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Potvin-Desrochers A, Atri A, Clouette J, Hepple RT, Taivassalo T, Paquette C. Resting-state Functional Connectivity of the Motor and Cognitive Areas is Preserved in Masters Athletes. Neuroscience 2024; 546:53-62. [PMID: 38522662 DOI: 10.1016/j.neuroscience.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024]
Abstract
Aging is characterized by a decline in physical and cognitive functions, often resulting in decreased quality of life. Physical activity has been suggested to potentially slow down various aspects of the aging process, a theory that has been supported by studies of Masters Athletes (MA). For example, MA usually have better cognitive and physical functions than age-matched sedentary and healthy older adults (OA), making them a valuable model to gain insights into mechanisms that promote physical and cognitive function with aging. The purpose of this study was to identify differences in resting-state functional connectivity (rs-FC) of motor and cognitive regions between MA and OA and determine if these differences in the resting brain are associated with differences in cognitive and physical performance between groups. Fifteen MA (9 males) and 12 age-matched OA (six males) were included. rs-FC images were compared to identify significant between-groups differences in brain connectivity. There was higher connectivity between the cognitive and motor networks for the OA group, whereas the MA group had stronger connectivity between different regions within the same network, both for the cognitive and the motor networks. These results are in line with the literature suggesting that aging reduces the segregation between functional networks and causes regions within the same network to be less strongly connected. High-level physical activity practiced by the MA most likely contributes to attenuating aging-related changes in brain functional connectivity, preserving clearer boundaries between different functional networks, which may ultimately favor maintenance of efficient cognitive and sensorimotor processing.
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Affiliation(s)
- Alexandra Potvin-Desrochers
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave., Montreal, Quebec, Canada; Jewish Rehabilitation Hospital Site of CISSS-Laval and Research Site of the Montreal Centre for Interdisciplinary Research in Rehabilitation (CRIR), 3205 Place Alton-Goldbloom, Laval, Quebec, Canada; Integrated Program in Neuroscience (IPN), McGill University, 1033 Pine Ave, Montreal, Quebec, Canada
| | - Alisha Atri
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave., Montreal, Quebec, Canada; Jewish Rehabilitation Hospital Site of CISSS-Laval and Research Site of the Montreal Centre for Interdisciplinary Research in Rehabilitation (CRIR), 3205 Place Alton-Goldbloom, Laval, Quebec, Canada
| | - Julien Clouette
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave., Montreal, Quebec, Canada; Jewish Rehabilitation Hospital Site of CISSS-Laval and Research Site of the Montreal Centre for Interdisciplinary Research in Rehabilitation (CRIR), 3205 Place Alton-Goldbloom, Laval, Quebec, Canada
| | - Russell T Hepple
- Department of Physical Therapy, University of Florida, 101 Newell Dr, Gainesville, FL, USA; Department of Physiology and Functional Genomics, University of Florida, 1600 SW Archer Rd, Gainesville, FL, USA
| | - Tanja Taivassalo
- Department of Physiology and Functional Genomics, University of Florida, 1600 SW Archer Rd, Gainesville, FL, USA
| | - Caroline Paquette
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave., Montreal, Quebec, Canada; Jewish Rehabilitation Hospital Site of CISSS-Laval and Research Site of the Montreal Centre for Interdisciplinary Research in Rehabilitation (CRIR), 3205 Place Alton-Goldbloom, Laval, Quebec, Canada; Integrated Program in Neuroscience (IPN), McGill University, 1033 Pine Ave, Montreal, Quebec, Canada.
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Kong LL, Xie W, Dong ZY, Liu YT, Zhao HM, Fan JY, Qi XJ, Li J. Cognitive frailty and its association with disability among Chinese community-dwelling older adults: a cross-sectional study. BMC Geriatr 2024; 24:189. [PMID: 38409011 PMCID: PMC10895716 DOI: 10.1186/s12877-024-04773-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/02/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND There are a variety of determinants that are key to functional disability of older adults. However, little is known regarding the relationship between cognitive frailty and disability among older people. The aims of this study were to examine the associations between cognitive frailty and its six components with instrumental activities of daily living (IADL) functioning in community-dwelling older adults. METHODS A total of 313 community-dwelling older adults (aged ≥ 65 years) were recruited from eight community centers in central China. Cognitive frailty was operationalized using the Mini-Mental State Examination for the evaluation of cognitive status and the Fried criteria for the evaluation of physical frailty. The outcome was functional disability assessed by the IADL scale. The association between cognitive frailty, as well as its components, and IADL limitations was identified by conducting binary logistic regression analysis. RESULTS The prevalence of cognitive frailty was 8.9% in this study. The results showed that cognitive frailty (OR = 22.86) and frailty without cognitive impairment (OR = 8.15) were associated with IADL limitations. Subdimensions of cognitive frailty, exhaustion, weakness, low physical activity and cognitive impairment components were independently associated with IADL limitations. CONCLUSION Cognitive frailty was associated with a higher prevalence of disability. Interventions for improving cognitive frailty should be developed to prevent IADL disability among community-dwelling older adults in China.
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Affiliation(s)
- Ling-Lin Kong
- School of Public Health and Nursing, Hubei University of Science and Technology, Xianning, China
| | - Wen Xie
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zi-Yan Dong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue-Ting Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui-Min Zhao
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, China
| | - Jun-Yao Fan
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Jing Qi
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Tchalla A, Cardinaud N, Gayot C, Dumoitier N, Druet-Cabanac M, Laroche ML, Rudelle K, Mouret CL, Boyer S. Patterns, predictors, and outcomes of frailty trajectories in community-dwelling older adults: Results from the FREEDOM Cohort Study. Arch Gerontol Geriatr 2023; 114:105101. [PMID: 37321127 DOI: 10.1016/j.archger.2023.105101] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To identify subgroups of people with distinct frailty trajectories, identify baseline characteristics associated with these trajectories, and determine their coincident clinical outcomes. DESIGN This study examined the longitudinal database from the FREEDOM Cohort Study. SETTING AND PARTICIPANTS All 497 participants of the FREEDOM (French Acronym for "FRagilitéEtEvaluation àDOMicile" / In English "Frailty and Evaluation at Home") cohort requested a comprehensive geriatric assessment. Community-dwelling subjects over 75 years, or over 65 years with at least two comorbidities were included. METHODS Frailty was assessed using Fried's criteria, depression using the Geriatric Depression Scale (GDS) and cognitive function using the Mini Mental State Examination (MMSE) questionnaire. Frailty trajectories were modelled using k-means algorithms. Predictive factors were determined by multivariate logistic regression. Clinical outcomes included incident cognitive deficit, falls and hospitalization. RESULTS The trajectory models allowed determine four frailty trajectories: "robust stable" (Trajectory A, 26.8%), "pre-frail worsening to frailty" (Trajectory B, 35.8%), "frail improving to less frailty" (Trajectory C, 23.3%), and "frail worsening to more frailty" (Trajectory D, 14.1%). Trajectory B was associated with age (OR 1.2 (95CI, 1.05 - 1.17)), potential cognitive deficit/dementia (OR 2.01 (95CI, 1.01- 4.05)) and depressive symptoms (OR 2.36 (95CI, 1.36 - 4.12)). Hypertension was distinguishing factor between" trajectory B vs. C and D. Depressive symptoms were two time more associated with D (OR 10.51) vs. C (OR 4.55). The incidence of clinical outcomes was significantly increased in poor frailty trajectories. CONCLUSIONS AND IMPLICATIONS This study allowed to determine frailty trajectories among older subjects requested a comprehensive geriatric assessment. The more significant predictive factors associated with poor frailty trajectory were advanced in age, potential cognitive deficit/dementia, depressive symptoms and hypertension. This emphasizes the need for adequate measures to controlled hypertension, depressive symptoms and to maintain or improve cognition in older adults.
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Affiliation(s)
- Achille Tchalla
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France; Unité de Recherche Clinique et d'Innovation (URCI) de Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France.
| | - Noëlle Cardinaud
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France
| | - Caroline Gayot
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France; Unité de Recherche Clinique et d'Innovation (URCI) de Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
| | - Nathalie Dumoitier
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; Département de Médecine Générale, Faculté de Médecine de Limoges, Limoges, France
| | - Michel Druet-Cabanac
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France
| | - Marie-Laure Laroche
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; Centre de Pharmacovigilance et de Pharmaco-épidémiologie, CHU de Limoges, Limoges, France
| | - Karen Rudelle
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; Département de Médecine Générale, Faculté de Médecine de Limoges, Limoges, France
| | - Cécile Laubarie Mouret
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France
| | - Sophie Boyer
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France; Unité de Recherche Clinique et d'Innovation (URCI) de Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
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Das S, Prasad J. Gender Differences in Determinants of the Components of the Frailty Phenotype among Older Adults in India: Findings from LASI Wave-1. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3055. [PMID: 36833748 PMCID: PMC9965095 DOI: 10.3390/ijerph20043055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
This study examines the gender-specific determinants of the components of frailty in a community-dwelling setting in India. Using data from the Longitudinal Ageing Study in India (LASI) Wave-1, this study employed 30,978 (14,885 male and 16,093 female) older adults (aged 60+) to fulfil the study objective. The modified Fried frailty phenotype criteria defines frailty by the five components: exhaustion, weak grip strength, slow walking speed, unintentional weight loss, and low physical activity. The result showed grip strength (79.1%) as the most discriminant component among males, and physical activity (81.6%) as the most discriminant component among females. The results also indicated that grip strength (male: 98.0%, female: 93.5%) and physical activity (male: 94.8%, female: 96.9%) showed a sensitivity of more than 90%, which appears to be a good indicator of frailty. Combining this dual marker increased the accuracy to 99.97% among male and 99.98% among female samples. The findings suggested adding grip strength and physical activity as a proxy measure of frailty, which can increase the precision of screening without a large additional investment of time, training, or cost.
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Affiliation(s)
- Sayani Das
- International Institute of Health Management Research, Delhi 110075, India
| | - Jitender Prasad
- International Institute for Population Sciences, Mumbai 400088, India
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Leung T, Nahar van Venrooij LMW, Verdaasdonk EGG. Personal Devices to Monitor Physical Activity and Nutritional Intake After Colorectal Cancer Surgery: Feasibility Study. JMIR Perioper Med 2022; 5:e40352. [PMID: 36512385 PMCID: PMC9795396 DOI: 10.2196/40352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The use of self-monitoring devices is promising for improving perioperative physical activity and nutritional intake. OBJECTIVE This study aimed to assess the feasibility, usability, and acceptability of a physical activity tracker and digital food record in persons scheduled for colorectal cancer (CRC) surgery. METHODS This observational cohort study was conducted at a large training hospital between November 2019 and November 2020. The study population consisted of persons with CRC between 18- and 75 years of age who were able to use a smartphone or tablet and scheduled for elective surgery with curative intent. Excluded were persons not proficient in Dutch or following a protein-restricted diet. Participants used an activity tracker (Fitbit Charge 3) from 4 weeks before until 6 weeks after surgery. In the week before surgery (preoperative) and the fifth week after surgery (postoperative), participants also used a food record for 1 week. They shared their experience regarding usability (system usability scale, range 0-100) and acceptability (net promoter score, range -100 to +100). RESULTS In total, 28 persons were included (n=16, 57% male, mean age 61, SD 8 years), and 27 shared their experiences. Scores regarding the activity tracker were as follows: preoperative median system usability score, 85 (IQR 73-90); net promoter score, +65; postoperative median system usability score, 78 (IQR 68-85); net promotor score, +67. The net promoter scores regarding the food record were +37 (preoperative) and-7 (postoperative). CONCLUSIONS The perioperative use of a physical activity tracker is considered feasible, usable, and acceptable by persons with CRC in this study. Preoperatively, the use of a digital food record was acceptable, and postoperatively, the acceptability decreased.
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da Silva LP, Moreira NB, Grando RZ, Bento PCB, Rodacki ALF. Clinical-Functional Vulnerability, Functional Capacity, and Falls in Octogenarians with Different Physical Activity Levels-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11909. [PMID: 36231209 PMCID: PMC9564968 DOI: 10.3390/ijerph191911909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/14/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
AIM To compare differences between frailty, functional capacity, and fall prevalence among community-dwelling oldest-old adults regarding their physical activity levels. METHODS Two hundred and thirty-nine octogenarians (80+ years) were allocated according to their physical activity as insufficiently active (<150 min week-1; n = 98; 84.4 ± 3.7 years), active (150 to 300 min week-1, n = 81, 83.9 ± 3.1 years), and very active (>300 min week-1, n = 60; 83.8 ± 3.4 years). Frailty (CFVI-20 questionnaire), functional capacity (Five Times Sit-to-Stand Test, Timed Up and Go, Balance, and handgrip strength), fall history, and physical activity were assessed. RESULTS The insufficiently active group was the frailest and presented the worst functional performance compared to the other groups. The fall prevalence was higher in the insufficiently active (60.9%) compared to the active (26.4%) and very active (12.7%) groups. CONCLUSIONS The group of insufficiently active octogenarians showed the greatest frailty, worst functional capacity, and higher fall prevalence than the active and very active groups. The engagement in physical activity of at least 300 min week-1 is essential to reverse or minimize the deleterious effects of aging on frailty, functional capacity, and falls in octogenarians.
