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Anthony P. Marsh, W. Jack Rejeski, Stacy L. Hutton, Cristal L. Brown, Edward Ip and Jack M. Guralnik

Lateral mobility is integral to many activities of daily living involving transfer from one position to another. The objective of this study was to develop and evaluate the validity and test–retest reliability of a lateral-mobility (LATMOB) task for older adults. Measurements of lateral mobility, balance, and strength and self-reported and performance-based physical functioning were obtained in 63 women and 77 men ≥50 years of age. The LATMOB task was significantly correlated with age, knee-extensor strength, grip strength, functional reach, and one-leg-stance time. Test–retest reliability of the task was excellent. The LATMOB task was highly correlated with the car task. Balance was significantly correlated with time to get into and out of a car and performance on the LATMOB task. The LATMOB task was significantly correlated with the Short Physical Performance Battery score. The LATMOB task is valid and reliable, but additional work is needed to assess its sensitivity to change and predictive validity.

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Katherine B. Gunter, Jennifer De Costa, Karen N. White, Karen Hooker, Wilson C. Hayes and Christine M. Snow

This study assessed changes in balance self-efficacy (BSE) over 1 year in community-dwelling elderly, compared changes in BSE between fallers and nonfallers, and assessed the relationship between specific balance and mobility risk factors for side falls and BSE scores. Elderly fallers (n = 67; 80.2 ± 5.9 years) and nonfallers (n = 75; 79.4 ± 4.9), categorized based on self-reported falls over 1 year, were tested at baseline on postural sway, hip-abduction strength, lateral-stepping velocity, tandem walk, and get-up-and-go and given a BSE questionnaire. Fallers had lower BSE scores than nonfallers did (141.6 ± 33.5 and 154.9 ± 25.4; p = .008). BSE did not change over 1 year. In stepwise regression, BSE scores were predictive of time on the get-up-and-go, mediolateral sway, and tandem walk independent of age, height, and strength (p < .001). The BSE scale might be useful for screening individuals at risk for injurious falls because it is inexpensive and noninvasive.

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Seigo Mitsutake, Ai Shibata, Kaori Ishii, Shiho Amagasa, Hiroyuki Kikuchi, Noritoshi Fukushima, Shigeru Inoue and Koichiro Oka

among older adults. 1 Therefore, it is important to examine effective strategies aimed at reducing physical inactivity among older adults to help prevent functional decline and improve quality of life. Previous studies have shown an association between greater time spent in total sedentary behavior (SB

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Brett D. Tarca, Thomas P. Wycherley, Anthony Meade, Paul Bennett and Katia E. Ferrar

appropriate participant positioning, is a valid and reliable method for assessing and monitoring changes in isometric abdominal flexion strength, which may assist in the earlier detection and/or prevention of functional decline or injury. Future work could be directed at investigating the predictive validity

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Morten Villumsen, Martin Gronbech Jorgensen, Jane Andreasen, Michael Skovdal Rathleff and Carsten Møller Mølgaard

Lack of activity during hospitalization may contribute to functional decline. The purpose of this study was to investigate (1) the time spent walking during hospitalization by geriatric patients referred to physical and/or occupational therapy and (2) the development in time spent walking during hospitalization. In this observational study, 24-hr accelerometer data (ActivPal) were collected from inclusion to discharge in 124 patients at an acute geriatric ward. The median time spent walking was 7 min per day. During the first quartile of hospitalization, the patients spent 4 (IQR:1;11) min per day walking, increasing to 10 (IQR:1;29) min during the last quartile. Improvement in time spent walking was primarily observed in the group able to perform the Timed Up & Go task at admission. When walking only 7 min per day, patients could be classified as inactive and at risk for functional decline; nonetheless, the physical activity level increased significantly during hospitalization.

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Ching-Yi Wang, Ching-Fan Sheu and Elizabeth Protas

The purpose of this study was to test the construct validity of the hierarchical levels of self-reported physical disability using health-related variables and physical-performance tests as criteria. The study participants were a community-based sample of 368 adults age 60 years or older. These older adults were grouped into 4 levels according to their physical-disability status (able, mildly disabled, moderately disabled, and severely disabled groups) based on their self-reported measures on the mobility, instrumented activity of daily living (IADL), and activities of daily living (ADL) domains. Health-related variables (body-mass index, number of comorbidities, depression status, mental status, and self-perceived health status) and eight performance-based tests demonstrated significant group differences. Self-reported measures of physical disability can be used to categorize older adults into different stages of physical functional decline.

