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Fei Y, Niu S, Xi X, Tang W, Zhao Y, Zhang G, Yu X, Li C, Li X, Liu Y, Li Y, Yin Y, Cui Y, Li X. Physical frailty intensifies the positive association of oral frailty with poor global cognitive function and executive function among older adults especially for females: a cross-sectional study. BMC Geriatr 2024; 24:468. [PMID: 38811863 PMCID: PMC11134949 DOI: 10.1186/s12877-024-05056-4] [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: 01/25/2024] [Accepted: 05/08/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Oral frailty is reported to increase the risk of new onset of mild cognitive impairment. Whereas, the association of oral frailty with cognition among older adults in both physical frail and non-physical frail status has not been sufficiently explored, and whether there are sex differences in the association is unclear. This study investigated the association of oral frailty and physical frailty with global cognitive function and executive function among older adults, as well as the sex differences in such association. METHODS This cross-sectional study included 307 participants aged ≥ 60 years old from communities between June 2023 and August 2023, in Nanjing, China. Global cognitive function and executive function were assessed by using the Montreal Cognitive Assessment (MoCA) and Trail Making Tests A (TMT-A), respectively. Oral frailty was identified by the combination of natural tooth, Oral Frailty Index-8 (OFI-8), and oral diadochokinesis. Physical frailty was measured by using Fried phenotype model which contained 5 criteria: unintentional weight loss, weakness, exhaustion, slowness, and low physical activity. Multiple linear regression analyses for overall participants and stratified by sex and presence or absence of physical frailty were performed, respectively, to examine the association between oral frailty and cognitive functions. RESULTS The median age of participants was 70 years old. The study included 158 (51.5%) females, 53 (17.3%) individuals with physical frailty, and 65 (21.2%) participants with oral frailty. After adjustment, the association between oral frailty and global cognitive function was observed in the physical frailty group (B = -2.67, 95% Confidence Interval [CI]: -5.27 to -0.07, p = 0.045) and the females with physical frailty (B = -4, 95% CI: -7.41 to -0.58, p = 0.024). Oral frailty was associated with executive function in overall participants (B = 0.12, 95% CI: 0.01 to 0.22, p = 0.037), physical frailty group (B = 23.68, 95% CI: 1.37 to 45.99, p = 0.038). In the adjusted models, oral frailty was significantly associated with executive function in all females (B = 0.21, 95% CI: 0.05 to 0.36, p = 0.009), in females without physical frailty (B = 0.19, 95% CI: 0.02 to 0.36, p = 0.027), and in females with physical frailty (B = 48.69, 95% CI: 7.17 to 90.21, p = 0.024). CONCLUSIONS Physical frailty intensifies the positive association of oral frailty with poor global cognitive function and executive function among older adults, particularly among females. It is ponderable to consider sex differences and facilitate the management of physical frailty when it comes to promoting cognitive health based on the perspective of oral health among older adults.
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Affiliation(s)
- Yang Fei
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Shuzhen Niu
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Xueru Xi
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Wenping Tang
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Yue Zhao
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Ge Zhang
- Department of Geriatrics (Geriatric Neurology), the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, China
| | - Xiaohong Yu
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Cheng Li
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Xinru Li
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Ying Liu
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Yaxin Li
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Yueheng Yin
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China.
| | - Yan Cui
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China.
| | - Xianwen Li
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
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Bareiro FAQ, Carnicero JA, Acha AA, Artalejo CR, Jimenez MCG, Mañas LR, García García FJ. How cognitive performance changes according to the ankle-brachial index score in an elderly cohort? Results from the Toledo Study of Healthy Ageing. GeroScience 2024; 46:609-620. [PMID: 37870701 PMCID: PMC10828423 DOI: 10.1007/s11357-023-00966-4] [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: 05/23/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023] Open
Abstract
In the ageing process, the vascular system undergoes morphological and functional changes that may condition brain functioning; for this reason, the aims of this study were to assess the effect of vascular function indirectly measured by ankle-brachial index (ABI) on both cognitive performance at baseline and change in cognitive performance at end of follow-up. We developed a prospective, population-based, cohort study with 1147 participants aged > 65 years obtained from the Toledo Study for Healthy Ageing who had cognitive assessment and measured ABI in the first wave (2006-2009) were selected for the cross-sectional analysis. Those participants who also performed the cognitive assessment in the second wave (2011-2013) were selected for the prospective analysis. Cognitive impairment diagnosis and symptoms and/or history of cardio/neurovascular disease were used as exclusion criteria. Multivariate segmented regression model was used to assess the associations between ABI and cognitive performance in both the cross-sectional and prospective analyses. As ABI score decreased from 1.4, the cross-sectional analysis showed a higher decrease in cognitive performance and the prospective analysis showed a higher degree of worsening in cognitive performance. Our findings suggest that the ABI, a widespread measure of vascular health in primary care, may be a useful tool for predicting cognitive performance and its evolution.