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Affiliation(s)
- Letícia Pophal da Silva
- Department of Physical Education, Federal University of Paraná, Curitiba 80310-000, PR, Brazil
| | - Natália Boneti Moreira
- Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná, Curitiba 80310-000, PR, Brazil
| | - Renata Zacharias Grando
- Department of Physical Education, Federal University of Paraná, Curitiba 80310-000, PR, Brazil
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Choi Y, Bae Y, Cha B, Ryu J. Deep Learning-Based Subtask Segmentation of Timed Up-and-Go Test Using RGB-D Cameras. SENSORS (BASEL, SWITZERLAND) 2022; 22:6323. [PMID: 36080782 PMCID: PMC9459743 DOI: 10.3390/s22176323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
The timed up-and-go (TUG) test is an efficient way to evaluate an individual's basic functional mobility, such as standing up, walking, turning around, and sitting back. The total completion time of the TUG test is a metric indicating an individual's overall mobility. Moreover, the fine-grained consumption time of the individual subtasks in the TUG test may provide important clinical information, such as elapsed time and speed of each TUG subtask, which may not only assist professionals in clinical interventions but also distinguish the functional recovery of patients. To perform more accurate, efficient, robust, and objective tests, this paper proposes a novel deep learning-based subtask segmentation of the TUG test using a dilated temporal convolutional network with a single RGB-D camera. Evaluation with three different subject groups (healthy young, healthy adult, stroke patients) showed that the proposed method demonstrated better generality and achieved a significantly higher and more robust performance (healthy young = 95.458%, healthy adult = 94.525%, stroke = 93.578%) than the existing rule-based and artificial neural network-based subtask segmentation methods. Additionally, the results indicated that the input from the pelvis alone achieved the best accuracy among many other single inputs or combinations of inputs, which allows a real-time inference (approximately 15 Hz) in edge devices, such as smartphones.
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Serum TSH and Daily Physical Activity in a Cohort of Nonagenarians: Results from the Mugello Study. J Funct Morphol Kinesiol 2022; 7:jfmk7030056. [PMID: 35997372 PMCID: PMC9396985 DOI: 10.3390/jfmk7030056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The current literature does not furnish clear data concerning the relationship between thyroid function, sedentary time and daily physical activity (PA) in older adults with euthyroid condition. The aim of this study was to investigate the association of serum Thyrotropin-Stimulating Hormone (TSH), free Triiodothyronine (fT3) and free Thyroxine (fT4) with sedentary time and PA in a cohort of nonagenarians. METHODS A total of 108 nonagenarians (92.8 ± 3.2 years), participating in the Mugello Study, and with complete data on thyroid function, sedentary time, PA and sleeping (objectively collected through a multisensory device), were considered for the analysis. RESULTS Mainly, TSH negatively correlated with time spent lying down, and positively correlated with METs. fT4 levels were negatively associated with mean daily metabolic equivalents (METs) and with low-intensity PA practice (LIPAT), and positively associated with lying down and sleeping time. Similar results have been shown in the female sample. Mainly, participants with high-normal (third tertile) versus low-normal TSH (first tertile) had higher moderate-intensity PA (MIPAT) (p = 0.03). In the female sample, first TSH tertile had higher METs (p = 0.010), LIPAT (p = 0.02), MIPAT (p = 0.01) and lower time lying down (p = 0.04) than third TSH tertile. CONCLUSION High-normal serum TSH and low-normal fT4 are associated with higher levels and intensity of daily PA, together with higher MIPAT continuity, in the oldest-old.
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Low physical activity is the strongest factor associated with frailty phenotype and frailty index: data from baseline phase of Birjand Longitudinal Aging Study (BLAS). BMC Geriatr 2022; 22:498. [PMID: 35689187 PMCID: PMC9188172 DOI: 10.1186/s12877-022-03135-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Frailty is the most complicated expression of aging that is related to disability or multi-morbidity. The aim of the present study was to estimate the prevalence of frailty and its associated factors among community-dwelling aged population. Methods A total of 1529 eligible community- dwelling older adults (≥ 60 years) were enrolled in the baseline phase of Birjand Longitudinal Aging Study (BLAS) from 2019 to 2020. Their frailty status was assessed using the Fried’s frailty phenotype and frailty index. Sociodemographic factors, including sex, age, marital status, and education level, were collected. Health status assessment included the history of hypertension, diabetes mellitus, cardiovascular disease, Alzheimer’s diseases and dementia, and other health conditions. Furthermore, functional assessment (ADL, IADL) and anthropometric measurements including height, weight, waist, calf, and mid-arm circumference were made and the body mass index was calculated. The nutrition status and polypharmacy (use 3 or more medication) were also evaluated. Results The prevalence of frailty was 21.69% according to the frailty phenotype and 23.97% according to the frailty index. A multiple logistic regression model showed a strong association between low physical activity and frailty phenotype (OR = 36.31, CI = 16.99–77.56, P < 0.01), and frailty index (OR = 15.46, CI = 5.65–42.34, P < 0.01). Other factors like old age (≥80), female sex, malnutrition, polypharmacy, obesity, and arthritis were also associated with frailty. The Kappa coefficient of the agreement between these two instruments was 0.18. Conclusion It seems that low physical activity is the most important determinant of frailty. Low physical activity and some other factors may be preventable or modifiable and thus serve as clinically relevant targets for intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03135-y.
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Jang H, Tang F, Fusco RA, Engel RJ, Albert SM. Grandparenting, Social Relations, and Mortality in Old Age. Res Aging 2022; 44:265-275. [PMID: 34109863 PMCID: PMC10784123 DOI: 10.1177/01640275211015433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Guided by a convoy model of social relations, this study investigates the relationships between grandparenting status, social relations, and mortality among community-dwelling grandparents age 65 and older who are caring for their grandchildren. The data were drawn from the 2008 and 2016 waves of the Health and Retirement Study (N = 564). Latent class analysis was used to identify the social network structure based on six indicators of interpersonal relationships and activities. A series of hierarchical Weibull hazard models estimated the associations between grandparent caregiving, social relations, and mortality risk. Results of survival analyses indicate that co-parenting and custodial grandparents had higher all-cause mortality risk than grandparents who babysat occasionally; however, for custodial grandparents, the association was not significant once social relation variables were added to the model. This study suggests that community-based support may be beneficial to older grandparents and improved relationship quality is integral to the well-being of older adults.
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Affiliation(s)
- Heejung Jang
- Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA
| | - Fengyan Tang
- School of Social Work, 6614University of Pittsburgh, PA, USA
| | - Rachel A Fusco
- School of Social Work, 1355University of Georgia, Athens, GA, USA
| | - Rafael J Engel
- School of Social Work, 6614University of Pittsburgh, PA, USA
| | - Steven M Albert
- Graduate School of Public Health, 6614University of Pittsburgh, PA, USA
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Thiamwong L. Future Nursing Research of Older Adults: Preserving Independence and Reducing Health Disparities. PACIFIC RIM INTERNATIONAL JOURNAL OF NURSING RESEARCH 2022; 26:1-5. [PMID: 35935604 PMCID: PMC9355488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Nursing professionals are at the forefront of primary care and the largest segment of the health workforce, and nurse researchers can bring vital perspectives to aging research and clinical practice. Although healthcare systems are experiencing more work from the aging of populations, unfortunately there are limited nurse researchers trained in gerontological nursing. Future research in older adults needs to be based on the current needs of and for older adults. In this article, I identify potential future research of aspects for older adults by highlighting opportunities and examples to conduct culturally appropriate interventions that aim to reduce health disparities and preserve independence. Because there is a complexity of health issues in older adults, nurse researchers need to pursue the best ways to address their needs, investigate and disseminate technology-based assessments, provide culturally appropriate interventions to promote independence, prevent chronic conditions, and enhance health equality. Nurses and nurse researchers also need to monitor the changes in functional status and health of older adults, especially as the global burden and costs of diseases and disability of this population grows, and to save unnecessary health care expenditure. To create new knowledge and discover best practices in aging care, nurse researchers lead multidisciplinary teams, develop innovative ideas with the potential for significant clinical impact, and use appropriate research approaches that steer to successful grant applications to national funding agencies. It is essential to establish a program for training or mentoring nurse researchers dedicated to caring for older adults, advocating, and disseminating innovative care to maximize the independence of older adults.
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Affiliation(s)
- Ladda Thiamwong
- Correspondence to: Ladda Thiamwong, PhD, RN, Associate Professor, College of Nursing, University of Central Florida, Orlando, FL, USA.
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Kitamura M, Izawa KP, Ishihara K, Matsuda H, Okamura S, Fujioka K. Physical Activity and Sarcopenia in Community-Dwelling Older Adults with Long-Term Care Insurance. Eur J Investig Health Psychol Educ 2021; 11:1610-1618. [PMID: 34940392 PMCID: PMC8700727 DOI: 10.3390/ejihpe11040114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 12/14/2022] Open
Abstract
The present study aimed to clarify the difference in physical activity (PA) due to sarcopenia in community-dwelling older adults with long-term care insurance (LTCI). This was a cross-sectional study that investigated data of 97 consecutive community-dwelling older Japanese adults with LTCI who underwent rehabilitation at one day care center in Japan from November 2018 to May 2019. Sarcopenia was determined according to criteria of the Asian Working Group for Sarcopenia. Unpaired t-test, Mann-Whitney U test, chi-square test and analysis of covariance were used to compare participant characteristics and clinical parameters between the older adults with and without sarcopenia. A receiver operating characteristic (ROC) curve was constructed to determine the cut-off value of PA for sarcopenia. The sarcopenia group (n = 20) had significantly lower body mass index (BMI), skeletal muscle mass index, gait speed, and PA than those in the no sarcopenia group (n = 28) (p < 0.05). After adjustment for BMI and sex, the sarcopenia group showed significantly lower PA than the no sarcopenia group. Findings showed that the cut-off value of PA indicating sarcopenia by ROC curve analysis was 1494.4 steps/day (p < 0.05); this value may aid in identifying sarcopenia in older adults with LTCI.
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Affiliation(s)
- Masahiro Kitamura
- Department of Physical Therapy, Fukuokawajiro Professional Training College, 2-1-13 Wajirooka, Higashi-ku, Fukuoka 811-0213, Japan;
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
| | - Kazuhiro P. Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Correspondence: ; Tel.: +81-78-796-4566
| | - Kodai Ishihara
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Department of Rehabilitation, Sakakibara Heart Institute of Okayama, 5-1 Nakaicho 2-Chome, Kita-ku, Okayama 700-0804, Japan
| | - Hiroaki Matsuda
- Department of Rehabilitation, Rifuru Yukuhashi Day Care Center, 379-1 Takase, Yukuhashi 824-0027, Japan; (H.M.); (S.O.); (K.F.)
| | - Soichiro Okamura
- Department of Rehabilitation, Rifuru Yukuhashi Day Care Center, 379-1 Takase, Yukuhashi 824-0027, Japan; (H.M.); (S.O.); (K.F.)
| | - Koji Fujioka
- Department of Rehabilitation, Rifuru Yukuhashi Day Care Center, 379-1 Takase, Yukuhashi 824-0027, Japan; (H.M.); (S.O.); (K.F.)
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Prescott M, Lilley-Kelly A, Cundill B, Clarke D, Drake S, Farrin AJ, Forster A, Goodwin M, Goodwin VA, Hall AJ, Hartley S, Holland M, Hulme C, Nikolova S, Parker C, Wright P, Ziegler F, Clegg A. Home-based Extended Rehabilitation for Older people (HERO): study protocol for an individually randomised controlled multi-centre trial to determine the clinical and cost-effectiveness of a home-based exercise intervention for older people with frailty as extended rehabilitation following acute illness or injury, including embedded process evaluation. Trials 2021; 22:783. [PMID: 34749783 PMCID: PMC8576988 DOI: 10.1186/s13063-021-05778-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background The majority of older people (> 65 years) in hospital have frailty and are at increased risk of readmission or death following discharge home. In the UK, following acute hospitalisation, around one third of older people with frailty are referred on for rehabilitation, termed ‘intermediate care’ services. Although this rehabilitation can reduce early readmission to hospital (< 30 days), recipients often do not feel ready to leave the service on discharge, suggesting possible incomplete recovery. Limited evidence suggests extended rehabilitation is of benefit in several conditions and there is preliminary evidence that progressive physical exercise can improve mobility and function for older people with frailty, and slow progression to disability. Our aim is to evaluate the effectiveness of the Home-based Older People’s Exercise (HOPE) programme as extended rehabilitation for older people with frailty discharged home from hospital or intermediate care services after acute illness or injury. Methods A multi-centre individually randomised controlled trial, to evaluate the clinical and cost-effectiveness of the HOPE programme. This individualised, graded and progressive 24-week exercise programme is delivered by NHS physiotherapy teams to people aged 65 and older with frailty, identified using the Clinical Frailty Scale, following discharge from acute hospitalisation and linked intermediate care rehabilitation pathways. The primary outcome is physical health-related quality of life, measured using the physical component summary score of the modified Short Form 36- item health questionnaire (SF36) at 12 months. Secondary outcomes include self-reported physical and mental health, functional independence, death, hospitalisations, care home admissions. Plans include health economic analyses and an embedded process evaluation. Discussion This trial seeks to determine if extended rehabilitation, via the HOPE programme, can improve physical health-related quality of life for older people with frailty following acute hospitalisation. Results will improve awareness of the rehabilitation needs of older people with frailty, and provide evidence on the clinical and cost-effectiveness of the targeted exercise intervention. There is potential for considerable benefit for health and social care services through widespread implementation of trial findings if clinical and cost-effectiveness is demonstrated. Trial registration ISRCTN 13927531. Registered on April 19, 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05778-5.
