Factors Affecting Quality of Life of the Homebound Elderly Hemiparetic Stroke Patients

[Purpose] This study examined the quality of life (QOL) of homebound elderly hemiparetic stroke patients and factors that affect it. [Subjects] The subjects of the study were 21 homebound elderly hemiparetic stroke patients who were 65 years old or over and required care for daily living (12 males and 9 females, average age: 79.3 ± 8.4 years old). Their physical and psychological conditions, QOL, and other characteristics were researched. [Methods] The Functional Independence Measure (FIM) was used for the activities of daily living (ADL) assessment, and the MOS 36-Item Short-Form Health Survey (SF-36, Japanese version 1.2) was used for the QOL assessment. [Results] No correlations were observed between the QOL of homebound elderly hemiparetic stroke patients and their age and gender. However, the results showed that their QOL was affected by their independence in ADL, bedridden degree, and care-need level. [Conclusion] These results suggest that in order to improve the QOL of homebound elderly hemiparetic stroke patients, ongoing rehabilitation to improve independence in ADL and lower the bedridden degree and care-need level is required.Key words: QOL, Homebound elderly hemiparetic stroke patients, ADL     

The relationship between fear of falling,activities of daily living and quality of life among elderly individuals

Abstract The purpose of the present study was to examine the relationship between functional disability and fear of falling during daily activities. Also examined was the relationship between fear of falling and health-related Quality of Life (QOL). Health-related QOL concepts were measured using the Short Form 36 Health Survey (SF-36) within an elderly day services sample. Eligible subjects were elderly persons using Day Service (type B) who were capable of independently answering a questionnaire and had no memory problems. Forty-three males and 92 females were eligible for this study. Forty-nine (36.3%) subjects expressed no fear of falling, whereas 22 (16.3%) reported that they were very fearful of falling. Among females, walking and bathing had a highly significant relationship with the fear of falling. The fear of falling can contribute to psychological conditions such as depression, and also impacts on the health-related QOL of frail elderly people. Thus, it is critical to provide integrated health care activities for these individuals that address both psychological well-being and physical functioning.     

Cross-cultural adaptation of the Satisfaction and Recovery Index among Japanese people with musculoskeletal disorders

[Purpose] The primary aim was to cross-culturally adapt the Satisfaction and Recovery Index (SRI) among Japanese people. The secondary aim was to preliminarily investigate the convergent validity of the SRI with the SF-12v2^® Health Survey among ambulatory patients with musculoskeletal disorders. [Participants and Methods] A provisional Japanese SRI was developed after forward and backward translations and confirmation from its original developer. This study included 30 outpatients diagnosed with musculoskeletal disorders at an orthopedic clinic in Japan. All participants underwent the SF-12v2^® Health Survey and the provisional Japanese SRI. They were then asked to provide comments about the provisional Japanese SRI. Pearson’s r was calculated to examine the convergent validity between the SF-12v2^® Health Survey scores and the provisional Japanese SRI scores. [Results] The provisional Japanese SRI was accepted as the final version due to no serious concerns raised by the participants. Only the mental component scores of the SF-12v2^® Health Survey had a statistically significant correlation (r=0.45), indicating partial evidence of the convergent validity of the provisional Japanese SRI. [Conclusion] This study developed the Japanese SRI with preliminary validity evidence among ambulatory patients with musculoskeletal disorders.     

Effects of a Task-specific Exercise Program on Balance,Mobility, and Muscle Strength in the Elderly

[Purpose] The aim of this study was to investigate the effects of a task-specific exercise program based on motor learning on balance ability and strength of the lower extremity in the elderly with/without falling experiences. [Subjects and Methods] Individuals who had experiences of falling over 2 times within the past 6 months were included in the falling group. The task-specific exercise program consisted of 3 stages (weeks 1–2, 3–4, and 5–6) and was conducted according to the level of difficulty in this study. [Results] The scores of the Korean version of the Activities-Specific Balance Confidence Scale and Performance-Oriented Mobility Assessment were significantly changed in both the falling group and non-falling group after the task-specific exercise program. In comparisons between the falling group and non-falling group, there were also significant differences in the Korean version of the Activities-Specific Balance Confidence Scale and muscle strength of the semitendinosus and gastrocnemius. [Conclusion] The task-specific exercise program has a positive effect on balance ability and muscle strength related to falls in the elderly.Key words: Falling, Task-specific exercise, Elderly people     

