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Specific impairments in numerical functions may cause severe problems in everyday life that cannot be inferred from the available scales evaluating instrumental activities of daily living. The Numerical Activities of Daily living (NADL) is a battery designed to assess the patient's performance in everyday activities involving numbers (Informal Test) and in more scholastic capacities (Formal Test). A downside of this battery is its duration (45 min). The aim of the present study is to build a shorter version of NADL to make it more suitable for clinical and research purposes. The shortening procedure involved only the Formal test, and followed two steps: (i) a correlation of subtests with the general scores, and (ii) an item-analysis within the subtests previously showing higher correlations. Correlations between NADL-Short and NADL original version, and the new cut-offs were calculated. Lastly, the relationship between NADL-Short and other brief cognitive screening tests used in the clinical practice was evaluated in neurological patients and healthy controls. The NADL-Short includes the original Informal Test and the shortened Formal Test. It is a quick and easy clinical tool (15 min) to assess numerical abilities applied to informal and formal situations. It correlates highly with the original battery (Kendall's tau greater than 0.6 across tasks) and the cut-offs correctly identify impaired performance (accuracy of 95% or above). Correlation analysis showed a low positive correlation between NADL-Short and other brief cognitive scales. These findings suggest that it is appropriate to use specific tools to make inferences about a person's numerical abilities. [ABSTRACT FROM AUTHOR]

緩和ケアチーム（PCT）が介入したリハ実施例の全体像把握および ADL と転帰を調査 し，PCT 専任 PT の役割について検討した．対象は，2018 年 4 月からの 1 年間に介入を行っ た入院患者 216 例とし，診療録より情報を抽出し記述統計量を算出した．リハ実施例は全体 の 52%（112 例）で全例 PT が介入していた．リハ実施例の転帰は自宅退院 37 例（33%），転 院 16 例（14%），死亡 59 例（53%）で，全例の BI 点はリハ開始時が 50 点，リハ終了時は 75 点，自宅退院例のリハ開始時と終了時の BI 点および自宅退院例と転院例のリハ終了時の BI 点に有意差を認めた（p<0.05）．今回の結果から，PCT 専任 PT の役割として，自宅退院に向 けた身体機能や ADL の改善への関わり，ADL の改善を見込めず転院もしくは死亡退院となる 例に対する症状緩和や心理的な関わり，リハ専門職内および他職種間での丁寧な情報共有 の重要性が示唆された． [ABSTRACT FROM AUTHOR]

While radiation therapy (RT) improves function, and quality of life for patients with advanced cancers, patients frequently experience a period of acute toxicity during which functional abilities may decline. Little is understood about changes in functional outcomes after RT in older adults. This study aims to examine changes in daily function at 1 and 6 months following RT. We reviewed the charts of 117 patients who underwent palliative RT on a prospective registry. Activities of daily living (ADL) and instrumental activities of daily living (IADL) scores ranging from 0 to 6 and 0–8, respectively, were collected at baseline, one-month, and six months post-RT. Patients were classified as low deficit for ADL/IADL if they had 0–1 deficits and high deficit if they had 2+ deficits. One-hundred seventy RT courses were identified; 99 were evaluable at each time point. The median age was 67 years. At baseline, 29.5 and 29.9% of patients were classified as high-deficit for ADL and IADL functioning, respectively. At one-month, the majority of patients who were low-deficit at baseline remained so for both measures while approximately one quarter of high-deficit patients showed improvement. Most patients identified as low-deficit at one-month remained so at six-months, while no high-deficit patients improved from one- to six-months. Factors associated with high ADL and IADL deficits included: time (six months), increasing age, and Hispanic/other race. Compared to those with ECOG score of 3, patients with lower scores (0–2) had lower odds of high deficit. ADL and IADL tools may be useful in describing changes in daily function after palliative RT and in identifying groups of patients who may benefit from additional supportive geriatric care interventions. [ABSTRACT FROM AUTHOR]

Reduced strength, balance, and functional independence diminish quality of life and increase health care costs. Sixty adults (82.2 ± 4.9 years) were randomized to a control or three 12-week intervention groups: bioDensity (bD); Power Plate (PP) whole-body vibration (WBV); or bD+PP. bD involved one weekly 5-s maximal contraction of four muscle groups. PP involved two 5-min WBV sessions. Primary outcomes were strength, balance, and Functional Independence Measure (FIM). No groups differed initially. Strength significantly increased 22–51% for three muscle groups in bD and bD+PP (P < .001), with no changes in control and PP. Balance significantly improved in PP and bD+PP but not in control or bD. bD, PP, and bD+PP differentially improved FIM self-care and mobility. Strength improvements from weekly 5-min sessions of bD may impart health/clinical benefits. Balance and leg strength improvements suggest WBV beneficially impacts fall risk and incidence. Improved FIM scores are encouraging and justify larger controlled trials on bD and bD+PP efficacy. [ABSTRACT FROM AUTHOR]

Background: Food Insecurity (FI) is a crucial social determinant of health, independent of other socioeconomic factors, as inadequate food resources create a threat to physical and mental health especially among older person. The present study explores the associations between FI and cognitive ability among the aged population in India.Methods: To measure the cognitive functioning we have used two proxies, word recall and computational problem. Descriptive analysis and multivariable logistic regression was used to understand the prevalence of word recall and computational problem by food security and some selected sociodemographic parameters. All the results were reported at 95% confidence interval.Results: We have used the data from the first wave of longitudinal ageing study of India (LASI), with a sample of 31,464 older persons 60 years and above. The study identified that 17 and 5% of the older population in India experiencing computational and word recall problem, respectively. It was found that respondents from food secure households were 14% less likely to have word recall problems [AOR:0.86, 95% CI:0.31-0.98], and 55% likely to have computational problems [AOR:0.45, 95% CI:0.29-0.70]. We also found poor cognitive functioning among those experiencing disability, severe ADL, and IADL. Further, factors such as age, education, marital status, working status, health related factors were the major contributors to the cognitive functioning in older adults.Conclusion: This study suggest that food insecurity is associated with a lower level of cognition among the elderly in India, which highlight the need of food policy and interventional strategies to address food insecurity, especially among the individuals belonging to lower wealth quintiles. Furthermore, increasing the coverage of food distribution may also help to decrease the burden of disease for the at most risk population. Also, there is a need for specific programs and policies that improve the availability of nutritious food among elderly. [ABSTRACT FROM AUTHOR]

