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Masutomi K, Bando M, Inagaki Y, Kido R, Uemura Y, Hatada Y, Kido JI, Fukui M, Hinode D, Yumoto H. Relationship between oral hypofunction and salivary biomarkers in older adults: a cross-sectional study. BMC Oral Health 2024; 24:766. [PMID: 38971720 PMCID: PMC11227702 DOI: 10.1186/s12903-024-04556-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/02/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Oral health problems have increased among older adults. Oral hypofunction is characterized by seven signs and symptoms: oral uncleanness, oral dryness, decline in occlusal force, decline in the movement function of the tongue and lips, decline in tongue pressure, decline in masticatory function, and decline in swallowing function, the latter being a significant risk factors for oral frailty. Recent research has suggested that salivary biomarkers can be used to assess not only oral diseases, including dental caries and periodontitis, but also systemic diseases, such as cancer and diabetes mellitus. This cross-sectional study investigated the relationship between oral hypofunction and the levels of salivary biomarkers. METHODS In total, 116 patients, aged 65 years or older, were included in this cross-sectional study. If three or more signs or symptoms in seven kinds of tests met the criteria of each test, oral hypofunction was diagnosed. The levels of biomarkers in the saliva collected from the patients were analyzed using an enzyme-linked immunosorbent assay. RESULTS In total, 63.8% of patients were diagnosed with oral hypofunction. Multivariable linear regression analysis showed that calprotectin levels in the saliva were significantly related to oral moisture and masticatory function. Furthermore, 8-OHdG levels in saliva were associated with the movement function of the tongue and lips and oral hygiene level, and salivary AGE correlated only with the movement function of the tongue and lips. Multiple logistic regression analysis revealed that calprotectin levels in the saliva were significantly correlated with the prevalence of oral hypofunction, even after adjusting for age, sex, and periodontal status. However, none of the biomarker levels in the saliva had a significant relationship with the number of examinations outside the reference range. CONCLUSIONS Calprotectin, 8-OHdG, and AGE levels are associated with oral hypofunction in older adults.
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Affiliation(s)
- Kenji Masutomi
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Mika Bando
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan.
| | - Yuji Inagaki
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Rie Kido
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Yuta Uemura
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Yukari Hatada
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Jun-Ichi Kido
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Makoto Fukui
- Department of Hygiene and Oral Health Science, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Daisuke Hinode
- Department of Hygiene and Oral Health Science, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Hiromichi Yumoto
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
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Delbari A, Abolfathi Momtaz Y, Bidkhori M, Ghavidel F. Association between mental health and sleep condition with social frailty: evidence from ardakan cohort study on aging (ACSA). Aging Ment Health 2024:1-7. [PMID: 38961749 DOI: 10.1080/13607863.2024.2372475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVE This population-based study aimed to evaluate the association of mental health and several sleep conditions with Social Frailty (SF) in a sample of Iranian middle-aged and older adults. METHOD This cross-sectional study was conducted using data from the Ardakan Cohort Study on Aging (ACSA). SF was assessed by five questions: inability to help others, limited social participation, loneliness, financial difficulty, and not having anyone to talk to (HALFT). Based on the responses, the participants were divided into three groups: social robust (a score of 0), pre-SF (a score of 1-2), and SF (a score of ≥3). Mental health factors included depression and anxiety. Within the domain of sleep conditions, considerations included sleep duration, quality, subjective sleep health, and daytime sleepiness. The logistic regression models were employed to analyze the data. RESULTS A total of 5782 subjects participated in the study, with females comprising 50.7% of the sample. This study revealed the total prevalence of pre-SF and SF were 76.4 and 9.3%, respectively. After adjusting for age, sex, marital status, education, number of comorbidities, and mental health, in the age group of 50-60 years, anxiety (borderline and abnormal compared to normal, OR = 1.49, 95% CI: 1.05-2.11 and OR = 1.98, 95% CI: 1.26-3.12, respectively) were associated with SF. Similarly, in the age group of 60 years and above, only depression was associated with SF (OR = 2.24, 95% CI: 1.45-3.44). CONCLUSION These findings imply that mental health might contribute to SF in the middle-aged and older Iranian population.
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Affiliation(s)
- Ahmad Delbari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Yadollah Abolfathi Momtaz
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Bidkhori
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Ghavidel
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Quintero-Cruz MV, Mantilla-Morrón M, Urina-Jassir M, Pinillos-Patiño Y, Quijano-Del Gordo CI, Buelvas W, De Ávila-Quintana L, Cotes K, Urina-Triana M. Factors associated with frailty among older individuals with chronic diseases: A multicenter study. SAGE Open Med 2024; 12:20503121241255000. [PMID: 38799003 PMCID: PMC11119381 DOI: 10.1177/20503121241255000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Objective Frailty is a syndrome that predisposes older individuals to adverse health outcomes, such as disability, dependence, falls, hospitalization, post-operative complications, and poor health in general. This study aimed to identify factors associated with frailty in older people with chronic diseases in Colombia. Methods A cross-sectional study was conducted with a nonprobabilistic sample of 230 older people (aged ⩾ 60 years) from four Colombian cities. Frailty was based on Fried's phenotype (frail defined as having ⩾3 criteria). Comorbidities were classified based on Charlson's Comorbidity Index and key questionnaires for activities of daily living (ADLs) were evaluated. Results Most were female (57.8%) with a mean ± SD age of 71.9 ± 8 years. Among them, 27.4% were frail and 58.7% were prefrail. Female gender, age ⩾ 75 years, low educational and socioeconomic level, dependence on ADLs, and cognitive impairment were associated with higher odds of prefrailty/frailty. Conclusions Prefrailty and frailty are common among older people with chronic diseases in Colombia. This syndrome is associated with social and health-related conditions, which should be addressed when providing care for these patients.
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Affiliation(s)
| | - Mirary Mantilla-Morrón
- Faculty of Health Sciences, Physiotherapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | - Manuel Urina-Jassir
- Department of Medicine, Boston Medical Center and Boston University Chobanian, Avedisian School of Medicine, Boston, MA, USA
| | - Yisel Pinillos-Patiño
- Faculty of Health Sciences, Physiotherapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | | | | | - Luzdaris De Ávila-Quintana
- Centro de Rehabilitación Pulmonar Integral, Cartagena, Cordoba, Colombia
- Universidad de San Buenaventura, Cartagena, Colombia
| | | | - Miguel Urina-Triana
- Faculty of Health Sciences, Universidad Simón Bolívar, Barranquilla, Atlántico, Colombia
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Gupta P, Chan A, Tai-Anh V, Man REK, Fenwick EK, Aravindhan A, Junxing C, Wood JM, Black AA, Ng JH, Cheng CY, Sabanayagam C, Lamoureux EL. Prevalence, associated risk factors; and patient and economic impact of multiple sensory impairment in a multi-ethnic elderly population in Singapore: the PIONEER study. BMC Public Health 2024; 24:1102. [PMID: 38649854 PMCID: PMC11034097 DOI: 10.1186/s12889-024-18635-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND To determine the prevalence, risk factors; and impact on patient health and economic outcomes across the laterality spectrum of multiple sensory impairment (MSI) in a multi-ethnic older Asian population. METHODS In this population-based study of Singaporeans aged ≥ 60 years, MSI was defined as concomitant vision (visual acuity > 0.3 logMAR), hearing (pure-tone air conduction average > 25 dB), and olfactory (score < 12 on the Sniffin' Sticks test) impairments across the spectrum of laterality (any, unilateral, combination [of unilateral and bilateral], and bilateral). RESULTS Among 2,057 participants (mean ± SD 72.2 ± 0.2 years; 53.1% female), the national census-adjusted prevalence rates of any, unilateral, combination, and bilateral MSI were 20.6%, 1.2%, 12.2%, and 7.2%, respectively. Older age, male gender, low socioeconomic status (SES), and smoking (all p < 0.05) were independently associated with higher likelihood of any MSI. Compared to those with no sensory loss, those with MSI had significantly decreased mobility (range 5.4%-9.2%), had poor functioning (OR range 3.25-3.45) and increased healthcare costs (range 4-6 folds) across the laterality spectrum. Additionally, bilateral MSI had a significant decrease in HRQoL (5.5%, p = 0.012). CONCLUSIONS MSI is a highly prevalent medical condition, with 1 in 5; and almost 1 in 10 community-dwelling older Asians having any and bilateral MSI, respectively, with a higher likelihood in men, smokers, and those with low SES. Critically, MSI has a substantial negative impact on patient health and economic outcomes across the laterality spectrum. Sensory testing is critical to detect and refer individuals with MSI for management to improve their functional independence and QoL.
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Affiliation(s)
- Preeti Gupta
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Aurora Chan
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
| | - Vu Tai-Anh
- Duke-NUS Medical School, Singapore, Singapore
| | - Ryan E K Man
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Amudha Aravindhan
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | | | - Joanne M Wood
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Jia Hui Ng
- Singapore General Hospital (SGH), Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
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Potes Y, Bermejo-Millo JC, Mendes C, Castelão-Baptista JP, Díaz-Luis A, Pérez-Martínez Z, Solano JJ, Sardão VA, Oliveira PJ, Caballero B, Coto-Montes A, Vega-Naredo I. p66Shc signaling and autophagy impact on C2C12 myoblast differentiation during senescence. Cell Death Dis 2024; 15:200. [PMID: 38459002 PMCID: PMC10923948 DOI: 10.1038/s41419-024-06582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024]
Abstract
During aging, muscle regenerative capacities decline, which is concomitant with the loss of satellite cells that enter in a state of irreversible senescence. However, what mechanisms are involved in myogenic senescence and differentiation are largely unknown. Here, we showed that early-passage or "young" C2C12 myoblasts activated the redox-sensitive p66Shc signaling pathway, exhibited a strong antioxidant protection and a bioenergetic profile relying predominantly on OXPHOS, responses that decrease progressively during differentiation. Furthermore, autophagy was increased in myotubes. Otherwise, late-passage or "senescent" myoblasts led to a highly metabolic profile, relying on both OXPHOS and glycolysis, that may be influenced by the loss of SQSTM1/p62 which tightly regulates the metabolic shift from aerobic glycolysis to OXPHOS. Furthermore, during differentiation of late-passage C2C12 cells, both p66Shc signaling and autophagy were impaired and this coincides with reduced myogenic capacity. Our findings recognized that the lack of p66Shc compromises the proliferation and the onset of the differentiation of C2C12 myoblasts. Moreover, the Atg7 silencing favored myoblasts growth, whereas interfered in the viability of differentiated myotubes. Then, our work demonstrates that the p66Shc signaling pathway, which highly influences cellular metabolic status and oxidative environment, is critical for the myogenic commitment and differentiation of C2C12 cells. Our findings also support that autophagy is essential for the metabolic switch observed during the differentiation of C2C12 myoblasts, confirming how its regulation determines cell fate. The regulatory roles of p66Shc and autophagy mechanisms on myogenesis require future attention as possible tools that could predict and measure the aging-related state of frailty and disability.
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Affiliation(s)
- Yaiza Potes
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain.
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain.
| | - Juan C Bermejo-Millo
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
| | - Catarina Mendes
- CNC-UC, Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
- CIBB, Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - José P Castelão-Baptista
- CNC-UC, Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
- CIBB, Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- PDBEB - Doctoral Program in Experimental Biology and Biomedicine, Institute of Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Andrea Díaz-Luis
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain
| | - Zulema Pérez-Martínez
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Microbiology service, University Central Hospital of Asturias, Oviedo, Spain
| | - Juan J Solano
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Geriatric Service, Monte Naranco Hospital, Av. Doctores Fernández Vega, Oviedo, Spain
| | - Vilma A Sardão
- CIBB, Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- MIA-Portugal - Multidisciplinary Institute of Ageing, University of Coimbra, Coimbra, Portugal
| | - Paulo J Oliveira
- CNC-UC, Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
- CIBB, Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Beatriz Caballero
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
| | - Ana Coto-Montes
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
| | - Ignacio Vega-Naredo
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain.
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain.
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Kiljunen O, Välimäki T, Savela RM, Koponen S, Nykänen I, Suominen AL, Schwab U. Prevalence and risk factors of frailty among older family caregivers. Scand J Caring Sci 2024; 38:57-64. [PMID: 37341070 DOI: 10.1111/scs.13190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/16/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023]
Abstract
AIM The aim of this study was to investigate the prevalence of frailty and identify the demographical and clinical factors associated with frailty among older family caregivers. METHOD The participants of this cross-sectional study were older family caregivers (n = 125) living in Eastern Finland. Data on functional and cognitive status, depressive symptoms, nutritional status, medication, chronic diseases, stroke, and oral health were obtained. The Mini Nutritional Assessment (MNA) was used to evaluate nutritional status. Frailty status was evaluated using the abbreviated comprehensive geriatric assessment (aCGA) scale. RESULTS Seventy-three percent of caregivers were identified as frail. According to multivariable logistic regression, cataract, glaucoma, or macular degeneration and the MNA score were predictors of frailty. After adjusting for age, gender, and number of own teeth, the MNA score remained a significant predictor of frailty (adjusted OR = 1.22, 95% CI = 1.06, 1.41). As the MNA scores decreased (meaning poorer nutritional status), the risk of frailty increased. CONCLUSIONS The present study showed that frailty is prevalent among older family caregivers. Recognising older family caregivers with frailty or at risk of frailty is vital. It is essential to acknowledge vision problems' role in frailty and to monitor and support the nutritional status of family caregivers regularly to prevent frailty development.
