Showing papers on "Physical disability published in 2018"
TL;DR: Sleep patterns change as age progresses, and Loud snoring, which is more common in the elderly, can be a symptom of obstructive sleep apnoea, which puts a person at risk for cardiovascular diseases, headaches, memory loss, and depression.
Abstract: In contrast to newborns, who spend 16-20 h in sleep each day, adults need only about sleep daily. However, many elderly may struggle to obtain those 8 h in one block. In addition to changes in sleep duration, sleep patterns change as age progresses. Like the physical changes that occur during old age, an alteration in sleep pattern is also a part of the normal ageing process. As people age, they tend to have a harder time falling asleep and more trouble staying asleep. Older people spend more time in the lighter stages of sleep than in deep sleep. As the circadian mechanism in older people becomes less efficient, their sleep schedule is shifted forward. Even when they manage to obtain 7 or 8 h sleep, they wake up early, as they have gone to sleep quite early. The prevalence of sleep disorders is higher among older adults. Loud snoring, which is more common in the elderly, can be a symptom of obstructive sleep apnoea, which puts a person at risk for cardiovascular diseases, headaches, memory loss, and depression. Restless legs syndrome and periodic limb movement disorder that disrupt sleep are more prevalent in older persons. Other common medical problems of old age such as hypertension diabetes mellitus, renal failure, respiratory diseases such as asthma, immune disorders, gastroesophageal reflux disease, physical disability, dementia, pain, depression, and anxiety are all associated with sleep disturbances.
240 citations
TL;DR: The lack of systematic reviews comparing stigma across mental illness, HIV/AIDS, and physical disability indicates the need for more cross-comparative analyses among these conditions.
Abstract: Stigma across HIV/AIDS, mental illness, and physical disability can be co-occurring and may interact with other forms of stigma related to social identities like race, gender, and sexuality. Stigma is especially problematic for people living with these conditions because it can create barriers to accessing necessary social and structural supports, which can intensify their experiences with stigma. This review aims to contribute to the knowledge on stigma by advancing a cross-analysis of HIV/AIDS, mental illness, and physical disability stigma, and exploring whether and how intersectionality frameworks have been used in the systematic reviews of stigma. A search of the literature was conducted to identify systematic reviews which investigated stigma for HIV/AIDS, mental illness and/or physical disability. The electronic databases MEDLINE, CINAHL, EMBASE, COCHRANE, and PsycINFO were searched for reviews published between 2005 and 2017. Data were extracted from eligible reviews on: type of systematic review and number of primary studies included in the review, study design study population(s), type(s) of stigma addressed, and destigmatizing interventions used. A keyword search was also done using the terms “intersectionality”, “intersectional”, and “intersection”; related definitions and descriptions were extracted. Matrices were used to compare the characteristics of reviews and their application of intersectional approaches across the three health conditions. Ninety-eight reviews met the inclusion criteria. The majority (99%) of reviews examined only one of the health conditions. Just three reviews focused on physical disability. Most reviews (94%) reported a predominance of behavioural rather than structural interventions targeting stigma in the primary studies. Only 17% of reviews used the concept and/or approach of intersectionality; all but one of these reviews examined HIV/AIDS. The lack of systematic reviews comparing stigma across mental illness, HIV/AIDS, and physical disability indicates the need for more cross-comparative analyses among these conditions. The integration of intersectional approaches would deepen interrogations of co-occurring social identities and stigma.
115 citations
TL;DR: This large-scale study lends support to existing research showing that people with disabilities are at greater risk of violence than people without disabilities and shows that gender is significant in explaining the type of violence experienced and the experience of discrimination.
