Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Jonkman, Nini H.; Panta, Vieri Del; Hoekstra, Trynke; Colpo, Marco; Schoor, Natasja M. van; Bandinelli, Stefania; Cattelani, Luca; Helbostad, Jorunn L.; Vereijken, Beatrix; Pijnappels, Mirjam; Maier, Andrea B.

doi:10.1159/000485135

Cited by 63 publications

(54 citation statements)

References 40 publications

(47 reference statements)

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“…Also, this study shows that the probability of disability increases with age regardless of the early onset or late onset of disability. No group of older people could live independently with their physical functions being not affected by increasing age in the long term, different from previous research [2,21,25,26], yet consistent with LG Martin, Z Zimmer and J Lee [23]. This may be because the follow-up time of this study was long; those without physical limitations at baseline may eventually develop functional decline in the late period of follow-up.…”

Section: Resultscontrasting

confidence: 48%

“…3 here] We identi ed two distinct IADL disability trajectory groups (late-onset and early-onset) representing respectively 67.7% and 32.3% of the population. Previous studies based on different study populations have identi ed three or more trajectory groups [2,[21][22][23][24][25][26]. The difference in numbers of trajectory groups may stem from different study populations, measurements of disability, or modelling methods.…”

Section: Resultsmentioning

confidence: 99%

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Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

Liao¹,

Chang²

2020

Preprint

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Objectives This study aims to identify the age trajectories of disability in instrumental activities of daily life (IADLs) over 11 years and their correlates, and to estimate disability-free life expectancy for identified trajectory groups in middle-aged and older adults. Methods We included 3,118 participants aged 50 and over without IADL limitations at baseline from the Taiwan Longitudinal Study in Aging, followed across 1996–2007. We used group-based trajectory models to identify age trajectories of IADL disability, and multiple logistic regressions to examine their correlates. Sullivan method was used to compute IADL disability-free life expectancy for trajectory groups at different ages. Results We identified two trajectories groups: 67.7% of participants classified as the late-onset group and 32.3% as the early-onset group. Female (adjusted odds ratio [aOR]: 1.93, 95% confidence interval [95% CI]: 1.54, 2.41), not being employed (aOR: 1.30, 95% CI: 1,08, 1,56), poor/fair self-rated health (aOR: 1.31, 95% CI:1.09, 1.58), hypertension (aOR: 1.32, 95% CI: 1.07, 1.63), diabetes mellitus (aOR: 2.29, 95% CI: 1.72, 3.07), arthritis (aOR: 1.42, 95% CI: 1.11, 1.81), stroke (aOR: 2.21, 95% CI: 1.04, 4.70), and one-point increase in a 10-item depression scale (aOR: 1.04, 95% CI: 1.02, 1.06) were associated with early-onset of disability, whereas higher education (aOR: 0.59, 95% CI: 0.42, 0.81), regular physical activity (aOR: 0.76, 95% CI: 0.62, 0.93), and participating voluntary or club activities (aOR: 0.78, 95% CI: 0.65, 0.93) related to the late-onset. IADL disability-free life expectancies at 65 years old in the late-onset group were 15.6 years for women and 14.4 for men, respectively, comprising 56.6% and 64.2% of their remaining life, whereas those of the early-onset group were 4.8 and 4.6 years for women and men respectively, comprising 22.5% and 27.2% of remaining life. Conclusions Early-onset of IADLs disability may correlate to chronic conditions, and interventions to increase employment, physical activity and social participation are warranted to extend health expectancy.

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Section: Resultscontrasting

confidence: 48%

Section: Resultsmentioning

confidence: 99%

Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

Liao¹,

Chang²

2020

Preprint

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“…Higher muscle strength is protective against declining below the threshold where dependence in ADL and IADL occurs . In community‐dwelling older adults, physical performance measured by gait speed has been shown to be a strong predictor of ADL disability . Similarly, low muscle mass, muscle strength, and gait speed have all been associated with an impaired ability to perform ADL and IADL .…”

Section: Introductionmentioning

confidence: 99%

“…14 In community-dwelling older adults, physical performance measured by gait speed has been shown to be a strong predictor of ADL disability. 15,16 Similarly, low muscle mass, muscle strength, and gait speed have all been associated with an impaired ability to perform ADL and IADL. 17,18 Currently, there are no systematic review and/or meta-analyses that quantifies the association between muscle mass, muscle strength, and physical performance as predictors of ADL and IADL dependence.…”

Section: Introductionmentioning

confidence: 99%

Muscle mass, strength, and physical performance predicting activities of daily living: a meta‐analysis

