GerontologyPub Date : 2024-01-01Epub Date: 2024-04-27DOI: 10.1159/000538598
Laura Schmidt, Tania Zieschang, Jessica Koschate, Tim Stuckenschneider
{"title":"Impaired Standing Balance in Older Adults with Cognitive Impairment after a Severe Fall.","authors":"Laura Schmidt, Tania Zieschang, Jessica Koschate, Tim Stuckenschneider","doi":"10.1159/000538598","DOIUrl":"10.1159/000538598","url":null,"abstract":"<p><strong>Introduction: </strong>Fall-related sequelae as well as balance and gait impairments are more pronounced in older adults who are cognitively impaired (OACI) compared to older adults who are cognitively healthy (OACH). Evidence is scarce about differences in standing balance and gait in OACH and OACI after a fall, even though these are major risks for recurrent falls. Thus, the aim of this study was to investigate early impairments in gait and balance, by adding inertial measurement units (IMUs) to a functional performance test in OACH and OACI after a severe fall with a presentation to the emergency department (ED) and immediate discharge.</p><p><strong>Methods: </strong>The study sample was stratified into participants with and without probable cognitive impairment using the result of the Montreal Cognitive Assessment total score (maximum of 30 points). The cutoff for probable cognitive impairment was set at ≤ 24. Standing balance and gait parameters were measured using three IMUs in n = 69 OACH (72.0 ± 8.2 years) and n = 76 OACI (78.7 ± 8.1 years). Data were collected at participants' homes as part of a comprehensive geriatric assessment in the \"SeFallED\" study within 4 weeks after presentation to the ED after a severe fall (German Clinical Trials Register ID: 00025949). ANCOVA was used for statistical analysis, adjusted for age.</p><p><strong>Results: </strong>The data indicated significantly more sway for OACI compared to OACH during balance tasks, whereas no differences in gait behavior were found. In detail, differences in standing balance were revealed for mean velocity (m/s) during parallel stance with eyes open (<inline-formula><mml:math id=\"m1\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:msubsup><mml:mi>η</mml:mi><mml:mi>p</mml:mi><mml:mn>2</mml:mn></mml:msubsup></mml:mrow></mml:math></inline-formula> = 0.190, p < 0.001) and eyes closed on a balance cushion (<inline-formula><mml:math id=\"m2\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:msubsup><mml:mi>η</mml:mi><mml:mi>p</mml:mi><mml:mn>2</mml:mn></mml:msubsup></mml:mrow></mml:math></inline-formula> = 0.059, p = 0.029), as well as during tandem stance (<inline-formula><mml:math id=\"m3\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:msubsup><mml:mi>η</mml:mi><mml:mi>p</mml:mi><mml:mn>2</mml:mn></mml:msubsup></mml:mrow></mml:math></inline-formula> = 0.034, p = 0.044) between OACI and OACH. Further differences between the two groups were detected for path length (m/s2) during parallel stance with eyes open (<inline-formula><mml:math id=\"m4\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:msubsup><mml:mi>η</mml:mi><mml:mi>p</mml:mi><mml:mn>2</mml:mn></mml:msubsup></mml:mrow></mml:math></inline-formula> = 0.144, p < 0.001) and eyes closed (<inline-formula><mml:math id=\"m5\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:msubsup><mml:mi>η</mml:mi><mml:mi>p</mml:mi><mml:mn>2</mml:mn></mml:msubsup></m","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"755-763"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GerontologyPub Date : 2024-01-01Epub Date: 2024-05-02DOI: 10.1159/000538314
Cheng Huang, Bei Wu, Chen Zhang, Zhuqin Wei, Liming Su, Junwei Zhang, Lina Wang
{"title":"Motoric Cognitive Risk Syndrome as a Predictor of Adverse Health Outcomes: A Systematic Review and Meta-Analysis.","authors":"Cheng Huang, Bei Wu, Chen Zhang, Zhuqin Wei, Liming Su, Junwei Zhang, Lina Wang","doi":"10.1159/000538314","DOIUrl":"10.1159/000538314","url":null,"abstract":"<p><strong>Introduction: </strong>Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome characterized by subjective cognitive complaints (SCCs) and slow gait (SG). Increasing evidence links MCR to several adverse health outcomes, but the specific relationship between MCR and the risk of frailty, Alzheimer's disease (AD), and vascular dementia (VaD) remains unclear. Additionally, literature lacks analysis of MCR's components and associated health outcomes, complicating risk identification. This systematic review and meta-analysis aimed to provide a comprehensive overview of MCR's predictive value for adverse health outcomes.</p><p><strong>Methods: </strong>Relevant cross-sectional, cohort, and longitudinal studies examining the association between MCR and adverse health outcomes were extracted from ten electronic databases. The Newcastle-Ottawa Scale (NOS) and modified NOS were used to assess the risk of bias in studies included in the analysis. Relative ratios (RRs) and 95% confidence intervals (CIs) were pooled for outcomes associated with MCR.