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Garner IW, Varey S, Navarro‐Pardo E, Marr C, Holland CA. An observational cohort study of longitudinal impacts on frailty and well-being of COVID-19 lockdowns in older adults in England and Spain. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2905-e2916. [PMID: 35089638 PMCID: PMC9545919 DOI: 10.1111/hsc.13735] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/19/2021] [Accepted: 01/08/2022] [Indexed: 05/15/2023]
Abstract
To reduce the spread of COVID-19, governments initiated lockdowns, limiting mobility and social interaction of populations. Lockdown is linked to health issues, yet the full impact on health remains unknown, particularly in more vulnerable groups. This study examined the impact on frailty and outcomes in high and low COVID-19 risk older adults. We examined health-related behaviours and support resources participants used during lockdown(s). Lockdown impacts in two countries were compared across four time points to examine impacts of different rules. We recruited 70 participants (aged >70 years) in England and Spain. Participants were allocated to higher or lower COVID-19-risk groups based on UK NHS guidelines. They completed assessments for frailty, quality-of-life, loneliness, exercise frequency and social interaction, coping resources and perception of age-friendliness of their environment. The four assessments took place over a 7-month period. Frailty was highest at Time 1 (most severe lockdown restrictions) and significantly higher in the Spanish group. It was lower at Time 3 (lowest restrictions), but did not continue to reduce for the English participants. Perceptions of the age friendliness of the environment matched these changes. Coping resources did not mitigate changes in frailty and outcomes over time, but more frequent physical activity predicted more reduction in frailty. Lockdown had a negative impact on frailty, increasing risk of adverse events for older people, but recovery once lockdowns are eased is evidenced. Further research is required to consider longer term impacts and methods to mitigate effects of lockdown on health.
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Affiliation(s)
- Ian W. Garner
- Division of Health ResearchLancaster UniversityLancasterUK
- Lancaster Centre for Ageing Research (C4AR)Lancaster UniversityLancasterUK
| | - Sandra Varey
- Division of Health ResearchLancaster UniversityLancasterUK
- Lancaster Centre for Ageing Research (C4AR)Lancaster UniversityLancasterUK
| | | | - Calum Marr
- Division of Health ResearchLancaster UniversityLancasterUK
- Lancaster Centre for Ageing Research (C4AR)Lancaster UniversityLancasterUK
| | - Carol A. Holland
- Division of Health ResearchLancaster UniversityLancasterUK
- Lancaster Centre for Ageing Research (C4AR)Lancaster UniversityLancasterUK
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Gomes CS, Pirkle CM, Barbosa JFS, Vafaei A, Câmara SMA, Guerra RO. Age at First Birth, Parity and History of Hysterectomy Are Associated to Frailty Status: Cross-Sectional Analysis from the International Mobility in Aging Study -Imias. J Cross Cult Gerontol 2018; 33:337-354. [DOI: 10.1007/s10823-018-9360-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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D’Avanzo B, Shaw R, Riva S, Apostolo J, Bobrowicz-Campos E, Kurpas D, Bujnowska M, Holland C. Stakeholders' views and experiences of care and interventions for addressing frailty and pre-frailty: A meta-synthesis of qualitative evidence. PLoS One 2017; 12:e0180127. [PMID: 28723916 PMCID: PMC5516973 DOI: 10.1371/journal.pone.0180127] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Frailty is a common condition in older age and is a public health concern which requires integrated care and involves different stakeholders. This meta-synthesis focuses on experiences, understanding, and attitudes towards screening, care, intervention and prevention for frailty across frail and healthy older persons, caregivers, health and social care practitioners. Studies published since 2001 were identified through search of electronic databases; 81 eligible papers were identified and read in full, and 45 papers were finally included and synthesized. The synthesis was conducted with a meta-ethnographic approach. We identified four key themes: Uncertainty about malleability of frailty; Strategies to prevent or to respond to frailty; Capacity to care and person and family-centred service provision; Power and choice. A bottom-up approach which emphasises and works in synchrony with frail older people's and their families' values, goals, resources and optimisation strategies is necessary. A greater employment of psychological skills, enhancing communication abilities and tools to overcome disempowering attitudes should inform care organisation, resulting in more efficient and satisfactory use of services. Public health communication about prevention and management of frailty should be founded on a paradigm of resilience, balanced acceptance, and coping. Addressing stakeholders’ views about the preventability of frailty was seen as a salient need.