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Affiliation(s)
- Outi Kiljunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Sohvi Koponen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Irma Nykänen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral Health Teaching Clinic, Kuopio University Hospital, Kuopio, Finland
| | - Ursula Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
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Steinsdóttir HR, Sigurðsson MI, Björnsson ES, Jónsdóttir F. The incidence and prevalence of proton pump inhibitor usage among internal medicine patients after hospital admission: A retrospective cohort study. Eur J Clin Pharmacol 2024; 80:273-281. [PMID: 38105298 DOI: 10.1007/s00228-023-03607-z] [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: 03/16/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The use of proton pump inhibitors (PPIs) has increased over the past decades. One potential gateway into new PPI use is following a hospital admission. The study aimed to examine the incidence of new PPI usage following admission to internal medicine services and the ratio of new persistent users. METHODS A retrospective descriptive study was conducted among all adults who had been admitted to internal medicine wards at the National University Hospital of Iceland from 2010-2020. Data was obtained from the Icelandic Internal Medicine Database. The proportion of patients who started treatment with PPI within 3 months of discharge (new users) and the proportion of patients who continued to use it after 3 months (persistent users) were examined. RESULTS Among 85.942 admissions during the study period, 7238 (15.6%) became new users, and of those 4942 (68%) were new persistent users. The incidence of new PPI use was highest for patients discharged from gastroenterology (32.2%), hematology (31.8%), and oncology (29.2%). Patients with new PPI use more commonly had a history of malignancy (19.5%) and liver disease (22.7%) and more commonly were admitted to the ICU during their hospitalization. The highest ratio of persistent usage was among patients discharged from geriatric medicine (84%). CONCLUSION One in every six patients admitted to internal medicine wards filled out a prescription for PPI within 3 months from discharge, and a large proportion of them became persistent users. The high rate of new PPI users from oncology and hematology is noteworthy and requires further research.
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Affiliation(s)
- Helga Rut Steinsdóttir
- Clinical Pharmacy Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
| | - Martin I Sigurðsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Division of Anesthesia and Intensive Care Medicine, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Einar Stefán Björnsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Internal Medicine, Division of Gastroenterology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Freyja Jónsdóttir
- Clinical Pharmacy Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
- Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland
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Bag Soytas R, Levinoff EJ, Smith L, Doventas A, Morais JA, Veronese N, Soysal P. Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review. EPIDEMIOLOGIA 2023; 4:382-407. [PMID: 37873884 PMCID: PMC10594531 DOI: 10.3390/epidemiologia4040035] [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: 07/15/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 10/25/2023] Open
Abstract
Frailty is a geriatric syndrome that has physical, cognitive, psychological, social, and environmental components and is characterized by a decrease in physiological reserves. Frailty is associated with several adverse health outcomes such as an increase in rehospitalization rates, falls, delirium, incontinence, dependency on daily living activities, morbidity, and mortality. Older adults may become frailer with each hospitalization; thus, it is beneficial to develop and implement preventive strategies. The present review aims to highlight the epidemiological importance of frailty in rehospitalization and to compile predictive strategies and related interventions to prevent hospitalizations. Firstly, it is important to identify pre-frail and frail older adults using an instrument with high validity and reliability, which can be a practically applicable screening tool. Comprehensive geriatric assessment-based care is an important strategy known to reduce morbidity, mortality, and rehospitalization in older adults and aims to meet the needs of frail patients with a multidisciplinary approach and intervention that includes physiological, psychological, and social domains. Moreover, effective multimorbidity management, physical activity, nutritional support, preventing cognitive frailty, avoiding polypharmacy and anticholinergic drug burden, immunization, social support, and reducing the caregiver burden are other recommended predictive strategies to prevent post-discharge rehospitalization in frail older adults.
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Affiliation(s)
- Rabia Bag Soytas
- Department of Medicine, Division of Geriatric Medicine, McGill University, Montreal, QC H3G 1A4, Canada; (R.B.S.); (E.J.L.); (J.A.M.)
| | - Elise J. Levinoff
- Department of Medicine, Division of Geriatric Medicine, McGill University, Montreal, QC H3G 1A4, Canada; (R.B.S.); (E.J.L.); (J.A.M.)
| | - Lee Smith
- Center for Health Performance and Wellbeing, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | - Alper Doventas
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34320, Turkey;
| | - José A. Morais
- Department of Medicine, Division of Geriatric Medicine, McGill University, Montreal, QC H3G 1A4, Canada; (R.B.S.); (E.J.L.); (J.A.M.)
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, 90133 Palermo, Italy;
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34320, Turkey;
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9
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Hamiduzzaman A, Wu R, Murray V, Kalantar-Zadeh K, Streja E, Sy J. Comparing the Fried frailty phenotype versus the Veterans Affairs frailty index among dialysis dependent patients. Hemodial Int 2023; 27:444-453. [PMID: 37318050 DOI: 10.1111/hdi.13101] [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: 03/01/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Frailty in dialysis patients is a modifiable disease state which can increase mortality if left untreated but remains underdiagnosed as frailty evaluations can be arduous or time consuming. We evaluate the agreement between a clinical frailty construct (Fried frailty phenotype, FFP) against and an electronic health record-based Veterans Affairs Frailty Index (VAFI) and their association with mortality. METHODS A retrospective cohort analysis of 764 participants from the ACTIVE/ADIPOSE study was performed. Frailty as measured by VAFI and FFP was obtained and Kappa statistic estimating concordance between the two scores were calculated. Differences in mortality risk were analyzed according to presence or absence of frailty. FINDINGS When assessing agreement between the VAFI and FFP, the kappa statistic was 0.09 (95% confidence interval [CI] 0.02-0.16) suggesting a low level of agreement. Frailty was independently associated with higher mortality risk (hazards ratio [HR] 1.40-1.42 in fully adjusted models depending upon frailty construct). Discordantly frail patients by construct had a higher risk of mortality though this was not statistically significant after adjustment. However, concordantly frail patients had much higher mortality risk compared to concordantly nonfrail (adjusted HR 2.08, 95% CI 1.44-3.01). DISCUSSION Poor agreement between constructs is likely reflective of the multifactorial definition of frailty. While further longitudinal studies are needed to determine if the VAFI would be beneficial in the reassessment of frailty, it may be beneficial as a cue for further frailty testing (e.g., with FFP) with the combination of multiple frail constructs providing improved prognostic information.
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Affiliation(s)
- Anum Hamiduzzaman
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, School of Medicine, Orange, California, USA
- Veterans Affairs Long Beach Healthcare System, Division of Nephrology, Long Beach, California, USA
| | - Ruoxue Wu
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, School of Medicine, Orange, California, USA
| | - Victoria Murray
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, School of Medicine, Orange, California, USA
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, School of Medicine, Orange, California, USA
- Veterans Affairs Long Beach Healthcare System, Division of Nephrology, Long Beach, California, USA
| | - Elani Streja
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, School of Medicine, Orange, California, USA
- Veterans Affairs Long Beach Healthcare System, Division of Nephrology, Long Beach, California, USA
| | - John Sy
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, School of Medicine, Orange, California, USA
- Veterans Affairs Long Beach Healthcare System, Division of Nephrology, Long Beach, California, USA
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10
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Qi X, Li Y, Hu J, Meng L, Zeng P, Shi J, Jia N, Zeng X, Li H, Zhang Q, Li J, Liu D. Prevalence of social frailty and its associated factors in the older Chinese population: a national cross-sectional study. BMC Geriatr 2023; 23:532. [PMID: 37658332 PMCID: PMC10474699 DOI: 10.1186/s12877-023-04241-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Social frailty has not been comprehensively studied in China. Our objective is to investigate the prevalence of social frailty among the older population in China, as well as identify relevant factors and urban-rural differences. METHODS We obtained data from the Fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) database. The study employed a multistage, stratified, cluster-sampling method, recruiting a total of 224,142 adults aged 60 years or older. Participants were interviewed to gather demographic data and information on family, health and medical conditions, health care service status, living environment conditions, social participation, protected rights status, spiritual and cultural life, and health. Social frailty was assessed using the HALFE Social Frailty Index. A score of three or above indicated social frailty. RESULTS We analyzed a total of 222,179 cases, and the overall prevalence of social frailty was found to be 15.2%. The highest prevalence was observed among participants aged 75-79 years (18.0%). The prevalence of social frailty was higher in rural older populations compared to urban older populations (19.9% in rural vs. 10.9% in urban, P < 0.0001). In urban areas, women had a higher prevalence than men (11.7% in women vs. 9.9% in men, P < 0.0001), while in rural areas, men had a higher prevalence than women (20.6% in men vs. 19.2% in women, P < 0.0001). Multivariate regression analysis revealed that living in a rural/urban environment (OR 1.789, 95% CI 1.742-1.837), absence of a spouse/spousal presence (OR 4.874, 95% CI 4.743-5.009), self-assessed unhealthy/health status (OR 1.696, 95% CI 1.633-1.761), and housing dissatisfaction/satisfaction (OR 2.303, 95% CI 2.233-2.376) were all significantly associated with social frailty. CONCLUSIONS Using the HALFE social frailty index, we found a prevalence of 15.2% among older people in China, with the highest prevalence observed in the 75-79 age group. Social frailty was more prevalent in rural areas than in urban areas. Various factors, including spousal presence, housing satisfaction, health status, and urban-rural residential differences, were significantly associated with social frailty. These findings highlight the modifiable and non-modifiable factors that contribute to social frailty among older individuals in China.
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Affiliation(s)
- Xin Qi
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Yingying Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Jiabin Hu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Lingbing Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Ping Zeng
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Na Jia
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Xuezhai Zeng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Hui Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | | | - Juan Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China.
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Levitt EB, Patch DA, Johnson JP, Love B, Waldrop RP, McGwin G, Spitler CA, Quade JH. Risk Factors for Prolonged Hospital Stay After Femoral Neck Fracture. Orthopedics 2023; 46:211-217. [PMID: 36779739 DOI: 10.3928/01477447-20230207-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The purpose of this study was to investigate the association between pre-operative anemia and prolonged hospital stay among geriatric patients with operative femoral neck fractures. This retrospective cohort study was performed at a level I trauma center and included geriatric patients with femoral neck fractures (OTA/AO 31) and operative treatment with Current Procedural Terminology code 27236. Exclusion criteria were admission to the intensive care unit, evacuation of subdural hematoma, and conditions requiring exploratory laparotomy. A total of 207 individuals, with data collected between January 2015 and August 2019 and age 65 years and older, were included in the analysis. Linear regression was used to evaluate the association between anemia and length of stay adjusting for potential confounders. Anemia was defined using preoperative hematocrit. The primary outcome was prolonged length of stay, defined as 5 or more days. The group was 65% women. The mean age was 80.2 years (range, 64-98 years). The majority (61%) of patients had anemia. American Society of Anesthesiologists classification was associated with preoperative anemia (P=.02). Patients with anemia had a 16% higher risk of prolonged length of stay compared with patients without anemia (81% vs 65%, P=.009). In the linear regression model, preoperative hematocrit was associated with length of stay (P=.032) when adjusted for sex, age, preoperative tranexamic acid, preoperative hemoglobin, postoperative hemoglobin, and postoperative hematocrit. Length of stay was approximately 1 week in this study, with anemia being a statistically significant risk factor for prolonged length of stay. Health care providers and administrators can consider anemia on admission when predicting length of stay. [Orthopedics. 2023;46(4):211-217.].
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12
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Qi X, Jia N, Hu J, Meng LB, Zeng P, Liu J, Shi J, Zeng X, Li H, Zhang Q, Li J, Liu D. Analysis of the status of social frailty in Chinese older adults with cardiovascular and cerebrovascular diseases: a national cross-sectional study. Front Public Health 2023; 11:1022208. [PMID: 37293616 PMCID: PMC10244724 DOI: 10.3389/fpubh.2023.1022208] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 05/05/2023] [Indexed: 06/10/2023] Open
Abstract
Background Social frailty is one type of frailty. Physical frailty with cardiovascular and cerebrovascular diseases (CCVD) have been studied a lot, but less research on social frailty. Objectives To study the prevalence, related risk factors and regional differences of social frailty with CCVD in Chinese older adults. Methods SSAPUR was a national cross-sectional survey. Participants aged 60 years or older were recruited in August 2015. Demographic data and information regarding family, health and medical conditions, living environment conditions, social participation, spiritual and cultural life, and health condition were obtained. Social frailty was assessed in five areas (HALFE Social Frailty Index) including inability to help others, limited social participation, loneliness, financial difficulty, and living alone. The prevalence of CCVD with social frailty, related risk factors and regional differences in CCVD with social frailty were studied. Results A total of 222,179 participants were enrolled. 28.4% of them had CCVD history. The prevalence of social frailty in the CCVD group was 16.03%. In CCVD participants, compared with the group without social frailty, there were significant differences in gender, age, urban-rural distribution, ethnicity, marital status, and education levels in the social frailty group. Significant differences were also found in physical exercise participation, health status, cataract, hypertension, diabetes mellitus, hospitalization within 1 year, self-assessed health status, crutch or wheelchair usage, urinary and fecal incontinence, need for care from others, fall history, housing satisfaction, and self-assessed happiness in the social frailty group. Women with CCVD had a higher prevalence of social frailty than men. By age in CCVD with social frailty, the highest prevalence was found in participants 75-79 years old. The prevalence of CCVD was significant difference between social frailty in urban and rural group. The prevalence of social frailty with CCVD was significantly different in different regions. The highest prevalence was 20.4% in southwest area, and the lowest prevalence was 12.5% in northeast with area. Conclusion The prevalence of social frailty among the CCVD older adults is high. Factors such as gender, age, region, urban-rural residence, and the state of the disease may be associated with social frailty.
