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Son J, Sung P. A Reciprocal Relationship between Formal and Informal Social Engagement and Handgrip Strength of Older Adults in South Korea. Gerontology 2024:1-15. [PMID: 39008957 DOI: 10.1159/000540344] [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: 10/31/2023] [Accepted: 07/09/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION The relationship between social engagement and handgrip strength has been underexplored. Further, no prior research examined a plausible reciprocal association between them. METHODS The study employed the seven waves of data (2006-2018) from the Korean Longitudinal Study of Aging (KLoSA) survey (7,927 respondents, mean age: 59 years old at wave 1 [71 years old at wave 7], women: 58%). It used ML-SEM, a cross-lagged panel model with fixed effects fitted by structural equation modeling with maximum likelihood estimation. In particular, the ML-SEM examined whether a reciprocal relationship existed between formal social engagement (number of association memberships and frequency of organizational activities)/informal social engagement (frequency of contact with familiar persons) and handgrip strength (the average of the four dynamometer measurements). RESULTS The empirical analyses identified a systematic reciprocal association between formal social engagement and handgrip strength. Specifically, formal social engagement was positively associated with handgrip strength over time (the number of association memberships standardized coefficient: 0.012*, the frequency of organizational activities standardized coefficient: 0.022***). Conversely, handgrip strength was positively related to the number of memberships (the handgrip strength standardized coefficient: 0.025*) and the frequency of organizational activities (the handgrip strength standardized coefficient: 0.042**). CONCLUSION The study thus supports the social causation proposition that formal social engagement in and through diverse associations may be positively associated with handgrip strength. It also validates the health selection argument that handgrip strength may increase the likelihood of formal social engagement.
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Affiliation(s)
- Joonmo Son
- Department of Sociology and Anthropology, National University of Singapore, Singapore, Singapore
| | - Pildoo Sung
- Department of Sociology, Hong Kong Baptist University, Hong Kong, Hong Kong, China
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Hanlon P, Wightman H, Politis M, Kirkpatrick S, Jones C, Andrew MK, Vetrano DL, Dent E, Hoogendijk EO. The relationship between frailty and social vulnerability: a systematic review. THE LANCET. HEALTHY LONGEVITY 2024; 5:e214-e226. [PMID: 38432249 DOI: 10.1016/s2666-7568(23)00263-5] [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: 09/12/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 03/05/2024] Open
Abstract
Both frailty (reduced physiological reserve) and social vulnerability (scarcity of adequate social connections, support, or interaction) become more common as people age and are associated with adverse consequences. Analyses of the relationships between these constructs can be limited by the wide range of measures used to assess them. In this systematic review, we synthesised 130 observational studies assessing the association between frailty and social vulnerability, the bidirectional longitudinal relationships between constructs, and their joint associations with adverse health outcomes. Frailty, across assessment type, was associated with increased loneliness and social isolation, perceived inadequacy of social support, and reduced social participation. Each of these social vulnerability components was also associated with more rapid progression of frailty and lower odds of improvement compared with the absence of that social vulnerability component (eg, more rapid frailty progression in people with social isolation vs those who were not socially isolated). Combinations of frailty and social vulnerability were associated with increased mortality, decline in physical function, and cognitive impairment. Clinical and public health measures targeting frailty or social vulnerability should, therefore, account for both frailty and social vulnerability.
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Affiliation(s)
- Peter Hanlon
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Heather Wightman
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Marina Politis
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Caitlin Jones
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Melissa K Andrew
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontological Research Center, Stockholm, Sweden
| | - Elsa Dent
- Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, SA, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, Netherlands
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Li Y, Du Z, Kondo N. Effect modification of social participation in the relationship between living arrangements and frailty among older adults in Japan: Differences based on gender. Arch Gerontol Geriatr 2024; 117:105231. [PMID: 37897853 DOI: 10.1016/j.archger.2023.105231] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/07/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Frailty is a common global concern that is closely related to aging, especially in Japan. This study clarifies the relationship between living arrangements and frailty among older Japanese adults and the effect of social participation based on gender, with the aim of developing social preventive and intervention strategies. METHODS Panel data were obtained from the 2016 and 2019 Japan Gerontological Evaluation Studies. A total of 23,630 older adults, aged 65 years and older, were included. Frailty was assessed using the Kihon Checklist. Multivariable logistic regression models were used to examine the association between living arrangements and frailty and the effect of social participation based on gender. RESULTS A total of 1,589 (6.72 %) participants reported the new onset of frailty. No independent association was found between living arrangements and frailty, regardless of gender, after controlling for covariates. Diverse forms of social participation decreased the risk for frailty among men. For women, living with a spouse was associated with a higher risk for frailty, compared with women who lived alone; however, women who lived with children and participated in three or more social activities had a lowered risk for frailty. CONCLUSIONS For men, social participation played a more important role in the risk for frailty than did living arrangement. However, social participation moderated the association between living arrangements and frailty in women. Therefore, the promotion of social participation can be included in health prevention and intervention programs to decrease the risk for frailty.
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Affiliation(s)
- Yanzhang Li
- Department of Social Epidemiology, School of Public Health and Graduate School of Medicine, Kyoto University, Floor #2, Science Frontier Laboratory, Yoshida Konoe-cho Sakyo-ku Kyoto, Kyoto 606-8501, Japan; Sichuan Research Center of Applied Psychology, Chengdu Medical College, Xindu Avenue No. 783, Xindu District, Chengdu 610500, China.
| | - Zhen Du
- Department of Social Epidemiology, School of Public Health and Graduate School of Medicine, Kyoto University, Floor #2, Science Frontier Laboratory, Yoshida Konoe-cho Sakyo-ku Kyoto, Kyoto 606-8501, Japan.
| | - Naoki Kondo
- Department of Social Epidemiology, School of Public Health and Graduate School of Medicine, Kyoto University, Floor #2, Science Frontier Laboratory, Yoshida Konoe-cho Sakyo-ku Kyoto, Kyoto 606-8501, Japan.
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Khalil AH, Gobbens RJJ. What If the Clinical and Older Adults' Perspectives about Frailty Converge? A Call for a Mixed Conceptual Model of Frailty: A Traditional Literature Review. Healthcare (Basel) 2023; 11:3174. [PMID: 38132064 PMCID: PMC10742490 DOI: 10.3390/healthcare11243174] [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: 10/04/2023] [Revised: 11/01/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
Existing frailty models have enhanced research and practice; however, none of the models accounts for the perspective of older adults upon defining and operationalizing frailty. We aim to propose a mixed conceptual model that builds on the integral model while accounting for older adults' perceptions and lived experiences of frailty. We conducted a traditional literature review to address frailty attributes, risk factors, consequences, perceptions, and lived experiences of older adults with frailty. Frailty attributes are vulnerability/susceptibility, aging, dynamic, complex, physical, psychological, and social. Frailty perceptions and lived experience themes/subthemes are refusing frailty labeling, being labeled "by others" as compared to "self-labeling", from the perception of being frail towards acting as being frail, positive self-image, skepticism about frailty screening, communicating the term "frail", and negative and positive impacts and experiences of frailty. Frailty risk factors are classified into socio-demographic, biological, physical, psychological/cognitive, behavioral, and situational/environmental factors. The consequences of frailty affect the individual, the caregiver/family, the healthcare sector, and society. The mixed conceptual model of frailty consists of interacting risk factors, interacting attributes surrounded by the older adult's perception and lived experience, and interacting consequences at multiple levels. The mixed conceptual model provides a lens to qualify frailty in addition to quantifying it.
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Affiliation(s)
- Asya Hani Khalil
- Hariri School of Nursing, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Robbert J. J. Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands;
- Zonnehuisgroep Amstelland, 1186 AA Amstelveen, The Netherlands
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
- Tranzo, Tilburg University, 5037 DB Tilburg, The Netherlands
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Wang Y, Wang X, Zhu X, Sun Y, Han B, Chen T. Physical activity, physical frailty and depressive symptoms among Chinese male and female older adults: do different indicators make a difference? Front Public Health 2023; 11:1280952. [PMID: 38089035 PMCID: PMC10711064 DOI: 10.3389/fpubh.2023.1280952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives Older adults become more inactive and frailer with aging. Physical status is closely linked to mental health, but it is unclear which physical indicator is more strongly associated with depressive symptoms in older adults. The present study aimed to compare relationships between self-reported physical activity, physical frailty (muscle mass, muscle strength, and gait ability) and depressive symptoms in community male and female older adults. Methods A total of 1,180 adults aged 60 years and older were recruited to participate in this study from a Chinese community receiving annual check-up service from September 2018 to May 2019. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ). The Bio-electrical Impedance Analyzer was used to determine the muscle mass. As the indicators of muscle function, grip strength and gait ability were assessed by the dynamometer and Timed Up and Go Test (TUGT), respectively. The 15-item version of Geriatric Depression Scale (GDS-15) was used to examine depressive symptoms. Demographic variables, health status and sleep quality were collected using questionnaire. Results 11.8% men and 11.9% women reported depressive symptoms. Logistic regression showed that depressive symptoms was associated with low grip strength (OR = 2.42, 95% CI: 1.04-5.63), slow gait ability (OR = 3.60, 95% CI: 1.28-10.13) in older males, and associated with low level of self-reported physical activity (OR = 3.85, 95% CI: 2.00-7.42) in older females. No significant association was found between muscle mass and depressive symptoms. Conclusion There were gender differences in the relationship between physical activity, physical frailty, and depressive symptoms. Grip strength and gait ability may be a better indicator of frailty for predicting depressive symptoms in older men while physical activity may be useful in predicting depressive symptoms in older women.