In rheumatology, occupational therapy offers specific support for numerous symptoms and deformities. In this short article a small overview is shown, with naming of frequently occurring abnormalities in rheumatological patients. One focus of consideration is in the area of hand therapy. Subsequently, approaches and possible prescribable offers of occupational therapy are explained in summary. These include splint construction, joint protection and functional training. [ABSTRACT FROM AUTHOR]

Aims: Clinical scores that consider physical and social factors to predict long‐term observations in patients after acute heart failure are limited. This study aimed to develop and validate a prediction model for patients with acute heart failure at the time of discharge. Methods and results: This study was retrospective analysis of the Kitakawachi Clinical Background and Outcome of Heart Failure Registry database. The registry is a prospective, multicentre cohort of patients with acute heart failure between April 2015 and August 2017. The primary outcome to be predicted was the incidence of all‐cause mortality during the 3 years of follow‐up period. The development cohort derived from April 2015 to July 2016 was used to build the prediction model, and the test cohort from August 2016 to August 2017 was used to evaluate the prediction model. The following potential predictors were selected by the least absolute shrinkage and selection operator method: age, sex, body mass index, activities of daily living at discharge, social background, comorbidities, biomarkers, and echocardiographic findings; a risk scoring system was developed using a logistic model to predict the outcome using a simple integer based on each variable's β coefficient. Out of 1253 patients registered, 1117 were included in the analysis and divided into the development (n = 679) and test (n = 438) cohorts. The outcomes were 246 (36.2%) in the development cohort and 143 (32.6%) in the test cohort. Eleven variables including physical and social factors were set into the logistic regression model, and the risk scoring system was created. The patients were divided into three groups: low risk (score 0–5), moderate risk (score 6–11), and high risk (score ≥12). The observed and predicted mortality rates were described by the Kaplan–Meier curve divided by risk group and independently increased (P < 0.001). In the test cohort, the C statistic of the prediction model was 0.778 (95% confidence interval: 0.732–0.824), and the mean predicted probabilities in the groups were low, 6.9% (95% confidence interval: 3.8–10%); moderate, 30.1% (95% confidence interval: 25.4%–34.8%); and high, 79.2% (95% confidence interval: 72.6%–85.8%). The predicted probability was well calibrated to the observed outcomes in both cohorts. Conclusions: The Kitakawachi Clinical Background and Outcome of Heart Failure score was helpful in predicting adverse events in patients with acute heart failure over a long‐term period. We should evaluate the physical and social functions of such patients before discharge to prevent adverse outcomes. [ABSTRACT FROM AUTHOR]

Human Activity Recognition (HAR) has become one of the most important research fields to achieve real-time monitoring of human activities for timely decision making in various applications like fall detection, elderly care etc. Now-a-days, most people use smartphones which come with various embedded inertial sensors like accelerometer and gyroscope to monitor acceleration and angular velocity. These smartphone-based sensors have proven to be cost-effective solution in identification of activities belonging to ADL (Activities of Daily Living). Various Machine Learning, Deep learning and hybrid models have been proposed and implemented for HAR. This paper also proposes various hybrid deep learning approaches which combine Deep Neural Networks with other models like LSTM (Long Short Term Memory) Model and GRU (Gated Recurrent Unit) for effective classification of engineered features from CNN (Convolutional Neural Network) Model. A novel architecture that integrates CNN with Random Forest Classifier (DeepCNN-RF) is proposed to add randomness to the model. The proposed models have been tested on publicly available HAR Datasets like UCI HAR and WISDM Activity Recognition Datasets. Experimental results show that the hybrid models outperform the state-of-the-art data mining, machine learning techniques in UCI HAR and WISDM with an overall maximum accuracy of 97.77% and 98.2% respectively. [ABSTRACT FROM AUTHOR]

Background: To date, only a few studies have investigated the association between personality and functional impairment. Therefore, our purpose was to add to this knowledge. Methods: Data from wave 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used (70 028 individuals in the analytical sample). Personality was measured using the 10‐item Big Five Inventory (BFI‐10). Functional impairment was quantified using activities of daily living (ADL) and instrumental activities of daily living (IADL) indices. Multiple linear regressions were conducted. Results: Regressions showed that an increased likelihood of limitations in ADL was associated with higher extraversion, higher agreeableness, lower conscientiousness, higher neuroticism, and higher openness to experience. Similarly, an increased likelihood of limitations in IADL was associated with higher agreeableness, lower conscientiousness, higher neuroticism, and higher openness to experience (only with one IADL index). Conclusions: This knowledge of associations between personality and functional limitations may help in determining individuals at risk for increased functional impairment (e.g., individuals with low conscientiousness or high neuroticism). Future research is needed to clarify the underlying mechanisms. [ABSTRACT FROM AUTHOR]

BACKGROUND: More than 7000 patients developed poliomyelitis during the main epidemic in the fifties in Israel. In recent years, there is a further deterioration in their condition due to accelerated aging process and post-polio syndrome. OBJECTIVE: To evaluate the risk factors for the progression of functional status in a cohort of patients with late effect of poliomyelitis over a period of ten years. METHODS: A cross-sectional cohort study including 82 individuals with late effect of poliomyelitis evaluated over ten years. Mean age was 67±8.5 years, 52.4%were men and 79.3%were Jewish. Functional status was evaluated by activities of daily living (ADL) questionnaire. Risk factors, including general comorbidities, history of poliomyelitis infection, use of assistive devices, employment, and physical activity statuses were evaluated using specific questionnaires. RESULTS: Independence in ADL functions deteriorated significantly over ten years. Older age, ethnicity, use of a wheelchair, and use of orthotic devices in childhood were risk factors for deterioration in ADL function. No correlation was found between the presence of other comorbidities or poliomyelitis parameters and worsening of ADL functions. CONCLUSIONS: Late effect of poliomyelitis was associated with deterioration in ADL functions probably due to the combined effect of the initial severity of the paralytic poliomyelitis symptoms and accelerated aging. [ABSTRACT FROM AUTHOR]

The objective of this research study was to investigate the effect of patient-centered robot-assisted intervention for upper limb function improvement in stroke patients. Design: A double-blind randomized controlled trial. Intervention: Subjectively preferred areas of need for performing daily activities were identified by pre-interviewing and applied as target goals in the experimental group using a robotic device. Control-1 underwent a program focused on the robot system involving movements of upper limb joints. Control-2 participated in a conventional rehabilitation program. Methods: Forty-five participants engaged in 60 min of daily therapy, five times weekly for 3 weeks. The experimental group used the Canadian occupational performance measure (COPM) to identify subjectively preferred "patient-centered" focus needed areas to perform robotic device aided daily activities. Control-1 used a robot device-focused rehabilitation involving upper limb joint movements. Control-2 participated in conventional rehabilitation. Pre-post intervention measurements of hand, grip, power, and upper limb ROM were acquired by FMA-UE, MFT, and K-MBI. Results: A significant increase of function in the experimental group was observed in each subclass of function and activities of daily living (ADL) performance. Control-1 showed an increase in function without ADL improvement. Control-2 showed an increase in ADL and proximal areas of upper limb function without an increase in other areas. Conclusion: The "patient-centered" approach significantly improved upper limb function and ADL performance compared to "robot-centered" rehabilitation. Further studies are warranted to confirm these results and for generalizability in clinical application. [ABSTRACT FROM AUTHOR]

