Influence of caregiver understanding of their capability to perform activities of daily living, disease comprehension, and attitudes on occupational low back pain: a cross-sectional study.

[Purpose] The aim in this study was to evaluate the impact of caregiver understanding of their ability to perform activities of daily living (ADLs), movement abilities, diseases, and attitudes on the prevalence of occupational low back pain. [Participants and Methods] A cross-sectional survey was conducted of caregivers of older adults living in residential care facilities. Of the 150 questionnaires distributed, 71 were valid. The survey collected data on demographics, low back pain status using a numerical rating scale, and familiarity with ten ADLs and five diseases (stroke, rheumatoid arthritis, fractures, Parkinson's disease, and dementia). [Results] In this study, 52% of the participants reported lower back pain. Significant factors included an understanding of repositioning in ADLs, familiarity with stroke and rheumatoid arthritis, and attitudes toward using patients' residual functions. Participants with limited knowledge of repositioning and stroke, a better understanding of rheumatoid arthritis, and those who did not consider residual function were more prone to lower back pain. [Conclusion] Our findings highlight the importance of enhancing caregiver education on ADL movements and disease specifics, particularly stroke and rheumatoid arthritis, and promoting the use of patients' residual capabilities. Improved training and information sharing among caregivers may reduce the risk of occupational low back pain.

Exploring factors affecting activities of daily living in patients with osteoporotic vertebral fractures managed conservatively: a post-hoc analysis of a prospective cohort study.

STUDY DESIGN: A post-hoc analysis of a prospective cohort study. PURPOSE: This study aimed to identify factors at the time of injury associated with declining activities of daily living (ADLs) in the chronic phase of osteoporotic vertebral fractures (OVFs) managed conservatively. OVERVIEW OF LITERATURE: Although a conservative approach is the treatment of choice for OVFs, ADLs do not improve or eventually decrease in some cases. However, the risk factors for ADL decline after the occurrence of OVFs, particularly the difference between those with or without initial bed rest, are unknown. METHODS: A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline. RESULTS: In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2- weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09-16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32-11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively. CONCLUSIONS: In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively.

Impact of Social Support and Self-Efficacy on Activity of Daily Living among Post-Stroke Patients in Saudi Arabia: A Cross-Sectional Study.

This study employed a cross-sectional design to explore the impact of social support and self-efficacy on activity of daily living (ADL) among post-stroke patients in Saudi Arabia and investigate the mediating role of self-efficacy. Data were collected from 158 post-stroke patients across six healthcare facilities in three regions of Saudi Arabia using convenience sampling, between February 2023 and July 2023. The analysis included descriptive statistics, variance analysis, and linear regression using bootstrap methods. PROCESS Macro was used for the mediation model. This study revealed that most participants had high ADL, social support, and self-efficacy levels. Significant negative associations were found between ADL and age (p < 0.001), time since stroke (p = 0.009), and stroke history (p < 0.001), while significant positive associations were observed with educational background (p = 0.049), employment status (p < 0.001), and self-efficacy (p < 0.001). ADL in post-stroke patients was significantly influenced negatively by age (p = 0.025), time since stroke (p = 0.027), and stroke history (p < 0.001), while self-efficacy (p < 0.001) had a positive impact and moderated the relationship between social support and ADL. This study highlights the physical and psychosocial aspects affecting post-stroke patients, identifies key areas for enhancing their experiences, and informs the development of targeted interventions to address their comprehensive needs.

Social and physical environment effects on toileting disability among older adults in India.