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Affiliation(s)
- Ying Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xue Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Department of Rehabilitation, General Hospital of Tianjin Medical University, Tianjin, China
| | - Xinyu Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yawen Sun
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Buxin Han
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Tianyong Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Chang WN, Tzeng PL, Huang WJ, Lin YH, Lin KP, Wen CJ, Chou YC, Liao Y, Hsueh MC, Chan DC. Objective assessment of the association between frailty and sedentary behavior in older adults: a cross-sectional study. Eur Rev Aging Phys Act 2023; 20:14. [PMID: 37550620 PMCID: PMC10405382 DOI: 10.1186/s11556-023-00324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/27/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Given the inconsistent findings of the association between frailty and sedentary behavior in older adults, this cross-sectional study investigated the aforementioned association using four different frailty criteria and two sedentary behavior indices in older adults. METHODS Data from older adults (age ≥ 65 y) who participated in health examinations or attended outpatient integrated clinics at a medical center in Taipei, Taiwan, were collected. Frailty was measured using the modified Fried Frailty Phenotype (mFFP), Clinical Frailty Scale in Chinese Translation (CFS-C), Study of Osteoporotic Fractures (SOF) index, and Clinical Frailty-Deficit Count (CF-DC) index; sedentary behavior was assessed with a waist-worn accelerometer. Adjusted linear regression ascertained the association between frailty and both sedentary behavior outcomes. RESULTS Among the 214 participants (mean age 80.82 ± 7.14 y), 116 were women. The average total sedentary time and number of sedentary bouts were 609.74 ± 79.29 min and 5.51 ± 2.09 times per day, respectively. Frail participants had a longer total sedentary time (odds ratio [OR]: 30.13, P = .01 and 39.43, P < .001) and more sedentary bouts (OR: 3.50 and 5.86, both P < .001) on mFFP and CFS-C assessments, respectively. The SOF index revealed more sedentary bouts among frail than in robust participants (OR: 2.06, P = .009), without a significant difference in the total sedentary time. Frail participants defined by the CF-DC index were more likely to have frequent sedentary bouts (OR: 2.03, P = .016), but did not have a longer total sedentary time. CONCLUSIONS Regardless of the frailty criteria adopted, frailty was positively associated with the number of sedentary bouts per day in older adults. A significant correlation between frailty and total sedentary time was detected only with mFFP and CFS-C indices. Further research may target decreasing the sedentary bouts in older adults as a strategy to improve frailty.
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Affiliation(s)
- Wen-Ning Chang
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Pei-Lin Tzeng
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Health Promotion and Health Education, National Taiwan Normal University, No 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
| | - Wei-Jia Huang
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yu-Hung Lin
- Department of Health Promotion and Health Education, National Taiwan Normal University, No 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
- National Taiwan University Hospital, Bei-Hu Branch, No. 87 Neijiang Street, Taipei, 108206, Taiwan
| | - Kun-Pei Lin
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Chiung-Jung Wen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yi-Chun Chou
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, No. 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, No. 101, Sec. 2, Zhongcheng Rd, Taipei, 111036, Taiwan
| | - Ding-Cheng Chan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan.
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan.
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Lin TY, Hung SC. Frailty and Humoral Immune Responses Following COVID-19 Vaccination among Patients Undergoing Hemodialysis. J Nutr Health Aging 2023; 27:980-986. [PMID: 37997719 DOI: 10.1007/s12603-023-1994-x] [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: 05/23/2023] [Accepted: 07/25/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Patients with end-stage kidney disease who are undergoing dialysis have reduced immune responses to COVID-19 vaccination. Frailty is extremely common among dialysis patients and may contribute to the impaired immunogenicity. This study aimed to determine the association between frailty and humoral immune responses following COVID-19 vaccination in hemodialysis patients. DESIGN, SETTING, PARTICIPANTS Adult hemodialysis patients without prior SARS-CoV-2 infection who received a priming dose of ChAdOx1 nCoV-19, an adenovirus-vectored vaccine, were assessed for eligibility. Participants were categorized as robust, pre-frail, or frail using the Fried frailty criteria. Humoral responses were assessed 28 days after vaccination by measuring titers of anti-spike IgG antibodies. The primary outcome was anti-spike antibody seroconversion, defined as antibody levels ≥50 AU/mL. Multivariable-adjusted logistic regression models were used to assess the association between frailty status and the primary outcome. RESULTS A total of 206 participants (mean age 67 ± 13 years, 50% women) were included in the study, of whom 50 (24%) were characterized as frail, 86 (42%) were characterized as pre-frail, and 70 (34%) were characterized as robust. Anti-spike antibody levels were progressively lower with more advanced stages of frailty (P <0.001). Compared with robust patients, a significantly smaller proportion of pre-frail and frail patients developed anti-spike antibody seroconversion (87%, 66%, and 40%, respectively; P <0.001). Frailty was associated with the absence of humoral responses after adjustment for age, sex, body mass index, diabetes, coronary artery disease, serum albumin, and lymphocyte count (OR=0.25; 95% CI, 0.08-0.80). CONCLUSIONS Frailty is independently associated with impaired humoral responses following COVID-19 vaccination among hemodialysis patients. Strategies aimed at preventing or attenuating frailty in the dialysis population are warranted.
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Affiliation(s)
- T-Y Lin
- Szu-Chun Hung, Division of Nephrology, Taipei Tzu Chi Hospital, 289, Jianguo Road, Xindian District, New Taipei City 231, Taiwan. E-mail:
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Luo CM, Hsieh MY, Cheng CH, Chen CH, Liao MT, Chuang SY, Wu CC. Association of Frailty With Thrombosis of Hemodialysis Vascular Access: A Prospective Taiwanese Cohort Study. Am J Kidney Dis 2022; 80:353-363.e1. [PMID: 35257814 DOI: 10.1053/j.ajkd.2021.12.017] [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: 08/10/2021] [Accepted: 12/29/2021] [Indexed: 01/27/2023]
Abstract
RATIONALE & OBJECTIVE Frailty, a multidimensional construct, has been associated with poor outcomes in patients receiving maintenance dialysis. This study assessed the association of frailty with dialysis vascular access patency. STUDY DESIGN Multicenter prospective cohort study. SETTING & PARTICIPANTS 761 prevalent patients receiving hemodialysis at 9 centers in Taiwan as of January 2018. EXPOSURE Performance-based frailty was defined as 3 of the following: unintentional weight loss, weakness, exhaustion, low physical activity, and slow gait speed. Patients were categorized as prefrail if they had 1 or 2 of these characteristics. OUTCOME Rate of and time to dialysis access thrombosis. Data regarding vascular access events were collected for 30 months after enrollment through December 31, 2020. ANALYTICAL APPROACH Logistic regression analysis was used to estimate the association of clinical characteristics with frailty. Cox proportional hazards regression analysis was used to estimate the association of frailty with vascular access thrombosis adjusted for known clinical risk factors. RESULTS The patients' mean age was 66 years, 46% were female, 18% had synthetic graft accesses, and 82% arteriovenous fistulas. Overall, 31% were frail, 35% were prefrail, and 34% were not frail. The frailty phenotype was associated with age, female sex, low body mass index, diabetes mellitus, and prior stroke. During a median follow-up of 731 days, 161 patients (21%) had access thrombosis events (not frail, 14%; prefrail, 20%; frail, 30%; P < 0.001). Frail patients had a higher risk of vascular access thrombosis than nonfrail patients (HR, 2.31 [95% CI, 1.55-3.39], P < 0.001). After multivariable adjustment for age and comorbidities, frailty remained significantly associated with access thrombosis for both fistulas and grafts. LIMITATIONS Limited generalizability and potential residual confounding. CONCLUSIONS Frailty is associated with an increased risk of vascular access thrombosis. These findings highlight the risks of access failure experienced by frail patients receiving hemodialysis.
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Affiliation(s)
- Chien-Ming Luo
- Cardiovascular Division, Department of Surgery, National Taiwan University Hospital, Hsin-Chu Hospital, Hsin-Chu; College of Medicine, National Taiwan University, Taipei
| | - Mu-Yang Hsieh
- Cardiology Division, Department of Medicine, National Taiwan University Hospital, Hsin-Chu Hospital, Hsin-Chu; College of Medicine, National Taiwan University, Taipei
| | | | - Chiu-Hui Chen
- Hemodialysis Center, National Taiwan University Hospital, Hsin-Chu Hospital, Hsin-Chu
| | - Min-Tsun Liao
- Cardiology Division, Department of Medicine, National Taiwan University Hospital, Hsin-Chu Hospital, Hsin-Chu; College of Medicine, National Taiwan University, Taipei
| | - Shao-Yuan Chuang
- Institute of Population Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Chih-Cheng Wu
- Quality Control Center, National Taiwan University Hospital, Hsin-Chu Hospital, Hsin-Chu; College of Medicine, National Taiwan University, Taipei; Institute of Biomedical Engineering, National Tsing-Hua University, Hsin-Chu; Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan.
