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Zhu Q, Ping P, Zhang P, Ning C, Zhao Y, Yao Y, Li X, Fu S. Sex hormones and physical function among the Chinese oldest-old and centenarian women. J Transl Med 2022; 20:340. [PMID: 35902963 PMCID: PMC9331572 DOI: 10.1186/s12967-022-03539-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/15/2022] [Indexed: 11/29/2022] Open
Abstract
Background Physical independence is crucial for overall health in the elderly individuals. The life expectancy of women has been shown to be higher than that of men, which is also known as the “male–female health-survival paradox”. Sex hormones may be one of the explanations. However, the relationships between sex hormones and physical function remain unclear in the elderly females. This study was designed to explore these relationships among the Chinese oldest-old and centenarian women. Methods Data from 1226 women were obtained from the China Hainan Centenarian Cohort Study. Home interviews, physical examinations and blood analyses were conducted using standardized procedures. Variables including age, Han ethnicity, illiteracy, smoker, drinker, estradiol (E2), testosterone (T), follicle-stimulating hormone, and luteinizing hormone were used in the multivariate logistic and linear regression analyses. Results In all the participants, age [beta (95% confidence interval): − 0.84 (− 0.98, − 0.71)] and E2 levels [beta (95% confidence interval): − 0.22 (− 0.28, − 0.17)] were negatively associated with activities of daily living (ADLs) in the multivariate linear regression analyses (P < 0.05 for all). We also observed significantly negative associations of age [odds ratio (95% confidence interval): 0.90 (0.88, 0.91)] and E2 levels [odds ratio (95% confidence interval): 0.98 (0.98, 0.99)] with physical normality in the multivariate logistic regression analyses (P < 0.05 for all). Age and E2 levels gradually decreased with increases in the ADL quartiles across all the participants (P < 0.05 for all). Conclusions This study demonstrated that E2 levels were negatively associated with physical function among the Chinese oldest-old and centenarian women.
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Affiliation(s)
- Qiao Zhu
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Ping Ping
- Main Station of Drug Instrument Supervision and Inspection, Joint Logistic Support Force of Chinese People's Liberation Army, Beijing, China
| | - Pei Zhang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Chaoxue Ning
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Yao Yao
- Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, USA. .,Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.
| | - Xiubing Li
- Department of Urology Medicine, The Third Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China. .,Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
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Espaulella-Ferrer M, Espaulella-Panicot J, Noell-Boix R, Casals-Zorita M, Ferrer-Sola M, Puigoriol-Juvanteny E, Cullell-Dalmau M, Otero-Viñas M. Assessment of frailty in elderly patients attending a multidisciplinary wound care centre: a cohort study. BMC Geriatr 2021; 21:727. [PMID: 34922487 PMCID: PMC8684133 DOI: 10.1186/s12877-021-02676-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/25/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The incidence of frailty and non-healing wounds increases with patients' age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. METHODS The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centres (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at 6 months or upon wound healing. Wounds were followed up every 2 weeks. To analyse the relationship between two variables was used the Chi-square test and Student's or the ANOVA model. The t-test for paired data was used to analyse the evolution of the frailty index during follow-up. RESULTS A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at 6 months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p = 0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p = 0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p = 0.637). Wound healing rate is statically significantly higher in non-frail patients (8.9% wound reduction/day, P25-P75 3.34-18.3%/day;AQ6 p = 0.044) in comparison with frail patients (3.26% wound reduction/day, P25-P75 0.8-8.8%/day). CONCLUSION Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.
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Affiliation(s)
- Mariona Espaulella-Ferrer
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.,Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain
| | - Joan Espaulella-Panicot
- Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain.,Central Catalonia Chronicity Research Group (C3RG), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain
| | - Rosa Noell-Boix
- Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain.,Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, Barcelona, 08500, Vic, Spain
| | - Marta Casals-Zorita
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.,Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain
| | - Marta Ferrer-Sola
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.,Hospital Universitari de la Santa Creu de Vic, 08500, Vic, Barcelona, Spain
| | - Emma Puigoriol-Juvanteny
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain.,Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain
| | - Marta Cullell-Dalmau
- Quantitative BioImaging (QuBI) Lab, University of Vic - Central University of Catalonia (UVIC-UCC), 08500, Vic, Barcelona, Spain.,Faculty of Sciences and Technology, University of Vic - Central University of Catalonia (UVIC-UCC), C. de la Laura, 13, 08500, Vic, Barcelona, Spain
| | - Marta Otero-Viñas
- Tissue Repair and Regeneration Laboratory (TR2Lab), Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVIC-UCC), Fundació Hospital Universitari de la Santa Creu de Vic, and Hospital Universitari de Vic, 08500, Vic, Barcelona, Spain. .,Faculty of Sciences and Technology, University of Vic - Central University of Catalonia (UVIC-UCC), C. de la Laura, 13, 08500, Vic, Barcelona, Spain.