Abstract: The aim of the study was to quantify levels of violence and discrimination among people with disabilities and analyze the effects of gender and the type and degree of disability. The study analyzed data on self-reported violence and discrimination from a Danish national survey of 18,019 citizens, of whom 4519 reported a physical disability and 1398 reported a mental disability. Individuals with disabilities reported significantly higher levels of violence than those without. Specifically, individuals reporting a mental disability reported higher levels of violence and discrimination. Significant gender differences were found with regard to type of violence: while men with disabilities were more likely to report physical violence, women with disabilities were more likely to report major sexual violence, humiliation and discrimination. Neither severity nor visibility of disability was found to be a significant factor for risk of violence. This large-scale study lends support to existing research showing that people with disabilities are at greater risk of violence than people without disabilities. Further, the study found that people with mental disabilities were significantly more likely to report all types of violence and discrimination than those with physical disabilities. The findings also show that gender is significant in explaining the type of violence experienced and the experience of discrimination.
71 citations
TL;DR: Clinicians need heightened awareness of comorbidities in adults with autism to improve detection and suitable care, especially given the added complexity of assessment in this population and the fact that hearing and visual impairments may cause additional difficulties with reciprocal communication which are also a feature of autism; hence posing further challenges in assessment.
Abstract: Objectives To investigate the prevalence of comorbid mental health conditions and physical disabilities in a whole country population of adults aged 25+ with and without reported autism. Design Secondary analysis of Scotland’s Census, 2011 data. Cross-sectional study. Setting General population. Participants 94% of Scotland’s population, including 6649/3 746 584 adults aged 25+ reported to have autism. Main outcome measures Prevalence of six comorbidities: deafness or partial hearing loss, blindness or partial sight loss, intellectual disabilities, mental health conditions, physical disability and other condition; ORs (95% CI) of autism predicting these comorbidities, adjusted for age and gender; and OR for age and gender in predicting comorbidities within the population with reported autism. Results Comorbidities were common: deafness/hearing loss—17.5%; blindness/sight loss—12.1%; intellectual disabilities—29.4%; mental health conditions—33.0%; physical disability—30.7%; other condition—34.1%. Autism statistically predicted all of the conditions: OR 3.3 (95% CI 3.1 to 3.6) for deafness or partial hearing loss, OR 8.5 (95% CI 7.9 to 9.2) for blindness or partial sight loss, OR 94.6 (95% CI 89.4 to 100.0) for intellectual disabilities, OR 8.6 (95% CI 8.2 to 9.0) for mental health conditions, OR 6.2 (95% CI 5.8 to 6.6) for physical disability and OR 2.6 (95% CI 2.5 to 2.8) for other condition. Contrary to findings within the general population, female gender predicted all conditions within the population with reported autism, including intellectual disabilities (OR=1.4). Conclusions Clinicians need heightened awareness of comorbidities in adults with autism to improve detection and suitable care, especially given the added complexity of assessment in this population and the fact that hearing and visual impairments may cause additional difficulties with reciprocal communication which are also a feature of autism; hence posing further challenges in assessment.
70 citations
TL;DR: Difficulties with employment and/or reduced work hours were associated with cognitive impairment in MS.
Abstract: BACKGROUND Almost half of people with multiple sclerosis (MS), with low levels of physical disability, are unemployed. It is likely that the impact of "invisible" symptoms of MS, such as cognition, are involved. Evidence also suggests that cognition is a mediating factor between physical disabilities and unemployment. METHODS A systematic review was conducted to investigate the link between objective cognitive performance and unemployment in MS. The search was carried out in September 2017 using identical search terms across three search engines: PubMed, PSYCH Info and Web of Science. Inclusion criteria included peer review, participant age range of 18 to 65, objective neuropsychological testing and self-reported employment information. RESULTS The search returned a total of 910 articles of which 13 were considered eligible for inclusion. The eligible studies consistently found that people with MS who were unemployed, or who had more negative work-related events, performed less well on neuropsychological tests than both employed people with MS and healthy control groups. People with MS who were employed or had no changes in their work situation also performed less well than healthy controls on neuropsychological tests. Significant between group differences were seen in the following cognitive domains: information processing speed, immediate recall, delayed recall and executive function. CONCLUSION Difficulties with employment and/or reduced work hours were associated with cognitive impairment in MS.