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Affiliation(s)
- Fabio A Quiñónez Bareiro
- Department of Geriatrics, Hospital Virgen del Valle, Hospital Universitario de Toledo, Toledo, Spain
| | - José A Carnicero
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
- Geriatric Research Group, Biomedical Research Foundation at Getafe University Hospital, Ctra. Toledo Km. 12.5, 28905, Getafe, Spain.
| | - Ana Alfaro Acha
- Department of Geriatrics, Hospital Virgen del Valle, Hospital Universitario de Toledo, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Cristina Rosado Artalejo
- Department of Geriatrics, Hospital Virgen del Valle, Hospital Universitario de Toledo, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - María C Grau Jimenez
- Department of Geriatrics, Hospital Virgen del Valle, Hospital Universitario de Toledo, Toledo, Spain
| | - Leocadio Rodriguez Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Francisco J García García
- Department of Geriatrics, Hospital Virgen del Valle, Hospital Universitario de Toledo, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
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Effect of Exercise Cognitive Combined Training on Physical Function in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2023; 31:155-170. [PMID: 35961648 DOI: 10.1123/japa.2021-0475] [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: 12/06/2021] [Revised: 04/20/2022] [Accepted: 06/04/2022] [Indexed: 02/03/2023]
Abstract
This study aimed to evaluate the effects of exercise cognitive combined training (ECCT) compared with non-ECCT on physical function in cognitively healthy older adults. Databases were searched for randomized controlled trials from inception to December 2, 2021, and 22 studies (1,091 participants, Mage = 74.90) were included in the meta-review. The Cochrane Risk of Bias and Grading of Recommendations Assessment, Development, and Evaluation tools were used for quality assessments. ECCT improved gait speed (mean difference: 0.06 m/s, 95% CI [confidence interval] [0.02, 0.11]; 446 participants, 11 studies) and balance (standardized mean difference: 0.38, 95% CI [0.14, 0.61]; 292 participants, seven studies). Simultaneous ECCT, but not nonsimultaneous ECCT, improved gait speed (mean difference: 0.11 m/s, 95% CI [0.07, 0.15]), balance (standardized mean difference: 0.40, 95% CI [0.16, 0.64]), and functional mobility (mean difference: -0.85 s, 95% CI [-1.63, -0.07]; 327 participants, nine studies). Future research should focus on the duration and form of ECCT intervention optimal for improving the functional activities of older individuals.
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Ribeiro MLT, Almeida DMD, Voos MC. Relationship between motor coordination and executive function in adults and older adults. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21027729022022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Brazilian older adults present a relatively low schooling level when compared with other populations. In clinical practice, defining if more subtle alterations observed in executive function (EF) and motor coordination tests in older adults are due to an initial neurological condition or low schooling level is difficult. This study aimed to evaluate the possible differences in motor coordination and EF between adults and older adults with high and low schooling level as well as the possible correlations between motor coordination and EF in this sample. A total of 75 healthy individuals (aged from 30 to 89 years) were evaluated. EF was assessed by the trail making test (TMT) whereas motor coordination was assessed by the upper limb diadochokinetic test, which is the rapid alternation between supination and pronation of the forearms (right, left, both performing in-phase movements, and both performing anti-phase movements). Analysis of variance showed that age and schooling level possibly influenced EF and motor coordination. Possible relationships between EF and diadochokinesis were calculated by Pearson’s correlation. Older adults with low schooling level were significantly slower on the TMT part B (cognitive and motor) and delta TMT (cognitive). All groups were slower performing the anti-phase movement, especially those with low schooling level. Results showed only weak correlations between EF and motor coordination. Age and schooling level influenced executive function and motor coordination. However, the EF and motor coordination tests presented no correlation when these two factors were statistically corrected.
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Affiliation(s)
| | | | - Mariana Callil Voos
- Pontifícia Universidade Católica de São Paulo, Brasil; Universidade de São Paulo, Brasil
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5
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Ribeiro MLT, Almeida DMD, Voos MC. Relação entre a coordenação motora e a função executiva em adultos e idosos. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21027729022022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO A população idosa brasileira possui escolaridade relativamente baixa, quando comparada a outras populações. Na prática clínica, torna-se difícil decidir se alterações mais sutis, observadas nos testes de função executiva (FE) e coordenação motora de idosos, devem-se a um quadro neurológico inicial ou à baixa escolaridade. O objetivo do trabalho foi investigar: (1) possíveis diferenças na coordenação motora e FE de adultos e idosos com escolaridade alta e baixa; e (2) possíveis correlações entre coordenação motora e FE nessa amostra. Foram avaliados 75 indivíduos saudáveis, com idade entre 30 e 89 anos. A FE foi avaliada por meio do trail making test (TMT) e a coordenação motora foi avaliada com o teste de diadococinesia dos membros superiores, que consiste na alternância rápida entre supinação e pronação do antebraço (direito, esquerdo, de ambos os antebraços em fase, e ambos em antifase). A análise de variância investigou possíveis influências da idade e da escolaridade na FE e coordenação motora. O teste de correlação de Pearson investigou possíveis relações entre FE e diadococinesia. Idosos com escolaridade baixa foram significativamente mais lentos na parte B (cognitivo-motora) e no delta (cognitiva) do TMT. Todos os grupos foram mais lentos na condição antifase, sobretudo os idosos com escolaridade baixa. Encontramos apenas correlações fracas entre FE e coordenação motora. A idade e a escolaridade influenciaram na FE e na coordenação motora; porém, os testes de FE e coordenação motora não apresentaram correlação quando esses dois fatores foram corrigidos estatisticamente.
