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BMJ Open Dec 2021To map in the current literature instruments for the assessment and stratification of frailty in community-dwelling older people, as well as to analyse them from the... (Review)
Review
OBJECTIVE
To map in the current literature instruments for the assessment and stratification of frailty in community-dwelling older people, as well as to analyse them from the perspective of the Brazilian context.
DESIGN
Scoping review.
STUDY SELECTION
The selection of studies took place between March and April 2020. Includes electronic databases: Medline, Latin American and Caribbean Literature in Health Sciences, Scopus, Web of Science and Cumulative Index of Nursing and Literature Health Alliance, in addition to searching grey literature.
DATA EXTRACTION
A data extraction spreadsheet was created to collect the main information from the studies involved, from the title to the type of assessment and stratification of frailty.
RESULTS
In summary, 17 frailty assessment and stratification instruments applicable to community-dwelling older people were identified. Among these, the frailty phenotype of Fried was the instrument most present in the studies (45.5%). The physical domain was present in all the instruments analysed, while the social, psychological and environmental domains were present in only 10 instruments.
CONCLUSIONS
This review serves as a guideline for primary healthcare professionals, showing 17 instruments applicable to the context of the community-dwelling older people, pointing out advantages and disadvantages that influence the decision of the instrument to be used. Furthermore, this scoping review was a guide for further studies carried out by the same authors, which aim to compare instruments.
Topics: Aged; Brazil; Frail Elderly; Frailty; Geriatric Assessment; Health Personnel; Humans; Independent Living
PubMed: 34937719
DOI: 10.1136/bmjopen-2021-052301 -
The Journal of International Medical... Jul 2022In this scoping review, we aimed to evaluate the effectiveness of integrated multidisciplinary team discharge planning and identify common outcomes among older adults... (Review)
Review
In this scoping review, we aimed to evaluate the effectiveness of integrated multidisciplinary team discharge planning and identify common outcomes among older adults with complex needs, focusing on a safe transition from the hospital to the community. We performed a literature search for relevant articles using seven electronic databases and agreed search terms. Only articles published in English were included. In total, 23,772 articles were identified, with 27 articles meeting the inclusion criteria. A preponderance of patients aged ≥65 years and women was inferred based on population demographics. Initiatives on complex discharge planning were noted across most Western countries. Common outcomes of complex discharge planning were functionality (n = 11) including frailty (n = 4), quality of life (n = 11), and patient-centered factors including psychosocial needs (n = 9). Various outcomes from complex discharge planning initiatives and pathways were explored in this scoping review. None of the selected studies covered all nine domains of outcome assessment. Further research is needed involving follow-up studies after complex discharge planning interventions to assess their true effectiveness or value.
Topics: Aged; Female; Humans; Outcome Assessment, Health Care; Patient Discharge; Quality of Life
PubMed: 35903858
DOI: 10.1177/03000605221110511 -
Annals of Epidemiology May 2021Previous studies on neighborhoods and breast cancer survival examined neighborhood variables as unidimensional measures (e.g. walkability or deprivation) individually...
PURPOSE
Previous studies on neighborhoods and breast cancer survival examined neighborhood variables as unidimensional measures (e.g. walkability or deprivation) individually and thus cannot inform how the multitude of highly correlated neighborhood domains interact to impact breast cancer survival. Neighborhood archetypes were developed that consider interactions among a broad range of neighborhood social and built environment attributes and examine their associations with breast cancer survival.
METHODS
Archetypes were measured using latent class analysis (LCA) fit to California census tract-level data. Thirty-nine social and built environment attributes relevant to eight neighborhood domains (socioeconomic status (SES), urbanicity, demographics, housing, land use, commuting and traffic, residential mobility, and food environment) were included. The archetypes were linked to cancer registry data on breast cancer cases (diagnosed 1996-2005 with follow-up through Dec 31, 2017) to evaluate their associations with overall and breast cancer-specific survival using Cox proportional hazards models. Analyses were stratified by race/ethnicity.
RESULTS
California neighborhoods were best described by nine archetypal patterns that were differentially associated with overall and breast cancer-specific survival. The lowest risk of overall death was observed in the upper middle class suburb (reference) and high status neighborhoods, while the highest was observed among inner city residents with a 39% greater risk of death (95% CI = 1.35 to 1.44). Results were similar for breast cancer-specific survival. Stratified analyses indicated that differences in survival by neighborhood archetypes varied according to individuals' race/ethnicity.
CONCLUSIONS
By describing neighborhood archetypes that differentiate survival following breast cancer diagnosis, the study provides direction for policy and clinical practice addressing contextually-rooted social determinants of health including SES, unhealthy food environments, and greenspace.