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Suprawesta L, Hwang HF, Chen SJ, Yu WY, Lin MR. Specific cognitive domains and frailty trajectories among older Taiwanese adults. Aging Ment Health 2022:1-8. [PMID: 36016472 DOI: 10.1080/13607863.2022.2116393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objective: To investigate the associations of specific cognitive functions and with the frailty trajectory among older Taiwanese adults.Methods: At baseline, 730 community-dwelling older adults were recruited from outpatient clinics of a general hospital. Frailty status was defined using phenotype criteria. Global cognition was assessed using the modified Telephone Interview of Cognitive Status and Mini-Mental State Examination (MMSE). The Mattis Dementia Rating Scale (MDRS) and Digit Symbol Substitution Test were used to evaluate 6 cognitive domains: attention, initiation/perseveration, construction, conceptualization, memory, and processing speed. The group-based trajectory model was used to identify latent frailty trajectory groups and the multinomial logistic regression was to examine the relationships of specific cognitive functions with frailty trajectory.Results: Among 485 participants (168 men, 317 women, and mean age: 71.1 ± 5.5 years) completed 2 annual follow-up assessments, three frailty trajectory groups of improvement, no-change, and progression were identified. After adjusting for baseline frailty status, age, sex, global cognition, regular exercise habit, and number of comorbidities, higher scores on MDRS's initiation/perseveration (odds ratio [OR] = 0.85; 95% CI = 0.75-0.95) and attention (OR = 0.63; 95% CI = 0.38-1.00), respectively, were significantly associated with lower risk of frailty progression. Conversely, no significant association was detected between MMSE or TICSM scores and frailty improvement or progression.Conclusion: Specific cognitive functions of initiation/perseveration and attention, rather than global cognition, may be more useful to predict frailty progression, thus allowing the identification of at-risk older adults.
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Affiliation(s)
- Lalu Suprawesta
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan, R.O.C.,Department of Sport and Health Education, Faculty of Sport Science and Public Health, Universitas Pendidikan Mandalika, Kota Mataram, West Nusa Tenggara, Indonesia
| | - Hei-Fen Hwang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, R.O.C
| | - Sy-Jou Chen
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Wen-Yu Yu
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan, R.O.C
| | - Mau-Roung Lin
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan, R.O.C
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Lin H, Wang D, Ma S, Suo Y, Zhou P, Zhao Q, Liu J, Ding G. Frailty's Prevalence and the Association with Aging-Related Health Conditions in Chinese Community Dwelling Elderly. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:1748162. [PMID: 36017459 PMCID: PMC9398729 DOI: 10.1155/2022/1748162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/05/2022] [Accepted: 06/22/2022] [Indexed: 12/01/2022]
Abstract
In this paper, we have investigated the frailty's prevalence and the association with aging-related health conditions in Chinese community dwelling elderly aged ≥60 years in Lianyungang City of China. In this regard, participants were 1,072 adults aged ≥60 years from Houhe Community of Lianyungang City of China. All the enrolled participants were tested for following parameters: (1) the related risk factors of frailty: including economic status, personal health, understanding and communication skills, and mental and psychological status; (2) aging-related health conditions related to frailty: Charlson's comorbidity index (CCI), Mini Nutritional Assessment Short Form (MNA-SF), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder 7-item (GAD-7); (3) body composition, physical strength, and function testing: appendicular skeletal muscle mass index (ASMI), grip strength, five-repetition sit-to-stand test, 6 m walking speed, and strength assistance rise-climb-fall (SARC-F); (4) assessment of the degree and severity of frailty: physical frailty phenotype (PFP), Morse fall scale (MFS), and activities of daily living (ADL). The frailty's prevalence among the elderly aged ≥60 years in the community of Lianyungang City was 13.8%, 55.4% were prefrail, and 30.8% were robust. The independent risk factors of frailty were age, appendicular skeletal muscle mass index, sarcopenia, education, nutrition, and strength assistance rise-climb-fall (P < 0.05). Aging-related health conditions were associated with frailty, including sarcopenia, nutrition, and falls. However, mental and psychological statuses were not significantly associated with frailty.
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Affiliation(s)
- Hongxiao Lin
- Department of Geratology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China
- Department of Osteoporosis, The First Affiliated Hospital of Kangda College of Nanjing Medical University, 6 Zhenhua East Road, Lianyungang 222000, China
- Department of Osteoporosis, The Affiliated Lianyungang Hospital of Xuzhou Medical University, 6 Zhenhua East Road, Lianyungang 222000, China
| | - Dongyan Wang
- Department of Osteoporosis, The First Affiliated Hospital of Kangda College of Nanjing Medical University, 6 Zhenhua East Road, Lianyungang 222000, China
- Department of Osteoporosis, The Affiliated Lianyungang Hospital of Xuzhou Medical University, 6 Zhenhua East Road, Lianyungang 222000, China
| | - Shanjun Ma
- Department of Geratology, Xinpu Community Health Service Center, 146 Nanji North Road, Lianyungang 222000, China
| | - Yan Suo
- Department of Geratology, Xinpu Community Health Service Center, 146 Nanji North Road, Lianyungang 222000, China
| | - Peng Zhou
- Department of Geratology, Xinpu Community Health Service Center, 146 Nanji North Road, Lianyungang 222000, China
| | - Qing Zhao
- Department of Geratology, Xinpu Community Health Service Center, 146 Nanji North Road, Lianyungang 222000, China
| | - Juan Liu
- Department of Geratology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China
| | - Guoxian Ding
- Department of Geratology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China
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11
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Marsden E, Craswell A, Taylor A, Barnett A, Wong PK, Wallis M. Translation of the geriatric emergency department intervention into other emergency departments: a post implementation evaluation of outcomes for older adults. BMC Geriatr 2022; 22:290. [PMID: 35392828 PMCID: PMC8988321 DOI: 10.1186/s12877-022-02999-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Increasing numbers of older adults with complex health deficits presenting to emergency departments has prompted the development of innovative models of care. One such model designed to reduce poor outcomes associated with acute healthcare, is the Geriatric Emergency Department Intervention. This intervention is a nurse-led, physician-championed, Emergency Department intervention that improves the health outcomes for frail older adults in the emergency department. Methods This quantitative cohort study aimed to evaluate the healthcare outcomes and costs associated with the implementation of the Geriatric Emergency Department Intervention (GEDI) for adults aged 70 years and over at two hospital sites that implemented the model using the integrated-Promoting Action on Research Implementation in Health Services (i-PARHIS) framework. Hospital A was large teaching hospital located in the tropical north of Australia. Hospital B was a medium sized teaching hospital near Brisbane, Queensland Australia. The effect of the intervention was examined in two ways. Outcomes were compared between: 1) all patients in the pre- and post- implementation periods, and 2) patients seen or not seen by the Geriatric Emergency Department Intervention team in the post-implementation period. The outcomes measured were disposition (discharged home, admitted); emergency department length of stay; hospital length of stay; all cause in-hospital mortality within 28 days; time to re-presentation up to 28 days post-discharge; emergency department and in-hospital costs. Survival analyses were used for the primary and secondary outcome variables and a Cox survival model was used to estimate the associations between variables and outcomes. Multiple regression models were used to examine other secondary outcomes whilst controlling for a range of confounders. Results The Geriatric Emergency Department Intervention was successfully translated into two different emergency departments. Both demonstrated an increased likelihood of discharge, decreased emergency department length of stay, decreased hospital costs for those who were admitted, with an associated reduction in risk of mortality, for adults aged 70 years and over. Conclusions The Geriatric Emergency Department Intervention was successfully translated into new sites that adapted the model design. Improvement in healthcare outcomes for older adults presenting to the emergency department was demonstrated, although this was more subtle than in the original model setting.
Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02999-4.
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Affiliation(s)
- Elizabeth Marsden
- Sunshine Coast Hospital and Health Service, Sunshine Coast University Hospital, 4 Doherty Street, Birtinya, QLD, 4575, Australia
| | - Alison Craswell
- University of the Sunshine Coast, Sunshine Coast Health Institute, 4 Doherty Street, Birtinya, QLD, Australia.
| | - Andrea Taylor
- Sunshine Coast Hospital and Health Service, Sunshine Coast University Hospital, 4 Doherty Street, Birtinya, QLD, 4575, Australia
| | - Adrian Barnett
- Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, Qld, 4059, Australia
| | - Pan-Kar Wong
- Gold Coast Hospital and Health Service, Gold Coast University Hospital, 1 Hospital Blvd, Gold Coast, Qld, 4215, Australia
| | - Marianne Wallis
- University of the Sunshine Coast, Sunshine Coast Health Institute, 4 Doherty Street, Birtinya, QLD, Australia.,Southern Cross University, Southern Cross Drive, Bilinga, QLD, 4225, Australia
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12
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Jing Z, Li J, Tingting G, Wang Y, Chen Z, Zhou C. Identifying Vulnerability to Poverty and its Determinants Among Older Adults in Empty-Nest Households: An Empirical Analysis from Rural Shandong Province, China. Health Policy Plan 2022; 37:849-857. [PMID: 35349699 DOI: 10.1093/heapol/czac029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/05/2022] [Accepted: 03/26/2022] [Indexed: 11/13/2022] Open
Abstract
Although extreme poverty has been eradicated in China, older adults in empty-nest households may risk falling into or returning to poverty in the future. Previous studies on poverty alleviation had focused on the measurement of ex-post poverty at a particular time. Few studies have assessed households' vulnerability to poverty from a forward-looking perspective. This study aims to identify the vulnerability to poverty and its determinants among rural empty-nest households with older adults. A total of 1,951 rural empty-nest households with older adults followed for one year were included in the analysis. The Three-stage Feasible Generalized Least Square method was used to estimate the vulnerability to poverty in 2019 and 2020. A regression model was used to explore the effect of different factors on vulnerability to poverty, and Shapley values were used to decompose each factor's contribution and the attributable percentage. With the increase of the poverty threshold, the success rate of predicting poverty status in 2020 based on poverty vulnerability in 2019 increased from 33.00% to 63.71%. Regardless of the poverty threshold, the vulnerability to poverty incidence decreased from 2019 to 2020. For example, under the Shandong province poverty line, the estimated proportion of rural empty-nest households with older adults vulnerable to poverty had decreased from 15.63% in 2019 to 11.17% in 2020. The Shapley decomposition results suggested that the number of the household labor force, the interviewees' education and age, and household size were the four most influential factors that contributed significantly to the poverty vulnerability. This study reveals that a portion of rural empty-nest households with older adults are still vulnerable to poverty. The formulation of future anti-poverty policies should prioritize these groups and adopt targeted poverty prevention and poverty alleviation measures based on the driving factors of poverty vulnerability among rural empty-nest households with older adults.
