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Differences between self-reported and observed physical functioning in independent older adults.

https://arctichealth.org/en/permalink/ahliterature262880
Source
Disabil Rehabil. 2014;36(17):1395-401
Publication Type
Article
Date
2014
Author
Rona Feuering
Elisha Vered
Talma Kushnir
Alan M Jette
Itshak Melzer
Source
Disabil Rehabil. 2014;36(17):1395-401
Date
2014
Language
English
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Aged
Aged, 80 and over
Anxiety - epidemiology
Depression - epidemiology
Disability Evaluation
Female
Finland
Geriatric Assessment - methods
Humans
Independent living
Male
Self Report
Abstract
Understanding whether there is an agreement between older persons who provide information on their functional status and clinicians who assess their function is an important step in the process of creating sound outcome instruments.
To examine whether there is agreement between self-reported and clinician assessment of similar performance items in older adults.
Fifty independent older adults aged 70-91 years (mean age 80.3?±?5.2 years) who live in the community were examined separately and blindly in two data collection sessions. Self-reported and observed lower and upper extremity physical tasks were compared. Life Function and Disability Instrument (LLFDI) was used in both sessions. We performed intra-class correlation coefficients (ICC) as indices of agreement and "mountain plots" that were based on a cumulative distribution curve. Associations between self-reported and observed function with Fear of Fall Scale (FES) and Geriatric Depression Scale (GDS) were also assessed.
ICCs were high between self-reported lower extremity function and observed lower extremity function (ICC?=?0.83), and were poorer for self-reported and observed upper extremity function (ICC?=?0.31). In both comparisons, mountain plots revealed a right shift that was larger for upper than lower extremity functions, indicating systematic differences in self-reported and observed assessments. Associations with FES and GDS were higher for self-reported than observed function.
There is a systematic bias between self-reported and clinician observation. Professionals should be aware that information provided by patients and observation of activity assessed by clinicians could differ substantially, especially for upper extremity function. Implications for Rehabilitation There is a systematic bias between self-reported and clinician assessment of similar performance items in older adults. In general, older adults overestimate their physical function or clinicians underestimate older adults function. The bias between self-reported and clinician assessment for upper extremity function is larger than that for lower extremity function. The conclusions regarding agreement across upper extremity and lower extremity function scores are not different when using mountain plots graphs versus relying solely on the value of the ICCs. However, the graphs expand our understanding of the direction and magnitude of score differences. Professionals should be aware that information provided by patients and assessment by clinicians could differ substantially, especially for upper extremity function.
PubMed ID
24001263 View in PubMed
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Type D personality is associated with increased prevalence of ventricular arrhythmias in community-residing persons without coronary heart disease.

https://arctichealth.org/en/permalink/ahliterature259254
Source
Eur J Prev Cardiol. 2014 May;21(5):592-600
Publication Type
Article
Date
May-2014
Author
Gunnar Einvik
Toril Dammen
Silje K Namtvedt
Harald Hrubos-Strøm
Anna Randby
Håvard A Kristiansen
Inger H Nordhus
Virend K Somers
Torbjørn Omland
Source
Eur J Prev Cardiol. 2014 May;21(5):592-600
Date
May-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anxiety - epidemiology
Chi-Square Distribution
Cross-Sectional Studies
Electrocardiography, Ambulatory
Female
Humans
Independent living
Linear Models
Logistic Models
Male
Middle Aged
Multivariate Analysis
Norway - epidemiology
Odds Ratio
Personality Assessment
Prevalence
Risk assessment
Risk factors
Tachycardia, Ventricular - diagnosis - epidemiology - physiopathology - psychology
Time Factors
Type D Personality
Ventricular Premature Complexes - diagnosis - epidemiology - physiopathology - psychology
Abstract
Type D personality may be a risk factor for poor outcome in patients with cardiovascular disease. The biological mechanisms underlying this association are poorly understood. The objective of the study was to test the hypotheses that Type D personality is associated with biological markers for sympathetic dysregulation.
Cross-sectional community-based study.
Type D personality was evaluated by DS-14 in 450 persons (46% men), aged between 30 and 65 years. From a Holter-recording, (mean length 18.3 hours), long-term heart rate, ventricular arrhythmias, and heart rate variability (HRV) were registered as markers of sympathetic dysregulation. Traditional cardiovascular risk factors, apnoea-hypopnoea index, medication, and anxiety symptoms were adjusted for.
Type D persons had higher long-term averaged heart rate (74 vs. 71 beats/min, p = 0.003), but this difference was attenuated and not significant in the multivariate model (p = 0.078)). There was an increased prevalence of complex ventricular ectopy (bigeminy, trigeminy, or non-sustained ventricular tachycardia; 14 vs. 6%, p = 0.005 in multivariate model). HRV indices did not differ significantly between those with or without Type D personality. Anxiety symptoms did not confound these associations.
Type D personality is independently associated with a higher likelihood of ventricular arrhythmias, which may be implicated in the increased cardiovascular risk observed in persons with Type D personality.
PubMed ID
23008135 View in PubMed
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