Previous research indicates a better improvement of functional independence measure (FIM) at discharge in acute-stroke patients who received physiatrist and registered therapist operating rehabilitation (PROr) within 24 hrs compared with those who received after 24 hrs was reported. The aim of this prospective cohort study was to determine whether PROr provided within 24 hrs for new-onset stroke patients affects home-discharge rate at 6 months later. Acute new-onset stroke patients admitted to our hospital and received PROr (n = 227) and were conducted into 3 categories based on the time until starting PROr; within 24 hrs (very early mobilization; VEM; n = 47), 24-48 hrs (early mobilization; EM; n = 77) and >48 hrs (later mobilization; LM; n = 103). Home-discharge rates as well as changes in FIM, and rates of recurrence and mortality during the 6-month follow-up were assessed. A total of 139 patients [VEM (n = 32), EM (n = 43), LM (n = 64)] could be followed throughout the 6-month period. The home-discharge rate was ∼80% and significantly higher by ∼20% in VEM than EM. The gains in the motor subscale of FIM at 6 months were significantly higher in VEM than LM, while the mortality and recurrent rates were not significantly different among the categories. Starting PROr within 24 hrs of new-onset stroke may help to increase home-discharge rates at 6-month follow-up, simultaneously with a higher FIM. Very early mobilization in our hospital did not increase the risks of recurrence or death. [ABSTRACT FROM AUTHOR]

Background: Predictive cancer tools focus on survival; none predict severe symptoms. Aim: To develop and validate a model that predicts the risk for having low performance status and severe symptoms in cancer patients. Design: Retrospective, population-based, predictive study Setting/Participants: We linked administrative data from cancer patients from 2008 to 2015 in Ontario, Canada. Patients were randomly selected for model derivation (60%) and validation (40%). Using the derivation cohort, we developed a multivariable logistic regression model to predict the risk of an outcome at 6 months following diagnosis and recalculated after each of four annual survivor marks. Model performance was assessed using discrimination and calibration plots. Outcomes included low performance status (i.e. 10–30 on Palliative Performance Scale), severe pain, dyspnea, well-being, and depression (i.e. 7–10 on Edmonton Symptom Assessment System). Results: We identified 255,494 cancer patients (57% female; median age of 64; common cancers were breast (24%); and lung (13%)). At diagnosis, the predicted risk of having low performance status, severe pain, well-being, dyspnea, and depression in 6-months is 1%, 3%, 6%, 13%, and 4%, respectively for the reference case (i.e. male, lung cancer, stage I, no symptoms); the corresponding discrimination for each outcome model had high AUCs of 0.807, 0.713, 0.709, 0.790, and 0.723, respectively. Generally these covariates increased the outcome risk by >10% across all models: lung disease, dementia, diabetes; radiation treatment; hospital admission; pain; depression; transitional performance status; issues with appetite; or homecare. Conclusions: The model accurately predicted changing cancer risk for low performance status and severe symptoms over time. [ABSTRACT FROM AUTHOR]

Financial capacity is the ability to manage money and finances according to a person's values and self-interests. In Italy, the first instrument specifically designed to assess financial capacity has recently been developed: the Numerical Activities of Daily Living – Financial (NADL-F). The aims of this study are (1) to prepare a shorter version of NADL-F and (2) to examine the relationship between the new short version and a measure of general cognitive functioning of comparable length, the MMSE. After an item analysis performed on NADL-F, the items presenting a higher internal consistency were selected. The resulting NADL-F Short is a reliable, easy to use, and quick to administer tool for assessing financial capacity both in clinical and legal practice. Correlation analysis showed a low positive correlation between four NADL-F Short tasks and the MMSE, for the healthy participants group. For the patient group, instead, a low-moderate correlation was found for all the NADL-F Short tasks, except one. Many participants scoring high in the MMSE (both healthy controls and neurological patients) showed low NADL-F Short scores. These findings suggest that it is not correct to use generic tools like the MMSE to make inferences on a person's financial capacity. [ABSTRACT FROM AUTHOR]

The concept of a-minimal prime ideal of an ADL is introduced and its characterizations are established. The set of all a-minimal prime ideals of an ADL is topologized and resulting space is studied. [ABSTRACT FROM AUTHOR]

Abstract Background Among the previous studies about the ADL recovery and its predictors, the researches and resources used to study and protect the baseline-independent older patients from being permanently ADL-dependent was few. We aimed to describe the level of activities of daily living (ADL) at discharge and ADL change within 6 months after discharge in older patients who were ADL-independent before admission but became dependent because of acute illness, and to identify the predictors of early rehabilitation,so as to provide the basis to early intervention. Methods Stratified cluster sampling was used to recruit 520 hospitalised older patients who were ADL-independent from departments of internal medicine at two tertiary hospitals from August 2017 to May 2018. Demographics, clinical data, and ADL status at 1, 3, and 6 months after discharge were collected. Data were analysed using descriptive statistics, Student’s t-test, Pearson’s chi-square test,Spearman’s correlation analysis, binary logistic regression analysis, and receiver operating characteristic (ROC) curve analysis. Results There were 403 out of 520 patients completing the 6-month follow-up, and 229 (56.8%) regained independence at 6 months after discharge. There was an overall increasing trend in ADL with time. The recovery rate was the highest within the first month after discharge, gradually declined after 1 month, and changed less obviously from 3 to 6 months after discharge (p