BACKGROUND: To examine the prevalence of toileting disability among older adults in India and its association with broad aspects of the physical and social environment. METHODS: We use data from the inaugural wave of the Longitudinal Ageing Study in India and focus on adults aged 65 and older (N = 20,789). We draw on the disablement process model and existing frameworks to identify environmental factors and other risk factors that may be associated with toileting disability. Hierarchical logistic regressions are implemented to analyze the health impacts from physical and social environment characteristics. RESULTS: One in five older Indian adults had difficulties with toileting, and the prevalence rate of this functional disability varied across sub-national regions. We find that low neighborhood trust was associated with an increased likelihood of toileting disability, as was the use of assistive mobility devices. The negative effects of these social and external environment characteristics hold when we stratified the sample by rural and urban residency. Also, older adults in urban areas without access to toilets and using shared latrines had higher odds of being disabled in terms of toileting. Other factors important in explaining toileting disability among older adults included poor self-rated health, arthritis, currently working, living in the East or West region, and having functional limitations. CONCLUSIONS: Poor person-environment fit can compromise older adults' ability to perform self-care tasks. Policymakers need to look beyond the physical environment (e.g., dedicating resources to construct toilet facilities) to adopt a more holistic, multi-faceted approach in their sanitation policies. Improving the safety of neighborhood surroundings in which shared latrines are located and the availability of accessible toilets that cater to those with mobility impairments can help improve independence in toileting among older adults.

Exploratory analysis of swallowing behaviour in community-dwelling older adults using a wearable device: Differences by age and ingestant under different task loads.

Objective: To develop a new method of evaluating swallowing behaviour. Methods: Sixty-nine healthy participants were divided into a younger (16 males and 16 females, mean age 39.09 ± 12.16 years) and older (18 males and 19 females, mean age 71.43 ± 5.50 years) group. The participants ingested water and yoghurt twice (directed and free swallowing) at rest and after performing simple daily life tasks (calculation and exercise). To measure swallowing frequency, we employed a smartphone-based, portable and neck-worn swallowing-sound-monitoring device. This device monitors swallowing behaviour continuously by collecting biological sounds from the neck without imposing behavioural restrictions. A neural network model of swallowing sound identification by deep learning was used for the subsequent evaluation. This device was used to obtain two types of saliva-swallowing sounds associated with different ingestants, at rest and after performing a stimulating task. Furthermore, we assessed the associated subjective psychological states. Results: The younger group showed a higher directed swallowing frequency (for both water and yoghurt) than the older group did. Regarding the type of ingestant, the swallowing frequency for yoghurt was higher during free swallowing in both the young and the older groups. 'Feeling calm' was reported significantly more often in the older group after swallowing yoghurt following exercise. Conclusions: Swallowing status in daily life was measured non-invasively using a wearable mobile device. It is important to consider the type of ingestant, daily living activities, and age when assessing swallowing.

Cerebellar transcranial magnetic stimulation for improving balance capacity and activity of daily living in stroke patients: a systematic review and meta-analysis.

BACKGROUND: The application of cerebellar transcranial magnetic stimulation (TMS) in stroke patients has received increasing attention due to its neuromodulation mechanisms. However, studies on the effect and safety of cerebellar TMS to improve balance capacity and activity of daily living (ADL) for stroke patients are limited. This systematic review and meta-analysis aimed to investigate the effect and safety of cerebellar TMS on balance capacity and ADL in stroke patients. METHOD: A systematic search of seven electronic databases (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang and Chinese Scientific Journal) were conducted from their inception to October 20, 2023. The randomized controlled trials (RCTs) of cerebellar TMS on balance capacity and/or ADL in stroke patients were enrolled. The quality of included studies were assessed by Physiotherapy Evidence Database (PEDro) scale. RESULTS: A total of 13 studies involving 542 participants were eligible. The pooled results from 8 studies with 357 participants showed that cerebellar TMS could significantly improve the post-intervention Berg balance scale (BBS) score (MD = 4.24, 95%CI = 2.19 to 6.29, P < 0.00001; heterogeneity, I2 = 74%, P = 0.0003). The pooled results from 4 studies with 173 participants showed that cerebellar TMS could significantly improve the post-intervention Time Up and Go (TUG) (MD=-1.51, 95%CI=-2.8 to -0.22, P = 0.02; heterogeneity, I2 = 0%, P = 0.41). The pooled results from 6 studies with 280 participants showed that cerebellar TMS could significantly improve the post-intervention ADL (MD = 7.75, 95%CI = 4.33 to 11.17, P < 0.00001; heterogeneity, I2 = 56%, P = 0.04). The subgroup analysis showed that cerebellar TMS could improve BBS post-intervention and ADL post-intervention for both subacute and chronic stage stroke patients. Cerebellar high frequency TMS could improve BBS post-intervention and ADL post-intervention. Cerebellar TMS could still improve BBS post-intervention and ADL post-intervention despite of different cerebellar TMS sessions (less and more than 10 TMS sessions), different total cerebellar TMS pulse per week (less and more than 4500 pulse/week), and different cerebellar TMS modes (repetitive TMS and Theta Burst Stimulation). None of the studies reported severe adverse events except mild side effects in three studies. CONCLUSIONS: Cerebellar TMS is an effective and safe technique for improving balance capacity and ADL in stroke patients. Further larger-sample, higher-quality, and longer follow-up RCTs are needed to explore the more reliable evidence of cerebellar TMS in the balance capacity and ADL, and clarify potential mechanisms.

