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Intellectual activity and likelihood of subsequently improving or maintaining instrumental activities of daily living functioning in community-dwelling older Japanese: a longitudinal study
- Authors:
- FUJIWARA Yoshinori, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(6), June 2009, pp.547-555.
- Publisher:
- Wiley
This study aimed to test the a priori hypothesis that increase or maintenance of the level of cognitive activity would be independently associated with a subsequent beneficial impact (i.e. improvement or maintenance) on instrumental activity of daily living (IADL) functioning. An observational study was carried out using 4-year longitudinal data from 1477 community-dwelling Japanese who were 66 years and older and living in Yoita town, a rural community located in the northwest along the Sea of Japan. Baseline assessment occurred in November 2000. Intellectual Activity and IADL were evaluated using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence. Results showed that an Increase or maintenance of exposure to intellectual activities over a period of 2 years was associated with increased likelihood of better IADL functioning trajectory (i.e. improvement or stability) over the subsequent 2 years, even after adjustment for major confounders. The authors conclude that this study documented a longitudinal, independent association of exposure to intellectual activities with better IADL functioning over time. These findings provide preliminary support for promotion of exposure to intellectual activities among older adults as an opportunity to prevent disability in the older segment of the population. Assessment of public health programs targeting such an opportunity is warranted.
Dementia care: a practical photographic guide
- Authors:
- GREALY James, MCMULLEN Helen, GREALY Julia
- Publisher:
- Blackwell
- Publication year:
- 2005
- Pagination:
- 188p.
- Place of publication:
- Oxford
Illustrated guide to caring for people with dementia in care homes. It presents practical prevention and management techniques for resistance to care in common activities of daily living, explores cognitive loss, physical loss and sensory loss in dementia, and examines means of improving communication with those with dementia to enhance their understanding of their environment and improve their compliance in care.
Perceptions of older people in Ireland and Australia about the use of technology to address falls prevention
- Authors:
- MACKENZIE Lynette, CLIFFORD Amanda
- Journal article citation:
- Ageing and Society, 40(2), 2020, pp.369-388.
- Publisher:
- Cambridge University Press
Falls are common events with serious consequences for older people. With an ageing population and increasing health-care costs, information and communication technologies (ICT) will have a potential role in future health-care delivery. However, research on technology acceptance in health care for older people is limited and its application to falls prevention is unknown. The aims of this study were to explore and describe the perceptions of community-dwelling Australian and Irish older people about their current use of technology, and the potential use of technology for falls prevention. Qualitative data were collected from three focus groups conducted in and around Limerick in Ireland, and three in the Sydney area, Australia. A total of 35 older people participated. Data were analysed using thematic analysis. Four themes emerged from the data: (a) perceptions of vulnerability to falls, (b) preferences for exercise interventions, (c) participation in and ownership of technology, and (d) perceptions about applications of technology for falls prevention. As the use of technology is an instrumental activity of daily living, health professionals need to assess the capacity of older people to adopt these technologies, and provide falls prevention interventions to accommodate the technology skills of older people. Some participants were reluctant to embrace technology and barriers to the effective use of technology to assist in preventing falls may conflict with future health service trends. (Publisher abstract)
Room to improve: the role of home adaptations in improving later life
- Author:
- CENTRE FOR AGEING BETTER
- Publisher:
- Centre for Ageing Better
- Publication year:
- 2017
- Pagination:
- 14
- Place of publication:
- London
This report summarises the findings from an evidence review on how home adaptations can improve later lives and provides recommendations to improve access to, and delivery of, home adaptation and repair services. It shows that both minor and major home adaptations are an effective intervention to improve outcomes for people in later life, including improved performance of everyday activities, improved mental health and preventing falls and injuries. It also identifies good evidence that greatest outcomes are achieved when individuals and families are involved in the decision-making process, and when adaptations focus on individual goals. Based on the findings, the report makes recommendations for commissioners and service provides. These include for Local Sustainability and Transformation partnerships to put in place preventative strategies to support people at risk in their home environment; for local authorities to make use of the Disabled Facilities Grant to fund both major and minor adaptations; and for local authorities to ensure people have access to information and advice on how home adaptations could benefit them, in line with the Care Act 2014. (Edited publisher abstract)
The role of home adaptations in improving later life
- Authors:
- POWELL Jane, et al
- Publisher:
- Centre for Ageing Better
- Publication year:
- 2017
- Pagination:
- 40
- Place of publication:
- London
