Archives of gerontology and geriatrics
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Arch Gerontol Geriatr · Sep 2014
The prediction of disability by self-reported physical frailty components of the Tilburg Frailty Indicator (TFI).
Disability is an important health outcome for older persons; it is associated with impaired quality of life, future hospitalization, and mortality. Disability also places a high burden on health care professionals and health care systems. Disability is regarded as an adverse outcome of physical frailty. ⋯ The other three components of the physical frailty subscale of the TFI (poor balance, poor hearing, poor vision) together did not predict disability. Low physical activity predicted both total and ADL disability, and slowness both total and IADL disability. In conclusion, self-report assessment using the physical subscale of the TFI aids the prediction of future ADL and IADL disability in older persons two and a half years later.
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Arch Gerontol Geriatr · Sep 2014
Randomized Controlled Trial Comparative StudyA randomized trial comparing Tai Chi with and without cognitive-behavioral intervention (CBI) to reduce fear of falling in community-dwelling elderly people.
The aim of this randomized trial was to compare the effects of Tai Chi with and without CBI on a primary outcome of reducing the fear of falling, and on secondary outcomes including encouraging better social engagement, improving self-perceived personal wellbeing, and achieving better mobility among elderly people with fear of falling. One hundred and twenty-two community-dwelling elderly people aged ≥ 65 were randomly assigned to either a Tai Chi or a Tai Chi plus CBI group. Participants' level of fear of falling, physical mobility, self-perceived personal wellbeing and social participation were compared before and after completing the 8-week intervention and then at a 2-month follow-up. ⋯ Apart from a slight improvement in participants' self-perceived personal wellbeing, other outcome effects were similar for Tai Chi with and without CBI. This finding raises a question about the additive effects of combined intervention over Tai Chi alone in reducing elderly people's fear of falling. In view of the higher demand for resources and manpower to implement a combined intervention, further study is still required to confirm the potential additional benefits of this combined intervention prior to recommending it to community services.
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Arch Gerontol Geriatr · Sep 2014
A novel scale predicting postoperative delirium (POD) in patients undergoing cerebrovascular surgery.
The purpose of this study was to develop and test a scale for predicting POD in patients undergoing cerebrovascular surgery. ⋯ The present scale is a promising a tool for predicting POD but needs to be studied further.
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Arch Gerontol Geriatr · Jul 2014
Association of dementia with early rehospitalization among Medicare beneficiaries.
Preventable hospital readmissions have been recognized as indicators of hospital quality, a source of increased healthcare expenditures, and a burden for patients, families, and caregivers. Despite growth of initiatives targeting risk factors associated with potentially avoidable hospital readmissions, the impact of dementia on the likelihood of rehospitalization is poorly characterized. Therefore, the primary objective of this retrospective cohort study was to investigate whether dementia was an independent predictor of 30-day readmissions. ⋯ Nearly 20% of admissions (n=5133) were followed by a readmission within thirty days. Hospitalizations of beneficiaries with a dementia diagnosis were more likely to be followed by a readmission within thirty days (adjusted odds ratio (AOR) 1.18; 95% CI, 1.08, 1.29), compared to hospitalizations of those of without dementia. Controlling for discharge site of care did not attenuate the association (AOR 1.21; 95% CI, 1.10, 1.33).
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Arch Gerontol Geriatr · Jul 2014
Meta AnalysisMeta-analysis of risk factors for the second hip fracture (SHF) in elderly patients.
This study aims to quantitatively summarize the risk factors for the incidence of SHF. A meta-analysis was performed with the data obtained from 22 relevant papers published in Pubmed, Embase and Cochrane central database (all through January 2014) following strict selection. ⋯ Our meta-analysis indicated the significant risk factors for SHF were female (OR, 1.46; 95%CI, 1.29-1.66), living in institutions (OR, 2.23; 95%CI, 1.29-3.83), osteoporosis (Singh index (SI) 1-3) (OR, 10.02; 95%CI, 5.41-18.57), low vision (OR, 2.09; 95%CI, 1.06-4.12), dementia (OR, 1.89; 95%CI, 1.47-2.43), Parkinson (OR, 2.90; 95%CI, 1.41-5.95), cardiac diseases (OR, 1.32; 95%CI, 1.02-1.70) and respiratory disease (OR, 1.97; 95%CI, 1.16-3.32). Related strategies must be implemented on those involved with above-mentioned medical conditions to effectively prevent a SHF.