Loneliness shapes disparities in healthy life expectancy: a multi-state analysis from China.

OBJECTIVES: To assess the influence of loneliness on the healthy life expectancy of older adults in China and its gender disparities across different health indicators, in order to provide insights for enhancing the health status and subjective well-being of the older population. METHOD: We conducted a cohort analysis using four waves of weighted samples (2008, 2011, 2014, and 2018) from the Chinese Longitudinal Healthy Longevity Survey, encompassing 15,507 respondents aged 65-99. Physical and subjective health were assessed through activity of daily living (ADL) and self-rated health (SRH), respectively. Utilizing loneliness status as a time-variant variable, we employed the multi-state interpolated Markov Chain to explore the associations between loneliness and age-specific life expectancy (LE), healthy life expectancy (HLE), and the proportion of healthy life expectancy in life expectancy (HLE/LE). RESULTS: Compared to the non-lonely population, both LE and HLE were lower among lonely individuals. Regarding gender differences, the HLE/LE for females in the lonely population was consistently lower than that for males. The impact of loneliness on the health of older adults varied by measurement indicators and gender. Specifically, based on ADL results, the decline in HLE/LE was greater for females, with a decline of 53.6% for lonely females compared to 51.7% for non-lonely females between the ages of 65 and 99. For males, the decline was 51.4% for lonely males and 51.5% for non-lonely males. According to SRH, the gender difference in the decline of HLE/LE due to loneliness was less apparent. For males, the change in HLE/LE for non-lonely individuals was 3.4%, compared to 4.2% for lonely individuals, whereas for females, the change was 3.7% for non-lonely individuals and 4.4% for lonely individuals. CONCLUSION: Loneliness exerts varied effects on health across different measurement indicators and gender demographics. Targeted health promotion interventions are imperative to mitigate these negative impacts, particularly emphasizing the enhancement of subjective well-being and physical functioning, especially among older adult females.

I Am Afraid I Will Not Be Able to Walk, That Is What Worries Me-The Experience of Patients with Knee Osteoarthritis before Total Knee Arthroplasty: A Qualitative Study.

Background: Knee osteoarthritis is the most prevalent type of osteoarthritis. Patients frequently encounter pain triggered by movement that evolves into impaired joint function. Needing persistent rest or having night-time pain signifies advanced disease. Qualitative research is considered the most effective method for comprehending patients' needs and contexts. Methods: This study employed a qualitative research design, allowing the researchers to acquire insights into the patients' beliefs and values, and the contextual factors influencing the formation and expression of these beliefs and values. Results: A cohort of nine patients awaiting total knee replacement (TKR) surgery was included and they were interviewed until data saturation was achieved. The results of the phenomenological analysis resulted in the identification of three themes: "The existence of pain impedes the capacity to participate in daily life activities"; "TKR induced fears and uncertainties regarding the progression of the disease"; "Severe nighttime pain compromising sleep quality". Conclusions: This study analyzes the experiences of people awaiting TKR surgery, emphasizing the importance of addressing their unique needs to improve preoperative education and rehabilitation. In this way, patients' recovery during the postoperative phase can be improved.

