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Sun Q, Xia X, He F. Longitudinal association between Body mass index (BMI), BMI trajectories and the risk of frailty among older adults: A systematic review and meta-analysis of prospective cohort studies. Arch Gerontol Geriatr 2024; 124:105467. [PMID: 38728821 DOI: 10.1016/j.archger.2024.105467] [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: 01/16/2024] [Revised: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE We aimed to determine whether BMI categories and BMI trajectories were longitudinally associated with frailty in older adults via systematic review and meta-analysis of prospective cohort studies. METHOD 3 databases (PubMed/MEDLINE, EMBASE and Web of Science) were systematically searched from inception to 8 September 2023. Two independent reviewers extracted data and appraised study quality. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Data were pooled using random-effects models. RESULTS 7 prospective cohort studies with 23043 participants were included in final BMI categories analyses, and 3 studies included BMI trajectory(23725 individuals). Compared with normal weight, we found a positive association between obesity (odds ratios(OR) = 1.74, 95 % confidence interval (CI): 1.21-2.51, P = 0.003), underweight (OR = 1.70, 95 % CI: 1.13-2.57, P = 0.011) and frailty in older adults. In middle age subgroup, compared with normal weight, OR of 2.21 (95 % CI: 1.44-3.38;I2 = 0 %) for overweight and OR of 5.20 (95 % CI: 2.56-10.55; I2 = 0 %) for obesity were significantly associated with frailty. In old age subgroup, compared with normal weight, only OR of 1.41 (95 % CI: 1.13-1.77; I2 = 65 %) for obesity was significantly associated with frailty. The results of BMI trajectories found that decreasing BMI (OR = 3.25, 95 % CI: 2.20-4.79, P < 0.0001) and consistently high BMI (OR = 3.66, 95 % CI: 2.03-6.61, P < 0.0001) increase the risk of frailty compared to consistently normal or overweight. CONCLUSION Overweight and obesity in middle age were associated with significantly higher frailty in older adults, while obesity and underweight in old age were associated with relatively higher frailty in older adults. Early weight control may be beneficial for old age.
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Affiliation(s)
- Qianqian Sun
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xin Xia
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Fuqian He
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Hsiao ML, Su CY, Loh CH, Kao SL. Effects of integrated care with case management and nutritional counselling for frail older adults with nutritional risk in the primary care setting. Fam Pract 2024:cmae011. [PMID: 38423070 DOI: 10.1093/fampra/cmae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The effects of integrated care with case management and nutritional counselling for frail patients with nutritional risk are unclear. OBJECTIVES To assess the impact of the integrated care model for frail patients with nutritional risk in the primary care setting. METHODS This was a retrospective observational study. We enrolled 100 prefrail or frail patients according to Clinical Frailty Scale (CFS) aged ≥ 60 years with nutritional risk from the geriatric clinic. We implemented the frailty intervention model, including integrated care with comprehensive geriatric assessments (CGA), case management, and nutritional counselling by the dietitian. We obtained measures of CGA components, physical performance, body mass index (BMI), and daily caloric intake before and after the 2-month care program. We used the Wilcoxon signed-rank test to analyse differences after the care program and applied multiple linear regression to determine the predictive factors for CFS improvement. RESULTS Among the 100 patients (mean age, 75.0 ± 7.2 years; females, 71.0%; frail patients, 26%), 93% improved their CFS status, and 91% achieved > 80% of recommended daily caloric intake after the care program. The Mini Nutritional Assessment Short-Form significantly improved after the program. BMI and daily caloric intake increased significantly after nutritional counselling. The post-test short physical performance battery (SPPB) significantly increased with a faster 4 m gait speed. Baseline poor CFS was a significant predictor for CFS improvement. CONCLUSIONS Integrated care with case management and nutritional counselling for prefrail and frail patients with nutritional risk in the primary care setting may improve physical performance and nutritional status.
