The Experts below are selected from a list of 39975 Experts worldwide ranked by ideXlab platform
Julie R Steele - One of the best experts on this subject based on the ideXlab platform.
-
obese older adults suffer foot pain and foot related Functional Limitation
Gait & Posture, 2015Co-Authors: Karen J Mickle, Julie R SteeleAbstract:There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI=25-30) and not overweight (BMI <25). Obese participants were found to have a significantly higher prevalence of foot pain and scored significantly lower on the SF-36. Obesity was also associated with foot-related Functional Limitation whereby ankle dorsiflexion strength, hallux and lesser toe strength, stride/step length and walking speed were significantly reduced in obese participants compared to their leaner counterparts. Therefore, disabling foot pain and altered foot structure and foot function are consequences of obesity for older adults, and impact upon their quality of life. Interventions designed to reduce excess fat mass may relieve loading of the foot structures and, in turn, improve foot pain and quality of life for older obese individuals.
-
obese older adults suffer foot pain and foot related Functional Limitation
Gait & Posture, 2015Co-Authors: Karen J Mickle, Julie R SteeleAbstract:Abstract There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI = 25–30) and not overweight (BMI
Karen J Mickle - One of the best experts on this subject based on the ideXlab platform.
-
obese older adults suffer foot pain and foot related Functional Limitation
Gait & Posture, 2015Co-Authors: Karen J Mickle, Julie R SteeleAbstract:There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI=25-30) and not overweight (BMI <25). Obese participants were found to have a significantly higher prevalence of foot pain and scored significantly lower on the SF-36. Obesity was also associated with foot-related Functional Limitation whereby ankle dorsiflexion strength, hallux and lesser toe strength, stride/step length and walking speed were significantly reduced in obese participants compared to their leaner counterparts. Therefore, disabling foot pain and altered foot structure and foot function are consequences of obesity for older adults, and impact upon their quality of life. Interventions designed to reduce excess fat mass may relieve loading of the foot structures and, in turn, improve foot pain and quality of life for older obese individuals.
-
obese older adults suffer foot pain and foot related Functional Limitation
Gait & Posture, 2015Co-Authors: Karen J Mickle, Julie R SteeleAbstract:Abstract There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI = 25–30) and not overweight (BMI
David T Felson - One of the best experts on this subject based on the ideXlab platform.
-
daily walking and the risk of incident Functional Limitation in knee osteoarthritis an observational study
Arthritis Care and Research, 2014Co-Authors: Daniel K White, David T Felson, Yuqing Zhang, Michael C Nevitt, Cora E Lewis, Catrine Tudorlocke, Roger A Fielding, Michael P Lavalley, Douglas K Gross, James C TornerAbstract:Objective Physical activity is recommended to mitigate Functional Limitations associated with knee osteoarthritis (OA). However, it is unclear whether walking on its own protects against the development of Functional Limitation. Methods Walking over 7 days was objectively measured as steps/day within a cohort of people with or at risk of knee OA from the Multicenter Osteoarthritis Study. Incident Functional Limitation over 2 years was defined by performance-based (gait speed 28 of 68) measures. We evaluated the association of steps/day at baseline with developing Functional Limitation 2 years later by calculating risk ratios adjusted for potential confounders. The number of steps/day that best distinguished risk for developing Functional Limitation was estimated from the maximum distance from chance on receiver operating characteristic curves. Results Among 1,788 participants (mean age 67 years, mean body mass index 31 kg/m(2) , 60% women), each additional 1,000 steps/day was associated with a 16% and 18% reduction in incident Functional Limitation by performance-based and self-report measures, respectively. Walking Conclusion More walking was associated with less risk of Functional Limitation over 2 years. Walking >6,000 steps/day provides a preliminary estimate of the level of walking activity to protect against developing Functional Limitation in people with or at risk of knee OA.