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Affiliation(s)
- Xin Qi
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Na Jia
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiabin Hu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Ling-bing Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ping Zeng
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Junmeng Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuezhai Zeng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Juan Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Ripa M, Schipa C, Rizzo S, Sollazzi L, Aceto P. Is the visual impairment a risk factor for frailty in older adults? A systematic review and meta-analysis of 10-year clinical studies. Aging Clin Exp Res 2023; 35:227-244. [PMID: 36367632 DOI: 10.1007/s40520-022-02296-5] [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: 06/16/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Frailty is linked to poor health outcomes later in life. Recent research suggests that visual loss is a possible modifiable risk factor for frailty. AIMS To analyze the relationship between visual impairment (VI) and frailty and investigate whether it can increase the risk of frailty in older adults. METHODS We performed a systematic review and meta-analysis of cohort studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched PubMed, Embase, and Scopus databases for relevant studies published between 2012 and 2022 that clearly described VI and frailty measurement methods. Cross-sectional and longitudinal studies that examined the associations between VI and the existence of frailty in adults aged 65 years or older were synthesized. Meta-analyses were conducted using the measurement of risk and a 95% confidence interval for each study. Quality assessment using the Newcastle-Ottawa Scale (NOS), risk of bias, heterogeneity, and sensitivity analyses were also conducted. RESULTS Our search identified 1074 manuscripts published in the English language between 1 January 2012 and 9 June 2022. After studies screening, seventeen articles, including 22,192 participants and 3624 cases of frailty, were selected. A random-effect meta-analysis demonstrated a significant association between visual impairment and the risk of frailty (OR 2.13; 95% CI 1.67-2.72). The quality rating of the cross-sectional studies averaged 8.33 (95% CI 7.77-8.89) of the maximum score on the NOS. CONCLUSIONS Visual impairment increases the risk of frailty in later life and should be accurately assessed in frail older adults.
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Affiliation(s)
- Matteo Ripa
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Chiara Schipa
- Catholic University "Sacro Cuore", Rome, Italy.
- Department of Emergency, Anesthesiological and Reanimation Sciences, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - Stanislao Rizzo
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
| | - Liliana Sollazzi
- Catholic University "Sacro Cuore", Rome, Italy
- Department of Emergency, Anesthesiological and Reanimation Sciences, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Paola Aceto
- Catholic University "Sacro Cuore", Rome, Italy
- Department of Emergency, Anesthesiological and Reanimation Sciences, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
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14
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Self-reported hearing and vision impairment and incident frailty in Japanese older people: A 3-year longitudinal analysis of the Japan Gerontological Evaluation Study. Arch Gerontol Geriatr 2023; 104:104834. [PMID: 36257161 DOI: 10.1016/j.archger.2022.104834] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/01/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND We examined the associations and interactions of hearing impairment (HI) and vision impairment (VI) with frailty. METHODS We performed a 3-year longitudinal analysis of the Japan Gerontological Evaluation Study (JAGES), a nationwide prospective cohort study of functionally independent Japanese older people (age ≥ 65 years). Frailty status at baseline and follow-up was defined according to the Kihon Checklist. HI and VI at baseline were self-reported. Logistic regression models were used to examine the main and interaction effects of HI and VI on incident frailty during a 3-year follow-up period. RESULTS Of the 7,852 participants (mean age 73.2 years, standard deviation 5.6; 50.7% women), 9.7%, 5.3%, and 1.9% reported HI, VI, and concurrent HI and VI, respectively. After adjusting for possible confounders and the other sensory impairment, VI (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.62-3.85, p < 0.001), but not HI (OR 1.29, 95% CI 0.97-1.72, p = 0.081), was significantly associated with incident combined pre-frailty and frailty from a robust baseline. No interaction was observed between HI and VI (OR 0.83, 95% CI 0.38-1.81, p = 0.636). We observed no significant associations between sensory impairments and incident frailty from a pre-frail baseline (HI: OR 1.26, 95% CI 0.88-1.80, p = 0.205; VI: OR 1.44, 95% CI 0.90-2.31, p = 0.127; interaction between HI and VI: OR 1.16, 95% CI 0.53-2.53, p = 0.718). CONCLUSIONS VI, rather than HI, may be an independent risk factor for frailty, without any interaction between the two.
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15
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Takeshima T, Yamamoto Y, Iwasaki K, Ha C, Oishi M, Sato A, Sonoyama Y, Honda N, Niida H, Takeda J. Prevalence, treatment status, medical costs, quality of life, and productivity loss in Japanese adult patients with anemia: a real-world database study. J Med Econ 2023; 26:1386-1397. [PMID: 37849298 DOI: 10.1080/13696998.2023.2271752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/13/2023] [Indexed: 10/19/2023]
Abstract
AIMS To investigate the prevalence, treatment status, and effect of anemia on medical costs, quality of life (QOL), and productivity loss in Japan. METHODS This cross-sectional study used a database containing claims, health check-ups, and questionnaire data. Adults with hemoglobin data at 2020 check-ups were included. QOL and productivity loss were evaluated using EuroQol 5-Dimension (EQ-5D) and Work Productivity and Activity Impairment questionnaire data available for a subset of the population. Nationwide anemia prevalence, including both diagnosed as having anemia and undiagnosed but with low hemoglobin levels, were estimated. Treatment status was described by hemoglobin levels. Differences in medical costs, QOL, and productivity loss were compared between individuals with and without anemia. Subgroup analyses were performed using the Charlson Comorbidity Index (CCI). RESULTS The study population included 554,798 individuals. Anemia prevalence was estimated at 15.1% with 55.3% undiagnosed. In patients with anemia, 85.3% were untreated; 79.5% of the treated patients received only oral iron drugs. In patients with anemia, monthly medical costs were ¥17,766 higher, EQ-5D score was 0.0118 lower, and productivity loss was 2.6% higher than in those without anemia. The trends were consistent even in limited patients with CCI = 0. Nationwide annual excess medical costs, deficit QOL, and productivity loss in patients with anemia were estimated at ¥3.32 trillion, 138,000 quality-adjusted life-years, and ¥1.13 trillion, respectively. LIMITATIONS As the study population only included individuals who underwent health check-ups, they may be healthier than general population. Whether the differences in medical costs, QoL, and productivity loss are caused by anemia or other underlying differences in patient characteristics is unclear, given the likelihood of residual confounding. CONCLUSIONS The results suggest that more than half of patients with anemia were undiagnosed and untreated. Patients with anemia had higher medical costs, lower QOL, and greater productivity loss than those without anemia.
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Affiliation(s)
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | | | - Masahito Oishi
- Data Intelligence Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Asuka Sato
- Data Intelligence Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Yohei Sonoyama
- Medical Planning Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Natsumi Honda
- Medical Planning Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Hiromichi Niida
- Medical Planning Dept., Nippon Shinyaku Co., Ltd, Kyoto, Japan
| | - Jun Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
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de Godoi Rezende Costa Molino C, Woll L, Wieczorek M, Abderhalden LA, Lanz P, Schaer DJ, Spahn DR, Orav EJ, Egli A, Bischoff-Ferrari HA. Association between iron deficiency and hospitalization rate in community-dwelling older adults: A 3-year prospective observational study of DO-HEALTH. Am J Clin Nutr 2023; 117:12-21. [PMID: 36789930 DOI: 10.1016/j.ajcnut.2022.11.001] [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: 06/09/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Iron deficiency (ID) is associated with negative health outcomes in older adults. However, data on the impact of ID on the number of hospitalizations and length of hospital stay (LOS) is lacking. OBJECTIVE To explore the associations between baseline ID and the number of hospitalizations and between baseline ID and at least one LOS ≥5 days in community-dwelling older adults. METHODS This is a secondary observational analysis of a randomized controlled trial including 2157 community-dwelling adults aged ≥70 years without major diseases at baseline. The main exposure was defined as ID (soluble transferrin receptor [sTfR] concentrations >28.1 nmol/L) at baseline. The primary outcome was the number of hospitalizations over a 3-year follow-up. The secondary outcome was having at least one LOS ≥5 days over the study period among individuals with one or more hospitalizations. Interaction between ID and anemia (hemoglobin <130 g/L for men and <120 g/L for women) was also investigated. RESULTS Baseline sTfR concentration was determined in 2141 participants (median age 74.0 years). At 3 year, 1497 hospitalizations were reported with an incidence rate of hospitalization of 0.26 per person-year (95% CI: 0.24, 0.28). Overall, baseline ID was associated with a 24% increased incidence rate of hospitalization (incidence rate ratio: 1.24; 95% CI: 1.05, 1.45) over 3 years. This association was independent of anemia status at baseline since the interaction between ID and anemia at baseline was not significant. Moreover, ID was not significantly associated with having a LOS ≥5 days (OR: 1.40; 95% CI: 1.00, 1.97) among participants with at least one hospitalization over 3 years. CONCLUSIONS ID is associated with increased hospitalization rate and not associated with LOS ≥5 days among generally healthy older adults. Efforts to minimize ID in older adults may improve overall health and optimize healthcare costs.
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Affiliation(s)
- Caroline de Godoi Rezende Costa Molino
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Laurence Woll
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Maud Wieczorek
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Lauren A Abderhalden
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Patricia Lanz
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Dominik J Schaer
- Clinic for Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Donat R Spahn
- Institute of Anesthesiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - E John Orav
- Department of Biostatistics, Harvard School of Public Health, Boston, USA
| | - Andreas Egli
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland; University Clinic for Aging Medicine, Zurich City Hospital-Waid, Zurich, Switzerland.
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Provost G, Lavoie FB, Larbi A, Ng TP, Ying CTT, Chua M, Fulop T, Cohen AA. Novel approach to analysis of the immune system using an ungated model of immune surface marker abundance to predict health outcomes. Immun Ageing 2022; 19:35. [PMID: 35927749 PMCID: PMC9351261 DOI: 10.1186/s12979-022-00291-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022]
Abstract
AbstractTraditionally, the immune system is understood to be divided into discrete cell types that are identified via surface markers. While some cell type distinctions are no doubt discrete, others may in fact vary on a continum, and even within discrete types, differences in surface marker abundance could have functional implications. Here we propose a new way of looking at immune data, which is by looking directly at the values of the surface markers without dividing the cells into different subtypes. To assess the merit of this approach, we compared it with manual gating using cytometry data from the Singapore Longitudinal Aging Study (SLAS) database. We used two different neural networks (one for each method) to predict the presence of several health conditions. We found that the model built using raw surface marker abundance outperformed the manual gating one and we were able to identify some markers that contributed more to the predictions. This study is intended as a brief proof-of-concept and was not designed to predict health outcomes in an applied setting; nonetheless, it demonstrates that alternative methods to understand the structure of immune variation hold substantial progress.
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Lu Y, Lim WS, Jin X, Zin Nyunt MS, Fulop T, Gao Q, Lim SC, Larbi A, Ng TP. Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults. Front Med (Lausanne) 2022; 9:971622. [PMID: 36482911 PMCID: PMC9722960 DOI: 10.3389/fmed.2022.971622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/07/2022] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Sarcopenia is common among older individuals with and without type 2 diabetes mellitus (T2DM). There are conflicting evidence in support of the role of insulin in the development of age-related and T2DM-related sarcopenia. We investigated the relationships between the levels of fasting insulin and other blood biomarkers related to insulin or lipid metabolism with the presence of sarcopenia in two independent studies. MATERIALS AND METHODS In 246 pre-frail frail older individuals with (n = 41) and without T2DM (n = 205) in the Singapore Frailty Interventional Trial, sarcopenia was defined by low appendicular lean mass (ALM) relative to total body mass (skeletal muscle index, SMI = ALM/height2) and low lower limb strength or gait speed according to the Asian Working Group for Sarcopenia (AWGS) criteria released in 2019, and related to levels of fasting insulin and glucose, C-peptide, IGF-1, leptin, and active ghrelin. This investigation was validated in another independent study sample of 189 robust and pre-frail frail elderly in the Singapore Longitudinal Aging Study Wave 2 (SLAS-2). RESULTS Compared to non-sarcopenic individuals, those with sarcopenia and possible sarcopenia showed significantly lower fasting insulin (p < 0.05) in pre-frail/frail and non-frail older individuals. Consistent trends of relationships were observed for serum levels of C-peptide, IGF-1, leptin, and active ghrelin. In multivariable logistic regression models, sarcopenia was independently associated with low insulin (p < 0.05). Levels of fasting insulin, C-peptide, and leptin were also significantly associated with BMI, SMI, knee extension strength, gait speed, and physical activity score. CONCLUSION Dysregulated insulin secretion in diabetic and non-diabetic older individuals may play an important role in age-related and diabetes-related sarcopenia.