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Affiliation(s)
- Mei-Lan Hsiao
- Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan
| | - Chen-Ying Su
- Department of Nutrition, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan
| | - Ching-Hui Loh
- Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707 Sec. 3, Chung Yang Rd., Hualien 970, Taiwan
- Department of Family Medicine, College of Medicine, Tzu Chi University, No. 701, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan
| | - Sheng-Lun Kao
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707 Sec. 3, Chung Yang Rd., Hualien 970, Taiwan
- Department of Family Medicine, College of Medicine, Tzu Chi University, No. 701, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan
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Cano-Ibáñez N, Bueno-Cavanillas A. Lifestyle Interventions in an Aged Population: Challenges and Opportunities from a Public Health Perspective. Nutrients 2024; 16:173. [PMID: 38202002 PMCID: PMC10780799 DOI: 10.3390/nu16010173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
In recent decades, the prevalence of non-communicable diseases (NCDs) such as obesity, type 2 diabetes mellitus, cancer and cardiovascular disease has increased worldwide [...].
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Affiliation(s)
- Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs. GRANADA), Complejo Hospitales Universitarios de Granada/Universidad de Granada, 18071 Granada, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs. GRANADA), Complejo Hospitales Universitarios de Granada/Universidad de Granada, 18071 Granada, Spain
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Slagel IC, Hatcher V, Romanowski KS, Skeete DA, Galet C. Frailty in mid-life predicts outcome following trauma. Eur J Trauma Emerg Surg 2022; 49:1071-1078. [PMID: 36266479 DOI: 10.1007/s00068-022-02145-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/14/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Midlife adults (50-64 y) are at risk for falls and subsequent injury; yet current guidance on fall screening only pertains to older adults (> 65 y). Herein, we evaluated whether frailty was predictive of readmission for falls in midlife trauma patients. STUDY DESIGN This was a retrospective cohort study of trauma midlife patients admitted for traumatic injuries from 2010 to 2015. Demographics, injury data, fall history, and post-index readmission for falls were collected from medical records. Frailty scores were calculated retrospectively using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS). The association between frailty and outcomes was assessed. p < 0.05 was considered significant. RESULTS A total of 326 midlife patients were included, 54% were considered fit, 33.7% pre-frail, and 12.3% frail. Compared to their fit and pre-frail counterparts, frail patients were more likely to be female (67.5% vs. 46.3% vs. 36.3%, p < 0.001), have a history of fall (22.5% vs. 15.5% vs. 6.2%, p < 0.001), and to have suffered a ground level fall on index admission (52.5% vs. 20% vs. 5.7%, p < 0.001). Controlling for age, BMI, gender, race, and fall history, frailty was associated with readmission of midlife adults for falls (OR = 1.82 [1.23-2.69]; p = 0.003) and discharge to skilled nursing facilities (OR = 26.86 [8.03-89.81], p < 0.001). CONCLUSIONS Pre-injury frailty may be an effective tool to predict risk of readmission for fall and discharge disposition in midlife trauma patients.
