Sustaining and increasing Fresh Fund-type programme operations should be a top priority for future policy decisions concerning farmers' market use in low-income neighbourhoods.
Objectives
This study examines the cross-sectional associations of cognitive and physical function with life satisfaction in middle-class, community-dwelling adults aged 60 and older.
Study Design
Participants were 632 women and 410 men who had cognitive function tests (CFT) and physical function tasks (PFT) assessed at a clinic visit between 1988 and 1992, and who responded in 1992 to a mailed survey that included life satisfaction measures. Cognitive impairment was defined as ≤24 on MMSE, ≥132 on Trails B, ≤12 on Category Fluency, ≤13 on Buschke long-term recall, and ≤7 on Heaton immediate recall. Physical impairment was defined as participants’ self-reported difficulty (yes/no) in performing 10 physical functions. Multiple linear regression examined associations between life satisfaction and impairment on ≥1 CFT or difficulty with ≥1 PFT.
Main Outcome Measures
The Satisfaction with Life Scale (SWLS; range:0–26) and Life Satisfaction Index-Z (LSI-Z; range:5–35).
Results
Participants’ average age was 73.4 years (range=60–94). Categorically defined cognitive impairment was present in 40% of men and 47% of women. Additionally, 30% of men and 43% of women reported difficulty performing any PFT. Adjusting for age and impairment on ≥1 CFT, difficulty performing ≥1 PFT was associated with lower LSI-Z and SWLS scores in men (β=−1.73, −1.26, respectively, p<0.05) and women (β= −1.79, −1.93, respectively, p<0.01). However, impairment on ≥1 CFT was not associated with LSI-Z or SWLS score after adjusting for age and difficulty with ≥1 PFT.
Conclusions
Limited cognitive function was more common than limited physical function; however, limited physical function was more predictive of lower life satisfaction. Interventions to increase or maintain mobility among older adults may improve overall life satisfaction.
The Advancing the Patient Experience (APEX) in Chronic Obstructive Pulmonary Disease (COPD) registry (https:// www.apexcopd.org/) is the first primary care health system-based COPD registry in the United States. While its ultimate goal is to improve the care of patients diagnosed with COPD, the registry is also designed to describe real-life experiences of people with COPD, track key outcomes longitudinally, and assess the effectiveness of interventions. It will retrospectively and prospectively collect information from 3000 patients enrolled in 5 health care organizations. Information will be obtained from electronic health records, and from extended annual and brief questionnaires completed by patients before clinic visits. Core variables to be collected into the APEX COPD registry were agreed on by Delphi consensus and fall into 3 domains: demographics, COPD monitoring, and treatment. Main strengths of the registry include: 1) its size and scope (in terms of patient numbers, geographic spread and use of multiple information sources including patient-reported information); 2) collection of variables which are clinically relevant and practical to collect within primary care; 3) use of electronic data capture systems to ensure high-quality data and minimization of data-entry requirements; 4) inclusion of clinical, database development, management and communication experts; 5) regular sharing of key findings, both at international/national congresses and in peer-reviewed publications; and 6) a robust organizational structure to ensure continuance of the registry, and that research outputs are ethical, relevant and continue to bring value to both patients and physicians.
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