51
|
Kang KY, Jung YE, Jang H, Kim MD, Bahk WM. Relationship between Handgrip Strength and Low-grade Inflammation in Older Adults with Depression. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:721-730. [PMID: 34690127 PMCID: PMC8553523 DOI: 10.9758/cpn.2021.19.4.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/08/2023]
Abstract
Objective The relationship among physical functional decline, low-grade inflammation, and depression remains unclear. The aim of this study was to examine the association between hand grip strength (HGS) and high-sensitivity C-reactive protein (hs-CRP) in a large sample with depression. Methods This study used data obtained from a representative Korean sample of 9,402 people who participated in the seventh Korean National Health and Nutrition Examination Survey. Physical function was assessed using a digital grip strength dynamometer. Depression was identified using a cutoff of 5 on the Patient Health Questionnaire-9 (PHQ-9), and high hs-CPR level was defined as ≥ 3.0 mg/L. Results In older adults (≥ 60 years) with depression, 43.8% of those with high hs-CRP levels had low HGS, compared to 21.8% of those with hs-CRP levels < 3.0 mg/L (p = 0.002). Multivariate analysis revealed that, after adjustments for potentially confounding factors, high hs-CRP was independently associated with lower HGS (B = −2.25; 95% confidence interval = −4.49 to −0.02) in older adults with depression, but not in younger or middle-aged adults with depression. Conclusion These findings suggest a significant correlation between physical functional decline and low-grade inflammation in older adults with depression.
Collapse
Affiliation(s)
- Kwi Young Kang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Division of Rheumatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Young-Eun Jung
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Korea
| | - Hwan Jang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
52
|
Liu A, Peng Y, Zhu W, Zhang Y, Ge S, Zhou Y, Zhang K, Wang Z, He P. Analysis of Factors Associated With Depression in Community-Dwelling Older Adults in Wuhan, China. Front Aging Neurosci 2021; 13:743193. [PMID: 34867276 PMCID: PMC8636125 DOI: 10.3389/fnagi.2021.743193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 10/21/2021] [Indexed: 02/02/2023] Open
Abstract
Objectives: This study aimed to identify the independent factors associated with depression in community-dwelling older adults in Wuhan, China. Methods: Four hundred and seventy older adults (aged ≥65 years) from four communities dwelling on Junshan Street in Wuhan, China were included in this study. Participants completed a questionnaire that asked questions pertaining to age, gender, educational level, income, living situation, care situation, social support, and social engagement. The 30-item Geriatric Depression Scale (GDS-30), the Fried frailty phenotype scale, the activities of daily living (ADL) scale, the mini nutritional assessment scale-short form (MNA-SF), and the Mini-cog scale were used to assess depression, frailty, self-care ability, malnutritional risk, and cognitive dysfunction, respectively. Differences in age, gender, educational level, income, living situation, care situation, social support, social engagement, ADL score, risk of malnutrition, frailty, and cognitive dysfunction between the non-depression (GDS-30 score <10 points) and depression groups (GDS-30 score ≥10 points) were compared using a chi-square test. Moreover, correlations between factors and depression were analyzed using Pearson's correlation. Then, significant variables (p < 0.05) from the chi-square test were included in a multivariable logistic regression model to identify the independent factors associated with depression. Results: The incidence of depression among the participants was 14.04%. Age (p < 0.001), educational level (p < 0.001), living situation (p < 0.001), social support (p = 0.001), ADL score (p = 0.023), frailty (p < 0.001), and cognitive dysfunction (p < 0.001) were all significantly associated with depression, in which age, poor social support, frailty, and cognitive dysfunction were identified as independent factors. Conclusion: Improving social support and effective interventions for frailty and cognitive dysfunction may help relieve depression in community-dwelling older adults.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Zhaohui Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping He
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
53
|
Coelho-Júnior HJ. Is High-Speed Resistance Training an Efficient and Feasible Exercise Strategy for Frail Nursing Home Residents? J Am Med Dir Assoc 2021; 23:44-46. [PMID: 34736893 DOI: 10.1016/j.jamda.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/27/2021] [Accepted: 10/02/2021] [Indexed: 10/20/2022]
Abstract
High-speed resistance training (HSRT) has been strongly recommended by experts in the field as a possible strategy to manage frailty in older adults; however, investigations to support this hypothesis are still lacking. Frailty is highly prevalent in nursing home residents and understanding if HSRT might contribute to frail patients' care is an urgent issue. Notably, frail older adults who live in long-term institutions commonly present reduced joint flexibility and cognitive resiliency. These characteristics might reduce the efficiency and feasibility of HSRT in frail nursing home residents. In the present, an evidence-based discussion about this topic is offered.
Collapse
|
54
|
Butt MS, Tariq U, Iahtisham-Ul-Haq, Naz A, Rizwan M. Neuroprotective effects of oleuropein: Recent developments and contemporary research. J Food Biochem 2021; 45:e13967. [PMID: 34716610 DOI: 10.1111/jfbc.13967] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 12/16/2022]
Abstract
Neurological disorders are increasing at a faster pace due to oxidative stress, protein aggregation, excitotoxicity, and neuroinflammation. It is reported that the Mediterranean diet including olives as a major dietary component prevents and ameliorates neurological anomalies. Oleuropein is the major bioactive component in different parts of the Olive (Olea europaea L.) tree. Several mechanisms have been reported for the neuroprotective role of oleuropein including induction of apoptosis and autophagy, enhancing the antioxidant pool of the cerebral region, decreasing the unnecessary release of proinflammatory cytokines and chemokines by deactivating the microglia cells and astrocytes thus preventing the occurrence of neuroinflammation. Regular intake of oleuropein seems to be correlated with decreased risks of neural disorders including Alzheimer's, Parkinson's, strokes, depression, anxiety, epilepsy, and others. This review majorly discusses the chemistry, biosynthesis, and metabolism of oleuropein along with an updated vision of its neuroprotective role in counteracting the acute and chronic neurodegenerative and neuropsychiatric disorders. Moreover, mechanisms by which oleuropein may prevent neurodegeneration are reviewed. PRACTICAL APPLICATION: Neurological disorders are negatively affecting the health and life quality of individuals around the globe. Although various medicinal solutions are available to tackle such ailments, none has proven to fully cure and being deprived of side effects. In this respect, the prevention of such disorders using natural remedies may be an effective strategy to overcome the incidence of the increasing cases. Furthermore, the natural compounds provide a safer alternative to pharmaceutical drugs. Hence, oleuropein from olive tree products is found to be efficacious against neurological disorders. This review provides an updated insight on the positive effects of oleuropein against neurodegenerative and neuropsychiatric disorders. The diet practitioners and nutraceutical companies may benefit from the provided information to design and develop strategies to improve the mental health of suffering individuals.
Collapse
Affiliation(s)
- Masood Sadiq Butt
- Faculty of Food, Nutrition and Home Sciences, National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Urwa Tariq
- Faculty of Food, Nutrition and Home Sciences, National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Iahtisham-Ul-Haq
- Faculty of Life Sciences, Department of Food Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Ambreen Naz
- Department of Food Science and Technology, Muhammad Nawaz Shareef University of Agriculture, Multan, Pakistan
| | - Muhammad Rizwan
- Faculty of Life Sciences, Department of Food Science and Technology, University of Central Punjab, Lahore, Pakistan
| |
Collapse
|
55
|
Cardiac rehabilitation in heart failure: Indications for exercise training based on heart failure phenotype. Prog Cardiovasc Dis 2021; 70:16-21. [PMID: 34756951 DOI: 10.1016/j.pcad.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 10/24/2021] [Indexed: 12/19/2022]
Abstract
Exercise intolerance with dyspnea and fatigue is pervasive amongst individuals with heart failure (HF) due to both central and peripheral mechanisms. Cardiac rehabilitation (CR) is a cornerstone therapy for numerous cardiovascular disease (CVD) processes, and it's use in HF with reduced ejection fraction (HFrEF) has shown significant benefit in improved mortality and quality of life (QoL). Less is known about the benefit of CR in the setting of HF with preserved ejection fraction (HFpEF), and optimal exercise therapy (ET) may vary based on underlying disease phenotype. Here we offer review of existing data for ET in both HFrEF and HFpEF with proposed exercise treatment modalities based on underlying comorbidities and variable phenotypes.
Collapse
|
56
|
Sutton JL, Gould RL, Howard RJ. Assessing frailty indicators in the context of psychiatric disorder: A Delphi consensus study. Int J Geriatr Psychiatry 2021; 37. [PMID: 34677834 DOI: 10.1002/gps.5642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/18/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Substantial construct overlap exists between indicators of frailty and symptoms of some psychiatric disorders. This study aimed to gain consensus of expert academic opinion on the potential impact of psychiatric illness on frailty assessment and how best to conceptualise and measure frailty indicators in the context of psychiatric symptoms. DESIGN A classic Delphi approach was employed across two studies to achieve consensus: The first-round questionnaire consisted of open-ended questions, analysed through content analysis. The results informed the development of statements for participants to rate their agreement with in subsequent Delphi rounds. Statements with ≥66% agreement were accepted. Delphi Study 1 recruited experts in frailty assessment (n = 13) and Delphi Study 2 recruited experts in frailty and psychiatric disorder (n = 8). Experts were recruited globally. RESULTS Overall, 40% of Delphi Study 1 statements and 43% of Delphi Study 2 statements were accepted. Primarily, consensus was reached for statements concerning the influence of depression/anxiety on frailty assessment and potential methods of conceptualising and measuring frailty indicators in the context of psychiatric symptoms. Little consensus was reached concerning the ease and importance of differentiating between frailty indicators and psychiatric assessment criteria with substantial overlap. CONCLUSIONS The Delphi studies provide a novel exploration and consensus of expert academic opinions concerning the assessment of frailty indicators in the context of psychiatric symptoms. The results will inform future research into the adaptation or development of a frailty assessment tool specifically for use in older adult psychiatric populations.
Collapse
Affiliation(s)
- Jennifer L Sutton
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rebecca L Gould
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Division of Psychiatry, University College London, London, UK
| | - Robert J Howard
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Division of Psychiatry, University College London, London, UK
| |
Collapse
|
57
|
Ademuyiwa OH, Fasogbon BM, Adebo OA. The potential role of Piper guineense (black pepper) in managing geriatric brain aging: a review. Crit Rev Food Sci Nutr 2021; 63:2840-2850. [PMID: 34609267 DOI: 10.1080/10408398.2021.1980764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Brain aging is one of the unavoidable aspects of geriatric life. As one ages, changes such as the shrinking of certain parts (particularly the frontal cortex, which is vital to learning and other complex mental activities) of the brain may occur. Consequently, communications between neurons are less effective, and blood flow to the brain could also decrease. Efforts made at the biological level for repair become inadequate, leading to the accumulation of β-amyloid peptide in the brain faster than its probable degradation mechanism, resulting in cognitive malfunction. Subsequent clinical usage of drugs in battling related brain-aging ailments has been associated with several undesirable side effects. However, recent research has investigated the potential use of natural compounds from food in combating such occurrences. This review provides information about the use of Piper guineense (black pepper) as a possible agent in managing brain aging because of its implications for practical brain function. P. guineense contains an alkaloid (piperine) reported to be an antioxidant, anti-depressant, and central nervous system stimulant. This alkaloid and other related compounds are neuroprotective agents that reduce lipid oxidation and inhibit tangles in the brain tissues.
Collapse
Affiliation(s)
| | - Beatrice Mofoluwaso Fasogbon
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Doorfontein, Gauteng, South Africa
| | - Oluwafemi Ayodeji Adebo
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Doorfontein, Gauteng, South Africa
| |
Collapse
|
58
|
Abstract
Certain psychosocial elements, such as depression, anxiety, stress, lack of social support, and loneliness, should be considered as part of frailty. Women are more likely to be frail toward the end of life, because they live longer and are less likely to develop diseases with abrupt ends. Women are also more prone to develop psychosocial elements associated with frailty because of their lifetime stressors, poverty, and loneliness at the end of life. Clinicians should recognize this phenomenon and create early interventions to ensure women are able to live according to their preferences during the last part of their lives.