Joint daily functional trajectory and risk of new-onset Alzheimer's disease and related dementias in older adults with normal and abnormal weight.

BACKGROUND: Associations between daily functional trajectories and new-onset all-cause dementia and Alzheimer's disease (AD) and the role of body weight are underexplored. METHODS: Data were from the Health and Retirement Study (HRS) 1994-2020. Daily function was assessed using (instrumental) activities of daily living ([I]ADLs). All-cause dementia and AD were defined by self- or proxy-reported physician diagnoses. Body weight was assessed using body mass index (BMI) and categorized as normal (18.5 kg/m2 ≤ BMI < 30 kg/m2) and abnormal (BMI < 18.5 kg/m2 or ≥30 kg/m2). The group-based trajectory modeling and Cox proportional hazards regression were utilized. RESULTS: Of 18,763 adults included, 1236 developed new-onset dementia during a 10-year follow-up. The associations of ADL and IADL limitations at baseline with all-cause dementia and AD were much more pronounced in those with abnormal weight (P for interaction < 0.005). Five joint trajectories of ADL and IADL limitations were identified: No (72.7 %), Recovery (4.0 %), Recent emerging (16.4 %), Early emerging (4.8 %), and Severe (2.1 %). Furthermore, the 'Severe' joint trajectory (vs. 'No') was associated with 3.57- and 3.59-times higher risks of new-onset all-cause dementia and AD in participants with abnormal weight (P for interaction = 0.002 and 0.005). Notably, the Recovery joint trajectory (vs. No) was not associated with increased risks of all-cause dementia or AD. LIMITATIONS: Self-/proxy-reported all-cause dementia and AD may introduce misclassification bias. Lifestyle factors were not quantified. BMI at baseline, but not its trajectory, was utilized. Potential reverse causation deserved attention. CONCLUSIONS: Body weight control can help reduce the risk of progression from functional limitations to all-cause dementia and AD.

A Comprehensive Physiotherapeutic Intervention for Complex Proximal Tibia Fracture With Ilizarov Fixator and Foot Drop in 18-Year-Old Adult: A Case Report.

The susceptibility of the tibia to fractures arises from its exposed position, making it a commonly affected area. The proximal tibia exhibits a wide metaphyseal region that gradually narrows distally, forming a triangular shape. The extended tibia shaft articulates with the fibula, talus, and distal femur. We have discussed the case of an 18-year-old male who experienced a road traffic accident on January 7, 2023, involving a collision between his bike and four-wheeler, resulting in high-energy forces impacting his left lower limb. As a consequence, he lost mobility in the left lower limb. Upon examination, he was diagnosed with a compound grade 3C proximal tibia fracture treated with Ilizarov fixators, accompanied by a neurovascular deficit leading to a foot drop on the left side. Additionally, he had a previous operative case involving a femur shaft fracture on the left side, which was managed with in situ implants. It concluded that the rehabilitation approach was effective in pain reduction, improving range of motion, muscle strength, and reducing sensory impairment. Improved results on the lower extremity functional scale and the foot and ankle ability measures showed that the physiotherapy method had been successful in helping the patient regain independence in everyday activities. The success of rehabilitation and the recovery of patients are greatly influenced by post-operative physical therapy.

Sleep Duration and Functional Disability Among Chinese Older Adults: Cross-Sectional Study.