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Affiliation(s)
- Zhengyue Jing
- School of Health Policy and Management, Nanjing Medical University, Nanjing, 211166, China.,Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Gao Tingting
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Zhuo Chen
- Department of Health Policy Management, College of Public Health, University of Georgia, Athens, GA, 30602, USA
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
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13
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Zak M, Sikorski T, Wasik M, Courteix D, Dutheil F, Brola W. Frailty Syndrome-Fall Risk and Rehabilitation Management Aided by Virtual Reality (VR) Technology Solutions: A Narrative Review of the Current Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2985. [PMID: 35270677 PMCID: PMC8910391 DOI: 10.3390/ijerph19052985] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 02/06/2023]
Abstract
Frailty, a physiological syndrome (FS) affecting primarily the older adults, manifests itself through significantly depleted bodily reserves, and appreciably higher (up to over threefold) individual exposure to fall risk. Concomitant medical conditions such as balance impairment, reduced visual acuity, limited mobility, and significantly diminished daily functional performance further exacerbate the patients' condition. Their resultant susceptibility to frequent hospitalisations makes their prognosis even worse. This narrative review aimed to provide an overview of published studies focused on rehabilitation management approaches aided by virtual reality (VR) technology in frail older adults. The authors had it also augmented with their own, evidence-based body of experience in rehabilitation. Making use of technologically advanced exercise machinery, specially adapted for rehabilitating frail older adults, combined with a structured exercise regimen, further aided by the application of select virtual reality (VR) technology solutions, clearly proved effective. Consequently, the patients were helped to move back from the frail to the pre-frail stage, as well as had their motor and cognitive functions appreciably enhanced. The application of modern technology in rehabilitating older adults over 65, affected by FS, when specifically aided by the select VR technology solutions, was also proven to complement successfully the conventional rehabilitation management. The overall versatility of the VR technology solutions, e.g., adaptation for home use allowing remote supervision, also makes this novel approach to rehabilitation far more appealing to the patients. They find it both very attractive and far more mentally engaging. Its considerable potential lies mostly in being appreciably more effective in bringing in desirable therapeutic outcomes.
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Affiliation(s)
- Marek Zak
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University of Kielce, Zeromskiego 5, 25-369 Kielce, Poland;
| | - Tomasz Sikorski
- Doctoral School, Collegium Medicum, The Jan Kochanowski University of Kielce, Zeromskiego 5, 25-369 Kielce, Poland; (T.S.); (M.W.)
| | - Magdalena Wasik
- Doctoral School, Collegium Medicum, The Jan Kochanowski University of Kielce, Zeromskiego 5, 25-369 Kielce, Poland; (T.S.); (M.W.)
| | - Daniel Courteix
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Frederic Dutheil
- Occupational and Environmental Medicine, CHU, 63000 Clermont-Ferrand, France;
- CNRS, LaPSCo, Physiological and Psychosocial Stress, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Waldemar Brola
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University of Kielce, Zeromskiego 5, 25-369 Kielce, Poland;
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Lin SY, Tseng HC. Short-Term Changes of Frailty in Prematurely Aging Adults With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:57-65. [PMID: 35104351 DOI: 10.1352/1934-9556-60.1.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/02/2021] [Indexed: 06/14/2023]
Abstract
The purpose of this study was to investigate short-term changes of frailty in adults and identify predictors of frailty and disability changes between baseline and the follow-up. A cohort study was conducted in 85 adults with intellectual disability (ID) in southern Taiwan. Variables of frailty phenotype, Barthel Index, fall, comorbidity, and hospitalization were measured at baseline and at a 9-month follow-up. Descriptive statistics, correlations, and generalized linear model technique were used for data analysis. The percentages of frailty and pre-frail conditions were high at baseline. Improvement or deterioration on frailty was noticed in 37.6% of participants. Disability and comorbidity were significant predictors to changes in frailty, and severity of ID and frailty conditions were significant predictors to changes in disability.
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Affiliation(s)
- Shu-Yuan Lin
- Shu-Yuan Lin and Hui-Chen Tseng, Kaohsiung Medical University, Taiwan
| | - Hui-Chen Tseng
- Shu-Yuan Lin and Hui-Chen Tseng, Kaohsiung Medical University, Taiwan
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15
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Venturini C, Moreira BDS, Ferriolli E, Liberalesso Neri A, Lourenço RA, Sampaio RF. Can Social Resources Explain the Limitations in the Activities of Daily Living of Older Adults Classified by the Phenotype of Physical Frailty? J Appl Gerontol 2022; 41:1445-1453. [PMID: 35025622 DOI: 10.1177/07334648211064267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective is to investigate the mediating roles of living alone and personal network in the relationship between physical frailty and activities of daily living (ADL) limitations among older adults. 2271 individuals were classified as vulnerable (pre-frail or frail) or robust. Mediating variables were living alone and personal network. Katz Index and Lawton-Brody scale were used to assess ADL. Mediating effects were analyzed with beta coefficients from linear regression models using the bootstrapping method. Mediation analysis showed significant mediating effects of living alone (β = .011; 95% CI = .004; .018) and personal network (β = .005; 95% CI = .001; .010) on the relationship between physical frailty and basic ADL limitations. Mediation effects of living alone and personal network on the relationship between physical frailty and instrumental ADL limitations were β = -.074 (95% CI=-.101; -.046) and β = -.044 (95% CI = -.076; -.020), respectively. Physically vulnerable older adults who lived alone or had poor personal network were more dependent on basic and instrumental ADL.
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Affiliation(s)
- Claudia Venturini
- Graduate Program in Rehabilitation Science, Department of Physical Therapy, 28114Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Bruno de Souza Moreira
- Graduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | | | | | - Rosana Ferreira Sampaio
- Graduate Program in Rehabilitation Science, Department of Physical Therapy, 28114Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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16
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Zhang L, Ji T, Sun F, Li Y, Tang Z, Ma L. A Simplified Frailty Index Predicts Mortality in Older Adults in Beijing. Risk Manag Healthc Policy 2021; 14:4867-4873. [PMID: 34887689 PMCID: PMC8650771 DOI: 10.2147/rmhp.s302354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The comprehensive geriatric assessment (CGA) is an integral tool used to identify vulnerable older adults in need of individualized plans to delay the course of diseases and monitor treatment outcomes. We previously developed and validated a 68-item frailty index (FI) based on the CGA in a large, older, Chinese population. However, substantial time is needed to evaluate the 68 items. Therefore, we aimed to develop and validate a simplified FI for use in Chinese older population. Design Longitudinal study. Setting and Participants Data were drawn from the Beijing Longitudinal Study of Aging. The study was conducted in 2004 with 1808 participants evaluated using the CGA and was followed-up for 13 years. Mortality was recorded at 3, 5, 8, 10, and 13 years intervals. Measures 27-Item, 50-item, and 68-item frailty indices were investigated. A Cox proportional hazards model and area under the curve of the receiver operating characteristic (AUC-ROC) were calculated to compare mortality predictions. Results The FI was positively correlated with age in males (r = 0.174, P <0.001) and females (r = 0.270, P <0.001). The mean baseline FI was 0.225 ± 0.085 (range: 0.04-0.56) as evaluated by the 27-item FI, 0.181 ± 0.117 (range: 0.02-0.62) by the 50-item FI, and 0.167 ± 0.101 (range: 0.02-0.59) by the 68-item FI. Cox regression models showed that mortality was significantly higher in frail people than in non-frail people for all 3 indices (p<0.001). The AUCs of the 68-item FI, 50-item FI, and 27-item FI for predicting mortality were 0.720, 0.717, and 0.677, respectively (p<0.001). Conclusion The 27-item FI is reasonable to expect that the AUC of the indices with the higher items number is inferior to the performance of the indices with higher number of items (FI50 and FI68). But 27-item maybe used as a tool to identify frail older adults and predict mortality in clinical and primary care practices in China.
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Affiliation(s)
- Li Zhang
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.,Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
| | - Tong Ji
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.,Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
| | - Fei Sun
- Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
| | - Yun Li
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China
| | - Zhe Tang
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.,Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.,Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
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17
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Bessa B, Coelho T, Ribeiro Ó. Social frailty dimensions and frailty models over time. Arch Gerontol Geriatr 2021; 97:104515. [PMID: 34597877 DOI: 10.1016/j.archger.2021.104515] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Social frailty is a complex concept and there is still no consensus on the criteria that best define it, nor on the role that social dimensions play in well-established frailty models. AIM To analyse the predictive value of social frailty dimensions on distinct frailty models. METHOD A non-probabilistic sample of 193 community-dwelling adults aged 65 years and over was recruited in 2016 and followed for three years. Frailty was assessed by the Tilburg Frailty Indicator, the Groningen Frailty Indicator, and the Fried Phenotype criteria. Questions about living alone, social network, social support, loneliness, and frequency of social activities engagement were used to assess social criteria. Bivariate correlations and sequential multiple hierarchical logistic regression analyses were performed. RESULTS At baseline, 22.2% older adults lived alone, 47.2% reported missing people around them, 21.1% reported lack of social support, 26.1% reported having reduced their participation in social activities recently and 52.2% reported loneliness. The percent of frail individuals varied across frailty measures, and social criteria showed significant correlations and increased the prediction of frailty status. Loneliness and social activities engagement were associated with frailty as assessed by the Tilburg frailty Indicator and by the Fried Phenotype criteria; the lack of social support is associated with frailty as assessed by the Groningen Frailty Indicator. Living alone and lack of social relationships did not predict frailty. CONCLUSION Including social dimensions in a frailty model needs a consensual theoretical basis as they have different roles in predicting frailty, varying over time and across assessment tools.