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Disability for basic and instrumental activities of daily living in older individuals. PLoS One 2019; 14:e0220157. [PMID: 31348797 PMCID: PMC6660130 DOI: 10.1371/journal.pone.0220157] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 07/09/2019] [Indexed: 01/10/2023] Open
Abstract
AIMS To know the prevalence, associated factors and temporal trends of disabilities for basic and instrumental activities of daily living in older people in Spain from 2009 to 2017. BACKGROUND Disability in older people is associated with health problems, increased health costs and low quality of life. There are no updated data in Spain with a representative sample about disability. METHODS Cross-sectional study with 25,465 non-institutionalized older people who participated in the European Health Survey in 2009 and 2014 and the National Health Survey in 2011/12 and 2017 in Spain. The prevalence rates of disability were evaluated using the Katz Scale and Lawton and Brody Scale. Logistic regression was used to determine if there was an association between basic and instrumental activities of daily living and sociodemographic characteristics. RESULTS More individuals had disability for instrumental activities of daily living (31.9%) than disability for basic activities of daily living (11.1%). The most predominant disability for instrumental activities of daily living was performing severe housework (34%). The prevalence of disabilities decreased from 2009 to 2017. In general, disability was associated with female gender, advanced age, lower education, restricted daily activity, being bedridden and higher pain levels. CONCLUSION There is a considerable prevalence of disabilities for basic and instrumental activities of daily living in older people in Spain. Although the disability prevalence has decreased slowly from 2009 to 2017, it continues to remain a health problem. Gender may influence the disabilities for basic and instrumental activities of daily living. Health policymakers should establish prevention strategies and effective interventions (e.g., physical exercise) for prevention and reduction of the disabilities for basic and instrumental activities of daily living, particularly in older females.
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Arnau A, Espaulella J, Serrarols M, Canudas J, Formiga F, Ferrer M. Risk factors for functional decline in a population aged 75 years and older without total dependence: A one-year follow-up. Arch Gerontol Geriatr 2016; 65:239-47. [PMID: 27131227 DOI: 10.1016/j.archger.2016.04.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/02/2016] [Accepted: 04/03/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES estimation of functional loss incidence and identification of risk factors associated with new disability onset in people aged 75 and older without severe dependence in a rural primary care setting. PATIENTS AND METHOD Prospective cohort study of a representative sample of people aged 75 years or older without severe dependence (Barthel Index>20 and Lawton Index>1) at a primary care center, with a 12-month follow-up. The baseline geriatric assessment recorded activities of daily living (ADL), sociodemographic information, numbers of drugs prescribed, previous hospital admissions and falls, cognitive function, hearing and visual capacity, body mass index, blood pressure, and the Short Physical Performance Battery to evaluate lower limb function. ADL was re-assessed after 12 months, defining functional loss as a fall of ≥10 points on the Barthel Index and/or ≥2 instrumental activities of the Lawton Index. Bivariate and multivariate analyses using logistic regression models were conducted to identify factors independently associated with functional loss. RESULTS Mean age was 81.7 years, 58.7% of patients were men, and 23.4% presented functional loss at the 12-month follow-up. Variables identified as independent predictors of functional loss were hospital admissions (aOR 3.92; 95%CI: 1.35-11.39), cognitive impairment (aOR 2.60; 95%CI: 1.39-4.92) and lower limbs functional limitation (aOR 2.01; 95%CI: 1.02-3.97). CONCLUSIONS Our results support the use of performance batteries in primary care for identifying elderly persons at risk of functional decline; and they also highlight the relevance of appropriate management of hospital admissions and planned discharges in order to preserve patients' functional status.