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Affiliation(s)
- Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Xia Jin
- The Third Hospital of Jinan, Jinan, China
| | - Ma Schwe Zin Nyunt
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tamas Fulop
- Department of Medicine, Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Su Chi Lim
- Department of Endocrinology, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Anis Larbi
- Department of Medicine, Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
- Biology of Ageing Laboratory, Singapore Immunology Network (SIgN), Agency for Science Technology and Research (A*STAR), Biopolis, Singapore, Singapore
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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The mediator role of frailty in the effect of fear of falling avoidance behavior on quality of life in older adults admitted to hospital. Geriatr Nurs 2022; 48:132-138. [PMID: 36219931 DOI: 10.1016/j.gerinurse.2022.09.010] [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: 07/26/2022] [Revised: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 12/14/2022]
Abstract
The aim of this research was to determine the mediator role of frailty in the effect of fear of falling avoidance behavior on quality of life in the older adults. This descriptive and cross-sectional study was conducted with 312 individuals in Istanbul between June-October 2021. The Edmonton Frail Scale (EFS) score was 7.06±3.69, Fear of Falling Avoidance Behavior Questionnaire (FFABQ) score was 17.84±15.3. Quality of Life Scale (SF-12) physical component score was 34.21±25.12 and mental component score was 41.81±17.87. EFS plays a mediating role in the effect of FFABQ on SF-12 and strengthens its negative effect on SF-12. The frailty severity of the participants was moderate, activity limitation and participation restriction due to fear of falling were low, and their quality of life in physical and mental components was low. Avoidance behavior has a direct effect on quality of life and an indirect effect with the role of frailty.
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Itokazu M, Ishizaka M, Uchikawa Y, Takahashi Y, Niida T, Hirose T, Ito A, Yakabi A, Endo Y, Sawaya Y, Igawa T, Kobayashi K, Hara T, Watanabe M, Kubo A, Urano T. Relationship between Eye Frailty and Physical, Social, and Psychological/Cognitive Weaknesses among Community-Dwelling Older Adults in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13011. [PMID: 36293591 PMCID: PMC9602133 DOI: 10.3390/ijerph192013011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the relationship between eye frailty and physical, social, and psychological/cognitive weaknesses among older adults in Japan. The participants were 192 community-dwelling older adult women. We measured handgrip strength, walking speed, and skeletal muscle mass; additionally, their physical, social, and psychological/cognitive frailties were surveyed using questionnaires. Eye frailty self-checks were used to assess eye frailty. Exploratory and confirmatory factor analyses were employed to verify the validity of the eye frailty self-checks. Eye frailty prevalence and related factors were investigated by conducting a binomial logistic regression analysis, with eye frailty as the dependent variable. The factor analysis results showed that a model could be constructed with the two factors of visual acuity or contrast and visual field. The model's goodness of fit was acceptable, supporting the validity of the self-checking construct. The Kihon checklist was the only variable with a significant relationship to eye frailty. Regarding the relationship between eye frailty and subordinate items of the Kihon checklist, social withdrawal [odds ratio (OR) 2.437, 95% confidence interval 1.145-5.188], cognitive function (OR 2.047, 95%CI 1.051-3.984), and depressed mood (OR 1.820, 95%CI 1.163-2.848) were significant. Eye frailty can be considered a factor reflecting the existence of social and psychological/cognitive frailties.
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Affiliation(s)
- Masafumi Itokazu
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshikazu Uchikawa
- Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Takahashi
- Department of Ophthalmology, Dokkyo Medical University Nikko Medical Center, Nikko 321-2593, Tochigi, Japan
| | - Takahiro Niida
- Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Ito
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Endo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tatsuya Igawa
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Kaoru Kobayashi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita 286-8686, Chiba, Japan
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Beier F, Löffler M, Nees F, Hausner L, Frölich L, Flor H. Sensory and motor correlates of frailty: dissociation between frailty phenotype and frailty index. BMC Geriatr 2022; 22:755. [PMID: 36109693 PMCID: PMC9479302 DOI: 10.1186/s12877-022-03416-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Frailty has been associated with a decline in sensory and motor function. However, given that different frailty measures were shown to overlap but also differ in their diagnostic properties, sensory and motor correlates of frailty might be different depending on the operationalization of frailty. Our objective was to identify sensory and motor determinants of frailty and compare the results between frailty phenotype (FP) and frailty index (FI).
Methods
Data from 44 pre-frail and frail subjects aged 65 and above were used. Frailty was measured using the FP and the FI. Sensory function in the visual, auditory, and tactile domain was assessed using visual acuity, absolute hearing threshold and mechanical detection threshold. Upper extremity motor performance was evaluated by the Purdue Pegboard Test and the Short Physical Performance Battery was used to assess lower extremity motor function. Multiple logistic regression models were employed to determine associations of sensory and motor function with frailty vs. pre-frailty for both frailty measures.
Results
The frailty measures were moderately correlated (0.497, p ≤ 0.01) and had a Kappa agreement of 0.467 (p = 0.002). Using the FP, frailty was significantly associated with reduced upper extremity motor function only (OR = 0.50, 95% CI 0.29–0.87, p = 0.014). Frailty as assessed by the FI was significantly related to higher hearing thresholds (OR = 1.21, 95% CI 1.02–1.43, p = 0.027) and reduced lower extremity performance (OR = 0.32, 95% CI 0.13–0.77, p = 0.012).
Conclusion
Frailty is related to reduced performance in measures of sensory and motor function. However, traditional measures of frailty might be differentially sensitive to capture sensory and motor decline, possibly contributing to the much-observed discordance between the diagnostic instruments. This should be taken into account by researchers and clinicians when planning and evaluating therapeutic interventions for frailty.
Trial registration
ClinicalTrials.gov NCT03666039. Registered 11 September 2018 – Retrospectively registered.
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22
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Liu Y, Qian P, Guo S, Liu S, Wang D, Yang L. Frailty and hearing loss: From association to causation. Front Aging Neurosci 2022; 14:953815. [PMID: 36158533 PMCID: PMC9490320 DOI: 10.3389/fnagi.2022.953815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundObservational studies suggest that frailty is associated with hearing loss (HL) but with inconsistent results. This study aims to examine such association and to assess its causality.Materials and methodsThe cross-sectional data from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression models were used to assess the association between HL and frailty index (FI). Genetic variants associated with the FI and HL were obtained from a large genome-wide association study (GWAS) meta-analysis and UK Biobank GWAS. The inverse variance weighting (IVW) method was used to estimate causal effects. Sensitivity analyses were performed to further validate the robustness of results.ResultsIn this cross-sectional analysis, results support the possibility that frailty may be associated with a higher risk of developing HL, with self-reported [odds ratio (OR) = 2.813; 95% CI, 2.386, 3.317; p < 0.001], speech frequency HL (OR = 1.975; 95% CI, 1.679–2.323; p < 0.001), and high frequency HL (OR = 1.748; 95% CI, 1.459–2.094; p < 0.001). In the adjusted model, frail participants remained at high risk of HL. Mendelian randomization (MR) studies showed a bidirectional causal association between genetically predicted FI and risk of HL (FI for exposure: OR = 1.051; 95% CI, 1.020–1.083; p = 0.001; HL for exposure: OR = 1.527; 95% CI, 1.227–1.901; p < 0.001).ConclusionOur observational study found that inter-individual differences in frailty were associated with the risk of developing HL. Genetic evidence suggests a potential bidirectional causal association between FI and HL. Furthermore, the potential mechanisms of this association require investigation.
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Affiliation(s)
- Yun Liu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Peiyi Qian
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shuli Guo
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shuangyan Liu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dahui Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Lei Yang,
| | - Lei Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Lei Yang,
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Sasagawa T, Yokogawa N, Hayashi H, Tsuchiya H, Ando K, Nakashima H, Segi N, Watanabe K, Nori S, Takeda K, Furuya T, Yunde A, Ikegami S, Uehara M, Suzuki H, Imajo Y, Funayama T, Eto F, Yamaji A, Hashimoto K, Onoda Y, Kakutani K, Kakiuchi Y, Suzuki N, Kato K, Terashima Y, Hirota R, Yamada T, Hasegawa T, Kawaguchi K, Haruta Y, Seki S, Tonomura H, Sakata M, Uei H, Sawada H, Tominaga H, Tokumoto H, Kaito T, Iizuka Y, Takasawa E, Oshima Y, Terai H, Tamai K, Otsuki B, Miyazaki M, Nakajima H, Nakanishi K, Misaki K, Inoue G, Kiyasu K, Akeda K, Takegami N, Yoshii T, Ishihara M, Okada S, Aoki Y, Harimaya K, Murakami H, Ishii K, Ohtori S, Imagama S, Kato S. A multicenter study of 1-year mortality and walking capacity after spinal fusion surgery for cervical fracture in elderly patients. BMC Musculoskelet Disord 2022; 23:798. [PMID: 35987644 PMCID: PMC9392237 DOI: 10.1186/s12891-022-05752-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The 1-year mortality and functional prognoses of patients who received surgery for cervical trauma in the elderly remains unclear. The aim of this study is to investigate the rates of, and factors associated with mortality and the deterioration in walking capacity occurring 1 year after spinal fusion surgery for cervical fractures in patients 65 years of age or older.
Methods
Three hundred thirteen patients aged 65 years or more with a traumatic cervical fracture who received spinal fusion surgery were enrolled. The patients were divided into a survival group and a mortality group, or a maintained walking capacity group and a deteriorated walking capacity group. We compared patients’ backgrounds, trauma, and surgical parameters between the two groups. To identify factors associated with mortality or a deteriorated walking capacity 1 year postoperatively, a multivariate logistic regression analysis was conducted.
Results
One year postoperatively, the rate of mortality was 8%. A higher Charlson comorbidity index (CCI) score, a more severe the American Spinal Cord Injury Association impairment scale (AIS), and longer surgical time were identified as independent factors associated with an increase in 1-year mortality. The rate of deterioration in walking capacity between pre-trauma and 1 year postoperatively was 33%. A more severe AIS, lower albumin (Alb) and hemoglobin (Hb) values, and a larger number of fused segments were identified as independent factors associated with the increased risk of deteriorated walking capacity 1 year postoperatively.
Conclusions
The 1-year rate of mortality after spinal fusion surgery for cervical fracture in patients 65 years of age or older was 8%, and its associated factors were a higher CCI score, a more severe AIS, and a longer surgical time. The rate of deterioration in walking capacity was 33%, and its associated factors were a more severe AIS, lower Alb, lower Hb values, and a larger number of fused segments.
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Floyd SB, Sarasua SM, Pill SG, Shanley E, Brooks JM. Factors related to initial treatment for adhesive capsulitis in the medicare population. BMC Geriatr 2022; 22:548. [PMID: 35773660 PMCID: PMC9248121 DOI: 10.1186/s12877-022-03230-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary adhesive capsulitis (AC) is not well understood, and controversy remains about the most effective treatment approaches. Even less is known about the treatment of AC in the Medicare population. We aimed to fully characterize initial treatment for AC in terms of initial treatment utilization, timing of initial treatments and treatment combinations. METHODS Using United States Medicare claims from 2010-2012, we explored treatment utilization and patient characteristics associated with initial treatment for primary AC among 7,181 Medicare beneficiaries. Patients with primary AC were identified as patients seeking care for a new shoulder complaint in 2011, with the first visit related to shoulder referred to as the index date, an x-ray or MRI of the shoulder region, and two separate diagnoses of AC (ICD-9-CM codes: 726.00). The treatment period was defined as the 90 days immediately following the index shoulder visit. A multivariable logistic model was used to assess baseline patient factors associated with receiving surgery within the treatment period. RESULTS Ninety percent of beneficiaries with primary AC received treatment within 90 days of their index shoulder visit. Physical therapy (PT) alone (41%) and injection combined with PT (34%) were the most common treatment approaches. Similar patient profiles emerged across treatment groups, with higher proportions of racial minorities, socioeconomically disadvantaged and more frail patients favoring injections or watchful waiting. Black beneficiaries (OR = 0.37, [0.16, 0.86]) and those residing in the northeast (OR = 0.36, [0.18, 0.69]) had significantly lower odds of receiving surgery in the treatment period. Conversely, younger beneficiaries aged 66-69 years (OR = 6.75, [2.12, 21.52]) and 70-75 years (OR = 5.37, [1.67, 17.17]) and beneficiaries with type 2 diabetes had significantly higher odds of receiving surgery (OR = 1.41, [1.03, 1.92]). CONCLUSIONS Factors such as patient baseline health and socioeconomic characteristics appear to be important for physicians and Medicare beneficiaries making treatment decisions for primary AC.
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Affiliation(s)
- Sarah B Floyd
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA. .,Center for Effectiveness Research in Orthopaedics, Greenville, USA.
| | | | - Stephan G Pill
- Steadman Hawkins Clinic of the Carolinas, Prisma Health, Greenville, SC, USA
| | | | - John M Brooks
- Center for Effectiveness Research in Orthopaedics, Greenville, USA.,Department of Health Services Policy and Management, University of South Carolina, Columbia, USA
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Ho YW, Chen SY, Hung YS, Lin SY, Chou WC. Optimal Frailty Dimensions for Assessing Frailty and Predicting Chemotherapy Adverse Events in Older Taiwanese Cancer Patients. Front Med (Lausanne) 2022; 9:828865. [PMID: 35774998 PMCID: PMC9237432 DOI: 10.3389/fmed.2022.828865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/17/2022] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to investigate the effects of different frailty dimensions on frailty prevalence in older Taiwanese cancer patients receiving chemotherapy, and to analyze the dimensions that should be included in frailty assessment for effectively predicting serious adverse events, unexpected hospitalizations, and emergency department visits. Materials and Methods This study prospectively enrolled 234 cancer patients with solid cancer or lymphoma and aged 65 years or older who later received chemotherapy at a medical center in Taiwan from September 2016 to November 2018. First, all patients were subjected to a frailty assessment on eight frailty dimensions within 1 week before their first chemotherapy treatment. The effects of different dimensions on frailty were analyzed using a Poisson regression model. Second, after sequentially excluding one, two, and three dimensions with the lowest effects, frailty was sequentially assessed in the remaining seven, six, and five dimensions for comparison of chemotherapy-related adverse events. Results Nutritional status, comorbidity, history of falls, cognitive status, and polypharmacy were the top five important dimensions of frailty in older Taiwanese cancer patients. Regardless of the number (five to eight) of dimensions used for frailty assessment, frail patients had higher rates of serious adverse events, unexpected hospitalizations, and emergency room visits than non-frail patients during chemotherapy. Conclusions Frailty assessment in older Taiwanese cancer patients should be based on at least five dimensions to accurately identify those at high risk of serious adverse events during chemotherapy. It is expected that the present findings may be used to design a frailty scale for older Taiwanese in the future.