Collapse
Affiliation(s)
- Louisa Whitesides
- George Washington University Medical Faculty Associates, 2300 M St. NW, Third floor, Washington, DC 20037, USA.
| | - Joanne Lynn
- Center for Eldercare Improvement, Altarum, 2000 M St, NW, Suite 400, Washington, DC 20036, USA
| |
Collapse
|
59
|
Abstract
Frailty is an important clinical syndrome of age-related decline in physiologic reserve and increased vulnerability. In older adults, frailty leads to progressive multisystem decline and increased adverse clinical outcomes. The pathophysiology of frailty is hypothesized to be driven by dysregulation of neuroendocrine, inflammatory, and metabolic pathways. Sex-specific differences in the prevalence of frailty have been observed. Treatment interventions of geriatric care can be applied to the care of frail older women with these differences in mind. As additional evidence regarding sex-specific differences in frailty emerges, research efforts should encompass the development of screening tools and therapeutic interventions that optimize outcomes.
Collapse
Affiliation(s)
- Caroline Park
- Section of Geriatrics, Division of Primary Care & Population Health, Stanford School of Medicine, Stanford Senior Care, 211 Quarry Road. Suite 4C, Palo Alto, CA 94304, USA
| | - Fred C Ko
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1070, New York, NY 10029, USA; Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.
| |
Collapse
|
60
|
Gilmore N, Kehoe L, Bauer J, Xu H, Hall B, Wells M, Lei L, Culakova E, Flannery M, Grossman VA, Sardari RA, Subramanya H, Kadambi S, Belcher E, Kettinger J, O'Rourke MA, Dib EG, Vogelzang NJ, Dale W, Mohile S. The Relationship Between Frailty and Emotional Health in Older Patients with Advanced Cancer. Oncologist 2021; 26:e2181-e2191. [PMID: 34510642 DOI: 10.1002/onco.13975] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/24/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Aging-related deficits that eventually manifest as frailty may be associated with poor emotional health in older patients with advanced cancer. This study aimed to examine the relationship between frailty and emotional health in this population. METHODS This was a secondary analysis of baseline data from a nationwide cluster randomized trial. Patients were aged ≥70 years with incurable stage III/IV solid tumors or lymphomas, had ≥1 geriatric assessment (GA) domain impairment, and had completed the Geriatric Depression Scale, Generalized Anxiety Disorder-7, and Distress Thermometer. Frailty was assessed using a Deficit Accumulation Index (DAI; range 0-1) based on GA, which did not include emotional health variables (depression and anxiety), and participants were stratified into robust, prefrail, and frail categories. Multivariate logistic regression models examined the association of frailty with emotional health outcomes. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported. RESULTS Five hundred forty-one patients were included (mean age: 77 years; 70-96). DAI ranged from 0.04 to 0.94; 27% of patients were classified as robust, 42% prefrail, and 31% frail. Compared with robust patients, frail patients had an increased risk of screening positive for depression (aOR = 12.8; 95% CI = 6.1-27.0), anxiety (aOR = 6.6; 95% CI = 2.2-19.7), and emotional distress (aOR = 4.62; 95% CI = 2.9-8.3). Prefrail compared with robust patients also had an increased risk of screening positive for depression (aOR = 2.22; 95% CI = 1.0-4.8) and distress (aOR = 1.71; 95% CI = 1.0-2.8). CONCLUSION In older patients with advanced cancer, frailty is associated with poorer emotional health, which indicates a need for an integrated care approach to treating these patients. IMPLICATIONS FOR PRACTICE A relationship exists between frailty and poor emotional health in older adults with advanced cancer. Identifying areas of frailty can prompt screening for emotional health and guide delivery of appropriate interventions. Alternatively, attention to emotional health may also improve frailty.
Collapse
Affiliation(s)
- Nikesha Gilmore
- University of Rochester Medical Center, Rochester, New York, USA
| | - Lee Kehoe
- University of Rochester Medical Center, Rochester, New York, USA
| | - Jessica Bauer
- University of Rochester Medical Center, Rochester, New York, USA
| | - Huiwen Xu
- University of Rochester Medical Center, Rochester, New York, USA
| | - Bianca Hall
- University of Rochester Medical Center, Rochester, New York, USA
| | - Megan Wells
- University of Rochester Medical Center, Rochester, New York, USA
| | - Lianlian Lei
- University of Michigan, Ann Arbor, Michigan, USA
| | - Eva Culakova
- University of Rochester Medical Center, Rochester, New York, USA
| | - Marie Flannery
- University of Rochester Medical Center, Rochester, New York, USA
| | - Valerie Aarne Grossman
- University of Rochester Medical Center, Rochester, New York, USA.,SCOREboard Stakeholder Advisory Group, University of Rochester Medical Center, Rochester, New York, USA
| | | | - Himal Subramanya
- University of Rochester Medical Center, Rochester, New York, USA
| | - Sindhuja Kadambi
- University of Rochester Medical Center, Rochester, New York, USA
| | | | | | - Mark A O'Rourke
- Cancer Centers of the Carolinas, Greenville, South Carolina, USA
| | - Elie G Dib
- Michigan Cancer Research Consortium, Ypsilanti, Michigan, USA
| | | | - William Dale
- City of Hope National Medical Center, Duarte, California, USA
| | - Supriya Mohile
- University of Rochester Medical Center, Rochester, New York, USA
| |
Collapse
|
61
|
Lipsitz O, Di Vincenzo JD, Rodrigues NB, Cha DS, Lee Y, Greenberg D, Teopiz KM, Ho RC, Cao B, Lin K, Subramaniapillai M, Flint AJ, Kratiuk K, McIntyre RS, Rosenblat JD. Safety, Tolerability, and Real-World Effectiveness of Intravenous Ketamine in Older Adults With Treatment-Resistant Depression: A Case Series. Am J Geriatr Psychiatry 2021; 29:899-913. [PMID: 33478865 DOI: 10.1016/j.jagp.2020.12.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the safety, tolerability, and effectiveness of repeated doses of intravenous (IV) ketamine in older adults (i.e., ≥60 years of age) with treatment-resistant depression. METHOD In this case series, fifty-three older adults (Mage = 67, SD = 6; 57% female [n = 30]) received 4 IV ketamine infusions, administered over 1-2 weeks. Effectiveness of IV ketamine was measured using the Quick Inventory for Depressive Symptomatology-Self Report 16 (QIDS-SR16) approximately 2 days after infusions 1-3, and 1-2 weeks after infusion 4. Safety was measured as hemodynamic changes before, during, immediately after, and 20 minutes after each infusion. Tolerability was assessed via systematic reporting of treatment-emergent adverse events during and after each infusion, in addition to symptoms of dissociation measured using the Clinician Administered Dissociative States Scale. Partial response (25%-50% symptomatic improvement from baseline), response (≥50% symptomatic improvement from baseline), clinically significant improvements (≥25% symptomatic improvement from baseline), and remission rates (QIDS-SR16 ≤5) were also calculated. RESULTS Participants reported significant decreases in depressive symptoms (i.e., as measured by the QIDS-SR16) with repeated ketamine infusions (F(4, 92) = 7.412, p <0.001). The mean QIDS-SR16 score was 17.12 (SD = 5.33) at baseline and decreased to 12.52 (SD = 5.79) following 4 infusions. After 4 infusions, 31% (n = 8) of participants partially responded to IV ketamine, 27% (n = 7) responded, 58% (n = 15) experienced clinically significant improvements, and 10% (n = 3) met remission criteria. Thirty-six participants (69%) experienced treatment-emergent hypertension during at least 1 infusion, and 10 (19%) required intervention with an antihypertensive. Drowsiness was the most commonly reported adverse event (50% of infusions; n = 73). CONCLUSION Ketamine was associated with transient treatment-emergent hypertension. Response and remission rates were comparable to those reported in general adult samples. Findings are limited by the open-label, chart review nature of this study.
Collapse
Affiliation(s)
- Orly Lipsitz
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Joshua D Di Vincenzo
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto (JDV, RSM), Toronto, ON, Canada
| | - Nelson B Rodrigues
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Danielle S Cha
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; School of Medicine, Faculty of Medicine, University of Queensland (DSC), Brisbane, QLD, Australia
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - David Greenberg
- Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Kayla M Teopiz
- Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (RCH), Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore (RCH), Singapore
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University (BC), Chongqing, 400715, PR China
| | - Kangguang Lin
- Department of Affective Disorder, The Affiliated Brain Hospital of Guangzhou Medical University, (Guangzhou Huiai Hospital), Guangzhou Medical University (KL), Guangzhou, China; Laboratory of Emotion and Cognition, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou Medical University (KL), Guangzhou, China
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Alastair J Flint
- Department of Psychiatry, University of Toronto (AJF, RSM, JDR), Toronto, ON, Canada; Centre for Mental Health, University Health Network (AJF), Toronto, ON, Canada
| | - Kevin Kratiuk
- Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada; Department of Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada; Department of Psychiatry, University of Toronto (AJF, RSM, JDR), Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto (JDV, RSM), Toronto, ON, Canada.
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada; Department of Psychiatry, University of Toronto (AJF, RSM, JDR), Toronto, ON, Canada
| |
Collapse
|
62
|
Abstract
OBJECTIVES To investigate if depression risk modifies the association between frailty and mortality in older adults. DESIGN Ongoing cohort study. SETTING Albacete city, Spain. PARTICIPANTS Eight hundred subjects, 58.8% women, over 70 years of age from the Frailty and Dependence in Albacete (FRADEA) study. MEASUREMENTS Frailty phenotype, Geriatric Depression Scale (GDS), comorbidity, disability, and drug use were collected at baseline. Six groups were categorized: (G1: non-frail/no depression risk; G2: non-frail/depression risk; G3: prefrail/no depression risk; G4: prefrail/depression risk; G5: frail/no depression risk; and G6: frail/depression risk). Mean follow-up was 2542 days (SD 1006). GDS was also analyzed as a continuous variable. The association between frailty and depression risk with 10-year mortality was analyzed. RESULTS Mean age was 78.5 years. Non-frail was 24.5%, prefrail 56.3%, frail 19.3%, and 33.5% at depression risk. Mean GDS score was 3.7 (SD 3.2), increasing with the number of frailty criteria (p < 0.001). Ten-year mortality rate was 44.9%. Mortality was 21.4% for the non-frail, 45.6% for the prefrail, and 72.7% for the frail participants, 56% for those with depression risk, and 39.3% for those without depression risk. Mean survival times for groups G1 to G6 were, respectively, 3390, 3437, 2897, 2554, 1887, and 1931 days. Adjusted mortality risk was higher for groups G3 (HR 2.1; 95% confidence interval (CI) 1.4-3.1), G4 (HR 2.5; 95% CI 1.7-3.8), G5 (HR 3.8; 95% CI 2.4-6.1), and G6 (HR 4.0; 95% CI 2.6-6.2), compared with G1 (p < 0.001). Interaction was found between frailty and depression risk, although they were independently associated with mortality. CONCLUSIONS Depression risk increases mortality risk in prefrail older adults but not in non-frail and frail ones. Depression should be monitored in these older adults to optimize health outcomes. Factors modulating the relationship between frailty and depression should be explored in future studies.
Collapse
|
63
|
Coelho-Júnior HJ, Uchida MC, Picca A, Bernabei R, Landi F, Calvani R, Cesari M, Marzetti E. Evidence-based recommendations for resistance and power training to prevent frailty in community-dwellers. Aging Clin Exp Res 2021; 33:2069-2086. [PMID: 33587271 DOI: 10.1007/s40520-021-01802-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/21/2021] [Indexed: 02/07/2023]
Abstract
Frailty is a reversible state of reduced resilience to stressful events resulting from a multisystem impairment of the human body. As frailty progresses, people become more vulnerable to numerous adverse events, including falls and fractures, cognitive decline, disability, hospitalization, nursing home placement, and death. As such, substantial health care costs are associated with frailty. These features have led to the recognition of frailty as a public health problem. The identification of strategies for the management of frailty has, therefore, become a topic of extensive instigation. In this context, resistance (RT) and power training (PT) have received considerable attention, and experts in the field have recently suggested that both training modalities may improve frailty-related parameters. However, most studies have only included robust people and investigated frailty as a secondary outcome, so that current literature only allows RT and PT preventive programs against frailty to be designed. Here, we provide evidence-based critical recommendations for the prescription of RT and PT programs against incident frailty in community-dwellers.