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Affiliation(s)
- Anna Arnau
- Clinical Research Unit, Althaia Xarxa Assistencial Universitària de Manresa, Dr. Joan Soler, 1-3, 08243 Manresa, Barcelona, Spain; Programa de Doctorat en Salut Pública i Metodologia de la Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Facultat de Medicina, Edifici M, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain; Department of Clinical Epidemiology, Hospitalari Universitari de Vic, Francesc Pla "El Vigatà", 1, 08500 Vic Barcelona, Spain.
| | - Joan Espaulella
- Servei de Geriatria i Cures Palliatives, Hospitalari Universitari de Vic-Hospital Universitari de la Santa Creu, Rambla Hospital, 52, 08500 Vic Barcelona, Spain
| | - Marta Serrarols
- Equip d'Assitència Primària Vic, Primary Care Center El Remei, Pla del Remei, 10-12, 08500 Vic Barcelona, Spain
| | - Judit Canudas
- Equip d'Assitència Primària Vic, Primary Care Center El Remei, Pla del Remei, 10-12, 08500 Vic Barcelona, Spain
| | - Francesc Formiga
- Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Feixa Llarga, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Montserrat Ferrer
- Programa de Doctorat en Salut Pública i Metodologia de la Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Facultat de Medicina, Edifici M, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain; Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Arnau A, Espaulella J, Méndez T, Serrarols M, Canudas J, Formiga F, Ferrer M. Lower limb function and 10-year survival in population aged 75 years and older. Fam Pract 2016; 33:10-6. [PMID: 26560093 DOI: 10.1093/fampra/cmv088] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Scientific societies recommend assessing lower limb function in usual clinical practice. The Short Physical Performance Battery (SPPB) is one of the most validated tools to assess this, but its capacity to predict long-term mortality in very old population attending primary care has not been studied. OBJECTIVE To assess the ability of the SPPB to predict 10-year survival in individuals aged 75 and over. METHODS Prospective cohort study with a 10-year follow-up. A representative sample of people aged 75 years or older without severe dependence (Barthel Index > 20) treated at a Spanish primary care centre (n = 315). Baseline evaluation included geriatric assessment with most well-known death predictors. The three SPPB subtasks (standing balance, walking speed and chair stand tests) were administered. Kaplan-Meier curves and Cox proportional hazard models were calculated for all-cause mortality. RESULTS Mean age was 81.9 years (60.6% female). Ten-year survival of elders with SPPB score <7 and ≥7 was 0.23 and 0.37 (P < 0.001), respectively. This difference remained statistically significant in the Cox model adjusted by age, gender, number of drugs prescribed, cognitive status, body mass index and visual sharpness (adjusted hazard ratio = 1.37; 95% confidence interval: 1.01-1.86). Also, walking speed and chair stand subtasks were both individual-independent predictors of 10-year survival. CONCLUSIONS Our findings indicate that SPPB is an independent predictor of long-term survival. The chair stand subtask could be a predictor as useful as the full performance battery, becoming a good alternative for primary care where the burden of performing all three subtasks could be excessive.
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Affiliation(s)
- Anna Arnau
- Clinical Research Unit, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Programa de Doctorat en Salut Pública i Metodologia de La Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i Medicina Preventiva, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Barcelona,
| | - Joan Espaulella
- Servei de Geriatria i Cures Pal liatives, Hospital Universitari de Vic-Hospital Universitari de la Santa Creu, Vic, Barcelona
| | - Teresa Méndez
- Servei de Geriatria i Cures Pal liatives, Hospital Universitari de Vic-Hospital Universitari de la Santa Creu, Vic, Barcelona
| | - Marta Serrarols
- Equip d'Assitència Primària Vic, Primary Care Center El Remei, Vic, Barcelona
| | - Judit Canudas
- Equip d'Assitència Primària Vic, Primary Care Center El Remei, Vic, Barcelona
| | - Francesc Formiga
- Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona
| | - Montserrat Ferrer
- Programa de Doctorat en Salut Pública i Metodologia de La Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i Medicina Preventiva, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona and CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Socio-Demographic Determinants, Physical Health Status, and Depression Associated with Functional Limitations Among Older Chinese Adults. AGEING INTERNATIONAL 2015. [DOI: 10.1007/s12126-015-9221-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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