</p><p><strong>Results: </strong>Twenty-eight longitudinal or cohort studies and four cross-sectional studies with 1,224,569 participants were included in the final analysis. The risk of bias in all included studies was rated as low or moderate. Pooled analysis of RR indicated that MCR had a greater probability of increased the risk of dementia (adjusted RR = 2.02; 95% CI = 1.94-2.11), cognitive impairment (adjusted RR = 1.72; 95% CI = 1.49-1.99), falls (adjusted RR = 1.32; 95% CI = 1.17-1.50), mortality (adjusted RR = 1.66; 95% CI = 1.32-2.10), and hospitalization (adjusted RR = 1.46; 95% CI = 1.16-1.84); MCR had more prominent predictive efficacy for AD (adjusted RR = 2.23; 95% CI = 1.81-2.76) compared to VaD (adjusted RR = 3.78; 95% CI = 0.49-28.95), while excluding analyses from the study that utilized the timed-up-and-go test and one-leg-standing to evaluate gait speed. One study examined the association between MCR and disability (hazard ratios [HR] = 1.69; 95% CI = 1.08-2.02) and frailty (OR = 5.53; 95% CI = 1.46-20.89). SG was a stronger predictor of the risk for dementia and falls than SCC (adjusted RR = 1.22; 95% CI = 1.11-1.34 vs. adjusted RR = 1.19; 95% CI = 1.03-1.38).</p><p><strong>Conclusion: </strong>MCR increases the risk of developing any discussed adverse health outcomes, and the predictive value for AD is superior to VaD. Additionally, SG is a stronger predictor of dementia and falls than SCC. Therefore, MCR should be routinely assessed among adults to prevent poor prognosis and provide evidence to support future targeted interventions.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"669-688"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GerontologyPub Date : 2024-01-01Epub Date: 2024-10-16DOI: 10.1159/000541754
Pablo Villalobos Dintrans, Antonia Echeverría, Constanza Inzunza
{"title":"Comparing Cost and Acceptability of Two Instruments to Measure Instrumental Activities of Daily Living in Older People in Chile.","authors":"Pablo Villalobos Dintrans, Antonia Echeverría, Constanza Inzunza","doi":"10.1159/000541754","DOIUrl":"10.1159/000541754","url":null,"abstract":"<p><strong>Introduction: </strong>Population aging and increasing long-term care needs call for designing and implementing better tools for assessing functional ability. In Chile, the Lawton and Brody (L&B) scale is used for identifying limitations with instrumental activities. This study compared the costs and acceptability of the L&B with a new instrument to measure instrumental activities of daily living (IADL): the Instrument for the Assessment of Functionality Stages (Instrumento de Evaluación de Estadios de Funcionalidad; IDEEF).</p><p><strong>Methods: </strong>Phone surveys were carried out to apply the L&B and the IDEEF to a sample of 200 older people (60+) participating in public programs for older people in the Metropolitan Region, Chile. Besides the items assessed by each scale, the survey captured completion times and included a short questionnaire on acceptability, data that allowed comparisons between instruments.</p><p><strong>Results: </strong>On average, the L&B takes around 4 min to be applied; the completion times for the IDEEF are 4 times longer. However, the IDEEF performs better in terms of acceptability and has neither gender bias nor dependency bias.</p><p><strong>Conclusion: </strong>Both instruments have pros and cons, but the IDEEF appears as a feasible alternative to the L&B to improve the assessment of IADL in the country.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1305-1313"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GerontologyPub Date : 2024-01-01Epub Date: 2024-10-04DOI: 10.1159/000541732
Joanna Reeves, Roxana Buckley, Sharon Dixon
{"title":"Differences in Foot Morphology across Age Groups for Women Active in Sport.","authors":"Joanna Reeves, Roxana Buckley, Sharon Dixon","doi":"10.1159/000541732","DOIUrl":"10.1159/000541732","url":null,"abstract":"<p><strong>Introduction: </strong>Foot morphology in the general population has been shown to change with age, and active older adults have reported a need for wide-fitting footwear.</p><p><strong>Methods: </strong>This study recruited 374 women active in racket sports and team sports in the UK who had their feet scanned while 50% weight bearing. Participants were grouped into 10-year age bands ranging from 18-29 years to 70-79 years. Data analysis was performed on the widths, heights, and circumferences of participants' right feet normalised to foot length, as well as an assessment of hallux valgus angle and deformity.</p><p><strong>Results: </strong>The 18-29-year group had significantly smaller measures of foot width, ball of foot circumference and short heel circumference (p < 0.05, η2 = 0.042, η2 = 0.056) compared to the older groups. The foot dorsum height and circumference at 50% foot length were significantly less in the oldest age groups compared to the middle age groups (p = 0.0001, η2 = 0.055 and p = 0.0007, η2 = 0.044, respectively). There was some evidence of increased hallux valgus deformity with age.