BackgroundThe extension of the life span has led to an increase in the number of older people and an increase in the prevalence of disability in people over 60 years of age. The aim of this study was to assess the prevalence of ADL and IADL disability and to analyze its determinants among people aged 60 and older living in southeastern Poland.MethodsThis cross-sectional study was carried out among a randomly selected, representative population of people aged 60 and older living in southeastern Poland. Disability was assessed using the Katz Index of Independence in Basic Activities of Daily Living and Instrumental Activities of Daily Living. Logistic regression models were used to identify the factors related to ADLs and IADLs. For the variables that were included in the above models, their clustered influence on the increase in the odds ratio for the occurrence of an ADL or IADL limitation was also examined.ResultsThe research results show that 35.75% of the participants reported at least one problem with IADLs. At least one problem with ADLs was reported by 17.13% of the participants. The most significant modifiable factors influencing the occurrence of disability were the presence of barriers in the participant’s environment, poor relations with relatives, a lack of social contacts, multimorbidity and pain. A multiple increase in the odds ratio of disability was found with the presence of pairs of analyzed factors. The highest odds ratio of at least one ADL limitation was observed for the combination of barriers in the participant’s environment with multimorbidity (OR 74.07). With regard to IADL disability, the highest odds ratio was observed for the combination of pain on the VAS scale ≥3 points with older age (OR 19.47).ConclusionsThe study showed a high prevalence of ADL and IADL disability in older people living in southeastern Poland. It also indicated the extent to which modifiable factors influenced the occurrence of disability and the extent to which the risk of disability increased with the presence of pairs of factors, especially those that included environmental barriers in the participant’s environment.

Age, education, pain, falls, household not fully adapted for one's needs, using assistive devices, lack of satisfaction with life, and low assessment of quality of life had a significant impact on the prevalence of ADL and/or IADL disabilities in the elderly inhabitants of rural areas. Most of these factors can be subject to modification. They are also a complex of predictors that allow for identifying and supporting those elderly patients from rural areas who are the most vulnerable.

Introduction Low muscle strength is common and important in geriatric syndromes including frailty and sarcopenia. The epidemiology of grip strength of older people under long-term care facilities has been little explored. Purpose The aim of this study was to assess handgrip strength of older women and men covered by institutional care and to analyse the associations between HGS and mobility, leg strength, flexibility, and postural balance. Materials and Methods This is a cross-sectional study carried out at care homes in southeastern Poland. After considering the inclusion criteria, 209 older people aged 65 to 85 were included in the study. Sociodemographic data were collected, and tests of muscular strength, mobility, flexibility, and postural balance were carried out by the use of the stabilometric platform CQ Stab 2P. Results The average handgrip strength in the study group amounted to 19.8 kg, including 14.8 kg in women and 25.9 kg in men. Low grip strength was found in 67.83% women and 52.13% men in institutional care. A negative correlation between handgrip strength (HGS) and the Timed Up and Go (TUG) test was demonstrated, both with and without cognitive task and strength of lower limbs. Gait speed and dynamic balance were positively correlated with HGS. A negative correlation was found between the total length of the centre of pressure (COP) path, the length of the COP path in the lateral-medial direction, and the sway area delimited by the COP and HGS for the dominant hand. Speaking of women, gait speed was most strongly associated with HGS, while among men, it was upper limb flexibility. Conclusion Regardless of gender, HGS is associated with mobility, strength of the lower limbs, and dynamic balance. By means of simple tools, early diagnosis will facilitate the planning of appropriate interventions in order to prevent disability and mortality in long-term care facilities.