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Affiliation(s)
- Isaac C Slagel
- Division of Acute Care Surgery, Department of Surgery, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Victor Hatcher
- Division of Vascular Surgery, Department of Surgery, University of Iowa, Iowa City, IA, USA
| | - Kathleen S Romanowski
- Division of Burn Surgery, Department of Surgery, University of California, Davis, Sacramento, CA, USA
| | - Dionne A Skeete
- Division of Acute Care Surgery, Department of Surgery, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Colette Galet
- Division of Acute Care Surgery, Department of Surgery, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
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Aşık Z, Kılınç Ş, Kurşun Ö, Özen M. Validation of the Clinical Frailty Scale version 2.0 in Turkish older patients. Geriatr Gerontol Int 2022; 22:730-735. [PMID: 35871523 DOI: 10.1111/ggi.14445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 11/26/2022]
Abstract
AIM Frailty is a syndrome that affects certain older adults more than others, and it has physical, cognitive, psychological, social and environmental aspects. The aim of our study was to determine the validity and reliability of the Clinical Frailty Scale (CFS) version 2.0 in Turkish. In total, 204 older adults aged ≥65 years took part in this study. METHODS The necessary permissions were obtained from Rockwood et al. The Turkish version of CFS version 2.0 had been appropriately translated through translation to the back-translation process. A questionnaire was used to investigate certain descriptive features, as well as the newly edited Turkish translation of CFS version 2.0, the Turkish version of the FRAIL Scale and the Turkish version of the Edmonton Frail Scale. RESULTS The age range was 65-95 years. In a Pearson correlation analysis, a positive link was discovered between FRAIL and CFS (r = 0.761 and P = 0.000) as well as CFS and Edmonton (r = 0.895 and P = 0.000). CONCLUSION The Turkish translation of CFS version 2.0 has been determined to be suitable, valid and reliable for use in frailty screening in outpatient clinics. Geriatr Gerontol Int 2022; 22: 730-735.
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Affiliation(s)
- Zeynep Aşık
- Department of Family Medicine Antalya Training and Research Hospital Antalya Turkey
| | - Şule Kılınç
- Department of Family Medicine Karaman Sarıveliler Country State Hospital Sarıveliler Turkey
| | - Özge Kurşun
- Department of Family Medicine Çaldıran Soğuksu Family Health Center Çaldıran Turkey
| | - Mehmet Özen
- Department of Family Medicine Antalya Training and Research Hospital Antalya Turkey
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Chang HC, Lu YY, Kao SL. Association of frailty and functional recovery in an Acute Care for Elders unit: a prospective observational study. BMC Geriatr 2022; 22:608. [PMID: 35864478 PMCID: PMC9306076 DOI: 10.1186/s12877-022-03290-2] [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: 10/24/2021] [Accepted: 07/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background Evidence on the effects of Acute Care for Elders (ACE) units in frail older adults remains limited. Therefore, we aimed to evaluate the effects of the ACE unit on functional outcomes in frail older adults. Methods In this prospective observational study, we enrolled 114 consecutive patients aged 65 years and older admitted to the ACE unit for acute medical conditions between October 2019 and September 2020. The FRAIL scale (5-question assessment of fatigue, resistance, aerobic capacity, illnesses, and loss of weight) was used to classify the patients into three groups: robust (score = 0, n = 28), prefrail (score = 1–2, n = 57), and frail (score = 3–5, n = 29). The primary outcome was the activities of daily living (ADL) measured by the Barthel Index at admission and before discharge. Paired sample t-test was employed to determine the difference in ADL. Multiple linear regression analysis, with adjustment for covariates, was conducted to examine the association between frailty status and change in ADL. Results Among 114 patients enrolled (mean age, 79.8 ± 8.1 years; mean length of stay, 6.4 ± 5.6 days), 77 (67.5%) were female. ADL at admission (60.3 ± 31.9) and before discharge (83.7 ± 21.6) were significantly different (P < 0.001). After covariates adjustment, a significant association between frailty status and change in ADL was found (prefrail vs. robust: β = 9.0, 95% confidence interval [CI] 0.3–17.6, P = 0.04; frail vs. robust: β = 13.4, 95% CI 2.7–24.0, P = 0.01). Conclusions Older adults with frailty experienced functional improvement after admission to the ACE unit. Prefrail and frail groups were associated with a more significant change in ADL between admission and discharge compared to the robust group.