Collapse
Affiliation(s)
- Hélio José Coelho-Júnior
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, 13083-970, Brazil.
- Rehabilitation Unit, Lar Mãe Mariana Nursing Home, Poá, Brazil.
| | - Marco Carlos Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, 13083-970, Brazil
| | - Anna Picca
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | - Roberto Bernabei
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | | | - Riccardo Calvani
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, Università di Milano, 20122, Milan, Italy
- Geriatric Unit, IRCCS Istutiti Clinici Scientifici Maugeri, 20138, Milan, Italy
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy.
| |
Collapse
|
64
|
Alexopoulos GS. Mechanisms and Treatment of Late-Life Depression. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2021; 19:340-354. [PMID: 34690604 DOI: 10.1176/appi.focus.19304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
(Appeared originally in Translational Psychiatry 2019; 9:188).
Collapse
Affiliation(s)
- George S Alexopoulos
- Weill Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY 10605, USA
| |
Collapse
|
65
|
Ramos-Henderson M, Ledezma-Dámes A, López N, Machado Goyano Mac Kay AP. Executive functions and functional impairment in Latin seniors suffering from depression. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2021; 28:543-558. [PMID: 32715938 DOI: 10.1080/13825585.2020.1796915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
UNLABELLED Functional impairment (FI) relates to the condition of executive functions (EFs). While EFs become affected by age and educational level (EL). Seniors suffering from depression (SSDs) on the other hand show EF-related deficiencies; however, there is hardly any literature available regarding their relationship with FI in Latin SSDs, who usually have low ELs. OBJECTIVE To verify the relationship between EFs and FI in SSDs of Latin origins, by controlling the effects associated with age and educational level. METHODOLOGY Cross-sectional study, of cases and controls, conducted on a nonprobability sample, made up of 102 self-sufficient SSDs and 142 control subjects over age 50, monolinguals of Latin origin (Chileans), all assessed by means of a battery of assessments such as: Geriatric Depression Scale, Addenbrook's Cognitive Assessment III, Trail making Tests A and B, STROOP word-color test, and semantic and phonological verbal fluency tests. A domain of composite EFs was established with standardized Chilean population scores, where age and educational levels were controlled. A simple linear regression analysis was conducted to determine the relationship between EFs and FI in SSDs. RESULTS Upon controlling age and educational levels, EFs explained an FI variance of 3.9% in SSDs; depression explained an EF variance of 3.2%, and 3.7% of FI. CONCLUSION The results of the present study highlight the importance of a timely intervention when it comes to geriatric depression, considering the negative effect it has over the executive functions and the functionality of seniors.
Collapse
Affiliation(s)
- Miguel Ramos-Henderson
- Centro De Investigación E Innovación En Gerontología Aplicada (CIGAP), Facultad De Salud, Universidad Santo Tomás , Antofagasta, Chile
- Escuela De Psicología, Facultad De Ciencias Sociales Y De La Comunicación, Universidad Santo Tomás , Antofagasta, Chile
| | - Andrés Ledezma-Dámes
- Centro De Investigación E Innovación En Gerontología Aplicada (CIGAP), Facultad De Salud, Universidad Santo Tomás , Antofagasta, Chile
| | - Norman López
- Departamento De Ciencias Sociales, Universidad De La Costa , Barranquilla, Colombia
| | | |
Collapse
|
66
|
The relationship between insomnia symptoms and frailty in community-dwelling older persons: a path analysis. Sleep Med 2021; 84:237-243. [PMID: 34175659 DOI: 10.1016/j.sleep.2021.05.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/02/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The relationship between sleep and frailty in older age is complex. Most previous studies focused on sleep duration, while insomnia, a common sleep problem in older adults, has not been adequately examined and the factors implicated in its association with frailty were under-explored. METHODS A community-based sample of 345 prefrail and frail older adults were recruited and completed the measures on insomnia symptoms (Pittsburgh Sleep Quality Index) and frailty status (FRAIL Scale). The relationship between insomnia symptoms and frailty, with potential mediators including physical performance (Short Physical Performance Battery), depression (Patient Health Questionnaire-9), and level of physical activity (Physical Activity Scale for the Elderly), were tested in path analysis adjusting for age, gender, body mass index and sleep medications. RESULTS The prevalence of sleep-onset insomnia was higher in frail participants than their prefrail counterparts (48% vs. 34%, aOR = 1.73; 95% CI 1.09, 2.76; p = 0.02), but there was no significant difference in the prevalence of sleep-maintenance insomnia (61% vs. 54%). The association between sleep-onset insomnia and frailty was explained by reduced physical performance (standardized coefficient = 0.11; 95% BCa CI [0.002, 0.233]), but not depression and level of physical activity. Sleep-maintenance insomnia was not associated with frailty. CONCLUSIONS Insomnia symptoms are prevalent in frail and prefrail older adults. Sleep-onset insomnia is associated with poorer physical performance, which is further linked to a higher risk for frailty in older persons. The findings highlight the importance of timely assessing and managing insomnia among older adults at risk of frailty.
Collapse
|
67
|
Lekan DA, Jenkins M, McCoy TP, Mohanty S, Manda P, Yasin R. Hospital Readmission Outcomes by Frailty Risk in Adults in Behavioral Health Acute Care. J Psychosoc Nurs Ment Health Serv 2021; 59:27-39. [PMID: 34142911 DOI: 10.3928/02793695-20210427-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of the current retrospective study was to determine whether frailty is predictive of 30-day readmission in adults aged ≥50 years who were admitted with a psychiatric diagnosis to a behavioral health hospital from 2013 to 2017. A total of 1,063 patients were included. A 26-item frailty risk score (FRS-26-ICD) was constructed from electronic health record (EHR) data. There were 114 readmissions. Cox regression modeling for demographic characteristics, emergent admission, comorbidity, and FRS-26-ICD determined prediction of time to readmission was modest (incremental area under the receiver operating characteristic curve = 0.671). The FRS-26-ICD was a significant predictor of readmission alone and in models with demographics and emergent admission; however, only the Elixhauser Comorbidity Index was significantly related to hazard of readmission adjusting for other factors (adjusted hazard ratio = 1.26, 95% confidence interval [1.17, 1.37]; p < 0.001), whereas FRS-26-ICD became non-significant. Frailty is a relevant syndrome in behavioral health that should be further studied in risk prediction and incorporated into care planning to prevent hospital readmissions. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].
Collapse
|
68
|
Amanzio M, Canessa N, Bartoli M, Cipriani GE, Palermo S, Cappa SF. Lockdown Effects on Healthy Cognitive Aging During the COVID-19 Pandemic: A Longitudinal Study. Front Psychol 2021; 12:685180. [PMID: 34108923 PMCID: PMC8180921 DOI: 10.3389/fpsyg.2021.685180] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic is a health issue leading older adults to an increased vulnerability to unfavorable outcomes. Indeed, the presence of physical frailty has recently led to higher mortality due to SARS-CoV-2 infection. However, no longitudinal studies have investigated the role of neuropsychogeriatric factors associated with lockdown fatigue in healthy cognitive aging. Eighty-one healthy older adults were evaluated for their neuropsychological characteristics, including physical frailty, before the pandemic (T0). Subsequently, 50 of them agreed to be interviewed and neuropsychologically re-assessed during the lockdown (T1) and immediately after it (T2). Moreover, during another home confinement, they performed a psychological screening (T3) to evaluate possible mood changes and fatigue. According to Fried's frailty criteria, at T0, 63% of the sample was robust, 34.5% pre-frail, and only 2.5% frail. Significantly, these subjects presented a decrease in handgrip strength and walking speed (29.6 and 6.1%, respectively). Results from Principal Component Analyses and multiple regression models highlighted the contribution of “cognitive” and “psychological” factors (i.e., attentive-executive performance and mood deflections) in explaining handgrip strength and gait speed. At T3, lockdown fatigue was explained by higher scores on the Beck Depression Inventory and lower scores on the Trail Making Test part A. Results from a moderated-mediation model showed that the effect of psychomotor speed on lockdown fatigue was mediated by depression, with a moderating effect of gait speed. Our findings highlight the complex interrelationship between cognitive, psychological, and physical factors in the emergence of pandemic fatigue in a carefully selected older population.
Collapse
Affiliation(s)
- Martina Amanzio
- Department of Psychology, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Ageing, Brussels, Belgium
| | - Nicola Canessa
- Department of Humanities and Life Sciences, Scuola Universitaria Superiore Istituto Universitario di Studi Superiori (IUSS), Pavia, Italy.,Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | | | | | - Sara Palermo
- Department of Psychology, University of Turin, Turin, Italy.,UOC Neuroradiologia -IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Stefano F Cappa
- Department of Humanities and Life Sciences, Scuola Universitaria Superiore Istituto Universitario di Studi Superiori (IUSS), Pavia, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Mondino Foundation, Pavia, Italy
| |
Collapse
|
69
|
Wang X, Shen K. The Reciprocal Relationship between Frailty and Depressive Symptoms among Older Adults in Rural China: A Cross-Lag Analysis. Healthcare (Basel) 2021; 9:healthcare9050593. [PMID: 34067906 PMCID: PMC8156888 DOI: 10.3390/healthcare9050593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/01/2021] [Accepted: 05/13/2021] [Indexed: 12/02/2022] Open
Abstract
(1) Objective: This study aimed to investigate the reciprocal relationship between frailty and depressive symptoms using longitudinal data among older adults in China. (2) Methods: Data derived from 2014 and 2017 waves of a longitudinal study of 1367 older adults aged 70–84 years, living in rural areas of Jiangsu Province, China. Cross-lagged panel model and a multiple group model were used to examine the temporal effect of frailty on depressive symptoms and vice versa. (3) Results: Frailty was associated with subsequent increase in depressive symptoms, such that participants with higher levels of frailty increase the risks of depressive symptoms (b = 0.090, p < 0.01). Depressive symptoms were significant predictors of increased frailty (b = −0.262, p <0.001). However, older men and older women had no significant differences in the reciprocal relationship between frailty and depressive symptoms. (4) Conclusions: In conclusion, we find a significant bi-directional relationship between frailty and depressive symptoms. This finding confirms the dyadic model of frailty and depression. Implications for interventions and policy to help frail and depressive older adults are discussed.
Collapse
Affiliation(s)
- Xuehui Wang
- Center for Population and Development Policy Studies, School of Social Development and Public Policy, Fudan University, Shanghai 200433, China;
| | - Kaijun Shen
- School of Social Development and Public Policy, Fudan University, Shanghai 200433, China
- Correspondence:
| |
Collapse
|
70
|
Setiati S, Soejono CH, Harimurti K, Dwimartutie N, Aryana IGPS, Sunarti S, Budiningsih F, Mulyana R, Dwipa L, Sudarso A, Rensa R, Istanti R, Azwar MK, Marsigit J. Frailty and Its Associated Risk Factors: First Phase Analysis of Multicentre Indonesia Longitudinal Aging Study. Front Med (Lausanne) 2021; 8:658580. [PMID: 33996862 PMCID: PMC8116892 DOI: 10.3389/fmed.2021.658580] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/29/2021] [Indexed: 11/14/2022] Open
Abstract
Background: National long-term care development requires updated epidemiological data related to frailty. We aimed to find the prevalence of frailty and its associated factors among Indonesian elderly. Methods: We conducted first-phase cross-sectional analysis of Indonesia Longitudinal Aging Study (INALAS) data collected from community-dwelling outpatients aged 60 years and older without acute illness in nine geriatric service care centres. Descriptive, bivariate and multivariate analyses were conducted. Results: Among 908 elderly in this study, 15.10% were robust, 66.20% were pre-frail, and 18.70% were frail. Functional dependence was associated with frailty among Indonesian elderly (OR 5.97, 95% CI 4.04–8.80). Being depressed and at risk for malnutrition were also associated with frailty with OR 2.54, 95% CI 1.56–4.12, and OR 2.56, 95% CI 1.68–3.90, respectively. Prior history of fall (OR 1.77, 95% CI 1.16–2.72) and hospitalization (OR 1.46, 95% CI 0.97–2.20) in the previous 12 months were associated with frailty. There is also significant association between poly pharmacy and frailty (OR 2.42, 95% CI 1.50–3.91). Conclusion: Approximately one in five Indonesian community-dwelling elderly was frail. Frailty is associated with functional dependence, being at risk for malnutrition or being malnourished, depression, history of fall, history of hospitalization, and poly pharmacy. There may be bidirectional relationships between the risk factors and frailty. The development of long-term care in Indonesia should be considered, without forcing the elderly who need it.