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Affiliation(s)
- Bruno Bessa
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS.UP), Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, 4200-450, Porto, Portugal.
| | - Tiago Coelho
- School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal; Psychosocial Rehabilitation Lab, Center for Rehabilitation Research (CIR), Rua Dr. António Bernardino de Almeida 400, 4200-072, Porto, Portugal
| | - Óscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, 4200-450, Porto, Portugal; Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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Lin YH, Chen HC, Hsu NW, Chou P. Using hand grip strength to detect slow walking speed in older adults: the Yilan study. BMC Geriatr 2021; 21:428. [PMID: 34271880 PMCID: PMC8285830 DOI: 10.1186/s12877-021-02361-0] [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: 03/10/2021] [Accepted: 06/28/2021] [Indexed: 01/23/2023] Open
Abstract
Background Walking speed is an important health indicator in older adults, although its measurement can be challenging because of the functional decline due to aging and limited environment. The aim of this study was to examine whether hand grip strength can be a useful proxy for detecting slow walking speed in this population. Methods A cross-sectional study was conducted using the cohort from the Yilan Study in Taiwan. Community-dwelling older adults aged 65 years and older were included. Slow walking speed was defined as a 6-meter walking speed < 1.0 m/s, according to the 2019 Asian Working Group for Sarcopenia diagnostic criteria. Stepwise multiple linear regression was used to determine the most significant variables associated with walking speed. Receiver operating characteristic analysis was used to determine the optimal cutoff values for hand grip strength in detecting slow walking speed. Results A total of 301 participants with an average age of 73.9 ± 6.8 years were included; 55.1 % participants were women. In stepwise multiple linear regression analysis that included various variables, hand grip strength was found to be the most explainable factor associated with walking speed among all participants and among participants of each sex. The optimal cutoff values for hand grip strength in the detection of slow walking speed were 19.73 kg for all participants (sensitivity: 55 %, specificity: 83 %, area under the curve: 0.74, accuracy: 66.9 %), 35.10 kg for men (sensitivity: 92 %, specificity: 42 %, area under the curve: 0.70, accuracy: 66.4 %), and 17.93 kg for women (sensitivity: 62 %, specificity: 80 %, area under the curve: 0.76, accuracy: 67.9 %). Conclusions Hand grip strength was found to be a useful proxy for the identification of slow walking speed in older adults.
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Affiliation(s)
- Yen-Huai Lin
- Department of Medical Imaging, Cheng Hsin General Hospital, Taipei, Taiwan.,Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Nai-Wei Hsu
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Community Medicine Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Division of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, 152 Hsing-Ming Road, 26042, Yilan, Taiwan. .,Public Health Bureau, Yilan County, Taiwan.
| | - Pesus Chou
- Community Medicine Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Kong LN, Lyu Q, Yao HY, Yang L, Chen SZ. The prevalence of frailty among community-dwelling older adults with diabetes: A meta-analysis. Int J Nurs Stud 2021; 119:103952. [PMID: 34022743 DOI: 10.1016/j.ijnurstu.2021.103952] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 03/17/2021] [Accepted: 04/13/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Coexistence of frailty and chronic diseases including diabetes is related to a higher risk of adverse health outcomes. There is an increasing interest in the intersection of diabetes and frailty. Understanding the prevalence of frailty in older adults with diabetes is of great importance. However, estimates of the prevalence of frailty among this population varied widely in the relevant literature. OBJECTIVES To conduct a systematic review and meta-analysis to estimate the overall prevalence of frailty and prefrailty among community-dwelling older adults with diabetes, and examine the risk factors associated with frailty in this population. METHODS PubMed, Web of Science, Embase, Wiley Cochrane Library, and Cumulative Index of Nursing and Allied Health were searched from inception to May 30th, 2020. Investigators assessed eligibility, extracted data and evaluated methodological quality. The pooled prevalence of frailty and prefrailty was calculated using the random-effects model. Meta-regression analysis and subgroup analysis were conducted to explore sources of heterogeneity. RESULTS A total of 32 studies met the inclusion criteria, involving 14,450 individuals. The pooled prevalence of frailty and prefrailty in older adults with diabetes was 20.1% (95% CI = 16.0-24.2%) and 49.1% (95%CI = 45.1-53.1%), respectively, with significant heterogeneity across the studies. Frailty was more prevalent in older adults with diabetes than those without diabetes (OR = 1.61, 95%CI = 1.47-1.77, p < 0.001). The pooled prevalence of frailty was lower in studies using Frailty Phenotype to define frailty (16.3%) and conducted in Asia (14.3%). Female gender and unmarried status were risk factors of frailty among this population. CONCLUSION Frailty and prefrailty are common in community-dwelling older adults with diabetes. Early screening of frailty and interventions should be integrated into diabetes care for older adults to prevent and reduce the negative effects of frailty at the community level. Better quality longitudinal research is required to examine the temporal relationship between diabetes and frailty.
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Affiliation(s)
- Ling-Na Kong
- School of Nursing, Chongqing Medical University, No. 1 Yixueyuan Road, Yu Zhong District, Chongqing 400016, PR China; School of Nursing, The first Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Qiong Lyu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Hai-Yan Yao
- Library, The first Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, PR China
| | - Shuo-Zhen Chen
- Clinical Nursing Teaching and Research Section, Affiliated Hospital of Zunyi Medical University, Zunyi, PR China
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20
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Lin SY. Effects of exercise interventions on frailty in pre-maturely aging adults with intellectual disabilities- a preliminary study. Disabil Health J 2021; 14:101105. [PMID: 33910765 DOI: 10.1016/j.dhjo.2021.101105] [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: 08/18/2020] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Effects of exercise interventions targeting frail adults with intellectual disabilities (ID) are unknown. OBJECTIVE This study compared the effects of a combined exercise, walking programs and no intervention on frailty and muscle mass in adults with ID and pre-frail or frail conditions. METHODS This study was a quasi-experimental design, with 103 adults from six residential care and day-care centers in southern Taiwan completing study participation. A 10-week combined exercise and walking program were administered to the experimental (n = 36) and comparison (n = 32) groups respectively, with no intervention provided to the control group (n = 35). A questionnaire, measurements of frailty phenotype and a body composition machine were used to collect data. Descriptive statistics, chi-squared test, ANOVA and repeated measure ANOVA tests were conducted in the Chinese IBM SPSS 20.0. RESULTS Significant differences on level of frailty among the three groups were revealed after interventions. Mean differences of muscle mass demonstrated significant changes between baseline and after interventions, although improvements of frailty score between baseline and after interventions were not significant. CONCLUSIONS Our preliminary findings demonstrated the tendency of positive effects of combined exercise or walking programs in improving level of frailty and muscle mass in adults with ID. Early implementation of exercise interventions might be beneficial for prematurely aging adults with ID.
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Affiliation(s)
- Shu-Yuan Lin
- College of Nursing, Kaohsiung Medical University, Research Associate in Department of Medical Research, Kaohsiung Medical University Hospital, #100 Shih-Chuan 1st Rd, Kaohsiung, 807, Taiwan.
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21
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Lee TY, Susanti HD, Hung KC, Yang SY, Fang HF, Tsai JR, Chiou JF, Chung MH. Health care needs of elderly patients with lung, liver, or colon cancer in Taiwan. BMC Palliat Care 2021; 20:21. [PMID: 33485348 PMCID: PMC7827987 DOI: 10.1186/s12904-021-00708-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 01/03/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Globally, different age groups in the elderly population have experienced major shifts over time. Human life expectancy doubled from the 19th to the twentieth century and has increased to 80 years in the twenty-first century. These conditions imply economic challenges and the increasing prevalence of certain health conditions. Old age is associated with increased care needs in various aspects of daily life. This study assessed the health care needs of elderly patients with lung, liver, and colorectal cancer in Taiwan and analyzed the factors underlying their needs. METHODS This cross-sectional descriptive survey assessed 234 elderly patients with diagnosis of lung, liver, and colorectal cancer in Taiwan. We investigated their health care needs and daily living functions by using the Supportive Care Needs Survey and Karnofsky Performance Status, respectively. RESULTS Patients required the most assistance in physical functioning and daily living. Patients aged ≥85 years required more care than those aged 65-74 years in terms of information access and sexuality needs. Patients with poor functional status required more care than those capable of undertaking normal activities. Patients diagnosed as having liver cancer required more care than those with lung or colorectal cancer. Patients with advanced cancer required more physical and daily care than those with early-stage cancer. CONCLUSIONS Patients' health care needs differed with age, primary cancer site, and functional status. Patients aged ≥85 years and those with poor function, primary liver cancer, and advanced cancer had higher care needs.
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Affiliation(s)
- Tzu-Yin Lee
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan
| | - Henny Dwi Susanti
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan.,Department of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, East Java, Indonesia
| | - Kuo-Chen Hung
- Department of Computer Science and Information Management, Hungkuang University, Taichung City, Taiwan
| | - Su-Yueh Yang
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hui-Fen Fang
- Department of Nursing, Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,Cancer Center, Taipei Medical University Hospital, Taipei, Taiwan.,Nursing Services, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jia-Ruey Tsai
- Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jeng-Fong Chiou
- Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan. .,Department of Nursing, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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22
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Abstract
Although geriatric research in general has increased in recent years, there is no effective treatment for frailty. Among older adults, those with frailty have an increased risk of falls, disability, and death. The population of older adults has increased rapidly in China, and resulting in an increased demand for medical care services for older adults, including those with frailty. However, much of the research on frailty has been conducted in Europe and the United States, and European and American standards for frailty are not always applicable to Chinese individuals. Clinicians and researchers in China have shown increasing interest in frailty in recent years. Here, we reviewed the current state of frailty research in China.