BACKGROUND: The duration of sleep plays a crucial role in the development of physiological functions that impact health. However, little is known about the associations between sleep duration and functional disability among older adults in China. OBJECTIVE: This study aimed to explore the associations between sleep duration and functional disabilities in the older population (aged≥65 years) in China. METHODS: The data for this cross-sectional study were gathered from respondents 65 years and older who participated in the 2018 survey of the China Health and Retirement Longitudinal Study, an ongoing nationwide longitudinal investigation of Chinese adults. The duration of sleep per night was obtained through face-to-face interviews. Functional disability was assessed according to activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. The association between sleep duration and functional disability was assessed by multivariable generalized linear models. A restricted cubic-spline model was used to explore the dose-response relationship between sleep duration and functional disability. RESULTS: In total, 5519 participants (n=2471, 44.77% men) were included in this study with a mean age of 73.67 years, including 2800 (50.73%) respondents with a functional disability, 1978 (35.83%) with ADL disability, and 2299 (41.66%) with IADL disability. After adjusting for potential confounders, the older adults reporting shorter (≤4, 5, or 6 hours) or longer (8, 9, or ≥10 hours) sleep durations per night exhibited a notably increased risk of functional disability compared to that of respondents who reported having 7 hours of sleep per night (all P<.05), which revealed a U-shaped association between sleep duration and dysfunction. When the sleep duration fell below 7 hours, increased sleep duration was associated with a significantly lower risk of functional disability (odds ratio [OR] 0.85, 95% CI 0.79-0.91; P<.001). When the sleep duration exceeded 7 hours, the risk of functional disability associated with a prolonged sleep duration increased (OR 1.16, 95% CI 1.05-1.29; P<.001). CONCLUSIONS: Sleep durations shorter and longer than 7 hours were associated with a higher risk of functional disability among Chinese adults 65 years and older. Future studies are needed to explore intervention strategies for improving sleep duration with a particular focus on functional disability.

A simple scoring algorithm based on intrinsic capacity for functional ability in community-dwelling older adults in Taiwan.

BACKGROUND: Intrinsic capacity (IC) is a comprehensive indicator of the overall well-being of older adults, and assessing of IC can help identify early stage of disability and tailor intervention to individual needs. However, there is a lack of effective and simple IC assessment tools. This study aimed to establish predictive scoring algorithms of IC to identify older adults at high risk of impaired functional ability. METHODS: We conducted a cross-sectional study in Southern Taiwan, measuring IC using 7 subitems: cognition, locomotion, vitality, vision, hearing, psychological well-being, and medication usage were measured. Functional ability outcomes included frailty, basic activities of daily living, and instrumental activities of daily living (IADL). The capability of 7 domains of IC in predicting functional ability was assessed by multivariable logistic regression. The prediction of capability of scoring algorithms was indicated by receiver operating characteristic (AUC) curves and measures of sensitivity and specificity. RESULTS: A total of 1,152 older adults were recruited and analyzed. Locomotion emerged as a significant predictor of IADL disability and worsening frailty. The IC-based weighted scoring algorism for predicting IADL demonstrated satisfactory capability (AUC: 0.80), as did the algorithm for predicting worsening frailty (AUC: 0.90). The optimal cutoff points for predicting IADL disability and frailty worse were estimated respectively at 13 and 16, with sensitivity/specificity values of 0.74/0.75 for the IADL prediction algorithm and 0.92/0.77 for the frailty prediction algorithm. CONCLUSION: Our 7-domain IC screening tool proves to be sensitive and practical for early identification of functional disability and frailty among community-dwelling older adults in Taiwan.

Assessment of Dependency in Activities of Daily Living (ADL) and its Predictors: A Cross-Sectional Study among the Elderly Rural Population in a Sub-Himalayan UT of India.

Background: With an increase in life expectancy over the last few decades, there has been a parallel increase in the prevalence of disabilities among the elderly population. To estimate the prevalence of dependency in activities of daily living (ADL) and its predictors among the rural elderly population. Material and Methods: This was a cross-sectional study carried out in the community among the rural geriatric population in the field practice area of PG Department of Community Medicine, Government Medical College Jammu. The Barthel Scale Index was used to measure ADL dependency. PSPP software was used to analyze the data. Results: The mean age of study participants was 68.31 ± 7.9 years. ADL dependency was observed in 46.3% of the subjects, with the majority demonstrating mild to moderate dependence. Only 2.5% of the respondents reported a severe degree of ADL dependence. The mean ADL score was 94.47 ± 8.98. On multivariate logistic regression analysis, age, educational status, the presence of stress in the family, personal history, and the presence of co-morbidities emerged to be independent predictors of ADL dependence. Conclusion: High prevalence of physical disability in the geriatric population is now an area of major concern. This emphasizes the significance of setting up geriatric care centers especially in rural areas preferably integrating with health and wellness centers.