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Affiliation(s)
- Hsiao-Chen Chang
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd, Hualien, 97002, Taiwan
| | - Yi-Yen Lu
- Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Sheng-Lun Kao
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd, Hualien, 97002, Taiwan. .,Department of Family Medicine, Tzu Chi University, Hualien, Taiwan. .,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
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Anderson S, Parmar J, L’Heureux T, Dobbs B, Charles L, Tian PGJ. Family Caregiving during the COVID-19 Pandemic in Canada: A Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8636. [PMID: 35886490 PMCID: PMC9317413 DOI: 10.3390/ijerph19148636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022]
Abstract
Family caregiving is a public health issue because of caregivers' significant contribution to the health and social care systems, as well as the substantial impact that giving and receiving care has on the health and quality of life of care receivers and caregivers. While there have been many studies that associate caregivers' care work, financial difficulty, navigation, and other caregiving factors with family caregivers' psychological distress, we were interested not only in the factors related to family caregiver anxiety but also in hypothesizing how those effects occur. In this study, we used Andrew Hayes' PROCESS moderation analysis to explore the link between caregiver frailty, weekly care hours, and perceptions of financial difficulty, social support, and anxiety. In this analysis, we included 474 caregivers with relatively complete data on all of the variables. In regression analysis after controlling for gender and age, social loneliness (β = 0.245), frailty (β = 0.199), financial difficulty (β = 0.196), care time (β = 0.143), and navigation confidence (β = 0.131) were all significant. We then used PROCESS Model 6 to determine the significance of the direct, indirect, and total effects through the serial mediation model. The model pathway from frailty to care time to financial difficulty to social loneliness to anxiety was significant. The proportions of family caregivers who were moderately frail, anxious, and experiencing social loneliness after eighteen months of the COVID-19 pandemic found in this survey should be of concern to policymakers and healthcare providers.
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Affiliation(s)
- Sharon Anderson
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
| | - Jasneet Parmar
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Medically At-Risk Driver Centre, University of Alberta, Edmonton, AB T5G 2T4, Canada
| | - Tanya L’Heureux
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
| | - Bonnie Dobbs
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Alberta Health Services, Edmonton, AB T5G 0B7, Canada
| | - Lesley Charles
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Medically At-Risk Driver Centre, University of Alberta, Edmonton, AB T5G 2T4, Canada
- Alberta Health Services, Edmonton, AB T5G 0B7, Canada
| | - Peter George J. Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
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Shen F, Chen J, Yang R, Yang J, Li H. Association between control status of blood pressure and frailty among middle-aged and older adults with hypertension in China: a longitudinal study. BMJ Open 2022; 12:e056395. [PMID: 35288389 PMCID: PMC8921919 DOI: 10.1136/bmjopen-2021-056395] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the association between blood pressure (BP) control and frailty among middle-aged and older populations with hypertension in China from 2013 to 2018. DESIGN Prospective longitudinal study. SETTING This study analysed data from the China Health and Retirement Longitudinal Study, a nationally representative survey administered in 28 provinces of China. PARTICIPANTS A total of 3254 participants diagnosed with hypertension previous to 2013 were taken into analysis. 1932 participants who were not frail in 2013 were enrolled to calculate relative risk. OUTCOME MEASURES The frailty score was constructed following Rookwood's Cumulative deficit frailty index, with a score >0.25 defined as frailty (outcome variable). The self-reported status of BP control (exposure variable) represented the general status of the participant's BP level. A fixed-effects model was used to analyse the association between BP control and frailty. A Cox proportional hazard model was further used to further calculate the relative risk of frailty for different BP control levels. RESULTS The fixed-effects model showed that compared with well-controlled BP, poorly controlled BP exhibited a positive association with frailty score (β=0.015; 95% CI 0.011 to 0.019; p<0.001). The Cox proportional hazard model also revealed a higher risk of frailty in the poorly controlled group (HR=1.96; 95% CI 1.49 to 2.56; p<0.001). Based on subgroup analyses, poorly controlled BP was positively associated with frailty in respondents aged <60 years old (fix-effects model: β=0.015, p=0.021; Cox model: HR=2.25, p<0.001), but not significant among those aged ≥75 years old. CONCLUSIONS We provide new evidence of a negative association between BP control and frailty risk, but the findings differ among different age groups. Individualised strategies for BP management should be developed, especially for older hypertension patients.