Rina Juel Kaptain,1,2 Tina Helle,1,2 Ann-Helen Patomella,2 Ulla Møller Weinreich,3,4 Anders Kottorp2,5 1Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark; 2Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden; 3Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; 4The Clinical Institute, Aalborg University, Aalborg, Denmark; 5Faculty of Health and Society, Malmö University, Malmö, SwedenCorrespondence: Rina Juel Kaptain Selma Lagerloefs Vej 2, Aalborg 9220, DenmarkTel +4572690928Email rio@ucn.dkPurpose: A decline in the ability to perform activities of daily living (ADL) and ability to use everyday technology can pose threats to independent living, healthcare management and quality of life (QOL) of patients suffering from chronic obstructive pulmonary disease (COPD). Evidence of the relationship between these variables remains limited. The dual aim of this study was, first, to investigate if health-related QOL (HRQOL) was associated with quality in ADL performance and everyday technology use; second, to examine whether lung function, years with COPD diagnosis, living status or educational level affected physical and mental domains of HRQOL.Methods: This cross-sectional study included (N=80) participants aged 46–87 years recruited at healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were gathered through standardized assessments and analysed using multiple regression analysis.Results: The regression model explained 50.6% (R2=0.506) of the variation in HRQOL–physical. The following four variables were statistically significantly associated with HRQOL – physical: years since COPD diagnosis (p=0.023), ability to use everyday technology (p=0.006), amount of relevant everyday technologies (p=0.015) and ADL motor ability (p

Recently, a significant amount of literature concerning machine learning techniques has focused on automatic recognition of activities performed by people. The main reason for this considerable interest is the increasing availability of devices able to acquire signals which, if properly processed, can provide information about human activities of daily living (ADL). The recognition of human activities is generally performed by machine learning techniques that process signals from wearable sensors and/or cameras appropriately arranged in the environment. Whatever the type of sensor, activities performed by human beings have a strong subjective characteristic that is related to different factors, such as age, gender, weight, height, physical abilities, and lifestyle. Personalization models have been studied to take into account these subjective factors and it has been demonstrated that using these models, the accuracy of machine learning algorithms can be improved. In this work we focus on the recognition of human activities using signals acquired by the accelerometer embedded in a smartphone. The contributions of this research are mainly three. A first contribution is the definition of a clear validation model that takes into account the problem of personalization and which thus makes it possible to objectively evaluate the performances of machine learning algorithms. A second contribution is the evaluation, on three different public datasets, of a personalization model which considers two aspects: the similarity between people related to physical aspects (age, weight, and height) and similarity related to intrinsic characteristics of the signals produced by these people when performing activities. A third and last contribution is the development of a personalization model that considers both the physical and signal similarities. The experiments show that the employment of personalization models improves, on average, the accuracy, thus confirming the soundness of the approach and paving the way for future investigations on this topic.

Context: Population across the globe are aging rapidly due to demographic transition. More than 50% of the elderly in India suffer from one or more chronic diseases and psychological distress is one of the most common morbidities among them. Aims and Objective: This study was conducted with the objective to assess the status of psychological distress among the elderly. Settings and Design: Acommunity based, cross-sectional study among 347 elderly aged 60 years and above. Methods and Materials: This study was done in 30 villages (clusters) in Singur block of West Bengal. A predesigned and pretested schedule was used to collect data. Statistical Analysis: Data were analysed by univariate and multivariate analyses. Results: The mean (± SD) age of the elderly was 67.67 (± 7.15) years, majority (67.4%) were in the 60–69 years age group. Most (62.8%) of the elderly were suffering from psychological distress which is significantly associated with below primary education level [AOR (95% CI)] = [25.09 (11.88-52.96)], living without spouse and child [AOR (95% CI) =7.88 (3.90-15.89)], financial dependence [AOR (95% CI) =20.23 (7.58-54.00)], dependent functional activity (assessed by ADL) [AOR (95% CI) =3.84 (1.25-11.76)], and decision for healthcare taken by others [AOR (95% CI)] = [3.84 (1.25-11.76)]. Conclusions: Alarmingly, the proportion of psychological distress was found to be high among the elderly of this rural area. Therefore, all steps must be taken with special focus on the mental health of the old people so that they may continue to contribute to the upliftment of the society.

Abstract Background The purpose of this research was to assess the health-related quality of life (HRQOL) and functional abilities of Yi and Han elderly who resided in Yi Autonomous prefecture or Counties in Yunnan Province, as well as to compare their differences in HRQOL, functional abilities and other factors. Methods A total of 1636 older subjects, which included 863 Han and 773 Yi, were recruited from 10 Yi Autonomous regions. Their HRQOL and functional capabilities were assessed by the MOS 36-Item Short Form Health Survey (SF-36), activities of daily living (ADL), and instrumental activities of daily living (IADL) scales. Results The Han elderly performed better in every domain of SF-36 than the Yi elderly. Both of the two ethnic groups could perform their ADL independently but the Yi elderly showed greater dependency in IADL abilities. The HRQOL was positively associated with their ADL, IADL, and education levels. Moreover, age, health insurance status, and living arrangement were negatively correlated with HRQOL. Conclusion The HRQOL and IADL capabilities of the Han elderly were higher than that of the Yi counterparts in the Yi Autonomous regions. The HRQOL of both the two ethnic groups was positively connected with ADL, IADL abilities as well as education levels, whereas it was negatively correlated with age and health insurance. The elderly-care policy on the Yi autonomous areas should focus more on the HRQOL, ADL improvement, education background, age needs, and health insurance, etc.

Abstract Background Dupuytren’s contracture (DC) is a fibrotic hand condition in which one or more fingers develop progressive flexion deformities. Quality of life is diminished due to disabling limitations in performing everyday activities. For DC patients treated with collagenase, referral for subsequent hand therapy is inconsistent. It is unknown whether subsequent hand therapy is beneficial compared to no therapy. The purpose of this study is to determine whether hand therapy improves DC patients’ performance of and satisfaction with performing everyday activities one year after collagenase treatment. Methods We will conduct a randomised controlled trial with two treatment groups (hand therapy vs. control) of DC patients who have received collagenase treatment. DC patients with contracted metacarpophalangeal joint(s) (MCPJ) (hand therapy, n = 40; control, n = 40) and those with proximal interphalangeal joint(s) (PIPJ) involvement (hand therapy, n = 40; control, n = 40) comprise two subgroups, and we will study if the treatment effect will be different between both groups (n = 160). Patients with a previous injury or treatment for DC in the treatment finger are excluded. Hand therapy includes oedema and scar management, splinting, movement exercises, and practice of everyday activities. The main outcome variable is patients’ performance of and satisfaction with performing everyday activities, as assessed with the Canadian Occupational Performance Measure. Secondary outcomes are DC-specific activity problems, as assessed with the Unité Rhumatologique des Affections de la Main scale, and active/passive flexion/extension of treated joints and grip force using standard measuring tools, and self-reported pain level. Demographic and clinical variables, degree of scarring, cold hypersensitivity, number of occupational sick-leave days are collected. Self-reported global impression of change will be used to assess patient satisfaction with change in hand function. Assessments are done pre-injection and 6 weeks, 4 months, and 1 year later. Standard univariate and multivariate statistical analyses will be used to evaluate group differences. Discussion This study aims to assess whether hand therapy is beneficial for activity-related, biomechanical, and clinical outcomes in DC patients after collagenase treatment. The results will provide an objective basis for determining whether hand therapy should be conducted after collagenase treatment. Trial registration This study has been registered at ClinicalTrials.gov as NCT03580213 (April 5, 2018).

