Disability During the Last Two Years of Life.

Disability During the Last Two Years of Life.

JAMA Intern Med. 2013 Jul 8;
Smith AK, Walter LC, Miao Y, Boscardin WJ, Covinsky KE

IMPORTANCE Whereas many persons at advanced ages live independently and are free of disability, we know little about how likely older people are to be disabled in the basic activities of daily living that are necessary for independent living as they enter the last years of life. OBJECTIVE To determine national estimates of disability during the last 2 years of life. DESIGN Prospective cohort study. SETTING A nationally representative study of older adults in the United States. PARTICIPANTS Participants 50 years and older who died while enrolled in the Health and Retirement Study between 1995 and 2010. Each participant was interviewed once at a varying time point in the last 24 months of life. We used these interviews to calculate national estimates of the prevalence of disability across the 2 years prior to death. We modeled the prevalence of disability in the 2 years prior to death for groups defined by age at death and sex. MAIN OUTCOMES AND MEASURES Disability was defined as need for help with at least 1 of the following activities of daily living: dressing, bathing, eating, transferring, walking across the room, and using the toilet. RESULTS There were 8232 decedents (mean [SD] age at death, 79 [11] years; 52% women). The prevalence of disability increased from 28% (95% CI, 24%-31%) 2 years before death to 56% (95% CI, 52%-60%) in the last month of life. Those who died at the oldest ages were much more likely to have disability 2 years before death (ages 50-69 years, 14%; 70-79 years, 21%; 80-89 years, 32%; 90 years or more, 50%; P for trend, <.001). Disability was more common in women 2 years before death (32% [95% CI, 28%-36%]) than men (21% [95% CI, 18%-25%]; P?<?.001), even after adjustment for older age at death. CONCLUSIONS AND RELEVANCE Those who live to an older age are likely to be disabled, and thus in need of caregiving assistance, many months or years prior to death. Women have a substantially longer period of end-of-life disability than men. HubMed – eating


Health behaviors and quality of life among patients with chronic respiratory disease.

Adv Exp Med Biol. 2013; 788: 401-6
Kurpas D, Mroczek B, Jasinska M, Bielska D, Nitsch-Osuch A, Kassolik K, Andrzejewski WM, Gryko A, Krzyzanowski DM, Steciwko A

The purpose of this study was to analyze health behaviors of patients with chronic respiratory disease and the correlations between health behaviors (HB) and quality of life (QoL). The study involved 256 adult patients (135 women and 121 men), mean age was 62.6 ± 16.1 years, with chronic respiratory disease. The research tools consisted of the Health Behavior Inventory (HBI) and the World Health Organization Quality of Life Instrument Short Form. The mean general score for HB was 85.6 ± 17.8. Most patients (74 persons) obtained high scores (7-10 stens). The strongest correlations between QoL and HB were as follows: Psychological Domain correlated with positive mental attitude (r = 0.308, p < 0.001), healthy eating habits (r = 0.224, p = 0.001), and with the level of health behaviors (r = 0.222, p = 0.003); Social Relationship Domain correlated with positive mental attitude (r = 0.282, p < 0.001) and healthy eating habits (r = 0.238, p < 0.001). We conclude that QoL in patients with chronic respiratory diseases is significantly shaped by their health behaviors. HubMed – eating


Effectiveness of 2 methods of promoting physical activity, healthy eating, and emotional well-being with the americans in motion–healthy interventions approach.

Ann Fam Med. 2013 Jul-Aug; 11(4): 371-80
Pace WD, Lanigan AM, Staton EW, Graham DG, Manning BK, Dickinson LM, Emsermann CB, Stewart EE

PURPOSE An increasing number of Americans are putting their health at risk from being overweight. We undertook a study to compare patient-level outcomes of 2 methods of implementing the Americans In Motion-Healthy Interventions (AIM-HI) approach to promoting physical activity, healthy eating, and emotional well-being. METHODS We conducted a randomized trial in which 24 family medicine practices were randomized to (1) an enhanced practice approach in which clinicians and office staff used AIM-HI tools to make personal changes and created a healthy environment, or (2) a traditional practice approach in which physicians and staff were trained and asked to use the tools with patients. Of the 610 patients enrolled, 331 were in healthy practices, and 279 were in traditional practices. At 0, 4, and 10 months we assessed blood pressure, body mass index, fasting blood glucose and insulin levels, nuclear magnetic resonance lipoprotein profiles, fitness, dietary intake, physical activity, and emotional well-being. Outcome data were analyzed using linear, mixed-effects multivariate models, adjusting for practices as a random effect. RESULTS Regardless of patient group, 16.2% of patients who completed a 10-month visit (n = 378 patients, 62% of enrollees) and 10% of all patients enrolled lost 5% or more of their body weight; 16.7% of patients who completed a 10-month visit (10.3% of all enrollees) had a 2-point or greater increase in their fitness level; and 29.2% of 10-month completers (18.0% of all enrollees) lost 5% or more of their body weight and/or increased their fitness level by 2 or more points. There were no significant differences in these outcomes between groups. CONCLUSIONS There was no difference between the 2 groups in the primary and most secondary outcomes. Both patient groups were able to show significant before-after improvements in selected patient-level outcomes. HubMed – eating


Serum leptin and loss of control eating in children and adolescents.

Int J Obes (Lond). 2013 Jul 9;
Miller R, Tanofsky-Kraff M, Shomaker LB, Field SE, Hannallah L, Reina SA, Mooreville M, Sedaka N, Brady SM, Condarco T, Reynolds JC, Yanovski SZ, Yanovski JA

BackgroundBoth insufficiency and resistance to the actions of the adipocyte-derived hormone leptin promote hunger, increased food intake, and greater body weight. Some studies suggest adults reporting binge eating have increased serum leptin compared to those without binge eating, even after adjusting for the greater adiposity that characterizes binge eaters. Pediatric binge or loss of control (LOC) eating are prospective risk factors for excessive weight gain and may predict development of metabolic abnormalities, but whether LOC eating is associated with higher leptin among children is unknown. We therefore examined leptin and LOC eating in a pediatric cohort.MethodsA convenience sample of 506 lean and obese youth (7-18y) was recruited from Washington, DC and its suburbs. Serum leptin was collected after an overnight fast. Adiposity was measured by dual-energy X-ray absorptiometry or air displacement plethysmography. LOC eating was assessed by interview methodology.ResultsLeptin was strongly associated with fat mass (r=0.79, P<0.001). However, even after adjusting for adiposity and other relevant covariates, youth with LOC eating had higher serum leptin compared to those without LOC episodes (15.42±1.05 vs 12.36±1.04?ng/mL, P<0.001). Neither reported amount of food consumed during a recent LOC episode nor number of LOC episodes in the previous month accounted for differences in leptin (ps>0.05). The relationship between LOC eating and leptin appeared to be significant for females only (P=0.002).ConclusionsReports of LOC eating were associated with higher fasting leptin in youth, beyond the contributions of body weight. Prospective studies are required to elucidate if LOC eating promotes greater leptin or if greater leptin resistance may promote LOC eating.International Journal of Obesity accepted article preview online, 9 July 2013. doi:10.1038/ijo.2013.126. HubMed – eating



Eating Disorders! – This is a project i had to do for my english class about eatind disorders…watch and comment plz! it’s funny! jonas brothers demi lovato selena gomez miley …