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Affiliation(s)
| | | | - Mariana Callil Voos
- Pontifícia Universidade Católica de São Paulo, Brasil; Universidade de São Paulo, Brasil
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6
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Wang P, Fang Y, Qi JY, Li HJ. FISHERMAN: A Serious Game for Executive Function Assessment of Older Adults. Assessment 2022:10731911221105648. [PMID: 35762827 DOI: 10.1177/10731911221105648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Executive functions (EFs) are essential for daily living activities but decline with age. Convenient assessment and timely intervention have particular significance for older adults. However, the traditional laboratory tasks of EFs are typically monotonous and inconvenient. The current study aimed to develop an interesting and convenient supplementary tool to assess EFs for older adults. According to the theory of EFs, we developed a serious game, FISHERMAN, to assess EFs. The game includes three subgames, Cautious Fisherman, Agile Fisherman, and Wise Fisherman, targeting core components of inhibition, shifting, and working memory, respectively. The current study aims to verify the reliability and validity of the game. One hundred and eight healthy older adults participated in this study and were tested through the FISHERMAN game and a battery of cognitive tests. The results show that the FISHERMAN game has high internal consistency reliability and good construct validity as well as criterion-related validity, suggesting that the game design is valid and can be used in EFs assessment for older adults. Future studies are warranted to establish the norm of the FISHERMAN game in older adults and investigate whether the FISHERMAN game can be generalized to other populations.
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Affiliation(s)
- Ping Wang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuan Fang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jing-Yi Qi
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hui-Jie Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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7
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Statsenko Y, Habuza T, Gorkom KNV, Zaki N, Almansoori TM, Al Zahmi F, Ljubisavljevic MR, Belghali M. Proportional Changes in Cognitive Subdomains During Normal Brain Aging. Front Aging Neurosci 2021; 13:673469. [PMID: 34867263 PMCID: PMC8634589 DOI: 10.3389/fnagi.2021.673469] [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: 02/27/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Neuroscience lacks a reliable method of screening the early stages of dementia. Objective: To improve the diagnostics of age-related cognitive functions by developing insight into the proportionality of age-related changes in cognitive subdomains. Materials and Methods: We composed a battery of psychophysiological tests and collected an open-access psychophysiological outcomes of brain atrophy (POBA) dataset by testing individuals without dementia. To extend the utility of machine learning (ML) classification in cognitive studies, we proposed estimates of the disproportional changes in cognitive functions: an index of simple reaction time to decision-making time (ISD), ISD with the accuracy performance (ISDA), and an index of performance in simple and complex visual-motor reaction with account for accuracy (ISCA). Studying the distribution of the values of the indices over age allowed us to verify whether diverse cognitive functions decline equally throughout life or there is a divergence in age-related cognitive changes. Results: Unsupervised ML clustering shows that the optimal number of homogeneous age groups is four. The sample is segregated into the following age-groups: Adolescents ∈ [0, 20), Young adults ∈ [20, 40), Midlife adults ∈ [40, 60) and Older adults ≥60 year of age. For ISD, ISDA, and ISCA values, only the median of the Adolescents group is different from that of the other three age-groups sharing a similar distribution pattern (p > 0.01). After neurodevelopment and maturation, the indices preserve almost constant values with a slight trend toward functional decline. The reaction to a moving object (RMO) test results (RMO_mean) follow another tendency. The Midlife adults group's median significantly differs from the remaining three age subsamples (p < 0.01). No general trend in age-related changes of this dependent variable is observed. For all the data (ISD, ISDA, ISCA, and RMO_mean), Levene's test reveals no significant changes of the variances in age-groups (p > 0.05). Homoscedasticity also supports our assumption about a linear dependency between the observed features and age. Conclusion: In healthy brain aging, there are proportional age-related changes in the time estimates of information processing speed and inhibitory control in task switching. Future studies should test patients with dementia to determine whether the changes of the aforementioned indicators follow different patterns.
