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Argyriou C, Dimitriadou I, Saridi M, Toska A, Lavdaniti M, Fradelos EC. Assessment of the relation between depression, frailty, nutrition and quality of life among older adults: findings from a cross-sectional study in Greece. Psychogeriatrics 2024; 24:1065-1074. [PMID: 38926119 DOI: 10.1111/psyg.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Quality of life (QOL) among older adults is a crucial aspect of geriatric care, particularly in the context of global demographic shifts toward ageing societies. Understanding the determinants of QOL in older adults is essential for developing effective interventions to promote well-being in this population. METHODS This cross-sectional study conducted in Greece aimed to investigate the complex relationship between depression, frailty, nutritional status, and QOL on 90 older adults (aged ≤65). Assessment instruments including the World Health Organization Quality of Life (WHOQoL)-BREF questionnaire, Geriatric Depression Scale (GDS), Clinical Frailty Scale (CFS), and Mini Nutritional Assessment (MNA) were utilised to evaluate various dimensions of QOL, depressive symptoms, frailty, and nutritional status. RESULTS The study revealed significant negative correlations between depression and frailty with all domains of QOL (P < 0.05), indicating that higher levels of depressive symptoms and frailty were associated with lower QOL across physical, psychological, social, and environmental dimensions. Conversely, positive correlations were found between nutritional status and all QOL domains (P < 0.05), suggesting that better nutritional status was linked to higher QOL. Multivariate logistic regression analysis further demonstrated associations between nutritional status and participant characteristics, with females being more likely to be malnourished (odds ratio (OR) = 6.56, P = 0.013), while better health status (OR = 0.34, P = 0.486) and marital status (OR = 0.02, P = 0.019) were protective against malnutrition. CONCLUSION These findings underscore the interconnectedness of depression, frailty, and nutritional status in shaping QOL among individuals. Holistic interventions targeting mental health, physical vulnerability, and nutritional well-being are essential for promoting overall well-being and functional outcomes in this population.
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Affiliation(s)
| | - Ioanna Dimitriadou
- Laboratory of Clinical Nursing, Department of Nursing, University of Thessaly, Larissa, Greece
| | - Maria Saridi
- School of Social Sciences, Hellenic Open University, Patra, Greece
- Laboratory of Clinical Nursing, Department of Nursing, University of Thessaly, Larissa, Greece
| | - Aikaterini Toska
- School of Social Sciences, Hellenic Open University, Patra, Greece
- Laboratory of Clinical Nursing, Department of Nursing, University of Thessaly, Larissa, Greece
| | - Maria Lavdaniti
- School of Social Sciences, Hellenic Open University, Patra, Greece
- Nursing Department, International Hellenic University, Thessaloniki, Greece
| | - Evangelos C Fradelos
- School of Social Sciences, Hellenic Open University, Patra, Greece
- Laboratory of Clinical Nursing, Department of Nursing, University of Thessaly, Larissa, Greece
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Kim HS, Kim J, Kim JA. Mediating role of health literacy in relationship between frailty and health-related quality of life in community-dwelling older adults. PLoS One 2024; 19:e0303164. [PMID: 38814978 PMCID: PMC11139303 DOI: 10.1371/journal.pone.0303164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/21/2024] [Indexed: 06/01/2024] Open
Abstract
PURPOSE The aim of this study was to investigate the mediating effects of health literacy on the relationship between frailty and health-related quality of life (HRQOL) among community-dwelling older adults. METHODS This study used the Korean Frailty and Aging Cohort Database (KFACD) for secondary data analysis. We selected data from 1,631 people without missing main variable values for analysis. Frailty was determined based on the modified Fried's phenotype [MFP], and HRQOL was measured using the Korean version of the 5-level EuroQol questionnaire (EQ-5D-5L). Health literacy was assessed using the questions on the Behavioral Risk Factor Surveillance System (BRFSS) used by the U.S. Center for Disease Control and Prevention. To examine the mediating role of health literacy in the relationship between frailty and HRQOL, Baron & Kenny's three-step mediating effect verification method was utilized. RESULTS The participants had a mean frailty score of 1.37±1.02, health literacy score of 8.56±2.59, and HRQOL score of 0.84±0.10. Frailty was negatively correlated with health literacy (r = -0.27, p < .001) and HRQOL (r = -0.32, p < .001), while health literacy was positively correlated with HRQOL (r = 0.34, p < .001). We observed that health literacy played a partial mediating role in the relationship between frailty and HRQOL. CONCLUSION To increase older adults' HRQOL, measures that directly prevent and manage frailty as well as interventions that target the enhancement of health literacy are needed.
