Patient- and tumor-related predictors of chemotherapy intolerance in older patients with cancer: A systematic review

Objective

The aim of this systematic review was to investigate patient-related factors (e.g. depressive symptoms, cognition, mobility, activities of daily living (ADL)) as well as tumor-related factors (e.g. tumor type, chemotherapy regimen) influencing chemotherapy intolerance in cancer patients aged 65?years or older.

Gender-specific associations between activities of daily living disability and depressive symptoms among older adults in China: Evidence from the China Health and Retirement Longitudinal Study

PurposeTo evaluate the associations between BADL/IADL disability and depressive symptoms from the perspective of gender among older adults in China.MethodsThis cross-sectional study used the data from the second wave of the China Health and Retirement Longitudinal Study (CHARLS). The sample included 3463 older adults aged 60 years and older across China. Multivariable logistic regression models were conducted.ResultsAmong 3463 older adults, 1240 (35.8%) were classified as depressed, the prevalence of BADL and IADL disabilities were 756 (21.8%) and 1194 (34.5%), respectively. After controlling for covariates, BADL/IADL disability was significantly associated with an increased risk of depression prevalence both in men and women among older adults. Compared with IADL independent, IADL disability was about two times more likely to develop depressive symptoms in men (OR = 2.165, 95% CI = 1.661–2.822), which was much higher than that in women (OR = 1.748, 95% CI = 1.415–2.160). In contrast, the odds of being depressed for women with BADL disability (OR = 1.824, 95% CI = 1.447–2.299) were much higher than the odds for men with BADL disability (OR = 1.791, 95% CI = 1.348–2.379).ConclusionsOlder adults with BADL/IADL disability were more likely to have depressive symptoms both for men and women. However, the associations between depressive symptoms and BADL/IADL disability were different in gender. Our results suggest that differential institutional care service and appropriate strategies for improvement in mental health are required.     

Perceived difficulty in everyday technology use among older adults with or without cognitive deficits

This study's purpose was comparing perceived relevance of and difficulty in use of everyday technology such as remote controls, cell phones, and microwave ovens, in older adults with/without cognitive deficits. Three groups included 157 participants; 34 had mild-stage dementia, 30 had mild cognitive impairment (MCI), and 93 lacked known cognitive impairments. Data were collected in structured interviews with the Everyday Technology Use Questionnaire (ETUQ). Analyses revealed that participants with no known cognitive deficits (Group 3) considered a higher proportion of technologies relevant to their life situation than participants with mild-stage dementia (Group 1) and those with MCI (Group 2). Furthermore, participants with no known cognitive deficits reported the lowest mean level of perceived difficulty in everyday technology use, followed by those with MCI and those with mild-stage dementia. All three groups differed significantly (p <0.01; p <0.001) in perceived difficulty using technology, indicating that measurement of perceived difficulty in everyday technology use may sensitively detect changes resulting from MCI/dementia. Findings indicate that perceived difficulty in using everyday technology increases in people with MCI and is accentuated in mild-stage dementia. This calls for increased attention to these issues when assessing functional ability in daily activities of older adults with possible MCI/dementia, and for further research.     

农村老年人抑郁状况评定及影响因素分析

目的 了解老人抑郁症状水平及其影响因素.方法 采用多阶段随机抽样方法,应用老年抑郁短量表( GDS-15)、Katz 日常生活活动量表(Katz-ADL)和Lawton 工具性日常生活活动量表(ADL)为评定工具,对济宁市≥65岁的504位老年人进行问卷调查.结果 男性老年人抑郁症状评分低于女性,分别为(2.24±2.12)分、(3.35±3.49)分(t’=4.236,P＜0.01);年龄、有无配偶、是否健身锻炼、睡眠质量、自评健康状况、生活状况、经济状况、孤独感觉不同的老年人抑郁症状评分差异显著;抑郁症状评分与孤独感觉、IADL、生活状况、经济状况、自评健康状况、年龄等因素密切相关;影响老年人抑郁症状评分的前5位因素为孤独、IADL、性别、自评健康状况、经济状况(F=27.47,P＜0.01,R2=0.372,R'2 =0.358),贡献率为35.8％.结论 孤独感觉、IADL、女性、自身健康状况、经济状况、单身是老年人抑郁症状的重要影响因素.提高老年人的工具性日常生活活动能力,有利于减少抑郁危险因素.     

Trends and variation in mild disability and functional limitations among older adults in Norway, 1986�C2008

An increase in the number of older adults may raise the demand for health and care services, whereas decreasing prevalence of disability and functional limitations among them might counteract this demographic effect. However, the trends in health are inconsistent between studies and countries. In this article, we estimated the trends in mild disability and functional limitations among older Norwegians and analyzed whether they differ between socio-demographic groups. Data were obtained from repeated cross-sectional surveys conducted in 1987, 1991, 1995, 2002, 2005, and 2008, in total 4,036 non-institutionalized persons aged 67 years or older. We analyzed trends using multivariate logistic regression. On average, the age-adjusted trend in functional limitations was −3.3% per year, and in disability 3.4% per year. The risk for functional limitations or disability was elevated for women compared to men, for married compared to non-married, and was inversely associated with educational level The trends were significantly weaker with increasing age for disabilities, whereas none of the trends differed significantly between subgroups of sexes, educational level or marital status. Both functional limitations free and disability-free life expectancy appeared to have increased more than total life expectancy at age 67 during this period. The analysis suggests downward trends in the prevalence of mild disability and functional limitations among older Norwegians between 1987 and 2008 and a compression of lifetime in such health states. The reduced numbers of older people with disability and functional limitations may have restrained the demand for health and care services caused by the increase in the number of older adults.     

A hierarchical categorisation of tasks in mobility disability

Purpose.?In the field of long-term care, disability usually refers to difficulties in instrumental activities of daily living (IADL) or basic activities of daily living (BADL); this term may also refer to difficulties in mobility for those more interested in preventive intervention or general health promotion. The aims of this study were to (1) categorise a complete set of mobility tasks according to a revealed hierarchy, and (2) examine the relationship between this mobility hierarchy and IADL/BADL disabilities.

Methods.?We categorised nine mobility tasks according to appearance order in self-reported difficulties data obtained from a Taiwanese national database of community-dwelling elders aged over 65. We also performed correlation tests to explore the relationships of these mobility tasks with six tasks each of IADL and BADL.

Results.?The results revealed a three-level hierarchy of mobility disability: (1) mild disability indicated by difficulties in four mobility tasks, which correlated with difficulty in one IADL task; (2) moderate disability indicated by difficulties in three mobility tasks, which correlated with difficulties in most IADL tasks; and (3) severe disability indicated by difficulties in two mobility tasks, which correlated with difficulties in all BADL tasks. The same hierarchy was observed for males and females.

Conclusions.?There is a clear hierarchical structure of mobility disability that correlates differently with IADL and BADL disabilities. These results suggest that different mobility tasks should be included in disability assessments to suit specific purposes.