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Medicine Jun 2024This study aimed to investigate the different impacts of sensorial and mobility frailty on overall and domain-specific cognitive function. Further, the independent... (Observational Study)
Observational Study
This study aimed to investigate the different impacts of sensorial and mobility frailty on overall and domain-specific cognitive function. Further, the independent associations between other intricate capacity (IC) dimensions, including vitality and psychological dimensions, and overall and domain-specific cognitive function were investigated. A total of 429 participants (mean age, 72.91 ± 7.014 years; 57.30% female) underwent IC capacity assessment. Other covariates, such as demographics, health-related variables were also assessed. Overall or domain-specific cognitive impairment was used as a dependent variable in logistic regression analyses adjusted for demographic, health-related, and psychosocial confounders. After adjustment for demographic, health-related, and psychosocial confounders, individuals with sensorial frailty (odds ratio [OR] = 0.435; 95% confidence interval [CI] = 0.236-0.801; P = .008) had a significantly lower risk of mild cognitive impairment (MCI), marginally low delayed memory impairment (OR = 0.601, 95% CI = 0.347-1.040; P = .069), and language impairment (OR = 0.534, 95% CI = 0.305-0.936; OR = 0.318, P = .029; OR = 0.318,95% CI = 0.173-0.586; P < .001) by Boston naming and animal fluency tests than did those with both sensorial and mobility frailty or mobility frailty only. Depressive symptoms had a significant negative influence on executive function. Cardiovascular disease and non-skin malignancy were independent determinants of MCI, and diabetes mellitus was independently associated with processing speed, attention, and executive function. Sensorial and mobility frailty were independent risk factors for cognitive impairment. Mobility frailty had a greater negative influence on the overall cognitive function and memory and language function than did sensorial frailty. The reserve decline in the psychological dimension of IC and chronic diseases also had a significant adverse influence on overall and domain-specific cognition function.
Topics: Humans; Female; Male; Aged; Cognitive Dysfunction; Independent Living; China; Cognition; Frailty; Frail Elderly; Aged, 80 and over; Geriatric Assessment; Cross-Sectional Studies; Mobility Limitation; East Asian People
PubMed: 38847667
DOI: 10.1097/MD.0000000000038500 -
Annals of the American Thoracic Society May 2023There is a lack of outcome measures with robust clinimetric properties in bronchiectasis. To determine the clinimetric properties (reliability over 1 year during...
There is a lack of outcome measures with robust clinimetric properties in bronchiectasis. To determine the clinimetric properties (reliability over 1 year during clinical stability and responsiveness over the course of antibiotics for pulmonary exacerbation) of objective and patient-reported outcome measures. This multicenter cohort study included adults with bronchiectasis from seven hospitals in the United Kingdom. Participants attended four visits, 4 months apart over 1 year while clinically stable and at the beginning and end of exacerbation and completed lung function (spirometry and multiple breath washout), provided a blood sample for C-reactive protein (CRP) measurement, and completed health-related quality of life (HRQoL) questionnaires (Quality of Life-Bronchiectasis, St. George's Respiratory Questionnaire, and EuroQoL 5-Dimensions 5-Levels). Participants ( = 132) had a mean (standard deviation) age of 66 (11) years, and 64% were female. Lung function parameters (forced expiratory volume in one second [FEV], standard lung clearance index [LCI]) were reliable over time [coefficient of variation (CV): <10%]). Regarding responsiveness, FEV demonstrated better properties than LCI; therefore, a clear justification for the use of LCI in future trials is needed. CRP was less reliable (CV > 20%) over time than FEV and LCI, and whereas CRP had a large mean change between the start and end of an exacerbation, this may have been driven by a small number of patients having a large change in CRP. Reliability of HRQoL questionnaires and questionnaire domains ranged from acceptable (CV: 20-30%) to good (CV: 10-20%), and HRQoL were responsive to treatment of exacerbations. Considering the specific questionnaire domain relevant to the intervention and its associated clinimetric properties is important. Additional statistics will support future power and/or sample size analysis. This information on the clinimetric properties of lung function parameters, CRP, and HRQoL parameters should be used to inform the choice of outcome measures used in future bronchiectasis trials.
