Journal of the American Geriatrics Society
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomized trial of exercise programs among older individuals living in two long-term care facilities: the FallsFREE program.
To use two different exercise programs over a 2-year period to reduce falls and their sequelae among residents of two long-term care facilities. ⋯ There were no significant differences in falls among the two exercise groups and the control group. Lack of treatment differences and low adherence rates suggest that residents of long-term care facilities may require individualized exercise interventions that can be adapted to their changing needs.
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To examine the relationship between muscular strength and dynamic balance in a sample of older adults with knee pain and to determine the role that obesity and severity of knee pain play in the ability to maintain balance. ⋯ Strength appears to play a significant role in maintaining balance in an older, osteoarthritic population. We found that mean knee strength accounted for approximately 19% of the variability in dynamic balance. Hence, greater knee strength was associated with better dynamic balance. The best dynamic balance performances occurred in participants that had a combination of strong knees and strong ankles. However, knee osteoarthritic patients with weak knee strength could still maintain high levels of dynamic balance by having strong ankle strength. Moreover, we have shown that obesity is associated with attenuated dynamic balance performance and that poorer balance is associated with higher pain scores in the presence of weaker knees. For stronger knees, however, pain does not appear to be related to balance.
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To examine whether functional ability at age 75 and age 80 is associated with oral health and use of dental services cross-sectionally and whether changes in functional ability from age 75 to age 80 are associated with oral health and regular use of dental services at age 80. ⋯ The results indicate that oral impairment (e.g., having no or few teeth), oral functional limitations (e.g., chewing problems), and general functional limitations (e.g., mobility problems) are interrelated and that prevention of disabilities should be aimed at both functional limitations and oral health problems if the intention is to promote a good life in old age. In addition, the results point to the importance of taking problems in mobility seriously in delivering preventive services to old people because people who are tired or dependent on help seem to be at a higher risk of not using dental services regularly.
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To test the hypothesis that performance on a clock-drawing test in a mailed survey to an older cohort is associated with known and potential risk and protective factors for Alzheimer's disease. ⋯ The clock-drawing task is an appealing measure of cognitive function for large epidemiological studies because it is a simple, self-administered test that is easily adapted to mail surveys and correlates with more-detailed and more-time-consuming cognitive screens. Although it is relatively free of influence by language, cultural, or ethnic factors, our study shows that even in a highly educated population, clock drawing is influenced by educational level and other known risk factors for Alzheimer's disease. Thus a clock-drawing task may help predict cognitive frailty and future disability in older people. Such determination can direct high-risk individuals to earlier diagnosis, potential therapies, and better management.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Exercise rehabilitation improves functional outcomes and peripheral circulation in patients with intermittent claudication: a randomized controlled trial.
To determine the effects of a 6-month exercise program on ambulatory function, free-living daily physical activity, peripheral circulation, and health-related quality of life (QOL) in disabled older patients with intermittent claudication. ⋯ Improvements in claudication following exercise rehabilitation in older PAOD patients are dependent on improvements in peripheral circulation and walking economy. Improvement in treadmill claudication distances in these patients translated into increased accelerometer-derived physical activity in the community, which enabled the patients to become more functionally independent.