65 citations
TL;DR: The interaction of mechanisms and context as a whole facilitated meaningful outcomes for children and youth with disabilities, and their parents.
Abstract: The need to identify strategies that facilitate involvement in physical activity for children and youth with disabilities is recognised as an urgent priority. This study aimed to describe the association between context, mechanisms and outcome(s) of a participation-focused physical activity intervention to understand what works, in what conditions, and how. This study was designed as a realist evaluation. Participant recruitment occurred through purposive and theoretical sampling of children and parents participating in the Local Environment Model intervention at Beitostolen Healthsports Centre in Norway. Ethnographic methods comprising participant observation, interviews, and focus groups were employed over 15 weeks in the field. Data analysis was completed using the context-mechanism-outcome framework of realist evaluation. Context-mechanism-outcome connections were generated empirically from the data to create a model to indicate how the program activated mechanisms within the program context, to enable participation in physical activity. Thirty one children with a range of disabilities (mean age 12y 6 m (SD 2y 2 m); 18 males) and their parents (n = 44; 26 mothers and 18 fathers) participated in the study. Following data synthesis, a refined program theory comprising four context themes, five mechanisms, and six outcomes, were identified. The mechanisms (choice, fun, friends, specialised health professionals, and time) were activated in a context that was safe, social, learning-based and family-centred, to elicit outcomes across all levels of the International Classification of Functioning, Disability and Health. The interaction of mechanisms and context as a whole facilitated meaningful outcomes for children and youth with disabilities, and their parents. Whilst optimising participation in physical activity is a primary outcome of the Local Environment Model, the refined program theory suggests the participation-focused approach may act as a catalyst to promote a range of outcomes. Findings from this study may inform future interventions attempting to enable participation in physical activity for children and youth with disabilities.
54 citations
TL;DR: Investigation of how an individual’s social determinants of health are affected by the acquisition of physical disability in adulthood found changes to social determinant of health had substantial flow-on consequences in all aspects of life for the individual and those close to them.
Abstract: Purpose: The purpose of this study was to investigate how an individual’s social determinants of health are affected by the acquisition of physical disability in adulthood. The secondary aim was to...
54 citations
TL;DR: Interventions to increase PA behaviour in people with physical disability are effective, especially when theory is used to guide their development, according to a meta‐analysis of randomized controlled trials.
46 citations
TL;DR: To which degree quality of life correlates with physical and cognitive function in progressive MS is assessed.
Abstract: Background Patients with progressive multiple sclerosis (MS) often have cognitive impairment in addition to physical impairment. The burden of cognitive and physical impairment progresses over time, and may be major determinants of quality of life. The aim of this study was to assess to which degree quality of life correlates with physical and cognitive function in progressive MS. Methods This is a retrospective study of 52 patients with primary progressive (N = 18) and secondary progressive MS (N = 34). Physical disability was assessed using the Expanded Disability Status Scale, Timed 25 Foot Walk (T25FW) test and 9-Hole Peg Test (9HPT). Cognitive function was assessed using Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test, and Trail Making Test B (TRAIL-B). In addition, quality of life was assessed by the Short Form 36 (SF-36) questionnaire. Results Only measures of cognitive function correlated with the overall SF-36 quality of life score and the Mental Component Summary score from the SF-36. The only physical measure that correlated with a measure of quality of life was T25FW test, which correlated with the Physical Component Summary from the SF-36. We found no other significant correlations between the measures of cognitive function and the overall physical measures but interestingly, we found a possible relationship between the 9HPT score for the nondominant hand and the SDMT and TRAIL-B. Conclusion Our findings support inclusion of measures of cognitive function in the assessment of patients with progressive MS as these correlated closer with quality of life than measures of physical impairment.
43 citations
TL;DR: Research regarding the effectiveness of eye-gaze control technology used to access a laptop, tablet or computer on communication outcomes, participation, quality of life and self-esteem in children, adolescents and adults with cerebral palsy and significant physical disability is sparse.