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Affiliation(s)
- Yauhen Statsenko
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tetiana Habuza
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Klaus Neidl-Van Gorkom
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nazar Zaki
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Taleb M Almansoori
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fatmah Al Zahmi
- Department of Neurology, Mediclinic Middle East Parkview Hospital, Dubai, United Arab Emirates.,Department of Clinical Science, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Milos R Ljubisavljevic
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maroua Belghali
- College of Education, United Arab Emirates University, Al Ain, United Arab Emirates
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Wu C. The mediating and moderating effects of depressive symptoms on the prospective association between cognitive function and activities of daily living disability in older adults. Arch Gerontol Geriatr 2021; 96:104480. [PMID: 34274875 DOI: 10.1016/j.archger.2021.104480] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This study aimed to examine to what extent depressive symptoms mediated and moderated the association between cognitive function and activities of daily living (ADL) disability in older adults. METHODS In older participants from the China Health and Longitudinal Retirement Survey (CHARLS), structural equation modeling and multiple regression were performed to examine the mediating and moderating role of depressive symptoms (measured by the 10-item Center for Epidemiologic Studies Depression Scale) in the association between baseline cognitive function (episodic memory, attention, orientation to time, and visuospatial ability) and endpoint disability in basic ADL (BADL) or instrumental ADL (IADL). RESULTS Over a 2-year follow-up, among 1677 participants (67.5 ± 6.0 years old) free of BADL disability and 1194 participants (66.9 ± 5.6 years old) free of IADL disability, 8.3% and 22.9% developed BADL disability and IADL disability, respectively. Good baseline cognitive performance was significantly associated with the reduced incidence of BADL/IADL disability. The indirect effects of baseline depressive symptoms explained 16.9% and 14.5% of the total effect between cognition and BADL and IADL dependency, respectively. The Johnson-Neyman technique identified a threshold of 7.88 for endpoint depressive symptoms, beyond which the protective effect of baseline cognitive function on BADL emerged. CONCLUSIONS In older adults, good cognitive function reduces the risk of BADL/IADL disability. Depressive symptoms downregulate the protective effect of cognitive function on BADL/IADL over time. Intervention techniques focusing on the simultaneous improvement of cognitive dimensions and depression help improve ADL difficulty and prevent disability in older adults.
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Affiliation(s)
- Chao Wu
- Peking University School of Nursing, Beijing, 100191, China.
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9
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Segaux L, Broussier A, Oubaya N, Leissing-Desprez C, Laurent M, Naga H, Fromentin I, David JP, Bastuji-Garin S. Several frailty parameters highly prevalent in middle age (50-65) are independent predictors of adverse events. Sci Rep 2021; 11:8774. [PMID: 33888851 PMCID: PMC8062562 DOI: 10.1038/s41598-021-88410-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 04/09/2021] [Indexed: 12/26/2022] Open
Abstract
Although frailty can arise in middle age, very few studies have investigated frailty before 65 years. Our objectives were to assess the prevalence of frailty parameters in middle-aged individuals and probe the association with future adverse events. We performed cross-sectional and longitudinal analyses of community-dwelling individuals aged 50 to 65 (n = 411, median age: 59.0) having undergone a multidomain geriatric assessment (2010–2015) in an outpatient clinic in the greater Paris area of France (SUCCEED cohort). The primary outcome was a composite measure of adverse events (non-accidental falls, fractures, unplanned hospitalizations, death), recorded in 2016/2017. Multivariable logistic regression models were built to identify independent predictors. Six frailty parameters were highly prevalent (> 20%): low activity (40.1%), exhaustion (31.3%), living alone (28.5%), balance impairment (26.8%), weakness (26.7%), and executive dysfunction (23.2%). Female sex (odds ratio: 2.67 [95% confidence interval: 1.17–6.11]), living alone (2.39 [1.32–4.33]), balance impairment (2.09 [1.16–3.78]), executive dysfunction (2.61, [1.18–5.77]), and exhaustion (2.98 [1.65–5.39]) were independent predictors of adverse events. Many frailty parameters are already altered in middle-aged individuals and are predictive of adverse health events. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged individuals.
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Affiliation(s)
- Lauriane Segaux
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France. .,Clinical Research Unit (URC Mondor), AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil Cedex, France.