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Affiliation(s)
- L Ma
- Dr. Lina Ma, Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China, E-mail:
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Abe T, Okuyama K, Kamada M, Yano S, Toyama Y, Isomura M, Nabika T, Sakane N, Ando H, Miyazaki R. Social participation and physical prefrailty in older Japanese adults: The Shimane CoHRE study. PLoS One 2020; 15:e0243548. [PMID: 33326452 PMCID: PMC7743931 DOI: 10.1371/journal.pone.0243548] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/24/2020] [Indexed: 11/19/2022] Open
Abstract
As older adults in an early stage (prefrailty) of frailty may return to a healthy state, it is necessary to examine the prevention of prefrailty. In this context, the number and types of social participation activities associated with physical prefrailty in community-dwelling older adults have remained relatively unexplored. This cross-sectional study investigates this issue by analyzing 616 participants living in Okinoshima, Shimane, a rural area of Japan, in 2019. Frailty was assessed using the 5-item frailty phenotype (unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity). Data on social participation were obtained using a questionnaire based on participants' level of involvement with volunteer groups, sports clubs/groups, neighborhood associations, religious organizations/groups, and community elderly salons; their answers were categorized as "yes" if they answered "several times per year or more" and "no" if they answered "never." Binominal logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) of prefrailty by the number or types of social participation activities, adjusted for gender, age, body mass index, smoking, medication-taking, educational attainment, working status, and living arrangement. Of the 616 participants, 273 (44.3%) and 28 (4.5%) had prefrailty and frailty, respectively. The analysis showed that the number of social participation activities was significantly associated with lower odds of prefrailty (OR = 0.83; 95% CI, 0.74-0.94). Regarding the types of social participation, sports clubs/groups were associated with lower odds of prefrailty (OR = 0.47; 95% CI, 0.31-0.73). Participation in neighborhood associations was associated with prefrailty/frailty (OR = 0.57; 95% CI, 0.37-0.86). These results suggest that increasing the number of social participation activities or involvement in sports clubs/groups and neighborhood associations may be important to prevent physical prefrailty in the older population.
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Affiliation(s)
- Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- * E-mail:
| | - Kenta Okuyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Masamitsu Kamada
- Department of Health and Social Behavior, School of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shozo Yano
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Department of Laboratory Medicine, Faculty of Medicine, Shimane University, Izumo City, Shimane, Japan
| | - Yuta Toyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Human Sciences, Shimane University, Matsue City, Shimane, Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Department of Functional Pathology, Faculty of Medicine, Shimane University, Izumo City, Shimane, Japan
| | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute for Endocrine and Metabolic Disease, National Hospital Organization, Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Hitoshi Ando
- Department of Cellular and Molecular Function Analysis, Kanazawa University Graduate School of Medical Sciences, Kanazawa City, Ishikawa, Japan
| | - Ryo Miyazaki
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Human Sciences, Shimane University, Matsue City, Shimane, Japan
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Sardella A, Catalano A, Lenzo V, Bellone F, Corica F, Quattropani MC, Basile G. Association between cognitive reserve dimensions and frailty among older adults: A structured narrative review. Geriatr Gerontol Int 2020; 20:1005-1023. [PMID: 32998186 DOI: 10.1111/ggi.14040] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/18/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022]
Abstract
Frailty is a broadly investigated geriatric condition, which is characterized by an increased vulnerability to stressors. It represents an extremely relevant public health issue, increasingly conceptualized in a multidimensional perspective. The concept of cognitive reserve (CR), as originally conceptualized by Stern, has been developed in the past decades as a potential factor able to determine individual differences in cognitive vulnerability and trajectories occurring with aging. Our purpose was to provide a comprehensive review of the literature exploring the relationship between CR dimensions, selected according to the Stern model, and frailty status. A review of the literature on the association between potential CR dimensions and frailty was carried out through PubMed, Web of Knowledge and Scopus. CR expressed in terms of education, occupation, premorbid intelligence quotient and leisure time activities was associated with frailty in both cross-sectional and longitudinal observations. The majority of reviewed evidence suggests a potential protective role of CR factors against the onset and the worsening of frailty among older adults. To the best of our knowledge, this is the first attempt to provide a comprehensive overview regarding the association between CR dimensions and frailty. Education, occupation, premorbid intelligence quotient and leisure time activities are able to interact with the general concept of frailty, rather than simply affecting the cognitive trajectory towards dementia. The lack of a unique and operationalized approach to the assessment of CR, as well as the wide heterogeneity of frailty evaluation tools and criteria, denote some methodological critical issues that need to be overcome. Geriatr Gerontol Int 2020; 20: 1005-1023..
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Affiliation(s)
- Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonino Catalano
- School and Unit of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vittorio Lenzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Federica Bellone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Corica
- School and Unit of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giorgio Basile
- School and Unit of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Mehrabi F, Béland F. Effects of social isolation, loneliness and frailty on health outcomes and their possible mediators and moderators in community-dwelling older adults: A scoping review. Arch Gerontol Geriatr 2020; 90:104119. [DOI: 10.1016/j.archger.2020.104119] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 12/20/2022]
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26
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Liu W, Puts M, Jiang F, Zhou C, Tang S, Chen S. Physical frailty and its associated factors among elderly nursing home residents in China. BMC Geriatr 2020; 20:294. [PMID: 32807098 PMCID: PMC7433121 DOI: 10.1186/s12877-020-01695-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/10/2020] [Indexed: 01/15/2023] Open
Abstract
Background Evidence is scarce on the trend in prevalence of physical frailty in China; the primary purpose of this study was to identify the prevalence and correlates of physical frailty among older nursing home residents in China. Methods Cross-sectional study in 20 nursing homes in Changsha, China. Physical frailty was defined based on the frailty phenotype including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Participants with at least three affected criteria were defined as being frail. Participants with one or two affected criteria were considered as pre-frail, and those with no affected criteria were considered as robust. A total of 1004 nursing home residents aged 60 and over were included in this study. A multinomial logistic regression model was used to analyze the associations of physical frailty with its potential risk factors, including age, sex, education levels, marital status, type of institution, living status, current drinking, current smoking, regular exercise, and self-reported health. Results The overall prevalence of physical frailty and prefrailty was 55.6, and 38.5%, respectively. The rate of physical frailty substantially increased with age, and was higher in women than in men (69.5% vs. 30.5%). The multinomial logistic regression analysis showed that older age, being women, living in a private institution, living alone or with unknown person, having no regular exercise (≤ 2 times/week), and poor self-reported health were significantly associated with increased odds of being physically frail. Conclusion We demonstrated physical frailty is highly prevalent among older residents in nursing homes in China, especially in women. The potential role of those associated factors of physical frailty warrant further investigations to explore their clinical application among elderly nursing home residents.
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Affiliation(s)
- Weiwei Liu
- Xiangya Nursing School of Central South University, Changsha, Hunan, China
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Fen Jiang
- Medical College of Hunan Normal University, Changsha, Hunan, China
| | - Chuyi Zhou
- Xiangya Nursing School of Central South University, Changsha, Hunan, China
| | - Siyuan Tang
- Xiangya Nursing School of Central South University, Changsha, Hunan, China
| | - Sanmei Chen
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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27
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Yang MT, Wu YW, Chan DC, Chien MY. The relationship between atrial fibrillation and frailty in community-dwelling older adults. Arch Gerontol Geriatr 2020; 90:104103. [PMID: 32531645 DOI: 10.1016/j.archger.2020.104103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES (1) To compare the frailty status between community-dwelling older adults with and without atrial fibrillation (AF) in Taiwan and (2) to test the hypothesis that AF is associated with frailty in community-dwelling older adults. METHODS We conducted a cross-sectional study in several communities in Taipei. AF was confirmed by electrocardiogram recordings or medical diagnosis. Frailty status was assessed using both the Cardiovascular Health Study (CHS) frailty phenotype and Edmonton Frail Scale (EFS). RESULTS A total of 207 community-dwelling older adults voluntarily participated in this study, and 38 had AF. There was a significantly higher percentage of frailer (prefrail and frailty) older adults in the AF group (69 % vs. 36 %, p < 0.001) according to CHS phenotype, but no significant difference was detected by EFS criteria (92 % vs. 92 %, p = 0.966). The AF group showed significantly lower grip strength in men (26.8 ± 8.3 vs. 33.0 ± 6.9 kg, p = 0.006), walking speed (1.1 ± 0.3 vs. 1.2 ± 0.3 m/s, p = 0.003), and Timed Up and Go performance (8.8 ± 2.4 vs. 7.0 ± 1.9 s, p < 0.001) than the control group. The multiple logistic regression model showed that AF was an independent factor associated with frailer community-dwelling older adults after adjusted for covariates (odds ratio, 3.02; 95 % confidence interval, 1.32-6.89, p = 0.009). CONCLUSION Community-dwelling older adults with AF showed a significantly higher percentage of frailer individuals and lower physical function than those without AF. Furthermore, AF was an independent predictor of frailer community-dwelling older adults.
