of dementia were identified in a primary care setting. [ABSTRACT FROM AUTHOR]

Summary Background/Objective The Everyday Technology Use Questionnaire (ETUQ), which evaluates the perceived relevance of and the perceived ability in everyday technology (ET) use, has demonstrated acceptable psychometric properties in Swedish studies of older adults. The aim of this study was to examine the reliability and validity of the ETUQ in a Japanese context in older Japanese adults. Methods A sample of older Japanese adults ( n = 164) including persons with ( n = 32) and without ( n = 132) cognitive impairment was interviewed with the ETUQ, including original items (ETs) and added Japanese context-specific items. Data were analyzed using a Rasch measurement model. Results The analysis demonstrated acceptable functioning of the rating scale, internal scale validity, person response validity, and person-separation reliability of the Japanese ETUQ according to the Rasch model. However, evidence supporting unidimensionality in the Japanese ETUQ was not consistent in this sample. The added Japanese items did not significantly change the estimated individual person measures of perceived ability to use ET. Conclusion The Japanese ETUQ seems to be a sensitive tool to evaluate perceived ability in ET use among elderly people in Japan with and without cognitive impairment. Therefore, it could be used in research and clinical practice. [ABSTRACT FROM AUTHOR]

Background: Appropriate information about the functional capacity of patients with dementia disease plays an important role in assessment of their health status and functional independence. The purpose of the present study is to investigate the reliability and validity of the Lawton IADL Persian version in patients with dementia. Method: International Quality Of Life Assessment (IQOLA) approach was used for translation process and then content validity was assessed by five experts. To evaluate the reliability of the scale, test-retest, inter-rater reliability and items' internal consistency methods were used. To analyze the construct validity, the Functional Assessment Staging Test (FAST) was used. The results were reported based on the data collected from the Iranian Alzheimer Associations of 60 patients with dementia. (53.3% female, 46.7% male, Mean age=75.91 (SD=7.72)) Results: No significant statistically differences were observed in the distribution of the experts' opinions (p>0.05). The correlations between first and second administrations of the test (SEM=0. 238, r=0.993, CI: 0.988-0.996) and first and second raters (r=0. 961, p<0.001) were very high. Internal consistency between items and the total score (0.606 >r>0.427) had almost an average power. There was a significant negative relationship between the participants' score in IADL and FAST (p<0.001). Conclusion: These results confirm that the Persian version of the Lawton IADL Scale has excellent reliability and validity for dementia patients. And it can be used as clinical and research tool for assessment IADL and determine disease progression by professionals. [ABSTRACT FROM AUTHOR]

Background/Aims: Since widely accepted definitions of dementia encompass impairments in social and occupational, as well as cognitive, function, we investigated the diagnostic accuracy of Lawton and Brody’s Instrumental Activities of Daily Living (IADL) Scale as an independent test for the diagnosis of dementia. Methods: The IADL Scale was administered to consecutive referrals to 2 memory clinics over a 2-year period, independent of other tests (interview, neuropsychology, imaging) which were used to establish diagnoses according to standard diagnostic criteria, and the results were compared. Results: In a cohort of 296 patients, 52% adjudged to have dementia, IADL Scale scores and subscores showed low sensitivity, specificity, and positive and negative predictive values for the diagnosis of dementia. The likelihood ratios, a measure of diagnostic gain, were generally small to unimportant, and diagnostic accuracy as measured by area under the receiver operating characteristic curve was no better than 0.75. Conclusion: IADL Scale scores are not very helpful in making a diagnosis of dementia. More sensitive scales may be required to detect dementia-related functional decline, although it is also possible that dementia syndromes may be present in the absence of functional decline, challenging accepted definitions of dementia. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We investigate if rTMS has a therapeutic role in the treatment of dysphagia in patients with Parkinson's disease (PD). Material and Methods . Thirty-three patients with PD and dysphagia were randomly classified with ratio 1:2 to receive sham or real rTMS (2000 pulses; 20 Hz; 90% resting motor threshold; 10 trains of 10 seconds with 25 seconds between each train) over the hand area of each motor cortex (5 minutes between hemispheres) for 10 days (5 days per week) followed by 5 booster sessions every month for 3 months. Assessments included the Unified Parkinson's Disease Rating Scale part III (UPDRS), Instrumental Activities of Daily Living (IADL), and Arabic-Dysphagia Handicap Index (A-DHI) before, after the last session, and 3 months later. Video-fluoroscopy measures of pharyngeal transit time (PTT) and time to maximal hyoid elevation (H1-H2) were taken before and after the treatment sessions. Results . There were no significant differences between groups. There was a significant improvement on all rating scales (analysis of variance) after real rTMS with a significant time × group interaction. In particular, there was a significant and long-lasting (3 months) effect of time on all subitems of the A-DHI (functional, P = .0001; physical, P = .0001; emotional, P = .02) but not in the sham group. This was associated with significant improvement in H1-H2 ( P = .03) and PTT ( P = .01) during solid swallows in the real rTMS but not the sham group. Conclusion . Real rTMS improves dysphagia in PD as documented by A-DHI scores and by video-fluoroscopy.