A systematic review of evidence on the effectiveness and cost effectiveness on how home adaptations can contribute in helping older people to maintain their independence for as long as possible and what works best to improve the health and wellbeing. Conducted by a team from the University of the West of England, the review covered peer-reviewed literature and professional and practitioner-led grey literature published between 2000 and 2016. It found evidence that both minor and major home adaptations can improve outcomes for people in later life, including improved performance of everyday activities, improved mental health and preventing falls and injuries. It also identified good evidence that greatest outcomes are achieved when individuals and families are involved in the decision-making process, and when adaptations focus on individual goals. It also found strong evidence that minor home adaptations are an effective and cost-effective intervention. The report also includes analysis from the Building Research Establishment which shows that home interventions to prevent falls on stairs, can lead to savings of £1.62p for every £1 spent. Based on the findings, the report makes recommendations for commissioners and service provides. These include for Local Sustainability and Transformation partnerships to put in place preventative strategies to support people at risk in their home environment; for local authorities to make use of the Disabled Facilities Grant to fund both major and minor adaptations; and for local authorities to ensure people have access to information and advice on how home adaptations could benefit them, in line with the Care Act 2014. (Edited publisher abstract)
Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a scoping review of the literature and international policies
- Authors:
- PUTS Martine T.E., et al
- Journal article citation:
- Age and Ageing, 46(3), 2017, pp.383-392.
- Publisher:
- Oxford University Press
Background: Frailty impacts older adults’ ability to recover from an acute illness, injuries and other stresses. Currently, a systematic synthesis of available interventions to prevent or reduce frailty does not exist. The authors conducted a scoping review of interventions and international policies designed to prevent or reduce the level of frailty in community-dwelling older adults. Methods and analysis: Using the framework of Arksey and O'Malley, the authors systematically searched articles and grey literature to identify interventions and policies that aimed to prevent or reduce the level of frailty. Results: Fourteen studies were included: 12 randomised controlled trials and 2 cohort studies (mean number of participants 260 (range 51–610)), with most research conducted in USA and Japan. The study quality was moderate to good. The interventions included physical activity; physical activity combined with nutrition; physical activity plus nutrition plus memory training; home modifications; prehabilitation (physical therapy plus exercise plus home modifications) and comprehensive geriatric assessment (CGA). The review showed that the interventions that significantly reduced the number of frailty markers present or the prevalence of frailty included the physical activity interventions (all types and combinations), and prehabilitation. The CGA studies had mixed findings. Conclusion: Nine of the 14 studies reported that the intervention reduced the level of frailty. The results need to be interpreted with caution, as only 14 studies using 6 different definitions of frailty were retained. Future research could combine interventions targeting more frailty markers including cognitive or psychosocial well-being. (Edited publisher abstract)
Associations between cognitively stimulating leisure activities, cognitive function and age-related cognitive decline
- Authors:
- FERRERIA Nicola, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(4), 2015, pp.422-430.
- Publisher:
- Wiley
Objectives: Emerging literature suggests that lifestyle factors may play an important role in reducing age-related cognitive decline. There have, however, been few studies investigating the role of cognitively stimulating leisure activities in maintaining cognitive health. This study sought to identify changes in cognitive performance with age and to investigate associations of cognitive performance with several key cognitively stimulating leisure activities. Method: Over 65,000 participants provided demographic and lifestyle information and completed tests of grammatical reasoning, spatial working memory, verbal working memory and episodic memory. Results: Regression analyses suggested that frequency of engaging in Sudoku or similar puzzles was significantly positively associated with grammatical reasoning, spatial working memory and episodic memory scores. Furthermore, for participants aged under 65 years, frequency of playing non-cognitive training computer games was also positively associated with performance in the same cognitive domains. The results also suggest that grammatical reasoning and episodic memory are particularly vulnerable to age-related decline. Further investigation to determine the potential benefits of participating in Sudoku puzzles and non-cognitive computer games is indicated, particularly as they are associated with grammatical reasoning and episodic memory, cognitive domains found to be strongly associated with age-related cognitive decline. Conclusions: Results of this study have implications for developing improved guidance for the public regarding the potential value of cognitively stimulating leisure activities. The results also suggest that grammatical reasoning and episodic memory should be targeted in developing appropriate outcome measures to assess efficacy of future interventions, and in developing cognitive training programmes to prevent or delay cognitive decline. (Publisher abstract)
Determining the effectiveness of a falls prevention programme to enhance quality of life: an occupational therapy perspective
- Authors:
- TOLLEY Louise, ATWAL Anita
- Journal article citation:
- British Journal of Occupational Therapy, 66(6), June 2003, pp.269-276.