-
foot musculoskeletal disorders pain and foot related Functional Limitation in older persons
Journal of the American Geriatrics Society, 2005Co-Authors: Fadi Badlissi, Julie J Keysor, Julie E. Dunn, Carol L Link, James B Mckinlay, David T FelsonAbstract:Objectives: To examine whether common musculoskeletal disorders of feet are associated with pain and foot-related Functional Limitation. Design: A cross-sectional study using stratified random sampling. Setting: A residential community. Participants: Ethnically diverse sample of elderly persons (n=784). Measurements: Foot disorders (hallux valgus/bunion, pes planus (flat foot), pes cavus (high arch), hammertoe, mallet toe, claw toe, overlapping toes, bunionette, and plantar fasciitis), foot pain, the foot health Functional status (FHFS, range 0–100, 100=no problems) scale, and walk time score (range 0–4, 4=fastest). Results: Most commonly assessed musculoskeletal disorders, including hallux valgus and toe deformities, were not associated with pain or function Limitation. Plantar fasciitis and, to a lesser extent, pes cavus were associated with worse FHFS scores; foot pain partially explained this association. Neither foot disorders nor foot pain were significantly associated with slower walk times. Conclusion: Many foot disorders had little relationship with foot pain or function and may not require clinical attention when asymptomatic. Risk factors and preventive and therapeutic interventions for plantar fasciitis require further longitudinal investigation.
Gordon L Jensen - One of the best experts on this subject based on the ideXlab platform.
-
obesity as a risk factor for developing Functional Limitation among older adults a conditional inference tree analysis
Obesity, 2017Co-Authors: Feon W Cheng, Xiang Gao, Le Bao, Diane C Mitchell, Craig Wood, Martin J Sliwinski, Helen Smiciklaswright, Christopher D Still, David D K Rolston, Gordon L JensenAbstract:Objective To examine the risk factors of developing Functional decline and make probabilistic predictions by using a tree-based method that allows higher order polynomials and interactions of the risk factors. Methods The conditional inference tree analysis, a data mining approach, was used to construct a risk stratification algorithm for developing Functional Limitation based on BMI and other potential risk factors for disability in 1,951 older adults without Functional Limitations at baseline (baseline age 73.1 ± 4.2 y). We also analyzed the data with multivariate stepwise logistic regression and compared the two approaches (e.g., cross-validation). Over a mean of 9.2 ± 1.7 years of follow-up, 221 individuals developed Functional Limitation. Results Higher BMI, age, and comorbidity were consistently identified as significant risk factors for Functional decline using both methods. Based on these factors, individuals were stratified into four risk groups via the conditional inference tree analysis. Compared to the low-risk group, all other groups had a significantly higher risk of developing Functional Limitation. The odds ratio comparing two extreme categories was 9.09 (95% confidence interval: 4.68, 17.6). Conclusions Higher BMI, age, and comorbid disease were consistently identified as significant risk factors for Functional decline among older individuals across all approaches and analyses.
-
obesity in older adults relationship to Functional Limitation
Current Opinion in Clinical Nutrition and Metabolic Care, 2010Co-Authors: Gordon L Jensen, Pao Ying HsiaoAbstract:Purpose of reviewThe present review is intended to provide a critical overview of recent investigations of obesity among older persons with emphasis upon associated Functional Limitations, potential for intervention, and a future research agenda.Recent findingsObesity is growing in prevalence among
-
the relationship between body mass index and self reported Functional Limitation among older adults a gender difference
Journal of the American Geriatrics Society, 2001Co-Authors: Janet M Friedmann, Tom A Elasy, Gordon L JensenAbstract:OBJECTIVES: To determine whether there is a gender difference in how body mass index (BMI) relates to self-reported Functional Limitation. Also, to evaluate whether the method of categorizing BMI changes the observed results. DESIGN: Cross-sectional cohort study. SETTING: Rural Pennsylvania. PARTICIPANTS: A total of 7,120 male (n = 3,312) and female (n = 3,808) community-dwelling older adults enrolled in a Medicare managed-risk contract. MEASUREMENTS: All subjects completed a modified Level II Nutrition Risk Screen upon enrollment in the health plan. Height and weight were obtained by nursing personnel during an enrollment clinic visit. Subjects who reported 10 or more pounds weight loss in the previous 6 months were excluded. Logistic regression was used to evaluate the relationship between BMI and self-reported Functional Limitation separately for each sex, adjusting for age, depression, and polypharmacy. Two schemes were used to categorize BMI: equally distributed sex-specific quintiles and arbitrary division based on National Institutes of Health (NIH) Obesity Guidelines. RESULTS: How BMI relates to Functional Limitation depends upon both sex and method of categorizing BMI. When BMI was considered in gender-specific quintiles, women in the highest quintile of BMI had increased risk of Functional impairment; there was no relationship between BMI and Functional Limitation for men. When BMI was categorized by the NIH obesity guidelines, both men and women with BMI >40 had significantly increased risk of Functional Limitation. CONCLUSIONS: The mechanisms behind gender discrepancy in self-reported Functional Limitation remain unclear. Studies may need to consider men and women separately, because how BMI relates to function depends on gender. Further research is needed to evaluate how changes in weight and body composition during middle and old age affect Functional status.