| | - Amaury Broussier
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Nadia Oubaya
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Department of Public Health, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France
| | - Claire Leissing-Desprez
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Marie Laurent
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Henri Naga
- Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Isabelle Fromentin
- Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Jean-Philippe David
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Sylvie Bastuji-Garin
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Clinical Research Unit (URC Mondor), AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil Cedex, France.,Department of Public Health, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France
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10
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Mello BHD, Lenardt MH, Moraes DC, Setoguchi LS, Seima MD, Betiolli SE. Cognitive impairment and physical frailty in older adults in secondary health care. Rev Esc Enferm USP 2021; 55:e03687. [PMID: 33886914 DOI: 10.1590/s1980-220x2019029803687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 09/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the association between cognitive impairment and physical frailty in older adults in secondary health care. METHOD This is a cross-sectional study carried out with people aged ≥ 60 years, assisted at a geriatric and gerontology outpatient clinic. For cognitive screening, the Mini Mental State Examination, the semantic verbal fluency test, and frailty assessment using the physical frailty phenotype were used. The likelihood ratio test was applied to the predictive model. RESULTS 407 older adults participated in the study. Cognitive impairment was observed in 58.5% (n=238) of the sample, being higher in frail (n=66; 75%). A change in the semantic verbal fluency test was identified in 22% (n=90), with a higher prevalence in pre-frail patients (55.5%; n=226). It was identified 2.5 times more chance of a frail older person, when compared to a non-frail one, to have cognitive impairment (95% CI, +0.947 - 0.322). The chance for alteration in the semantic verbal fluency test was 5.4 times higher in frail compared to non-frail ones (95% CI, 1.68 - 0.38). CONCLUSION A relationship was observed between cognitive impairment and physical frailty. Screening for frailty in geriatric nursing practice and the implementation of specific care is recommended.
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Affiliation(s)
- Bruno Henrique de Mello
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | - Maria Helena Lenardt
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | - Dayana Cristina Moraes
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | | | - Marcia Daniele Seima
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | - Susanne Elero Betiolli
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
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11
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Suárez-Méndez I, Walter S, López-Sanz D, Pasquín N, Bernabé R, Castillo Gallo E, Valdés M, Del Pozo F, Maestú F, Rodríguez-Mañas L. Ongoing Oscillatory Electrophysiological Alterations in Frail Older Adults: A MEG Study. Front Aging Neurosci 2021; 13:609043. [PMID: 33679373 PMCID: PMC7935553 DOI: 10.3389/fnagi.2021.609043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The role of the central nervous system in the pathophysiology of frailty is controversial. We used magnetoencephalography (MEG) to search for abnormalities in the ongoing oscillatory neural activity of frail individuals without global cognitive impairment. Methods: Fifty four older (≥70 years) and cognitively healthy (Mini-Mental State Examination ≥24) participants were classified as robust (0 criterion, n = 34) or frail (≥ 3 criteria, n = 20) following Fried's phenotype. Memory, language, attention, and executive function were assessed through well-validated neuropsychological tests. Every participant underwent a resting-state MEG and a T1-weighted magnetic resonance imaging scan. We performed MEG power spectral analyses to compare the electrophysiological profiles of frail and robust individuals. We used an ensemble learner to investigate the ability of MEG spectral power to discriminate frail from robust participants. Results: We identified increased relative power in the frail group in the mu (p < 0.05) and sensorimotor (p < 0.05) frequencies across right sensorimotor, posterior parietal, and frontal regions. The ensemble learner discriminated frail from robust participants [area under the curve = 0.73 (95% CI = 0.49–0.98)]. Frail individuals performed significantly worse in the Trail Making Test, Digit Span Test (forward), Rey-Osterrieth Complex Figure, and Semantic Fluency Test. Interpretation: Frail individuals without global cognitive impairment showed ongoing oscillatory alterations within brain regions associated with aspects of motor control, jointly to failures in executive function. Our results suggest that some physical manifestations of frailty might partly arise from failures in central structures relevant to sensorimotor and executive processing.
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Affiliation(s)
- Isabel Suárez-Méndez
- Laboratory of Cognitive and Computational Neuroscience (Complutense University of Madrid - Universidad Politécnica de Madrid), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Structure of Matter, Thermal Physics and Electronics, Complutense University of Madrid (UCM), Madrid, Spain.,Department of Experimental Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Stefan Walter
- Foundation for Biomedical Research, University Hospital of Getafe, Getafe, Spain.,Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Spain.,Department of Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain
| | - David López-Sanz
- Laboratory of Cognitive and Computational Neuroscience (Complutense University of Madrid - Universidad Politécnica de Madrid), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Psychobiology and Methodology in Behavioral Sciences, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Natalia Pasquín
- Foundation for Biomedical Research, University Hospital of Getafe, Getafe, Spain
| | - Raquel Bernabé
- Foundation for Biomedical Research, University Hospital of Getafe, Getafe, Spain
| | | | - Myriam Valdés
- Foundation for Biomedical Research, University Hospital of Getafe, Getafe, Spain.,Geriatric Service, University Hospital of Getafe, Getafe, Spain
| | - Francisco Del Pozo
- Laboratory of Cognitive and Computational Neuroscience (Complutense University of Madrid - Universidad Politécnica de Madrid), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience (Complutense University of Madrid - Universidad Politécnica de Madrid), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Experimental Psychology, Complutense University of Madrid (UCM), Madrid, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain
| | - Leocadio Rodríguez-Mañas
- Foundation for Biomedical Research, University Hospital of Getafe, Getafe, Spain.,Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Spain.,Geriatric Service, University Hospital of Getafe, Getafe, Spain