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Richard J. Havlik, Eleanor M. Simonsick, Kim Sutton-Tyrrell, Anne Newman, Michelle E. Danielson, Dwight B. Brock, Marco Pahor, Edward Lakatta, Harold Spurgeon and Peter Vaitkevicius

Although it is well established that stiff blood vessels contribute to systolic hypertension and increased cardiovascular disease with aging, risk factors for vascular stiffness are still being defined. The Health, Aging, and Body Composition study is a longitudinal investigation of the determinants of physical-functional decline in a well-functioning biracial cohort of 3,075 men and women, age 70–79, in Pittsburgh, PA, and Memphis, TN. Aortic pulse-wave velocity (APWV), an index of vascular stiffness, was measured in 2,488 participants. Self-reported physical activity and exercise habits and fitness/walking endurance were also assessed. Moderate or greater physical activity, exercise, and fitness variables were independently associated with less vascular stiffness, even after inclusion of heart rate, visceral fat, and other correlates of APWV. Physical activity’s association with APWV was particularly strong when levels of physical activity were quite low, suggesting that a minimal amount of physical activity might be sufficient to reduce arterial stiffness in older adults.

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Afroditi Stathi and Piers Simey

Life in the Fourth Age has been typified as a time of continued functional decline and reduced quality of life. Exercise might positively affect this experience. This study explored the exercise experiences of nursing home residents age 86–99 years who participated in a 6-month exercise intervention. An interpretive phenomeno-logical approach was adopted. Twenty-one interviews were held with 14 residents at baseline and 7 residents at follow-up. Although their expectations were initially conservative, by the end of the intervention participants noted improved quality of life through better mobility, decreased fear of falling, and feelings of achievement and success. They valued the program as an opportunity to do something for themselves, to add something to their weekly routine, to meet other people, and to be more active generally. The professionalism of the exercise instructor appears to have been critical, balancing principles of safe and effective practice with the need to ensure that participants had fun in a supportive environment.

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Abigail L. Gilbert, Jungwha Lee, Madeleine Ma, Pamela A. Semanik, Loretta DiPietro, Dorothy D. Dunlop and Rowland W. Chang

Background:

Sedentary behavior is associated with increased risk of functional decline and disability. Individuals with rheumatoid arthritis (RA) spend more time sedentary than healthy adults. Self-reported assessment of sedentary behavior has not been well-developed in this patient population.

Methods:

172 adults with RA wore an accelerometer for 7 days and completed a modified version of the Yale Physical Activity Survey (YPAS). YPAS-derived sedentary estimates included 1) daily sitting categories (<3, 3 to 6, 6 to 8, >8 hours/day), 2) continuous daily sedentary time calculated by subtracting hours spent sleeping or in physical activity from a 24-hour day, and 3) rank order of YPAS-derived continuous daily sedentary time. Each estimate was compared with objective accelerometer-derived sedentary time using linear regression and Bland-Altman analysis.

Results:

A significant relationship was observed between accelerometer-derived sedentary time and all 3 estimates. Bland-Altman plot demonstrated systematic bias, however Bland-Altman plot of rank-order demonstrated that the ranked YPAS-derived continuous estimate was an unbiased predictor of ranked accelerometer sedentary time though limits of agreement were wide.

Conclusions:

This patient-reported approach using the YPAS shows promise to be a useful tool to identify the most sedentary patients. Providing a practical and accurate tool may increase the frequency sedentary behavior is assessed by clinicians.

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Juliessa M. Pavon, Richard J. Sloane, Carl F. Pieper, Cathleen S. Colón-Emeric, David Gallagher, Harvey J. Cohen, Katherine S. Hall, Miriam C. Morey, Midori McCarty, Thomas L. Ortel and Susan N. Hastings

Prolonged periods of immobility during hospitalization are a contributor to functional decline and a marker of sicker individuals at risk for poor hospital outcomes (e.g., prolonged length of stay, falls, and discharge to skilled nursing facilities; Covinsky, Pierluissi, & Johnston, 2011 ; Fisher