Topics: Breast Neoplasms; California; Ethnicity; Humans; Residence Characteristics; Social Class; Socioeconomic Factors
PubMed: 33577928
DOI: 10.1016/j.annepidem.2021.01.004 -
Revista Da Associacao Medica Brasileira... 2022The aim of this work was to present hypotheses supporting capoeira as an activity aimed at health rehabilitation and maintenance of quality of life.
OBJECTIVE
The aim of this work was to present hypotheses supporting capoeira as an activity aimed at health rehabilitation and maintenance of quality of life.
METHODS
Capoeira players (n=245), residing in Brazil and abroad, were evaluated for quality of life (physical, social, psychological, and environmental domains from WHOQOL-bref). The capoeira players' quality of life scores were compared to normative values and reference values in martial arts. Besides, studies involving capoeira (Medline/Embase/Cinahl/SportDiscus) were also reviewed for health-related hypotheses, describing population, intervention, comparator, and outcome.
RESULTS
There are hypotheses on capoeira improving health through (1) body composition, addressed by two studies investigating waist circumference, bone, and muscle mass; (2) functional capacity, investigated by three studies considering performance variables; (3) metabolism, in two studies demonstrating triglycerides and blood glucose reduction, and an enhancement of anaerobic glycolysis; and (4) cardiovascular parameters, addressed by two studies highlighting an increase in maximal oxygen consumption, heart rate, and rate of pressure product reduction, as well as an increase in parasympathetic activity at rest. The sample of this study had higher quality of life scores when compared to normative values for Brazilians, similar quality of life when it comes to social relationships, higher quality of life in the psychological and environmental domains, and lower quality of life in the physical domain when compared to practitioners of other combat sports/martial arts.
CONCLUSION
An analysis of the impacts of capoeira resulted in hypotheses on the rehabilitation of players' biological health. Although the individuals were evaluated within the pandemic period, their quality of life domains were similar or superior to normative or reference values found by studies from before the pandemic.
Topics: Humans; Quality of Life; Medicine; Brazil; Reference Values; Martial Arts
PubMed: 36449770
DOI: 10.1590/1806-9282.20220360 -
Reproductive Health Apr 2022Human papillomavirus is the most common sexually transmitted infection, usually passing from one person to another after the first sexual activity. Infection with this...
BACKGROUND
Human papillomavirus is the most common sexually transmitted infection, usually passing from one person to another after the first sexual activity. Infection with this virus and the occurrence of genital warts (GWs) could have several effects on patients' health. This study was performed to evaluate the sexual function and sexual quality of life (SQOL) in men with GWs.
METHODS
This cross-sectional study was conducted from September 2019 to March 2020 with a sample size of 105 men with GWs in the dermatology clinic of Shahid Faghihi Hospital in Shiraz University of Medical Sciences, Iran. Data were collected using a demographic questionnaire, the International Index of Erectile Function (IIEF), and the Sexual Quality of Life-Men (SQOL-M) questionnaires and analyzed by descriptive and inferential tests with SPSS software version 22.
RESULTS
The mean score for overall sexual function in men was 48.50 ± 8.89. About 35.2% of men had overall sexual dysfunction (SD). The highest disorder rate was related to the erection domain (85.7%), and the lowest was related to the desire domain (5.7%). In the erection domain, most men (54.3%) experienced mild to moderate erectile dysfunction. The mean score for SQOL-M was 38.36 ± 14.47, and 56.2% of them had a good SQOL.
CONCLUSIONS
GWs affected men's erection more than the other sexual function domains. SD in men with GWs has a significant impact on their SQOL and ED was associated with impaired SQOL. Therefore, it is recommended to pay more attention to SD screening alongside SQOL assessment of men with GW.
Topics: Condylomata Acuminata; Cross-Sectional Studies; Female; Humans; Male; Quality of Life; Sexual Behavior; Sexual Dysfunction, Physiological
PubMed: 35477528
DOI: 10.1186/s12978-022-01403-z -
Journal of AAPOS : the Official... Aug 2021Patient-reported outcome measures such as the Pediatric Eye Questionnaire (PedEyeQ) are increasingly recognized as important in healthcare assessment. Defining normal...
Patient-reported outcome measures such as the Pediatric Eye Questionnaire (PedEyeQ) are increasingly recognized as important in healthcare assessment. Defining normal PedEyeQ thresholds would allow classification of individual children as having reduced versus normal domain scores. We prospectively enrolled visually normal children (aged 0-17 years; n = 310) to calculate normal PedEyeQ domain thresholds. In addition, 48 children with bilateral visual impairment (VI; best-eye acuity worse than 20/70 or 20/70 or better with limited visual fields) were enrolled for validation. The Child PedEyeQ (four domains) was completed by 5- to 17-year-olds. Parents completed Proxy (five domains) and Parent PedEyeQ (four domains). Each domain was Rasch scored (converted to 0-100); normal thresholds were defined as the 5th percentile of scores in visually normal controls. For Child 5-11 PedEyeQ, 39%-78% of VI children had reduced domain scores, and 88%-100% for 12- to 17-year-olds. For Proxy PedEyeQ, proportions ranged from 55% to 100% and for Parent PedEyeQ ≥83% had reduced scores. High prevalence of reduced PedEyeQ domain scores in the VI cohort, validates the use of normal thresholds. Nevertheless, variability in child self-reporting creates challenges for identifying individual 5- to 11-year-olds with reduced scores.