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Affiliation(s)
- Ya-Wen Ho
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Ying Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Shin Hung
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shinn-Yn Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wen-Chi Chou
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Wen-Chi Chou
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Low physical activity is the strongest factor associated with frailty phenotype and frailty index: data from baseline phase of Birjand Longitudinal Aging Study (BLAS). BMC Geriatr 2022; 22:498. [PMID: 35689187 PMCID: PMC9188172 DOI: 10.1186/s12877-022-03135-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Frailty is the most complicated expression of aging that is related to disability or multi-morbidity. The aim of the present study was to estimate the prevalence of frailty and its associated factors among community-dwelling aged population. Methods A total of 1529 eligible community- dwelling older adults (≥ 60 years) were enrolled in the baseline phase of Birjand Longitudinal Aging Study (BLAS) from 2019 to 2020. Their frailty status was assessed using the Fried’s frailty phenotype and frailty index. Sociodemographic factors, including sex, age, marital status, and education level, were collected. Health status assessment included the history of hypertension, diabetes mellitus, cardiovascular disease, Alzheimer’s diseases and dementia, and other health conditions. Furthermore, functional assessment (ADL, IADL) and anthropometric measurements including height, weight, waist, calf, and mid-arm circumference were made and the body mass index was calculated. The nutrition status and polypharmacy (use 3 or more medication) were also evaluated. Results The prevalence of frailty was 21.69% according to the frailty phenotype and 23.97% according to the frailty index. A multiple logistic regression model showed a strong association between low physical activity and frailty phenotype (OR = 36.31, CI = 16.99–77.56, P < 0.01), and frailty index (OR = 15.46, CI = 5.65–42.34, P < 0.01). Other factors like old age (≥80), female sex, malnutrition, polypharmacy, obesity, and arthritis were also associated with frailty. The Kappa coefficient of the agreement between these two instruments was 0.18. Conclusion It seems that low physical activity is the most important determinant of frailty. Low physical activity and some other factors may be preventable or modifiable and thus serve as clinically relevant targets for intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03135-y.
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Huang F, Yang X, Yuan L, Wang M, Li R, Ye Z, Lv J, He T. Development and validation of a predictive risk model for frailty in elderly patients with multimorbidity. Geriatr Gerontol Int 2022; 22:471-476. [PMID: 35485599 DOI: 10.1111/ggi.14390] [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] [Received: 12/11/2021] [Revised: 03/14/2022] [Accepted: 03/30/2022] [Indexed: 02/05/2023]
Abstract
AIMS This study aimed to investigate the influencing factors of frailty in elderly patients with multimorbidity and to develop a predictive risk model for frailty in elderly patients with multimorbidity. METHODS In total, 3836 elderly patients with multimorbidity who were admitted to the medical wards of five grade A tertiary hospitals in Sichuan Province from March 2020 to June 2021 were selected. Based on the general data of patients with multimorbidity, the independent risk factors for frailty were obtained using logistic analysis, and a risk prediction model of frailty was developed. RESULTS Independent risk factors for frailty in patients with multimorbidity were age, types of medication, and comorbidity with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) and chronic cerebrovascular disease (CCVD); and the protective factors for frailty were body mass index (BMI), exercise and education level. The expression of the model was Z = -2.054 + 0.016 × age - 0.029 × BMI - 0.153 × education level-1.059 × exercise + 0.203 × types of medication + 0.788 × comorbidity with CHF + 0.950 × comorbidity with COPD + 0.363 × comorbidity with CCVD. CONCLUSION Age, BMI, education level, exercise, types of medication, and comorbidity with CHF, COPD and CCVD can affect frailty risk in elderly patients with multimorbidity, which may be helpful to predict the frailty risk of elderly patients with multimorbidity. Geriatr Gerontol Int 2022; 22: 471-476.
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Affiliation(s)
- Fengmei Huang
- West China School of Nursing, Sichuan University/Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoling Yang
- West China School of Nursing, Sichuan University/Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Li Yuan
- West China School of Nursing, Sichuan University/Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Miye Wang
- Engineering Research Center of Medical Information Technology, Ministry of Education, West China Hospital, Sichuan University, Chengdu, China.,Information Technology Center, West China Hospital, Sichuan University, Chengdu, China
| | - Rao Li
- West China School of Nursing, Sichuan University/Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Ziwei Ye
- West China School of Nursing, Sichuan University/Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Lv
- West China School of Nursing, Sichuan University/Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Ting He
- West China School of Nursing, Sichuan University/Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
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Gao Y, Chen Y, Hu M, Gan T, Sun X, Zhang Z, He W, Wu IXY. Characteristics and Quality of Diagnostic and Risk Prediction Models for Frailty in Older Adults: A Systematic Review. J Appl Gerontol 2022; 41:2113-2126. [PMID: 35500139 DOI: 10.1177/07334648221097084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Several prediction models for frailty in older adults have been published, but their characteristics and methodological quality are unclear. This review aims to summarize and critically appraise the prediction models. Studies describing multivariable prediction models for frailty among older adults were included. PubMed, Embase, Web of Science, and PsycINFO were searched from outset to Feb 21, 2021. Methodological and reporting quality of included models were evaluated by PROBAST and TRIPOD, respectively. All results were descriptively summarized. Twenty articles including 39 models were identified. The included models showed good predictive discrimination with C indices ranging from 0.70 to 0.98. However, all studies except one were assessed as high risk of bias mainly due to inappropriate analysis; meanwhile, poor reporting quality was also frequently observed. Few mature prediction models can be used in practice. Researchers should pay more attention to external validation and improving the quality both in methodology and reporting.
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Affiliation(s)
- Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yancong Chen
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ting Gan
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Zixuan Zhang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Wenbo He
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
| | - Irene X. Y. Wu
- Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, China
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Lu Y, Liu BP, Tan CT, Pan F, Larbi A, Ng TP. Lifetime pathogen burden, inflammatory markers, and depression in community-dwelling older adults. Brain Behav Immun 2022; 102:124-134. [PMID: 35202734 DOI: 10.1016/j.bbi.2022.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/31/2022] [Accepted: 02/18/2022] [Indexed: 02/07/2023] Open
Abstract
The link between pathogen exposure and mental health has long been hypothesized, but evidence remains limited. We investigated the association of seropositivity to common pathogens and total pathogen burden with depression and mental health and explored the role of mediating inflammatory cytokines. We profiled in 884 participants in the Singapore Longitudinal Ageing Studies, mean (SD) age: 67.9 (8.1) years, their seropositivities for 11 pathogens (CMV, HSV 1, HSV 2, HHV-6, EBV, VZV, RSV, Dengue, Chikungunya, H. Pylori and Plasmodium) and pathogen burden, Geriatric Depression Scale (GDS) score at baseline and 3-4 and 6-8 years follow-up, and baseline Mental Component Score (MCS) of 12-Item Short Form Survey (SF-12). Inflammatory markers included CRP, TNF-α, IL-6, MIP-1α, sgp130, sTNF-RI, sTNF-RII, C3a, and MCP-2. Controlling for age, sex, ethnicity, education, marital status, living alone, and smoking status, high pathogen burden (7 + cumulative infections) compared to low pathogen burden (1-5 cumulative infections) was significantly associated with period prevalence (the highest GDS score from baseline and follow-up measurements) of depressive symptoms (OR = 2.36, 95% CI = 1.05-5.33) and impaired mental health (OR = 2.25, 95% CI = 1.18-4.30). CMV seropositivity and HSV1 seropositivity, which are highly prevalent and most widely studied, were associated with estimated 2-fold increased odds of depression, but only HSV1 seropositivity was significantly associated with depression after adjusting for confounders. Notably, adjusted for confounders, RSV, H. pylori and Plasmodium seropositivity were significantly associated with increased odds, and Dengue seropositivity was associated with unexpectedly deceased odds of depressive symptoms and impaired mental health. The association of pathogen exposure with depression and mental health were at least in parts explained by inflammatory markers. Adding certain inflammatory markers to the models attenuated or weakened the association. Bootstrap method showed that MIP-1α significantly mediated the association between pathogen burden and mental health. In conclusion, lifelong pathogen burden and specific infections are associated with depression and impaired mental health in older adults.
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Affiliation(s)
- Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, China.
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
| | - Crystal Ty Tan
- Biology of Aging Laboratory, Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Fang Pan
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, China
| | - Anis Larbi
- Geriatrics Division, Department of Medicine, Research Center on Aging, University of Sherbrooke, Sherbrooke, Quebec, Canaa
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Geriatric Education and Research Institute, Ministry of Health, Singapore.
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Kasajima M, Eggleston K, Kusaka S, Matsui H, Tanaka T, Son BK, Iijima K, Goda K, Kitsuregawa M, Bhattacharya J, Hashimoto H. Projecting prevalence of frailty and dementia and the economic cost of care in Japan from 2016 to 2043: a microsimulation modelling study. Lancet Public Health 2022; 7:e458-e468. [PMID: 35487231 PMCID: PMC9094718 DOI: 10.1016/s2468-2667(22)00044-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Dementia and frailty often accompany one another in older age, requiring complex care and resources. Available projections provide little information on their joint impact on future health-care need from different segments of society and the associated costs. Using a newly developed microsimulation model, we forecast this situation in Japan as its population ages and decreases in size. METHODS In this microsimulation modelling study, we built a model that simulates an individual's status transition across 11 chronic diseases (including diabetes, coronary heart disease, and stroke) as well as depression, functional status, and self-reported health, by age, sex, and educational strata (less than high school, high school, and college and higher), on the basis of nationally representative health surveys and existing cohort studies. Using the simulation results, we projected the prevalence of dementia and frailty, life expectancy with these conditions, and the economic cost for formal and informal care over the period 2016-43 in the population of Japan aged 60 years and older. FINDINGS Between 2016 and 2043, life expectancy at age 65 years will increase from 23·7 years to 24·9 years in women and from 18·7 years to 19·9 years in men. Years spent with dementia will decrease from 4·7 to 3·9 years in women and 2·2 to 1·4 years in men. By contrast, years spent with frailty will increase from 3·7 to 4·0 years for women and 1·9 to 2·1 for men, and across all educational groups. By 2043, approximately 29% of women aged 75 years and older with a less than high school education are estimated to have both dementia and frailty, and so will require complex care. The expected need for health care and formal long-term care is anticipated to reach costs of US$125 billion for dementia and $97 billion for frailty per annum in 2043 for the country. INTERPRETATION Japan's Government and policy makers should consider the potential social challenges in caring for a sizable population of older people with frailty and dementia, and a widening disparity in the burden of those conditions by sex and by educational status. The future burden of dementia and frailty should be countered not only by curative and preventive technology innovation, but also by social policies to mitigate the health gap. FUNDING Japan Society for the Promotion of Science, Hitachi - the University of Tokyo Laboratory for a sustainable society, and the National Institute of Ageing.
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Affiliation(s)
| | - Karen Eggleston
- Walter H Shorenstein Asia-Pacific Research Center, Freeman Spogli Institute for International Studies, Stanford University, CA, USA
| | - Shoki Kusaka
- Graduate School of Economics, University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- School of Public Health, University of Tokyo, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, University of Tokyo, Tokyo, Japan
| | - Bo-Kyung Son
- Institute of Gerontology, University of Tokyo, Tokyo, Japan; Institute for Future Initiatives, University of Tokyo, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, University of Tokyo, Tokyo, Japan; Institute for Future Initiatives, University of Tokyo, Tokyo, Japan
| | - Kazuo Goda
- Institute of Industrial Science, University of Tokyo, Tokyo, Japan
| | | | - Jay Bhattacharya
- Center for Primary Care and Outcomes Research, Stanford School of Medicine, CA, USA
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The prevalence of frailty and its associated factors in an Italian institutionalized older population: findings from the cross-sectional Alvise Cornaro Center Study. Aging Clin Exp Res 2022; 34:1103-1112. [PMID: 34762253 DOI: 10.1007/s40520-021-02020-9] [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] [Received: 09/13/2021] [Accepted: 10/29/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND While it is well established that frail older people have a higher risk of negative health outcomes, the prevalence of frailty and its associated factors in Italian older institutionalized population has never been investigated. AIMS The aims of this study were to assess the prevalence of frailty and to identify its associated factors in an Italian residential care home population. METHODS An observational cross-sectional study was designed to evaluate older people aged 70 or over of an Italian residential care home. A multidimensional assessment examining functional, geriatric, ophthalmic, and audiological domains was carried out to identify factors associated with frailty. Physical frailty was evaluated using Fried's criteria. RESULTS Data analysis uncovered a 51.1% prevalence of pre-frailty and a 40.4% prevalence of frailty in the 94 eligible participants (64 females) whose data were complete. The multivariable analysis showed that a low education level (OR = 5.12, 95% CI 1.22-21.49), a low physical quality of life score (OR = 13.25, 95% CI 3.51-50.08), a low mental quality of life score (OR = 9.22, 95% CI 2.38-35.69), visual impairment (OR = 7.65, 95% CI 1.77-33.14), and hearing impairment (OR = 4.62, 95% CI 1.03-20.66) were independently associated with frailty. CONCLUSIONS Frailty was found to be highly prevalent in the residential care home studied. Since frailty is a reversible condition, identifying the modifiable factors associated to it should be viewed as an important step in planning and implementing targeted, early prevention strategies.