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12
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Comparison of Traditional Chinese Exercises and Nontraditional Chinese Exercise Modalities on Cognitive and Executive Function in Community Middle-Aged and Older Adults: A Cross-Sectional Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4380805. [PMID: 33299452 PMCID: PMC7704149 DOI: 10.1155/2020/4380805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/21/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022]
Abstract
Background Current evidence indicates that regular exercise can have a positive impact on cognitive function in older adults, but whether different exercise modalities may induce differential protective effects in different cognitive domains is uncertain. Objective To compare the effect of traditional Chinese exercise (TCE) modalities and non-traditional Chinese exercise (non-TCE) modalities on cognitive and executive function in community middle-aged and older adults through a cross-sectional study. Methods A total of 350 community middle-aged and older adults aged over 55 years participated in this study. Information on demographic characteristics, lifestyle and behavioural habits, and regular exercise was collected by a self-designed questionnaire. Global cognitive ability and executive function were assessed using the Montreal Cognitive Assessment (MoCA) scale, the clock drawing test (CDT), the animal naming test (ANT), and the trail making test (TMT). Eligible subjects were categorized into the no regular exercise (no-RE), non-TCE, or TCE groups according to their self-reported exercise information. Comparisons of global cognitive and executive function among the three groups were conducted using ANOVA or the general linear model with adjustment for potential confounding factors. Results The results showed that for the non-TCE or TCE groups, the MoCA and CDT scores were significantly higher, and the TMT-A test time was significantly shorter than those in the no-RE group (all P < 0.05), but no significant difference was observed for the TMT-B and ANT tests. After adjustment for potential confounding factors, the MoCA, the CDT, and TMT-A scores in the TCE group were significant compared to those in the no-RE group. In addition, subgroup analysis showed that in the TCE group, the MoCA scores were significantly higher than those in the non-TCE group. Furthermore, in the TCE group, the CDT scores for those with an exercise duration of <5 years were higher and the TMT-A test time for those with an exercise duration of ≥5 years was shorter than those in the non-TCE group. Conclusions Both TCE and non-TCE have potential protective effects on global cognitive and executive function in community middle-aged and older adults. Compared to the non-TCE modality, the TCE modality may have a more positive association with these protective effects. Furthermore, prospective studies are needed to confirm these findings.
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13
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Palermo S. Covid-19 Pandemic: Maximizing Future Vaccination Treatments Considering Aging and Frailty. Front Med (Lausanne) 2020; 7:558835. [PMID: 33072783 PMCID: PMC7530612 DOI: 10.3389/fmed.2020.558835] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/02/2020] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic is proving to be a multiplier of inequalities. Especially toward the elderly population. A voiceless scream that comes from geriatrics, nursing homes, hospices from all over Italy. They call it the silent massacre: from North to South, the bulletin of coronavirus positive—or already deceased—elderly people continues to grow exponentially without a chance to counter it. Population aging and chronicity are a question that needs to be addressed. Frailty is the most challenging expression of population aging, with major consequences for public health and clinical practice. It is a geriatric syndrome which consists in a state of higher vulnerability to stressors attributed to a lower homeostatic reserve due to an age-related multisystem physiological change. People over 60, and especially over 80, are particularly vulnerable to severe or fatal infection. Moreover, the age-related dysregulation of the immune system in the elderly (i.e., immunosenescence and inflammaging) results in poorer responses to vaccination. Physical frailty is an effective health indicator and it has previously shown to predict the response to the seasonal flu vaccine. These findings suggest that assessing frailty in the elderly may identify those who are less likely to respond to immunization and be at higher risk for COVID-19 and its complications. Moreover, cognitive frailty and neurocognitive disorders, mental health and reduced awareness of illness negatively impact on adherence to complex medication regimens among elderly patients. A worldwide research and development blueprint have been initiated to accelerate the development of vaccines and therapeutics for the COVID-19 outbreak. Considered the above, I suggest the importance to consider aging in thinking about future Civud-19 vaccination and treatment, focusing on the possible impact of physical and cognitive frailty.
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Affiliation(s)
- Sara Palermo
- Department of Psychology, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Aging, Bruxelles, Belgium
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14
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Rouch I, Padovan C, Boublay N, Pongan E, Laurent B, Trombert-Paviot B, Krolak-Salmon P, Dorey JM. Association between executive function and the evolution of behavioral disorders in Alzheimer's disease. Int J Geriatr Psychiatry 2020; 35:1043-1050. [PMID: 32383491 DOI: 10.1002/gps.5327] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/18/2020] [Accepted: 04/25/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study was aimed at evaluating the association between cognitive functioning and the occurrence of behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD). METHODS/DESIGN The population is derived from the PACO cohort, including 237 patients with prodromal or mild AD. A neuropsychological tests battery exploring verbal and visual memory, language, attention, and executive functions was performed at baseline. BPSD were assessed at 6-, 12-, and 18-month follow-up with neuropsychiatric inventory (NPI). RESULTS Lower baseline performance on Stroop test interference score was associated with higher subsequent overall NPI scores (P = .006), subscores of anxiety/depression (P = .03), and apathy inventory (P = .01). Conversely, other executive functions, verbal or visual memory, and language performances were not associated with a higher risk of BPSD. CONCLUSION Our results suggest that poorer inhibition performance would be associated with a higher risk of 18-month BPSD occurrence, including anxiety, depression, and apathy. A better knowledge of the predictive factors of the BPSDs would make it possible to better identify the patients at risk, to propose preventive strategies and an earlier adapted care. J Am Geriatr Soc 68:-, 2020.