Abstract: Purpose: The primary objective of this systematic review was to examine the effectiveness of eye-gaze control technology for facilitating communication across different social contexts for ...
42 citations
TL;DR: This is the first study to use grip strength weakness cut-points to identify those who may be at greatest risk for experiencing physical disability in later life, and underscores the importance of using population-specific cutpoints for clinical weakness in order to identify individuals at greatestrisk for adverse health outcomes.
Abstract: Muscle weakness is an important indicator of disability, chronic disease and mortality. While we recently proposed sex/race specific grip strength cutpoints for clinical muscle weakness in a diverse, nationally representative sample of older Americans, the extent to which these cutpoints predict physical disability remains unknown. To examine whether sex/race specific muscle weakness cutpoints predict physical disability status in a nationally representative sample of Americans age 65+. We used data from the 2006-2010 Health and Retirement Study. Fully-adjusted, weighted multinomial logistic regression models were used to quantify the odds of experiencing the onset, progression or persistence of disability in activities of daily living (ADL) among weak versus non-weak individuals over a 2-year period. General community, nationally representative sample of older Americans. Population-based, community dwelling sample of older American adults aged 65-years+; 57 percent were women, 91% were White and the mean age was 75 years. The primary outcome of interest was disability dynamics, defined by changes in ADL status across at 2- year period. The primary exposure was clinical muscle weakness as defined by previously identified cutpoints. Hypotheses were formulated before analyses were conducted. In this nationally representative sample (n= 8,725), 44% of individuals were classified as weak at baseline. At follow-up, 55% remained independent with no change in their ADL status, 11% had an onset of disability and 4% progressed in their disability status. The odds of experiencing an onset of ADL disability was 54% higher among weak individuals compared those who were not weak at baseline (OR= 1.54, 95% CI= 1.54, 1.5, p<.0001); the odds of experiencing a progression in physical disability status was 2.16 times higher among those who were weak at baseline compared to non-weak individuals (OR= 2.16, 95% CI= 2.15, 2.16, p<.0001). This is the first study to use grip strength weakness cut-points to identify those who may be at greatest risk for experiencing physical disability in later life. Results underscore the importance of using population-specific cutpoints for clinical weakness in order to identify individuals at greatest risk for adverse health outcomes.
TL;DR: The current results underscore the significant role of cognitive, affective, and behavioral factors in perceived physical disability and their mediated detrimental effect on physical and psychological quality of life in patients with rheumatic diseases.
Abstract: Purpose: To examine factors in the fear-avoidance model, such as pain, pain catastrophizing, fear-avoidance beliefs, physical disability, and depression and their relationships with physical and ps...
TL;DR: People with disabilities who perceive discrimination are less likely to seek healthcare, and this association was higher for people with communication and physical disabilities.
01 Jan 2018
TL;DR: It is a consensus that E DSS will not undergo major changes so that its greatest advantage can be preserved and the consensus in the available literature is that EDSS will never lose its value.
Abstract: Multiple Sclerosis (MS) is often seen in young adults and known to cause both physical and cognitive disability, and it is quite important to make an objective assessment of the physical-cognitive disability status of the patients. The first scale that assesses the physical disability in MS cases, the Disability Status Scale (DSS) elaborated in 1983 and transformed into the Expanded DSS (EDSS). It has been in use since 1983 without much change, which is one of its most significant advantages. It includes all functional systems (although with some shortcomings) that may be affected in MS and reflects the clinical status as a number, which is quite valuable. Although there may be differences between EDSS practitioners, it has been in use for more than 30 years and it can objectively display the difference between a patient’s clinical picture 20 years ago and today, which can be said for only a small number of scales. This shows the importance of using the same scale for diseases that require long-term monitoring such as MS. In conclusion; it is a consensus that EDSS will not undergo major changes so that its greatest advantage can be preserved. Also, the consensus in the available literature is that EDSS will never lose its value.