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Affiliation(s)
- Hee-Sun Kim
- National Evidence-Based Collaborating Agency, Seoul, South Korea
| | - Jinhee Kim
- Department of Nursing, Chosun University Hospital, Gwangju, South Korea
| | - Ji-Ah Kim
- National Evidence-Based Collaborating Agency, Seoul, South Korea
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Brech GC, da Silva VC, Alonso AC, Machado-Lima A, da Silva DF, Micillo GP, Bastos MF, de Aquino RDC. Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods. Front Nutr 2024; 10:1183058. [PMID: 38235441 PMCID: PMC10792032 DOI: 10.3389/fnut.2023.1183058] [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: 03/09/2023] [Accepted: 10/26/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction The aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over. Methods This cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD). Results The K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD. Conclusion Handgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.
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Affiliation(s)
- Guilherme Carlos Brech
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Vanderlei Carneiro da Silva
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Angelica Castilho Alonso
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Adriana Machado-Lima
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
| | - Daiane Fuga da Silva
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
| | | | - Marta Ferreira Bastos
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
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Melvin RL, Ruple A, Pearson EB, Olby NJ, Fitzpatrick AL, Creevy KE. A review of frailty instruments in human medicine and proposal of a frailty instrument for dogs. Front Vet Sci 2023; 10:1139308. [PMID: 37441560 PMCID: PMC10333704 DOI: 10.3389/fvets.2023.1139308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Over the last few decades, frailty has become a pillar of research and clinical assessment in human gerontology. This complex syndrome, characterized by loss of physiologic reserves leading to decreased resilience to stressors, is of critical importance because it predicts higher risks of poor health outcomes, including mortality. Thus, identifying frailty among the elderly human population has become a key focus of gerontology. This narrative review presents current scientific literature on frailty in both humans and animals. The authors discuss the need for an accessible frailty instrument for companion dogs suitable for general use in veterinary medicine and the advances that would be facilitated by this instrument. A phenotypic frailty instrument for companion dogs, utilizing components that are easily collected by owners, or in the general practice setting, is proposed. The authors elaborate on the domains (physical condition, physical activity, mobility, strength, cognitive task performance, and social behavior), factors that will be included, and the data from the Dog Aging Project that inform each domain.
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Affiliation(s)
- Rachel L. Melvin
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Elizabeth B. Pearson
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| | - Natasha J. Olby
- Department of Clinical Sciences, NC State University College of Veterinary Medicine, Raleigh, NC, United States
| | | | - Kate E. Creevy
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
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Ribeiro-Gonçalves JA, Costa PA, Leal I. Double Stigma in Portuguese Lesbian, Gay, and Bisexual Older Adults: A Study of Health Status. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:886-901. [PMID: 37222608 DOI: 10.1080/0092623x.2023.2215258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The double stigma-sexual stigma and ageism-can affect the health status of lesbian, gay, and bisexual (LGB) older adults, but little is known about this topic in Portugal and internationally. The aim of this study was to assess the health status and the prevalence of chronic diseases of Portuguese LGB older adults, as well as to assess the relationship between double stigma and health status. A sample of 280 Portuguese LGB older adults completed a chronic disease questionnaire, the Homosexuality-Related Stigma Scale, the Ambivalent Ageism Scale, and the SF-12 Short Form Health Survey. A structural equation model was performed using the double stigma variables as independent variables and health status as outcome. The mental health status of Portuguese LGB older adults was lower when compared to people from studies from more than 10 countries. Higher sexual self-stigma, sexual enacted stigma related to health care, and benevolent ageism significantly explained the worse general health status. The double stigma significantly affects the health status of these older adults in a profile of internalization of sexual stigma and benevolent age discrimination, and not necessarily by a hostile/aggressive profile. More research is needed on the double stigma.