Collapse
Affiliation(s)
- Siti Setiati
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia.,Clinical Epidemiology and Evidence-Based Medicine Unit, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Czeresna Heriawan Soejono
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Kuntjoro Harimurti
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia.,Clinical Epidemiology and Evidence-Based Medicine Unit, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Noto Dwimartutie
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - I G P Suka Aryana
- Department of Internal Medicine, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - Sri Sunarti
- Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Fatichati Budiningsih
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Solo, Indonesia
| | - Roza Mulyana
- Department of Internal Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
| | - Lazuardhi Dwipa
- Department of Internal Medicine, Faculty of Medicine, Universitas Padjajaran, Bandung, Indonesia
| | - Agus Sudarso
- Department of Internal Medicine, Faculty of Medicine, Universitas Hasanuddin, Makasar, Indonesia
| | - Rensa Rensa
- Department of Internal Medicine, Faculty of Medicine, Universitas Atma Jaya, Jakarta, Indonesia
| | - Rahmi Istanti
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Muhammad Khifzhon Azwar
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Jessica Marsigit
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|
71
|
Oyon J, Serra-Prat M, Ferrer M, Llinares A, Pastor N, Limón E, Rejón T, Ramírez S, Salietti A. Psychosocial factors associated with frailty in the community-dwelling aged population with depression. A cross-sectional study. Aten Primaria 2021; 53:102048. [PMID: 33813087 PMCID: PMC8050711 DOI: 10.1016/j.aprim.2021.102048] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE There is a two-way relationship between frailty and depression, but the mechanisms by which one may influence the other are not well understood. The objective of this study was to evaluate the relationship between psychosocial factors and frailty in community-dwelling aged populations with depression. DESIGN Observational cross-sectional study. SITE: 5 primary care centres. PARTICIPANTS Community-dwelling subjects with depression aged ≥70 years. MAIN MEASUREMENTS Frailty status was established according to Fried criteria, depression and depression severity were evaluated by DSM-IV criteria and the Hamilton Depression Rating Scale, respectively, and psychosocial factors were assessed using the Gijón Social-Familial Evaluation Scale and ad hoc questionnaires. RESULTS Recruited were 338 subjects (mean age 77.2 years), 82% women and 36.1% rated as frail. A dose-response relationship was observed between depression severity and frailty risk. Widowhood was a risk factor for frailty, while a higher educational level, home internet, stairs in the home, and an active social life had a protective effect. A multivariate analysis showed that age, number of drugs, and depression severity were independent risk factors for frailty, while an active social life was a protective factor. The severity of depressive symptoms showed higher association with frailty than other clinical and socio-demographic characteristics. CONCLUSIONS In depressed elderly subjects, frailty is associated with psychologiocal factors such as the intensity of depressive symptoms and with social factors such as education level, widowhood, loneliness, and limited social life. More research is required to better understand the modifiable psychological risk factors for frailty.
Collapse
Affiliation(s)
- Joaquim Oyon
- Primary Care Department, Consorci Sanitari del Maresme, Barcelona, Spain
| | | | - Mariona Ferrer
- Primary Care Department, Consorci Sanitari del Maresme, Barcelona, Spain
| | - Antònia Llinares
- Primary Care Department, Consorci Sanitari del Maresme, Barcelona, Spain
| | - Núria Pastor
- Primary Care Department, Institut Català de la Salut, Barcelona, Spain
| | - Esther Limón
- Primary Care Department, Institut Català de la Salut, Barcelona, Spain
| | - Tatiana Rejón
- Primary Care Department, Consorci Sanitari del Maresme, Barcelona, Spain
| | - Sara Ramírez
- Primary Care Department, Consorci Sanitari del Maresme, Barcelona, Spain
| | - Alba Salietti
- Primary Care Department, Consorci Sanitari del Maresme, Barcelona, Spain
| |
Collapse
|
72
|
Da Mata FAF, Miranda Forte Gomes M, Lício Ferreira Santos J, Aparecida de Oliveira Duarte Y, Gomes Pereira M. Depression and frailty in older adults: A population-based cohort study. PLoS One 2021; 16:e0247766. [PMID: 33662006 PMCID: PMC7932072 DOI: 10.1371/journal.pone.0247766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/13/2021] [Indexed: 12/20/2022] Open
Abstract
Background Studies have shown an association between depression and frailty, even though the literature has not reached a consensus regarding how these syndromes interact. Although prospective cohort studies on this topic are still scarce, they could contribute to understanding this relationship. We aimed to observe whether depressive symptoms are risk factors for the onset of frailty among older adults living in São Paulo, Brazil. Methods Prospective cohort study using the “Health, Well-being and Aging” (SABE) Study databases of 2006 and 2010. The sample was representative of the community-dwelling older adults living in São Paulo, and it is composed of non-frail men and women aged 60 years and older without cognitive decline. We calculated the frailty incidence rate between older adults with and without depressive symptoms and calculated the incidence rate ratio. Multiple analysis was carried out through Poisson regression with robust variance estimation. Results The initial sample (n = 1,109) presented a mean age of 72 years (from 60 to 96) and 61.1% were women. The final sample was composed of 830 individuals, and the mean follow-up time in the study was 3.8 years. After adjusting the model, depressive symptoms did not predict the onset of frailty at follow-up. Conclusion Depressive symptoms were not shown to be a risk factor for frailty among older adults living in São Paulo in this study.
Collapse
|
73
|
Wang N, Wang X, He M, Zheng W, Qi D, Zhang Y, Han CC. Ginseng polysaccharides: A potential neuroprotective agent. J Ginseng Res 2021; 45:211-217. [PMID: 33841001 PMCID: PMC8020291 DOI: 10.1016/j.jgr.2020.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 08/30/2020] [Accepted: 09/05/2020] [Indexed: 12/26/2022] Open
Abstract
The treatments of nervous system diseases (NSDs) have long been difficult issues for researchers because of their complexity of pathogenesis. With the advent of aging society, searching for effective treatments of NSDs has become a hot topic. Ginseng polysaccharides (GP), as the main biologically active substance in ginseng, has various biological properties in immune-regulation, anti-oxidant, anti-inflammation and etc. Considering the association between the effects of GP and the pathogenesis of neurological disorders, many related experiments have been conducted in recent years. In this paper, we reviewed previous studies about the effects and mechanisms of GP on diseases related to nervous system. We found GP play an ameliorative role on NSDs through the regulation of immune system, inflammatory response, oxidative damage and signaling pathway. Structure-activity relationship was also discussed and summarized. In addition, we provided new insights into GP as promising neuroprotective agent for its further development and utilization.
Collapse
Key Words
- AG, Arabinogalactan
- BBB, Blood–brain barrier
- BDNF, Brain-derived neurotrophic factor
- GP, Ginseng polysaccharides
- Ginseng
- HG, Homogalacturonan
- IFN-γ, Interferon-γ
- IL-17α, Interleukin-17 α
- MS, Multiple sclerosis
- Molecular mechanism
- NSDs, Nervous system diseases
- Nervous system
- Polysaccharides
- RG, Rhamnogalacturonan
- TNF-α, tumor necrosis factor-α
Collapse
Affiliation(s)
- Na Wang
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People’s Republic of China
| | - Xianlei Wang
- National Oceanographic Center, Qingdao, 88 Xuzhou Road, Qingdao, Shandong, 266071, People’s Republic of China
| | - Mengjiao He
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People’s Republic of China
| | - Wenxiu Zheng
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People’s Republic of China
| | - Dongmei Qi
- Experimental center, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People’s Republic of China
| | - Yongqing Zhang
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People’s Republic of China
| | - Chun-chao Han
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, 250355, People’s Republic of China
| |
Collapse
|
74
|
Banning LBD, Visser L, Zeebregts CJ, van Leeuwen BL, El Moumni M, Pol RA. Transition in Frailty State Among Elderly Patients After Vascular Surgery. World J Surg 2021; 44:3564-3572. [PMID: 32494998 PMCID: PMC7458900 DOI: 10.1007/s00268-020-05619-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Frailty in the vascular surgical ward is common and predicts poor surgical outcomes. The aim of this study was to analyze transitions in frailty state in elderly patients after vascular surgery and to evaluate influence of patient characteristics on this transition. METHODS Between 2014 and 2018, 310 patients, ≥65 years and scheduled for elective vascular surgery, were included in this cohort study. Transition in frailty state between preoperative and follow-up measurement was determined using the Groningen Frailty Indicator (GFI), a validated tool to measure frailty in vascular surgery patients. Frailty is defined as a GFI score ≥4. Patient characteristics leading to a transition in frailty state were analyzed using multivariable Cox regression analysis. RESULTS Mean age was 72.7 ± 5.2 years, and 74.5% were male. Mean follow-up time was 22.7 ± 9.5 months. At baseline measurement, 79 patients (25.5%) were considered frail. In total, 64 non-frail patients (20.6%) shifted to frail and 29 frail patients (9.4%) to non-frail. Frail patients with a high Charlson Comorbidity Index (HR = 0.329 (CI: 0.133-0.812), p = 0.016) and that underwent a major vascular intervention (HR = 0.365 (CI: 0.154-0.865), p = 0.022) had a significantly higher risk to remain frail after the intervention. CONCLUSIONS The results of this study, showing that after vascular surgery almost 21% of the non-frail patients become frail, may lead to a more effective shared decision-making process when considering treatment options, by providing more insight in the postoperative frailty course of patients.
Collapse
Affiliation(s)
- Louise B D Banning
- Department of Surgery, Division of Vascular Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Linda Visser
- Department of Surgery, Division of Vascular Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Clark J Zeebregts
- Department of Surgery, Division of Vascular Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Barbara L van Leeuwen
- Department of Surgery, Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, Groningen, The Netherlands
| | - Mostafa El Moumni
- Department of Surgery, Division of Trauma Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, Groningen, The Netherlands
| | - Robert A Pol
- Department of Surgery, Division of Vascular Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| |
Collapse
|
75
|
Sagong H, Jang AR, Kim DE, Won CW, Yoon JY. The Cross-Lagged Panel Analysis between Frailty and Physical Activity among Community-Dwelling Older Adults by Age Groups. J Aging Health 2021; 33:387-395. [PMID: 33517827 DOI: 10.1177/0898264320987365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: This study was to investigate the reciprocal relationship between frailty and physical activity among older adults by age group (middle-old: 70-79 years; oldest-old: 80-84 years) within 2 years using cross-lagged panel analysis. Methods: The study data were derived from the Korean Frailty and Aging Cohort Study, and a total of 1092 participants were included. Results: Frailty and high physical activity had significant reciprocal relationships in the middle-old group, which indicates that frailty was associated with less high physical activity, and high physical activity predicts less frailty after 2 years. In the oldest-old group, there was no statistically significant reciprocal relationship between frailty and any level of physical activity reference to low physical activity and vice versa after 2 years. Discussion: Further studies on the relationship between frailty and physical activity of the oldest-old population and specific physical activity guidelines for older adults are needed.