TL;DR: Physical activity was associated with measurable benefits on ability outcomes, but continuation is likely required to maintain benefits, while adverse events were generally mild and approximately half of studies actually reported safety outcomes.
Abstract: Background Physical activity may be neuroprotective in multiple sclerosis (MS). One review (2011) of exercise and MS disability was inconclusive, but highlighted the need for more studies. Objective To perform an updated systematic literature review examining the relationship between physical activity and physical ability outcomes in persons with MS. Methods EMBASE and MEDLINE were searched for original interventional studies (2011–2016) evaluating exercise on quantitative outcomes of physical disability in MS. We also assessed any reported adverse outcomes. Results Of the 153 articles identified, 12 were included; 3 examined endurance training; 6 resistance training; and 3 explored less conventional exercises, specifically, tai chi, kickboxing, and vestibular rehabilitation, each lasting 5–24 weeks. In total, 568 unique individuals were included, and >10 different scales used to assess outcomes. Endurance training provided benefits in walking ability, while mindfulness exercises (tai chi and vestibular rehabilitation), and dynamic workouts (kickboxing) led to improvements in balance and coordination. Resistance training alone did not improve walking ability, but improved lower limb muscular strength and endurance. When resistance and endurance training were combined, improvements were seen in mobility, balance and coordination. Four studies assessed discontinuation; most reported a return to pre-intervention function. Adverse outcomes were reported in 6 studies, and appeared generally mild, ranging from mild muscle soreness to exacerbation of MS symptoms. Conclusions Physical activity was associated with measurable benefits on ability outcomes, but continuation is likely required to maintain benefits. While adverse events were generally mild, approximately half of studies actually reported safety outcomes.
TL;DR: Long-term lifestyle interventions among overweight or obese adults with type 2 diabetes may reduce long-term disability, leading to an effect on disability-free life expectancy but not on total life expectancy.
Abstract: OBJECTIVE The impact of weight loss intervention on disability-free life expectancy in adults with diabetes is unknown. We examined the impact of a long-term weight loss intervention on years spent with and without physical disability. RESEARCH DESIGN AND METHODS Overweight or obese adults with type 2 diabetes age 45–76 years ( n = 5,145) were randomly assigned to a 10-year intensive lifestyle intervention (ILI) or diabetes support and education (DSE). Physical function was assessed annually for 12 years using the SF-36. Annual incidence of physical disability, mortality, and disability remission were incorporated into a Markov model to quantify years of life spent active and physically disabled. RESULTS Physical disability incidence was lower in the ILI group (6.0% per year) than in the DSE group (6.8% per year) (incidence rate ratio 0.88 [95% CI 0.81–0.96]), whereas rates of disability remission and mortality did not differ between groups. ILI participants had a significant delay in moderate or severe disability onset and an increase in number of nondisabled years ( P CONCLUSIONS Long-term lifestyle interventions among overweight or obese adults with type 2 diabetes may reduce long-term disability, leading to an effect on disability-free life expectancy but not on total life expectancy.
TL;DR: The relationship between physical disability and suicide has begun to be examined within empirically supported frameworks of suicide and indicates that interpersonal factors (e.g. perceived burdensomeness) and pain are mechanisms contributing to this heightened risk of suicide.
Abstract: Recent research indicates a heightened risk of suicide in this population, a concern given that suicide may be more accepted for those with physical disabilities than for those without such disabilities. The relationship between physical disability and suicide has begun to be examined within empirically supported frameworks of suicide and indicates that interpersonal factors (e.g. perceived burdensomeness) and pain are mechanisms contributing to this heightened risk of suicide. The suicide rate after acquiring a physical disability, such as a spinal cord injury, and the greater odds of suicide after reporting having a disability further support the association between physical disability and suicide. The multifaceted nature of physical disability is reflected in its relationship with suicidal ideation and behaviors.
TL;DR: The experiences reported by this study's participants suggest the need to include disability in undergraduate and postgraduate education and training to improve obstetric care to women with physical disabilities.