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Affiliation(s)
| | | | - Isabel Leal
- William James Center for Research, ISPA - University Institute, Lisbon, Portugal
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Kim Y, Kim J, Kim M, Song K, Choi M. Association of Depressive Mood and Frailty With Mortality and Health Care Utilization: Korean National Cohort Study. J Am Med Dir Assoc 2023; 24:504-510. [PMID: 36878262 DOI: 10.1016/j.jamda.2023.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To investigate the association of depressive mood and frailty with mortality and health care utilization (HCU) and identify the coexisting effect of depressive mood and frailty in older adults. DESIGN A retrospective study using nationwide longitudinal cohort data. SETTING AND PARTICIPANTS A total of 27,818 older adults age 66 years from the National Screening Program for Transitional Ages between 2007 and 2008, part of the National Health Insurance Service-Senior cohort. METHODS Depressive mood and frailty were measured by the Geriatric Depression Scale and Timed Up and Go test, respectively. Outcomes were mortality and HCU, including long-term care services (LTCS), hospital admissions, and total length of stay (LOS) from the index date to December 31, 2015. Cox proportional hazards regression and zero-inflated negative binomial regression were performed to identify differences in outcomes by depressive mood and frailty. RESULTS Participants with depressive mood and frailty represented 50.9% and 2.4%, respectively. The prevalence of mortality and LTCS use in the overall participants was 7.1% and 3.0%, respectively. More than 3 hospital admissions (36.7%) and total LOS above 15 days (53.2%) were the most common. Depressive mood was associated with LTCS use [hazard ratio (HR) 1.22, 95% confidence interval (CI) 1.05-1.42] and hospital admissions [incidence rate ratio (IRR) 1.05, 95% CI 1.02-1.08]. Frailty had associations with mortality risk (HR 1.96, 95% CI 1.44-2.68), LTCS use (HR 4.86, 95% CI 3.45-6.84), and LOS (IRR 1.30, 95% CI 1.06-1.60). The coexistence of depressive mood and frailty was associated with increased LOS (IRR 1.55, 95% CI 1.16-2.07). CONCLUSIONS AND IMPLICATIONS Our findings highlight the need to focus on depressive mood and frailty to reduce mortality and HCU. Identifying combined problems early in older adults may contribute to healthy aging by reducing adverse health outcomes and the burden of health care costs.
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Affiliation(s)
- Yesol Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Jeewuan Kim
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - Mihui Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Kijun Song
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Mona Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
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Hwang HJ, Choi YJ, Hong D. The Association between Self-Rated Health Status, Psychosocial Stress, Eating Behaviors, and Food Intake According to the Level of Sunlight Exposure in Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010262. [PMID: 36612583 PMCID: PMC9819439 DOI: 10.3390/ijerph20010262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/17/2022] [Accepted: 12/22/2022] [Indexed: 06/01/2023]
Abstract
Sunlight exposure has been reported to have various beneficial effects on human health. This study investigated the relationship between self-rated health status, psychosocial stress, eating behaviors, and food intake according to sunlight exposure in 948 adults. Sunlight exposure was classified as less than one hour, less than three hours, and greater than three hours. Of the participants, 49.2% had fewer than three hours of daily exposure to sunlight. Regarding participants exposed to sunlight for less than one hour, the largest response was that they did not engage in outdoor activities on weekdays or weekends, and the rate of being outdoors in the shade on sunny days was the highest in this group at 42.7%. Furthermore, the participants exposed to sunlight for less than one hour had a lower health response than the other two groups, and there were significantly more participants classified in the stress risk group. Regarding eating habits, those with less than an hour of exposure to sunlight frequently ate fried foods, fatty foods, added salt, and snacks, and had significantly lower total dietary scores or three regular meals. Additionally, their frequency of consumption of cereals, milk and dairy products, orange juice, and pork was also significantly lower than the other groups. Thus, it is necessary to provide sufficient guidelines for adequate sunlight exposure and food intake because participants with low sunlight exposure may have low vitamin D synthesis and insufficient food intake.
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Affiliation(s)
- Hyo-Jeong Hwang
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Republic of Korea
| | - Yean-Jung Choi
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Republic of Korea
| | - Dongwan Hong
- Department of Medical Informatics, College of Medicine, Catholic University of Korea, Seoul 06591, Republic of Korea
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Vogel O, Otto AK, Zimmel H, Hinrichs T, Giannouli E, Wollesen B. Definition and Contextual Factors of Nursing Home Residents' Mobility in a Holistic View: A Delphi Study. Innov Aging 2022; 7:igac067. [PMID: 36789366 PMCID: PMC9912704 DOI: 10.1093/geroni/igac067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Indexed: 11/05/2022] Open
Abstract
Background and Objectives Current definitions of older adults' mobility do not cover the full range of influencing factors and do not consider nursing home residents. The present study reports expert ratings from a Delphi study regarding factors influencing the mobility of long-term nursing home residents. Research Design and Methods We invited 129 professionals with expertise in a field relevant to research on mobility in older adults such as health care, medicine, or human movement science to participate in a Delphi study comprising 3 rounds of online questionnaires. Up to 40 experts participated in each round. In the first round, we used open-ended questions to solicit possible definitions, contextual factors, and assessment tools. In the second round, the participants used Likert scales (1-10) to rate their suitability. In the final round, we presented a definition based on consensus as well as the top-rated contextual factors and assessment tools from the first 2 rounds for a final rating of agreement. Results The experts showed broad agreement on the final version of the mobility definition, with 8.9 ± 1.4 (mean ± standard deviation) out of 10 points. The experts also showed broad consensus on the selected contextual factors, with 8.4 ± 1.8 points to 8.9 ± 1.2 points (out of 10 points). This was also the case for the top 3 assessment tools selected from results of previous rounds, which showed an agreement of 7 or more points (out of 10 points) by 81.6% to 100% of all experts in the different categories. Discussion and Implications Given that an interdisciplinary group of experts considered various hitherto neglected contextual factors as relevant, the Delphi survey and its results imply the need for an updated interdisciplinary and holistic understanding of mobility in nursing home residents and can provide a basis for putting it into practice.