Topics: Child; Humans; Parents; Quality of Life; Surveys and Questionnaires; Vision Disorders; Visual Acuity
PubMed: 34182085
DOI: 10.1016/j.jaapos.2021.03.006 -
BMC Geriatrics Oct 2021Population aging has been an emerging public and health concern globally. Balance performance can be applied as an indicator of functional status and a predictor of...
BACKGROUND
Population aging has been an emerging public and health concern globally. Balance performance can be applied as an indicator of functional status and a predictor of health outcomes in the elderly. However, reference data of balance performance in the elderly generated from large scale studies have been very limited. In research and geriatric assessment settings, the age and gender specific data on balance performance are indispensable prerequisites for identifying subpopulation with and at risk of impairments and subsequently implementing targeted interventions in clinics and public health to improve their balance performance.
METHODS
A total of 1984 elderly subjects aged 60 to 97 years from community settings in urban China were investigated. The balance performances together with 3 individual domains and 16 items were evaluated using the X16 balance testing scale.
RESULTS
In the elderly, with age increases each item, individual domain, and overall balance performance scores decreased gradually. Meanwhile, individual variations of individual domains and overall balance performance were all increased over age. Relative to levels of 60- years, postural stability and overall balance performance decreased significantly since 65 years old, static balance and dynamic balance capacities started to decrease significantly since 70 years old. There was no significant difference in each balance domain and overall balance performance between men and women. Across age groups, portions of individuals able to perform task 4, 8 and 11 successfully were the lowest amongst their corresponding domains static balance, postural stability, and dynamic balance, respectively. Similar patterns were observed in both men and women. Balance performances were categorized into poor, fair, and good groups with scores of 0 to 10, 11 to 17, and 18 to 20, respectively. With increases of age, proportions with poor and fair balance capacities elevated stably.
CONCLUSIONS
In the elderly, with advances in age, abilities of overall balance performance, individual domains of static balance, postural stability, and dynamic balance, and successful performances on specific tasks declined gradually and stably. The deterioration started to be obvious since 65-75 years. Men and women had similar patterns.
Topics: Aged; Aging; China; Female; Geriatric Assessment; Humans; Male; Physical Examination; Postural Balance
PubMed: 34696721
DOI: 10.1186/s12877-021-02560-9 -
Journal of Cachexia, Sarcopenia and... Apr 2021Aging is often associated with a decline in physical function that eventually leads to loss of autonomy in activities of daily living (ADL). Walking is a very common... (Review)
Review
Aging is often associated with a decline in physical function that eventually leads to loss of autonomy in activities of daily living (ADL). Walking is a very common ADL, important for main determinants of quality of life in older age, and it requires the integration of many physiological systems. Gait speed has been described as the 'sixth vital sign' because it is a core indicator of health and function in aging and disease. We reviewed original studies up to June 2020 that assessed frailty in both longitudinal and cross-sectional observational studies, paying particular attention to how gait is measured in older population and how the gait parameter adopted may influence the estimated frailty models and the health-related outcomes of the various studies (i.e. clinical, cognitive, physical, and nutritional outcomes). Eighty-five studies met the search strategy and were included in the present systematic review. According to the frailty tools, more than 60% of the studies used the physical phenotype model proposed by Fried and colleagues, while one-third referred to multi-domain indexes or models and only 5% referred to other single-domain frailty models (social or cognitive). The great heterogeneity observed in gait measurements and protocols limited the possibility to directly compare the results of the studies and it could represent an important issue causing variability in the different outcome measures in both clinical-and population-based settings. Gait appeared to be an indicator of health and function also in frail older adults, and different gait parameters appeared to predict adverse health-related outcomes in clinical, cognitive, and physical domains and, to a lesser extent, in nutritional domain. Gait has the potential to elucidate the common basic mechanisms of cognitive and motor decline. Advances in technology may extend the validity of gait in different clinical settings also in frail older adults, and technology-based assessment should be encouraged. Combining various gait parameters may enhance frailty prediction and classification of different frailty phenotypes.
Topics: Activities of Daily Living; Aged; Cross-Sectional Studies; Frailty; Gait; Geriatric Assessment; Humans; Quality of Life
PubMed: 33590975
DOI: 10.1002/jcsm.12667 -
Medical Decision Making : An... 2023The Dental Caries Utility Index (DCUI) is a new oral health-specific health state classification system for adolescents, consisting of 5 domains: pain/discomfort,...