Topics: Adult; Humans; Female; Aged; Male; Quality of Life; Cohort Studies; Reproducibility of Results; Bronchiectasis; Outcome Assessment, Health Care
PubMed: 36548542
DOI: 10.1513/AnnalsATS.202206-493OC -
BMC Gastroenterology May 2023Physical frailty is related with morbidity and mortality in patients with cirrhosis. Currently, there is no approved treatment of frailty in these patients. Here, we... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Physical frailty is related with morbidity and mortality in patients with cirrhosis. Currently, there is no approved treatment of frailty in these patients. Here, we evaluated the efficacy of 16 weeks branched-chain amino acids (BCAA) supplementation on frailty in frail compensated cirrhotic patients.
METHODS
After a 4-week run-in period consisted of dietary and exercise counseling, compensated cirrhotic patients with frailty, defined by liver frailty index (LFI)≥4.5, were randomly assigned (1:1) to BCAA or control group. The BCAA group received twice daily BCAAs supplementation (210 kcal, protein 13.5 g, BCAA 2.03 g) for 16 weeks. The primary outcome was frailty reversion. The secondary outcomes were changes in biochemistries, body composition evaluated by bioelectrical impedance analysis, and quality of life (QoL).
RESULTS
54 patients were prospectively enrolled (age 65.5 ± 9.9 years, 51.9% female, Child-Pugh A/B 68.5%/31.5%, MELD 10.3 ± 3.1). Baseline characteristics were similar between both groups. At week 16, BCAA group had a significant improvement in LFI (-0.36 ± 0.3 vs. -0.15 ± 0.28, P = 0.01), BMI (+ 0.51 ± 1.19 vs. -0.49 ± 1.89 kg/m, P = 0.03), and serum albumin (+ 0.26 ± 0.27 vs. +0.06 ± 0.3 g/dl, P = 0.01). The proportion of frailty reversion at week 16 was significantly higher in BCAA group (36% vs. 0%, P < 0.001). Compared with baseline, BCAA group had a significant increase in skeletal muscle index (7.5 ± 1.6 to 7.8 ± 1.5 kg/m, P = 0.03). Regarding the QoL, only the BCAA group had a significant improvement in all 4 domains of physical component score of the SF-36 questionnaire.
CONCLUSIONS
A 16-week BCAA supplementation improved frailty in frail compensated cirrhotic patients. In addition, this intervention resulted in an improvement of muscle mass and physical domain of QoL in these patients.
TRIAL REGISTRATION
This study was registered with Thai Clinical Trial Registry (TCTR20210928001; https://www.thaiclinicaltrials.org/# ).
Topics: Humans; Female; Aged; Middle Aged; Male; Amino Acids, Branched-Chain; Quality of Life; Frailty; Frail Elderly; Liver Cirrhosis; Dietary Supplements
PubMed: 37189033
DOI: 10.1186/s12876-023-02789-1 -
Quality of Life Research : An... Feb 2022To identify whether it is feasible to develop a mapping algorithm to predict presenteeism using multiattribute measures of health status.
OBJECTIVES
To identify whether it is feasible to develop a mapping algorithm to predict presenteeism using multiattribute measures of health status.
METHODS
Data were collected using a bespoke online survey in a purposive sample (n = 472) of working individuals with a self-reported diagnosis of Rheumatoid arthritis (RA). Survey respondents were recruited using an online panel company (ResearchNow). This study used data captured using two multiattribute measures of health status (EQ5D-5 level; SF6D) and a measure of presenteeism (WPAI, Work Productivity Activity Index). Statistical correlation between the WPAI and the two measures of health status (EQ5D-5 level; SF6D) was assessed using Spearman's rank correlation. Five regression models were estimated to quantify the relationship between WPAI and predict presenteeism using health status. The models were specified based in index and domain scores and included covariates (age; gender). Estimated and observed presenteeism were compared using tenfold cross-validation and evaluated using Root mean square error (RMSE).
RESULTS
A strong and negative correlation was found between WPAI and: EQ5D-5 level and WPAI (r = - 0.64); SF6D (r =- 0.60). Two models, using ordinary least squares regression were identified as the best performing models specifying health status using: SF6D domains with age interacted with gender (RMSE = 1.7858); EQ5D-5 Level domains and age interacted with gender (RMSE = 1.7859).
CONCLUSIONS
This study provides indicative evidence that two existing measures of health status (SF6D and EQ5D-5L) have a quantifiable relationship with a measure of presenteeism (WPAI) for an exemplar application of working individuals with RA. A future study should assess the external validity of the proposed mapping algorithms.
Topics: Absenteeism; Efficiency; Health Status; Humans; Presenteeism; Quality of Life; Surveys and Questionnaires
PubMed: 34313940
DOI: 10.1007/s11136-021-02936-9 -
The Lancet. Healthy Longevity Aug 2021Gender differences in life expectancy and societal roles have implications for a country's capacity to support its older population. Specifically, the longevity risk...