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Affiliation(s)
- Matthew Prescott
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK.
| | - Amanda Lilley-Kelly
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Bonnie Cundill
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - David Clarke
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Science, University of Leeds, based at: Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sian Drake
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Amanda J Farrin
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Anne Forster
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Science, University of Leeds, based at: Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Madeline Goodwin
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Victoria A Goodwin
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK
| | - Abi J Hall
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK
| | - Suzanne Hartley
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Mike Holland
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Claire Hulme
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK
| | - Silviya Nikolova
- Academic Unit of Health Economics, University of Leeds, Leeds, LS2 9JT, UK
| | - Catriona Parker
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Phil Wright
- Physiotherapy Department, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - Friederike Ziegler
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Andrew Clegg
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Science, University of Leeds, based at: Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
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Resident and Institutional-Level Factors, Frailty, and Nursing Homes Residents. Nurs Res 2021; 71:E1-E9. [PMID: 34620773 DOI: 10.1097/nnr.0000000000000556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Frailty is a major cause of adverse health outcomes such as hospitalization, falls, disability, and morbidity among older adults; the elucidation of factors affecting frailty trends over time may facilitate the development of effective interventions. OBJECTIVES This study aimed to examine the trend of frailty over time (at baseline, with 6-month and 12-month follow-ups) among Chinese nursing home residents and identify associated resident- and institutional-level factors. METHODS This longitudinal study included 353 residents who were admitted into 27 nursing homes in Jinan, China. Frailty was defined based on the seven self-reported components of the FRAIL-NH scale, which was designed for nursing home residents. Information was gathered using scales that assessed resident-level (sociodemographic characteristics and physical, psychological, and social factors) and institutional-level characteristics (hospital affiliation, fitness sites, green space, occupancy percentage, staff-resident ratio, staff turnover rate). These data were subjected to a multilevel linear analysis. RESULTS Frailty was identified in 49.7% of residents at baseline and exhibited a progressively worsening trend over 1 year. Among institutional-level characteristics, the provision of fitness sites in nursing homes was a protective factor for frailty. Among resident-level characteristics, undernutrition was a significant independent risk factor and played a key role in increasing frailty over time. Other risk factors for frailty included younger age, poorer self-rated health, lower physical function, chewing difficulty, loneliness, anxiety, and being less active in leisure activities. DISCUSSION Frailty was highly prevalent among Chinese nursing home residents and gradually increased over time. The results of this study could be used to inform the development of interventions targeted at modifiable risk factors and shape public health policies aimed at promoting healthy aging and delaying frailty and its adverse outcomes.
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Wanigatunga AA, Cai Y, Urbanek JK, Mitchell CM, Roth DL, Miller ER, Michos ED, Juraschek SP, Walston J, Xue QL, Appel LJ, Schrack JA. Objectively measured patterns of daily physical activity and phenotypic frailty. J Gerontol A Biol Sci Med Sci 2021; 77:1882-1889. [PMID: 34562073 DOI: 10.1093/gerona/glab278] [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: 06/28/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Self-reported low physical activity is a defining feature of phenotypic frailty but does not adequately capture physical activity performed throughout the day. This study examined associations between accelerometer-derived patterns of routine daily physical activity and frailty. METHODS Wrist accelerometer and frailty data from 638 participants (mean age 77 (SD=5.5) years; 44% women) were used to derive five physical activity metrics: active minutes/day, sedentary minutes/day, total activity counts/day, activity fragmentation (reciprocal of the average active bout length) and sedentary fragmentation (reciprocal of the average sedentary bout length). Robust, pre-frail and frail statuses were identified using the physical frailty phenotype defined as having 0, 1-2, or ≥3 of the following criterion: weight loss, exhaustion, slowness, self-reported low activity, and weakness. Frailty was collapsed into not frail (robust and prefrail) and frail, and each frailty criteria was dichotomized. Multiple logistic regression was used to model each accelerometer metric. Separate frailty criteria and interactions with age and sex were also examined. RESULTS With higher amounts and intensity of daily activity (more active minutes, fewer sedentary minutes, higher activity counts) and lower activity fragmentation, the odds of frailty were lower compared to robust/prefrail states (p<0.02 for all). For interactions, only an age by sedentary fragmentation interaction on the odds of frailty was observed (p=0.01). For each separate criteria, accelerometer metrics were associated with odds of slowness, low activity, and weakness. CONCLUSION Less favorable patterns of objectively measured daily physical activity are associated with frailty and the components of slowness, low self-reported activity, and weakness.
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Affiliation(s)
- Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA
| | - Yurun Cai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jacek K Urbanek
- Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Christine M Mitchell
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA
| | - David L Roth
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Edgar R Miller
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Erin D Michos
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Stephen P Juraschek
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, Massachusetts, USA
| | - Jeremy Walston
- Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Qian-Li Xue
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lawrence J Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA
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16
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Chen X, Zhao L, Liu Y, Zhou Z, Zhang H, Wei D, Chen J, Li Y, Ou J, Huang J, Yang X, Ma C. Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID-19: A randomised controlled trial. J Clin Nurs 2021:10.1111/jocn.15964. [PMID: 34289524 PMCID: PMC8447213 DOI: 10.1111/jocn.15964] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/09/2021] [Accepted: 06/21/2021] [Indexed: 12/28/2022]
Abstract
AIMS AND OBJECTIVES Quarantine during the COVID-19 pandemic resulted in longer-term sedentary behaviours and mental health problems. Our study aimed to evaluate the impact of the Otago exercise programme (OEP) on physical function and mental health among elderly with cognitive frailty during COVID-19. BACKGROUND Lockdowns and restrictions during the COVID-19 pandemic result in longer-term sedentary behaviours related disease and mental problem. Older people with cognitive frailty are more vulnerable to be influenced. Timely intervention may achieve better outcomes, OEP exercise was designed as a balance and muscle-strengthening programme for elderly people. DESIGN A parallel-group, assessor-blinded randomised controlled trial was performed according to CONSORT guidelines. METHODS This study was conducted from July 2020 to October 2020 among 62 elderly people with cognitive frailty from a nursing home. Participants were randomly divided into an OEP group (n = 31) or a control group (n = 31). Both groups received sleep- and diet-related health education. The OEP group also received a 12-week group exercise programme. The Five Times Sit to Stand Test (FTSST), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT) were used to assess physical function. The Geriatric Depression Scale-15 (GDS-15) and the 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) were used to assess mental health. Outcomes were measured at 6 and 12 weeks. RESULTS Physical function and mental health were similar in the two groups at baseline. At 12 weeks, the OEP group (difference in change from baseline: FTSST, -2.78; TUGT, -3.73; BBS, 2.17; GDS-15, -0.72; SF-12 MCS, 2.58; all p < .001) exhibited significantly greater improvements than the control group (difference in change from baseline: FTSST, 1.55; TUGT, 1.66; BBS, -0.10; GDS-15, 1.07; SF-12 MCS, -5.95; all p < .001). CONCLUSION Our findings showed the OEP group had better physical function and mental health outcomes than the control group. OEP can be used to improve the physical and mental function among elderly people with cognitive frailty during the COVID-19 pandemic. RELEVANCE TO CLINICAL PRACTICE Otago exercise program intervention programmes should be implemented to improve physical function for cognitive frailty elderly to reduce the harm of longer-term sedentary behaviours, and to ruduce depression symptom and improve mental health, particularly during COVID-19 pandemic period.
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Affiliation(s)
- Xi Chen
- The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Liping Zhao
- The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Youshuo Liu
- The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Zhiming Zhou
- Geriatric Rehabilitation Hospital of ChangshaChangshaChina
| | - Hua Zhang
- Changsha NO.1 Social Welfare InstitutionChangshaChina
| | - Dongli Wei
- Geriatric Rehabilitation Hospital of ChangshaChangshaChina
| | - Jianliang Chen
- Shenzhen Hostal of Integrated Traditional Chinese and Western MedicineShenzhenChina
| | - Yan Li
- The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Jinnan Ou
- The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Jin Huang
- The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Xiaomei Yang
- Guangzhou Development District HospitalGuangzhouChina
| | - Caili Ma
- The Second Xiangya HospitalCentral South UniversityChangshaChina
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17
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Legrand R, Nuemi G, Poulain M, Manckoundia P. Description of Lifestyle, Including Social Life, Diet and Physical Activity, of People ≥90 years Living in Ikaria, a Longevity Blue Zone. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126602. [PMID: 34205297 PMCID: PMC8296328 DOI: 10.3390/ijerph18126602] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 12/16/2022]
Abstract
A cross-sectional observational study was conducted to describe the lifestyle of people ≥90 years, living in Evdilos or Raches, two municipalities of the Greek island of Ikaria, classified a longevity blue zone. The 71 participants were interviewed and underwent the Mediterranean Islands study food frequency questionnaire (MEDIS-FFQ) and the international physical activity questionnaire (IPAQ). The frequency of social contacts was daily for 77.9% of participants, weekly for 16.1%, and monthly for 5.9%. Most participants (90.0%) believed in God, and 81.4% took part in religious events. A total of 62.0% attended Panigiria festivals. Access to primary health care was considered difficult in the past for 66.2% of participants, while 22.1% felt that it remained difficult at the time of the survey. The level of adherence to the Mediterranean diet was 62.7% (61.6% in women and 64.0% in men). Physical activity levels were moderate or high for 71.8% of participants (59.5% of women and 85.3% of men). In conclusion, the participants had a very high level of family solidarity, social interaction and physical activity. The results concerning the Mediterranean diet are less convincing. It would be interesting to study the impact of these factors on the longevity of the oldest old aged people living in Ikaria.
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Affiliation(s)
- Romain Legrand
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France;
| | - Gilles Nuemi
- Department of Biostatistics and Bioinformatics, François Mitterrand Hospital, University Hospital, 21079 Dijon, France;
| | - Michel Poulain
- Institute for the Analysis of Change in Historical and Contemporary Societies (IACCHOS), Université Catholique de Louvain, 1348 Ottignies-Louvain-la-Neuve, Belgium;
- Estonian Institute for Population Studies, Tallinn University, 10120 Tallinn, Estonia
| | - Patrick Manckoundia
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France;
- INSERM U-1093, Cognition, Action and Sensorimotor Plasticity, University of Burgundy Franche-Comté, 21000 Dijon, France
- Correspondence: ; Tel.: +33-3-80-29-39-70; Fax: +33-3-80-29-36-21
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18
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Blancafort Alias S, Cuevas-Lara C, Martínez-Velilla N, Zambom-Ferraresi F, Soto ME, Tavassoli N, Mathieu C, Heras Muxella E, Garibaldi P, Anglada M, Amblàs J, Santaeugènia S, Contel JC, Domingo À, Salvà Casanovas A. A Multi-Domain Group-Based Intervention to Promote Physical Activity, Healthy Nutrition, and Psychological Wellbeing in Older People with Losses in Intrinsic Capacity: AMICOPE Development Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5979. [PMID: 34199566 PMCID: PMC8199683 DOI: 10.3390/ijerph18115979] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/30/2022]
Abstract
The World Health Organization has developed the Integrated Care of Older People (ICOPE) strategy, a program based on the measurement of intrinsic capacity (IC) as "the composite of all physical and mental attributes on which an individual can draw". Multicomponent interventions appear to be the most effective approach to enhance IC and to prevent frailty and disability since adapted physical activity is the preventive intervention that has shown the most evidence in the treatment of frailty and risk of falls. Our paper describes the development of a multi-domain group-based intervention addressed to older people living in the community, aimed at improving and/or maintaining intrinsic capacity by means of promoting physical activity, healthy nutrition, and psychological wellbeing in older people. The process of intervention development is described following the Guidance for reporting intervention development studies in health research (GUIDED). The result of this study is the AMICOPE intervention (Aptitude Multi-domain group-based intervention to improve and/or maintain IC in Older PEople) built upon the ICOPE framework and described following the Template for Intervention Description and Replication (TIDieR) guidelines. The intervention consists of 12 face-to-face sessions held weekly for 2.5 h over three months and facilitated by a pair of health and social care professionals. This study represents the first stage of the UK Medical Research Council framework for developing and evaluating a complex intervention. The next step should be carrying out a feasibility study for the AMICOPE intervention and, at a later stage, assessing the effectiveness in a randomized controlled trial.