TL;DR: It is suggested that volunteer intervention programs may represent a major public health strategy to delay the progression of physical disability for older adults.
Abstract: Objectives To describe the association between initiating volunteering and changes in physical disability in older adults, and whether intensity and gender modify this relationship. Methods Employing propensity score weighted regression adjustment, we calculate changes in disability using a sample of U.S. adults (n = 7,135) in the Health and Retirement Study (1996-2012) not volunteering at baseline but later initiating volunteering (1-99 hr/year or 100+ hours per year) or remaining a nonvolunteer. Results Relative to continuous nonvolunteers, low-intensity volunteering is related to 34% lower disability in the low-intensity group (average treatment effect [ATE] = -0.12) and 63% lower in the higher-intensity group (ATE = -0.23). For men, progression was lower only in the highest intensity group (ATE = +0.02), but women experienced similarly less progression of disability (38%-39%) at either level of new engagement (ATE = -0.17 and -0.18). Discussion Initiating a new volunteer role in later life is related to decreased progression of disability, at low or high levels for women and only at higher levels for men. This study suggests that volunteer intervention programs may represent a major public health strategy to delay the progression of physical disability for older adults.
TL;DR: The second phase of GIM effectively sustained LTPA intentions and increased time spent on moderate-to-vigorous strength-training and total LTPA, with significantly positively related to intervention dose, intervention content (both informational and behavioral strategies), and clients’ perceptions of service credibility.
Abstract: Purpose: Get in Motion (GIM) is an evidence-based telephone counseling service that promotes leisure-time physical activity (LTPA) among Canadian adults with spinal cord injury (SCI). The first pha...
TL;DR: Understanding individuals' experiences and how they develop health-seeking behaviors to overcome access barriers will be critical for policy design and client-centered service delivery in rural Ghana and potentially other low- and middle-income countries.
TL;DR: Results indicate that inclusive out-of-school time physical activity programs are important for positive psychosocial and physical skill development of children/youth with physical disabilities.
Abstract: The objective of this study was to comprehensively evaluate inclusive out-of-school time physical activity programs for children/youth with physical disabilities. A search of the published literature was conducted and augmented by international expertise. A quality appraisal was conducted; only studies with quality ratings ≥60% informed our best practice recommendations. Seventeen studies were included using qualitative (n = 9), quantitative (n = 5), or mixed (n = 3) designs. Programs had a diversity of age groups, group sizes, and durations. Most programs were recreational level, involving both genders. Rehabilitation staff were the most common leaders. Outcomes focused on social skills/relationships, physical skill development, and psychological well-being, with overall positive effects shown in these areas. The best practice recommendations are consistent with an abilities-based approach emphasizing common group goals and interests; cooperative activities; mastery-oriented, individualized instruction; ...
TL;DR: It is found that significant proportions of Australians with a disability experience discrimination or engage in avoidance behaviours in various settings with potentially important human capital implications, such as the workforce, education and healthcare.
Abstract: Across most high-income countries, populations are ageing. With this demographic change is an increase in the number of people living with disabilities. In this context, we sought to examine the prevalence of disability discrimination and disability avoidance in Australia, the demographic and health correlates of exclusion and the contexts in which disability discrimination and avoidance are experienced. Methods: Utilising newly released measures from the 2015 ABS Survey of Disability, Ageing and Carers, we calculate the prevalence of people living with a disability who have experienced discrimination and engage in avoidance behaviours, and the contexts in which they occur. Logistic regression models were fitted to examine the correlates of discrimination and avoidance behaviours, once controls and complex survey design were accounted for. Approximately 9% (95% CI = 8.1, 9.2) of people with a disability experienced disability discrimination in 2015 and 31% (95% CI = 30.9, 32.9) engaged in avoidance behaviours because of their disability. With controls included, the prevalence of avoidance and discrimination declined with age, was higher for divorced people (versus married), the unemployed (versus employed) and was lower for people with lower levels of education (versus a degree) and those born overseas. Having a psychosocial or physical disability significantly increased the odds of experiencing discrimination or avoidance, as did having an increasing number of long-term health conditions. We further find that disability discrimination and avoidance occurs in contexts critical to human capital, such as the workforce, education and healthcare. Despite protections in legislation and international accords, significant proportions of Australians with a disability experience discrimination or engage in avoidance behaviours in various settings with potentially important human capital implications. Recently, sectoral responses (eg., in education and the workplace) have been offered by Government reports, providing direction for future research and evaluation.
