The younger we feel, the better we rehabilitate

Here's all the questionaires you need to take to find out how young you feel. If your doctor/hospital doesn't have them, ask why not? I certainly don't feel like I'm 66.

Participants completed a variety of measures: They were asked their subjective age (SA “How old/young do you feel?”); about how meaningful life is for them via subscales of the Presence of Meaning and Search for Meaning surveys; how successfully they felt they were aging using the Self-Rated Successful Aging Scale; their stance toward life via the Life Orientation Test; how much stress they experienced using the Perceived Stress Scale; how much they felt they had reached a state of comfort with themselves via the Personal Mastery Scale; measures of health and well-being including the Brief Symptom Inventory Anxiety Scale, the Patient Health Questionnaire, the CES-D Happiness Scale, and the Satisfaction with Life Scale; and other relevant measures including the Connor-Davidson Resilience Scale, the Brief Multidimensional Measure of Religiousness/Spirituality, the Santa Clara Brief Compassion Scale, and the Curiosity and Exploration Inventory.

The younger we feel, the better we rehabilitate

As scientists gradually discover evidence that people who feel younger than their chronological age are typically healthier and more psychologically resilient, the saying "you're only as old as you feel" rings increasingly true.

Could the expression also hold true for older people recuperating from physical disabilities? Apparently so. Researchers from Bar-Ilan University in Israel have found that feeling young can increase the chances of successful rehabilitation from medical conditions, even in old age. Their study was recently published in the journal Gerontology.

The study tracked 194 adult patients aged 73-84 undergoing rehabilitation from osteoporotic fractures or stroke in several rehabilitation facilities across Israel. Fractures (mostly due to falls) and stroke are frequent health events that result in the loss of one's functional independence, considered the greatest fear of older adults.

Patients were interviewed several times throughout their rehabilitation. They were asked about their subjective age (how young they felt), feelings and experiences. Their functional independence was assessed by nursing personnel who rated their functioning level at admission and at discharge using the Functional Independence Measurement (FIM) test.

Patients who felt younger (had a younger subjective age) at hospital admission showed better functional independence at discharge approximately one month later. The beneficial effect of feeling younger was found both for patients who rehabilitated from osteoporotic fractures (mainly due to falls) and for those who rehabilitated from a stroke. The researchers also found that those who felt younger rehabilitated better because they were more optimistic about their chances of regaining their functional abilities.

"The effect of subjective age at admission on functional independence at discharge was confirmed," says Prof. Amit Shrira, from the Gerontology Program at the Department of Interdisciplinary Social Sciences, who led the study together with Prof. Ehud Bodner, also from the Interdisciplinary Social Sciences department. "However, the reverse effect—that of functional independence at admission on subjective age at discharge—was not confirmed. This supports the conclusion that a younger age identity is an important psychological construct that contributes to a more successful rehabilitation," added Shrira, who conducted the research with Dr. Daphna Magda Kalir from the Gender Studies Program, among others.

Surprisingly, subjective age was the strongest predictor of rehabilitation outcomes, stronger even than patients' chronological age and multiple chronic health conditions occurring simultaneously (physical multimorbidity) at admission. Chronological age and physical multimorbidity are generally considered by health care practitioners in determining prognosis, whereas subjective age is unknown to most practitioners. "Those who feel younger can maintain their health and functioning for longer periods, and as the current study shows, can recuperate better from disability. Therefore, by perceiving themselves to age successfully people may preserve a healthy and vigorous lifestyle," says Shrira.

In view of the findings, the researchers suggest that clinicians consider evaluating patients' subjective age when they design rehabilitation protocols. A younger subjective age may motivate older individuals to adhere to the rehabilitation protocol following osteoporotic fracture and stroke. Future research could assist in designing interventions geared to induce a younger subjective age in patients that might assist them in rehabilitating more successfully. Such interventions may help correct false beliefs of aging and include cognitive techniques that help change negative automatic thoughts about aging.

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Feeling younger buffers older adults from stress, protects against health decline

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More information: Daphna Magda Kalir et al, Feeling Younger, Rehabilitating Better: Reciprocal and Mediating Effects between Subjective Age and Functional Independence in Osteoporotic Fracture and Stroke Patients, Gerontology (2022). DOI: 10.1159/000524885

 

Association of breakfast intake with incident stroke and coronary heart disease

My god, what fucking laziness, questionaires rather than actually doing research to solve all the fucking problems in stroke.  These people need to be shamed out of the field. What next, seeing which side of the bed you get up in the morning and risk of stroke?
https://www.mdlinx.com/internal-medicine/medical-news-article/2016/02/01/breakfast-cardiovascular-diseases-coronary-heart-disease/6509632/?

Stroke, 02/01/2016 Kubota Y, et al.

The authors sought to prospectively investigate whether the omission of breakfast is related to increased risks of stroke and coronary heart disease in general Japanese populations. The frequency of breakfast intake was inversely associated with the risk of stroke, especially cerebral hemorrhage in Japanese, suggesting that eating breakfast everyday may be beneficial for the prevention of stroke.

Methods

• A total of 82 772 participants (38 676 men and 44 096 women) aged 45 to 74 years without histories of cardiovascular disease or cancer were followed up from 1995 to 2010.
• Participants were classified as having breakfast 0 to 2, 3 to 4, 5 to 6, or 7 times/wk.
• The hazard ratios of cardiovascular disease were estimated using Cox proportional hazards models.