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Affiliation(s)
- Sergi Blancafort Alias
- Fundació Salut i Envelliment (Foundation on Health and Ageing)—UAB, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (À.D.); (A.S.C.)
| | - César Cuevas-Lara
- Navarrabiomed, Geriatrics Department, Hospital Complex of Navarra (CHN)—Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), 31008 Pamplona, Spain; (C.C.-L.); (N.M.-V.); (F.Z.-F.)
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Geriatrics Department, Hospital Complex of Navarra (CHN)—Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), 31008 Pamplona, Spain; (C.C.-L.); (N.M.-V.); (F.Z.-F.)
| | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Geriatrics Department, Hospital Complex of Navarra (CHN)—Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), 31008 Pamplona, Spain; (C.C.-L.); (N.M.-V.); (F.Z.-F.)
| | - Maria Eugenia Soto
- Equipe Régional Vieillissement et Prévention de la Dépendance, Gérontopôle, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (M.E.S.); (N.T.); (C.M.)
| | - Neda Tavassoli
- Equipe Régional Vieillissement et Prévention de la Dépendance, Gérontopôle, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (M.E.S.); (N.T.); (C.M.)
| | - Céline Mathieu
- Equipe Régional Vieillissement et Prévention de la Dépendance, Gérontopôle, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (M.E.S.); (N.T.); (C.M.)
| | - Eva Heras Muxella
- Ageing and Health Department in the Andorran Healthcare System, Servei Andorrà d’Atenció Sanitaria, AD700 Escaldes-Engordany, Andorra; (E.H.M.); (P.G.); (M.A.)
| | - Pablo Garibaldi
- Ageing and Health Department in the Andorran Healthcare System, Servei Andorrà d’Atenció Sanitaria, AD700 Escaldes-Engordany, Andorra; (E.H.M.); (P.G.); (M.A.)
| | - Maria Anglada
- Ageing and Health Department in the Andorran Healthcare System, Servei Andorrà d’Atenció Sanitaria, AD700 Escaldes-Engordany, Andorra; (E.H.M.); (P.G.); (M.A.)
| | - Jordi Amblàs
- Chronic Care Program, Department of Health, Generalitat de Catalunya, 08028 Barcelona, Spain; (J.A.); (S.S.); (J.C.C.)
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic/Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - Sebastià Santaeugènia
- Chronic Care Program, Department of Health, Generalitat de Catalunya, 08028 Barcelona, Spain; (J.A.); (S.S.); (J.C.C.)
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic/Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - Joan Carles Contel
- Chronic Care Program, Department of Health, Generalitat de Catalunya, 08028 Barcelona, Spain; (J.A.); (S.S.); (J.C.C.)
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic/Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - Àlex Domingo
- Fundació Salut i Envelliment (Foundation on Health and Ageing)—UAB, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (À.D.); (A.S.C.)
| | - Antoni Salvà Casanovas
- Fundació Salut i Envelliment (Foundation on Health and Ageing)—UAB, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (À.D.); (A.S.C.)
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19
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Río X, Guerra-Balic M, González-Pérez A, Larrinaga-Undabarrena A, Coca A. [Reference values for SPPB in people over 60 years of age in the Basque Country]. Aten Primaria 2021; 53:102075. [PMID: 34004592 PMCID: PMC8141526 DOI: 10.1016/j.aprim.2021.102075] [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: 09/30/2020] [Revised: 12/30/2020] [Accepted: 02/27/2021] [Indexed: 01/07/2023] Open
Abstract
Objetivo Proporcionar valores de referencia del Short Physical Performance Battery (SPPB) en adultos y adultos mayores en el País Vasco, identificando puntos de corte para medir la fragilidad y comparar los valores con otras poblaciones de España. Emplazamiento Bilbao capital, País Vasco (España). Participantes 1.923 personas mayores de 60 años incluidos en el Programa de Salud para Personas Mayores del Ayuntamiento de Bilbao participaron en el estudio. El programa de actividad física (AF) se impartió dos veces por semana durante un mínimo de 12 semanas, con sesiones de 50 minutos. Mediciones principales Se evaluó a los participantes con la prueba SPPB que evalúa: equilibrio (PE), velocidad de la marcha en 4 m (PM) y la fuerza a través de la prueba de levantarse y sentarse de la silla (PS). Según el resultado obtenido de todas las pruebas, se identificó la funcionalidad de las personas en: limitación grave (cero a cuatro puntos), moderada (cuatro a seis puntos), leve (siete a nueve puntos) y mínima (10 a 12 puntos). Resultados Edad media 77,9 (5,6) años, siendo el 87,9% mujeres y el 12,1% hombres. La batería SPPB mostro diferencias significativas en la edad (p = 0,000) y género (p = 0,005) Además, se realizó una comparación con una población similar: 70 a 75 años = 0,6 (d de Cohen), 76 a 79 años = 0,98 (d de Cohen) y >80 años = 0,98 (d de Cohen). Conclusiones El presente estudio señala los valores normativos para SPPB. La funcionalidad de las personas disminuye a medida que avanza la edad. A pesar de los hallazgos actuales que los profesionales de la salud disponen para una detección más eficaz de la fragilidad, muchos de ellos aún no se han traducido a la práctica clínica.
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Affiliation(s)
- Xabier Río
- Facultad de Psicología y Educación, Ciencias de la Actividad Física y del Deporte, Universidad de Deusto, Bizkaia, España; Departamento de Actividad Física y Salud, Mugikon, Bizkaia, España.
| | - Myriam Guerra-Balic
- Facultad de Psicología, Educación y Ciencias del Deporte de Blanquerna, Universitad Ramon Llul, Barcelona, España
| | - Alexander González-Pérez
- Facultad de Psicología y Educación, Ciencias de la Actividad Física y del Deporte, Universidad de Deusto, Bizkaia, España
| | - Arkaitz Larrinaga-Undabarrena
- Facultad de Psicología y Educación, Ciencias de la Actividad Física y del Deporte, Universidad de Deusto, Bizkaia, España; Departamento de Actividad Física y Salud, Mugikon, Bizkaia, España
| | - Aitor Coca
- Facultad de Psicología y Educación, Ciencias de la Actividad Física y del Deporte, Universidad de Deusto, Bizkaia, España
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20
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Understanding frailty among older people living in old age homes and the community in Nepal: A cross-sectional study. PLoS One 2021; 16:e0251016. [PMID: 33914828 PMCID: PMC8084172 DOI: 10.1371/journal.pone.0251016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/17/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Frailty is a state of being vulnerable to adverse health outcomes such as falls, delirium, and disability in older people. Identifying frailty is important in a low-income setting to prevent it from progressing, reducing healthcare costs, increasing the chances of reversibility, and implementing effective interventions. The factors affecting frailty in older people living in old age homes could differ from those living in the community. This study was conducted to identify the factors associated with frailty in older people residing in old age homes and communities in Kathmandu Valley, Nepal. Methods This is a cross-sectional study conducted from April to June 2019 in three districts of Kathmandu Valley, Nepal. Data were collected from 193 older people residing in old age homes and 501 residing in communities aged 60 and above using convenience sampling. Frailty was measured using the Groningen Frailty Indicator. Data were collected via face-to-face interviews. Multiple linear regression analyses were used to examine the association between independent variables and frailty. Results Frailty was more prevalent among older people in old age homes (71.5%) compared to those in the community (56.3%). Older people who were satisfied with their living environment had lower frailty scores in both old age homes (β = -0.20, p<0.01) and the community (β = -0.15, p<0.001). Those who had self-rated unhealthy lifestyle had higher frailty scores in both old age homes (β = 0.45, p<0.001) and the community (β = 0.25, p<0.001). In the community, those over 80 years of age had higher frailty scores (β = 0.15, p<0.01) and those with higher education had lower scores (β = -0.13, p<0.05). Conclusion The living environment and lifestyle are key modifiable risk factors of frailty, both in old age homes and the community. The findings suggest a need for lifestyle modification and reforms in building standards, especially in old age homes, to promote age-friendly communities.
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21
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La Rosa F, Agostini S, Saresella M, Costa AS, Piancone F, Miglioli R, Trecate F, Clerici M. Deregulation of IL-37 and its miRNAs modulators in sarcopenic patients after rehabilitation. J Transl Med 2021; 19:172. [PMID: 33902634 PMCID: PMC8077701 DOI: 10.1186/s12967-021-02830-5] [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: 01/26/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022] Open
Abstract
Background sarcopenia is a highly prevalent condition in elderly individuals which is characterized by loss of muscle mass and functions; recent results showed that it is also associated with inflammation. Rehabilitation protocols for sarcopenia are designed to improve physical conditions, but very scarce data are available on their effects on inflammation We verified whether in sarcopenic patients the inflammation is reduced by rehabilitation and investigated the biological correlates of such effect. Methods Twenty-one sarcopenic patients undergoing a specifically-designed rehabilitation program were enrolled in the study. Physical, cognitive and nutritional parameters, as well as the concentration of C-Reactive Protein (CRP), pro-and anti-inflammatory cytokines and cytokine production-modulating miRNAs were measured at the beginning (T0) and at end (30-days; T1) of the rehabilitation. Results Rehabilitation resulted in a significant improvement of physical and cognitive conditions; this was accompanied by a significant reduction of CRP (p = 0.04) as well as of IL-18 (p = 0.008) and IL-37 (p = 0.009) concentration. Notably, the concentration of miR-335-3p (p = 0.007) and miR-657, the two known post-transcriptional regulators of IL-37 production, was increased by the rehabilitation protocol. Conclusions Results herein confirm that successful rehabilitation for sarcopenia results in a reduction of the inflammatory milieu, raise the possibility that IL-37 may be a key target to monitor the rehabilitation-associated improvement in sarcopenia, and suggest that this cytokine could be a therapeutic target in sarcopenic patients.
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Affiliation(s)
| | | | | | | | | | - Rossella Miglioli
- Specialist Rehabilitation Unit, Istituto Palazzolo Don Carlo Gnocchi, Milano, Italy
| | - Fabio Trecate
- Specialist Rehabilitation Unit, Istituto Palazzolo Don Carlo Gnocchi, Milano, Italy
| | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi-ONLUS, Milano, Italy.,Department of Pathophysiology and Transplantation, University of Milano, Milano, Italy
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22
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Amarasekera AT, Chang D, Schwarz P, Tan TC. Vascular endothelial dysfunction may be an early predictor of physical frailty and sarcopenia: A meta-analysis of available data from observational studies. Exp Gerontol 2021; 148:111260. [PMID: 33571660 DOI: 10.1016/j.exger.2021.111260] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Physical frailty and sarcopenia (PF & S) are major public health problems in the older population and promising predictors of adverse cardiovascular outcomes. However, the underlying mechanisms linking physical frailty, sarcopenia and adverse cardiovascular outcomes are not well defined. We recently published a systematic review which highlighted early-stage vascular endothelial dysfunction (VED) as one of the potential underlying mechanisms of physical frailty and the role of inflammation in modulating this association. OBJECTIVE AND METHOD A meta-analysis was performed to estimate the pooled effect size of studies examining the relationship between VED and PF & S. RESULTS Out of 18 cross-sectional studies selected for the original review, 13 studies were excluded due to lack of available data for pooled analysis. The five remaining studies had a total of 6616 participants, of which the pooled sample size of the frail or sarcopenic cohort was 607 and robust or pre-frail or non-sarcopenic cohort was 6009. Mean age of the participants ranging from 64 to 80 years or over. In this analysis, high heterogeneity was observed among studies (99.35% of the variation between studies was due to heterogeneity). Parameters used to assess both PF & S and VED were very different across the studies. CONCLUSION The absence of a standardized and valid operational definition of frailty and sarcopenia is a principal limiting factors for frailty research and this is clearly reflected in our study findings. This limits the ability to interpret and define the effects of vascular endothelial dysfunction on these different parameters of frailty and sarcopenia. Similarly, assessment of vascular endothelial dysfunction was very heterogeneous with different parameters utilized across these studies.
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Affiliation(s)
- Anjalee Thanuja Amarasekera
- Blacktown Clinical and Research School, Western Sydney University, Sydney, Australia; Western Sydney Local Health District, Sydney, Australia; School of Nursing and Midwifery, Blacktown Hospital, Western Sydney University, Sydney, Australia.
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Sydney, Australia
| | - Peter Schwarz
- Department of Clinical Medicine, Rigshospitalet, Denmark
| | - Timothy C Tan
- Western Sydney Local Health District, Sydney, Australia; School of Medicine, Western Sydney University, Sydney, Australia
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23
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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.
