PubMed · 6903519
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P Miller. Interrupting the depression cycle.. https://doi.org/10.1016/s0197-4572(80)80017-6
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The purpose of this study was to determine skeletal muscle cutpoints for identifying elevated physical disability risk in older adults. Subjects included 4,449 older (> or = 60 years) participants from the Third National Health and Nutrition Examination Survey during 1988-1994. Physical disability was assessed by questionnaire, and bioimpedance was used to estimate skeletal muscle, which was normalized for height. Receiver operating characteristics were used to develop the skeletal muscle cutpoints associated with a high likelihood of physical disability. Odds for physical disability were compared in subjects whose measures fell above and below these cutpoints. Skeletal muscle cutpoints of 5.76-6.75 and < or =5.75 kg/m2 were selected to denote moderate and high physical disability risk in women. The corresponding values in men were 8.51-10.75 and < or =8.50 kg/m2. Compared with women with low-risk skeletal muscle values, women with moderate- and high-risk skeletal muscle values had odds for physical disability of 1.41 (95% confidence interval (CI): 0.97, 2.04) and 3.31 (95% CI: 1.91, 5.73), respectively. The corresponding odds in men were 3.65 (95% CI: 1.92, 6.94) and 4.71 (95% CI: 2.28, 9.74). This study presents skeletal muscle cutpoints for physical disability risk in older adults. Future applications of these cutpoints include the comparison of morbidity risk in older persons with normal muscle mass and those with sarcopenia, the determination and comparison of sarcopenia prevalences, and the estimation of health-care costs attributable to sarcopenia.
PURPOSE: To compare the score of functional independence measure (FIM) between urban and rural residents living in long-term care facilities (LTCF) in Taiwan. METHODS: A total of 437 subjects in 112 licensed LTCF in Taiwan were randomly selected by stratification strategy. Physical therapists interviewed the subjects in nursing homes (NH) and intermediate care facilities (ICF) to obtain the basic data, and the FIM score. RESULTS: (1) There was no significant difference in basic demographic data between urban and rural LTC subjects. (2) Most of the subjects in urban and rural LTCF were males, less than 80 years old, single/widowed, having multiple diseases, using more than one assistive devices, and having social welfare financial support. (3) Motor abilities (eating, grooming, and transfer) and cognition (comprehension, social interaction and problem solving) in rural LTCF subjects were significantly (p < 0.05) higher than those in urban areas as revealed by the FIM assessment. (4) The median of FIM total score of rural LTCF subjects was 90.5, which was significantly (p < 0.05) higher than that of urban LTCF subjects (median = 76). CONCLUSIONS: Some of the functional performance of subjects in rural long-term care institutions is better than those in urban areas. Our results may provide guidelines for the manpower and equipment supply estimation.
This study investigated the early and late effects of coronary artery bypass grafting (CABG) on left ventricular (LV) function during different physical daily activities in patients with multivessel coronary artery disease (CAD). In ten patients with multivessel CAD, cardiac haemodynamics were assessed during a 6-min walk test and during stair climbing 8+/-2 days before (study 1) and 15+/-3 days (study 2) and 120+/-3 days (study 3) after CABG. LV function was monitored by an ambulatory radionuclide system. In study 1, the walk test induced a significant increase in relative end-diastolic volume (EDV) and end-systolic volume (ESV) and no change in LV ejection fraction as compared to rest. In both study 2 and study 3, EDV increased significantly and ESV was unchanged. As a consequence, LV ejection fraction rose from 48%+/-8% to 52%+/-10% and from 48%+/-7% to 51%+/-6%, respectively (both P<0.05). In study 1, stair climbing induced a significant increase in EDV and ESV and as a consequence LV ejection fraction decreased from 46%+/-8% to 42%+/-9% (P<0.05) as compared to rest. In both study 2 and study 3, EDV increased significantly whereas ESV did not change. As a consequence, LV ejection fraction rose from 48%+/-8% to 52%+/-7% and from 48%+/-8% to 51%+/-7%, respectively (both P<0.05). In conclusion, CABG has beneficial effects on cardiac performance during moderate or more intense physical activity in patients with multivessel CAD and these effects are due to improvement in systolic function. Radionuclide monitoring of LV function provides an objective method for quantitative evaluation of cardiac performance after CABG.