Collapse
Affiliation(s)
- Hae Sagong
- College of Nursing, 26725Seoul National University, Seoul, Korea
| | - Ah Ram Jang
- College of Nursing, 26725Seoul National University, Seoul, Korea.,Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, 26725Seoul National University, Seoul, Korea
| | - Da Eun Kim
- Research Institute of Nursing Science, College of Nursing, 34986Kyungpook National University, Daegu, Korea
| | - Chang Won Won
- College of Medicine, 26723Kyung Hee University, Seoul, Korea
| | - Ju Young Yoon
- College of Nursing, 26725Seoul National University, Seoul, Korea.,Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, 26725Seoul National University, Seoul, Korea.,Research Institute of Nursing Science, 26725Seoul National University, Seoul, Korea
| |
Collapse
|
76
|
Lenardt MH, Falcão ADS, Hammerschmidt KSDA, Barbiero MMA, Leta PRG, Sousa RLD. Sintomas depressivos e fragilidade física em pessoas idosas: revisão integrativa. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2021. [DOI: 10.1590/1981-22562021024.210013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo identificar a relação entre sintomas depressivos e fragilidade física em pessoas idosas por meio de uma revisão integrativa de literatura. Método Foram realizadas buscas em portais e bases de dados: Biblioteca Virtual em Saúde, SciELO, Resultados dos 486 artigos encontrados, 126 foram excluídos por duplicidade, 339 por não se adequarem aos critérios pré-estabelecidos, restando 21 artigos que compuseram o corpus da revisão. Conclusão os sintomas depressivos e fragilidade física estão presentes entre
Collapse
|
77
|
Luo MS, Chui EWT, Li LW. The Longitudinal Associations between Physical Health and Mental Health among Older Adults. Aging Ment Health 2020; 24:1990-1998. [PMID: 31429303 DOI: 10.1080/13607863.2019.1655706] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study examines the lead-lag relationship between physical and mental health among older adults. METHOD Data are collected from 16,417 older adults aged 50 years and older participating in the biannual Health and Retirement Study (HRS). Participants were assessed on up to 11 measurement points over a 21-year period from 1994 to 2014. Physical health was measured as a composite of chronic diseases, functional limitations, and difficulties in basic and instrumental activities of daily living. Mental health was measured with the modified CES-D. Bivariate latent change score models (BLCSM) were estimated. RESULTS Both physical and mental health declined in the observed years, with slower declining rates over time. A reciprocal relationship emerged, with the prior level of physical health acting as the leading indicator of subsequent change in mental health, and the prior mental health state acting as the leading indicator of subsequent changes in physical health. Additionally, the influence of physical health on mental health changes was larger than the corresponding effect of mental health on subsequent physical health. CONCLUSION This study demonstrates the reciprocal relationship between physical and mental health in later adulthood and highlights the need to pay attention to the mental health of older people with physical health problems.
Collapse
Affiliation(s)
- Meng Sha Luo
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ernest Wing Tak Chui
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Lydia W Li
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
78
|
Kojima M, Kojima T, Waguri-Nagaya Y, Takahashi N, Asai S, Sobue Y, Nishiume T, Suzuki M, Mitsui H, Kawaguchi Y, Kuroyanagi G, Yasuoka M, Watanabe M, Suzuki S, Arai H. Depression, physical function, and disease activity associated with frailty in patients with rheumatoid arthritis. Mod Rheumatol 2020; 31:979-986. [PMID: 33066713 DOI: 10.1080/14397595.2020.1838402] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To investigate the clinical and psychosocial backgrounds of frailty in rheumatoid arthritis (RA) patients. METHODS Patients with RA between 40 and 79 years of age who visited university hospitals in an urban area were recruited. Well-validated self-reported questionnaires were used to evaluate patient physical function (Health Assessment Questionnaire, HAQ), depressive symptoms (Beck Depression Inventory-II, BDI-II), and frailty (Kihon Checklist). A 28-point Disease Activity Score (DAS-28) was calculated to evaluate RA disease activity. RESULTS A total of 375 RA patients, 323 of whom were women, were enrolled (average age: 65.2 ± 9.7 years; average disease duration: 16.6 ± 11.9 years). The prevalence rates of frailty, working-age (40-64 years), young-old (65-74 years), and old-old (≥75 years) patients were 18.5, 28.8, and 36.6%, respectively. Higher age and longer disease duration were associated with frailty. Multivariable logistic regression analysis revealed that HAQ, DAS-28, and BDI-II scores were independently associated with frailty in RA patients. CONCLUSION Frailty is common, even among working-age RA patients. Physical function, disease activity, and depressive symptoms were independently associated with frailty. A multidisciplinary intervention approach, along with adequate pharmacological therapy, may promote successful aging in patients with RA.
Collapse
Affiliation(s)
- Masayo Kojima
- Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Toshihisa Kojima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuko Waguri-Nagaya
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Center of Joint Surgery for Rheumatic Diseases and Osteoporosis, Nagoya City East Medical Center, Nagoya, Japan
| | - Nobunori Takahashi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuji Asai
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasumori Sobue
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Orthopaedic Surgery, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Tsuyoshi Nishiume
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Orthopaedic Surgery, Okazaki City Hospital, Okazaki, Japan
| | - Mochihito Suzuki
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroto Mitsui
- Department of Orthopaedic Surgery, Aichi Medical University, Nagoya, Japan
| | - Yohei Kawaguchi
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Gen Kuroyanagi
- Department of Rehabilitation Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mikako Yasuoka
- Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Miki Watanabe
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
79
|
Ambagtsheer RC, Beilby J, Seiboth C, Dent E. Prevalence and associations of frailty in residents of Australian aged care facilities: findings from a retrospective cohort study. Aging Clin Exp Res 2020; 32:1849-1856. [PMID: 31686388 DOI: 10.1007/s40520-019-01379-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Studies conducted among older people have shown that frailty is a common condition associated with an array of adverse outcomes. The aims of this study were to identify the prevalence and associations of frailty in older people residing in several aged care facilities located in Queensland, Australia. METHODS The database used for this study was drawn from the Aged Care Funding Instrument (ACFI) database of an Australian aged care provider, and contained data from ten aged care facilities in Queensland, Australia. A modification of an eFI originally developed by Clegg and colleagues and based on Rockwood's Frailty Index (FI) of cumulative deficits was used to identify frailty. RESULTS In total, 592 participants aged 75 years and over were included in the study (66.6% female). Median (IQR) age was 88.0 (9.0) years. Frailty prevalence among the sample was 43.6%, with 46.3% pre-frail and 10.1% not frail. In a multivariate logistic regression analysis incorporating three different models, frailty was significantly associated with three ACFI domains (Nutrition, Depression and Complex Health Care), along with facility size, consistently across two models. In the third model, frailty was also significantly associated with arthritis, diabetes, hypertension, osteoporosis and vision problems, along with male gender. CONCLUSION There is a need to develop frailty identification and management programs as part of standard care pathways for older adults residing in aged care facilities. Aged care facilities should consider regular frailty screening in residential aged care residents, along with interventions addressing specific issues such as dysphagia and depression.
Collapse
|
80
|
Uchmanowicz I, Lomper K, Gros M, Kałużna-Oleksy M, Jankowska EA, Rosińczuk J, Cyrkot T, Szczepanowski R. Assessment of Frailty and Occurrence of Anxiety and Depression in Elderly Patients with Atrial Fibrillation. Clin Interv Aging 2020; 15:1151-1161. [PMID: 32764902 PMCID: PMC7371919 DOI: 10.2147/cia.s258634] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/13/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose Atrial fibrillation (AF) is the most common cardiac arrhythmia, and its incidence increases with age. The elderly population is commonly affected by frailty syndrome (FS). FS syndrome along with anxiety and depressive symptoms are prevalent among elderly patients with AF. It is unclear whether depression contributes to AF or vice versa. The purpose of this study was to assess correlations between FS and the occurrence of anxiety and depression symptoms in a group of elderly patients with AF. Patients and Methods This cross-sectional study included 100 elderly patients (69 females, 31 males, mean age: 70.27 years) with AF. Standardized research instruments were used including the Tilburg Frailty Indicator (TFI) to assess FS, and two questionnaires to assess depression including the Geriatric Depression Scale (GDS), and the Hospital Anxiety Depression Scale (HADS). Results Mild FS was found in 38% and moderate FS in 29% of patients. Based on GDS scores, depression symptoms were found in 51% of patients’ sample. Based on HADS scores, 20% of patients were found to have anxiety symptoms, and 28% revealed depression symptoms. Single-factor analysis demonstrated a significant positive correlation between HADS anxiety symptoms (r=0.492), HADS depression symptoms (r=0.696), and GDS score (r=0.673) on the one hand, and overall TFI frailty score on the other. Multiple-factor analysis identified overall GDS score, education, and lack of bleeding as significant independent predictors of TFI scores (p<0.05). Conclusion FS is common in the population of elderly patients with AF. We found evidence for the association between symptoms of anxiety and depression and the incidence of FS in this group of patients. Due to the risk of consequences which may in part be irreversible, screening for FS is recommended.
Collapse
Affiliation(s)
| | - Katarzyna Lomper
- Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Małgorzata Gros
- Student Research Circle in Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Kałużna-Oleksy
- 1st Department of Cardiology, University of Medical Sciences in Poznan, Poznan, Poland
| | - Ewa A Jankowska
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,Centre for Heart Diseases, University Hospital, Wroclaw, Poland
| | - Joanna Rosińczuk
- Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Cyrkot
- Department of Public Health, Wroclaw Medical University, Wroclaw, Poland
| | | |
Collapse
|
81
|
Jönsson M, Siennicki-Lantz A. Depressivity and mortality risk in a cohort of elderly men. A role of cognitive and vascular ill-health, and social participation. Aging Ment Health 2020; 24:1246-1253. [PMID: 30945552 DOI: 10.1080/13607863.2019.1597012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objectives: Depressive symptoms in the elderly have been shown to be associated with increased mortality. The purpose of this study was to examine symptoms of depression in octogenarian men and their association with all-cause mortality, and whether physical, cognitive and social factors influence this association.Methods: Out of the 703 initially included 55-years-old men, from the prospective cohort study "Men born in 1914", we studied 163 survivors who could take a part in a survey at age 81, and followed them until their death.Results: Those men who had at least mild depressive symptoms, defined with Zung Self-rating Depression Scale, were found to have an increased mortality risk (HR = 1.52; CI =1.10-2.08; p = 0.01). This association persisted significantly after adjusting for: education, global cognition at age 81, cognitive abilities at age 68, vascular risk factors and comorbidities. Instead, it was attenuated after adjustments for Activities of Daily Life (ADL) - dependency and for a grade of Satisfaction with Participation in daily life.Conclusion: In octogenarian men with survival above the average, mild depressive symptoms predict all-cause mortality. Neither cognitive capacity nor vascular comorbidity explained this association, but lower Satisfaction with Participation in daily life, especially in combination with moderate ADL-dependency.
Collapse
Affiliation(s)
- Max Jönsson
- Department of Clinical Sciences, Geriatric Research group, Lund University, Malmö, Sweden
| | | |
Collapse
|
82
|
Hajek A, Brettschneider C, Röhr S, Gühne U, van der Leeden C, Lühmann D, Mamone S, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Weeg D, Mösch E, Heser K, Wagner M, Maier W, Riedel-Heller SG, Scherer M, König HH. Which Factors Contribute to Frailty among the Oldest Old? Results of the Multicentre Prospective AgeCoDe and AgeQualiDe Study. Gerontology 2020; 66:460-466. [PMID: 32634802 DOI: 10.1159/000508723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION There is a lack of studies investigating the link between time-varying factors associated with changes in frailty scores in very old age longitudinally. This is important because the level of frailty is associated with subsequent morbidity and mortality. OBJECTIVE To examine time-dependent predictors of frailty among the oldest old using a longitudinal approach. METHODS Longitudinal data were drawn from the multicentre prospective cohort study "Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe), covering primary care patients aged 85 years and over. Three waves were used (from follow-up, FU, wave 7 to FU wave 9 [with 10 months between each wave]; 1,301 observations in the analytical sample). Frailty was assessed using the Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (CFS). As explanatory variables, we included sociodemographic factors (marital status and age), social isolation as well as health-related variables (depression, dementia, and chronic diseases) in a regression analysis. RESULTS In total, 18.9% of the individuals were mildly frail, 12.4% of the individuals were moderately frail, and 0.4% of the individuals were severely frail at FU wave 7. Fixed effects regressions revealed that increases in frailty were associated with increases in age (β = 0.23, p < 0.001), and dementia (β = 0.84, p < 0.01), as well as increases in chronic conditions (β = 0.03, p = 0.058). CONCLUSION The study findings particularly emphasize the importance of changes in age, probably chronic conditions as well as dementia for frailty. Future research is required to elucidate the underlying mechanisms. Furthermore, future longitudinal studies based on panel regression models are required to confirm our findings.