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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
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24
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Kolehmainen L, Havulinna S, Ngandu T, Strandberg T, Levälahti E, Lehtisalo J, Antikainen R, Hietikko E, Peltonen M, Pölönen A, Soininen H, Tuomilehto J, Laatikainen T, Rauramaa R, Kivipelto M, Kulmala J. Earlier life leisure-time physical activity in relation to age-related frailty syndrome. Age Ageing 2021; 50:161-168. [PMID: 32808971 DOI: 10.1093/ageing/afaa132] [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] [Received: 11/01/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND frailty syndrome is common amongst older people. Low physical activity is part of frailty, but long-term prospective studies investigating leisure-time physical activity (LTPA) during the life course as a predictor of frailty are still warranted. The aim of this study is to investigate whether earlier life LTPA predicts frailty in older age. METHODS the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) included older adults (aged 60-77 years) from the general population who were at increased risk of cognitive decline. Frailty was assessed for 1,137 participants at a baseline visit using a modified version of Fried's phenotype, including five criteria: weight loss, exhaustion, weakness, slowness and low physical activity. Self-reported data on earlier life LTPA were available from previous population-based studies (average follow-up time 13.6 years). A binomial logistic regression analysis was used to investigate the association between earlier life LTPA and pre-frailty/frailty in older age. RESULTS the prevalence of frailty and pre-frailty was 0.8% and 27.3%, respectively. In the analyses, pre-frail and frail groups were combined. People who had been physically very active (OR 0.37, 95% CI 0.23-0.60) or moderately active (OR 0.45, 95% CI 0.32-0.65) earlier in life had lower odds of becoming pre-frail/frail than individuals who had been sedentary. CONCLUSIONS frailty was rare in this relatively healthy study population, but almost a third of the participants were pre-frail. Earlier life LTPA was associated with lower levels of pre-frailty/frailty. The results highlight the importance of physical activity when aiming to promote healthy old age.
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Affiliation(s)
- Laura Kolehmainen
- Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Satu Havulinna
- Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tiia Ngandu
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Esko Levälahti
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Lehtisalo
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
| | - Riitta Antikainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
- Oulu City Hospital, Oulu, Finland
| | - Elina Hietikko
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
- Oulu City Hospital, Oulu, Finland
| | - Markku Peltonen
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Hilkka Soininen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Jaakko Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- National School of Public Health, Madrid, Spain
- South Ostrobothnia Central Hospital, Seinäjoki, Finland
| | - Tiina Laatikainen
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Miia Kivipelto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
| | - Jenni Kulmala
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
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25
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Ghram A, Briki W, Mansoor H, Al-Mohannadi AS, Lavie CJ, Chamari K. Home-based exercise can be beneficial for counteracting sedentary behavior and physical inactivity during the COVID-19 pandemic in older adults. Postgrad Med 2020; 133:469-480. [PMID: 33275479 DOI: 10.1080/00325481.2020.1860394] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The novel pandemic called coronavirus disease 2019 (COVID-19), as a global public health emergency, seems to be having a major impact on physical activity (PA) behaviors. Older adults are at high risk of death from the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Health authorities around the world have been implementing preventive health measures, including quarantine and self-isolation, to mitigate the COVID-19 outbreak. This period is characterized by the cessation of outdoor exercising. During this period of lockdown, PA has been one of the rare reasons for going out in some countries. To avoid the harmful effects of periods of exercise cessation, PA could be prescribed to older adults, which is of great importance for breaking their sedentary lifestyle and improving their immunity. The present review discusses the potential impacts of the COVID-19 pandemic on sedentary behavior and physical inactivity in older adults. The importance of performing PA to reduce the harmful effects of the COVID-19 pandemic is discussed, and useful recommendations on home-based exercise for the older adults to maintain their level of independence, physical and mental health as well as their well-being are provided.
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Affiliation(s)
- Amine Ghram
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.,Department of Cardiac Rehabilitation, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Walid Briki
- Sport Science Program, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Hend Mansoor
- College of Health and Life Sciences,Hamad Bin Khalifa University, Doha, Qatar
| | - Abdulla Saeed Al-Mohannadi
- Research and Scientific Support Department, Aspetar Orthopaedic and Sports Medicine Hospital, Qatar.,World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School the University of Queensland School of Medicine, New Orleans, Louisiana, USA
| | - Karim Chamari
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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26
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Zupo R, Castellana F, Bortone I, Griseta C, Sardone R, Lampignano L, Lozupone M, Solfrizzi V, Castellana M, Giannelli G, De Pergola G, Boeing H, Panza F. Nutritional domains in frailty tools: Working towards an operational definition of nutritional frailty. Ageing Res Rev 2020; 64:101148. [PMID: 32827687 DOI: 10.1016/j.arr.2020.101148] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/11/2022]
Abstract
Different methods have been proposed for the assessment of the nutritional status in frailty phenotypes. In the present narrative review article, we have summarized the number and specifications of nutritional items in existing frailty tools, in order to develop a possible means of assessment and operational definition of the nutritional frailty phenotype. In six different databases until December 2019, we searched for original articles regarding frailty tools (i.e., scales, indexes, scores, questionnaires, instruments, evaluations, screening, indicators), analyzing each tool regarding nutritional items. We identified 160 articles describing 71 frailty tools. Among the selected frailty tools, 54 were community-based (70 %), 17 hospital-based (22 %), 4 validated in long-term care institutions for older adults (LTCIOA) (5.1 %) and 2 validated in both community- and hospital-based settings, including LTCIOA (2.5 %). Fifty-two of these tools (73 %) included at least one nutritional item. Twenty-two (42 %) reported two or more nutritional items. The items were grouped in the following categories: A) anthropometric measurements, B) laboratory measurements, and C) other nutritional-related measurements. Anthropometric measurements stood out compared to all other items. Nutritional items are included in the majority of frailty tools, strengthening the concept that they may have a direct implication on an increased risk of adverse health-related outcomes in frail subjects. This supports the development of the concept of nutritional frailty as an independent frailty phenotype. Subsequent steps will be to assess the contribution of each nutritional item to a possible operational definition of nutritional frailty and define the items that may best identify this new frailty phenotype.
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27
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Thompson ME, Machanda ZP, Fox SA, Sabbi KH, Otali E, Thompson González N, Muller MN, Wrangham RW. Evaluating the impact of physical frailty during ageing in wild chimpanzees ( Pan troglodytes schweinfurthii). Philos Trans R Soc Lond B Biol Sci 2020; 375:20190607. [PMID: 32951544 DOI: 10.1098/rstb.2019.0607] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
While declining physical performance is an expected consequence of ageing, human clinical research has placed increasing emphasis on physical frailty as a predictor of death and disability in the elderly. We examined non-invasive measures approximating frailty in a richly sampled longitudinal dataset on wild chimpanzees. Using urinary creatinine to assess lean body mass, we found moderate but significant declines in physical condition with age in both sexes. While older chimpanzees spent less of their day in the trees and feeding, they did not alter activity budgets with respect to travel or resting. There was little evidence that declining lean body mass had negative consequences independent of age. Old chimpanzees with poor lean body mass rested more often but did not otherwise differ in activity. Males, but not females, in poor condition were more likely to exhibit respiratory illness. Poor muscle mass was associated acutely with death in males, but it did not predict future mortality in either sex. While there may be some reasons to suspect biological differences in the susceptibility to frailty in chimpanzees versus humans, our data are consistent with recent reports from humans that lean, physically active individuals can successfully combat frailty. This article is part of the theme issue 'Evolution of the primate ageing process'.
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Affiliation(s)
- Melissa Emery Thompson
- Department of Anthropology, University of New Mexico, 500 University Boulevard NE, Albuquerque, NM 87131, USA.,Kibale Chimpanzee Project, Makerere University Biological Field Station, PO Box 409, Fort Portal, Uganda
| | - Zarin P Machanda
- Department of Anthropology, Tufts University, 302 Eaton Hall, 5 The Green, Medford, MA 02155, USA
| | - Stephanie A Fox
- Department of Anthropology, University of New Mexico, 500 University Boulevard NE, Albuquerque, NM 87131, USA
| | - Kris H Sabbi
- Department of Anthropology, University of New Mexico, 500 University Boulevard NE, Albuquerque, NM 87131, USA
| | - Emily Otali
- Kibale Chimpanzee Project, Makerere University Biological Field Station, PO Box 409, Fort Portal, Uganda
| | - Nicole Thompson González
- Department of Anthropology, University of New Mexico, 500 University Boulevard NE, Albuquerque, NM 87131, USA
| | - Martin N Muller
- Department of Anthropology, University of New Mexico, 500 University Boulevard NE, Albuquerque, NM 87131, USA.,Kibale Chimpanzee Project, Makerere University Biological Field Station, PO Box 409, Fort Portal, Uganda
| | - Richard W Wrangham
- Kibale Chimpanzee Project, Makerere University Biological Field Station, PO Box 409, Fort Portal, Uganda.,Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge, MA 02138, USA
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28
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A Study of Physical Activity, Frailty, and Health-Related Quality of Life Among Community-Dwelling Older Adults in Taiwan. J Nurs Res 2020; 28:e124. [PMID: 32941303 PMCID: PMC7664969 DOI: 10.1097/jnr.0000000000000402] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) in community-dwelling older adults increases as physical activity improves, and age-related frailty has a negative effect on HRQoL. Research on these associations is lacking. PURPOSE The aims of this study were to (a) analyze the effect of demographic characteristics on HRQoL, (b) explore the correlation between physical activity and HRQoL, (c) analyze the effect of frailty on HRQoL, and (d) investigate the potential predictors of HRQoL in community-dwelling older adults. METHODS In this cross-sectional study, a convenience sample of 150 older adults was recruited from community care sites in Shilin and Beitou Districts in Taipei City, Taiwan. Data were collected at baseline using a demographic characteristics datasheet, the Center for Epidemiologic Studies Depression Scale, the Physical Activity Scale for the Elderly, and the 12-Item Short Form Health Survey. The Senior Fitness Test and hand-grip strength test were also performed. Student t test, chi-square test, analysis of variance, Pearson correlation coefficient, and hierarchical regression were applied to analyze the statistical results using IBM SPSS Statistics Version 22.0. RESULTS Being of older age, experiencing a higher number of falls, having more chronic diseases, and having a higher body mass index were identified as factors that significantly affect HRQoL. Moreover, HRQoL was found to be significantly affected by the performance of physical activity or status of frailty. Furthermore, the prefrail period was shown to be an important predictor of HRQoL after adjusting for demographic variables, history of chronic illness, history of falls, and physical activity. CONCLUSIONS/IMPLICATIONS FOR PRACTICE In this study, HRQoL was found to be significantly affected by upper limb dysfunction and the prefrail period. Community health promotion activities should focus greater attention on the physical functioning of older adults. Furthermore, providing information on age-related frailty and promoting active participation in community activities may increase the attention given by community-dwelling older adults to physical fitness and quality of life.
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An Artificial Neural Network Model for Assessing Frailty-Associated Factors in the Thai Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186808. [PMID: 32961919 PMCID: PMC7558567 DOI: 10.3390/ijerph17186808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/09/2020] [Accepted: 09/16/2020] [Indexed: 01/13/2023]
Abstract
Frailty, one of the major public health problems in the elderly, can result from multiple etiologic factors including biological and physical changes in the body which contribute to the reduction in the function of multiple bodily systems. A diagnosis of frailty can be reached using a variety of frailty assessment tools. In this study, general characteristics and health data were assessed using modified versions of Fried's Frailty Phenotype (mFFP) and the Frail Non-Disabled (FiND) questionnaire (mFiND) to construct a Self-Organizing Map (SOM). Trained data, composed of the component planes of each variable, were visualized using 2-dimentional hexagonal grid maps. The relationship between the variables and the final SOM was then investigated. The SOM model using the modified FiND questionnaire showed a correct classification rate (%CC) of about 66% rather than the model responded to mFFP models. The SOM Discrimination Index (SOMDI) identified cataracts/glaucoma, age, sex, stroke, polypharmacy, gout, and sufficiency of income, in that order, as the top frailty-associated factors. The SOM model, based on the mFiND questionnaire frailty assessment, is an appropriate tool for assessment of frailty in the Thai elderly. Cataracts/glaucoma, stroke, polypharmacy, and gout are all modifiable early prediction factors of frailty in the Thai elderly.