Introduction and objective For many years, Europe has been struggling with the problem of an aging society. It is obvious that everyone would like to live longer while retaining good psycho-physical health and social activity. This, however, is influenced by many factors, such as health, which may be a form of limitation in everyday life or in performing social roles in accordance with the norms. Objective The aim of the study was to analyze the use of scales for functional assessment of basic and complex daily living activities in individuals aged 80+ in various EU countries. Materials and method Potentially essential articles were obtained through review and analysis of the PUBMED (MEDLINE) database by entering the following keywords: functional activities of daily living, ADL, IADL, complex activities of daily living, basic activities of daily living. Article selection was based on the following inclusion criteria set by the authors and the appointed Advisory Board. Results Assessment of independence and fitness of elderly persons in the area of basic and complex activities of daily living provides information on the quality of life of senior individuals. Analysis of research data used for comparing functional independence of senior persons on the basis of ADL and IADL scales is difficult due to the discrepancies, which may be confusing for researchers studying this area. Conclusions The use of different methodologies for assessing functional fitness of elderly individuals makes it difficult to interpret, compare and practically apply the outcomes. Standardization of research methods used for assessment of basic and complex daily living activities in 80+ persons would enable comparing the obtained data in an interdisciplinary perspective.

Background: Several instruments are used for measuring functional limitations among rheumatoid arthritis (RA) patients. However, these instruments are incongruously assessed for their psychometric properties. The National Health and Nutritional Examination Survey (NHANES) uses a generic questionnaire to assess the activities of daily living (ADL) to measure functional limitations among its participants. The psychometric properties of the NHANES-ADL scale were evaluated using a patient examination and survey data. Methods: NHANES-ADL scale was assessed for its internal consistency and factor structure. Scale reliability was assessed with Cronbach’s alpha reliability coefficient. Principal component analysis with Promax rotation was used to obtain factor structure. Confirmatory factory analysis was used to calculate fit indices. The graded item response theory model was used to estimate item discrimination, difficulty, and test information. Results: Our sample included 1132 individuals with RA. Exploratory factor analyses of 19-item NHANES ADL scale produced one factor solution and accounted for 35% of variance. The Cronbach alpha of this scale was 0.92. The results of graded item response model indicated items performing well discriminating high and low level of functional ability. A higher slope (α) reflected stronger ability of items to discriminate across the continuum. Conclusions: The NHANES ADL scale showed good reliability, single dimensionality, and validity in RA patients. Studies should explore its test-retest reliability and its ability to reliably measure functional change over time in the future.

Background: Greenland is facing an ageing population, and little is known about the characteristics of the elderly population in Greenland. This study offers both a comparison and a description of the demographics, causes of admission, comorbidities and medication of the residents in care homes in the capital, major and minor towns in four of the five administrative regions of Greenland.Methods: The study was conducted from 2010 to 2016 as a descriptive questionnaire-based cross-sectional study. Data from eligible residents from eight care homes were collected from the regular care staff. Data were categorised into three groups based on town size for analysis.Results: 244 (100 %) of eligible residents participated in the study. Nearly 100 % were of Greenlandic ethnicity based on parents' place of birth, and 62 % were women. The median age at admission/study was 69/71 years for men and 77/79 years for women (both p = 0.001). The median Body Mass Index was 25.6 kg/m2, more than half of the population were previous- or never-smokers and less than ten per cent consumed more than ten drinks of alcohol per week. The most common causes of admission were dementia (25.4 %), stroke (19.3 %) and social causes (11.1 %), while stroke (30.7 %), dementia (29.5 %) and musculoskeletal diseases (25.8 %) were the most common diagnoses at the time of the study. The Barthel Index was used to estimate the residents' level of independence, and residents in smaller towns were found to have a higher level of independence than residents in the capital. The median number of prescribed medications was five, and more residents in the capital were prescribed more than ten medications than elsewhere in Greenland.Conclusions: This study is the first to describe care home residents in Greenland. We found a population younger than residents in comparable Danish care homes and that women were older than men at admission. In addition, care home residents in the capital had a lower level of independence and a higher number of prescribed medications, which could relate to differences in morbidity, access to health care services and differences in social circumstances influencing the threshold for care home admission. [ABSTRACT FROM AUTHOR]

Objective: To study the effect of flunarizine combined with nerve growth factor(NGF) on NIHSS in patients with cerebral hemorrhage, ADL score and volume of hematoma. Methods: 98 cases of cerebral hemorrhage admitted to our hospital from September 2015 to October 2016 were selected as the study subjects, and divided into 2 groups by random number method, 49 cases in each group. Patients in the control group received conventional basic treatment, and patients in the study group received oral sibiline combined with intramuscular injection of NGF on the basis of this treatment. Compare two groups of patients with total effective rate of treatment, at the same time comparative hematoma, edema zone volume, neural function defect scale(NIHSS) scores, daily life ability scale(ADL)score, neurogenic nutrition factor(BDNF), monocyte chemotactic protein 1(MCP 1), neuron specific enolization enzyme(NSE) level changes and adverse reactions occur. Results: After treatment, the total effective rate between the two groups was significantly different(P<0.05). Before treatment, there were no significant differences in hematoma volume and edema zone volume between the study group and the control group. After treatment, the volume of hematoma and edema zone in the study group and the control group decreased with time, and the difference was significant(P<0.05). Before treatment, there were no significant differences in NIHSS and ADL scores between the study group and the control group. After treatment, the NIHSS of the study group and the control group decreased over time, and the ADL score of the study group was higher than that of the control group, and the difference was significant(P<0.05). Before treatment, there were no significant differences in BDNF, MCP-1 and NSE between the study group and the control group. After treatment,MCP-1 and NSE of the study group and control group decreased with time, and both of the study group were lower than the control group, while BDNF increased with time, and the study group was higher than the control group, the difference was significant(P<0.05).There was no significant difference in ADR between the two groups (P>0.05). Conclusion: The effect of sibilin combined with NGF in patients with intracerebral hemorrhage is reliable, which can significantly reduce the secondary injury, and the treatment is safe and worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Background: Limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) reduce the independence of the elderly and compromise the quality of life. Objective: This study examined the prevalence and factors affecting the ADL and IADL limitations of elderly. Methods: In this community based cross-sectional study, a representative sample (n=723) of elderly aged >65 years was obtained by multi-stage cluster sampling. ADL and IADL were assessed using validated Sinhala versions of 10-item Barthel Index and Lawton IADL scales respectively. Simple and multiple logistic regression analyses were conducted to find the factors associated with ADL/IADL limitations. Results: Mean±SD age was 72.23±6.3 years. Mean±SD ADL and IADL scores were 94.42±17.08 (out of 100) and 6.58±2.3 (out of 8) respectively. Of the elderly, 16.9% and 39.4% had more than one ADL and IADL limitations respectively. Out of the ADL limited elderly, 91.8% had IADL limitations. Most of the ADL (80.3%) and IADL (76.5%) limited elderly had more than one chronic disease. Age (75-84 years odds ratio [OR]=3.03, p<0.001; >85 years OR=3.80, p<0.001), male gender (OR=1.79, p<0.05), history of a stroke (OR=6.12, p<0.001) and arthritis (OR=1.96, p>0.05) showed significant positive associations with ADL limitations in adjusted model. IADL limitations positively associated with age (75-84 years OR=2.91, p<0.001; >85 years OR=3.93, p<0.001), having more than one disease condition (OR=1.67, p<0.05) and history of a stroke (OR=5.53, p<0.001) in the adjusted model. Conclusion: The mean scores for ADL and IADL are high in this sample indicating a low disability level. Almost all elderly with ADL limitations also had IADL limitations. The odds of having ADL and IADL were greatest for the elderly who are over 75 years and has had a stroke. It is recommended that comorbidities are managed optimally in order to minimize activity limitations among elderly in informal caregiving settings. [ABSTRACT FROM AUTHOR]