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Affiliation(s)
- Ming-Ting Yang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ding-Cheng Chan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Superintendent Office, National Taiwan University Hospital Chu-Tung Branch, Hsinchu, Taiwan; Department of Gerontology and Geriatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Meng-Yueh Chien
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
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28
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Hsieh TJ, Su SC, Chen CW, Kang YW, Hu MH, Hsu LL, Wu SY, Chen L, Chang HY, Chuang SY, Pan WH, Hsu CC. Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial. Int J Behav Nutr Phys Act 2019; 16:119. [PMID: 31791364 PMCID: PMC6889427 DOI: 10.1186/s12966-019-0855-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 10/02/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Frail older adults are predisposed to multiple comorbidities and adverse events. Recent interventional studies have shown that frailty can be improved and managed. In this study, effective individualized home-based exercise and nutrition interventions were developed for reducing frailty in older adults. METHODS This study was a four-arm, single-blind, randomized controlled trial conducted between October 2015 and June 2017 at Miaoli General Hospital in Taiwan. Overall, 319 pre-frail or frail older adults were randomly assigned into one of the four study groups (control, exercise, nutrition, and exercise plus nutrition [combination]) and followed up during a 3-month intervention period and 3-month self-maintenance period. Improvement in frailty scores was the primary outcome. Secondary outcomes included improvements in physical performance and mental health. The measurements were performed at baseline, 1 month, 3 months, and 6 months. RESULTS At the 6-month measurement, the exercise (difference in frailty score change from baseline: - 0.23; 95% confidence interval [CI]: - 0.41, - 0.05; p = 0.012), nutrition (- 0.28; 95% CI: - 0.46, - 0.11; p = 0.002), and combination (- 0.34; 95% CI: - 0.52, - 0.16; p < 0.001) groups exhibited significantly greater improvements in the frailty scores than the control group. Significant improvements were also observed in several physical performance parameters in the exercise, nutrition, and combination groups, as well as in the 12-Item Short Form Health Survey mental component summary score for the nutrition group. CONCLUSIONS The designated home-based exercise and nutrition interventions can help pre-frail or frail older adults to improve their frailty score and physical performance. TRIAL REGISTRATION Retrospectively registered at ClinicalTrials.gov (identifier: NCT03477097); registration date: March 26, 2018.
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Affiliation(s)
- Tsung-Jen Hsieh
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan
| | - Shin-Chang Su
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chun-Wei Chen
- Department of Chest Medicine, Miaoli General Hospital, Miaoli, Taiwan
| | - Yaw-Wen Kang
- Department of Physical Medicine and Rehabilitation, Miaoli General Hospital, Miaoli, Taiwan
| | - Ming-Hsia Hu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Lin Hsu
- Food Industry Research and Development Institute, Hsinchu, Taiwan
| | - Szu-Yun Wu
- Institute of Biomedical Sciences, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 11529, Taiwan
| | - Likwang Chen
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan
| | - Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan
| | - Wen-Harn Pan
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan. .,Institute of Biomedical Sciences, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 11529, Taiwan.
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan. .,Department of Health Services Administration, China Medical University, Taichung, Taiwan. .,Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan.
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Huang CY, Lee WJ, Lin HP, Chen RC, Lin CH, Peng LN, Chen LK. Epidemiology of frailty and associated factors among older adults living in rural communities in Taiwan. Arch Gerontol Geriatr 2019; 87:103986. [PMID: 31901458 DOI: 10.1016/j.archger.2019.103986] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/17/2019] [Accepted: 11/17/2019] [Indexed: 01/19/2023]
Abstract
Frailty is a well-known geriatric syndrome with strong adverse health impact to older people. The socio-economic status and the accessibility of health services in rural communities may increase the risk of frailty. We conducted a cross-sectional study in rural districts of New Taipei City, Taiwan, to explore the epidemiology and associated factors of frailty. Data of 1014 participants (mean age: 78.7 ± 8.0 years, 66.3 % females) were obtained with the prevalence of frailty and pre-frailty 17.6 % and 23.1 %, respectively. The mean Barthel Index was 98.5 ± 5.8, and their mean Instrumental Activities of Daily Living (IADL) were 7.2 ± 1.5. Frail older people tended perform worse in timed up-and-go tests (24.7 % in frailty and 0.4 % in robust). The mean mini-mental state examination (MMSE) score for all participants was 23.3 ± 5.1, but was lower in frail older for around 5 points. Depressive symptoms were more common in frail older persons than robust ones (31.5 % vs 14.3 %), which was similar in the nutritional status. Results of the logistic regression showed that better education, IADL and MMSE scores were protective factors against frailty. The presence of depressive symptoms, urinary incontinence, abnormal performance of TUG, and the presence of the risk for malnutrition were all independent assciated factors for frailty. In conclusion, the prevalence of frailty was higher among older adults living in rural communities that deserves specific public health attentions. Further intervention study covering special needs in rural communities is needed to promote health of older people.
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Affiliation(s)
- Chung-Yu Huang
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming University, New Taipei City, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, New Taipei City, Taiwan
| | - Wei-Ju Lee
- Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan; Aging and Health Research Center, National Yang Ming University, New Taipei City, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, New Taipei City, Taiwan
| | - Hui-Ping Lin
- Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Ren-Chou Chen
- Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Chi-Hung Lin
- Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming University, New Taipei City, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, New Taipei City, Taiwan.
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming University, New Taipei City, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, New Taipei City, Taiwan
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[Prevalence and profile of the frail population in La Palma, Canary Islands]. Rev Esp Geriatr Gerontol 2019; 54:129-135. [PMID: 30777385 DOI: 10.1016/j.regg.2018.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 10/23/2018] [Accepted: 11/06/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Population ageing requires that health and social systems focus their attention on identifying frailty in the elderly. In the Canary Islands, there are no studies to determine the prevalence of frailty among its population. The objective of this study is to determine the prevalence and profile of frailty in the island of La Palma, Canary Islands, Spain. MATERIAL AND METHOD A cross-sectional study was conducted to estimate the prevalence and the profile of frailty. The sample were residents over 70 years old, valued by the Fried criteria, and taking into account other related factors. The prevalence is offered with a confidence interval of 95% and is compared with that of other Spanish populations. To determine the profile, a simple comparison of variables was made, followed by using them in logistic regression models. All the tests were bilateral at a P≤0.05 level. RESULTS The prevalence of frailty in people over 70 years was estimated at 20% (17-23%). This prevalence shows differences with those of other Spanish populations. The factors that showed a relationship with frailty were, being female, widowed, living alone, low physical activity, cognitive impairment, depression, polymedication, and adverse clinical history. Multivariate analysis identifies factors associated with the frailty variables related to marital status, co-existence, polypharmacy, depressive states, and lack of physical exercise. CONCLUSIONS The elderly population of La Palma have greater frailty compared to that described in other regions of Spain, with their profile being that of a widowed person, with depression, polymedicated, living alone, and not exercising.
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He B, Ma Y, Wang C, Jiang M, Geng C, Chang X, Ma B, Han L. Prevalence and Risk Factors for Frailty among Community-Dwelling Older People in China: A Systematic Review and Meta-Analysis. J Nutr Health Aging 2019; 23:442-450. [PMID: 31021361 DOI: 10.1007/s12603-019-1179-9] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To systematically assess the prevalence of frailty, including prefrailty, stratified prevalence according to frailty criteria, gender, age, and region, and the risk factors for frailty in China. DESIGN We conducted a systematic literature review and meta-analysis using articles available in 8 databases including PubMed, Cochrane Library, Web of Science, CINAHL Plus, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and Weipu Database (VIP). SETTING Cross-sectional and cohort data from Chinese community. PARTICIPANTS Community-dwelling adults aged 65 and older. MEASUREMENTS Two authors independently extracted data based upon predefined criteria. Where data were available we conducted a meta-analysis of frailty parameters using a random-effects model. RESULTS We screened 915 different articles, and 14 studies (81258 participants) were ultimately included in this analysis. The prevalence of frailty and prefrailty in individual studies varied from 5.9% to 17.4% and from 26.8% to 62.8%, respectively. The pooled prevalence of frailty and prefrailty were 10% (95% CI: 8% to 12%, I2 = 97.4%, P = 0.000) and 43% (95% CI: 37% to 50%, I2 = 98.0%, P = 0.000), respectively. The pooled frailty prevalence was 8% for the Fried frailty phenotype, 12% for the frail index, and 15% for the FRAIL scale. Age-stratified meta-analyses showed the pooled prevalence of frailty to be 6%, 15%, and 25% for those aged 65-74, 75-84, and ≥85 years old, respectively. The pooled prevalence of frailty was 8% for males and 11% for females. The pooled prevalence of frailty in Mainland China, Taiwan, and Hong Kong was 12%, 8%, and 14%, respectively. The pooled frailty prevalence was 10% in urban areas and 7% in rural areas. After controlling for confounding variables, increasing age (OR = 1.28, 95% CI: 1.2 to 1.36, I2 = 98.0%, P = 0.000), being female (OR = 1.29, 95% CI: 1.16 to 1.43, I2 =92.7%, P=0.000), activities of daily living (ADL) disability (OR = 1.72, 95% CI: 1.57 to 1.90, I2 = 99.7%, P = 0.000), and having three or more chronic diseases (OR = 1.97, 95% CI: 1.78 to 2.18, I2 = 97.5%, P = 0.000) were associated with frailty. CONCLUSIONS These findings of this review indicate an overall pooled prevalence of frailty among Chinese community-dwelling older people of 10%. Increasing age, being female, ADL disability, and having three or more chronic diseases were all risk factors for frailty. Further research will be needed to identify additional frailty risk factors in order to better treat and prevent frailty in the community.