Introduction.In Poland, the number of the oldest-old people is increasing. The prevalence of health problems increases with age, which expands the cost of medical and social care. Therefore, there is a need to assess factors affecting the level of disability and quality of life in order to modify them. Materials and method. The study was carried out in a group of 498 people aged 80 and over who live in community in south-eastern Poland. The researchers collected socio-demographic and health data, the WHODAS 2.0 questionnaire was used to assess disability and functioning. Quality of life was studied using the WHOQOL-BREF questionnaire. Results. The general average level of disability was 37.41, with women having a higher level of general disability than men (38.94 vs. 33.94). The highest levels of disability occurred in areas such as mobility, life activity and participation. Statistically, a significantly higher level of disability develops in women who are older, with lower education, social involvement, not able to get help from other people and having more chronic diseases. In men, disability increased with age and greater number of chronic illnesses. The general quality of life of the study group was average (62.53) and comparable for both genders. The lowest quality of life was found in the domain of physical health. A significantly lower quality of life appeared in lonely people, with more chronic diseases, lower education, physical and social inactivity, as well as a lack of help from other people and non-adjustment to the environment. Conclusion.Factors affecting the disability and quality of life of the oldest-old people should be considered in developing senior health policy in Poland.

The study stresses the impact of modifiable determiners of QOL. Interventions aimed at improving the quality of life of older adults should involve interdisciplinary monitoring of health, early treatment of diagnosed problems, and promotion of physical activity and daily life activities.

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is considered by the World Health Organization (WHO) to be a useful tool for assessing the functioning and disability of the general population as well as the effectiveness of the applied interventions. Until this study, no data regarding the validity of the 36-item WHODAS 2.0 in chronic low back pain (LBP) in Poland have been explored. This study was conducted on 92 patients suffering from chronic LBP admitted to the rehabilitation ward. The Polish version of the 36-item WHODAS 2.0, the Sf-36 Health Survey (SF-36), the Oswestry Disability Index (ODI), the Hospital Anxiety and Depression Scale (HADS) and the Visual Analogue Scale (VAS) questionnaires were applied to assess patients. The scale score reliability of the entire tool for the study population was very high. The Cronbach’s alpha test result for the entire scale was 0.92. For the overall result of the WHODAS 2.0, the Intraclass Correlation Coefficient (ICC1,2) was 0.928, which confirmed that the scale was consistent over time. The total result and the vast majority of domains of the 36-item WHODAS 2.0 correlated negatively with domains of the SF-36 questionnaire; thus, a higher WHODAS 2.0 score was associated with a lower score on the SF-36 questionnaire. We found that the minimal clinically important difference (MCID) for the total WHODAS 2.0 score in patients after rehabilitation for LBP was 4.87. Overall, the results indicated that the Polish version of the 36-item WHODAS is suitable for assessing health and disability status in patients with LBP.

The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (n = 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (p < 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.

BackgroundThe proportion of elderly people living in Poland has risen in recent years. With rising life expectancy, there is likely to be a concurrent increase in the incidence of chronic diseases and disabilities. Therefore, this study aimed to analyze the prevalence of chronic diseases and disability of the elderly in order to help guide strategies of prevention and public health control.Material/MethodsThis was a cross-sectional study of 1,000 randomly-selected residents living in the Podkarpackie region of Poland. The WHODAS 2.0 questionnaire was used to assess the disability and functioning of the participants across six domains of functioning using the following scores: no disability (0–4%), mild disability (5–24%), moderate disability (25–49%), severe disability (50–95%), and extreme disability (96–100%).ResultsThe presence of at least one chronic disease was identified in 84.1% of participants. The most common diseases were: circulatory diseases (59.10%), spinal pain syndromes (51.50%), degenerative joint diseases (50.30%), and rheumatic diseases (23.90%). Severe or extreme disability was found in 8.46% of patients with circulatory disease, 9.32% of patients with spinal pain syndromes, 9.34% of patients with degenerative joint diseases, and 12.13% of patients with rheumatic diseases.ConclusionsBased on our findings, we recommend an emphasis be placed on early diagnosis of chronic diseases. We also recommend implementing methods of primary and secondary prevention aimed at reducing or eliminating disability resulting from chronic diseases. Our research highlights the need to plan targeted support and prevention programs using strategies that optimize social participation of older people with various chronic diseases.