BACKGROUND
Gender differences in life expectancy and societal roles have implications for a country's capacity to support its older population. Specifically, the longevity risk associated with longer life expectancy of women, with greater risk of morbidity entails different needs between genders in older age. We aimed to quantify gender differences in the ageing experience of older people in Organization for Economic Cooperation and Development (OECD) countries as a first step in identifying policy gaps and differences in the allocation of resources and social support for older men and women.
METHODS
We constructed a multidimensional Ageing Index to account for gender differences in societal ageing, using mostly gender-disaggregated latest available data between 2015 and 2019, for 18 OECD countries. Our Ageing Index is a weighted sum of scores for five domains, which consisted of various measures, that are important for societal ageing: wellbeing, productivity and engagement, equity, security, and cohesion. The construction of the domains and their relative weighting was determined by the Research Network on an Ageing Society, an interdisciplinary group of academics. We computed the overall index and domain scores (from 0 to 100) for each gender and compared these scores between genders and countries.
FINDINGS
In every country, gender differences in key domains of societal ageing favour men. Countries in northern Europe (ie, Denmark, Sweden, Finland and Norway), the Netherlands, and Japan had high overall Index scores for both genders, whereas many eastern and southern European countries (eg, Hungary, Poland, and Slovenia) performed less well. Countries with the largest gender difference in Index scores include the Netherlands, Germany, and Italy, whereas Ireland, Spain, and Poland had the smallest difference. Gender differences were present for the domains of productivity and engagement, security, and cohesion. Gender differences favoured men for domain productivity and engagement (mean 10·2, 95% CI 7·8-12·6; p<0·0001), security (10·3, 7·8-12·7; p<0·0001), and cohesion (21·1, 13·9-28·1; p<0·0001). Although the domains of wellbeing and equity showed more mixed results, they nonetheless showed a slight advantage for men.
INTERPRETATION
Our multidimensional index helps to identify specific gender differences along key domains of societal ageing in various OECD countries. Furthermore, the inter-country comparisons reveal those countries with more successful societal ageing, which could be instructive for policy makers.
FUNDING
John A Hartford Foundation and the Singapore Ministry of Education.
Topics: Aged; Aging; Cross-Sectional Studies; Europe; Female; Humans; Life Expectancy; Male; Sex Factors
PubMed: 36098150
DOI: 10.1016/S2666-7568(21)00121-5 -
Clinical Nutrition (Edinburgh, Scotland) Nov 2023Both during and after hospitalization, nutritional care with daily intake of oral nutritional supplements (ONS) improves health outcomes and decreases risk of mortality... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND & AIMS
Both during and after hospitalization, nutritional care with daily intake of oral nutritional supplements (ONS) improves health outcomes and decreases risk of mortality in malnourished older adults. In a post-hoc analysis of data from hospitalized older adults with malnutrition risk, we sought to determine whether consuming a specialized ONS (S-ONS) containing high protein and beta-hydroxy-beta-methylbutyrate (HMB) can also improve Quality of Life (QoL).
METHODS
We analyzed data from the NOURISH trial-a randomized, placebo-controlled, multi-center, double-blind study conducted in patients with congestive heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease. Patients received standard care + S-ONS or placebo beverage (target 2 servings/day) during hospitalization and for 90 days post-discharge. SF-36 and EQ-5D QoL outcomes were assessed at 0-, 30-, 60-, and 90-days post-discharge. To account for the missing QoL observations (27.7%) due to patient dropout, we used multiple imputation. Data represent differences between least squares mean (LSM) values with 95% Confidence Intervals for groups receiving S-ONS or placebo treatments.
RESULTS
The study population consisted of 622 patients of mean age ±standard deviation: 77.9 ± 8.4 years and of whom 52.1% were females. Patients consuming placebo had lower (worse) QoL domain scores than did those consuming S-ONS. Specifically for the SF-36 health domain scores, group differences (placebo vs S-ONS) in LSM were significant for the mental component summary at day 90 (-4.23 [-7.75, -0.71]; p = 0.019), the domains of mental health at days 60 (-3.76 [-7.40, -0.12]; p = 0.043) and 90 (-4.88 [-8.41, -1.34]; p = 0.007), vitality at day 90 (-3.33 [-6.65, -0.01]; p = 0.049) and social functioning at day 90 (-4.02 [-7.48,-0.55]; p = 0.023). Compared to placebo, differences in LSM values for the SF-36 general health domain were significant with improvement in the S-ONS group at hospital discharge and beyond: day 0 (-2.72 [-5.33, -0.11]; p = 0.041), day 30 (-3.08 [-6.09, -0.08]; p = 0.044), day 60 (-3.95 [-7.13, -0.76]; p = 0.015), and day 90 (-4.56 [-7.74, -1.38]; p = 0.005).