INTRODUCTION
The Dental Caries Utility Index (DCUI) is a new oral health-specific health state classification system for adolescents, consisting of 5 domains: pain/discomfort, difficulty eating food/drinking, worried, ability to participate in activities, and appearance. Each domain has 4 response levels. This study aims to generate an Australian-specific utility algorithm for the DCUI.
METHODS
An online survey was conducted using a representative sample of the adult Australian general population. The discrete choice experiment (DCE) was used to elicit the preferences on 5 domains. Then, the latent utilities were anchored onto the full health-dead scale using the visual analogue scale (VAS). DCE data were modeled using conditional logit, and 2 anchoring procedures were considered: anchor based on the worst health state and a mapping approach. The optimal anchoring procedure was selected based on the model parsimony and the mean absolute error (MAE).
RESULTS
A total of 995 adults from the Australian general population completed the survey. The conditional logit estimates on 5 dimensions and levels were monotonic and statistically significant, except for the second level of the "worried" and "appearance" domains. The mapping approach was selected based on a smaller MAE between the 2 anchoring procedures. The Australian-specific tariff of DCUI ranges from 0.1681 to 1.
CONCLUSION
This study developed a utility algorithm for the DCUI. This value set will facilitate utility value calculations from the participants' responses for DCUI in economic evaluations of dental caries interventions targeted for adolescents.
HIGHLIGHTS
Preference-based quality-of-life measures (PBMs), which consist of a health state classification system and a set of utility values (a scoring algorithm), are used to generate utility weights for economic evaluations.This study is the first to develop an Australian utility value set for the Dental Caries Utility Index (DCUI), a new oral health-specific classification system for adolescents.The availability of a utility value set will enable using DCUI in economic evaluations of oral health interventions targeted for adolescents and may ultimately lead to more effective and efficient planning of oral health care services.
Topics: Adult; Adolescent; Humans; Health Status; Australia; Dental Caries; Quality-Adjusted Life Years; Quality of Life; Surveys and Questionnaires
PubMed: 37724663
DOI: 10.1177/0272989X231197149 -
Orphanet Journal of Rare Diseases Oct 2021Fabry disease (FD) is an X-linked lysosomal storage disorder characterized by multiorgan dysfunction. Since individuals with FD usually experience progressive clinical...
BACKGROUND
Fabry disease (FD) is an X-linked lysosomal storage disorder characterized by multiorgan dysfunction. Since individuals with FD usually experience progressive clinical disease manifestations, their health-related quality of life (HRQOL) is expected to change over time. However, there is limited longitudinal research examining HRQOL outcomes in individuals with FD. We aimed to: assess longitudinal outcomes in HRQOL in adults with FD; examine the physical- and mental HRQOL trajectories at the initial registration (baseline), 3-5 year, and 7-13 year follow-ups; and evaluate the possible associations of age, sex and medical complications with the physical- and mental HRQOL trajectories.
METHODS
Forty-three individuals with FD (53% female) who were aged 18 to 81 years at baseline attended clinical follow-up visits between 2006 and 2020. Medical records were extracted retrospectively. Demographics and the 36-item Short-Form Health Survey (SF-36) were recorded at scheduled visits, except for the last data collection which was prospectively obtained in 2020. The physical (PCS) and mental (MCS) composite scores (SF-36) were chosen as outcome measures.
RESULTS
The eight SF-36 domain scores were stable over a span of 13 years, and only physical- and social functioning domains worsened clinically over this follow-up period. Mean baseline SF-36 domain scores were all significantly lower (decreased HRQOL) in the FD sample compared with Norwegian population norms. Two hierarchical linear models were run to examine whether demographics and medical complications (measured at the last clinical visit) predicted physical and mental HRQOL trajectories. Age above 47 years (p < 0.001), male sex (p = 0.027), small fibre neuropathy (p < 0.001), renal dysfunction (p < 0.001), and cerebrovascular events (p = 0.003) were associated with lower HRQOL over time. No significant interactions were found between the time of follow up and the abovementioned predictors of HRQOL.
CONCLUSIONS
Overall HRQOL trajectories remained stable between baseline, 3-5 year, and 7-13 year follow-ups, with the majority of individuals reporting decreased physical and mental HRQOL. Medical complications in combination with older age and male sex are important predictors of lower HRQOL in FD. Awareness of this relationship is valuable both for health care providers and for patients. The findings provide indicators that can guide treatment decisions to improve physical and mental HRQOL outcomes.
Topics: Adult; Aged; Fabry Disease; Female; Humans; Male; Middle Aged; Quality of Life; Retrospective Studies; Surveys and Questionnaires
PubMed: 34641933
DOI: 10.1186/s13023-021-02066-y