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Zhao Y, Ding Q, Lin T, Shu X, Xie D, Gao L, Yue J. Combined Vision and Hearing Impairment is Associated with Frailty in Older Adults: Results from the West China Health and Aging Trend Study. Clin Interv Aging 2022; 17:675-683. [PMID: 35528802 PMCID: PMC9075894 DOI: 10.2147/cia.s362191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/26/2022] [Indexed: 01/10/2023] Open
Abstract
Objective Hearing and vision loss have been independently associated with frailty in older adults, but the relationship between concurrent hearing and visual impairment (dual sensory impairment) and frailty is not well understood. Therefore, we aimed to examine whether dual sensory impairment is associated with frailty in older adults. Methods This cross-sectional study was based on the data from the West China Health and Aging Trend (WCHAT) study of community-dwelling individuals aged 60 years and older. Frailty status was evaluated by the FRAIL scale and categorized as robust, prefrail and frail. Hearing and vision functions were based on self-report. We used multinomial regression models to explore the association between dual sensory impairment and frailty. Results Of 3985 participants, 1655 (41.5%) were male and the median age was 66 years (interquartile range: 61–68). Overall, 7.6% of participants reported hearing impairment only, 32.7% reported vision impairment only, and 28.6% reported dual sensory impairment. The prevalence of prefrailty and frailty was 60.7% and 6.1%, respectively. After adjustment for confounding variables, results from the multinomial regression analysis showed that dual sensory impairment was significantly associated with greater odds of becoming frail (OR = 2.17, 95% CI = 1.40–3.38) compared with no impairment. When stratified by gender, dual sensory impairment was significantly associated with frailty in women (OR = 2.42, 95% CI = 1.40–4.20) but not in men (OR = 1.30, 95% CI = 0.58–2.91). Conclusion Older adults with dual sensory impairment are more likely to be frail than those with no impairment, suggesting that interventions to improve sensory function may potentially help reduce the risk of frailty in older adults.
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Affiliation(s)
- Yanli Zhao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Qunfang Ding
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
- Correspondence: Qunfang Ding, Department of Geriatrics and National Clinical Research Center for Geriatrics West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China, Tel +86 18980601353, Email
| | - Taiping Lin
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Xiaoyu Shu
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Dongmei Xie
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Langli Gao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
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Lee SY, Nyunt MSZ, Gao Q, Gwee X, Chua DQL, Yap KB, Wee SL, Ng TP. Association of Tai Chi exercise with physical and neurocognitive functions, frailty, quality of life and mortality in older adults: Singapore Longitudinal Ageing Study. Age Ageing 2022; 51:6563649. [PMID: 35380607 DOI: 10.1093/ageing/afac086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND real-world observations on the long-term benefits of Tai Chi (TC) exercise, in terms of physical and cognitive functioning, frailty, quality of life (QOL) and mortality are lacking. METHODS prospective cohort study participants were community-dwelling adults aged 55+, including 5,407 non-frequent TC participants (<1x/week) and 572 frequent TC participants (≥1x/week). Outcome measures at baseline and 3-5 years follow-up included physical performance (Knee Extension Strength, POMA Balance and Gait, Timed-up-and-go, Gait Speed) and neurocognitive performance (attention and working memory, visual-motor tracking and mental flexibility, verbal learning and memory, visual memory, spatial and constructional ability), Frailty Index ≥0.10, impaired QOL (SF12 physical and mental component) and all-cause mortality from mean 13 years follow-up. Effect estimates were adjusted for socio-demographics, other physical activities, nutritional risk and presence of cardiometabolic diseases. RESULTS frequent TC participation was associated with 0.7-fold lower prevalence of impaired physical QOL [95% confidence interval (CI) = 0.57-0.91], decreased 0.4-fold odds of incident prefrailty/frailty among robust participants at baseline and 0.7-fold odds of impaired mental QOL at follow-up among participants with normal mental QOL at baseline. Lower odds of mortality risk (HR = 0.89, 95%CI = 0.72-1.09) were not significant after controlling for socioeconomic, behavioural and health factors. Composite indexes of physical functional and neurocognitive performance were maintained at high level or increased at follow-up among frequent TC participants. CONCLUSION TC exercise practised among community-dwelling older adults is associated with better physical, cognitive and functional wellbeing.
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Affiliation(s)
- Shuen Yee Lee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Ma Shwe Zin Nyunt
- Office of the Senior Deputy President & Provost, National University of Singapore, Singapore
| | - Qi Gao
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Denise Qian Ling Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keng Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore
| | - Shiou Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
- Geriatric Education and Research Institute, Singapore
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Geriatric Education and Research Institute, Singapore
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Influence of oral health on frailty in patients with type 2 diabetes aged 75 years or older. BMC Geriatr 2022; 22:145. [PMID: 35183107 PMCID: PMC8858474 DOI: 10.1186/s12877-022-02841-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 02/14/2022] [Indexed: 01/28/2023] Open
Abstract
Abstract
Background
Poor oral health conditions are known to affect frailty in the older adults. Diabetes is a risk factor for both poor oral health and frailty, therefore, oral health status may affect frailty in diabetic patients more than in the general population. The purpose of this study was to evaluate the influence of oral health and other factors on frailty and the relationship among oral health, diabetes and frailty in older adult patients with type 2 diabetes.
Methods
Patients with type 2 diabetes aged 75 years or older were included in this cross-sectional study. Eligible patients were surveyed by questionnaire for frailty, oral health status, and cognitive and living functions. Factors influencing pre-frailty, frailty, and individual frailty screening index (FSI) classes were evaluated.
Results
Of the 111 patients analyzed, 66 cases (59.5%) were categorized as robust, 33 cases (29.7%) as pre-frailty, and 12 cases (10.8%) as frailty. The oral frailty index, the cognitive and living functions score, and BMI were found to be factors influencing pre-frailty or frailty. In the evaluation of individual FSI classes, BMI had an influence on those with a FSI ≤2. The cognitive and living functions score was a factor influencing those with FSI ≤3. The oral frailty index was found to have a significant influence on all FSI classes.
Conclusions
Poor oral health has an influence on frailty in patients with type 2 diabetes aged ≥75. In this patient population, as frailty progresses, the impact of oral health on frailty may increase.
Trial registration:
This study was retrospectively registered in UMIN-CTR (UMIN000044227).
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Chong EY, Lim AHS, Mah FCY, Yeo LHW, Ng ST, Yi H. Assessing the psychosocial dimensions of frailty among older adults in Singapore: a community-based cross-sectional study. BMJ Open 2022; 12:e047586. [PMID: 35135759 PMCID: PMC8830253 DOI: 10.1136/bmjopen-2020-047586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine how multiple dimensions of mental and social health, in addition to physical health, were associated with frailty among older adults. DESIGN A door-to-door sampling household community-based survey. SETTING Thirty-two public housing blocks within a residential town in Singapore's central region. PARTICIPANTS 497 residents aged 60 years or older from the public housing town. OUTCOME MEASURES Physical frailty was assessed using the FRAIL Scale, which stands for fatigue, resistance, ambulation, illnesses and loss of weight. Physical health was assessed by multimorbidity, physical activity and functional ability; mental illness was assessed by the General Health Questionnaire (GHQ); and social domains were assessed by the Lubben Social Network Scale, Community Integration Measure and UCLA (University of California, Los Angeles) Loneliness Scale. RESULTS Compared with robust (59.5%) and prefrail (32.6%) older adults, frail adults (7.9%) reported higher morbidity, lower functional ability and physical activity, higher scores on GHQ, and lower scores on all three social health scales. In multiple regression models, frailty was significantly associated with age 81-90 years (adjusted OR=2.22, 95% CI 1.23 to 3.99), having 2-3 (adjusted OR=1.56, 95% CI 1.02 to 2.38) or >3 (adjusted OR=1.83, 95% CI 1.05 to 3.18) chronic diseases, reduced ability to perform daily tasks without assistance (adjusted OR=0.41, 95% CI 0.23 to 0.73), having fallen in the past 6 months (adjusted OR=2.18, 95% CI 1.18 to 4.06), social dysfunction in GHQ (adjusted OR=1.24, 95% CI 1.08 to 1.43) and loneliness (adjusted OR=1.26, 95% CI 1.06 to 1.50). Physical activity did not remain significantly associated with frailty when mental and social health-related factors were entered in the regression. CONCLUSION Community intervention for frailty prevention and management needs to include mental health promotion and social engagement to increase its impact on older adults.
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Affiliation(s)
- Elliot Yeung Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Angela Hui-Shan Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Freda Cheng Yee Mah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lyn Hui Wen Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shu Tian Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Gosselin P, Guan D, Chen HY, Pichora-Fuller MK, Phillips N, Faris P, Smith E, Ismail Z. The Relationship Between Hearing and Mild Behavioral Impairment and the Influence of Sex: A Study of Older Adults Without Dementia from the COMPASS-ND Study. J Alzheimers Dis Rep 2022; 6:57-66. [PMID: 35360276 PMCID: PMC8925139 DOI: 10.3233/adr-210045] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/19/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Hearing loss and mild behavioral impairment (MBI), both non-cognitive markers of dementia, can be early warning signs of incident cognitive decline. Objective: We investigated the relationship between these markers and reported the influence of sex, using non-dementia participants (n = 219; 107 females) from the Canadian Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND). Methods: Hearing was assessed with the 10-item Hearing Handicap for the Elderly–Screening (HHIE-S) questionnaire, a speech-in-noise test, screening audiometry, and hearing aid use. MBI symptoms were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Multivariable linear regressions examined the association between hearing and MBI symptom severity and multiple logistic regressions examined the association between hearing and MBI domains. Results: HHIE-S score was significantly associated with greater global MBI symptom burden, and symptoms in the apathy and affective dysregulation domains. Objective measures of audiometric hearing loss and speech-in-noise testing as well as hearing aid use were not associated with global MBI symptom severity or the presence of MBI domain-specific symptoms. Males were older, had more audiometric and speech-in-noise hearing loss, higher rates of hearing-aid use, and showed more MBI symptoms than females, especially apathy. Conclusion: The HHIE-S, a subjective self-report measure that captures emotional and social aspects of hearing disability, was associated with informant-reported global MBI symptom burden, and more specifically the domains of affective dysregulation and apathy. These domains can be potential drivers of depression and social isolation. Hearing and behavior change can be assessed with non-invasive measures, adding value to a comprehensive dementia risk assessment.
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Affiliation(s)
- Penny Gosselin
- Audiology & Children’s Allied Health Services, Alberta Health Services, Lethbridge, AB, Canada
| | - Dylan Guan
- Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Hung-Yu Chen
- Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | | | | | - Peter Faris
- Health Services Statistical and Analytic Methods, Data and Analytics (DIMR), Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Eric Smith
- Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Departments of Clinical Neurosciences and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Zahinoor Ismail
- Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Departments of Clinical Neurosciences and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
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Tian R, Trevenen M, Ford AH, Jayakody DMP, Hankey GJ, Yeap BB, Golledge J, Flicker L, Almeida OP. Hearing impairment and frailty in later life: The Health in Men Study (HIMS). Maturitas 2022; 156:30-36. [PMID: 35033231 DOI: 10.1016/j.maturitas.2021.10.008] [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: 03/21/2021] [Revised: 07/11/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine if hearing loss is associated with increased risk of frailty in later life. STUDY DESIGN Cross-sectional study of a community sample of 4,004 men aged 70 years and above living in the metropolitan region of Perth, Western Australia. Data were retrieved from the Health in Men Study (HIMS) and the Western Australian Data Linkage System (WADLS). Frailty was assessed using the FRAIL scale and the Frailty Index. Hearing loss was defined by self-report or by diagnosis recorded in the WADLS. We also collected demographic, lifestyle and social support information. MAIN OUTCOME MEASURES Frailty was assessed using the FRAIL scale and the Frailty Index. RESULTS The prevalence of frailty in the sample population was 16.1% and 25.4% when assessed using the FRAIL scale and the Frailty Index respectively. After adjusting for participant demographic, lifestyle and social factors, hearing loss was significantly associated with the prevalence of frailty when diagnosed by either measure (FRAIL scale: odds ratio [OR] 1.59, 95 CI% 1.32 to 1.91; Frailty Index: OR 1.76, 95 CI% 1.50 to 2.05). The proportion of men with hearing loss increased with increasing severity of frailty. CONCLUSION Hearing loss is associated with increased prevalence of frailty in older men when assessed using the FRAIL scale and the Frailty Index. Future longitudinal studies using objective measures of hearing will be helpful in determining if this association is likely to be causal.
