Physical activity after a hip fracture : effect of a multicomponent home-based rehabilitation program - a secondary analysis of a randomized controlled trial

Objectives To investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over 1-year follow-up among older people recovering from a recent hip fracture. Design Secondary analysis of a randomized, controlled, parallel-group trial. Setting Home-based rehabilitation; measurements in university laboratory. Participants Community-dwelling people (N=81) aged ≥60 years recovering from a hip fracture. Participants were randomly assigned to an intervention (n=40) or a control (n=41) group, on average, 42±23 days after discharge from the hospital. Intervention A yearlong intervention included evaluation and …

Physical Activity After a Hip Fracture: Effect of a Multicomponent Home-Based Rehabilitation Program—A Secondary Analysis of a Randomized Controlled Trial

Objectives To investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over 1-year follow-up among older people recovering from a recent hip fracture. Design Secondary analysis of a randomized, controlled, parallel-group trial. Setting Home-based rehabilitation; measurements in university laboratory. Participants Community-dwelling people (N=81) aged ≥60 years recovering from a hip fracture. Participants were randomly assigned to an intervention (n=40) or a control (n=41) group, on average, 42±23 days after discharge from the hospital. Intervention A yearlong intervention included evaluation and …

Oral and Poster Papers Submitted for Presentation at the 5th Congress of the EUGMS “Geriatric Medicine in a Time of Generational Shift September 3–6, 2008 Copenhagen, Denmark

Effects of comprehensive geriatric intervention on physical performance among people aged 75 years and over.

Background and aims: We studied the effects of comprehensive geriatric assessment and multifactorial intervention on physical performance among older people. Methods: In a 3-year geriatric development project with an experimental design, 668 participants aged 75–98 were assigned to intervention (n=348) or control (n=320) groups. The intervention group received comprehensive geriatric assessment with an individually targeted intervention for 2 years. The outcome measures—performance in the Timed Up-and-Go (TUG), 10-meter walking and Berg Balance Scale tests 2 were gathered annually during the intervention and the 1-year follow-up after it. Results: With linear mixed models, over the 2-year i…

Health and Physical Function Predicting Strength and Balance Training Adoption: A Community-Based Study Among Individuals Aged 75 and Older

This study was conducted to determine the characteristics of health and physical function that are associated with not starting strength and balance training (SBT). The study population consisted of 339 community-dwelling individuals (75–98 years, 72% female). As part of a population-based intervention study they received comprehensive geriatric assessment, physical activity counseling, and had the opportunity to take part in SBT at the gym once a week. Compared with the SBT-adopters, the nonadopters (n = 157, 46%) were older and less physically active, had more comorbidities and lower cognitive abilities, more often had sedative load of drugs or were at the risk of malnutrition, had lower …

Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: a randomized controlled trial

Objective: To assess the effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people. In addition, the effectiveness of the geriatric intervention was evaluated among a subgroup of persons with musculoskeletal pain. Design: Three-year geriatric development project with randomized assignment to intervention and control group. Setting: Research centre, community and assisted living facilities. Participants: Seven hundred and eighty-one Finnish persons aged 75–98 years were assigned to an intervention ( n = 404) or control ( n = 377) group. Intervention: A comprehensive geriatric assessment with a multifactorial intervention lasting two ye…

Health condition and physical function as predictors of adherence in long-term strength and balance training among community-dwelling older adults

AIM: Strength and balance training (SBT) has remarkable health benefits, but little is known regarding exercise adherence in older adults. We examined the adherence to strength and balance training and determinants of adherence among ≥75 year old adults. METHODS: 182 community-dwelling individuals (aged 75-98 years, 71% female) began group-based SBT as part of a population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly study. Training was offered once a week for 2.3 years. Adherence was defined as the proportion of attended sessions relative to offered sessions. Participants were classified based on their adherence level into low (≤33.3%), moderate (33.4-66.5%) …

Analgesic use among community-dwelling people aged 75 years and older : a population-based interview study