TL;DR: The aims of this study were to determine whether known correlates of chronic pain in the general population are also present in young people both with physical disability and with chronic pain relative to peers.
Abstract: AIM Adolescents with physical disabilities may have co-occurring chronic pain, but the prevalence and specific associated factors are unknown. The aims of this study were to determine (1) the prevalence of chronic pain in adolescents with physical disabilities and (2) whether known correlates of chronic pain in the general population are also present in young people both with physical disability and with chronic pain relative to peers. METHOD We conducted a secondary analysis of cross-sectional nationally representative data from the National Longitudinal Study of Adolescent to Adult Health. Multivariate linear regression analysis was used to identify demographic and psychosocial factors associated with chronic pain. RESULTS A total of 989 (4.3%) adolescents reported physical disabilities. They had a significantly higher rate of pain (27.2%) compared with able-bodied peers (15.6%, χ2 =86.3550, p<0.001). There was no significant interaction between physical disability status and chronic pain in relation to depressive symptoms, anxiety, or insomnia. INTERPRETATION Adolescents with physical disabilities experience chronic pain at a significantly higher rate than able-bodied peers, but the comorbidity of physical disability and chronic pain is not related to depression, anxiety, or insomnia. Evaluation of chronic pain and tailored pain interventions need to be developed for this population. WHAT THIS PAPER ADDS Chronic pain and its correlates are important problems for adolescents with physical disabilities. These adolescents present with higher rates of chronic pain than other young people. Chronic pain is associated with increased levels of depressive symptoms, anxiety, and insomnia regardless of disability status.
TL;DR: Factors associated with high psychological distress among Aboriginal and non‐Aboriginal Australians and their contribution to the elevated distress prevalence among Aboriginal people are explored.
Eötvös Loránd University1, Semmelweis University2, Columbia University3, Karolinska Institutet4, University of Molise5, Tel Aviv University6, University of Oviedo7, University of Regensburg8, Heidelberg University9, Iuliu Hațieganu University of Medicine and Pharmacy10, Nancy-Université11, University of Primorska12, University of Bern13, Tallinn University14
TL;DR: Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant and functional impairment related to health conditions was both directly and indirectly associated with lowerWell-being.
Abstract: Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14⁻16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability (p < 0.001, Cohen's d = 0.40), suffering from chronic illnesses (p < 0.001, Cohen's d = 0.40), impairments associated to health conditions (p < 0.001, Cohen's d = 0.61), or reported poor to very poor self-rated health (p < 0.001, Cohen's d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms.
TL;DR: Sarcopenia in ambulatory community-dwelling elderly is significantly associated with depressive symptoms and functional disability, and elderly people at high risk of sarcopenia should be screened for functional disability and depression.
TL;DR: Psychological distress was the greatest influencing factor of suicide ideation among the rural elderly, followed by chronic disease and disability, and effective intervention measures should be taken to facilitate the early detection of psychological distress in clinical practice among the Rural elderly.