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Affiliation(s)
| | - Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
- Health Management Institute, Southern Medical University, Guangzhou, China
| | | | - Jun Yang
- Wuhan Red Cross Hospital, Wuhan, China
| | - Haomiao Li
- Department of Sociology, Huazhong Agricultural University, Wuhan, China
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Zietlow KE, Wong S, Heflin MT, McDonald SR, Sickeler R, Devinney M, Blitz J, Lagoo-Deenadayalan S, Berger M. Geriatric Preoperative Optimization: A Review. Am J Med 2022; 135:39-48. [PMID: 34416164 PMCID: PMC8688225 DOI: 10.1016/j.amjmed.2021.07.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 02/07/2023]
Abstract
This review summarizes best practices for the perioperative care of older adults as recommended by the American Geriatrics Society, American Society of Anesthesiologists, and American College of Surgeons, with practical implementation strategies that can be readily implemented in busy preoperative or primary care clinics. In addition to traditional cardiopulmonary screening, older patients should undergo a comprehensive geriatric assessment. Rapid screening tools such as the Mini-Cog, Patient Health Questionnaire-2, and Frail Non-Disabled Survey and Clinical Frailty Scale, can be performed by multiple provider types and allow for quick, accurate assessments of cognition, functional status, and frailty screening. To assess polypharmacy, online resources can help providers identify and safely taper high-risk medications. Based on preoperative assessment findings, providers can recommend targeted prehabilitation, rehabilitation, medication management, care coordination, and/or delirium prevention interventions to improve postoperative outcomes for older surgical patients. Structured goals of care discussions utilizing the question-prompt list ensures that older patients have a realistic understanding of their surgery, risks, and recovery. This preoperative workup, combined with engaging with family members and interdisciplinary teams, can improve postoperative outcomes.
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Affiliation(s)
- Kahli E Zietlow
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Michigan Medicine, Ann Arbor.
| | - Serena Wong
- Division of Geriatrics, Department of Medicine, Duke Health, Durham, NC
| | - Mitchell T Heflin
- Division of Geriatrics, Department of Medicine, Duke Health, Durham, NC; Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, NC
| | - Shelley R McDonald
- Division of Geriatrics, Department of Medicine, Duke Health, Durham, NC; Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, NC
| | | | - Michael Devinney
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC
| | - Jeanna Blitz
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC
| | | | - Miles Berger
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC
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Yaghi N, Yaghi C, Abifadel M, Boulos C, Feart C. Dietary Patterns and Risk Factors of Frailty in Lebanese Older Adults. Nutrients 2021; 13:2188. [PMID: 34202045 PMCID: PMC8308408 DOI: 10.3390/nu13072188] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 12/13/2022] Open
Abstract
Factors associated with frailty, particularly dietary patterns, are not fully understood in Mediterranean countries. This study aimed to investigate the association of data-driven dietary patterns with frailty prevalence in older Lebanese adults. We conducted a cross-sectional national study that included 352 participants above 60 years of age. Sociodemographic and health-related data were collected. Food frequency questionnaires were used to elaborate dietary patterns via the K-mean cluster analysis method. Frailty that accounted for 15% of the sample was twice as much in women (20%) than men (10%). Identified dietary patterns included a Westernized-type dietary pattern (WDP), a high intake/Mediterranean-type dietary pattern (HI-MEDDP), and a moderate intake/Mediterranean-type dietary pattern (MOD-MEDDP). In the multivariate analysis, age, waist to height ratio, polypharmacy, age-related conditions, and WDP were independently associated with frailty. In comparison to MOD-MEDDP, and after adjusting for covariates, adopting a WDP was strongly associated with a higher frailty prevalence in men (OR = 6.63, 95% (CI) (1.82-24.21) and in women (OR = 11.54, 95% (CI) (2.02-65.85). In conclusion, MOD-MEDDP was associated with the least prevalence of frailty, and WDP had the strongest association with frailty in this sample. In the Mediterranean sample, a diet far from the traditional one appears as the key deleterious determinant of frailty.