• One in four patients employed prior to injury no longer employed after injury. • There is ongoing burden of injury and impairment months to years after discharge. • Patients with longer length of stay may have higher risk of delayed return to work. • Poor functional status after injury may be associated with delayed return to work. Blunt chest trauma is associated with significant morbidity, but the long-term functional status for these patients is less well-known. Return to work (RTW) is a benchmark for functional recovery in trauma patients, but minimal data exist regarding RTW following blunt chest trauma. Patients ≥ 18 y old admitted to a Level 1 trauma center following blunt chest trauma with ≥ 3 rib fractures and length of stay (LOS) ≥ 3 d were included. An electronic survey assessing RTW was administered to patients after discharge. Patients were stratified as having delayed RTW (> 3 mo after discharge) or self-reported worse activities-of-daily-living (ADL) function after injury. Patient demographics, outcomes, and injury characteristics were compared between groups. Median time to RTW was 3 mo (IQR 2,5). Patients with delayed RTW had higher odds of having more rib fractures than those with RTW ≤ 3 mo (median 10 versus 7; OR:1.24, 95%CI:1.04,1.48) as well as a longer LOS (median 13 versus 7 d; OR:1.15, 95% CI:1.04,1.30). Patients with stable ADL after trauma returned to work earlier than those reporting worse ADL (median 2 versus 3.5 mo, P < 0.01). 23.6% of respondents took longer than 5 mo to return to independent functioning, and 50% of respondents' report limitations in daily activities due to physical health after discharge. The significant proportion of patients with poor physical health and functional status suggests ongoing burden of injury after discharge. Patients with longer LOS and greater number of rib fractures may be at highest risk for delayed RTW after injury. [ABSTRACT FROM AUTHOR]

Background: The functional consequences of injurious falls are well known. However, studies of the factors that can modify trajectories of disability after an injury from a fall are scarce. Aims: We aimed to investigate whether sociodemographic and health-related factors may impact this association. Methods: The study population consisted of 1426 community-dwelling older adults (≥ 60 years) from the SNAC-K cohort study in Stockholm, Sweden. Functional status over 12 years of follow-up was assessed using the number of limitations in basic and instrumental activities of daily living. Sex, cohabitation status, physical activity, and self-rated health were assessed at baseline. Injurious falls were defined as falls requiring healthcare and were assessed over 3 years starting at baseline. Data were analyzed using linear-mixed effects models. Results: The fastest increase in the number of disabilities was observed in those who had endured an injurious fall and were living alone (β coefficient = 0.408; p < 0.001), been physically inactive (β coefficient = 0.587; p < 0.001), and had poor self-rated health (β coefficient = 0.514; p < 0.001). The negative impact of these factors was more pronounced among fallers compared to non-fallers. Discussion: Living alone, being physically inactive, and having poor self-rated health magnifies the negative effect of an injurious fall on functional status. Among individuals who endure an injurious fall, the heterogeneity in long-term functional status is substantial, depending on the individuals' characteristics and behaviors. Conclusions: These findings emphasize the need for a person-centered approach in care provision and can guide secondary prevention within health care. [ABSTRACT FROM AUTHOR]

Reminders are a core component of many assistive technology systems and are aimed specifically at helping people with dementia function more independently by compensating for cognitive deficits. These technologies are often utilized for prospective reminding, reminiscence, or within coaching-based systems. Traditionally, reminders have taken the form of nontechnology based aids, such as diaries, notebooks, cue cards and white boards. This article is based on the use of machine learning algorithms for the detection of Alzheimer's disease. In the experimentation, the LWL, SimpleLogistic, Logistic, MultiLayerPercepton and HiperPipes algorithms were used. The result showed that the LWL algorithm produced the following results: Accuracy 98.81%, Precission 100%, Recall 97.62% and F- measure 98.80% [ABSTRACT FROM AUTHOR]

AI-based techniques have included countless applications within the engineering field. These range from the automation of important procedures in Industry and companies, to the field of Process Control. Smart Home (SH) technology is designed to help house residents improve their daily activities and therefore enrich the quality of life while preserving their privacy. An SH system is usually equipped with a collection of software interrelated with hardware components to monitor the living space by capturing the behavior of the resident and their occupations. By doing so, the system can report risks, situations, and act on behalf of the resident to their satisfaction. This research article shows the experimentation carried out with the human activity recognition dataset, CASAS Kyoto, through preprocessing and cleaning processes of the data, showing the Vía Regression classifier as an excellent option to process this type of data with an accuracy 99.7% effective [ABSTRACT FROM AUTHOR]