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Affiliation(s)
- Rong Tian
- Medical School, University of Western Australia, Perth, Australia.
| | - Michelle Trevenen
- Medical School, University of Western Australia, Perth, Australia; School of Physics, Mathematics and Computing, University of Western Australia, Perth, Australia; WA Centre for Health and Ageing of the University of Western Australia, Perth, Australia
| | - Andrew H Ford
- Medical School, University of Western Australia, Perth, Australia; WA Centre for Health and Ageing of the University of Western Australia, Perth, Australia
| | - Dona M P Jayakody
- Medical School, University of Western Australia, Perth, Australia; Ear Science Institute Australia, Subiaco, Western Australia, Australia; Ear Sciences Centre, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - Graeme J Hankey
- Medical School, University of Western Australia, Perth, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia; Department of Vascular and Endovascular Surgery, The Townsville University Hospital, Townsville, Australia
| | - Leon Flicker
- Medical School, University of Western Australia, Perth, Australia; WA Centre for Health and Ageing of the University of Western Australia, Perth, Australia
| | - Osvaldo P Almeida
- Medical School, University of Western Australia, Perth, Australia; WA Centre for Health and Ageing of the University of Western Australia, Perth, Australia
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Cheong CY, Yap P, Gwee X, Chua DQ, Wee SL, Yap KB, Ng TP. Physical and functional measures predicting long-term mortality in community-dwelling older adults: a comparative evaluation in the Singapore Longitudinal Ageing Study. Aging (Albany NY) 2021; 13:25038-25054. [PMID: 34894397 PMCID: PMC8714162 DOI: 10.18632/aging.203756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/24/2021] [Indexed: 11/25/2022]
Abstract
Measures of functional status are known to predict mortality more strongly than traditional disease risk markers in old adult populations. Few studies have compared the predictive accuracy of physical and functional measures for long-term mortality. In this prospective cohort study, community-dwelling older adults (N = 2906) aged 55 + (mean age 66.6 ± 7.7 years) were followed up for mortality outcome up to 9 years (mean 5.8 years). Baseline assessments included Timed Up-and-Go (TUG), gait velocity (GV), knee extension strength, Performance Oriented Mobility Assessment, forced expiratory volume in 1 second, Mini-Mental State Examination (MMSE), Geriatric Depression Scale, frailty, and medical morbidity. A total of 111 (3.8%) participants died during 16976.7 person-years of follow up. TUG was significantly associated with mortality risk (HR = 2.60, 95% CI = 2.05–3.29 per SD increase; HR = 5.05, 95% CI = 3.27–7.80, for TUG score ≥ 9 s). In multivariate analysis, TUG remained significantly associated with mortality (HR = 1.64, 95% CI = 1.20–2.19 per SD increase; HR = 2.66, 95% CI = 1.67–4.23 for TUG score ≥ 9 s). In multivariable analyses, GV, MMSE, Frailty Index (FI) and physical frailty, diabetes and multi-morbidity were also significantly associated with mortality. However, TUG (AUC = 0.737) demonstrated significantly higher discriminatory accuracy than GV (AUC = 0.666, p < 0.001), MMSE (AUC = 0.63, p < 0.001), FI (AUC = 0.62, p < 0.001), physical frailty (AUC = 0.610, p < 0.001), diabetes (AUC = 0.582, p < 0.001) and multi-morbidity (AUC = 0.589, p < 0.001). TUG’s predictive accuracy shows surpassing predictive accuracy for long-term mortality in community-dwelling older adults.
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Affiliation(s)
- Chin Yee Cheong
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Philip Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Xinyi Gwee
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Denise Q.L. Chua
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shiou Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Keng Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong Hospital, Singapore
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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The conceptual and practical definitions of frailty in older adults: a systematic review. J Diabetes Metab Disord 2021; 20:1975-2013. [PMID: 34900836 DOI: 10.1007/s40200-021-00897-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
Purpose This study aimed to review and extract all publications containing concepts related to definitions of frailty and categorize them. Methods A total of six electronic databases (PubMed, Ovid web, Web of Science, Scopus, Embase, Cochrane Library, and ProQuest) were searched to identify studies that introduced a definition of frailty up to October 2018. No language restrictions were imposed. Results Totally, 104,370 papers were found in the initial search and finally 68 papers were included. Of these, 21 studies provided a conceptual definition and 50 original articles also 9 review articles provided a practical definition. Moreover, 12 papers had both definitions of frailty. Of them, 62 were published in English, 2 in Portuguese, 1 in Japanese, 2 in Korean, and 1 in German languages. Conclusion Many screening tools have been developed but neither of them can cover a wide range of parameters at the same time, nor do they have simplicity in the execution. It is important to note that although a more or less general consensus on one single definition might be expected, we believe that the elderly population is too heterogeneous to allow a tool to address it as a whole, and such a definition may even be impossible. Therefore, in the absence of a "Gold Standard" definition, it is suggested to seek accurate knowledge of the strengths and weaknesses of each definition and choose the most appropriate definition and the most effective evaluation tool according to the purpose of the research and the characteristics of the older population.
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40
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Lee SY, Zin Nyunt MS, Gao Q, Gwee X, Ling Chua DQ, Yap KB, Wee SL, Ng TP. Co-occurrence of Physical Frailty and Chronic Obstructive Pulmonary Disease and Association with Disability and Mortality: Singapore Longitudinal Ageing Study. Chest 2021; 161:1225-1238. [PMID: 34914976 DOI: 10.1016/j.chest.2021.12.633] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Physical frailty is commonly associated with COPD, and its evaluation in COPD may provide important prognostic information for risk stratification. RESEARCH QUESTIONS What are the co-morbid associations of physical frailty with COPD? Does physical frailty singly and in combination with FEV1% and dyspnoea predict disability and mortality? STUDY DESIGN AND METHODS Prospective cohort study of community-dwelling adults aged 55+ in the Singapore Longitudinal Ageing Study. Baseline data of 1162 participants with COPD and 3465 participants without COPD included physical frailty, FEV1% and dyspnoea. Outcome measures were prevalent and incident IADL/ADL disability at 3-5 years follow up and all-cause mortality up to 11 years. Odds ratio (OR) and hazard ratio (HR) and 95% confidence intervals (95%CI) were adjusted for socioeconomic status, smoking and comorbidity count. RESULTS Baseline prevalence of prefrailty (48.8%) and frailty (6.8%) in participants with COPD were significantly higher than in participants without COPD: frailty OR=1.61, 95%CI=1.15-2.26. Prefrailty/frailty was associated significantly with 2-fold increased odds of prevalent and incident IADL/ADL disability and mortality in participants with COPD. In combination with FEV1%<80% or dyspnoea, frailty was associated with substantially increased 3-4-fold odds of prevalent and incident IADL/ADL disability, and 2-3-fold increased mortality hazard. A summary score combining physical frailty, FEV1<80% and dyspnoea predicted steeper risk gradients of prevalent and incident IADL/ADL disability and mortality across four risk categories (0,1,2,3-5), with the highest risk category predicting between 7-8.5-fold increased risks in crude analyses, which remained significantly high after covariate adjustment. INTERPRETATION The study supports the use of physical frailty in addition to lung function and dyspnoea in multidimensional evaluation of COPD.
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Affiliation(s)
- Shuen Yee Lee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Ma Shwe Zin Nyunt
- Office of the Senior Deputy President & Provost, National University of Singapore
| | - Qi Gao
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Denise Qian Ling Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keng Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore
| | - Shiou Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Geriatric Education and Research Institute, Singapore
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Geriatric Education and Research Institute, Singapore.
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Abe T, Seino S, Nofuji Y, Tomine Y, Nishi M, Hata T, Shinkai S, Kitamura A. Development of risk prediction models for incident frailty and their performance evaluation. Prev Med 2021; 153:106768. [PMID: 34419571 DOI: 10.1016/j.ypmed.2021.106768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/17/2021] [Accepted: 08/15/2021] [Indexed: 11/28/2022]
Abstract
There is currently no tool to predict incident frailty despite various frailty assessment tools. This study aimed to develop risk prediction models for incident frailty and evaluated their performance on discrimination, calibration, and internal validity. This 2-year follow-up study used data from 5076 non-frail older adults (51% women) living in Tokyo at baseline. We used the Kaigo-Yobo checklist, a standardised assessment instrument, to determine frailty. Twenty questionnaire-based variables that include sociodemographic, medical, behavioural, and subjective factors were entered into binary logistic regression analysis with stepwise backward elimination (p < 0.1 for retention in the model). Discrimination and calibration were assessed by area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow test, respectively. For the assessment of internal validity, we used a 5-fold cross-validation method and calculated the mean AUC. At the follow-up survey, 15.0% of men and 10.2% of women were frail. The frailty risk prediction model was composed of 10 variables for men and 11 for women. AUC of the model was 0.71 in men and 0.72 in women. The P-value for the Hosmer-Lemeshow test in both models was more than 0.05. For internal validity, the mean AUC was 0.71 in men and 0.72 in women. Probability of incident frailty rose with an increasing risk score that was calculated from the developed models. These results demonstrated that the developed models enable the identification of non-frail older adults at high risk of incident frailty, which could help to implement preventive approaches in community settings.
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Affiliation(s)
- Takumi Abe
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan; Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC 3122, Australia.
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Yui Tomine
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Mariko Nishi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Toshiki Hata
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan; Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Setagaya, Tokyo 156-8502, Japan
| | - Shoji Shinkai
- Department of Nutrition, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado City, Saitama prefecture 350-0288, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
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Ellwood A, Quinn C, Mountain G. Psychological and Social Factors Associated with Coexisting Frailty and Cognitive Impairment: A Systematic Review. Res Aging 2021; 44:448-464. [PMID: 34601993 PMCID: PMC9039321 DOI: 10.1177/01640275211045603] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Those living with coexistent frailty and cognitive impairment are at risk of poorer health outcomes. Research often focuses on identifying biological factors. This review sought to identify the association psychological and social factors have with coexisting physical and cognitive decline. Six databases were systematically searched in July 2020. Studies included individuals aged 60 years or older identified as being both frail and cognitively impaired. A narrative synthesis examined patterns within the data. Nine studies were included, most employed a cross-sectional design. Depression was investigated by all nine studies, those with coexistent frailty and cognitive impairment had higher levels of depressive symptoms than peers. Findings were mixed on social factors, although broadly indicate lower education, living alone and lower material wealth were more frequent in those living with coexistent decline. Further research is needed to explore potentially modifiable psychological and social factors which could lead to the development of supportive interventions.
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Affiliation(s)
- Alison Ellwood
- Centre for Applied Dementia Studies, 1905University of Bradford, Bradford, UK.,Wolfson Centre of Applied Health Research, Bradford, UK
| | - Catherine Quinn
- Centre for Applied Dementia Studies, 1905University of Bradford, Bradford, UK.,Wolfson Centre of Applied Health Research, Bradford, UK
| | - Gail Mountain
- Centre for Applied Dementia Studies, 1905University of Bradford, Bradford, UK
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Sarasua SM, Floyd S, Bridges WC, Pill SG. The epidemiology and etiology of adhesive capsulitis in the U.S. Medicare population. BMC Musculoskelet Disord 2021; 22:828. [PMID: 34579697 PMCID: PMC8474744 DOI: 10.1186/s12891-021-04704-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022] Open
Abstract
Background Adhesive capsulitis (AC) of the shoulder, also known as frozen shoulder, causes substantial pain and disability. In cases of secondary AC, the inflammation and fibrosis of the synovial joint can be triggered by trauma or surgery to the joint followed by extended immobility. However, for primary AC the inciting trigger is unknown. The burden of the disorder among the elderly is also unknown leading to this age group being left out of therapeutic research studies, potentially receiving delayed diagnoses, and unknown financial costs to the Medicare system. The purpose of this analysis was to describe the epidemiology of AC in individuals over the age of 65, an age group little studied for this disorder. The second purpose was to investigate whether specific medications, co-morbidities, infections, and traumas are risk factors or triggers for primary AC in this population. Methods We used Medicare claims data from 2010–2012 to investigate the prevalence of AC and assess comorbid risk factors and seasonality. Selected medications, distal trauma, and classes of infections as potential inflammatory triggers for primary AC were investigated using a case–control study design with patients with rotator cuff tears as the comparison group. Medications were identified from National Drug codes and translated to World Health Organization ATC codes for analysis. Health conditions were identified using ICD9-CM codes. Results We found a one-year prevalence rate of AC of approximately 0.35% among adults aged 65 years and older which translates to approximately 142,000 older adults in the United States having frozen shoulder syndrome. Diabetes and Parkinson’s disease were significantly associated with the diagnosis of AC in the elderly. Cases were somewhat more common from August through December, although a clear seasonal trend was not observed. Medications, traumas, and infections were similar for cases and controls. Conclusions This investigation identified the burden of AC in the US elderly population and applied case–control methodology to identify triggers for its onset in this population. Efforts to reduce chronic health conditions such as diabetes may reduce seemingly unrelated conditions such as AC. The inciting trigger for this idiopathic condition remains elusive.
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Affiliation(s)
- Sara M Sarasua
- School of Nursing, Clemson University, 436 Edwards Hall, Clemson, SC, USA.
| | - Sarah Floyd
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA.,Center for Effectiveness Research in Orthopaedics, University of South Caro, Greenville, SC, USA
| | - William C Bridges
- School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, USA
| | - Stephan G Pill
- Steadman Hawkins Clinic of the Carolinas, Prisma Health, Greenville, SC, USA
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Chen LH, Wu LW. Association between serum lactate dehydrogenase and frailty among individuals with metabolic syndrome. PLoS One 2021; 16:e0256315. [PMID: 34478437 PMCID: PMC8415577 DOI: 10.1371/journal.pone.0256315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/03/2021] [Indexed: 01/10/2023] Open
Abstract
While metabolic syndrome (MetS) is associated with frailty, the correlation of serum lactate dehydrogenase (sLDH) and frailty with MetS remain uncertain. To investigate the relationship between sLDH and frail components in the US with MetS. A total of 4,066 participants aged 40-90 years were assessed from the database of the third National Health and Nutrition Examination Survey, 1988-1994. The participants were classified into MetS and non-MetS groups. Multivariate logistic regression analysis with four models were performed to assess the odds ratio (OR) of the divided tertiles of sLDH levels with frailty, and frail components including slow walking (SW), weakness, exhaustion, low physical activity (LPA), and low body weight (LBW). Higher sLDH levels were positively associated with frailty in the MetS group (p = 0.024) but not in non-MetS group (p = 0.102). After covariate adjustments, the OR of frailty in the upper two tertiles compared to the lowest tertile and revealed statistical significance (p < 0.05). Frail components of SW, weakness, exhaustion, and LPA were associated with higher sLDH (p < 0.05) except for LBW in MetS and non-MetS groups. The results demonstrated the strong association of higher sLDH levels and frailty among US individuals with MetS.
