Gerontology
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Comparative Study
Accuracy of a portable multisensor body monitor for predicting resting energy expenditure in older people: a comparison with indirect calorimetry.
Accurate and comfortable methods are needed to determine resting energy expenditure (REE) in older people who are characterized by a lowered metabolic rate. The portable SenseWear® armband (SWA) body monitor, worn on the right upper arm, can easily be used by this age group in an ambulatory manner. ⋯ The SWA provides a reliable estimate of REE in healthy older subjects and has the advantage of easy handling. The 20-min recording time, which was recommended by the manufacturer, can be applied. However, the SWA overestimates REE in this group, possibly due to age-related changes in skin conductance and thermoregulation, both being measured by sensors of the SWA armband. This requires improving the SWA by developing better fitting algorithms for predicting REE in older people.
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Hip fracture patients often suffer from pain for several months after surgery. This may lead to physical inactivity and subsequent mobility limitation and disability. The purpose of this study was to investigate the association between severe musculoskeletal pain and the level of physical activity in older people with a history of hip fracture. ⋯ Pain is an important associated factor of physical inactivity in older people with a hip fracture history. Pain management may be important in restoring and sustaining the level of physical activity after hip fracture. Further prospective and experimental studies are, however, needed to explore the causality between pain and physical activity as well as the role of pain management and physical activity interventions in preventing mobility limitation and disability among older people recovering from hip fracture.
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Measures of fear of falling have not yet been validated in patients with dementia, leaving a methodological gap that limits research in a population at high risk of falling and fall-related consequences. ⋯ The Short FES-I is a valid measure to assess fear of falling in frail older adults with and without cognitive impairment, yet it may show floor effects in higher functioning older people. All scales, including the Short FES-I, were sensitive to detecting intervention-induced changes in concerns about falling in geriatric patients with dementia.
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Frail, old patients with and without cognitive impairment are at high risk of falls and associated medical and psychosocial issues. The lack of adequate, validated instruments has partly hindered research in this field. So far no questionnaire documenting fall-related self-efficacy/fear of falling has been validated for older persons with cognitive impairment or for different administration methods such as self-report or interview. ⋯ Both the FES as well as the FES-I showed good to excellent measurement properties in persons with and without moderate cognitive impairment. In frail older persons, especially in persons with cognitive impairment, an interview-based administration method is recommended.
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Hurricanes Katrina and Rita exposed significant flaws in US preparedness for catastrophic events and the nation's capacity to respond to them. These flaws were especially evident in the affected disaster areas' nursing homes, which house a particularly vulnerable population of frail older adults. Although evacuation of a healthcare facility is a key preparedness activity, there is limited research on factors that lead to effective evacuation. ⋯ We need to better understand how disaster plans can be adapted to meet the needs of frail elders and other residents in nursing homes. Moreover, we must address identified gaps in the scientific literature with respect to health outcomes by tracking outcomes over time. Information on health outcomes would allow administrators and others to more appropriately weigh the balance of risks and benefits associated with evacuation. Without this understanding of the relationship between evacuation and health outcomes, it is not possible to develop effective response plans that are tailored to meet the needs of nursing home residents.