Abstract Background: Pain is often underrecognized and undertreated among older people. However, older people may be particularly susceptible to adverse drug reactions linked to prescription and nonprescription analgesics. Objectives: The aims of this study were to assess the prevalence of analgesic use among a random sample of community-dwelling people aged ≥75 years, and to investigate factors associated with daily and as-needed analgesic use. Methods: A random sample of people aged ≥75 years was drawn from the population register in Kuopio, Finland, in November 2003. Data on prescription and nonprescription analgesic use were elicited during nurse interviews conducted once for each parti…

Psykoosilääkehoidon ohjaus voi tehostaa skitsofrenian hoitoa

Psykoosilääkkeet lievittävät skitsofrenian psykoosioireita ja vähentävät relapsiriskiä. Psykoosilääkityksen pitkäaikaiskäytön hyöty-haittasuhde skitsofrenian hoidossa on osin tuntematon. Etenkin suurten psykoosilääkeannosten pitkäaikaiskäyttö voi altistaa metabolisille, neurologisille, kognitiivisille ja psykologisille haitoille. Psykoosilääkehoidon haittoja voidaan minimoida systemaattisella lääkehoidon ohjauksella, jossa lääkehoito suunnitellaan ja toteutetaan moniammatillisessa yhteistyössä potilaan ja hänen läheistensä kanssa. Lääkehoidon ohjaus voi auttaa käyttämään pienintä vaikuttavaa hoitoannosta sekä parantaa hoitoon sitoutumista ja hoidon tuloksellisuutta. Skitsofrenian psykoosilä…

Association between Frailty and Dementia: A Population-Based Study

<b><i>Background:</i></b> Frailty is commonly considered as a syndrome with several symptoms, including weight loss, exhaustion, weakness, slow walking speed and physical inactivity. It has been suggested that cognitive impairment should be included in the frailty index, however the association between frailty and cognition has not yet been fully established. <b><i>Objective:</i></b> To investigate cross-sectionally whether frailty is associated with cognitive impairment or clinically diagnosed dementia in older people. <b><i>Methods:</i></b> The study included a total of<b> </b>654 persons aged 76-100 years…

Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older.

Background. Balance is among the most important prerequisites for safe and independent mobility. Whether musculoskeletal pain is related to standing balance impairment has received limited attention. The aim of this study was to examine the association of musculoskeletal pain with the control of balance in older people. Methods. A total of 605 participants aged 75 years and older (mean age 80.4, 71 % women) were interviewed about presence and severity of musculoskeletal pain. Balance was measured by a force platform, and impaired balance was defined as a high sway velocity moment or inability to maintain semitandem standing. Results. Musculoskeletal pain was reported by 48% of the participa…

Musculoskeletal pain and use of analgesics in relation to mobility limitation among community-dwelling persons aged 75 years and older

Pain and factors related to it constitute serious health problems in the older population. This populationbased cross-sectional study aimed to investigate whether musculoskeletal pain is associated with mobility limitation and whether the relationship between pain and mobility limitation varies according to the use of analgesics among community-dwelling older people. A total of 622 community-dwelling participants aged 75 years and older (mean age 80.4, 74% women) were interviewed about presence and severity of musculoskeletal pain. Self-reported analgesic drug utilization was verified against medical records. Mobility limitation was assessed by the Timed Up & Go test (TUG) time of >13.5 s o…

Impact of missing data mechanism on the estimate of change: a case study on cognitive function and polypharmacy among older persons

Piia Lavikainen,1,2 Esko Leskinen,3 Sirpa Hartikainen,1,2 Jyrki Möttönen,4 Raimo Sulkava,5 Maarit J Korhonen6 1Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland; 2School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; 3Department of Mathematics and Statistics, University of Jyväskylä, Jyväskylä, Finland; 4Department of Social Research, University of Helsinki, Helsinki, Finland; 5Department of Geriatrics, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; 6Department of Pharmacology, D…

Effects of comprehensive geriatric assessment-based individually targeted interventions on mobility of pre-frail and frail community-dwelling older people