Motion Analysis of the Mug Transportation Task Through Upper Limb Kinematics.

The task of transporting objects is a fundamental part of daily living activities. Previous kinematic studies focusing on tasks such as pointing, reach-to-grasp, and drinking have not fully captured the motor behaviors involved in object transportation, including placing a cup on a table or storing items in specific places. Hence, this study aimed to analyze the motor behavior associated with transporting a mug using upper limb kinematic variables. Fifteen healthy adults were instructed to transport an open-handle mug across a table. The kinematic metrics evaluated included object end-error for accuracy, frontal and lateral end-range for precision, movement time, peak velocity, time to peak velocity for control strategy, object path ratio for efficiency, and interjoint coordination. The stability of motor behavior was assessed through a test-retest analysis. The mug transporting task achieved accuracy with a radius <10 mm around the target, a peak velocity of ∼0.4 m/s, a control strategy where acceleration time constituted about 30% of the movement time, and a slightly curved trajectory. The test-retest analysis confirmed stable motor behavior across all kinematic metrics (ICCs > 0.75). Thus, the mug transporting task exhibited unique and stable kinematic characteristics, distinguishing it from non-transport activities and effectively mirroring transporting activities of daily living.

Impact of Virtual Reality-Based Group Activities on Activity Level and Well-Being Among Older Adults in Nursing Homes: Longitudinal Exploratory Study.

BACKGROUND: In addition to illness, inactivity is a risk factor for high mortality in nursing homes. Using innovative technology, such as virtual reality (VR), for meaningful group activities could provide new opportunities for solving this problem. VR interventions have already been approved as a promising method for enhancing the health of older adults. OBJECTIVE: In this study, we examined whether VR-based group activities can have a positive impact on activity level and group interaction among older adults living in nursing homes. METHODS: We conducted a longitudinal study and provided VR interventions as a group activity once a week for 4 consecutive weeks in nursing homes. Participants were recruited based on the experience of the nursing staff members and the natural decisions of the older adults. Within a virtual cottage, designed according to the needs of the target group, older adults were able to perform daily tasks that they were no longer able to do in real life, such as gardening and making pizza. Overall, 2 psychologists measured the psychosocial capacities, activities of daily life, and well-being before and after the interventions using standardized instruments. RESULTS: The results focus on a total of 84 older adults from 14 nursing homes who completed at least 3 VR interventions. The results indicate that several psychosocial capacities among the older adults improved, including adherence to regulations (P<.001; η²=0.122), flexibility (P<.001; η²=0.109), and group integration (P<.001; η²=0.141). Problems related to competence also showed a slight decrease (P=.04; η²=0.039). In addition, the VR intervention promoted their proactivity (P<.001; η²=0.104) and mobility (P=.04; η²=0.039). During the VR group intervention, older adults' well-being could be maintained at a high level. The results highlight the beneficial effects of VR intervention as a meaningful activity in nursing homes, showcasing the potential of VR applications in this setting. CONCLUSIONS: This study provides a novel and naturalistic perspective, offering new insights into the use of VR in nursing homes. The VR intervention was well accepted and fulfilled the aim of enhancing capacity and well-being. It could be a meaningful group activity in nursing homes to improve social group interaction. To provide stronger evidence, randomized controlled trials are necessary.

Social Activity and Cognitive Decline in Older Residents of Long-Term Care Facilities: A Cohort Study.