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Affiliation(s)
- Isabelle Rouch
- Memory Clinical and Research Center of Saint-Etienne (CMRR), Neurology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France.,Memory Clinical and Research Center of Lyon (CMRR), Aging Institute I-Vie, University Hospital of Lyon, Villeurbanne, France
| | - Catherine Padovan
- Aging Psychiatry Unit, University Hospital Le Vinatier, Bron, France.,DIPHE Laboratory, Lyon 2 University, Lyon, France
| | - Nawèle Boublay
- Memory Clinical and Research Center of Lyon (CMRR), Aging Institute I-Vie, University Hospital of Lyon, Villeurbanne, France
| | - Elodie Pongan
- Memory Clinical and Research Center of Saint-Etienne (CMRR), Neurology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France.,Memory Clinical and Research Center of Lyon (CMRR), Aging Institute I-Vie, University Hospital of Lyon, Villeurbanne, France
| | - Bernard Laurent
- Memory Clinical and Research Center of Saint-Etienne (CMRR), Neurology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France.,Neuropain Team, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, Lyon, France
| | - Béatrice Trombert-Paviot
- Public Health and Medical Information Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pierre Krolak-Salmon
- Memory Clinical and Research Center of Lyon (CMRR), Aging Institute I-Vie, University Hospital of Lyon, Villeurbanne, France.,Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, Lyon, France
| | - Jean-Michel Dorey
- Aging Psychiatry Unit, University Hospital Le Vinatier, Bron, France.,Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, Lyon, France
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15
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García-García FJ, Carnicero JA, Losa-Reyna J, Alfaro-Acha A, Castillo-Gallego C, Rosado-Artalejo C, Gutiérrrez-Ávila G, Rodriguez-Mañas L. Frailty Trait Scale–Short Form: A Frailty Instrument for Clinical Practice. J Am Med Dir Assoc 2020; 21:1260-1266.e2. [DOI: 10.1016/j.jamda.2019.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/04/2019] [Accepted: 12/09/2019] [Indexed: 12/26/2022]
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16
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Lin WC, Huang YC, Leong CP, Chen MH, Chen HL, Tsai NW, Tso HH, Chen PC, Lu CH. Associations Between Cognitive Functions and Physical Frailty in Patients With Parkinson's Disease. Front Aging Neurosci 2019; 11:283. [PMID: 31736737 PMCID: PMC6831640 DOI: 10.3389/fnagi.2019.00283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/03/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Parkinson’s disease (PD) is a neurodegenerative disease manifested by both motor and non-motor dysfunctions and co-existence of cognitive impairment and physical frailty is common. Given that research in this area is limited, a better understanding of associated factors with physical frailty could provide a focused screening method and facilitate early intervention in PD. Methods: Seventy-six patients with idiopathic PD were recruited and Fried’s criteria of physical frailty were used to group all participants. Comprehensive cognitive tests and clinical characteristics were measured, and univariate and multivariate analysis was performed to explore the relationship between clinical factors or neuropsychological functions. Results: Twenty-nine patients with PD (38%) exhibited physical frailty. Compared to PD patients without frailty, PD patients with frailty were older in age and demonstrated worse disease severity and poorer cognitive functions, including attention, executive function, memory, speech and language, and visuospatial function (p < 0.05). Further, stepwise logistic regression analysis revealed that disease severity by the Unified Parkinson’s Disease Rating Scale (UPDRS) total score (OR: 1.065; 95% CI: 1.033–1.099) and executive function (OR: 0.724; 95% CI: 0.581–0.877) were independent risk factors for predicting physical frailty (p = 0.003 and 0.002). The best cut-off points are 46 in UPDRS (sensitivity: 62.1%; specificity: 91.5%). Conclusions: Executive function impairment is an independent risk factor for the development of physical frailty with disease progression. Awareness of such comorbidity might provide a screening tool to facilitate investigation in their underlying etiology and early intervention for frailty prevention.