Wang

Yao

Zirek

et al. 2019

J cachexia sarcopenia muscle

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384

258

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Background Activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are essential for independent living and are predictors of morbidity and mortality in older populations. Older adults who are dependent in ADLs and IADLs are also more likely to have poor muscle measures defined as low muscle mass, muscle strength, and physical performance, which further limit their ability to perform activities. The aim of this systematic review and meta‐analysis was to determine if muscle measures are predictive of ADL and IADL in older populations. Methods A systematic search was conducted using four databases (MEDLINE, EMBASE, Cochrane, and CINAHL) from date of inception to 7 June 2018. Longitudinal cohorts were included that reported baseline muscle measures defined by muscle mass, muscle strength, and physical performance in conjunction with prospective ADL or IADL in participants aged 65 years and older at follow‐up. Meta‐analyses were conducted using a random effect model. Results Of the 7760 articles screened, 83 articles were included for the systematic review and involved a total of 108 428 (54.8% female) participants with a follow‐up duration ranging from 11 days to 25 years. Low muscle mass was positively associated with ADL dependency in 5/9 articles and 5/5 for IADL dependency. Low muscle strength was associated with ADL dependency in 22/34 articles and IADL dependency in 8/9 articles. Low physical performance was associated with ADL dependency in 37/49 articles and with IADL dependency in 9/11 articles. Forty‐five articles were pooled into the meta‐analyses, 36 reported ADL, 11 reported IADL, and 2 reported ADL and IADL as a composite outcome. Low muscle mass was associated with worsening ADL (pooled odds ratio (95% confidence interval) 3.19 (1.29–7.92)) and worsening IADL (1.28 (1.02–1.61)). Low handgrip strength was associated with both worsening ADL and IADL (1.51 (1.34–1.70); 1.59 (1.04–2.31) respectively). Low scores on the short physical performance battery and gait speed were associated with worsening ADL (3.49 (2.47–4.92); 2.33 (1.58–3.44) respectively) and IADL (3.09 (1.06–8.98); 1.93 (1.69–2.21) respectively). Low one leg balance (2.74 (1.31–5.72)), timed up and go (3.41 (1.86–6.28)), and chair stand test time (1.90 (1.63–2.21)) were associated with worsening ADL. Conclusions Muscle measures at baseline are predictors of future ADL and IADL dependence in the older adult population.

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“…The PreventIT project (Early risk detection and prevention in ageing people by self-administered ICT-supported assessment and a behavioural change intervention, delivered by use of smartphones and smartwatches) is a European Horizon 2020 Information and Communication Technology (ICT) and personal health project. The aim is to develop and test a personalised behaviour change intervention on PA aimed at young older adults that has the potential to prevent accelerated functional decline at older age 16…”

Section: Introductionmentioning

confidence: 99%

Protocol for the PreventIT feasibility randomised controlled trial of a lifestyle-integrated exercise intervention in young older adults

et al. 2019

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IntroductionThe European population is rapidly ageing. In order to handle substantial future challenges in the healthcare system, we need to shift focus from treatment towards health promotion. The PreventIT project has adapted the Lifestyle-integrated Exercise (LiFE) programme and developed an intervention for healthy young older adults at risk of accelerated functional decline. The intervention targets balance, muscle strength and physical activity, and is delivered either via a smartphone application (enhanced LiFE, eLiFE) or by use of paper manuals (adapted LiFE, aLiFE).Methods and analysisThe PreventIT study is a multicentre, three-armed feasibility randomised controlled trial, comparing eLiFE and aLiFE against a control group that receives international guidelines of physical activity. It is performed in three European cities in Norway, Germany, and The Netherlands. The primary objective is to assess the feasibility and usability of the interventions, and to assess changes in daily life function as measured by the Late-Life Function and Disability Instrument scale and a physical behaviour complexity metric. Participants are assessed at baseline, after the 6 months intervention period and at 1 year after randomisation. Men and women between 61 and 70 years of age are randomly drawn from regional registries and respondents screened for risk of functional decline to recruit and randomise 180 participants (60 participants per study arm).Ethics and disseminationEthical approval was received at all three trial sites. Baseline results are intended to be published by late 2018, with final study findings expected in early 2019. Subgroup and further in-depth analyses will subsequently be published.Trial registration numberNCT03065088; Pre-results.

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Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Cited by 63 publications

References 40 publications

Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

Muscle mass, strength, and physical performance predicting activities of daily living: a meta‐analysis

Protocol for the PreventIT feasibility randomised controlled trial of a lifestyle-integrated exercise intervention in young older adults

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