Abstract: Objective: Suicide is a major public health and social problem in contemporary societies. Previous studies showed that the older the seniors were, the more likely it was that they would experience disability, chronic disease, or both. The objective of this study was to examine the joint effects of chronic disease and physical disability on suicide ideation while controlling for psychological distress among the rural elderly living in Shandong Province, China. Method: A total of 5514 rural elderly individuals (60+) living in Shandong Province, China were included in this study. Suicidal ideation was assessed by using questions from the National Comorbidity Survey (NCS). Multiple logistic analyses were performed to examine the factors associated with suicide ideation. A path analysis was conducted to test the direct and indirect effects of chronic disease and of activity of daily living (ADL) limitation on suicide ideation while controlling for psychological distress. Results: The prevalence of suicide ideation among the rural elderly in Shandong, China was 11.0%. Psychological distress had the strongest direct (β = 0.392) and total effect (β = 0.392), chronic disease (β = -0.034; β = -0.063) had both direct and indirect impacts, and ADL (β = 0.091) had indirect impacts on suicide ideation. Psychological distress was a mediator between chronic disease, ADL limitation, and suicide ideation. Conclusions: Psychological distress was the greatest influencing factor of suicide ideation among the rural elderly, followed by chronic disease and disability. Effective intervention measures should be taken to facilitate the early detection of psychological distress in clinical practice among the rural elderly.
TL;DR: In older adults, PA could attenuate the increased risk of mortality associated with physical disability and reduce the risk of total and CVD death across types of disability.
Abstract: Background Regular physical activity (PA) has been shown to protect against disability onset but, once the disability is present, it is unclear if PA might attenuate its harmful health consequences. Thus, we examined if mortality risk associated with physical disability can be offset by PA among older adults. Methods We used data from a cohort of 3,752 individuals representative of the noninstitutionalized population aged 60 years and older in Spain. In 2000-2001, participants self-reported both PA levels (inactive, occasionally, monthly, weekly) and five physical disabilities (agility, mobility, global daily activities, instrumental activities of daily living, and self-care). Individuals were prospectively followed through 2014 to assess incident deaths. Results The mean follow-up was 10.8 years, with a total of 1,727 deaths, 638 of them due to cardiovascular disease (CVD). All disability types were associated with higher total and CVD mortality. Being physically active (ie, doing any PA) was associated with a statistically significant 26%-37% and 35%-50% lower risk of total and CVD death, respectively, across types of disability. As compared with those being physically active and without disability, those who were inactive and had a disability showed the highest mortality risk from total (hazard ratios from 1.52 to 1.90 across disabilities, all p < .05) and from CVD (hazard ratios from 1.99 to 2.24 across disabilities, all p < .05). Total and CVD mortality risk was similar in physically active participants with disabilities and in inactive individuals without disability. Conclusions In older adults, PA could attenuate the increased risk of mortality associated with physical disability.
TL;DR: The effects of a school-based once-a-week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability are promising for long-term fitness and health promotion.
Abstract: Objective To investigate the effects of a school-based once a week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability. Methods This controlled clinical trial included 71 children and adolescents from four schools for special education (mean age 13.7 (2.9) years, range 8-19, 55% boys). Participants had various chronic health conditions including cerebral palsy (37%), other neuromuscular (44%), metabolic (8%), musculoskeletal (7%), and cardiovascular (4%) disorders. Before recruitment and based on the presence of school-based sports, schools were assigned as sport or control group. School-based sports was initiated and provided by motivated experienced physical educators. The sport group (n=31) participated in a once a week school-based sports program for six months, which included team sports. The control group (n=40) followed the regular curriculum. Anaerobic performance was assessed by the Muscle Power Sprint Test. Secondary outcome measures included aerobic performance, VO2peak, strength, physical activity, blood pressure, arterial stiffness, body composition and the metabolic profile. Results A significant improvement of 16% in favour of the sport group was found for anaerobic performance (p=.003). In addition, the sport group lost 2.8% more fat mass compared to the control group (p=.007). No changes were found for aerobic performance, VO2peak, physical activity, blood pressure, arterial stiffness, and the metabolic profile. Conclusions Anaerobic performance and fat mass improved following a school-based sports program. These effects are promising for long-term fitness and health promotion, because sports sessions at school eliminate certain barriers for sports participation and adding a once a week sports session showed already positive effects over six months. This trial was registered with the Dutch Trial Registry (NTR4698)