CONCLUSIONS
In hospitalized older adults with cardiopulmonary diseases and evidence of poor nutritional status, daily intake of S-ONS compared to placebo improved post-discharge QoL scores for mental health/cognition, vitality, social functioning, and general health. These QoL benefits complement survival benefits found in the original NOURISH trial analysis.
CLINICAL TRIAL REGISTRATION
NCT01626742.
Topics: Female; Humans; Aged; Male; Quality of Life; Aftercare; Patient Discharge; Dietary Supplements; Hospitalization; Malnutrition; Nutritional Status
PubMed: 37757502
DOI: 10.1016/j.clnu.2023.09.004 -
Hepatology Communications Jul 2023Recent endeavors emphasize the importance of understanding early barriers to liver transplantation (LT) by consistently collecting data on patient demographics,...
BACKGROUND
Recent endeavors emphasize the importance of understanding early barriers to liver transplantation (LT) by consistently collecting data on patient demographics, socioeconomic factors, and geographic social deprivation indices.
METHODS
In this retrospective single-center cohort study of 1657 adults referred for LT evaluation, we assessed the association between community-level vulnerability and individual socioeconomic status measures on the rate of waitlisting and transplantation. Patients' addresses were linked to Social Vulnerability Index (SVI) at the census tract-level to characterize community-level vulnerability. Descriptive statistics were used to describe patient characteristics. Multivariable cause-specific HRs were used to assess the association between community-level vulnerability, individual measures of the socioeconomic status, and LT evaluation outcomes (waitlist and transplantation).
RESULTS
Among the 1657 patients referred for LT during the study period, 54% were waitlisted and 26% underwent LT. A 0.1 increase in overall SVI correlated with an 8% lower rate of waitlisting (HR 0.92, 95% CI 0.87-0.96, p < 0.001), with socioeconomic status, household characteristics, housing type and transportation, and racial and ethnic minority status domains contributing significantly to this association. Patients residing in more vulnerable communities experienced a 6% lower rate of transplantation (HR 0.94, 95% CI 0.91- 0.98, p = 0.007), with socioeconomic status and household characteristic domain of SVI significantly contributing to this association. At the individual level, both government insurance and employment status were associated with lower rates of waitlisting and transplantation. There was no association with mortality prior to waitlisting or mortality while on the waitlist.
CONCLUSION
Our findings indicate that both individual and community measures of the socioeconomic status (overall SVI) are associated with LT evaluation outcomes. Furthermore, we identified individual measures of neighborhood deprivation associated with both waitlisting and transplantation.
Topics: Adult; Humans; Liver Transplantation; Retrospective Studies; Cohort Studies; Ethnicity; Social Vulnerability; Minority Groups; Social Class; Referral and Consultation
PubMed: 37378636
DOI: 10.1097/HC9.0000000000000196 -
BMJ Open Apr 2022To evaluate the patterns and demographic correlates of domain-specific physical activities (PAs) and their associations with dyslipidaemia among ethnic minorities in...
OBJECTIVE
To evaluate the patterns and demographic correlates of domain-specific physical activities (PAs) and their associations with dyslipidaemia among ethnic minorities in China.
DESIGN
Cross-sectional.
PARTICIPANTS
In total, 17 081 individuals were included.
PRIMARY AND SECONDARY OUTCOME MEASURES
Domain-specific PAs were assessed using a questionnaire related to occupational, transportation, housework and leisure-time PAs. Dyslipidaemia was measured using an automatic biochemical instrument. Demographic variables were self-reported.