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Affiliation(s)
- Barbara D’Avanzo
- Unit for Quality of Care and Rights Promotion in Mental Health, IRCCS Istituto di Ricerche Farmcologiche Mario Negri, Milan, Italy
- * E-mail:
| | - Rachel Shaw
- Aston Research Centre for Healthy Ageing, Aston University, Birmingham, United Kingdom
| | - Silvia Riva
- Unit for Quality of Care and Rights Promotion in Mental Health, IRCCS Istituto di Ricerche Farmcologiche Mario Negri, Milan, Italy
- Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - Joao Apostolo
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, The Portugal Centre for Evidence-Based Practice: a Collaborating Centre of the Joanna Briggs Institute, Coimbra, Portugal
| | - Elzbieta Bobrowicz-Campos
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, The Portugal Centre for Evidence-Based Practice: a Collaborating Centre of the Joanna Briggs Institute, Coimbra, Portugal
| | - Donata Kurpas
- Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Maria Bujnowska
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, The Portugal Centre for Evidence-Based Practice: a Collaborating Centre of the Joanna Briggs Institute, Coimbra, Portugal
| | - Carol Holland
- Aston Research Centre for Healthy Ageing, Aston University, Birmingham, United Kingdom
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Liu LK, Guo CY, Lee WJ, Chen LY, Hwang AC, Lin MH, Peng LN, Chen LK, Liang KY. Subtypes of physical frailty: Latent class analysis and associations with clinical characteristics and outcomes. Sci Rep 2017; 7:46417. [PMID: 28397814 PMCID: PMC5387710 DOI: 10.1038/srep46417] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/15/2017] [Indexed: 12/23/2022] Open
Abstract
Frailty is a well-recognized geriatric syndrome with various definitions and conceptual frameworks. This study aimed to use latent class analysis to discover potential subtypes of pre-frail and frail older people. Data from the I-Lan Longitudinal Aging Study (ILAS), a community-based cohort study was used for analysis. Latent class analysis was applied to characterize classes or subgroups with different frailty phenotypes among ILAS participants targeting older adults aged 65 and above, capable of completing a 6-meter walk, without severe major or life threatening diseases, and not institutionalized. Latent class analysis identified three distinct subgroups with different frailty phenotypes: non-mobility-type (weight loss and exhaustion), mobility-type frailty (slowness and weakness), and low physical activity. Comparing these groups with the robust group, people with mobility-type frailty had poorer body composition, worse bone health, poorer cognitive function, lower survival (hazard ratio: 6.82, p = 0.019), and poorer overall health outcomes (hazard ratio: 1.67, p = 0.040). People in the non-mobility-type group had poorer bone health and more metabolic serum abnormalities. In conclusion, mobility-type frailty was a better predictor of adverse outcomes. However, further investigation is needed to evaluate how these phenotypic subgroups may help in predicting prognosis or in developing interventions.
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Affiliation(s)
- Li-Kuo Liu
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan
| | - Chao-Yu Guo
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital, Yuanshan Branch, No. 386 Rongguang Rd., Yuanshan Township, Yilan County 264, Taiwan
| | - Liang-Yu Chen
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
| | - An-Chun Hwang
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
| | - Ming-Hsien Lin
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Taipei 11217, Taiwan
| | - Kung-Yee Liang
- Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan.,Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Linong St., Taipei City 11221, Taiwan
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Cesari M, Landi F, Calvani R, Cherubini A, Di Bari M, Kortebein P, Del Signore S, Le Lain R, Vellas B, Pahor M, Roubenoff R, Bernabei R, Marzetti E. Rationale for a preliminary operational definition of physical frailty and sarcopenia in the SPRINTT trial. Aging Clin Exp Res 2017; 29:81-88. [PMID: 28188558 DOI: 10.1007/s40520-016-0716-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 10/10/2016] [Indexed: 12/25/2022]
Abstract
In the present article, the rationale that guided the operationalization of the theoretical concept of physical frailty and sarcopenia (PF&S), the condition of interest for the "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) trial, is presented. In particular, the decisions lead to the choice of the adopted instruments, and the reasons for setting the relevant thresholds are explained. In SPRINTT, the concept of physical frailty is translated with a Short Physical Performance Battery score of ≥3 and ≤9. Concurrently, sarcopenia is defined according to the recent definitions of low muscle mass proposed by the Foundation for the National Institutes of Health-Sarcopenia Project. Given the preventive purpose of SPRINTT, older persons with mobility disability (operationalized as incapacity to complete a 400-m walk test within 15 min; primary outcome of the trial) at the baseline are not included within the diagnostic spectrum of PF&S.
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Affiliation(s)
- Matteo Cesari
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse III, Paul Sabatier, 37 Allées Jules Guesde, 31000, Toulouse, France.