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Richards SJG, Jerram PM, Brett C, Falloon M, Frizelle FA. The association between low pre-operative step count and adverse post-operative outcomes in older patients undergoing colorectal cancer surgery. Perioper Med (Lond) 2020; 9:20. [PMID: 32626573 PMCID: PMC7330986 DOI: 10.1186/s13741-020-00150-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 06/11/2020] [Indexed: 12/20/2022] Open
Abstract
Background Multiple tools exist estimating perioperative risk. With an ageing surgical demographic, frailty is becoming an increasingly important concept in perioperative medicine due to its association with adverse post-operative outcomes. Reduced physical activity is a hallmark of frailty, and we postulate that a low pre-operative step count may be an objective measure of frailty. This study aimed to determine the association between low pre-operative step count and post-operative outcomes in patients undergoing elective colorectal cancer surgery. Methods A prospective analysis of 85 older patients undergoing major elective colorectal surgery was performed at a tertiary centre between October 2017 and October 2018. Patients aged 65 years and over who met inclusion criteria were provided with an activity tracker to wear for 14 days prior to planned surgery. Their median daily step count was measured and a cut-off of < 2500 steps/day was used to define a reduced step count. Primary outcomes included length of stay and 30-day post-operative complication rate. Multivariable logistic regression analyses were used to analyze the influence of low pre-operative step count and other preoperative variables, on post-operative outcomes including mortality, prolonged hospital admission, and complication rates. Results Of 85 patients, 17 (20%) were identified as having a low pre-operative step count. A low pre-operative step count was associated with a significantly increased length of stay (14 vs. 6 days, IRR 2.09, 95% CI 1.55–2.83, p ≤ 0.01) and rate of major post-operative complications (29.4% vs. 8.8%, OR 3.34, 95% CI 1.03–14.3, p = 0.04). It was also associated with significantly increased rates of discharge to care facilities (p < 0.01) and requiring support on discharge (p = 0.03). Conclusion Low pre-operative step count (< 2500 steps/day) is predictive of an increased risk of post-operative morbidity in patients undergoing elective colorectal surgery. Accurate preoperative identification may allow for treatment modification and tailored perioperative care. The possibility of using a wearable activity tracker as a simple but powerful pre-habilitation tool is raised as an important avenue for future study. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12618000045213).
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Affiliation(s)
- Simon J G Richards
- Christchurch Public Hospital, University of Otago, Christchurch, New Zealand
| | - Pippa M Jerram
- Department of Anaesthesia, Christchurch Public Hospital, University of Otago, Christchurch, New Zealand
| | - Christian Brett
- Department of Anaesthesia, Christchurch Public Hospital, University of Otago, Christchurch, New Zealand
| | - Michelle Falloon
- Christchurch Public Hospital, University of Otago, Christchurch, New Zealand
| | - Frank A Frizelle
- Christchurch Public Hospital, University of Otago, Christchurch, New Zealand
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Zhang X, Tan SS, Franse CB, Bilajac L, Alhambra‐Borrás T, Garcés‐Ferrer J, Verma A, Williams G, Clough G, Koppelaar E, Rentoumis T, van Staveren R, Voorham AJJ, Mattace‐Raso F, van Grieken A, Raat H. Longitudinal Association Between Physical Activity and Frailty Among Community-Dwelling Older Adults. J Am Geriatr Soc 2020; 68:1484-1493. [PMID: 32196638 PMCID: PMC7383618 DOI: 10.1111/jgs.16391] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/30/2020] [Accepted: 02/01/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To examine the longitudinal association between frequency of moderate physical activity (PA) and overall, physical, psychological, and social frailty among community-dwelling older adults older than 70 years. Second, we assessed the association between a 12-month change in frequency of moderate PA and frailty. DESIGN Longitudinal cohort study. SETTING Community settings in Spain, Greece, Croatia, the Netherlands, and the United Kingdom. PARTICIPANTS A total of 1735 participants (61.1% female; mean age = 79.6 years; SD = 5.5 years). MEASUREMENTS The frequency of self-reported moderate PA was measured and classified into two categories: "regular frequency" and "low frequency." The 12-month change in frequency of moderate PA between baseline and follow-up was classified into four categories: "continued regular frequency," "decreased frequency," "continued low frequency," and "increased frequency." The 15-item Tilburg Frailty Indicator assessed overall, physical, psychological, and social frailty. RESULTS Participants who undertook moderate PA with a regular frequency at baseline were less frail at 12-month follow-up than participants with a low frequency. Participants who undertook moderate PA with a continued regular frequency were least frail at baseline and at 12-month follow-up. After controlling for baseline frailty and covariates, compared with participants with a continued regular frequency, participants with a decreased frequency were significantly more overall (B = 1.31; 95% confidence interval [CI] = 0.99-1.63), physically (B = 0.80; 95% CI = 0.58-1.03), psychologically (B = 0.43; 95% CI = 0.30-0.56), and socially frail (B = 0.14; 95% CI = 0.04-0.23) at 12-month follow-up; participants with a continued low frequency were significantly more overall (B = 1.16; 95% CI = 0.84-1.49), physically (B = 0.73; 95% CI = 0.51-0.96), psychologically (B = 0.42; 95% CI = 0.29-0.55), and socially frail (B = 0.13; 95% CI = 0.04-0.23) at 12-month follow-up; the 12-month follow-up frailty level of participants who undertook moderate PA with an increased frequency was similar to those with a continued regular frequency. CONCLUSION Maintaining a regular frequency of PA as well as increasing to a regular frequency of PA are associated with maintaining or improving overall, physical, psychological, and social frailty among European community-dwelling older adults older than 70 years. J Am Geriatr Soc 68:1484-1493, 2020.
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Affiliation(s)
- Xuxi Zhang
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Siok Swan Tan
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Carmen Betsy Franse
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Lovorka Bilajac
- Faculty of Medicine, Department of Social Medicine and EpidemiologyUniversity of RijekaRijekaCroatia
| | | | - Jorge Garcés‐Ferrer
- Polibienestar Research Institute–Universitat de València C/SerpisValenciaSpain
| | - Arpana Verma
- Manchester Urban Collaboration on Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary CareManchester Academic Health Science Centre, The University of ManchesterManchesterUnited Kingdom
| | - Greg Williams
- Manchester Urban Collaboration on Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary CareManchester Academic Health Science Centre, The University of ManchesterManchesterUnited Kingdom
| | - Gary Clough
- Manchester Urban Collaboration on Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary CareManchester Academic Health Science Centre, The University of ManchesterManchesterUnited Kingdom
| | - Elin Koppelaar
- Rotterdam University of Applied Sciences, Research Centre Innovations in CareRotterdamThe Netherlands
| | | | | | - Antonius J. J. Voorham
- Rotterdam University of Applied Sciences, Research Centre Innovations in CareRotterdamThe Netherlands
| | - Francesco Mattace‐Raso
- Department of Internal MedicineErasmus University Medical CenterRotterdamThe Netherlands
| | - Amy van Grieken
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Hein Raat
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
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Social Frailty Is Independently Associated with Mood, Nutrition, Physical Performance, and Physical Activity: Insights from a Theory-Guided Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124239. [PMID: 32545853 PMCID: PMC7345462 DOI: 10.3390/ijerph17124239] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/06/2020] [Accepted: 06/11/2020] [Indexed: 01/21/2023]
Abstract
Notwithstanding the increasing body of evidence that links social determinants to health outcomes, social frailty is arguably the least explored among the various dimensions of frailty. Using available items from previous studies to derive a social frailty scale as guided by the Bunt social frailty theoretical framework, we aimed to examine the association of social frailty, independently of physical frailty, with salient outcomes of mood, nutrition, physical performance, physical activity, and life–space mobility. We studied 229 community-dwelling older adults (mean age 67.22 years; 72.6% females) who were non-frail (defined by the FRAIL criteria). Using exploratory factor analysis, the resultant 8-item Social Frailty Scale (SFS-8) yielded a three-factor structure comprising social resources, social activities and financial resource, and social need fulfilment (score range: 0–8 points). Social non-frailty (SNF), social pre-frailty (SPF), and social frailty (SF) were defined based on optimal cutoffs, with corresponding prevalence of 63.8%, 28.8%, and 7.4%, respectively. In logistic regression adjusted for significant covariates and physical frailty (Modified Fried criteria), there is an association of SPF with poor physical performance and low physical activity (odds ratio, OR range: 3.10 to 6.22), and SF with depressive symptoms, malnutrition risk, poor physical performance, and low physical activity (OR range: 3.58 to 13.97) compared to SNF. There was no significant association of SPF or SF with life–space mobility. In summary, through a theory-guided approach, our study demonstrates the independent association of social frailty with a comprehensive range of intermediary health outcomes in more robust older adults. A holistic preventative approach to frailty should include upstream interventions that target social frailty to address social gradient and inequalities.
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Peña-Longobardo LM, Oliva-Moreno J, Zozaya N, Aranda-Reneo I, Trapero-Bertran M, Laosa O, Sinclair A, Rodríguez-Mañas L. Economic evaluation of a multimodal intervention in pre-frail and frail older people with diabetes mellitus: the MID-FRAIL project. Expert Rev Pharmacoecon Outcomes Res 2020; 21:111-118. [PMID: 32394757 DOI: 10.1080/14737167.2020.1766970] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: The aim of this study was to estimate the incremental cost-utility ratio (ICUR) of a multi-modal intervention in frail and pre-frail subjects aged ≥70 years with type-2 diabetes versus usual care group focused on quality adjusted life years (QALYs) in different European countries. Methods: The MID-FRAIL study was a cluster randomized multicentre trial conducted in seven European countries. A cost-utility analysis was carried out based on this study, conducted from the perspective of the health care system with a time horizon of one year. Univariate and probabilistic analysis were carried out to test the robustness of the results. Results: The cost estimation showed the offsetting health effect of the intervention program on total health care costs. The mean annual health care costs were 25% higher among patients in usual care. The mean incremental QALY gained per patient by the intervention group were 0.053 QALY compared with usual care practice. Conclusions: The MID-FRAIL intervention program showed to be the dominant option in comparison with usual care practice. It saved costs to the health care system and achieved worthwhile health gains. This finding should encourage its implementation, at least, in the trial participant countries.
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Affiliation(s)
| | - Juan Oliva-Moreno
- Department of Economic Analysis and Finance, University of Castilla-La Mancha , Toledo, Spain
| | - Neboa Zozaya
- Department of Health Economics, Weber, Madrid Spain, University of Las Palmas de Gran Canaria , Las Palmas De Gran Canaria, Spain
| | - Isaac Aranda-Reneo
- Department of Economic Analysis and Finance, University of Castilla-La Mancha , Toledo, Spain
| | - Marta Trapero-Bertran
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya (UIC) , Barcelona, Spain
| | - Olga Laosa
- Servicio de Geriatría, Hospital Universitario de Getafe , Madrid, Spain
| | - Alan Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd , Luton, UK
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Combined Impact of Traditional and Nontraditional Healthy Behaviors on Frailty and Disability: A Prospective Cohort Study of Older Adults. J Am Med Dir Assoc 2020; 21:710.e1-710.e9. [DOI: 10.1016/j.jamda.2019.08.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/12/2019] [Accepted: 08/30/2019] [Indexed: 01/06/2023]
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Effects of dance intervention on frailty among older adults. Arch Gerontol Geriatr 2020; 88:104001. [PMID: 32113011 DOI: 10.1016/j.archger.2019.104001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/15/2019] [Accepted: 12/16/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aims of this study were to examine the effects of dance intervention on frailty in pre-frail and frail older persons. DESIGN This is a quasi-experimental, two-group trial. SETTING Older adults living nursing home. PARTICIPANTS Participants aged ≥ 60 years with low physical activity (mean age was 81.8 years; 71 % were female) (N = 66). METHODS Participants allocated to the dance group attended 40 min dance sessions in a nursing home, three times a week for 12-weeks. Participants allocated to the control group maintained their normal daily activities. Assessments were conducted at baseline, 6 weeks, and 12 weeks by researchers blinded to the allocation. Frailty was measured based on Fried criteria. Estimates of frailty between groups over time were calculated using the generalized estimating equations (GEE) and mixed effects models. RESULTS The prevalence of frailty decreased over time in the dance group compared to the control group (P = 0.002). The mean frailty scores decreased 0.69 at 6 weeks and 1.06 at 12 weeks. Compared to the control group, the prevalence of slowness (p = 0.002), weakness (p = 0.005), and low physical activity (p < 0.001) significantly decreased in the dance group. CONCLUSIONS Dance intervention may reduce the presence and severity of frailty in older adults. Slowness and low physical activity improve following 12 weeks of dance intervention.
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Garner IW, Holland CA. Age-friendliness of living environments from the older person's viewpoint: development of the Age-Friendly Environment Assessment Tool. Age Ageing 2020; 49:193-198. [PMID: 31790132 DOI: 10.1093/ageing/afz146] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND according to the World Health Organisation, the role of the environment for older adults is to maintain and facilitate independence and promote quality of life. However, measures that examine the environment in terms of its potential impact on older people are either oriented towards specific aspects of the environment, specifically designed for community-level assessment rather than individually oriented, or are unwieldy for everyday use. OBJECTIVES this article describes the development and validation of the Age-Friendly Environment Assessment Tool (AFEAT), assessing whether individual function and frailty impact on perceptions of environmental age-friendliness. The extent to which such perceptions may have moderate impacts of frailty on outcomes such as need for care support, quality of life and loneliness is examined. METHODS a total of 132 participants aged 58-96 were recruited from retirement villages and local communities in the Midlands of the UK. Participants completed the AFEAT, and a series of measures designed to assess frailty and assessments of quality of life, loneliness and perceptions of functional limitations. RESULTS internal reliability assessment indicated that the AFEAT possesses a Cronbach's Alpha score of 0.745. The AFEAT significantly predicted quality of life and loneliness, accounting for 17.1% and 5.8% of variance respectively, indicating high concurrent and predictive validity. Furthermore, the AFEAT moderated the predictive strength of frailty in predicting the amount of formal care an individual receives, but not quality of life or loneliness. DISCUSSION the AFEAT is a valid and reliable tool, and analyses highlight the need for an individual-oriented Age-Friendly environment tool.
