METHODS: First, challenges for seniors, including chronic diseases and other limitations associated with old age, are specified. Second, a review of seniors' needs and concerns is performed. Finally, solutions that can improve seniors' quality of life are discussed. Publications obtained from the following databases are used in this scoping review: Web of Science, PubMed, and Science Direct. Four independent reviewers screened the identified records and selected relevant publications published from 2010 to 2017. A total of 1916 publications were selected. In all, 52 papers were selected based on abstract content. For further processing, 21 full papers were screened."
RESULTS: The results indicate disabilities as a major problem associated with seniors' activities of daily living dependence. We founded seven categories of different conditions - psychological problems, difficulties in mobility, poor cognitive function, falls and incidents, wounds and injuries, undernutrition, and communication problems. In order to minimize ageing consequences, some areas require more attention, such as education and training; technological tools; government support and welfare systems; early diagnosis of undernutrition, cognitive impairment, and other diseases; communication solutions; mobility solutions; and social contributions.
CONCLUSIONS: This scoping review supports the view on chronic diseases in old age as a complex issue. To prevent the consequences of chronic diseases and other limitations associated with old age related problems demands multicomponent interventions. Early recognition of problems leading to disability and activities of daily living (ADL) dependence should be one of essential components of such interventions.
METHODS: The modified SPEED or M-SPEED is a sequence prediction algorithm, which modified the previous SPEED algorithm by using time duration of appliance's ON-OFF states to decide the next state. M-SPEED discovered periodic episodes of inhabitant behavior, trained it with learned episodes, and made decisions based on the obtained knowledge.
RESULTS: The results showed that M-SPEED achieves 96.8% prediction accuracy, which is better than other time prediction algorithms like PUBS, ALZ with temporal rules and the previous SPEED.
CONCLUSIONS: Since human behavior shows natural temporal patterns, duration times can be used to predict future events more accurately. This inhabitant activity prediction system will certainly improve the smart homes by ensuring safety and better care for elderly and handicapped people.
METHODS: Forty older participants were equally assigned to a supervised exercise program (group-I) or a home exercise program (group-II). Each participant performed the exercise program for 35-45 minutes, two times per week for four months. Balance indices and isometric muscle strength were measured with the Biodex Balance System and Hand-Held Dynamometer. Functional activities were evaluated by the Berg Balance Scale (BBS) and the timed get-up-and-go test (TUG).
RESULTS: The mean values of the Biodex balance indices and the BBS improved significantly after both the supervised and home exercise programs (P < 0.05). However, the mean values of the TUG and muscle strength at the ankle, knee and hip improved significantly only after the supervised program. A comparison between the supervised and home exercise programs revealed there were only significant differences in the BBS, TUG and muscle strength.
CONCLUSIONS: Both the supervised and home exercise training programs significantly increased balance performance. The supervised program was superior to the home program in restoring functional activities and isometric muscle strength in older participants.
INTRODUCTION: This service improvement project aimed to improve detection of incidental vertebral fractures on routine imaging. It embedded a vertebral fracture identification service (Optasia Medical, OM) on routine computerised tomography (CT) scans performed in this hospital as part of its Fracture Liaison Service (FLS).
METHODS: The service was integrated into the hospital's CT workstream. Scans of patients aged ≥ 50 years for 3 months were prospectively retrieved, alongside their clinical history and the CT report. Fractures were identified via OM's machine learning algorithm and cross-checked by the OM radiologist. Fractures identified were then added as an addendum to the original CT report and the hospital FLS informed. The FLS made recommendations based on an agreed algorithm.
RESULTS: In total, 4461 patients with CT scans were retrieved over the 3-month period of which 850 patients had vertebra fractures identified (19.1%). Only 49% had the fractures described on hospital radiology report. On average, 61 patients were identified each week with a median of two fractures. Thirty-six percent were identified by the FLS for further action and recommendations were made to either primary care or the community osteoporosis team within 3 months of fracture detection. Of the 64% not identified for further action, almost half was because the CT was part of cancer assessment or treatment. The remaining were due to a combination of only ≤ 2 mild fractures; already known to a bone health specialist; in the terminal stages of any chronic illness; significant dependency for activities of daily living; or a life expectancy of less than 12 months CONCLUSION: It was feasible to integrate a commercial vertebral fracture identification service into the daily working of a FLS. There was a significant increase in workload which needs to be considered by any future FLS planning to incorporate such a service into their clinical practice.