Results

• During the 1 050 030 person–years of follow–up, the authors documented a total of 4642 incident cases, 3772 strokes (1051 cerebral hemorrhages, 417 subarachnoid hemorrhages, and 2286 cerebral infarctions), and 870 coronary heart disease.
• Multivariable analysis showed that those consuming no breakfast per week compared with those consuming breakfast everyday had hazard ratios (95% confidence interval; P for trend) of 1.14 (1.01–1.27; 0.013) for total cardiovascular disease, 1.18 (1.04–1.34; 0.007) for total stroke, and 1.36 (1.10–1.70; 0.004) for cerebral hemorrhage.
• Similar results were observed even after exclusion of early cardiovascular events.
• No significant association between the frequency of breakfast intake and the risk of coronary heart disease was observed.

Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

Evaluation of patient satisfaction after stroke rehabilitation program. Validation study for the Spanish version of the Satisfaction Pound Scale

I bet this is totally bogus because the staff is influencing the answers. They are saying you recovered well, not even acknowledging that 100% recovery was the goal. And meeting that goal for the hospital is a complete failure.
http://www.sciencedirect.com/science/article/pii/S2387020616307057

Evaluación de la satisfacción con el programa de rehabilitación tras el ictus: validación de la versión española de la Pound Satisfaction Scale ^☆

• Aizpea Aguirrezabal Juaristi^{a, ,} ,
• Montse Ferrer Fores^b,
• Ester Marco Navarro^a,
• Sergi Mojal García^b,
• Gemma Vilagut Saiz^b,
• Esther Duarte Oller^a

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http://dx.doi.org/10.1016/j.medcle.2016.12.003

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• Aizpea Aguirrezabal Juaristi, Montse Ferrer Fores, Ester Marco Navarro, Sergi Mojal García, Gemma Vilagut Saiz, Esther Duarte Oller

• Evaluación de la satisfacción con el programa de rehabilitación tras el ictus: validación de la versión española de la Pound Satisfaction Scale

• Medicina Clínica, Volume 147, Issue 10, 18 November 2016, Pages 441-443
• •  Purchase PDF - $35.95

One in three people would risk shorter life rather than take daily pill to avoid heart disease

Considering the side effects from statins I don't see this as unusual.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=149267&CultureCode=en
One in three people say they would risk living a shorter life instead of taking a daily pill to prevent cardiovascular disease, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.
Researchers at the University of California San Francisco (UCSF) and the University of North Carolina at Chapel Hill surveyed 1,000 people (average age 50) via the Internet hypothetically asking how much time they were willing to forfeit at the end of their lives to avoid taking daily medication. They were also asked the amount of money they would pay and the hypothetical risk of death they were willing to accept to avoid taking medications to prevent cardiovascular disease.
The survey showed:

• More than 8 percent of participants were willing to trade as much as two years of life to avoid taking daily medication for cardiovascular disease; while roughly 21 percent would trade between one week and a year of their lives.  
• About 70 percent said they wouldn’t trade any weeks of their lives to avoid taking a CVD pill daily
• About 13 percent of participants said they would accept minimal risk of death to avoid taking a pill daily; 9 percent said they’d risk a 10 percent chance; and about 62 percent weren’t willing to gamble any risk of immediate death.  
• About 21 percent said they would pay $1,000 or more to avoid taking a pill each day for the rest of their lives, but 43 percent said they wouldn’t pay any amount. 

“What we were really trying to measure is how much the act of taking a pill — obtaining it, remembering to take it and actually taking it — interferes with one’s quality of life,” said Robert Hutchins, M.D., M.P.H., lead author and resident physician in UCSF’s Department of Medicine, Division of General Internal Medicine. “Even ignoring the side-effects of pills, the act of having to take a daily pill can have a large effect on an individual’s quality of life."
“When you consider that many adults are on numerous pills, the effect is often magnified for that person,” he said. “On a population level, even for the small reductions in quality of life like those found in this study, that effect multiplied across millions of people can have very large effects on the cost-effectiveness of that drug for a population.”
While Hutchins and co-authors, believe this is the largest study to date to quantify the utility of taking such medications, they note that the survey was hypothetical. Researchers used a time trade-off method as their primary goal, with the standard gamble and willingness-to-pay as secondary aims.
The standard gamble technique measures an individual’s preference under uncertain situations — in this case whether they may one day require cardiovascular medications and whether they would take them or risk CVD or related death.
Although the survey stipulated that participants wouldn’t have to pay for pills and to ignore any potential side effects, researchers aren’t certain that these issues didn’t affect responses.
“It is important to note that our survey only measured individuals’ preferences at one point in time,” Hutchins said. “However, the fact that we did not see large differences gives us confidence that this effect is probably not large.”
The respondents were 59 percent female and 63 percent Caucasian. Almost a third didn’t have college degrees and 51 percent had incomes between $25,000 and $75,000.
The mean utility – the value of taking just one daily pill for CVD prevention, such as statins or even aspirin – was found to be approximately 0.990 to 0.994. Utility refers to potential value of preventative services including disease prevention, cost effectiveness, quality of life and adverse effects.
The study’s findings are useful for policymakers evaluating preventive interventions, specifically the cost effectiveness of those interventions for cardiovascular disease, Hutchins said.
http://newsroom.heart.org/news/one-in-three-people-would-risk-shorter-life-rather-than-take-daily-pill-to-avoid-heart-disease?preview=9fc0c22d4003b55a01be79d9cf1932a6