- Publisher:
- Sage
Falling are common in older people and are associated with mortality, decreased mobility, premature nursing home admissions and a reduced ability to perform activities of daily living. In an attempt to reduce the incidence of falls, the National Service Framework for Older People has emphasised the need to develop falls services that provide support for older people who have fallen and use health promotion initiatives. This article reports the findings of an evaluation of a multifaceted falls prevention programme, which aimed to determine whether occupational therapy could enhance quality of life by educating people aged 65 years and over about the risk of falls. A pre-intervention and post-intervention non-standardised self-administered questionnaire was completed at week 1 and at week 14. Of the 172 older people attending the falls prevention programme, 45 percent completed both questionnaires. The findings from this study suggest that an occupational therapy falls prevention programme can reduce the impact of falls on older people by enhancing confidence to perform activities, which in turn can increase quality of life. However, further research is needed to determine the effectiveness of anxiety management techniques.
The lived experience of bathing adaptations in the homes of older adults and their carers (BATH‐OUT): a qualitative interview study
- Authors:
- WHITEHEAD Phillip J., GOLDING‐DAY Miriam R.
- Journal article citation:
- Health and Social Care in the Community, 27(6), 2019, pp.1534-1543.
- Publisher:
- Wiley
The onset of disability in bathing may be followed by disability in other daily activities for older adults. A bathing adaptation usually involves the removal of a bath or inaccessible shower and replacement with a level, easy access shower. The purpose is to remove the physical environmental barriers and restore older adults’ ability to bathe safely and/or independently. The aim of this study was to explore the views and experiences of older adults and their carers who had received a bathing adaptation in order to examine how the adaptation had affected them and identify mechanisms of impact and outcomes from their perspectives. The study was nested within a feasibility Randomised Controlled Trial (RCT) (BATH‐OUT) conducted within one local authority housing adaptations service in England. Semi‐structured interviews were completed between 21 December 2016 and 19 August 2017 with 21 older adults and five carer participants of the feasibility RCT. Interview participants were purposively sampled on living arrangement and gender. Interviews were audio‐recorded, transcribed verbatim and analysed in seven stages using framework analysis. Findings were presented thematically. Five themes were identified: ease of use; feeling safe; feeling clean; independence, choice and control; and confidence and quality of life. The removal of the physical barriers in the bathroom led to older adults re‐mastering the activity of bathing, having an improved sense of physical functioning which gave a sense of ‘freedom’. This appeared to impact a range of areas contributing to a wider sense of increased confidence consistent with constructs underpinning social care‐related quality of life. This study suggests that future research should examine housing adaptations from a person–environment fit approach, and that timely restoration of bathing ability is especially important as it can affect confidence and perceived competence in other areas of daily living. (Edited publisher abstract)
Home visits for prevention of impairment and death in older adults: a systematic review
- Authors:
- GRANT Sean, et al
- Journal article citation:
- Campbell Systematic Reviews, 10(1), 2014, pp.1-85.
- Publisher:
- Wiley
Home visits by health and social care professionals aim to prevent cognitive and functional impairment, thus reducing institutionalisation and prolonging life. This systematic review sought to assess the evidence on the effectiveness of preventive home visits for older adults (65+ years) and to identify factors that may moderate effects. Searches were conducted on the following databases: British Nursing Index and Archive, C2-SPECTR, CINAHL, CENTRAL, EMBASE, IBSS, Medline, Nursing Full Text Plus, PsycINFO, and Sociological Abstracts. Randomised controlled trials enrolling persons without dementia aged over 65 years and living at home; and those interventions that were not directly related to recent hospital discharge were included. Sixty-four studies with 28,642 participants were included. Evidence was assessed in relation to whether home visits: reduced absolute mortality; numbers of people who were institutionalised or hospitalised; numbers of people who fell; quality of life; and functioning. The authors were unable to identify reliable effects of home visits. It is possible that some home visiting programmes have beneficial effects for community-dwelling older adults, but poor reporting of how interventions and comparisons were implemented prevents more robust conclusions. (Edited publisher abstract)