RESULTS
Housework accounted for most PAs in the study. Elderly people were more likely to participate in housework and leisure-time PA, whereas the mean level of PA in people with low education level and household income was high. With G3-G4 levels of occupational PA, Dong men (G4: OR=0.530, 95% CI 0.349 to 0.806), Miao women (G3: OR=0.698, 95% CI 0.524 to 0.931; G4: OR=0.611, 95% CI 0.439 to 0.850) and Bouyei women (G3: OR=0.745, 95% CI 0.566 to 0.981; G4: OR=0.615, 95% CI 0.440 to 0.860) tended to have a low risk of dyslipidaemia. With G2 levels of transportation, PA could reduce the risk of dyslipidaemia in Bouyei women (G2: OR=0.747, 95% CI 0.580 to 0.962). G2-G3 levels of leisure-time PA could reduce the risk of dyslipidaemia in Miao men (G2: OR=0.645, 95% CI 0.446 to 0.933; G3: OR=0.700, 95% CI 0.513 to 0.954). However, a high risk of dyslipidaemia was observed with G4 levels of leisure-time PA among Bouyei women (G4: OR=.353, 95% CI 1.001 to 1.905) and with transportation PA among Dong men (G4: OR=1.591, 95% CI 1.130 to 2.240).
CONCLUSION
The main PA of the ethnic minorities in Guizhou Province involved housework. Domain-specific PAs varied with demographic factors, and active domain-specific PAs were associated with a reduced risk of dyslipidaemia.
Topics: Aged; China; Cohort Studies; Cross-Sectional Studies; Demography; Dyslipidemias; Exercise; Female; Humans; Leisure Activities; Male
PubMed: 35418424
DOI: 10.1136/bmjopen-2021-052268 -
International Journal of Environmental... Oct 2022Quality of life (QoL) is closely linked to the health status of the individual. In turn, health status strongly depends on lifestyle. Health behavior, which is defined...
UNLABELLED
Quality of life (QoL) is closely linked to the health status of the individual. In turn, health status strongly depends on lifestyle. Health behavior, which is defined as the actions and attitudes of a person that affect their physical and mental health, is one of many lifestyle components. The nursing community, which is exposed to a range of dangers associated with the job position and responsibilities of the nursing profession, has to contend with several negative impacts. This results in a decreased quality of life among the nursing staff and reduced effectiveness in providing care services to patients.
METHODS
This study was conducted using an online Google questionnaire, which was completed by 312 nurses nationwide. The questionnaire included questions about the respondents' socio-demographic survey and included the Health Behavior Inventory (HBI) by Juczyński and the WHOQoL-BREF questionnaire.
RESULTS
The mean QoL reported by respondents was 3.65 points (SD = 0.67), meaning that QoL ranked between good and average results. The respondents' mean rating of their own health was 3.58 points (SD = 0.79), indicating that they rated their health status between satisfactory and average. Low health-behavior prevalence was reported by 139 of the 312 survey participants (44.55%), while 111 respondents (35.58%) had average health-behavior prevalence and 62 (19.87%) had high health-behavior prevalence. Each of the QoL domains correlated significantly ( ˂ 0.05) and positively (r ˃ 0) with the total HBI score and all its subscales.
CONCLUSIONS
Higher quality of life improves the level of health behavior by nursing staff. Obesity lowers the quality of life in physical, psychological, and social domains. The psychological sphere was the best-rated quality of life domain by nurses. A good material situation for nurses has a positive effect on their quality of life.
Topics: Health Behavior; Health Status; Humans; Nurses; Quality of Life; Surveys and Questionnaires
PubMed: 36232229
DOI: 10.3390/ijerph191912927 -
International Journal of Environmental... Aug 2022Individuals who are prelingually deaf and have intellectual disabilities experience great challenges in their language, cognitive and social development, leading to...
Individuals who are prelingually deaf and have intellectual disabilities experience great challenges in their language, cognitive and social development, leading to heterogeneous profiles of intellectual and adaptive functioning. The present study describes these profiles, paying particular attention to domain discrepancies, and explores their associations with quality of life and maladaptive behavior. Twenty-nine adults with prelingual deafness (31% female) and mild intellectual functioning deficits (mean IQ = 67.3, SD = 6.5) were administered the Vineland Adaptive Behavior Scales-II (VABS-II) and an adapted sign language version of a quality of life scale (EUROHIS-QOL 8). Intellectual disability domain discrepancies were characterized as at least one standard deviation difference between the social domain and IQ and the practical domain and IQ, and a significant difference, according to the VABS-II manual, between the social and practical domains. Domain discrepancies were found between intellectual functioning and both the practical (58.6%) and social domain (65.5%). A discrepancy between intellectual and social functioning was significantly associated with a higher level of internalizing maladaptive behavior (T = 1.89, p < 0.05). The heterogeneous profiles highlight the importance of comprehensive assessments for adequate service provision.
Topics: Adaptation, Psychological; Adult; Cognition; Female; Humans; Intellectual Disability; Male; Quality of Life; Social Adjustment
PubMed: 36011569
DOI: 10.3390/ijerph19169919