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Affiliation(s)
- Nathalie Yaghi
- Department of Nutrition & Dietetics, Faculty of Pharmacy, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon; (N.Y.); (C.B.)
| | - Cesar Yaghi
- Department of Gastroenterology, Faculty of Medicine, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon;
- Hotel-Dieu de France of Beirut University Hospital, P.O. Box 166830, Alfred Naccache Blvd, Beirut, Lebanon
| | - Marianne Abifadel
- Laboratory of Biochemistry and Molecular Therapeutics, Faculty of Pharmacy, Pôle Technologie-Santé, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon;
| | - Christa Boulos
- Department of Nutrition & Dietetics, Faculty of Pharmacy, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon; (N.Y.); (C.B.)
| | - Catherine Feart
- LEHA team, INSERM U1219, Université de Bordeaux, F-33000 Bordeaux, France
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Won CW, Ha E, Jeong E, Kim M, Park J, Baek JE, Kim S, Kim SB, Roh J, Choi JH, Jeon SY, Jung H, Lee D, Seo Y, Shin H, Kim H. World Health Organization Integrated Care for Older People (ICOPE) and the Integrated Care of Older Patients with Frailty in Primary Care (ICOOP_Frail) Study in Korea. Ann Geriatr Med Res 2021; 25:10-16. [PMID: 33794585 PMCID: PMC8024169 DOI: 10.4235/agmr.21.0025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 03/19/2021] [Indexed: 02/06/2023] Open
Abstract
The World Health Organization (WHO) recently endorsed the proposal for a Decade of Healthy Ageing (2020–2030). The WHO defines “healthy aging” as “the process of developing and maintaining the functional ability that enables wellbeing in older age.” Among the strategies for the Decade of Healthy Ageing, the WHO has suggested enhancing intrinsic capacity, promoting functional ability, and implementing the Integrated Care for Older People (ICOPE) package. The WHO has defined steps for ICOPE evaluation and scale-up and is performing a prospective study in 2–3 countries (low and middle income, high income) to test its feasibility in 2021–2022 and a multinational randomized study to validate its clinical efficacy and effectiveness in 2022–2024. Intrinsic capacity and frailty represent two faces of the same coin, with one indicating the reserves of the individual and the other indicating the deficits that accumulate with age. The Integrated Care of Older Patients with Frailty in Primary Care (ICOOP_Frail) study is the first integrated care program for frailty or functional decline in primary care in Korea. The results suggest that the ICOOP_Frail study can be utilized as a reference for ICOPE studies in Korea or at least to provide important findings for the forthcoming ICOPE implementation study in Korea.
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Affiliation(s)
- Chang Won Won
- Department of Family medicine, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Eunmi Ha
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Eunjin Jeong
- Department of Family medicine, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Juhyun Park
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Ja Euk Baek
- Department of Family Medicine, Dongdong Family Medicine Clinic, Seoul, Korea
| | - Sungouk Kim
- Department of Surgery, Dongbu-hanil Surgery Clinic, Seoul, Korea
| | - Sung Bae Kim
- Department of Family Medicine, Mirae Family Medicine Clinic, Seoul, Korea
| | - Jihun Roh
- Department of Family Medicine, Seoul Family Medicine Clinic, Seoul, Korea
| | - Jee Hye Choi
- Department of Family Medicine, Woori Family Medicine Clinic, Seoul, Korea
| | - Seung Youn Jeon
- Department of Family Medicine, Haneul Family Medicine Clinic, Uijeongbu, Korea
| | - Heeeun Jung
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Daehyun Lee
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Yuri Seo
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Hyungeun Shin
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Heesun Kim
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
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KİYAK M, TANOĞLU A, DEMİRBAŞ MB, SHAUYET I, UÇAK BASAT S. Evaluation of effect of frailty on warfarin compliance among older patients. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.865648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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