Quality of life in Chinese women with gynaecological cancers

 Sixty-two Hong Kong Chinese women with gynaecological cancers participated in this cross-sectional study to assess their quality of life (QOL). Chinese versions of the World Health Organisation Quality of Life Measure – abbreviated version, the Profile of Mood States, and the Sexual Relationships subscale of the Psychosocial Adjustment to Illness Scale were used. Qualitative data were collected about the meaning of QOL and the areas of life most affected by the cancer and its treatments. The overall QOL was found to be moderate (mean 92.4, SD 16.34), with the domains of psychological health and social relationships most affected. The distressed facets of life were related to pain, dependency, finances, sexuality, psychological health and spirituality. Mobility, accepting one's outlook, social support and "eating" were areas considered by these women to contribute to a better QOL. The meaning of QOL was described in terms of happiness and material resources. The overall mood score was found to be impaired (mean 43.84, SD 32.31), with relatively high scores for depression, anger and tension. Depression could explain 45% of the variance in the QOL. Despite some missing data, sexual relationships among the respondents were moderately affected, with reduced sexual desire and activity. However, the patients' relationships with their husbands were minimally affected, suggesting the men's understanding and support in the cancer trajectory of their wives. Areas of life that may need further support, such as sexual functioning and psychosocial adjustment, could be improved by the use of sex therapy or group support interventions. Limitations of the present study and suggestions for future research are discussed. Published online: 10 May 2000     

Investigation of psychometric properties of the Falls Efficacy Scale using Rasch analysis in patients with hemiplegic stroke

[Purpose] The purpose of this study was to investigate the psychometric properties of the Falls Efficacy Scale using Rasch analysis in patients with hemiplegic stroke. [Subjects] Fifty-five community-dwelling hemiplegic stroke patients were selected as participants. [Methods] Data were analyzed using the Winsteps program (version 3.62) with the Rasch model to confirm the unidimensionality through item fit, reliability, and appropriateness of the rating scale. [Results] There were no misfit persons or items. Furthermore, infit and outfit statistics appeared adjacent. The person separation value was 3.07, and the reliability coefficient was 0.90. The reliability of all items was at an acceptable level for patients with hemiplegic stroke. [Conclusion] This was the first study to investigate the psychometric properties of the Falls Efficacy Scale using Rasch analysis. The results of this study suggest that the 6-point Falls Efficacy Scale is an appropriate tool for measuring the self-perceived fear of falling in patients with hemiplegic stroke.Key words: Falls Efficacy Scale, Hemiplegic stroke, Rasch analysis     

Japanese elderly persons walk faster than non-Asian elderly persons: a meta-regression analysis

[Purpose] The purpose of this study was to clarify ethnic differences in walking speed by comparing walking speed in both Japanese and non-Asian elderly individuals and to investigate the necessity of consideration of ethnic differences in walking speed. [Subjects and Methods] Articles that reported comfortable walking speeds for community-dwelling elderly individuals were identified from electronic databases. Articles that involved community-dwelling individuals who were 60 years old or older and well functioning were included in the study. Articles that involved Asians were excluded. Weighted means for 5-m walking times were calculated as walking speeds from the Japanese and non-Asian sample data. The effects of age, gender, and ethnicity on 5-m walking times were then investigated using meta-regression analysis. [Results] Twenty studies (34 groups) were included for Japanese, and 16 studies (28 groups) were included for non-Asians. The weighted mean 5-m walking time was estimated to be 4.15 sec (95% confidence interval [CI]: 3.87–4.44) for Japanese and 4.24 sec (95% CI: 4.09–4.40) for non-Asians. Furthermore, using meta-regression analysis adjusted for age and gender, the 5-m walking time was 0.40 sec faster (95% CI: 0.03–0.77) for Japanese than for non-Asian elderly individuals. [Conclusion] Walking speed appeared faster for Japanese community-dwelling elderly individuals than for non-Asian elderly individuals.Key words: Meta-regression analysis, Walking speed, Ethnicity     

社区老年人生活空间水平现状及影响因素分析

目的 调查合肥市社区老年人生活空间水平的现况,并分析其影响因素。方法 采用方便抽样法于2022年2—8月抽取合肥市6个社区1 288名老年人为研究对象,使用一般资料调查表、害怕跌倒评估、汉化版生活空间测评量表（LSA-C）、简易衰弱量表（FRAIL）、中文版老年抑郁量表（GDS-30）进行调查。结果 社区老年人生活空间总分为（63.54±20.83）分,526名（40.8%）老年人存在生活空间受限。多元线性回归结果显示：年龄、性别、共病数量、有无久坐爱好、害怕跌倒、抑郁程度、衰弱状态是社区老年人生活空间水平的影响因素（均P<0.05）,共解释总变异的50.9%。结论 社区老年人生活空间处于中等水平,且生活空间受限发生率较高。建议社区医务人员重点关注高龄、女性老人、共病数量多、有久坐爱好、害怕跌倒、抑郁及衰弱老年人的生活空间状况,并制定针对性干预策略以扩大老人生活空间、提高晚年生活质量。     