Jack M Guralnik - One of the best experts on this subject based on the ideXlab platform.
-
fear of falling predicts incidence of Functional Limitation two years later
Innovation in Aging, 2017Co-Authors: Mohammad Auais, B Alvarado, Emmanuelle Belanger, Carmen L Curcio, Jack M GuralnikAbstract:We examined if fear of falling (FOF) predicts incident Functional Limitation over a 2-year period in older adults using self-reported and performance-based measures. In 2012, 1,601 participants were recruited from Canada, Colombia, and Brazil, and were re-assessed in 2014. We quantified FoF using the Falls Efficacy Scale-International (FES-I). Functional Limitation measures were (1) self-reported mobility Limitation, and (2) physical performance Limitation, score<9 on the Short Physical Performance Battery (SPPB Limitation). We entered in the analysis only those without Functional Limitation at baseline. In 2014, 131 (14.3%) and 166 (15.4%) participants reported incident mobility and SPPB Limitation, respectively. After adjusting for age, sex, socioeconomic, and health covariates in logistic regression models, one-point increase in FES-I (range: 116–64) at baseline predicted a 6% increase in the chance of reporting mobility Limitation (95%CI: 1.04–1.09) and a 5% increase in the chance of having SPPB Limitation in 2014 (95%CI: 1.02–1.07). It is increasingly important to study FOF’s effect on Functional Limitation and to take necessary measures that prevent the transition to end-stage disability.
-
fatigue in a representative population of older persons and its association with Functional impairment Functional Limitation and disability
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2009Co-Authors: Sonja Vestergaard, Kushang V Patel, Luigi Ferrucci, Susan G Nayfield, Basil A Eldadah, Matteo Cesari, Graziano Ceresini, Jack M GuralnikAbstract:IN older adults, fatigue is a commonly reported symptom. Different definitions have sought to represent fatigue (1,2), and for use in the present study, it is conceptualized as “the awareness of a decreased capacity for physical and/or mental activity due to an imbalance in the availability, utilization, and/or restoration of resources needed to perform activity” (3). Typically, fatigue is studied in patient populations with an index condition such as cancer, HIV infection, or multiple sclerosis. Indeed, a review of symptoms associated with cancer, AIDS, heart disease, chronic obstructive pulmonary disease, and renal disease found that between 32% and 90% of patients report fatigue (4). However, although fatigue is often attributed to underlying disease, in a large study of the general population only about one third of all fatigue cases could be explained by a diagnosed medical condition (5). The prevalence of fatigue in nondisease–specific community-dwelling older adults has not been well established. General population surveys indicate that fatigue increases with advancing age (6,7), although not consistently (8). In those studies, it was difficult to identify the prevalence of fatigue specifically for older individuals. However, in a sample of 199 older ambulatory residents of a long-term care facility, 47% reported moderate and severe fatigue (9). Furthermore, in a primary care sample of 124 older adults the prevalence of fatigue was 27% (10). Although Functional consequences of fatigue have not been well characterized, studies in older adults have shown that fatigue is associated with restricted activity and disability. In a study of 754 nondisabled community-dwelling older adults, Gill and colleagues (11) showed that fatigue was the leading reason for restricted activity. In fact, among 24 prespecified reasons, 65.5 episodes of fatigue per 100 person-months of restricted activity were reported, whereas “pain or stiffness in joints” was the second leading cause associated with about half the rate (35.7 episodes per 100 person-months of restricted activity) (11). In addition, Avlund and colleagues (12) found that “tiredness” predicted adverse events such as the onset of disability, future hospitalization, and use of home care help (13) in an older nondisabled population. However, tiredness in these studies was evaluated in relation to task-specific activities of daily living (ADL), and