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Affiliation(s)
- B He
- Lin Han, Ph.D. Professor of Nursing, Nursing department, Gansu Provincial Hospital, No.204 donggang west road, chengguan district, Lanzhou, China; School of Nursing, Lanzhou University, No.28 yanxi road, chengguan district, Lanzhou, China (730000), E-mail:
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Assessing the social dimension of frailty in old age: A systematic review. Arch Gerontol Geriatr 2018; 78:101-113. [DOI: 10.1016/j.archger.2018.06.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 12/19/2022]
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Independent association between subjective cognitive decline and frailty in the elderly. PLoS One 2018; 13:e0201351. [PMID: 30071051 PMCID: PMC6072005 DOI: 10.1371/journal.pone.0201351] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 07/13/2018] [Indexed: 11/19/2022] Open
Abstract
Background The relationship between subjective cognitive decline and frailty, two components of the so-called reversible cognitive frailty, in the elderly remains unclear. This study aims to elucidate whether this association exists, independent of confounding factors such as nutritional status, kidney function, inflammation, and insulin resistance. Methods 2386 participants (≥ 65 years of age) selected from the Healthy Aging Longitudinal Study in Taiwan (HALST) study. Fried frailty phenotype was adopted to quantify frailty status. We classified cognitive status into two categories—subjective cognitive decline (SCD), and normal cognition—and used polytomous logistic regressions to investigate the associations between SCD and frailty. Results There were 188 (7.88%), 1228 (51.47%), and 970 (40.65%) participants with frailty, pre-frailty, and robustness, respectively. Compared to those with normal cognition, elders with SCD were more likely to have pre-frailty (odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.10–1.67, p = 0.004) or frailty (OR: 1.78, 95% CI: 1.23–2.58, p = 0.002) after adjusting for age, gender, education level, comorbidity, nutritional status, kidney function, and biochemical-related factors. Conclusions A significant association between subjective cognitive decline and frailty was revealed in this study. Subjective cognitive decline was positively associated with pre-frailty or frailty even after adjusting for potential confounding factors. Our results can provide useful references in understanding mechanisms and developing suitable preventive strategies for the elderly with reversible cognitive frailty.
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Siriwardhana DD, Hardoon S, Rait G, Weerasinghe MC, Walters KR. Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Open 2018; 8:e018195. [PMID: 29496895 PMCID: PMC5855322 DOI: 10.1136/bmjopen-2017-018195] [Citation(s) in RCA: 231] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 11/24/2017] [Accepted: 01/05/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs. DESIGN Systematic review and meta-analysis. PROSPERO registration number is CRD42016036083. DATA SOURCES MEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017. SETTING Low-income and middle-income countries. PARTICIPANTS Community-dwelling older adults aged ≥60 years. RESULTS We screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I2=99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I2=97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years. CONCLUSION The prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries. PROSPERO REGISTRATION NUMBER CRD42016036083.
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Affiliation(s)
- Dhammika D Siriwardhana
- Research Department of Primary Care and Population Health, University College London, London, UK
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Sarah Hardoon
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Greta Rait
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Manuj C Weerasinghe
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Kate R Walters
- Research Department of Primary Care and Population Health, University College London, London, UK
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Wu C, Smit E, Xue QL, Odden MC. Prevalence and Correlates of Frailty Among Community-Dwelling Chinese Older Adults: The China Health and Retirement Longitudinal Study. J Gerontol A Biol Sci Med Sci 2017; 73:102-108. [PMID: 28525586 PMCID: PMC5861883 DOI: 10.1093/gerona/glx098] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Frailty is an age-related clinical syndrome of decreased resilience to stressors and is associated with numerous adverse outcomes. Although there is preponderance of literature on frailty in developed countries, limited investigations have been conducted in less developed regions including China-a country that has the world's largest aging population. We examined frailty prevalence in China by sociodemographics and geographic region, and investigated correlates of frailty. METHODS Participants were 5,301 adults aged ≥60 years from the China Health and Retirement Longitudinal Study. Frailty was identified by the validated physical frailty phenotype (PFP) scale. We estimated frailty prevalence in the overall sample and by sociodemographics. We identified age-adjusted frailty prevalence by geographical region. Bivariate associations of frailty with health and function measures were evaluated by chi-squared test and analysis of variance. RESULTS We found 7.0% of adults aged 60 years or older were frail. Frailty is more prevalent at advanced ages, among women, and persons with low education. Age-adjusted frailty prevalence ranged from 3.3% in the Southeast and the Northeast to 9.1% in the Northwest, and was more than 1.5 times higher in rural versus urban areas. Frail versus nonfrail persons had higher prevalence of comorbidities, falls, disability, and functional limitation. CONCLUSIONS We demonstrated the utility of the PFP scale in identifying frail Chinese elders, and found substantial sociodemographic and regional disparities in frailty prevalence. The PFP scale may be incorporated into clinical practice in China to identify the most vulnerable elders to reduce morbidity, prevent disability, and enable more efficient use of health care resources.
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Affiliation(s)
- Chenkai Wu
- School of Biological and Population Health Sciences, Oregon State University, Corvallis
| | - Ellen Smit
- School of Biological and Population Health Sciences, Oregon State University, Corvallis
| | - Qian-Li Xue
- Department of Medicine, Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Michelle C Odden
- School of Biological and Population Health Sciences, Oregon State University, Corvallis
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Dury S, De Roeck E, Duppen D, Fret B, Hoeyberghs L, Lambotte D, Van der Elst M, van der Vorst A, Schols J, Kempen G, Rixt Zijlstra GA, De Lepeleire J, Schoenmakers B, Kardol T, De Witte N, Verté D, De Donder L, De Deyn PP, Engelborghs S, Smetcoren AS, Dierckx E. Identifying frailty risk profiles of home-dwelling older people: focus on sociodemographic and socioeconomic characteristics. Aging Ment Health 2017; 21:1031-1039. [PMID: 27267783 DOI: 10.1080/13607863.2016.1193120] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This paper investigates risk profiles of frailty among older people, as these are essential for detecting those individuals at risk for adverse outcomes and to undertake specific preventive actions. Frailty is not only a physical problem, but also refers to emotional, social, and environmental hazards. METHODS Using data generated from the Belgian Ageing Studies, a cross-sectional study (n = 28,049), we tested a multivariate regression model that included sociodemographic and socioeconomic indicators as well as four dimensions of frailty, for men and women separately. RESULTS The findings indicated that for both men and women, increased age, having no partner, having moved house in the previous 10 years, having a lower educational level and having a lower household income are risk characteristics for frailty. Moreover, when looking at the different frailty domains, different risk profiles arose, and gender-specific risk characteristics were detected. DISCUSSION This paper elaborates on practical implications, and formulates a number of future research recommendations to tackle frailty in an aging society. The conclusion demonstrates the necessity for a thorough knowledge of risk profiles of frailty, as this will save both time and money and permit preventive actions to be more individually tailored.
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Affiliation(s)
- Sarah Dury
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium
| | - Ellen De Roeck
- b Laboratory of Neurochemistry and Behavior , University of Antwerp , Antwerp , Belgium.,c Department of Clinical and Lifespan Psychology , Vrije Universiteit Brussel , Brussels , Belgium
| | - Daan Duppen
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium
| | - Bram Fret
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium
| | - Lieve Hoeyberghs
- d Faculty of Education, Health and Social Work , University College Ghent , Gent , Belgium
| | - Deborah Lambotte
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium
| | - Michaël Van der Elst
- e Department of General Practice , Catholic University of Leuven , Leuven , Belgium
| | - Anne van der Vorst
- f Department of Health Services Research, CAPHRI School for Public Health and Primary Care , Maastricht University , Maastricht , The Netherlands
| | - Jos Schols
- f Department of Health Services Research, CAPHRI School for Public Health and Primary Care , Maastricht University , Maastricht , The Netherlands.,g Department of General Practice, CAPHRI School for Public Health and Primary Care , Maastricht University , Maastricht , The Netherlands
| | - Gertrudis Kempen
- f Department of Health Services Research, CAPHRI School for Public Health and Primary Care , Maastricht University , Maastricht , The Netherlands
| | - G A Rixt Zijlstra
- f Department of Health Services Research, CAPHRI School for Public Health and Primary Care , Maastricht University , Maastricht , The Netherlands
| | - Jan De Lepeleire
- h Department of Public Health and Primary Care , University of Leuven , Leuven , Belgium
| | - Birgitte Schoenmakers
- h Department of Public Health and Primary Care , University of Leuven , Leuven , Belgium
| | - Tinie Kardol
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium
| | - Nico De Witte
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium.,d Faculty of Education, Health and Social Work , University College Ghent , Gent , Belgium
| | - Dominique Verté
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium
| | - Liesbeth De Donder
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium
| | - Peter Paul De Deyn
- b Laboratory of Neurochemistry and Behavior , University of Antwerp , Antwerp , Belgium
| | | | - An-Sofie Smetcoren
- a Department of Educational Sciences , Vrije Universiteit Brussel , Brussels , Belgium
| | - Eva Dierckx
- c Department of Clinical and Lifespan Psychology , Vrije Universiteit Brussel , Brussels , Belgium
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Badrasawi M, Shahar S, Kaur Ajit Singh D. Risk Factors of Frailty Among Multi-Ethnic Malaysian Older Adults. INT J GERONTOL 2017. [DOI: 10.1016/j.ijge.2016.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Validation of the Patient Health Questionnaire for Depression Screening Among the Elderly Patients in Taiwan. INT J GERONTOL 2016. [DOI: 10.1016/j.ijge.2016.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Woo J, Yu R, Wong M, Yeung F, Wong M, Lum C. Frailty Screening in the Community Using the FRAIL Scale. J Am Med Dir Assoc 2015; 16:412-9. [DOI: 10.1016/j.jamda.2015.01.087] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 01/20/2015] [Indexed: 10/23/2022]
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