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Affiliation(s)
- Ian W Garner
- Aston Research Centre for Healthy Ageing, Aston University, Birmingham, B4 7ET, UK
| | - Carol A Holland
- Division of Health Research, Centre for Ageing Research, Lancaster University, Lancaster, LA1 4YG, UK
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Park J, Sherman DG, Agogo G, Hoogendijk EO, Liu Z. Frailty modifies the intervention effect of chair yoga on pain among older adults with lower extremity osteoarthritis: Secondary analysis of a nonpharmacological intervention trial. Exp Gerontol 2020; 134:110886. [PMID: 32088398 PMCID: PMC7438234 DOI: 10.1016/j.exger.2020.110886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/12/2020] [Accepted: 02/20/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE In an 8-week nonpharmacological pain intervention trial among older adults with lower extremity osteoarthritis (OA), we aimed to examine: a) the baseline frailty level of the participants; b) whether such intervention is more beneficial for baseline frailer older adults than for their counterparts with less frailty; and c) whether the intervention could also alter frailty. METHODS Participants were randomly assigned to either chair yoga (CY) or health education program (HEP) groups and attended twice-weekly 45-minute CY or HEP sessions for 8 weeks. Following a standard procedure, 82 variables were used to construct a frailty index (FI, 0-1). Primary outcomes were: Western Ontario and McMaster Universities (WOMAC) pain and pain interference. Linear mixed-effects models were used to evaluate the modifying effect of baseline frailty on the intervention effect of CY on primary outcomes. Similar models were used to evaluate the effect of CY on frailty. RESULTS A total of 112 participants (n = 63 CY, n = 49 HEP; 75.3 [SD = 7.5] years) with 85 females (75.9%) were included. The mean values of baseline FI for the CY and HEP groups were similar (0.428 [0.05] and 0.433 [0.05], P = 0.355). Each 0.01 increment in baseline FI was associated with higher WOMAC pain (beta = 0.28, P < 0.001) and pain interference (beta = 0.51, P < 0.001). There was a significant interaction effect between intervention, time, and baseline FI (P = 0.020 for WOMAC pain; P = 0.010 for pain interference), indicating that participants with higher level of baseline FI had greater declines in WOMAC pain and pain interference. There was no significantly greater decline in FI for the CY group compared to the HEP group (between-group difference - 0.01; P = 0.509) and there were no significant trend changes in FI (P for interaction = 0.605). CONCLUSIONS Frailty modifies the intervention effect of CY on pain among older adults with lower extremity OA, underscoring the importance of assessing frailty to improve the management of pain in this population.
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Affiliation(s)
- Juyoung Park
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, Boca Raton, FL, USA
| | - Diane G Sherman
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, Boca Raton, FL, USA
| | - George Agogo
- Centers for Disease Control and Prevention (CDC), Village Market, Nairobi, Kenya; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Emiel O Hoogendijk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-location VU University Medical Center, Amsterdam, Netherlands
| | - Zuyun Liu
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA; Department of Precision Health and Data Science, School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Cognitive Functioning as a Moderator in the Relationship Between the Perceived Neighborhood Physical Environment and Physical Activity in Belgian Older Adults. J Aging Phys Act 2019; 27:890-898. [PMID: 31034319 DOI: 10.1123/japa.2018-0277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: To investigate whether the relationship of neighborhood environmental factors with physical activity (PA) is moderated by cognitive functioning in Belgian older adults. Methods: Seventy-one older adults completed validated questionnaires on PA and environmental perceptions, wore an accelerometer, and completed a computerized assessment of cognitive functioning. Moderated linear regression analyses were conducted in SPSS 24.0. Results: Overall cognitive functioning significantly moderated the associations of traffic safety and street connectivity with PA. Detailed analyses showed that these factors were only positively associated with PA in older adults with lower cognitive functioning. In addition, particularly, performance on tests assessing visuospatial and episodic memory moderated these associations. Discussion: Living in traffic-safe neighborhoods with short and many alternative routes might motivate older adults with lower cognitive functioning to be active. As such, the increase in PA might improve their cognitive abilities. This knowledge is crucial for health practitioners to develop effective PA promotion initiatives.
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Gee SB, Cheung G, Bergler U, Jamieson H. "There's More to Frail than That": Older New Zealanders and Health Professionals Talk about Frailty. J Aging Res 2019; 2019:2573239. [PMID: 31915552 PMCID: PMC6930781 DOI: 10.1155/2019/2573239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/15/2019] [Accepted: 10/26/2019] [Indexed: 11/17/2022] Open
Abstract
There is general agreement that frailty is common and important in later life, but there is less agreement about what frailty is. Little is known about the extent to which practicing health professionals and older people hold a mutual understanding of frailty. Focus groups were held to engage older people and health professionals in discussion about what made them think that someone was frail. Eighteen older people took part across three focus groups, and se'venteen health professionals took part across another three focus groups. Both the health professionals and the older people talked about the experience of frailty as an interplay of physical, psychological, and social dimensions. Older people with frailty were seen as needing help and being vulnerable to adverse outcomes, but accepting help was positioned by older people as an adaptive choice. The experience of frailty was described as being mediated by the individual's psychological mindset, highlighting the importance of approaches that recognise strengths and resilience. A broader and more balanced understanding of frailty may help create more rounded and appropriate approaches to assessment and management.
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Affiliation(s)
- Susan B. Gee
- University of Otago, Christchurch New Zealand, Canterbury District Health Board, Christchurch 8083, New Zealand
| | - Gary Cheung
- University of Auckland, Auckland 1023, New Zealand
| | - Ulrich Bergler
- University of Otago, Christchurch New Zealand, Canterbury District Health Board, Christchurch 8083, New Zealand
| | - Hamish Jamieson
- University of Otago, Christchurch New Zealand, Canterbury District Health Board, Christchurch 8083, New Zealand
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Leś A, Guszkowska M, Piotrowska J, Rutkowska I. Changes in perceived quality of life and subjective age in older women participating in Nordic Walking classes and memory training. J Sports Med Phys Fitness 2019; 59:1783-1790. [PMID: 31694364 DOI: 10.23736/s0022-4707.19.09588-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of the study was to determine the effect of regular Nordic walking (NW) and memory training on the quality of life and subjective age perception in older adults. Relationships between changes in quality of life and subjective age and changes in physical and perceptual fitness were also examined. METHODS The study examined 61 women aged 64 to 93 years living in adult day care centers. Twenty people participated in a 3-month program combining Nordic walking and cognitive training (group NW+C), 20 people participated only in Nordic walking classes (group NW), and 21 people were a control group (group C). The Fullerton Functional Fitness Test, the Romberg balance test, WHOQOL-Bref Age questionnaire and the Attention and Perceptivity Test were used in the study. RESULTS After three months of exercises, a decrease in subjective age and an improvement in perceived quality of life was observed in NW+C and NW groups, with no such changes found in group C. Positive correlations were also found for the index of decline in subjective age and quality of life with indices of physical fitness improvement. CONCLUSIONS Regular physical and intellectual activity has a positive effect on perceived quality of life and subjective age of the residents of adult day care centers.
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Affiliation(s)
- Anna Leś
- Department of Recreation Theory, Faculty of Tourism and Recreation, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland -
| | - Monika Guszkowska
- Department of Clinical Psychology and Special Education, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Joanna Piotrowska
- Department of Recreation Methodology, Faculty of Tourism and Recreation, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Izabela Rutkowska
- Department of Disability Sport, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
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de Bruin ED, Patt N, Ringli L, Gennaro F. Playing Exergames Facilitates Central Drive to the Ankle Dorsiflexors During Gait in Older Adults; a Quasi-Experimental Investigation. Front Aging Neurosci 2019; 11:263. [PMID: 31616287 PMCID: PMC6763617 DOI: 10.3389/fnagi.2019.00263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/05/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose Gait training might be of particular importance to reduce fall risk in older adults. In the present study we explore the hypothesis that video game-based training will increase tibialis anterior (TA) muscle EMG-EMG coherence and relates to functional measures of lower limb control. Methods We focus on video game-based training performed in standing position, where the subjects have to lift their toes to place their feet on different target zones in order to successfully play the game. This type of training is hypothesized leading to progressive changes in the central motor drive to TA motor neurons and, consequently, improved control of ankle dorsiflexion during gait. Results Twenty older adults, 79 ± 8 years old, 13 females/7 males, participated. Results showed a significant difference against 0 in the experimental ΔPOST condition in dual-task walking and beta Frequency Of Interest (p = 0.002). Walking under dual task condition showed significant change over time in minimal Toe Clearance for both the left [χ2(2) = 7.46, p = 0.024, n = 20] and right [χ2(2) = 8.87, p = 0.012, n = 20] leg. No change in lower extremity function was detectable. Conclusion Overall we conclude that the initiation of an exergame-based training in upright standing position improves neural drive to the lower extremities in older adults, effects on minimal Toe Clearance and seems an acceptable form of physical exercise for this group.
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Affiliation(s)
- Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Nadine Patt
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Lisa Ringli
- SRH Hochschule für Gesundheit, Gera, Germany
| | - Federico Gennaro
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
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Sebri V, Savioni L, Triberti S, Mazzocco K, Pravettoni G. How to Train Your Health: Sports as a Resource to Improve Cognitive Abilities in Cancer Patients. Front Psychol 2019; 10:2096. [PMID: 31572274 PMCID: PMC6753215 DOI: 10.3389/fpsyg.2019.02096] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/28/2019] [Indexed: 12/15/2022] Open
Abstract
From a cognitive-psychological perspective, physical exercise (PE) and sports are an interesting tool for improving people's cognitive abilities. One field of application for such a tool is decision making (DM) support in chronic patients, cancer patients, and survivors in particular. On the one hand, cancer patients and survivors have to continually take important decisions about their own care (e.g., treatment choice; changes in lifestyle), in collaboration with caregivers and health providers; on the other hand, side effects of treatment may be detrimental to cognitive abilities, such as attention, which make the health DM tasks even more demanding, complex, and emotionally disruptive for patients. Since cancer patients have to engage in healthy activities both for improving their own quality of life and for sustaining the effects of medications, clinical advice to engage in sport and PE is becoming more and more widespread within interventions. However, while sports are usually seen as healthy physical activities, their impact on cognitive abilities is mostly overlooked in the literature. The hypothesis of the present work is that sports could be fully exploited in their potential as focused exercises for cognitive ability training, in the field of cognitive training for chronic patients specifically. Indeed, literature shows that different sports (e.g., individual or team-based) influence and possibly augment cognitive abilities such as focused and divided attention, working memory, and DM under time constraints. Moreover, besides providing training for cognitive abilities, the experience of sports may represent an opportunity to explore, train and sharpen DM abilities directly: we identify five ways in which sport experiences may influence DM processes, and provide indications for future research on the topic.
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Affiliation(s)
- Valeria Sebri
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Lucrezia Savioni
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Triberti
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
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43
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Pan B, Li H, Wang Y, Sun M, Cai H, Wang J. Physical activity and the risk of frailty among community-dwelling healthy older adults: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e16955. [PMID: 31464936 PMCID: PMC6736461 DOI: 10.1097/md.0000000000016955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Frailty has become one of the biggest challenges in facilitating healthy aging. Our study aims to investigate the association between physical activity and the risk of frailty, meanwhile, conduct a dose-response to observe the relationship between physical activity volume and frailty. METHOD We will systematically search six databases to identify cohort studies assessing the association between physical activity and risk of frailty. Risk of bias of individual study will be assessed using the Newcastle-Ottawa Scale. Data will be analyzed by using STATA V.12.0. RESULTS The results of this study will be published in a peer-reviewed journal. CONCLUSION We will first investigate whether specific-physical activity reduce the risk to onset frailty in healthy older adults. However, predictable heterogeneity may exist in our study because of the inconsistent definitions of frailty.
