improvement and deterioration in physical functioning among israelis aged 60 and over n.
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Myers-JDC-Brookdale Institute. Center for Research on Aging. Improvement and Deterioration in Physical Functioning among Israelis Aged 60 and over. Jenny Brodsky, Tal Spalter , Yitschak Shnoor October 17, 2012. Outline. Background Study Purpose and Hypothesis Method of Analysis

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Improvement and Deterioration in Physical Functioning among Israelis Aged 60 and over


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improvement and deterioration in physical functioning among israelis aged 60 and over

Myers-JDC-Brookdale Institute

Center for Research on Aging

Improvement and Deterioration in Physical Functioning among Israelis Aged 60 and over

Jenny Brodsky, Tal Spalter, Yitschak Shnoor

October 17, 2012

outline
Outline
  • Background
  • Study Purpose and Hypothesis
  • Method of Analysis
  • Findings
  • Discussion
the iom disability in america
The IoM Disability in America

Disablement

Process is Dynamic-

Non-linear

IOM - Institute of Medicine report Disability in America (Pope and Tarlov 1991)

study objectives
Study Objectives
  • To examine the changes in physical functioning of older adults between two periods of time
  • To examine what variables predict the changes in function
hypothesis
Hypothesis
  • Together with patterns of functional deterioration, we will also find patterns of improvement
  • Women, the old-old, minorities (Arabs), and those with low income and low education, are at higher risk of functional deterioration
  • Older adults suffering from multi-pathology, as well as individuals with cognitive and mental problems, are at higher risk of functional deterioration
study population
Study Population
  • Individuals who were 60 and over in the first round of SHARE- Israel (2005-2006); they were 65 and over in the second round of SHARE-Israel (2009-2010)
  • N=982
dependent variables
Dependent Variables
  • Changes in mobility(walking 100 meters, sitting for two hours, getting up from a chair, climbing several floors or one floor without resting)
  • Changes in basic functions(pulling or pushing large objects; stooping, crouching, or kneeling; reaching or extending arms above shoulder level; handling small objects; carrying 5kg)
  • Changes in ADL (washing, dressing, eating, toileting, crossing a room, getting in and out of bed)
  • Changes in IADL(preparing a hot meal, buying groceries, using the telephone, taking drugs, financial management)
dependent variables cont
Dependent Variables cont.
  • Scales were built in the two rounds of SHARE by summing up items
  • Changes were calculated by taking round two minus round one
independent variables
Independent Variables
  • Socio-demographic status (age, gender, living arrangements, education, income, population group)
  • Function and health (function in the first wave, No. of illnesses, change in the No. of illnesses between waves, mental health, cognitive function)
  • Social Activities(volunteering, participating in social, religious, political and educational activities)
  • Receipt of formal support (personal care and homemaking)
  • Receipt of informal support
changes in functioning 1 n 982
Changes in Functioning1 N=982 (%)

1 The changes between rounds are significant by t-test for paired samples

**p<0.01

linear regression to predict changes in functioning n 982
Linear Regression to Predict Changes in Functioning: N=982

*p<0.05, **p<0.01

1Standardized coefficients-b; positive=improvement & negative=deterioration

major findings and implications
Major Findings and Implications
  • There is no single pattern of functional deterioration over time among older adults, there is also improvement
  • Arab older adults are at higher risk of deterioration in physical functioning over time
  • Physical health indicators, mainly multi-pathology, predict deterioration in functioning (according to the Disablement Model)
  • Mental and cognitive status predict deterioration in functioning
  • Receiving informal care and formal help (in homemaking) predict deterioration
major findings and implications cont
Major Findings and Implications (cont.)
  • These findings do not lead to the conclusion that there is no need to help the elderly.
  • However, they imply that many times, instrumental assistance to the elderly, "save the hassle" of doing things by themselves and thus, weakens a potential functional rehabilitation process.
slide20

Rehabilitation

While Mr. Johns never did make it into the Olympics, he did however get full motion back in his knees

i mprovement and preservation of functional capabilities
Improvement and Preservation of Functional Capabilities
  • Professional rehabilitation
  • Training of professional and non-professional staff (i.e., nurses and homecare workers)
  • Training of family caregivers
slide22

"My goal is to die before there's a technology breakthrough that forces me to live until one hundred and thirty"

Thank You