Effect of Whole Body Vibration Exercise in the Horizontal Direction on Balance and Fear of Falling in Elderly People: A Pilot Study

[Purpose] The purpose of the present study was to investigate the effects of whole body vibration exercise in the horizontal direction on balance and fear of falling in the elderly. [Methods] This study was a case series of 17 elderly individuals. Participants performed whole body vibration exercise in the horizontal direction using a whole body vibration device for 15 minutes a day, 3 times a week, for 6 weeks. At baseline and after the 6-week intervention, balance was measured using the Berg Balance Scale and Timed Up and Go test, and fear of falling was assessed using the Falls Efficacy Scale. [Results] After the intervention, significant improvements from baseline values in the Berg Balance Scale, Timed Up and Go test, and Falls Efficacy Scale were observed in the study participants. [Conclusion] Elderly individuals who performed whole body vibration exercise in the horizontal direction showed significant improvements in balance and fear of falling. However, the observed benefits of whole body vibration exercise in the horizontal direction need to be confirmed by additional studies.Key words: Whole body vibration, Elderly, Balance     

社区老年冠心病患者的生活质量及其影响因素

目的评估社区老年冠心病患者的生活质量(quality of life,QOL),分析影响其QOL的相关因素。方法采用问卷对山西省太原市某社区90例老年冠心病患者和90例健康老年人进行调查,该问卷由健康调查问卷、西雅图心绞痛问卷、社会支持量表和人口社会学资料组成。结果社区老年冠心病患者的健康简表评分在8个维度比健康老年人群低(P<0.05),其中生理职能维度下降最明显;影响QOL的因素有生理功能的改变、心理精神因素和社会支持。结论老年冠心病患者的生活质量明显低于健康老年人群,造成社区老年冠心病患者QOL下降的主要因素是生理功能改变导致的日常生活受限,人口社会学因素对QOL的改变也有一定程度的影响。     

Factors associated with health-related quality of life in PACE participants

Health-related quality of life (HRQoL) is an important measure of how health and illness affect the lives of older adults. This study aimed to determine the relationship between frailty, fear of falling, and depression with HRQoL in nursing home eligible community-dwelling older adults. A cross-sectional correlational design and chart review were conducted. Eighty four participants (mean age = 70.33 [SD = 6.33]) were surveyed on frailty, fear of falling, depression and physical and mental health measures of HRQoL. Increased frailty, fear of falling, and depression were associated with decreased physical and mental health and well-being. When controlling for sociodemographics, frailty and fear of falling were predictive of lower physical health and well-being whereas depression was independently predictive of lower mental health and well-being. The results of this study will assist in assessment and targeted interventions for modifiable risk factors that affect the HRQoL of nursing home eligible community-dwelling older adults.     

老年人社会支持情况与生活质量的关系

背景:美国简明健康测量量表中文版与中国老年人生活质量调查表,哪个更能反映中国老年人的社会支持情况与其生活质量的相关性?目的:分析和探讨老年人社会支持情况对其生活质量的影响。设计:随机抽样,以人群为基础的横断面调查研究。地点、对象和方法:采用社会支持评定量表(socialsupportreviewques-tionnaire,SSRS,MOSSF-36)和老年人生活质量调查表对苏州市167名离退休人员进行自评调查。主要观察指标:苏州市167名离退休人员SSRS,MOSSF-36,老年人生活质量调查评定结果。结果:用MOSSF-36量表测出的生活质量中的活力和精神健康与该老年人群的社会支持情况的主观支持相关,其余均与社会支持情况不相关。中国老年人生活质量调查表测出的生活质量总分和家庭和睦、社会交往、生活满意度与该老年人群的社会支持情况显著正相关,其中生活质量总分和家庭和睦、社会交往、生活满意度与主观支持显著正相关;家庭和睦、居住条件和生活满意度与客观支持显著正相关;心理卫生与支持利用度显著正相关。结论:对于中国老年人的社会支持情况是与其生活质量密切相关的因素,中国老年人生活质量调查表在社会支持方面较SF-36中文版量表更敏感、更明显。     

Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation

[Purpose] The aim of the present study was to investigate the effects of core stability exercise (CSE) on the physical and psychological functions of elderly women while negotiating general obstacles. [Subjects and Methods] After allocating 10 elderly women each to the core stability training group and the control group, we carried out Performance-Oriented Mobility Assessment (POMA) and measured crossing velocity (CV), maximum vertical heel clearance (MVHC), and knee flexion angle for assessing physical performances. We evaluated depression and fear of falling for assessing psychological functions. [Results] Relative to the control group, the core stability training group showed statistically significant overall changes after the training session: an increase in POMA scores, faster CV, lower MVHC, and a decrease in knee flexion angle. Furthermore, depression and fear of falling decreased significantly. [Conclusion] CSE can have a positive effect on the improvement of physical and psychological performances of older women who are vulnerable to falls as they negotiate everyday obstacles.Key words: Core stabilization exercises, Elderly women, Falls     

Fear of falling from a daily life perspective; narratives from later life

Fear of falling is a well-known condition in later life. The aim of this study was to illuminate the experiences and the meaning of fear of falling in a daily-life context. The method used was a qualitative study inspired by interpretive phenomenology. In narrative interviews, five community-dwelling women over 80 years of age told about their fear of falling from a daily-life perspective. The overall thematic analysis resulted in three main themes: the meaning of managing daily life necessities; keeping in contact with the outside; living with fear. The findings showed that to live with fear of falling was to discipline daily life, and to learn to live with the challenge of a vulnerable bodily condition and of losing control at different levels: from falling, from incontinence, from dirt and from the stigma of being in a humiliating situation. The women created a perception of independence while they were dependent on help and community care and on news from the outside. At an existential level, they coped with their fear by strengthening their will. The conclusion was that the older women studied accepted the condition of fear of falling. They shared the ability to cope in various ways with the limitations of their bodily capacity and their imbalance.     

Gait speed and related factors in Parkinson’s disease

[Purpose] The aim of this study was to investigate the relationship between gait speed and various factors in ambulatory patients with idiopathic Parkinson’s disease. [Subjects] Fifty ambulatory patients with idiopathic Parkinson’s disease who were admitted to an outpatient clinic were included in this cross-sectional study. [Methods] The Hoehn and Yahr Scale was used for measurement of the disease severity. Gait speed was measured by the 10-Meter Walk Test. Mobility status was assessed by Timed Up and Go Test. The Hospital Anxiety and Depression Scale was used for evaluation of emotional state. Cognitive status was examined with the Mini-Mental State Examination. The Downton Index was used for fall risk assessment. Balance was evaluated with the Berg Balance Scale. Comorbidity was measured with the Cumulative Illness Rating Scale. The 36-Item Short Form Health Survey was completed for measurement of quality of life. [Results] The mean age was 66.7 (47–83) years. Twenty-eight (56%) patients were men. Gait speed was correlated positively with height, male gender, Mini-Mental Examination score, Berg Balance Scale score and physical summary scores of the 36-Item Short Form Health Survey. On the other hand, there was a negative correlation between gait speed and age, disease severity, TUG time, Downton Index, fear of falling, previous falls and the anxiety and depression scores of the Hospital Anxiety and Depression Scale. There was no correlation between gait speed and comorbidity. [Conclusion] The factors related with the slower gait speed are, elder age, clinically advanced disease, poor mobility, fear of falling, falling history, higher falling risk, and mood disorder.Key words: Gait, Fear of falling, Parkinson’s disease     

The relationship between frailty and motor function among living in the community elderly females

[Purpose] This study aimed to investigate the prevalence of frailty among community-dwelling elderly females, and to examine its relation to motor function and the main risk factors of frailty. [Participants and Methods] The participants were 67 community-dwelling elderly females, aged 76.2 ± 7.7 years. We performed measurements of physical parameters, motor functions (such as grip strength), timed up and go test (TUG), walking speed, and frailty (measured using the Kihon Checklist [KCL]). [Results] KCL scores were 31.3%, 31.3%, and 37.3% in the frailty, pre-frailty, and robust groups, respectively. The frailty group was older than the pre-frailty and robust groups. Additionally, the different groups showed significant differences in grip strength, TUG, and walking speed. The highest median KCL score was for depression, followed by physical function. As a results, frailty was evident even among health-conscious elderly people. [Conclusion] It is essential to identify frailty at an early stage and identify its preventive factors, in order to extend the healthy life expectancy of the local population.     