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Affiliation(s)
- Bei Pan
- Gansu Provincial Hospital, Lanzhou
| | - Hongli Li
- Department of Social Medicine and Health Management, School of Public Health of Lanzhou University
| | - Yunhua Wang
- Department of Social Medicine and Health Management, School of Public Health of Lanzhou University
| | - Min Sun
- Lanzhou University Second Hospital, Lanzhou, China
| | - Hui Cai
- Gansu Provincial Hospital, Lanzhou
- Hospital Management Research Center, Lanzhou University, Lanzhou
| | - Jiancheng Wang
- Gansu Provincial Hospital, Lanzhou
- Hospital Management Research Center, Lanzhou University, Lanzhou
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44
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Thomson D, Liston M, Gupta A. Is the 10 metre walk test on sloped surfaces associated with age and physical activity in healthy adults? Eur Rev Aging Phys Act 2019; 16:11. [PMID: 31360260 PMCID: PMC6639969 DOI: 10.1186/s11556-019-0219-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 07/11/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Preferred walking speed is considered an important indicator of health in older adults and is measured on level ground. However, this may not represent the complex demands of community ambulation such as walking on sloped surfaces. Performing a 10 m walk test on a sloped surface is a novel test, and may be a more sensitive measure of walking capacity which may better discriminate age or health-related changes in gait speed compared to a traditional level 10 m walk test. The purpose of this investigation was to determine healthy adults' performance in the 10 m walk test across various inclines and speeds, and which version of the 10 m walk test would be best at discriminating age-related changes in walking speed. Further, this study aimed to determine whether measures of general health and physical activity are associated with the performance of each test. METHODS Healthy Adults (n = 181) aged 20-80 years completed the 10 m walk test on level, downhill and uphill surfaces (8° inclination) at fastest and preferred speeds. Descriptive statistics were calculated for walking speed for males and females across each decade of life. Repeated measures ANOVA was performed to discriminate age-related changes in gait speed by decade, for the 10 m walk test at each speed and slope. Multiple linear regression analyses were conducted to examine the association between waist to height ratio, resting heart rate, age and self-reported physical activity upon preferred and fastest walking speeds at each incline (level/downhill/uphill). RESULTS The 10 m walk test best discriminated age-related changes in gait speed when performed at fastest speeds on each slope, or at a preferred speed on an uphill slope. Waist to height ratio, age and the physical activity index were all significantly associated with fastest walking speeds over each incline and preferred uphill speed. Only waist to height ratio was associated with preferred walking speed on level and downhill surfaces. CONCLUSIONS The 10 m walk test has the greatest ability to discriminate age- and health-related changes in gait speed when it is performed at a fastest speed on any slope, or uphill at a preferred speed. The normative data reported in this study may be used to compare the performance of the 10 m walk test to that of healthy adults at preferred and fastest speeds on sloped surfaces.
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Affiliation(s)
- Daniel Thomson
- School of Science and Health, Western Sydney University, Sydney, Australia
| | - Matthew Liston
- School of Science and Health, Western Sydney University, Sydney, Australia
- Centre for Human and Applied Physiological Sciences, School of Biomedical Sciences, King’s College London, London, UK
| | - Amitabh Gupta
- School of Science and Health, Western Sydney University, Sydney, Australia
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45
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Panza F, Lozupone M, Solfrizzi V, Sardone R, Dibello V, Di Lena L, D'Urso F, Stallone R, Petruzzi M, Giannelli G, Quaranta N, Bellomo A, Greco A, Daniele A, Seripa D, Logroscino G. Different Cognitive Frailty Models and Health- and Cognitive-related Outcomes in Older Age: From Epidemiology to Prevention. J Alzheimers Dis 2019; 62:993-1012. [PMID: 29562543 PMCID: PMC5870024 DOI: 10.3233/jad-170963] [Citation(s) in RCA: 194] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Frailty, a critical intermediate status of the aging process that is at increased risk for negative health-related events, includes physical, cognitive, and psychosocial domains or phenotypes. Cognitive frailty is a condition recently defined by operationalized criteria describing coexisting physical frailty and mild cognitive impairment (MCI), with two proposed subtypes: potentially reversible cognitive frailty (physical frailty/MCI) and reversible cognitive frailty (physical frailty/pre-MCI subjective cognitive decline). In the present article, we reviewed the framework for the definition, different models, and the current epidemiology of cognitive frailty, also describing neurobiological mechanisms, and exploring the possible prevention of the cognitive frailty progression. Several studies suggested a relevant heterogeneity with prevalence estimates ranging 1.0–22.0% (10.7–22.0% in clinical-based settings and 1.0–4.4% in population-based settings). Cross-sectional and longitudinal population-based studies showed that different cognitive frailty models may be associated with increased risk of functional disability, worsened quality of life, hospitalization, mortality, incidence of dementia, vascular dementia, and neurocognitive disorders. The operationalization of clinical constructs based on cognitive impairment related to physical causes (physical frailty, motor function decline, or other physical factors) appears to be interesting for dementia secondary prevention given the increased risk for progression to dementia of these clinical entities. Multidomain interventions have the potential to be effective in preventing cognitive frailty. In the near future, we need to establish more reliable clinical and research criteria, using different operational definitions for frailty and cognitive impairment, and useful clinical, biological, and imaging markers to implement intervention programs targeted to improve frailty, so preventing also late-life cognitive disorders.
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Affiliation(s)
- Francesco Panza
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.,Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Madia Lozupone
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari "Aldo Moro", Bari, Italy
| | - Rodolfo Sardone
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Vittorio Dibello
- Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari Aldo Moro, Bari, Italy
| | - Luca Di Lena
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Francesca D'Urso
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Roberta Stallone
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari Aldo Moro, Bari, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | | | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Antonio Greco
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Davide Seripa
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Giancarlo Logroscino
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
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Sinclair AJ, Abdelhafiz AH, Forbes A, Munshi M. Evidence-based diabetes care for older people with Type 2 diabetes: a critical review. Diabet Med 2019; 36:399-413. [PMID: 30411402 DOI: 10.1111/dme.13859] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2018] [Indexed: 12/22/2022]
Abstract
In our ageing society diabetes imposes a significant burden in terms of the numbers of people with the condition, diabetes-related complications including disability, and health and social care expenditure. Older people with diabetes can represent some of the more complex and difficult challenges facing the clinician working in different settings, and the recognition that we have only a relatively small (but increasing) evidence base to guide us in diabetes management is a limitation of our current approaches. Nevertheless, in this review we attempt to explore what evidence there is to guide us in a comprehensive scheme of treatment for older adults, often in a high-risk clinical state, in terms of glucose lowering, blood pressure and lipid management, frailty care and lifestyle interventions. We strive towards individualized care and make a call for action for more high-quality research using different trial designs.
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Affiliation(s)
- A J Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Droitwich, UK
| | | | | | - M Munshi
- Harvard Medical School and Joslin Clinic, Boston, MA, USA
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Cho MS, Kim JY. Effects of exercise and nutrition education programs on motor function and eating habit in mild dementia patients. J Exerc Rehabil 2019; 15:88-94. [PMID: 30899742 PMCID: PMC6416496 DOI: 10.12965/jer.1836632.316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 01/22/2019] [Indexed: 12/17/2022] Open
Abstract
The purpose of this study was to investigate the effects of physical ac-tivity and nutrition education programs on mild dementia patients with changes in exercise function and eating habits. We examined the effects of pre and post program on 23 old patients with dementia who were diagnosed with menarche or mild dementia with the permission of the dementia center in Incheon city and visited from April to July 2017. The Mini-Mental State Examination score of the subjects in this study was 19.68±3.25, consisting of mild dementia patients. After performing the program for 16 weeks, the senior fitness test showed a significant change in the arm curl test, chair sit-and-reach test, and 2-min step test, and a total score of mini nutrition assessment increased from 19.16 to 21.0. In particular, in a level 2 evaluation, which contains more details such as the condition of taking drugs, number of daily meals, protein food intake condition, intake of vegetables, fruit, and water, whether one can eat alone, and evaluation of nutritive condition, a significant increase from 9.78 to 11.28 was verified. There is a significant increase in nutrition condition recovery as a result of nutrition education. In comparing pre and post program, a significant result was confirmed, and there was significance to provide the basic empirical data for the exercise and dietary life nutritional education of mild dementia patients.
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Affiliation(s)
- Min-Soo Cho
- Liberal Arts College, Chungwoon University, Incheon, Korea
| | - Ji-Youn Kim
- Exercise Rehabilitation Convergence Institute, Gachon University, Incheon, Korea
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Chen R, Wu Q, Wang D, Li Z, Liu H, Liu G, Cui Y, Song L. Effects of elastic band exercise on the frailty states in pre-frail elderly people. Physiother Theory Pract 2019; 36:1000-1008. [DOI: 10.1080/09593985.2018.1548673] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Rujie Chen
- Rehabilitation Department, North China University of Science and Technology, Tangshan, Hebei, China
| | - Qingwen Wu
- Rehabilitation Department, North China University of Science and Technology, Tangshan, Hebei, China
| | - Dongyan Wang
- Rehabilitation Department, North China University of Science and Technology, Tangshan, Hebei, China
| | - Zhou Li
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Howe Liu
- Physical Therapy Department, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Guangtian Liu
- Rehabilitation Department, North China University of Science and Technology, Tangshan, Hebei, China
| | - Ying Cui
- Rehabilitation Department, North China University of Science and Technology, Tangshan, Hebei, China
| | - Linlin Song
- Rehabilitation Department, North China University of Science and Technology, Tangshan, Hebei, China
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49
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Zhao M, Gao J, Li M, Wang K. Relationship Between Loneliness and Frailty Among Older Adults in Nursing Homes: The Mediating Role of Activity Engagement. J Am Med Dir Assoc 2019; 20:759-764. [PMID: 30630725 DOI: 10.1016/j.jamda.2018.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 10/19/2018] [Accepted: 11/06/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Previous literature has reported that loneliness is the strongest predictor of frailty, which is also closely associated with activity engagement. Yet, to date, the path from loneliness to frailty has not been investigated. In this study, we evaluated whether activity engagement mediates the relationship between loneliness and frailty among older adults living in nursing homes. DESIGN We employed the use of a cross-sectional descriptive survey. SETTING AND PARTICIPANTS Residents (N = 370; aged ≥60 years; 220 female, 150 male) were from 33 nursing homes in China. MEASURES Information was collected regarding loneliness, activity engagement, frailty, sociodemographic characteristics, nursing home characteristics, self-rated health, insomnia, and depression. The mediation analyses, comprising regression and bootstrap analyses, were performed to test both direct and indirect effects of loneliness on frailty (ie, the mediating role of activity engagement). RESULTS The prevalence of frailty was 29.2% among Chinese older adults living in nursing homes. Activity engagement mediated the association between loneliness and frailty [95% confidence interval (CI) = 0.011, 0.070]; however, loneliness was not significantly related to frailty when covarying for activity engagement (95% CI = 0.028, 0.190). CONCLUSION AND IMPLICATIONS Results suggest that it is not loneliness in general that affects frailty but actively engaging in activities. Therefore, preventing frailty by employing interventions that promote older adults' activity engagement may improve nursing home residents' quality of life. The main implication is that activity engagement should be an effective indicator for care planning and quality evaluation in nursing homes.
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Affiliation(s)
- Meng Zhao
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Jie Gao
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China
| | - Ming Li
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China.
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, Shandong, P.R. China.
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Kowalski KA, MacDonald SWS, Yeates KO, Tuokko HA, Rhodes RE. Decomposing the within-person and between-person sources of variation in physical activity-cognition associations for low-active older adults. Psychol Health 2018; 33:1431-1455. [PMID: 30430863 DOI: 10.1080/08870446.2018.1508682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To examine within-person and between-person sources of variation in the relationship between physical activity and cognition in older adults participating in a walking program. To explore whether demographic, health and fitness variables, and their interactions with activity, are significant predictors of cognition. DESIGN Brief longitudinal burst design. PARTICIPANTS 118 participants (91 females, mean age = 72.81 + 5.24 years). MAIN OUTCOME MEASURES Cognition, self-reported moderate-to-vigorous walking and self-reported moderate-to-vigorous physical activity were assessed at baseline and 6, 9, 12 and 16 weeks follow-up. Attendance at weekly walks was also recorded. RESULTS Within-persons, changes in physical activity were related to select measures of executive functioning, with increased activity predictive of better cognition (three of four cognitive functions, p<.05). Between-persons, activity was also associated with cognition (two of four cognitive functions, p<.05). Younger age and higher education were related to better cognition. Interactions of demographic, health, and fitness variables with changes in within-person activity were generally non-significant. CONCLUSION The results highlight the importance of distinguishing within- from between-person effects in longitudinal analyses of the association between physical activity and cognition. This stringent within-person test of association underscores the potential value of simple physical activity interventions for improving cognitive function.
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Affiliation(s)
- Kristina A Kowalski
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada.,b School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada.,c Institute on Aging & Lifelong Health, University of Victoria , Victoria , British Columbia , Canada
| | - Stuart W S MacDonald
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada.,c Institute on Aging & Lifelong Health, University of Victoria , Victoria , British Columbia , Canada
| | - Keith O Yeates
- d Department of Psychology , University of Calgary , Calgary , Alberta , Canada
| | - Holly A Tuokko
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada.,c Institute on Aging & Lifelong Health, University of Victoria , Victoria , British Columbia , Canada
| | - Ryan E Rhodes
- b School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada.,c Institute on Aging & Lifelong Health, University of Victoria , Victoria , British Columbia , Canada
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