</p><p><strong>Conclusion: </strong>Designers and manufacturers of athletic footwear should be aware of the changes in foot morphology with age in order to provide more inclusive footwear.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1267-1283"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association of Physical Frailty and Cognitive Function in a Population-Based Cross-Sectional Study of American Older Adults.","authors":"Shama Karanth, Dejana Braithwaite, Yuriko Katsumata, Ranjan Duara, Paul Norrod, Ikramuddin Aukhil, Erin Abner","doi":"10.1159/000533919","DOIUrl":"10.1159/000533919","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive impairment and frailty are prevalent in older persons. Physical frailty is associated with cognitive decline; however, the role of effect modifiers such as age, sex, race/ethnicity, and cognitive reserve is not well understood.</p><p><strong>Methods: </strong>Cross-sectional data from the National Health and Nutrition Examination Survey (2011-2014) were obtained for participants aged ≥60 years. Complete availability of cognitive scores was an inclusion criterion. Physical frailty was defined by the presence of exhaustion, weakness, low body mass, and/or low physical activity, and categorized into three groups: robust (0 present), pre-frail (1-2 present), or frail (3-4 present). Four cognitive test scores were converted to z-scores, and global cognition (composite z-score) was calculated by averaging the four-individual z-scores. Multivariable linear regression models were fit to estimate the associations between frailty and cognitive function. Frailty was also evaluated as a risk factor for self-reported subjective memory complaint (SMC) using logistic regression. All models were adjusted for age, sex, race/ethnicity, education, alcohol use, income, marital status, diabetes, hypertension, and history of stroke. Effect measure modification analyses were conducted by age, sex, race/ethnicity, education, and occupational cognitive demand.</p><p><strong>Results: </strong>The study population comprised 2,863 participants aged ≥60 years. 50.6% of the participants were categorized into robust, 43.2% pre-frail, and 6.2% frail. After adjusting for covariates, compared to robust participants, frail and prefrail participants had lower adjusted mean global cognitive z-scores, <inline-formula><mml:math id=\"m1\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:mover accent=\"true\"><mml:mi>β</mml:mi><mml:mo>^</mml:mo></mml:mover></mml:mrow></mml:math></inline-formula> = -0.61, 95% CI: -0.83, -0.38 and <inline-formula><mml:math id=\"m2\" xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:mover accent=\"true\"><mml:mi>β</mml:mi><mml:mo>^</mml:mo></mml:mover></mml:mrow></mml:math></inline-formula> = -0.21, 95% CI: -0.30, -0.12, respectively. Both prefrail and frail participants had higher odds of SMC compared to the robust participants. We did not see strong evidence that the association between frailty and cognition was modified by the factors we studied.</p><p><strong>Discussion/conclusion: </strong>Both pre-frailty and frailty were associated with lower cognitive performance and were more likely to report subjective memory complaints relative to persons without frailty. These findings provide additional evidence that physical frailty may serve as a prognostic factor for cognitive deterioration or dementia, and prevention of frailty may be an important public health strategy.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"48-58"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10961850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GerontologyPub Date : 2024-01-01Epub Date: 2024-06-05DOI: 10.1159/000539591
Ameer Nor Azhar, Shan M Bergin, Shannon E Munteanu, Hylton B Menz
{"title":"Footwear, Orthoses, and Insoles and Their Effects on Balance in Older Adults: A Scoping Review.","authors":"Ameer Nor Azhar, Shan M Bergin, Shannon E Munteanu, Hylton B Menz","doi":"10.1159/000539591","DOIUrl":"10.1159/000539591","url":null,"abstract":"<p><strong>Background: </strong>Footwear, orthoses, and insoles have been shown to influence balance in older adults; however, it remains unclear which features, singular or in combination, are considered optimal. The aim of this scoping review was to identify and synthesise the current evidence regarding how footwear, orthoses, and insoles influence balance in older adults. Four electronic databases (MEDLINE, CINAHL, Embase, and AMED) were searched from inception to October 2023. Key terms such as \"shoe*,\" \"orthoses,\" \"postural balance\" and \"older people\" were employed in the search strategy. Studies meeting the following criteria were included: (i) participants had a minimum age ≥60 years, and were free of any neurological, musculoskeletal, and cardiovascular diseases; (ii) an active intervention consisting of footwear, foot orthoses, or insoles was evaluated; and (iii) at least one objective outcome measure of balance was reported.