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Affiliation(s)
- Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Chi Huang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chau-Peng Leong
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsiu-Ling Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Nai-Wen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui-Hsin Tso
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Po-Cheng Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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17
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Sadiq F, Kronzer VL, Wildes TS, McKinnon SL, Sharma A, Helsten DL, Scheier LM, Avidan MS, Ben Abdallah A. Frailty Phenotypes and Relations With Surgical Outcomes: A Latent Class Analysis. Anesth Analg 2019; 127:1017-1027. [PMID: 30113393 DOI: 10.1213/ane.0000000000003695] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Frailty is an important concept in the care of older adults although controversy remains regarding its defining features and clinical utility. Both the Fried phenotype and the Rockwood deficit accumulation approaches cast frailty as a "burden" without exploring the relative salience of its cardinal markers and their relevance to the patient. New multifactorial perspectives require a reliable assessment of frailty that can validly predict postoperative health outcomes. METHODS In a retrospective study of 2828 unselected surgical patients, we used item response theory to examine the ability of 32 heterogeneous markers capturing limitations in physical, functional, emotional, and social activity domains to indicate severity of frailty as a latent continuum. Eighteen markers efficiently indicated frailty severity and were then subject to latent class analysis to derive discrete phenotypes. Next, we validated the obtained frailty phenotypes against patient-reported 30-day postoperative outcomes using multivariable logistic regression. Models were adjusted for demographics, comorbidity, type and duration of surgery, and cigarette and alcohol consumption. RESULTS The 18 markers provided psychometric evidence of a single reliable continuum of frailty severity. Latent class analyses produced 3 distinct subtypes, based on patients' endorsement probabilities of the frailty indicators: not frail (49.7%), moderately frail (33.5%), and severely frail (16.7%). Unlike the moderate class, severely frail endorsed emotional health problems in addition to physical burdens and functional limitations. Models adjusting for age, sex, type of anesthesia, and intraoperative factors indicated that severely frail (odds ratio, 1.89; 95% confidence interval, 1.42-2.50) and moderately frail patients (odds ratio, 1.31; 95% confidence interval, 1.03-1.67) both had higher odds of experiencing postoperative complications compared to not frail patients. In a 3-way comparison, a higher proportion of severely frail patients (10.7%) reported poorer quality of life after surgery compared to moderately frail (9.2%) and not frail (8.3%) patients (P < .001). There was no significant difference among these groups in proportions reporting hospital readmission (5.6%, 5.1%, and 3.8%, respectively; P = .067). CONCLUSIONS Self-report frailty items can accurately discern 3 distinct phenotypes differing in composition and their relations with surgical outcomes. Systematically assessing a wider set of domains including limitations in functional, emotional, and social activities can inform clinicians on what precipitates loss of physiological reserve and profoundly influences patients' lives. This information can help guide the current discussion on frailty and add meaningful clinical tools to the surgical practice.
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Affiliation(s)
- Furqaan Sadiq
- From the Department of Anesthesiology, Institute of Quality Improvement, Research & Informatics (INQUIRI), Washington University School of Medicine, St Louis, Missouri
| | | | - Troy S Wildes
- From the Department of Anesthesiology, Institute of Quality Improvement, Research & Informatics (INQUIRI), Washington University School of Medicine, St Louis, Missouri
| | - Sherry L McKinnon
- From the Department of Anesthesiology, Institute of Quality Improvement, Research & Informatics (INQUIRI), Washington University School of Medicine, St Louis, Missouri
| | - Anshuman Sharma
- From the Department of Anesthesiology, Institute of Quality Improvement, Research & Informatics (INQUIRI), Washington University School of Medicine, St Louis, Missouri
| | - Daniel L Helsten
- From the Department of Anesthesiology, Institute of Quality Improvement, Research & Informatics (INQUIRI), Washington University School of Medicine, St Louis, Missouri
| | | | - Michael S Avidan
- From the Department of Anesthesiology, Institute of Quality Improvement, Research & Informatics (INQUIRI), Washington University School of Medicine, St Louis, Missouri
| | - Arbi Ben Abdallah
- From the Department of Anesthesiology, Institute of Quality Improvement, Research & Informatics (INQUIRI), Washington University School of Medicine, St Louis, Missouri
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Vellas M, Fualdes C, Morley JE, Dray C, Rodriguez-Manas L, Meyer A, Michel L, Rolland Y, Gourinat Y. Aeroaging - A New Collaboration between Life Sciences Experts and Aerospace Engineers. J Nutr Health Aging 2017; 21:1024-1030. [PMID: 29083444 DOI: 10.1007/s12603-017-0969-1] [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] [Indexed: 10/18/2022]
Abstract
An open discussion between experts from life sciences and aeronautics has been held in order to investigate how both area of research overlap and could be relevant to each other, precisely on the topic of aging. Similarities in aging processes and prediction methodologies have been identified between human aging and aircraft aging. Two axis of collaboration have been raised: 1) The identification of the determinants in Aircraft aging (structural aging). 2) The development of P4 Systems medicine inspired new methodologies in the predictive maintenance.
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Affiliation(s)
- M Vellas
- M. Vellas, ISAE-SUPAERO DMSM, Institut Clément Ader (UMR CNRS 5312), Université de Toulouse, France,
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