Reproducibility and validity of the 50-meter walking test in community-dwelling elderly

[Purpose] This study aimed to investigate the reproducibility and validity of the 50-m walking test. [Subjects] Reproducibility was investigated in 19 community-dwelling elderly women (mean age, 76.3 years), and validity was investigated in 31 community-dwelling elderly individuals (12 men and 19 women; mean age, 75.7 years). [Methods] The time taken to walk 50 m, the time taken to walk each 10-m section (laps 1–5), the time taken to walk 10 m, and grip strength were measured. In addition, the functional reach test (FRT), one-leg standing test, and timed up and go (TUG) test were performed. [Results] In a reproducibility analysis, the interclass correlation coefficient (1,1) was 0.97. In a Bland-Altman analysis, no systematic error was found. The measured values from the 50-m walking test included a measurement error of 1.5 s, and the acceptable margin of error was confirmed to be 3.1 s. In a validity analysis, the 50-m walking test score was significantly correlated with the 10-m walking and TUG test scores. [Conclusion] Our results suggest that the 50-m walking test score may be a useful index of the walking ability of community-dwelling elderly.Key words: 50-meter walk test, Reproducibility, Validity     

Effects of a water-based program on women 65 years and over: a randomised controlled trial

The purpose of this study was to assess the effects of a water-based exercise and self-management program on balance, fear of falling, and quality of life in community-dwelling women 65 years of age or older with a diagnosis of osteopenia or osteoporosis. Fifty women with an average age of 73.3 years (range 65.5-82.4, SD 3.9) were randomised to intervention or control groups. The intervention group received a 10-week water-based exercise and self-management program compiled by Community Physiotherapy Services and conducted by a physiotherapist at an aquatic centre twice a week for one hour. The control group did not receive any instructions and were not encouraged to change their physical activity, activities of daily living or social habits during the study. Change in balance, measured using the step test, from baseline to follow-up differed between intervention and control groups, with mean (95% CI) between-group differences of 1.7 (0.9 to 2.6) and 2.1 (1.1 to 3.1) steps on the left and right sides respectively. Between-group differences in score changes were also significant in four of the eight domains of quality of life measured using the Short Form 36 questionnaire (SF36; physical function 8.6 (0.4 to 16.8), vitality 12.0 (2.3 to 21.8), social function, and 14.1 (0.6 to 27.7) mental health 10.2 (2.0 to 18.4)), but not fear of falling measured using the modified falls efficacy scale (0.25 (-0.3 to 0.81). It is concluded that a water-based exercise and self-management program produced significant changes in balance and quality of life, but not fear of falling, in this group of community-dwelling women 65 years of age or older with a diagnosis of osteopenia or osteoporosis.     

Survival rate and causes of mortality in the elderly with depression: a 15-year prospective study of a Japanese community sample, the Matsunoyama-Niigata suicide prevention project.

OBJECTIVE: To compare long-term survival rates and causes of death in community-dwelling elderly with and without depression using the International Research Diagnostic Criteria administered by a psychiatrist. METHOD: From 1985 to 2000, we prospectively examined Japanese persons (N = 920) aged 65 years or older. Cases with depression (n = 158) and a control sample without depression (N = 762) were evaluated. The main outcome variables were survival rates and causes of mortality. RESULTS: By 2000, 61% of the subjects with depression had died. By contrast, 48% had died in the control group at the completion of the 15-year follow-up. Using age-adjusted Kaplan-Meier survival analysis, we found a hazard ratio (HR) of 1.49 (95% confidence interval [CI] 1.16-1.89) for mortality in the depressed group compared with controls (p = .0009). Importantly, in female subjects with depression, the HR was 1.55 (95% CI 1.16-2.07; p = .002). In males with depression, by contrast, the HR (1.34) was not significant (95% CI 0.84-2.13; p = .19). Significantly more subjects died of cerebrovascular disorders, malignant tumors, respiratory disorders, or suicide after the onset of depression compared with controls (p < .05). CONCLUSIONS: Depression appears to be associated with a significant increase in the risk of mortality among elderly Japanese subjects, particularly in females. The elderly with a diagnosis of depression may be at an elevated risk of mortality owing to cerebrovascular disorder, malignant tumors, respiratory disorders, or suicide. These prospective data provide a new quantitative insight on gender differences and the long-term public health significance of depression among the community-dwelling elderly.