</p><p><strong>Summary: </strong>A total of 56 studies from 17 different countries were included. Three study designs were utilised (cross-sectional study, n = 44; randomised parallel group, n = 6; cohort study n = 6). The duration of studies varied considerably, with 41 studies evaluating immediate effects, 14 evaluating effects from 3 days to 12 weeks, and 1 study having a duration of 6 months. Seventeen different interventions were evaluated, including/consisting of textured insoles (n = 12), heel elevation (n = 8), non-specific standardised footwear and changes in sole thickness or hardness (n = 7 each), sole geometry or rocker soles, contoured or custom insoles and high collar height (n = 6 each), insole thickness or hardness and vibrating insoles (n = 5 each), outsole tread (n = 4), minimalist footwear and slippers (n = 3 each), balance-enhancing shoes, footwear fit, socks, and ankle-foot orthoses (n = 2 each), and eversion insoles, heel cups, and unstable footwear (n = 1 each). Twenty-three different outcomes were assessed, and postural sway was the most common (n = 20), followed by temporo-spatial gait parameters (n = 17). There was uncertainty regarding intervention effectiveness. Overall, features such as secure fixation, a textured insole, a medium-to-hard density midsole and a higher ankle collar, in isolation, were able to positively impact balance. Conversely, footwear with an elevated heel height and the use of socks and slippers impaired balance.</p><p><strong>Key messages: </strong>There is a substantial body of literature exploring the effects of footwear, orthoses, and insoles on balance in older adults. However, considerable uncertainty exists regarding the efficacy of these interventions due to variability in methodological approaches. Further high-quality research is necessary to determine whether a singular intervention or a combination of interventions is most effective for enhancing balance in older adults.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"801-811"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GerontologyPub Date : 2024-01-01Epub Date: 2024-08-29DOI: 10.1159/000540476
Shira Peleg, Miriam Wallimann, Theresa Pauly
{"title":"Associations between Daily Stressors, Health, and Affective Responses among Older Adults: The Moderating Effect of Age.","authors":"Shira Peleg, Miriam Wallimann, Theresa Pauly","doi":"10.1159/000540476","DOIUrl":"10.1159/000540476","url":null,"abstract":"<p><strong>Introduction: </strong>Reactivity to daily stressors may change as a function of stressor type and age. However, prior research often excludes older adults or compares them to younger age groups (e.g., younger and middle-aged adults). Recognizing older adults as a heterogeneous population with shifting motivations, this study focused on individuals aged ≥65 years and tested age differences in associations between different types of daily stressors, affect, and physical symptoms.</p><p><strong>Methods: </strong>A total of 108 older adults aged 65-92 years (M = 73.11, SD = 5.92; 58% women) completed daily dairy questionnaires on daily stressors, positive and negative affect, and physical symptoms for 14 consecutive days. Multilevel models were employed, adjusting for sex, age, education, living situation, and day-in-study.</p><p><strong>Results: </strong>Findings revealed age-dependent variations in the associations between daily stressors and affect and physical symptoms. Specifically, external stressors (e.g., finance and traffic stressors) and health stressors were more strongly associated with daily affective states and with overall physical symptoms (respectively) among older age adults. Age did not moderate associations between social stressors and affect or physical symptoms.</p><p><strong>Conclusion: </strong>These findings underscore the heterogeneous nature of older adults' responses to daily stressors based on stressor type and age. Specifically, the oldest-old might benefit from personalized support for dealing with challenges such as health and financial stressors.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1213-1226"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GerontologyPub Date : 2024-01-01Epub Date: 2024-08-17DOI: 10.1159/000540995
Ahmad J Abdulsalam, Pelin Analay, Murat Kara
{"title":"Painting a Clearer Picture by Measuring the Quadriceps Muscle with Ultrasound.","authors":"Ahmad J Abdulsalam, Pelin Analay, Murat Kara","doi":"10.1159/000540995","DOIUrl":"10.1159/000540995","url":null,"abstract":"","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1148-1149"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}