the Functional consequences of nontask-specific tiredness or fatigue are unclear. The present study used a measure of general fatigue to examine its distribution in a representative sample of older adults and to investigate the association of fatigue with measures of physical function and disability. Those classified as fatigued reported feeling that they could not get going and/or that everything was an effort on 3 or more days during a week (see the Methods section). Different measures of physical function were examined to understand whether fatigue was associated with each stage of the disablement process. In the framework of the disablement process (14–16), pathology is proposed as the first step in the model leading to impairments (e.g., low strength), Functional Limitation (e.g., slow walking speed), and ultimately, disability (e.g., inability to perform ADL). Typically, age-associated diseases are used to measure pathology, but markers of inflammation and thyroid function were examined as well in the current study to assess the subclinical disease that might be associated with fatigue and physical function (17–20).
-
assessing the building blocks of function utilizing measures of Functional Limitation
American Journal of Preventive Medicine, 2003Co-Authors: Jack M Guralnik, Luigi FerrucciAbstract:To better understand the health of older people, it is valuable to go beyond conventional measures of disease and self-perceived health and utilize assessments of Functional status and disability. Physical decrements can be characterized at the level of organs and body systems (impairments); the organism as a whole (Functional Limitations); and the person in the context of the environment and its challenges (disability). To understand the dynamics of the pathway leading from disease to disability, it is critical to measure Functional Limitations that can be assessed through either self-report or standardized objective measures of physical performance. Both of these approaches may be used to evaluate functions such as grasping objects, walking, and climbing stairs. In aging research, measures of Functional Limitation are utilized as outcomes that indicate the impact of disease, impairments, and other risk factors on function. In turn, measures of Functional Limitation can be used to characterize the Functional status of individuals and populations, and are powerful predictors of various adverse outcomes, including incident disability in people not currently disabled. Functional Limitation measures add substantially to our knowledge about older populations, but further work is needed to promote their standardization and use in both clinical and research settings.
-
severity of upper and lower extremity Functional Limitation scale development and validation with self report and performance based measures of physical function
Journals of Gerontology Series B-psychological Sciences and Social Sciences, 2001Co-Authors: Eleanor M Simonsick, Jack M Guralnik, Luigi Ferrucci, Judith D Kasper, Karen Bandeenroche, Rosemarie Hirsch, Suzanne G Leveille, Taina Rantanen, Linda FriedAbstract:Objectives. To better understand disablement and transitions from impairment to disability, discrete valid measures of Functional Limitation are needed. This study reports the development and criterion-related validity of scales that quantify severity of upper and lower extremity Functional Limitation. Methods. Data are from 3,635 cognitively intact community-dwelling women aged 65 years and older and 1,002 moderately to severely disabled participants in the Women’s Health and Aging Study. Scales assessing severity of upper and lower extremity Functional Limitation were constructed from commonly available questions on Functional difficulty. Criterion-related validity was evaluated with self-report and performance-based measures. Results. The upper and lower extremity scales range from 0 to 6 and 0 to 9, respectively. Scale scores were well distributed in the disabled group and discriminated Limitations in the broader community. For both scales, rates of difficulty for all ADL and IADL increased ( p , .001) with increasing severity score, and percent able and mean performance on respective upper and lower extremity tasks decreased ( p , .01).