Background: Direct fall on shoulder is most common mechanism of injury of fracture clavicle other mechanism include direct trauma to clavicle and fall on outstretched hand. The ideal management of the fracture of the mid-shaft of the clavicle remains a topic of debate. This study aimed to assess the better management of fracture mid shaft clavicle. Patients and Methods: This study included 18 patients with mid-shaft clavicular fractures. The patients were subdivided into : group A (9 patients) for conservative treatment and group B (9 patients) for operative treatment by using plate and screw fixation. Post-operative care was done. Every 2 weeks in first month and half then every month tall full union. At 6 weeks post operation anterior posterior x-ray for the clavicle is done and evaluates progress of fracture union. Patients was to remove the sling and start careful full range of motion and start physiotherapy and rehabilitation. Results: The present study showed no significant difference regards age distribution. In the mean age in conservative group (A) was 39.55 and operative group (B) was 36.11. Left side was the majority in both groups with no significant difference between groups. Regard Robinson classification 2B1 & 2B2 were the major classes with no significant difference between studied groups. Although time of union was shorter among operative cases but there was no significant difference. There was no significant difference between groups however surgical group was better and less regard pain. There was no significant difference between groups however surgical group was better regard Return to ADL. Conclusion: Conservative treatment remains the treatment of choice for simple undisplaced mid-shaft clavicle fractures, for displaced and comminuted fractures the surgical intervention gives better outcomes and early functional recovery in young active adults. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease is considered predominantly a disorder of the basal ganglia. Their vast system of communication allows them to get involved with a variety of functions, including automatic and voluntary motor control, procedural learning relating to routine behaviors, and emotional functions. The association with other cortical areas ensures smoothly orchestrated movement control and motor behaviors. Method: Experimental Study i.e. Pre to post-test experimental study design with two groups. Conventional sampling of 60 subjects diagnosed with Parkinson's disease were randomly distributed in two groups i.e. group E and group C. Group C were given global exercise whereas group E were given exercise using WII console. The outcome was assessed in terms of the Berg Balance Scale (BBS), Unified Parkinson's Disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MoCA), and Unipedal Stance Test (UST). The subject performed 14 individual 1-hour training sessions, twice a week for 7 weeks. Conclusion: Based on the statistical analysis, it is concluded that WII based motor and cognitive training have a good impact on Activity of daily living of patients with Parkinson's disease. WII based training showed slightly better improvement in the Experimental group. [ABSTRACT FROM AUTHOR]

Background: Virtual reality (VR) training are regarded as promising new tools for rehabilitation, but the effect on patients' daily participation is controversial. This study aimed to evaluate the effect of virtual reality (VR) training on different types of patients' daily participation through a meta-analysis. Methods: The PubMed, Cochrane central register of controlled trials, Embase, and web science databases were searched for studies published through September 2020. Thirty-five randomized controlled trials of virtual reality (VR) training compared with conventional treatment, Other electronic rehabilitation systems, usual care for various types of patients were included. All of the studies were available in English. Standardized mean differences (SMD), 95 % confidence intervals (CI), publication bias, and heterogeneity were calculated. Results: The Virtual reality (VR) training group is better than the control group in daily participation improvement on all types of patients. There was a small, significant effect(p＜0.001; SMD = 0.25[95 %CI,0.14 to 0.36], I2 = 0.00 %). Observing only the type of Stroke, the VR training group is still better than the control group in improving patients' daily participation (p＜0.001, SMD = 0.24[95 %CI, 0.11 to 0.37], I2 = 0.00 %). Using the cumulative Meta-analysis method to observe the included literature according to the timeline, Using the cumulative Meta-analysis method to observe the included literature according to the timeline, and it has only achieved positive results since 2015 (Nam-YoNg Lee 2015, p = 0.048, SMD = 0.22[95 %CI,0.00 to 0.44]). The heterogeneity of the studies was not detected, but there is obvious publication bias. Conclusions: Because of controversy over obvious publication bias, we need to be cautious about the conclusion that VR is better than the control group in promoting the patient's daily participation.

Objectives: To assess time trends in the social class inequalities and in total inequality in disability and self-rated health (SRH) in two oldest old populations.Methods: The data came from the Finnish Vitality 90+ Study (2001, 2003, 2007, 2010, 2014 and 2018; n = 5,440) and from the Swedish Panel Study of Living Conditions of the Oldest Old (2002, 2004, 2011 and 2014; n = 1,645). Inequalities in mobility and activities of daily living (ADL) disability and SRH were examined cross-sectionally and over time using relative and absolute measures.Results: Lower social classes had greater mobility and ADL disability and worse SRH than higher social classes and the inequalities tended to increase over time. Findings were remarkably similar in both studies and with absolute and relative measures. Total inequality, referring to the variance in health outcome in the total population, remained stable or decreased.Conclusion: The study suggests that the earlier findings of improved mobility and ADL are largely driven by the positive development in higher social classes while findings of decline in SRH are related to the worsening of SRH in lower social classes

Background: Skeletal related events due to metastatic bone tumors markedly affect the activities of daily living (ADL) and quality of life (QOL) in cancer patients. We focused on multidisciplinary therapy for metastatic bone tumors. This study aimed to evaluate the outcomes of surgical treatment for metastatic bone tumors in the extremities. Methods: We retrospectively reviewed 114 patients who underwent surgical treatment for metastatic bone tumors of the extremities between 2008 and 2019 and 69 patients were reassessed for more than 6 months after surgery. The most common primary tumor was renal, followed by lung, thyroid, and breast cancers. We assessed 69 patients’ performance status (PS), Barthel Index (BI) for ADL, EuroQol 5 Dimensions (EQ-5D) for QOL, and numerical rating scale (NRS) for pain and analyzed these postoperative values relative to preoperative values using Friedman’s test. The postoperative overall survival and the prognostic factors were evaluated using the Kaplan-Meier method, the log-rank test and Cox proportional hazards analysis. Results: The 1-year overall survival rate was 59%, and the median survival time after surgery was 20 months. Primary tumor, visceral metastasis, and surgical procedure were risk factors correlated with overall survival. PS, BI, EQ-5D, and NRS improved at 3 months after surgery and these improvements were maintained for 6 months after surgery regardless of the surgical procedure. Conclusions: The significant factors affecting survival after surgical treatment for bone metastases included the primary tumor, presence of visceral metastases, and internal fixation without tumor resection or curettage. Surgical treatment for metastatic bone tumors effectively reduced pain and improved PS, ADL, and QOL postoperatively after 3 months.