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Affiliation(s)
- Li-Hsiang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
- Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Hai S, Gao Q, Gwee X, Chua DQL, Yap KB, Ng TP. Malnutrition Risk, Physical Function Decline and Disability in Middle-Aged and Older Adults Followed Up in the Singapore Longitudinal Ageing Study. Clin Interv Aging 2021; 16:1527-1539. [PMID: 34447244 PMCID: PMC8384148 DOI: 10.2147/cia.s322696] [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: 05/31/2021] [Accepted: 07/15/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose Malnutrition and population ageing are doubly global healthcare challenges. It is widely recognized that disability is a major contributor to malnutrition among older people, but the importance of reducing malnutrition risk (MR) for disability prevention is given little attention. We investigated the association between MR and risk of incident disability and functional decline among community-dwelling older persons. Materials and Methods Prospective cohort study of community-dwelling older adults aged 55 and above (Singapore Longitudinal Ageing Study) with 3–5 years follow-up. MR was measured at baseline using an appropriate and validated index (ENIGMA); physical and functional measures at baseline and follow-up included instrumental and basic activity of daily living (ADL), knee extension (KES), gait velocity (GV), timed up-and-go (TUG). Results Compared to low MR, mild-moderate MR (OR = 1.43, 95% CI = 1.02–2.01) and severe MR (OR=1.74, 95% CI=1.10–2.74) were associated with higher risks of incident disability. Severe MR was associated with functional decline (OR = 1.69, 95% CI = 1.11–2.57). Estimates were adjusted for demographic, social, lifestyle behaviour and health variables. In particular, eating difficulty was associated with incident disability and functional decline, and low lymphocyte with functional decline. Severe MR and low albumin were associated with 37% worse GV and 126% worse TUG declines; consuming few vegetables or fruits with 34% worse KES decline; polypharmacy with 56% worse TUG decline. Conclusion Malnutrition risk increased the risk of incident disability and functional decline in non-disabled persons, it worsened physical performance declines. Further studies should investigate the effectiveness of nutritional interventions in reducing the risk of disability among older people.
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Affiliation(s)
- Shan Hai
- Gerontology and Geriatrics Centre, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Qi Gao
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Denise Qian Ling Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keng Bee Yap
- Department of Medicine, Ng Teng Fong General Hospital, Singapore
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Huang Y, Guo X, Du J, Liu Y. Associations Between Intellectual and Social Activities With Frailty Among Community-Dwelling Older Adults in China: A Prospective Cohort Study. Front Med (Lausanne) 2021; 8:693818. [PMID: 34381799 PMCID: PMC8350036 DOI: 10.3389/fmed.2021.693818] [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: 04/12/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Frailty is one of the most important global health challenges. We aimed to examine the associations between frequency of intellectual and social activities and frailty among community-dwelling older adults in China. Methods: This is a prospective analysis of older adults (aged ≥60 years) who had intellectual and social activity data and were free of frailty from the national representative China Health and Retirement Longitudinal Study (CHARLS). The exposure was frequency of intellectual and social activities. Frailty was measured by the frailty index (FI) and defined as FI ≥ 0.25. Frailty incidents were followed up for 2 years. We estimated the relative risks (RRs) with 95% confidence intervals (CIs) using log-linear binominal regression adjusting for potential confounders. Results: We documented 655 frailty cases over the past 2 years. Participants who had frequent intellectual activities had a lower frailty risk compared with participants who did not have intellectual activity (adjusted RR = 0.65, 95%CI = 0.47–0.90). The adjusted RRs were 0.51 (95%CI = 0.33–0.77) for participants who did not have a slip or a fall accident and 1.06 (95%CI = 0.65–1.75) for participants who had experienced slip and fall accidents (P = 0.01 for interaction). Having frequent social activities was not associated with a significant decrease in frailty risk compared with participants who did not have social activity (adjusted RR = 0.93, 95%CI = 0.78–1.12). Conclusions: This observational study showed that having frequent intellectual activities was associated with a decreased frailty risk. The association was likely to be stronger in participants without a slip or a fall accident. Randomized controlled trials are needed to confirm this observational finding.
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Affiliation(s)
- Yafang Huang
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Xiangyu Guo
- School of Pharmaceutical Sciences, Capital Medical University, Beijing, China
| | - Juan Du
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Yanli Liu
- Department of General Practice, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Ponvel P, Shahar S, Singh DKA, Ludin AFM, Rajikan R, Rajab NF, Ai-Vyrn C, Din NC, Ibrahim N, Subramaniam P, Haron H, Ismail A, Sharif R, Ramasamy K, Majeed ABA, Ali NM, Mohamad M, Noah SAM, Ibrahim AM, Safien AM, Khalid NM, Fadzil NHM, Mangialasche F, Kivipelto M. Multidomain Intervention for Reversal of Cognitive Frailty, Towards a Personalized Approach (AGELESS Trial): Study Design. J Alzheimers Dis 2021; 82:673-687. [PMID: 34092633 PMCID: PMC8385532 DOI: 10.3233/jad-201607] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Cognitive frailty (CF) is identified as one of the main precursors of dementia. Multidomain intervention has been found to delay or prevent the onset of CF. Objective: The aim of our present study is to determine the effectiveness of a comprehensive, multidomain intervention on CF; to evaluate its cost effectiveness and the factors influencing adherence toward this intensive intervention. Methods: A total of 1,000 community dwelling older adults, aged 60 years and above will be screened for CF. This randomized controlled trial involves recruitment of 330 older adults with CF from urban, semi-urban, and rural areas in Malaysia. Multidomain intervention comprised of physical, nutritional, cognitive, and psychosocial aspects will be provided to participants in the experimental group (n = 165). The control group (n = 165) will continue their usual care with their physician. Primary outcomes include CF status, physical function, psychosocial and nutritional status as well as cognitive performance. Vascular health and gut microbiome will be assessed using blood and stool samples. A 24-month intensive intervention will be prescribed to the participants and its sustainability will be assessed for the following 12 months. The effective intervention strategies will be integrated as a personalized telerehabilitation package for the reversal of CF for future use. Results: The multidomain intervention developed from this trial is expected to be cost effective compared to usual care as well as able is to reverse CF. Conclusion: This project will be part of the World-Wide FINGERS (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) Network, of which common identifiable data will be shared and harmonized among the consortia.
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Affiliation(s)
- Pavapriya Ponvel
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Roslee Rajikan
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chin Ai-Vyrn
- Geriatric Division, Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Aniza Ismail
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Razinah Sharif
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | | | - Mazlyfarina Mohamad
- Centre for Diagnostic, Therapeutic & Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shahrul Azman Mohd Noah
- Centre for Artificial Intelligence Technology, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Malaysia
| | - Azianah Mohd Ibrahim
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Aisyah Mohd Safien
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Mustafa Khalid
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Hidayah Md Fadzil
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Alzheimer Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Alzheimer Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
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Ye L, Elstgeest LEM, Zhang X, Alhambra-Borrás T, Tan SS, Raat H. Factors associated with physical, psychological and social frailty among community-dwelling older persons in Europe: a cross-sectional study of Urban Health Centres Europe (UHCE). BMC Geriatr 2021; 21:422. [PMID: 34247573 PMCID: PMC8274028 DOI: 10.1186/s12877-021-02364-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/18/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Frailty is an age-related condition resulting in a state of increased vulnerability regarding functioning across multiple systems. It is a multidimensional concept referring to physical, psychological and social domains. The purpose of this study is to identify factors (demographic characteristics, lifestyle factors and health indicators) associated with overall frailty and physical, psychological and social frailty in community-dwelling older people from five European countries. METHODS This cross-sectional study used baseline data from 2289 participants of the Urban Health Center European project in five European countries. Multivariable logistic regression models were used to assess associations of the factors with overall frailty and the three frailty domains. RESULTS The mean age was 79.7 (SD = 5.7). Participants who were older, were female, had secondary or equivalent education, lived alone, not at risk of alcohol use, were less physically active, had multi-morbidity, were malnourished or with a higher level of medication risk, had higher odds of overall frailty (all P < 0.05). Age was not associated with psychological and social frailty; sex was not associated with social frailty; smoking and migration background was not associated with overall frailty or any of its domains. There existed an interaction effect between sex and household composition regarding social frailty (P < 0.0003). CONCLUSIONS The present study contributed new insights into the risk factors for frailty and its three domains (physical, psychological and social frailty). Nurses, physicians, public health professionals and policymakers should be aware of the risk factors of each type of frailty. Furthermore, examine these risk factors more comprehensively and consider overall frailty as well as its three domains in order to further contribute to decision-making more precisely on the prevention and management of frailty. TRIAL REGISTRATION The intervention of the UHCE project was registered in the ISRCTN registry as ISRCTN52788952 . The date of registration is 13/03/2017.
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Affiliation(s)
- Lizhen Ye
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000, Rotterdam, CA, The Netherlands
| | - Liset E M Elstgeest
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000, Rotterdam, CA, The Netherlands
| | - Xuxi Zhang
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000, Rotterdam, CA, The Netherlands.,Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, 100871, China
| | - Tamara Alhambra-Borrás
- Polibienestar Research Institute - Universitat de València ES, 29 46022, Valencia, Spain
| | - Siok Swan Tan
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000, Rotterdam, CA, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000, Rotterdam, CA, The Netherlands.
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49
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Watanabe N, Takagi K, Tanaka A, Yoshioka N, Morita Y, Yoshida R, Kanzaki Y, Nagai H, Yamauchi R, Komeyama S, Sugiyama H, Shimojo K, Imaoka T, Sakamoto G, Ohi T, Goto H, Okumura T, Ishii H, Morishima I, Murohara T. Ten-Year Mortality in Patients With ST-Elevation Myocardial Infarction. Am J Cardiol 2021; 149:9-15. [PMID: 33753036 DOI: 10.1016/j.amjcard.2021.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 12/22/2022]
Abstract
Knowledge of the long-term prognosis (>10 years) and mortality predictors of ST-elevation myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (p-PCI) is scarce. Therefore, this study evaluated the long-term prognosis and determined the predictors of long-term outcomes for STEMI patients after p-PCI. Between January, 2006 and December, 2010, we collected data and analyzed 459 consecutive patients with acute STEMI who underwent p-PCI and were discharged from the hospital (mean age, 66.8 years; male, 75.2%; peak creatine phosphokinase level, 2,292.5 IU/L). The primary endpoint was 10-year all-cause mortality. The cumulative 10-year incidence of all-cause death was 23.8%. The Cox multivariate regression analysis identified age ≥ 65 years (adjusted hazard ratio [aHR], p <0.001), body mass index (aHR, 0.93, p = 0.033), presence of atrial fibrillation (aHR, 1.69, p = 0.038), mineralocorticoid receptor antagonist use (aHR, 1.95, p = 0.008), ejection fraction <40% (aHR, 2.14, p = 0.005), and albumin <3.5 g/dL (aHR, 2.01, p = 0.005) as independent predictors of all-cause mortality. In conclusion, a post-discharge 10-year survival rate of 76.2% was identified for STEMI patients who underwent p-PCI.
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50
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Katsumi A, Abe A, Tamura S, Matsushita T. Anemia in older adults as a geriatric syndrome: A review. Geriatr Gerontol Int 2021; 21:549-554. [PMID: 34085375 DOI: 10.1111/ggi.14183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/08/2021] [Accepted: 04/28/2021] [Indexed: 12/11/2022]
Abstract
Anemia, a frequently occurring condition in older patients, has no standard definition; however, in most studies, it is defined as hemoglobin level <12 and <13 g/dL in women and men, respectively. Approximately 10% of older adults living in the community have anemia. The prevalence of anemia is significantly correlated with advanced age and male sex. Anemia is associated with falls, frailty and other negative outcomes, including early mortality. However, there remains little consensus regarding whether anemia treatment favorably affects these adverse outcomes. Therefore, this article reviews the prevalence of anemia, and provides updates on its common causes and treatments in older adults. While excluding well-established hematopoietic diseases, the etiology of anemia in older adults has been grouped into four categories: (i) nutritional deficiency; (ii) inflammation; (iii) clonal hematopoiesis; and (iv) "unexplained anemia," when there is no clear mechanism to account for the anemia. Recently, clonal leukocytes were detected in a considerable number of older individuals. The number of somatic mutations in blood leukocytes increases with age; however, single mutations of DNMT3A, TET2 and ASXL1 are not correlated with the presence of unexplained anemia in older adults. With an increased understanding of anemia etiology and the availability of innovative anti-anemic drugs, future studies that evaluate the causes and benefits of treatment are required. Geriatr Gerontol Int 2021; 21: 549-554.
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Affiliation(s)
- Akira Katsumi
- Department of Hematology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Akihiro Abe
- Department of Hematology, Fujita Health University, Toyoake, Japan
| | - Shogo Tamura
- Department of Pathophysiological Laboratory Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tadashi Matsushita
- Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Japan
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