Aim To assess the effects of comprehensive geriatric assessment (CGA)-based individually targeted interventions on the ability to walk 400 m in pre-frail or frail and non-frail community-dwelling older people. Methods A subgroups analysis of a population-based comparative study, the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) was carried out in the city of Kuopio, Finland, from 2004 to 2007. This study was based on data from 2005 to 2007. The present analysis included 605 community-dwelling older adults aged ≥76 years (mean age 80.9, 70% women), 314 in the intervention and 291 in the control group. Frailty status was assessed in 2005. Mobility was assessed b…

Long-term strength and balance training in prevention of decline in muscle strength and mobility in older adults

Background. Reductions in muscle strength and poor balance may lead to mobility limitations in older age. Aims. We assessed the effects of long-term once-weekly strength and balance training (SBT) on muscle strength and physical functioning in a community-based sample of older adults. Methods. 182 individuals [130 women and 52 men, mean age 80 (SD ± 3.9) years] underwent supervised SBT as part of the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly study. Training was offered once a week for 2.3 years. Isometric knee extension and flexion strength, chair rise, maximal walking speed, timed up and go (TUG) and Berg Balance Scale (BBS) were measured at baseline, after 2-ye…

Physical activity at age of 20-64 years and mobility and muscle strength in old age: a community-based study.

Background. Physical activity in midlife has been related to lower mortality and better health in old age. The present study evaluated whether physical activity at age of 20–64 years was associated with mobility and muscle strength in old age. Methods. A random sample of 1,000 persons was extracted from all the ≥75-year-old people living in Kuopio, Finland, and 679 community-dwelling participants were included in the present analyses. Data on health status, ability to walk outside or 400 m, and physical activity level were obtained through structured interviews. Participants’ walking speed, grip strength, and knee extension strength were measured by physiotherapists. Relationship between ph…

Comprehensive geriatric assessment decreases prevalence of orthostatic hypotension in older persons

Background: Orthostatic hypotension (OH) is associated with significant morbidity and mortality among older people. We have studied whether its prevalence can be reduced by a Comprehensive Geriatric Assessment (CGA). Study design and setting: 1000 randomly-selected persons aged ≥75 years were divided into intervention ( n = 500) and control groups ( n = 500). We focused on those subjects in whom an orthostatic blood pressure test had been performed at least once during the study period (2004–2007) ( n = 365 and 332 for intervention and control groups, respectively). A CGA, including evaluation of the adequacy of the medication, was performed annually in the intervention group but not in th…

S285 EFFECT OF COMPREHENSIVE GERIATRIC ASSESSMENT AND INDIVIDUALIZED INTERVENTION ON MOBILITY AMONG OLDER PERSONS WITH AND WITHOUT PAIN

Frailty as a predictor of all-cause mortality in older men and women

Aims To investigate the modifying effect of sex on the association between frailty and all-cause mortality, and to determine the effects of changes in frailty status on mortality. Methods This population-based study comprised 654 persons aged 76–100 years (mean age 82 ± 4.6 years). Frailty status was assessed at baseline in 2005, and reassessed in 2007 (n = 546) using the Cardiovascular Health Study criteria. Death dates were received from the official register until the end of 2009. The associations between frailty, changes in frailty and mortality were investigated using Cox regression models. Results At baseline, 93 (14%) participants were classified as frail, and 311 (48%) as pre-frail.…

Relationship between functional vision and balance and mobility performance in community-dwelling older adults

Background and Aims: Vision is an important prerequisite for balance control and mobility. The role of objectively measured visual functions has been previously studied but less is known about associations of functional vision. That refers to selfperceived vision-based ability to perform daily activities. The aim was to investigate the relationship between functional vision and balance and mobility performance in a community-based sample of older adults. Methods: This study is part of a Geriatric Multidisciplinary Strategy for the Good Care of the Elderly project (GeMS). Participants (576) aged 76 to 100 years (mean age 81 years, 70% women) were interviewed using a seven-item functional vis…