Medicine and Health Sciences Commons^™

Evidence-Based Review Of Interventions For Medically At-Risk Older Drivers, Sherilenne Classen, Miriam Monahan, Beth Auten, Abraham Yarney

Miriam Monahan

OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions.

METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I 5 highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A 5 strongly recommend the intervention; B 5 recommend intervention is provided routinely; C 5 weak evidence that the intervention can improve outcomes; D 5 recommend not to provide the intervention; I 5 insufficient evidence to recommend for or against the intervention.

RESULTS. For clients with stroke, we recommend a graded simulator …

Examining Evidence Based Resistance Plus Balance Training In Community-Dwelling Older Adults With Complex Health Care Needs: Trial Protocol For The Muscling Up Against Disability Project., Justin W L Keogh, Tim Henwood, Paul Gardiner, Anthony Tuckett, Brent Hodgkinson, Kevin Rouse

Justin Keogh

Progressive resistance plus balance training (PRBT) has been demonstrated as effective in reducing later life physical disability, falls risk and poor health, even among those with complex health care needs. However, few studies have examined the influence of PRBT on health service utilisation, cognitive wellbeing and training modality acceptance or undertaken a cost benefit analysis. This project will investigate the broad scope benefits of PRBT participation among community-dwelling older Australians receiving Government supported aged care packages for their complex health care needs. Using a modified stepped-wedge design, 248 community-dwelling adults 65 years and older with some level of government support …

For Low-Income Adults Who Experience Trouble With One Or More Activities Of Daily Living (Adl) Or Two Or More Instrumental Activities Of Daily Living (Iadl), Does The Community Aging In Place: Advancing Better Living For Elders (Capable) Improve Performance Of Adls And Iadls?, Noelle Bakken, Lauryn Banovitz, Abigail Lafrenz, Kitsum Li

Kitsum Li

The growing population of older adults has created a societal shift, with many older adults preferring to stay in their homes for a longer period of time. This trend, known as aging-inplace, may provide greater independence and autonomy to older adults compared with those living in nursing homes. However, physical and cognitive changes associated with age may affect the ability to safely perform activities of daily living (ADL) and instrumental activities of daily living (IADL). This study examined performance in ADLs and IADLs, fall efficacy, and quality of life in 40 low-income, community dwelling adults aged 65 and older. Participants …

Do Restorative Home Care Programs Increase Independence In Adls And Iadls In Older Adults Receiving Home Health Services?, Adrienne Angeles, Shanee Ben-Haim, Amy Smith-Schwartz, Kitsum Li

Kitsum Li

There has been a worldwide shift from viewing aging as a dependent stage of life to one that increasingly encourages independence and a more active lifestyle for older adults. In Australia, where this study was conducted, restorative care that embraces active aging was not yet considered an essential component of home health care on the national level. However, restorative home care has been gaining more recognition as increasing importance is placed on independence and self-management in older adults. The researchers of this study explored whether older adults’ participation in restorative home care programs reduced the need for ongoing personal care. …

Does A Multicomponent Home Intervention Reduce Functional Difficulties In Community-Dwelling Older Adults As Compared To No Intervention?, Laura Henty-Clark, Rosemarie Lion, Nadine Marcelo, Kitsum Li

Kitsum Li

Many older adults live with chronic conditions that may affect their ability to safely perform their daily occupations. Small decreases in ability of older adults to function independently can have profound effects, possibly leading to hospitalization, institutionalization, or death. However, preventative home-based interventions for older adults typically are not reimbursed by Medicare or other insurance carriers. This study on intervention effectiveness contributes to a growing body of evidence for providing preventative home-based intervention to older adults to support their abilities to function independently in their communities. This study examined whether a preventative home-based intervention, including occupational therapy and physical therapy, …

Effect Of Dual Tasking On Walking Over Even And Uneven Surfaces In Functionally Independent Community Older Adults, Olajide L. Kolawole

Olajide L Kolawole

While several studies have reported a decrement in performance by older adults while walking and concurrently performing a dual task on even surfaces, to date the effects of dual tasking while walking on uneven surfaces commonly found in the community has received less attention. Thus, we sought to test the hypothesis that an incremental decrement in gait parameters will be observed, when walking on an uneven versus an even surface and furthermore, that this decrement would be dependent upon the concurrent performance of a secondary cognitive and/or motor task in functionally independent-living-community older adults. Dynamic Gait Index assessed the subject’s …

Validity Of Boston Marathon Qualifying Times, Paul M. Vanderburgh

Paul M. Vanderburgh

Purpose: To assess the validity of Boston Marathon qualifying (BMQ) standards for men and women. Methods: Percent differences between BMQ and current world records (WR) by sex and age group were computed. WR was chosen as the criterion comparison because it is not confounded by intensity, body composition, lifestyle, or environmental factors. A consistent difference across age groups would indicate an appropriate slope of the age-vs-BMQ curve. Inconsistent differences were corrected by adjusting BMQ standards to achieve a uniform percentage difference from WR. Results: BMQ standards for men were consistently ~50% slower than WR (mean 51.5% ± 1.4%, range 49.6–54.4%), …

Perceived Barriers, Benefits And Motives For Physical Activity: Two Primary-Care Physical Activity Prescription Programs, Asmita Patel, Grant M. Schofield, Gregory S. Kolt, Justin Keogh

Justin Keogh

This study examined whether perceived barriers, benefits, and motives for physical activity differed based on allocation to 2 different types of primary-care activity prescription programs (pedometer-based vs. time-based Green Prescription). Eighty participants from the Healthy Steps study completed a questionnaire that assessed their perceived barriers, benefits, and motives for physical activity. Factor analysis was carried out to identify common themes of barriers, benefits, and motives for physical activity. Factor scores were then used to explore betweengroups differences for perceived barriers, benefits, and motives based on group allocation and demographic variables. No significant differences were found in factor scores based on …

Sarcopenia In Older Adults, Timothy Henwood, Justin Keogh, Mike Climstein

Justin Keogh

Extract:Sarcopenia is a little acknowledged geriatric syndrome associated with significant health care and personal burden (Janssen et al 2004). Defined by an age associated loss in muscle mass and function (either muscle strength or physical performance), sarcopenia is a known precursor to later life disability (Cruz-Jentoft et al 2010). Across the lifespan, an adult can expect a 35% loss in muscle size and 50% loss in muscle strength that will significantly reduce their capacity to undertake activities of daily living, and increase their risk of falls due to reduced balance capacity and core strength (Bean et al 2002).

Sarcopenia In Older Adults, Timothy Henwood, Justin Keogh, Mike Climstein

Mike Climstein

Extract:
Sarcopenia is a little acknowledged geriatric syndrome associated with significant health care and personal burden (Janssen et al 2004). Defined by an age associated loss in muscle mass and function (either muscle strength or physical performance), sarcopenia is a known precursor to later life disability (Cruz-Jentoft et al 2010). Across the lifespan, an adult can expect a 35% loss in muscle size and 50% loss in muscle strength that will significantly reduce their capacity to undertake activities of daily living, and increase their risk of falls due to reduced balance capacity and core strength (Bean et al 2002).

Physical Function And Health-Related Quality Of Life Of Older Adults Undergoing Hospital Rehabilitation: How Strong Is The Association?, Steven Mcphail, Elaine Beller, Terry Haines

Elaine Beller

Extract:To the Editor: When an elderly patient has a first-time presentation of psychiatric symptoms, a physical cause should be suspected. In geriatric practice, these symptoms are often due to delirium, cognitive decline, or a mood disorder. The present case history illustrates the importance of further investigation when geriatric assessment alone cannot explain the symptoms sufficiently.