Background: Cognitive decline is a major reason for dependence and resource use in long-term care. Objective: We explored whether social activities may prevent cognitive decline of older residents of long-term care facilities. Methods: In a routine care cohort, 3,603 residents of long-term care facilities were assessed on average 4.4 times using the interRAI-Long-Term-Care-Facilities instrument which includes frequency of participation in social activities of long standing interest over the last 30 days and the Cognitive Performance Scale. Linear mixed models repeated measures analyses were performed corrected for age, sex, physical activity, Activities of Daily Living, mood, and health indicators. Results: Social activity was associated with cognitive preservation over time. This association was stronger in those with no or mild cognitive impairment at baseline, relative to those with moderate to severe impairment. Participation in specific social activities such as conversing and helping others showed a similar positive association. The relation between social activity and cognitive impairment appeared to be bi-directional. Conclusions: The protective effects of social activity offer a window of opportunity to preserve cognitive functioning in long-term care residents.

The relation between cognitive functioning and activities of daily living in normal aging, mild cognitive impairment, and dementia: a meta-analysis.

Literature suggests that dementia and, more generally, cognitive impairment affect the capacity to carry out activities of daily living (ADL) in aging. However, it is important to decipher the weight of specific cognitive domains and neurodegenerative profiles mainly related to ADL difficulties. A meta-analysis was conducted to investigate the nature and strength of the association between cognitive functioning and ADL in healthy older adults, mild cognitive impairment (MCI), and dementia. A comprehensive search of the PubMed, PsycINFO (PROQUEST), and Scopus databases for cross-sectional or longitudinal studies up until December 2022. Our meta-analytic results revealed that: overall, instrumental ADL (IADL) showed a significant association with executive functioning, in particular, abstraction ability/concept formation, set-shifting, and processing speed/complex attention/working memory, regardless of type of participants (i.e., healthy older adults, MCI, and dementia); whereas ADL (both basic ADL, BADL, and IADL) significantly correlated with global cognitive functioning and long-term verbal memory, with a moderator effect of clinical condition (e.g., increasing ES based on the level of cognitive impairment). Moreover, visuospatial and language abilities significantly correlated with ADL, mainly when performance-based tasks were used for ADL assessment. These findings emphasize the importance of neuropsychological assessment in aging to early identify people most at risk of functional decline and shed light on the need to consider specific cognitive abilities in rehabilitation programs.

The impact of exercise on Alzheimer's disease progression.

INTRODUCTION: The preventive effects of chronic physical exercise (CPE) on Alzheimer's disease (AD) are now admitted by the scientific community. Curative effects of CPE are more disputed, but they deserve to be investigated, since CPE is a natural non-pharmacological alternative for the treatment of AD. AREAS COVERED: In this perspective, the authors discuss the impact of CPE on AD based on an exhaustive literature search using the electronic databases PubMed, ScienceDirect and Google Scholar. EXPERT OPINION: Aerobic exercise alone is probably not the unique solution and needs to be complemented by other exercises (physical activities) to optimize the slowing down of AD. Anaerobic, muscle strength and power, balance/coordination and meditative exercises may also help to slow down the AD progression. However, the scientific evidence does not allow a precise description of the best training program for patients with AD. Influential environmental conditions (e.g. social relations, outdoor or indoor exercise) should also be studied to optimize training programs aimed at slowing down the AD progression.

Functional decline at 1 year in hospitalized elderly pneumonia with SARS-CoV-2 Omicron variant: Comparison with the ancestral strain and Alpha variant.

In the SARS-CoV-2 Omicron period, the pattern of pneumonia changed from primarily viral pneumonia to pneumonia mixed with bacteria in the elderly. We investigated functional outcomes at 1 year after hospital discharge in patients with primary Omicron pneumonia and pneumonia mixed with bacteria, mainly aspiration pneumonia. Functional decline rates calculated using the Barthel Index at 1 year after hospital discharge were significantly higher in the pneumonia mixed with bacteria group than the primary viral pneumonia group (42.6% vs. 20.5%, p < 0.0001). It is necessary to consider early rehabilitation and treatment in elderly patients even when the predominant strain is the Omicron variant.