DESIGN: This study was a two-arm within-participants trial with 4- and 12-wk follow-ups. Allocation ratio was 1:1, and pretraining and posttraining measurements were included. A total number of 25 healthy older adults were enrolled (mean = 63.32, SD = 4.44). Participants were randomly allocated into two conditions: (a) prospective memory training: participants underwent a multicomponent prospective memory training, and (b) control: participants were not contacted during the training phase. After the training phase was finished, participants crossed over to undergo the condition they did not experience before. The differences between pretraining and posttraining measures of prospective memory, activities of daily living, negative mood (depression), and anxiety were assessed. All changes in the measurements were analyzed using general linear method. This trial is registered at https://www.isrctn.com (#ISRCTN57600070).
RESULTS: Multicomponent prospective memory training program was significantly effective on both subjective and objective prospective memory performances among healthy older adults. Moreover, the training had significant positive effects on activities of daily living (independence) among participants. In addition, negative mood and anxiety levels were reduced after the training was finished.
CONCLUSIONS: This multicomponent prospective memory training improved prospective memory performance and activities of daily living and reduce negative mood (depression) and anxiety levels among healthy older adults.
Methods: A retrospective review was performed of all diplegic and quadriplegic patients with unilateral hip displacement treated with either bilateral or unilateral hip reconstructive surgery. Radiographic parameters [migration percentage (MP), pelvic obliquity angle (POA) and migration percentage difference (MPD)] and changes in functional ability (sitting, standing and walking) were evaluated and compared between the 2 groups. Failure was defined as post-operative MP>40%, POA>5° and MPD>30%.
Results: Eighteen patients had unilateral hip reconstruction and 42 patients had bilateral hip reconstruction. Mean age of 87 months and 90 months and means follow-up of 38 months and 40 months respectively. Post-operative MP was significant in both groups. However, of 18 patients in unilateral hip reconstruction group, 33.3% of patients had contralateral hip subluxation and 22.2% of patients had hip failure on the operated hip; compared to only one of 42 patients had hip failure and no contralateral hip problem in the other group. For assessment of pelvic symmetry, MPD was significantly improved in both group but POA was only significant in bilateral group. Overall functional improvement was significant in patients with bilateral hip reconstruction compared to unilateral group.
Conclusion: Bilateral hip reconstruction in unilateral displacement had shown to have better outcome in correcting unstable hip and pelvic asymmetry, thus provide good sitting balance and improvement in overall functional outcome.
METHODS: We used the 11-item Duke Social Support Index to assess perceived social support through a face-to-face interview. Higher scores indicate better social support. Linear regression analysis was carried out to determine the factors that influence perceived social support by adapting the conceptual model of social support determinants and its impact on health.
RESULTS: A total of 3959 respondents aged ≥60 years completed the Duke Social Support Index. The estimated mean Duke Social Support Index score was 27.65 (95% CI 27.36-27.95). Adjusted for confounders, the factors found to be significantly associated with social support among older adults were monthly income below RM1000 (-0.8502, 95% CI -1.3523, -0.3481), being single (-0.5360, 95% CI -0.8430, -0.2290), no depression/normal (2.2801, 95% CI 1.6666-2.8937), absence of activities of daily living (0.9854, 95% CI 0.5599-1.4109) and dependency in instrumental activities of daily living (-0.3655, 95% CI -0.9811, -0.3259).
CONCLUSION: This study found that low income, being single, no depression, absence of activities of daily living and dependency in instrumental activities of daily living were important factors related to perceived social support among Malaysian older adults. Geriatr Gerontol Int 2020; 20: 63-67.
Methods: Fifty-seven participants were assessed for their demographics and functional ability relating to the requirement for walking devices, including the Timed Up and Go Test (TUGT) and lower limb loading during sit-to-stand (LLL-STS).
Results: Thirty-five participants (61%) used a walking device, particularly a standard walker, for daily walking. More than half of them (n = 23, 66%) had potential of walking progression (i.e., safely walk with a less-support device than the usual one). The ability of walking progression was significantly associated with a mild severity of injury, increased lower-limb muscle strength, decreased time to complete the TUGT, and, in particular, increased LLL-STS.
Conclusion: A large proportion of ambulatory individuals with SCI have the potential for walking progression, which may increase their level of independence and minimise the appearance of disability. Strategies to promote LLL-STS are important for this progression.