- Université de Toulouse III Paul Sabatier, Toulouse, France.
| | - Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Rome, Italy
| | - Riccardo Calvani
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Rome, Italy
| | | | - Mauro Di Bari
- Research Unit of Medicine of Aging, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Division of Geriatric Cardiology and Medicine, Department of Geriatrics and Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Patrick Kortebein
- Physical Medicine and Rehabilitation Service, Sacramento VA Medical Center, Sacramento, CA, USA
- Department of Physical Medicine and Rehabilitation, University of California Davis, Sacramento, CA, USA
- Novartis Institutes of Biomedical Research, Cambridge, MA, USA
| | | | | | - Bruno Vellas
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse III, Paul Sabatier, 37 Allées Jules Guesde, 31000, Toulouse, France
- Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Ronenn Roubenoff
- Global Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Roberto Bernabei
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Rome, Italy
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Morley JE. The Future of Long-Term Care. J Am Med Dir Assoc 2017; 18:1-7. [DOI: 10.1016/j.jamda.2016.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023]
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Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle 2016; 7:512-514. [PMID: 27891296 PMCID: PMC5114626 DOI: 10.1002/jcsm.12147] [Citation(s) in RCA: 507] [Impact Index Per Article: 63.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/09/2016] [Indexed: 12/22/2022] Open
Abstract
The new ICD-10-CM (M62.84) code for sarcopenia represents a major step forward in recognizing sarcopenia as a disease. This should lead to an increase in availability of diagnostic tools and the enthusiasm for pharmacological companies to develop drugs for sarcopenia.
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Affiliation(s)
- Stefan D. Anker
- Innovative Clinical Trials, Department of Cardiology and PneumologyUniversity of Göttingen Medical Centre, Georg‐August‐UniversityGöttingenGermany
| | - John E. Morley
- Divisions of Geriatric Medicine and EndocrinologySaint Louis University School of MedicineSt. LouisMOUSA
| | - Stephan von Haehling
- Innovative Clinical Trials, Department of Cardiology and PneumologyUniversity of Göttingen Medical Centre, Georg‐August‐UniversityGöttingenGermany
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Kroc Ł, Socha K, Sołtysik B, Cieślak-Skubel A, Piechocka-Wochniak E, Błaszczak R, Kostka T. Validation of the Vulnerable Elders Survey-13 (VES-13) in hospitalized older patients. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Affiliation(s)
- Y Rolland
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO 63104,
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Relationship between the Gérontopôle Frailty Screening Tool and the frailty phenotype in primary care. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2015.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Morley JE. Aging Successfully: The Key to Aging in Place. J Am Med Dir Assoc 2015; 16:1005-7. [DOI: 10.1016/j.jamda.2015.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/23/2015] [Indexed: 12/16/2022]
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Morley JE, Cao L. Rapid screening for sarcopenia. J Cachexia Sarcopenia Muscle 2015; 6:312-4. [PMID: 26676168 PMCID: PMC4670738 DOI: 10.1002/jcsm.12079] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 02/05/2023] Open
Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine St. Louis, MO, USA
| | - Li Cao
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University Sichuan, China
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Morley JE. Psychoimmunology and Aging: A Tribute to George Freeman Solomon. J Am Med Dir Assoc 2015; 16:901-4. [PMID: 26432626 DOI: 10.1016/j.jamda.2015.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 08/24/2015] [Indexed: 11/26/2022]
Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St Louis, MO.
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Morley JE. Nutritional Supplementation and Sarcopenia: The Evidence Grows. J Am Med Dir Assoc 2015; 16:717-9. [DOI: 10.1016/j.jamda.2015.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/02/2015] [Indexed: 12/25/2022]
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Abstract
This article first reports the spontaneous course of frailty conditions, and then focuses on randomized, controlled frailty interventions (such as physical exercise, nutrition, combined exercise plus nutrition, and multifactorial interventions) or metaanalysis in community-dwelling older adults or volunteers published in 2012, 2013, and 2014. The main take-home messages that emerge from recent literature are summarized.
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Affiliation(s)
- Jean-Pierre Michel
- Geriatric Department, Geneva University, 40 A Route de Malagnou, Geneva 1208, Switzerland.
| | - Alfonso J Cruz-Jentoft
- Head of the Geriatric Department, University Hospital Ramón y Cajal, Carretera de Colmenar km 9, 1, Madrid 28034, Spain
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Dag Hammarskjöldsv. 14B, Uppsala Science Park, 75185 Uppsala, Sweden
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Affiliation(s)
- J-P Michel
- J.-P. Michel, Geneva University - Switzerland,
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