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Affiliation(s)
- Oliver Vogel
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Ann-Kathrin Otto
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Hanna Zimmel
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Timo Hinrichs
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Eleftheria Giannouli
- Address correspondence to: Eleftheria Giannouli, PhD, ETH Zurich, Department of Health Sciences and Technology, Institute of HumanMovement Sciences and Sport, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland. E-mail:
| | - Bettina Wollesen
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
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Su M, Yao N, Shang M, Shen Y, Qin T, Wang J, Sun X. Frailty and its association with health-related quality of life among older cancer patients: an evidence-based study from China. Health Qual Life Outcomes 2022; 20:124. [PMID: 35986354 PMCID: PMC9389706 DOI: 10.1186/s12955-022-02032-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is limited information about the population characteristics and adverse health outcomes of older cancer patients in China. This study aimed to describe the prevalence of frailty and examine the association between frailty and health-related quality of life (HRQoL) among older cancer patients. METHODS This was a cross-sectional study involving older patients diagnosed with cancer in two tertiary hospitals in Shandong Province, China. Frailty was assessed using Geriatric 8 (G-8). HRQoL was measured using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. The Tobit regression model and logistic regression model was used to identify the relationship between frailty and HRQoL. RESULTS Of the 229 older patients, 175 (76.4%) were frail. Frail patients had lower EQ-5D-5L utility scores than those who were non-frail (0.830 vs. 0.889; P = 0.004). After adjustments for sociodemographic and cancer-related variables, frailty was statistically associated with worse health-related quality of life (OR = 6.024; P = 0.001). CONCLUSION Frailty was associated with deteriorated HRQoL in older patients with cancer. Early frailty screening and preventive interventions are essential for improving quality of life through decision-making or pretreatment optimization in geriatric oncology.
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Affiliation(s)
- Mingzhu Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Nengliang Yao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Meimei Shang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China
| | - Yuzhen Shen
- Taian City Center Hospital, Taian, 271099, Shangdong, China
| | - Tingting Qin
- School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Jialin Wang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China.
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, Shandong, China.
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Chitalu P, Tsui A, Searle SD, Davis D. Life-space, frailty, and health-related quality of life. BMC Geriatr 2022; 22:646. [PMID: 35931955 PMCID: PMC9356461 DOI: 10.1186/s12877-022-03355-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/30/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Life-space and frailty are closely linked to health-related quality of life and understanding their inter-relationship could indicate potential intervention targets for improving quality of life. We set out to examine the relationship between frailty and life-space and their relative impact on quality of life measures. METHODS Using cross-sectional data from a population-representative cohort of people aged ≥ 70 years, we assessed quality of life with the EuroQol Health Index tool (5-levels) (EQ-5D-5L). We also undertook a life-space assessment and derived a frailty index. Linear regression models estimated EQ-5D-5L scores (dependent variable) using life-space assessment, frailty index and interactions between them. All models were adjusted by age, sex, lifestyle, and social care factors. RESULTS A higher EQ-5D Index was associated with higher life-space (0.02 per life-space assessment score, 95%CI: 0.01 to 0.03, p < 0.01) and decreasing frailty (-0.1 per SD, 95%CI: -0.1 to -0.1, p < 0.01). There was evidence of an interaction between life-space and frailty, where the steepest gradient for life-space and EQ-5D was in those with the highest frailty (interaction term = 0.02 per SD of frailty, 95%CI: 0.01 to 0.03, p < 0.01). CONCLUSION Individuals with the highest frailty were twice as likely to have higher quality of life in association with a larger life-space. Interventions designed to improve quality of life in frail older people could focus on increasing a person's life-space.
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Affiliation(s)
- Petronella Chitalu
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Alex Tsui
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Samuel D Searle
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK.,Division of Geriatric Medicine, Dalhousie University, Nova Scotia, Canada
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
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