Background: Although there have been studies on the association between nutritional status and functional limitations, there were few studies on Asian centenarians in community. Therefore, this study aims to identify associations between nutritional status and functional limitations among centenarians in China.Methods: This cross-sectional study was conducted with the data from the China Hainan Centenarian Cohort Study. These data ultimately included basic characteristics, hematologic indicators, and chronic disease status for 1,002 centenarians. The nutritional status was evaluated using the Mini Nutritional Assessment Short-Form scale. The functional limitations were assessed using the activities of daily living (ADL) scale, namely Barthel Index and Lawton Scale. The association between nutritional status and ADL was assessed using multivariate logistic regression models.Results: In this study, the prevalence of malnutrition was 20.8 % among centenarians, basic ADL (BADL) limitation was 28.6 %, and instrumental ADL (IADL) limitation was 64.7 %. As the nutritional status deteriorated, the risk of ADL limitations increased in total population (BADL limitation: OR = 17.060, 95 % CI: 8.093-35.964; IADL limitation: OR = 11.221, 95 % CI: 5.853-21.511; p for trend < 0.001). Similar results were found in both men and women after stratifying sex but were more prominent in women.Conclusions: Malnutrition is associated with functional limitations among centenarians in China and more pronounced among women. [ABSTRACT FROM AUTHOR]

The research was carried out to determine the feed quality characteristics of 19 varieties, 18 registered varieties and 1 local variety, under Iğdır ecological conditions in 2017, 2018 and 2019. Experiment were set up with 3 replications according to randomized complete block design in the wet trial field of Igdir University Agricultural Research and Application Center. In this research, crude protein content (CP), acid detergent lignin (ADL), neutral detergent fiber (NDF) rate, acid detergent fiber (ADF) rate, dry matter digestibility (DMD), dry matter intake (DMI) rate, digestible energy (SE ), metabolic energy (ME) and relative feed value (RFV) of Başbağ, Gea, Elçi, Kayseri, May İside, Magna 601, Savaş, Ezzeline, Magnum V, La Bella, Giulia, Plato, La Torre, Prosementi, Queen, Bilensoy 80, Emiliano, Sunter and Gacer (local variety) alfalfa varieties were determined. According to the three-year average, the CP rates of alfalfa varieties are 16.9% and 22.0%, ADL rates 6.88% and 9.81%, NDF rates 39.4% and 42.9%, ADF rates 28.1% and 31.9%, DMD rates 64.1% and 67.0%, DMI rates 2.82% with 3.06%, DE amounts between 3.01 and 3.14 Mcal kg-1, ME amounts between 2.47 and 2.58 Mcal kg-1 and RFV values between 141.2 and 156.8. [ABSTRACT FROM AUTHOR]

In this study, we propose a hyper-simplified indicator of health and well-being for data visualization purposes in large datasets and apply it to SHARE survey data, the largest macro survey on health, ageing and retirement for 18 European countries. The indicator is based on four thematic sub-indicators, each focussing on a particular issue, which are obtained from more than twenty mixed variables measured on more than 60,000 respondents; Next, PCA is used to summarize their information in order to find and visualize profiles of "healthy ageing" across Europe. As a result, EU countries are classified in three groups, that segment the database into the least to the most individuals at risk of health and well-being. The methodology we propose is wide enough to be extended to other surveys or disciplines. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: What is the association between mortality and basic activities of daily living upon hospital admission among patients with dementia? Findings: Patients with dementia have high levels of dependency in basic activities of daily living on hospital admission. Mortality increased with decreasing basic activities of daily living as assessed by Barthel Index at hospital admission. Message: Barthel Index may be a helpful tool when discussing treatment and care strategies with patients and their families. Purpose: Determining life expectancy in patients with dementia are challenging. We aimed at studying the association between basic activities of daily living as measured by the Barthel Index at hospital admission and mortality among older patients with dementia. Methods: All patients aged ≥ 65 years with diagnosed dementia in the population-based National Danish Geriatric Database from 2005 to 2014 were included and followed until death, emigration, or study termination (31.12.2015). Data on Barthel Index (BI) were used to assess ADL. Patients were categorized into four predefined standard BI subcategories according to the national Danish version of the statistical classification of diseases [BI = 0–24 (very low ADL), BI = 25–49 (low ADL), BI = 50–79 (moderate reduced ADL), and BI = 80–100 (independent ADL)]. Association with mortality was assessed using multivariable Cox regression analysis adjusting for age, marital status, Charlson Comorbidity Index, BMI, prior hospitalizations, year of admission and polypharmacy. Results: In total, 6550 patients (women 62%) were included, median (IQR) age 84 (79–88) years and BI 37 (13–63). Mortality increased significantly with decreasing BI in both the crude and multivariable analysis. In subcategories BI = (80–100) and BI = (0–24), survival time (median (95%)) was 3.6 (3.4–3.9) years and 0.8 (0.7–0.9) years, respectively. Also, in patients with BI = (0–24), the overall mortality risk (HR (95% CI)) was 2.5 (2.2–2.8), 30-day risk 11.8 (5.8–23.9), and 1-year risk 4.4 (3.6–5.5) when using BI = (80–100) as reference. Conclusion: Barthel Index is independently associated with all-cause mortality among older patients with dementia admitted to hospital. BI may be a helpful tool for clinicians when discussing treatment and care strategies with patients and their families. [ABSTRACT FROM AUTHOR]

Background: The Pittsburgh Fatigability Scale (PFS) was developed to capture fatigue and demand in a single tool, filling a gap that no validated questionnaire existed to measure perceived fatigability. Since fatigability is a more sensitive measure of a person's susceptibility to fatigue, we validated the simplified-Chinese version of the PFS among Chinese community-dwelling older adults.Methods: This cross-sectional study was conducted in an urban community in Beijing between November 2018 and July 2019. The PFS was translated into simplified-Chinese by the translation, retro-translation method. Internal consistency of the Physical subscale of the PFS was evaluated by Cronbach's alpha. Convergent validity and discriminant validity were evaluated against physical performance measures (i.e., Short Physical Performance Battery & Timed Up and Go Test) and daily living performance (i.e., Barthel Index & Instrumental activity of daily living).Results: Our study included 457 participants, including 182 men (39.8%) and 275 women (60.2%). The age range of the included participants was 61-96 years (mean = 84.8 years, SD = 5.8 years). The simplified-Chinese version of PFS Physical scores showed strong internal consistency (Cronbach's alpha = 0.81). Higher PFS Physical scores were associated with worse physical performance, and daily living performance (|correlation coefficient| range: 0.36-0.56, p < .001). Age- and sex-adjusted PFS Physical scores had moderate to good overall discrimination for correctly classifying people by their physical performance and daily living performance (AUCs range 0.70-0.87, p < .001).Conclusions: The PFS simplified-Chinese version is a valid instrument to assess perceived physical fatigability in Chinese-speaking older adults with good convergent validity. Thus, the PFS, with low cost and greater feasibility, is a desired tool to measure fatigability in large population studies. [ABSTRACT FROM AUTHOR]