Collapse
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Uta Gühne
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Carolin van der Leeden
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg, Germany
| | - Dagmar Lühmann
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg, Germany
| | - Silke Mamone
- Institute of General Practice, Hannover Medical School, Hanover, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hanover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
83
|
Ji L, Qiao X, Jin Y, Si H, Liu X, Wang C. Age differences in the relationship between frailty and depression among community-dwelling older adults. Geriatr Nurs 2020; 41:485-489. [DOI: 10.1016/j.gerinurse.2020.01.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 01/30/2023]
|
84
|
Nishikawa H, Yoh K, Enomoto H, Iwata Y, Sakai Y, Kishino K, Shimono Y, Ikeda N, Takashima T, Aizawa N, Takata R, Hasegawa K, Koriyama T, Yuri Y, Nishimura T, Nishiguchi S, Iijima H. Close Correlation between Frailty and Depressive State in Chronic Liver Diseases. ACTA ACUST UNITED AC 2020; 56:medicina56070319. [PMID: 32605049 PMCID: PMC7404642 DOI: 10.3390/medicina56070319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 11/30/2022]
Abstract
Background and objectives: Few data with regard to the relevance between depression and frailty in chronic liver disease (CLD) patients are currently available. We aimed to elucidate the relationship between frailty and depression as evaluated by the Beck Depression Inventory—2nd edition (BDI-II) in CLD patients (n = 340, median age = 65.0 years). Methods: Frailty was defined as a clinical syndrome in which three or more of the following criteria were met: body weight loss, exhaustion, muscle weakness, slow walking speed and low physical activity. Depressive state was defined as BDI-II score 11 or greater. Results: Robust (frailty score = zero), prefrail (frailty score = one or two) and frailty were identified in 114 (33.5%), 182 (53.5%) and 44 (12.9%). The median BDI-II score was five. Depressive state was identified in 84 patients (24.7%). The median BDI-II scores in patients with robust, prefrail and frail traits were 2, 7 and 12.5 (robust vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0003; robust vs. frail, p < 0.0001; overall p < 0.0001). The proportions of depressive state in patients with robust, prefrail and frail traits were 3.51%, 30.77% and 54.55% (robust vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0046; robust vs. frail, p < 0.0001; overall p < 0.0001). BDI-II score significantly correlated with frailty score (rs = 0.5855, p < 0.0001). Conclusions: The close correlation between frailty and depression can be found in CLD. Preventing frailty in CLD should be approached both physiologically and psychologically.
Collapse
Affiliation(s)
- Hiroki Nishikawa
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
- Center for Clinical Research and Education, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
- Correspondence:
| | - Kazunori Yoh
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Hirayuki Enomoto
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Yoshinori Iwata
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Yoshiyuki Sakai
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Kyohei Kishino
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Yoshihiro Shimono
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Naoto Ikeda
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Tomoyuki Takashima
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Nobuhiro Aizawa
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Ryo Takata
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Kunihiro Hasegawa
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Takashi Koriyama
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Yukihisa Yuri
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Takashi Nishimura
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | | | - Hiroko Iijima
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| |
Collapse
|
85
|
Hao G, Chen H, Ying Y, Wu M, Yang G, Jing C. The Relative Handgrip Strength and Risk of Cardiometabolic Disorders: A Prospective Study. Front Physiol 2020; 11:719. [PMID: 32714207 PMCID: PMC7344191 DOI: 10.3389/fphys.2020.00719] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/29/2020] [Indexed: 12/19/2022] Open
Abstract
Background This study aims to investigate the association between handgrip strength (HGS) and cardiometabolic disorders (CMD), including hypertension, diabetes, and dyslipidemia, in a prospective study. Methods The association between HGS and CMD was examined using the data from 5,271 Chinese adult participants ≥45 years old enrolled in the CHARLS (Chinese Health and Retirement Prospective Cohort Study) during 2011-2015. Relative HGS, calculated as maximal absolute HGS from both hands divided by body mass index, was used in the primary analysis and divided into three groups according to the tertiles (T1, T2, and T3). Results The participants with higher relative HGS had a lower risk of hypertension, diabetes, and dyslipidemia than those with lower HGS, although did not reach statistical significance for diabetes and hypertension in males. Participants with higher HGS had significantly lower risk of hypertension [T3 vs. T1: OR = 0.69, 95% CI = 0.51-0.91, P = 0.010] and dyslipidemia (OR = 0.65, 95% CI = 0.51-0.83, P < 0.001) in males. For females, participants with higher HGS had significantly lower risks of dyslipidemia (OR = 0.67, 95% CI = 0.54-0.83, P < 0.001). Conclusion A consistent association was observed between higher relative HGS and lower risk of CMD. Further research is required to evaluate whether relative HGS can be a convincing predictor for the occurrence of CMD and as a target for intervention in the high-risk population.
Collapse
Affiliation(s)
- Guang Hao
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Haiyan Chen
- Department of Endemic Disease, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yuting Ying
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Min Wu
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Guang Yang
- Department of Pathogen Biology, School of Medicine, Jinan University, Guangzhou, China.,Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, China
| | - Chunxia Jing
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China.,Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, China
| |
Collapse
|
86
|
Sex Differences in Factors Affecting Depressive Symptoms in Older People in the Prefrailty Phase. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124207. [PMID: 32545620 PMCID: PMC7344412 DOI: 10.3390/ijerph17124207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 11/17/2022]
Abstract
Depressive symptoms experienced late in life have considerable effects on the prevalence of comorbidity with physical and cognitive disabilities. By identifying and intervening on modifiable indicators for depression in prefrail older individuals, progression to the frailty phase can be delayed, and physical, psychosocial, and cognitive health problems of older people can be reduced and prevented. This study assessed sex differences in factors affecting depressive symptoms in older people in the prefrailty phase in Korea. Data from the 2014 National Survey of Older Koreans revealed 1706 women and 662 men in the early stages of old age. Regression analysis showed that economic status, number of medications, social support, nutritional status, and fear of falling collectively accounted for 39.0% of the variance among older men. Using the same analysis method, economic status, number of chronic diseases, number of medications, chewing discomfort, regular exercise, social support, mobility, nutritional status, and fear of falling collectively accounted for 37.5% of the variance among older women. Based on differences in characteristics with respect to the sex of older people in the prefrailty phase, public health workers in the community should consider sex differences when planning a frailty management program.
Collapse
|
87
|
Cebrián PD, Cauli O. Analysis of Functional and Cognitive Impairment in Institutionalized Individuals with Movement Disorders. Endocr Metab Immune Disord Drug Targets 2020; 19:1022-1031. [PMID: 30854981 DOI: 10.2174/1871530319666190311104247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/20/2019] [Accepted: 03/27/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Many neurological disorders lead to institutionalization and can be accompanied in their advanced stages by functional impairment, and progressive loss of mobility, and cognitive alterations. OBJECTIVE We analyzed the relationship between functional impairment and cognitive performance and its related subdomains in individuals with Parkinson's disease, Alzheimer's disease accompanied by motor dysfunction, and with other neurological disorders characterized by both motor and cognitive problems. METHODS All participants lived in nursing homes (Valencia, Spain) and underwent cognitive evaluation with the Mini-Mental State Examination; functional assessment of independence in activities of daily living using the Barthel score and Katz index; and assessment of mobility with the elderly mobility scale. RESULTS The mean age of the subjects was 82.8 ± 0.6 years, 47% of the sample included individuals with Parkinson's disease, and 48 % of the sample presented severe cognitive impairment. Direct significant relationships were found between the level of cognitive impairment and functional capacity (p < 0.01) and mobility (p < 0.05). Among the different domains, memory impairment was not associated with altered activities of daily living or mobility. The functional impairment and the risk of severe cognitive impairment were significantly (p<0.05) higher in female compared to male patients. Among comorbidities, overweight/obesity and diabetes were significantly (p < 0.05) associated with poor cognitive performance in those individuals with mild/moderate cognitive impairment. CONCLUSION In institutionalized individuals with movement disorders there is an association between functional and cognitive impairment. Reduction of over-weight and proper control of diabetes may represent novel targets for improving cognitive function at such early stages.
Collapse
Affiliation(s)
- Paula D Cebrián
- Department of Nursing, University of Valencia, Valencia, Spain
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia, Spain
| |
Collapse
|
88
|
Yuan H, Zhang Y, Xue G, Yang Y, Yu S, Fu P. Exploring psychosocial factors associated with frailty incidence among patients undergoing maintenance hemodialysis. J Clin Nurs 2020; 29:1695-1703. [PMID: 32092192 DOI: 10.1111/jocn.15225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/29/2019] [Accepted: 01/10/2020] [Indexed: 02/05/2023]
Abstract
AIM AND OBJECTIVE We investigated the correlation between the frailty status of maintenance haemodialysis (MHD) patients and psychosocial factors. BACKGROUND Varying degrees of frailty have been reported in MHD patients, which affect their quality of life. DESIGN We adopted a cross-sectional design in this study. METHODS Clinical data of 187 patients at our centre were collected from December 2017-June 2018 using a cross-sectional survey. Psychosocial factors were measured using the Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, 10-item Connor-Davidson Resilience Scale (CD-RISC), Chronic Disease Self-Efficacy Scales and Perceived Social Support Scale. Frailty status was estimated using the fatigue, resistance, ambulation, illnesses and loss of weight (FRAIL) scale. Spearman's correlation and multiple logistic regression analysis were conducted to identify the risk factors for frailty. This study complied with the STROBE checklist. RESULTS Of 187 patients, 11 cases (5.9%) of frailty were identified. Patient's age, comorbidities, parathyroid hormone level, sleep quality and depression were positively correlated with frailty (p < .05), while psychological resilience and social support were negatively correlated with frailty (p < .05). Logistic regression analysis revealed four risk factors for frailty among MHD patients, including age (p = .004), comorbidities (p = .023), depression (p = .023) and sleep disorders (p = .029). Conversely, protective factors included high psychological resilience (p = .019) and social support (p = .039). CONCLUSION Among MHD patients, the risk factors for frailty included age, comorbidity, depression and sleep disturbance, whereas the protective factors included psychological resilience and social support. RELEVANCE TO CLINICAL PRACTICE Frailty is not only common among older patients, but also among people of all age groups suffering from chronic diseases. Therefore, it is important to consider the health status of MHD patients and adopt targeted nursing strategies to alleviate symptoms of frailty and improve physical condition by the following ways: postpone the progress of comorbidities, improve sleep quality, control the symptoms of depression, foster psychological resilience and facilitate support from social and family.
Collapse
Affiliation(s)
- Huaihong Yuan
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Yingjun Zhang
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Guifang Xue
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Yujie Yang
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Shaobin Yu
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Fu
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.,National Clinical Research Center for Geriatrics, West China Hospital Sichuan University, Chengdu, China
| |
Collapse
|
89
|
Solvik E, Ytrehus S, Utne I, Grov EK. Pain, fatigue, anxiety and depression in older home-dwelling people with cancer. Nurs Open 2020; 7:430-438. [PMID: 31871728 PMCID: PMC6918018 DOI: 10.1002/nop2.406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/07/2019] [Indexed: 11/22/2022] Open
Abstract
Aim Globally, cancer incidence counts for more than 14 million cases and the number increases with age. The aim of this study was to investigate the occurrence of pain, fatigue, anxiety and depression in association with demographic and clinical factors. Design A cross-sectional descriptive design was used. Methods We performed descriptive statistics to analyse the questionnaires completed from 174 older home-dwelling people with cancer. Results The people with cancer reported low occurrence of pain, fatigue, anxiety and depression. We found strong correlation between anxiety and depression. Women reported significantly higher scores of anxiety and depression than men. A higher pain score was associated with higher scores of fatigue and anxiety. Conclusions Home care personnel meeting older home-dwelling people with cancer should emphasize these people' mental health problems and be aware that pain, fatigue and anxiety may occur at the same time.
