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  • 1
    Online Resource
    Online Resource
    Social Support and Functional Decline in the Oldest Old
    S. Karger AG ; 2022
    In:  Gerontology Vol. 68, No. 2 ( 2022), p. 200-208
    Details
    In: Gerontology, S. Karger AG, Vol. 68, No. 2 ( 2022), p. 200-208
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 Longitudinal studies investigating the link between social support and functional decline are limited among the oldest old. Thus, the aim of this study was to examine whether changes in social support are associated with functional decline among the oldest old longitudinally using panel regression models. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Longitudinal data from 3 waves (waves 7, 8, and 9) of a multicenter prospective cohort study covering primary care patients aged ≥85 years were used. In the analytical sample, 〈 i 〉 n 〈 /i 〉 equaled 624 individuals. The validated Lawton and Brody Instrumental Activities of Daily Living (IADL) scale and the well-established Barthel Index (ADL) were used to quantify functional status. The psychometrically sound Lubben Social Network Scale was used to measure social support. Several potential confounders such as age, marital status, cognitive decline, or depressive symptoms were included in the fixed effects (FE) regression models. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Linear FE regressions showed that a decrease in social support is associated with functional decline (IADL: β = 0.03, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.05; ADL: β = 0.27, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.05) in men but not in women. With IADL as outcome measure, the interaction term (sex × social support) achieved statistical significance ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.01). With regard to covariates, functional decline (IADL and ADL) was consistently associated with increasing age, an increase in the number of chronic conditions (except for women [ADL]), and cognitive decline (except for men [ADL] ). Furthermore, functional decline (ADL) was associated with an increase in depressive symptoms. 〈 b 〉 〈 i 〉 Discussion: 〈 /i 〉 〈 /b 〉 Our findings highlight the meaning of social support for functional status among the oldest old. Finding ways to sustain social support in highest age may be a promising approach in order to postpone functional decline.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    URL: Article
    DOI: 10.1159/000516077
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1482689-6
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  • 2
    Online Resource
    Online Resource
    Associations between Dementia Outcomes and Depressive Symptoms, Leisure Activities, and Social Support
    S. Karger AG ; 2014
    In:  Dementia and Geriatric Cognitive Disorders Extra Vol. 4, No. 3 ( 2014-12-10), p. 481-493
    Details
    In: Dementia and Geriatric Cognitive Disorders Extra, S. Karger AG, Vol. 4, No. 3 ( 2014-12-10), p. 481-493
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Social relations and depressive symptoms are intertwined. They both predict subsequent dementia, but only few studies on the association between social life aspects and subsequent dementia exist. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The risk of subsequent dementia was estimated over 2 follow-up assessments, each 18 months apart, depending on leisure activity, social support (general scale and the 3 factors emotional support, practical support, and social integration), and depressive symptoms, using proportional hazard models in a cohort of elderly patients (n = 2,300, with a mean age of 82.45 years) recruited for the study by their general practitioners. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Higher depressive symptoms and lower cognitive and physical activity were associated with an increased risk of subsequent all-cause dementia and Alzheimer's dementia (AD). While neither social engagement nor the general social support scale was associated with subsequent dementia, a higher level of social integration was associated with a lower dementia risk. In combined models, the results for activity variables remained similar, but the strength of the association between depressive symptoms and the subsequent risk of dementia decreased, and the association with social integration disappeared. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Depressive symptoms increased and activity variables decreased the risk of subsequent dementia; however, activity variables, namely cognitive and physical activity, partly mediated the effect of depressive symptoms on the subsequent risk of all-cause dementia and AD. In many cases, social support was not associated with a risk of subsequent dementia.
    Type of Medium: Online Resource
    ISSN: 1664-5464
    URL: Article
    DOI: 10.1159/000368189
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 2621464-7
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  • 3
    Online Resource
    Online Resource
    Malperformance in Verbal Fluency and Delayed Recall as Cognitive Risk Factors for Impairment in Instrumental Activities of Daily Living
    S. Karger AG ; 2011
    In:  Dementia and Geriatric Cognitive Disorders Vol. 31, No. 1 ( 2011), p. 81-88
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 31, No. 1 ( 2011), p. 81-88
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Maintaining independence in instrumental activities of daily living (IADL) is crucial for older adults. This study explored the association between cognitive and functional performance in general and in single IADL domains. Also, risk factors for developing IADL impairment were assessed. 〈 i 〉 Methods: 〈 /i 〉 Here, 3,215 patients aged 75–98 years were included. Data were collected during home visits. 〈 i 〉 Results: 〈 /i 〉 Cognitive functioning was associated with IADL both cross-sectionally and longitudinally. Regarding the single IADL domains cross-sectionally, executive functioning was especially associated with shopping, while episodic memory was associated with responsibility for own medication. 〈 i 〉 Conclusion: 〈 /i 〉 Reduced performance in neuropsychological tests is associated with a greater risk of current and subsequent functional impairment.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000323315
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1482186-2
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  • 4
    Online Resource
    Online Resource
    Frailty and Autonomy among the Oldest Old: Evidence from the Multicenter Prospective AgeCoDe-AgeQualiDe Study
    S. Karger AG ; 2021
    In:  Gerontology Vol. 67, No. 5 ( 2021), p. 591-598
    Details
    In: Gerontology, S. Karger AG, Vol. 67, No. 5 ( 2021), p. 591-598
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 There is a lack of studies examining the link between perceived autonomy and frailty among the oldest old. Therefore, our objective was to fill this gap. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Data were used from the multicenter prospective cohort study “Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)” (AgeQualiDe; follow-up [FU] wave 9; 〈 i 〉 n 〈 /i 〉 = 510 observations in the analytical sample). The average age was 90.3 years (SD: 2.7 years). The Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (CFS) was used to assess frailty. Socioeconomic and health-related covariates were included in our regression model. The autonomy scale developed by Schwarzer was used to assess perceived autonomy in old age. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Adjusting for various confounders, multiple linear regressions showed that lower perceived autonomy was associated with increased levels of frailty (total sample: β = −0.13, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; women: β = −0.14, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; and men: β = −0.12, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). Furthermore, lower perceived autonomy was associated with more depressive symptoms, higher cognitive impairment, and being institutionalized (except for men) in the total sample and in both sexes, but it was not significantly associated with age, sex, marital status, educational level, and social support. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Findings indicate that frailty is associated with lower autonomy among the oldest old. More generally, while health-related factors were consistently associated with autonomy, sociodemographic factors (except for being institutionalized) were not associated with autonomy among the oldest old. We should be aware of the strong association between autonomy and physical as well as mental health in very old age.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    URL: Article
    DOI: 10.1159/000514170
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1482689-6
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  • 5
    Online Resource
    Online Resource
    Factors Leading to Institutionalization among the Oldest Old: Longitudinal Findings from the AgeCoDe-AgeQualiDe Study
    S. Karger AG ; 2022
    In:  Gerontology Vol. 68, No. 8 ( 2022), p. 894-902
    Details
    In: Gerontology, S. Karger AG, Vol. 68, No. 8 ( 2022), p. 894-902
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the 〈 i 〉 oldest old 〈 /i 〉 longitudinally. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Longitudinal data (follow-up [FU] wave 7–9) were gathered from a multicenter prospective cohort study (“Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+] ,” AgeQualiDe). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85–100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00–0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04–1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61–49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11–0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    URL: Article
    DOI: 10.1159/000519709
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1482689-6
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