Objective: To explore the clinical features and prognostic factors of elderly MM patients. Methods: A retrospectively analysis of clinical characteristics in 93 newly diagnosed MM patients with more than 70 years of old between August 2011 and August 2016. Based on age, basic activities of daily living scale, instrumental activities of daily living scale, Charlson comorbidity index at diagnosis, patients were divided into three groups: Fit (score=0, n =15) , Intermediate fitness (score=1, n =31) , Frail (score≥2, n =47) according to a geriatric assessment system proposed by Antonio Palumbo et al. The treatment response rate, progression free survival time (PFS) and overall survival (OS) of the three groups were analyzed. Results: Complete remission was 60.0% in Fit, 22.6% in Intermediate fitness and 12.8% in Frail (Fisher χ (2)=12.398, P =0.002) . The median PFS for the three groups were 31 months, 24 months and 13 months ( χ (2)=17.832, P <0.001) . The median OS was not reached for Fit, 58 months for Intermediate fitness and 25 months for Frail ( χ (2)=40.678, P <0.001) . In 47 Frail cases, patients who received chemotherapy containing new drugs (proteasome inhibitor or immune-modulator) had a longer PFS (17 months vs 9 months, χ (2)=6.454, P =0.011) and patients who achieved CR had prolonged PFS and OS than non-CR (PFS: 24 months vs 12 months, χ (2)=4.117, P =0.042; OS: 37 months vs 25 months, χ (2)= 6.507, P =0.011) . Conclusion: The health status of the elderly MM patients was associated with better response and longer PFS and OS. Given on those with poor health status, new drugs may have better PFS and prolonged OS.

Unlabelled: Background Appropriate information about the functional capacity of patients with dementia disease plays an important role in assessment of their health status and functional independence. The purpose of the present study is to investigate the reliability and validity of the Lawton IADL Persian version in patients with dementia., Method: International Quality Of Life Assessment (IQOLA) approach was used for translation process and then content validity was assessed by five experts. To evaluate the reliability of the scale, test-retest, inter-rater reliability and items' internal consistency methods were used. To analyze the construct validity, the Functional Assessment Staging Test (FAST) was used. The results were reported based on the data collected from the Iranian Alzheimer Associations of 60 patients with dementia. (53.3% female, 46.7% male, Mean age=75.91 (SD=7.72)) RESULTS: No significant statistically differences were observed in the distribution of the experts' opinions (p>0.05). The correlations between first and second administrations of the test (SEM=0. 238, r=0.993, CI: 0.988-0.996) and first and second raters (r=0. 961, p<0.001) were very high. Internal consistency between items and the total score (0.606 >r>0.427) had almost an average power. There was a significant negative relationship between the participants' score in IADL and FAST (p<0.001)., Conclusion: These results confirm that the Persian version of the Lawton IADL Scale has excellent reliability and validity for dementia patients. And it can be used as clinical and research tool for assessment IADL and determine disease progression by professionals.