Collapse
Affiliation(s)
- Elena Solvik
- Department of Emergency ReceptionOstfold Hospital Trust, KalnesGrålumNorway
| | - Siri Ytrehus
- Faculty of HealthWestern Norway University of Applied SciencesBergenNorway
| | - Inger Utne
- Faculty of Health SciencesInstitute of Nursing and Health PromotionOslo Metropolitan UniversityOsloNorway
| | - Ellen Karine Grov
- Faculty of Health SciencesInstitute of Nursing and Health PromotionOslo Metropolitan UniversityOsloNorway
| |
Collapse
|
90
|
Ruiz JG, Rodriguez-Suarez M, Tang F, Aparicio-Ugarriza R, Ferri-Guerra J, Mohammed NY, Mintzer MJ. Depression but not frailty contributed to a higher risk for all-cause hospitalizations in male older veterans. Int J Geriatr Psychiatry 2020; 35:37-44. [PMID: 31608502 DOI: 10.1002/gps.5212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 09/15/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Frailty is a state of vulnerability to stressors resulting in higher morbidity, mortality, and utilization in older adults. Depression and frailty often coexist, suggesting a bidirectional relationship that may increase the effects of each individual condition on clinical outcomes and health-care utilization in older adults. OBJECTIVE To determine the effects of concurrent frailty and depression on all-cause hospitalizations. METHODS/DESIGN Prospective cohort study, conducted at a Veterans Affairs (VA) Medical Center. The participants were male, community-dwelling veterans 65 years and older. From 4 January through 30 December 2016, a 46-item frailty index was generated from data obtained from the VA electronic health record. Trained staff conducted in-depth reviews of electronic health records ascertaining depression status. Patients were followed through 31 December 2017 for all-cause hospitalizations following the initial assessment of frailty. After adjusting for covariates, the association of frailty and depression with all-cause hospitalizations was determined with the Andersen-Gill model, accounting for repeated hospitalizations. RESULTS Five hundred fifty-three male patients were part of the study, mean age 76.3 (SD = 8.2) years. One hundred eighty-one patients (32.7%) had depression diagnoses. During a median follow-up period of 530 days (interquartile range [IQR] = 245), 123 patients (22.2%) had 240 hospitalizations. Frailty status was not associated with future hospitalizations (adjusted hazard ratio [HR] = 1.61; 95% CI, 95-2.74; P > .05). Depression was associated with higher all-cause hospitalizations (adjusted HR = 1.57; 95% CI, 1.09-2.26); P = .0157). CONCLUSIONS Depression but not frailty was significantly associated with higher rates of all-cause hospitalization. Implementing interventions that target older adults with both frailty and depression may reduce the burden of both conditions and reduce hospitalizations.
Collapse
Affiliation(s)
- Jorge G Ruiz
- Miami VA Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Miami, FL.,Miller School of Medicine, University of Miami, Miami, FL
| | - Mercedes Rodriguez-Suarez
- Miller School of Medicine, University of Miami, Miami, FL.,Mental Health Service, Miami VA Healthcare System, Miami, FL
| | - Fei Tang
- Research Service, Miami VA Healthcare System, Miami, FL
| | - Raquel Aparicio-Ugarriza
- Miami VA Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Miami, FL.,Miller School of Medicine, University of Miami, Miami, FL
| | - Juliana Ferri-Guerra
- Miami VA Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Miami, FL.,Miller School of Medicine, University of Miami, Miami, FL
| | - Nadeem Y Mohammed
- Miami VA Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Miami, FL.,Miller School of Medicine, University of Miami, Miami, FL
| | - Michael J Mintzer
- Miami VA Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Miami, FL.,Miller School of Medicine, University of Miami, Miami, FL.,Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| |
Collapse
|
91
|
Zhang Y, Ge M, Zhao W, Hou L, Xia X, Liu X, Zuo Z, Zhao Y, Yue J, Dong B. Association Between Number of Teeth, Denture Use and Frailty: Findings from the West China Health and Aging Trend Study. J Nutr Health Aging 2020; 24:423-428. [PMID: 32242210 DOI: 10.1007/s12603-020-1346-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Frailty and poor oral health are both common age-related conditions. However, the association between oral health and frailty has not been explored thoroughly among older Chinese adults. We aimed to investigate the associations between number of teeth, denture use, and frailty among older adults in western China. DESIGN Cross-sectional study. SETTING Community-based. PARTICIPANTS Participants were 4037 community-dwelling individuals aged 60 and older from the West China Health and Aging Trend (WCHAT) study. MEASUREMENTS Frailty was assessed using the physical frailty phenotype (PFP) and categorized as non-frail, prefrail and frail. In addition, number of teeth and denture use were examined by calibrated dentists. Multinomial logistic regression models were performed to examine the association between number of teeth, denture use, and frailty. RESULTS The overall prevalence of frailty was 6.7% among 4037 participants aged 60 and older in western China. Participants with no more than 20 teeth were associated with higher odds of being prefrail or frail whether wearing dentures or not. Denture using could not help lower the odds of being prefrail or frail for older adults with fewer teeth. CONCLUSIONS This study suggested that frailty was associated with having fewer teeth (≤20 teeth) among older Chinese adults. Future research involving targeted interventions addressing number of teeth may help provide information to establish effective strategies for frailty prevention in older adults.
Collapse
Affiliation(s)
- Y Zhang
- Professor Birong Dong, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, GuoXueXiang, Chengdu, Sichuan, China, 610041. E-mail address: , Fax: +86-028-85421550, Tel: +86-028-85421550
| | | | | | | | | | | | | | | | | | | |
Collapse
|
92
|
Benraad CEM, Disselhorst L, Laurenssen NCW, Hilderink PH, Melis RJF, Spijker J, Olde Rikkert MGM. Frailty, multimorbidity and functional status as predictors for health outcomes of acute psychiatric hospitalisation in older adults. Aging Ment Health 2020; 24:119-128. [PMID: 30450946 DOI: 10.1080/13607863.2018.1515888] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objectives: Frailty, multimorbidity and functional decline predict adverse health outcomes in community dwelling older people and older patients in general hospitals. This study investigates whether these characteristics separately are independent predictors of health outcomes of acute psychiatric hospitalization.Methods: Observational study in a prospectively sampled cohort of older patients, consecutively admitted to a psychiatric hospital. On admission we assessed frailty (Frailty Index and walking speed); multimorbidity (Cumulative Index Rating Scale Geriatrics (CIRS-G)) and functional status (Barthel Index). We used the Clinical Global Impressions of Improvement scale (CGI-I) as the psychiatric outcome measure, and dichotomized discharge destination as overall outcome measure: favourable (able to return home or previous care level) or adverse (death, or move to higher level of residential care).Results: We included 120 patients, 74.6 years (±7.8). 52.5% of the patients was frail (FI ≥0.25). The mean level of the CIRS-G was 13.5 (5.4). Mean CGI-I at discharge was 2.8 (± 1.0), indicating moderate improvement in the psychiatric outcome. Neither FI, CIRS-G, nor Barthel scores were, independent of age, sex and diagnosis, associated with the CGI-I. FI was predictive for adverse discharge destination (OR 1.91, 95%CI 1.09-3.37 per 0.1), as were higher CIRS-G (OR 1.19 95%CI 1.06-1.34, per point) and lower walking speed (OR 1.35 95%CI 1.06-1.72 per 0.1 m/s).Conclusions: Half of our patients were frail and had a high level of multimorbidity. The FI, walking speed and multimorbidity did not predict improvement of psychiatric symptoms at discharge, but independently helped to predict adverse discharge destination.
Collapse
Affiliation(s)
- Carolien E M Benraad
- Department of Geriatric Medicine/Radboudumc Alzheimer Centre, Donders Institute for Medical Neurosciences, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Geriatric Psychiatry, Pro Persona Mental Health Care, Nijmegen, The Netherlands
| | - Luc Disselhorst
- Department of Geriatric Psychiatry, Pro Persona Mental Health Care, Nijmegen, The Netherlands
| | - Nicky C W Laurenssen
- Department of Geriatric Psychiatry, Pro Persona Mental Health Care, Nijmegen, The Netherlands
| | - Peter H Hilderink
- SeniorBeter, Practice for Old Age Psychiatry, Gendt, The Netherlands
| | - René J F Melis
- Department of Geriatric Medicine/Radboudumc Alzheimer Centre, Donders Institute for Medical Neurosciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jan Spijker
- Depression Expertise Centre, Pro Persona Mental Health Care, Nijmegen, The Netherlands.,Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Marcel G M Olde Rikkert
- Department of Geriatric Medicine/Radboudumc Alzheimer Centre, Donders Institute for Medical Neurosciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
93
|
Mallery L, MacLeod T, Allen M, McLean-Veysey P, Rodney-Cail N, Bezanson E, Steeves B, LeBlanc C, Moorhouse P. Systematic review and meta-analysis of second-generation antidepressants for the treatment of older adults with depression: questionable benefit and considerations for frailty. BMC Geriatr 2019; 19:306. [PMID: 31718566 PMCID: PMC6852920 DOI: 10.1186/s12877-019-1327-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/23/2019] [Indexed: 11/21/2022] Open
Abstract
Background Frail older adults are commonly prescribed antidepressants. Yet, there is little evidence to determine the efficacy and safety of antidepressants to treat depression with concomitant frailty. To better understand this issue, we examined the efficacy and safety of second-generation antidepressants for the treatment of older adults with depression and then considered implications for frailty. Methods Due to the absence of therapeutic studies of frail older adults with depression, we conducted a systematic review and meta-analysis of double-blind, randomized controlled trials that compared antidepressants versus placebo for adults with depression, age 65 years or older. We searched PubMed/MEDLINE, Cochrane Library, reference lists from meta-analyses/studies, hand searches of publication lists, and related articles on PubMed. Outcomes included rates of response, remission, and adverse events. After evaluating the data, we applied a frailty-informed framework to consider how the evidence could be applied to frailty. Results Nine trials were included in the meta-analysis (n = 2704). Subjects had moderate to severe depression. For older adults with depression, there was no statistically significant difference in response or remission to second-generation antidepressants compared to placebo. Response occurred in 45.3% of subjects receiving an antidepressant compared to 40.5% receiving placebo (RR 1.15, 95% CI: 0.96 – 1.37, p = 0.12, I2 = 71%). Remission occurred in 33.1% with antidepressant versus 31.3% with placebo (RR 1.10, 95% CI: 0.92 – 1.31, p = 0.30, I2 = 56%) (Figure 2 and 3). There were more withdrawals due to adverse events with antidepressants, 13% versus 5.8% (RR 2.30, 95% CI: 1.45–3.63; p < 0.001; I2 = 61%; NNH 14, 95% CI:10–28). Implications for frailty Subjects in the meta-analysis did not have obvious characteristics of frailty. Using framework questions to consider the implications of frailty, we hypothesize that, like older adults, frail individuals with depression may not respond to antidepressants. Further, observational studies suggest that those who are frail may be less responsive to antidepressants compared to the non-frail. Given the vulnerability of frailty, adverse events may be more burdensome. Conclusions Second-generation antidepressants have uncertain benefit for older adults with depression and cause more adverse events compared to placebo. Until further research clarifies benefit, careful consideration of antidepressant prescribing with frailty is warranted.
Collapse
Affiliation(s)
- Laurie Mallery
- Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Tanya MacLeod
- Continuing Professional Development, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michael Allen
- Continuing Professional Development, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pamela McLean-Veysey
- Drug Evaluation Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Natasha Rodney-Cail
- Drug Evaluation Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Evan Bezanson
- Sobeys National Pharmacy Group, Halifax, Nova Scotia, Canada
| | - Brian Steeves
- RK MacDonald Nursing Home, Halifax, Nova Scotia, Canada
| | - Constance LeBlanc
- Continuing Professional Development, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Paige Moorhouse
- Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
94
|
Gandolfini I, Regolisti G, Bazzocchi A, Maggiore U, Palmisano A, Piotti G, Fiaccadori E, Sabatino A. Frailty and Sarcopenia in Older Patients Receiving Kidney Transplantation. Front Nutr 2019; 6:169. [PMID: 31781571 PMCID: PMC6861371 DOI: 10.3389/fnut.2019.00169] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/23/2019] [Indexed: 12/14/2022] Open
Abstract
Kidney transplantation is the treatment of choice for most of the patients with end-stage renal disease (ESRD). It improves quality of life, life expectancy, and has a lower financial burden to the healthcare system in comparison to dialysis. Every year more and more older patients are included in the kidney transplant waitlist. Within this patient population, transplanted subjects have better survival and quality of life as compared to those on dialysis. It is therefore crucial to select older patients who may benefit from renal transplantation, as well as those particularly at risk for post-transplant complications. Sarcopenia and frailty are frequently neglected in the evaluation of kidney transplant candidates. Both conditions are interrelated complex geriatric syndromes that are linked to disability, aging, comorbidities, increased mortality, and graft failure post-transplantation. Chronic kidney disease (CKD) and more importantly ESRD are characterized by multiple metabolic complications that contribute for the development of sarcopenia and frailty. In particular, anorexia, metabolic acidosis and chronic low-grade inflammation are the main contributors to the development of sarcopenia, a key component in frail transplant candidates and recipients. Both frailty and sarcopenia are considered to be reversible. Frail patients respond well to multiprofessional interventions that focus on the patients' positive frailty criteria, while physical rehabilitation and oral supplementation may improve sarcopenia. Prospective studies are still needed to evaluate the utility of formally measuring frailty and sarcopenia in the older candidates to renal transplantation as part of the transplant evaluation process.
Collapse
Affiliation(s)
- Ilaria Gandolfini
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma & Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Giuseppe Regolisti
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma & Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Umberto Maggiore
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma & Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Alessandra Palmisano
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma & Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Giovanni Piotti
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma & Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Enrico Fiaccadori
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma & Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Alice Sabatino
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| |
Collapse
|
95
|
Depression and Incidence of Frailty in Older People From Six Latin American Countries. Am J Geriatr Psychiatry 2019; 27:1072-1079. [PMID: 31109899 PMCID: PMC6742503 DOI: 10.1016/j.jagp.2019.04.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/20/2019] [Accepted: 04/22/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Frailty and depression are highly comorbid conditions, but the casual direction is unclear and has not been explored in low- and middle-income countries. The aim of this study was to investigate the potential impact of depression on incident frailty in older people living in Latin America. METHODS This study was based on a population-based cohort of 12,844 people aged 65 or older from six Latin American countries (Cuba, Dominican Republic, Mexico, Venezuela, Puerto Rico, and Peru), part of the 10/66 cohort study. Two types of frailty measures were used: a modified Fried frailty phenotype and a multidimensional frailty criterion, which included measures from cognition, sensory, nutrition, and physical dimensions. Depression was assessed using EURO-D and International Classification of Diseases, Tenth Revision criteria. A competing risk model was used to examine the associations between baseline depression and incidence of frailty in the 3-5 years of follow-up, accounting for sociodemographic and health factors and the competing event of frailty-free death. RESULTS Depression was associated with a 59% increased hazard of developing frailty using the modified Fried phenotype (subdistribution hazard ratio [SHR]: 1.59; 95% confidence interval [CI]: 1.40, 1.80) and 19% for multidimensional frailty (SHR: 1.19; 95% CI: 1.06, 1.33) after adjusting for sociodemographic factors, physical impairments, and dementia. The associations between depression and the multidimensional frailty criteria were homogenous across all the sites (Higgins I2 = 0%). CONCLUSION Depression may play a key role in the development of frailty. Pathways addressing the association between physical and mental health in older people need to be further investigated in future research.
Collapse
|
96
|
Shimada H, Lee S, Doi T, Bae S, Tsutsumimoto K, Arai H. Prevalence of Psychological Frailty in Japan: NCGG-SGS as a Japanese National Cohort Study. J Clin Med 2019; 8:E1554. [PMID: 31569684 PMCID: PMC6832757 DOI: 10.3390/jcm8101554] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 01/10/2023] Open
Abstract
There has been less research conducted on the psychological aspects of frailty than on the physical and cognitive characteristics of frailty. Thus, we aimed to define psychological frailty, clarify its prevalence, and investigate the relationship between psychological frailty and lifestyle activity or disability incidence in older adults in Japan. The participants in our study were 4126 older adults (average age 71.7 years) enrolled in the National Center for Geriatrics and Gerontology-i87uStudy of Geriatric Syndromes (NCGG-SGS). We characterized physical frailty of the following as ≥ 3: slow walking speed, muscle weakness, exhaustion, low physical activity, and weight loss. We used the Geriatric Depression Scale 15 items version (GDS-15) to screen for depressive mood, indicated by 5 points or more on the scale. The co-presence of physical frailty and depressive mood was defined as psychological frailty. The incidence of disability was determined using data from the Japanese long-term care insurance system over 49 months. We found that the prevalence of physical frailty, depressive mood, and psychological frailty were 6.9%, 20.3%, and 3.5%, respectively. Logistic regression indicated that the odds ratios for loss of lifestyle activities were significantly higher in participants with psychological frailty for going outdoors using the bus or train, driving a car, using maps to go to unfamiliar places, reading books or newspapers, cognitive stimulation, culture lessons, giving advice, attending community meetings, engaging in hobbies or sports, house cleaning, fieldwork or gardening, and taking care of grandchildren or pets. During the follow-up period, 385 participants (9.3%) developed a disability. The incidence of disability was associated with both physical and psychological frailty in the fully adjusted model. However, no significant association between disability and depressive mood was found. We conclude that individuals with psychological frailty had the highest risk of disability. Future policies should implement disability prevention strategies among older adults with psychological frailty.
Collapse
Affiliation(s)
- Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Sangyoon Lee
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Takehiko Doi
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Seongryu Bae
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Kota Tsutsumimoto
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| |
Collapse
|
97
|
Alexopoulos GS. Mechanisms and treatment of late-life depression. Transl Psychiatry 2019; 9:188. [PMID: 31383842 PMCID: PMC6683149 DOI: 10.1038/s41398-019-0514-6] [Citation(s) in RCA: 263] [Impact Index Per Article: 52.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/26/2018] [Accepted: 01/01/2019] [Indexed: 01/25/2023] Open
Abstract
Depression predisposes to medical illnesses and advances biological aging indicated by shorter telomere length, accelerated brain aging and advanced epigenetic aging. Medical illnesses also increase the risk of late-life depression. The reciprocal relationships of depression with aging-related and disease-related processes have generated pathogenetic hypotheses and provided treatment targets. Targeting risk factors of vascular disease in mid-life is a logical approach in prevention of vascular depression. The depression-executive dysfunction and the vascular depression syndromes have clinical presentations and neuroimaging findings consistent with frontostriatal abnormalities. Dopamine D2/3 agonists are effective in depression of Parkinson's disease and their efficacy needs to be assessed in these two syndromes. Computerized cognitive remediation targeting functions of the cognitive control network may improve both executive functions and depressive symptoms of late-life major depression. Significant progress has been made in neurostimulation treatments in depressed younger adults. TMS targeting deep structures responsible for mood regulation is well tolerated by older adults and its efficacy in syndromes of late-life depression needs to be studied. Efficacious psychotherapies for late-life depression exist, but are underutilized in part because of their complexity. Streamlined, stepped psychotherapies targeting behaviors assumed to result from dysfunction of brain networks implicated in late-life depression can be easy to learn and have potential for dissemination. However, their effectiveness needs further investigation. Depression increases the risk of dementing disorders. Antidepressants are rather ineffective in treating depression of demented patients, but long-term use of antidepressants may reduce the risk of dementia. However, confirmation studies are needed.
Collapse
Affiliation(s)
- George S. Alexopoulos
- 000000041936877Xgrid.5386.8Weill Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY 10605 USA
| |
Collapse
|
98
|
Knoop V, Costenoble A, Vella Azzopardi R, Vermeiren S, Debain A, Jansen B, Scafoglieri A, Bautmans I, Bautmans I, Verté D, Beyer I, Petrovic M, De Donder L, Kardol T, Rossi G, Clarys P, Scafoglieri A, Cattrysse E, de Hert P, Jansen B. The operationalization of fatigue in frailty scales: a systematic review. Ageing Res Rev 2019; 53:100911. [PMID: 31136819 DOI: 10.1016/j.arr.2019.100911] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To identify the different fatigue items in existing frailty scales. METHODS PubMed, Web of Knowledge and PsycINFO were systematically screened for frailty scales. 133 articles were included, describing 158 frailty scales. Fatigue items were extracted and categorized in 4 fatigue constructs: "mood state related tiredness", "general feeling of tiredness", "activity based feeling of tiredness" and "resistance to physical tiredness". RESULTS 120 fatigue items were identified, of which 100 belonged to the construct "general feeling of tiredness" and only 9 to the construct "resistance to physical tiredness". 49,4% of the frailty scales included at least 1 fatigue item, representing 15 ± 9,3% of all items in these scales. Fatigue items have a significantly higher weight in single domain (dominantly physical frailty scales) versus multi domain frailty scales (21 ± 3.2 versus 10.6 ± 9.8%, p=<0,05). CONCLUSION Fatigue is prominently represented in frailty scales, covering a great diversity in fatigue constructs and underlying pathophysiological mechanisms by which fatigue relates to frailty. Although fatigue items were more prevalent and had a higher weight in physical frailty scales, the operationalization of fatigue leaned more towards psychological constructs. This review can be used as a reference for choosing a suitable frailty scale depending on the type of fatigue of interest.
Collapse
|
99
|
Han KM, Chang J, Yoon HK, Ko YH, Ham BJ, Kim YK, Han C. Relationships between hand-grip strength, socioeconomic status, and depressive symptoms in community-dwelling older adults. J Affect Disord 2019; 252:263-270. [PMID: 30991254 DOI: 10.1016/j.jad.2019.04.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/03/2019] [Accepted: 04/07/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Depressive symptoms have been found to be associated with decreased hand-grip strength (HGS) and low socioeconomic status (SES) in older adults. We aimed to investigate the potential moderating effect of SES on the association between HGS and depressive symptoms and the potential mediating effect of HGS on the association between SES and depressive symptoms using a nationally representative sample of older adults. METHOD Data from 3169 community-dwelling adults aged 60 years or older were acquired from the Korea National Health and Nutrition Examination Survey conducted in 2014 and 2016. HGS was measured using a digital hand-grip dynamometer. Depressive symptoms were evaluated using the 9-item version of the Patient Health Questionnaire-9 (PHQ-9). SES was assessed using equivalent monthly household income and education level. RESULTS Older adults in the lowest tertile of HGS measures were more likely to have experienced depressive symptoms compared to those in the highest tertile (odds ratio = 1.95, 95% confidence interval = 1.25-2.74). A significant moderating effect of household income level was observed on the association between HGS and PHQ-9 score (P = 0.014). Older adults with a low income had a stronger inverse correlation between HGS and PHQ-9 score compared to those with a high income (low income: beta = -0.162, P < 0.001; high income: beta = -0.119, P = 0.036). HGS partially mediated the association between low income and depressive symptoms. CONCLUSION Our findings indicate that there may be a stronger relationship between low HGS and depressive symptoms in socioeconomically deprived older people. Further research on muscle strength and income level in older adults is required regarding depression risk assessment.
Collapse
Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jisoon Chang
- Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Republic of Korea
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
100
|
Harerimana B, Forchuk C, O'Regan T. The use of technology for mental healthcare delivery among older adults with depressive symptoms: A systematic literature review. Int J Ment Health Nurs 2019; 28:657-670. [PMID: 30666762 DOI: 10.1111/inm.12571] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2018] [Indexed: 12/30/2022]
Abstract
Depression has been identified as the single largest contributor to poor health and functioning worldwide. Global estimates indicate that 4.4% of the world's population lives with depression, equating to about 322 million individuals. Research demonstrates that telehealth interventions (i.e. delivering therapy by phone or videoconferencing) have potential for improving mental health care among community-based older adults. This review analyses scholarly literature on telehealth interventions among older adults with depressive symptoms. Following PRISMA guidelines, a systematic search of peer-reviewed papers was conducted using the following key terms: telemedicine, telepsychogeriatrics, telepsychiatry, eHealth, mental health, depression, and geriatric. The review included nine articles examining telehealth for mental health care, published in English between 1946 and 26 September 2017. Telehealth for mental health care among older adults demonstrates a significant impact on health outcomes, including reduced emergency visits, hospital admissions, and depressive symptoms, as well as improved cognitive functioning. Positive or negative influences on the use of telehealth among older adults are identified. This review highlights keys aspects to consider in using telehealth interventions, including levels of education, cognitive function, and prior technology experience. The review highlights vital factors for designing interventions which aim to capitalize on the benefits of the use of telehealth for mental healthcare service delivery, especially in older adults with depressive symptoms.
Collapse
Affiliation(s)
- Boniface Harerimana
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Cheryl Forchuk
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada.,Aging, Mental Health, Rehabilitation and Recovery, Lawson Health Research Institute, London, Ontario, Canada
| | - Tony O'Regan
- Lawson Health Research Institute, London, Ontario, Canada
| |
Collapse
|