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Yoshimura M, Shiramoto H, Koga M, Morimoto Y. Development and validation of a machine learning model to predict postoperative delirium using a nationwide database: A retrospective, observational study. J Clin Anesth 2024; 96:111491. [PMID: 38678916 DOI: 10.1016/j.jclinane.2024.111491] [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: 10/03/2023] [Revised: 03/14/2024] [Accepted: 04/24/2024] [Indexed: 05/01/2024]
Abstract
STUDY OBJECTIVE Postoperative delirium is a neuropsychological syndrome that typically occurs in surgical patients. Its onset can lead to prolonged hospitalization as well as increased morbidity and mortality. Therefore, it is important to promptly identify its signs. This study aimed to develop and validate a machine learning predictive model for postoperative delirium using extensive population data. DESIGN Retrospective observational study. SETTING Japanese Diagnosis Procedure Combination inpatient data. Data were used for internal (2016.4-2018.12) and temporal validation (2019.01-2019.10). PATIENTS Patients aged ≥65 years who underwent general anesthesia for surgical procedure. MEASUREMENTS The primary outcome was postoperative delirium, which was defined as a condition requiring newly prescribed antipsychotic drugs or assignment of the corresponding insurance claim code after the date of surgery. We trained and tuned the optimal machine-learning model through 10-fold cross-validation using the selected optimal area under the receiver operating characteristic curve (AUC) value. In the temporal validation, we measured the performance of our model. MAIN RESULTS The analysis included 557,990 patients. The light-gradient boosting machine models showed a higher AUC value (0.826 [95% confidence interval (CI): 0.822-0.829]) than the other models. Regarding performance, the model had a recall value of 0.124 (95% CI: 0.119-0.129) and precision value of 0.659 (95% CI: 0.641-0.677]). This performance was sustained in the temporal validation (AUC, 0.815 [95% CI: 0.811-0.818]). At a sensitivity of 0.80, the model achieved a specificity of 0.672 (95% CI: 0.670-0.674]), a negative predictive value of 0.975 (95% CI: 0.974-0.975), and a positive predictive value of 0.176 (95% CI: 0.176-0.179). CONCLUSIONS Using extensive Diagnostic Procedure Combination data, we successfully created and validated a machine learning model for predicting postoperative delirium. This model may facilitate prediction of postoperative delirium.
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Affiliation(s)
- Manabu Yoshimura
- Department of Anesthesiology, Ube Industries Central Hospital, Ube City, Japan.
| | - Hiroko Shiramoto
- Department of Anesthesiology, Ube Industries Central Hospital, Ube City, Japan
| | - Mami Koga
- Department of Anesthesiology, Ube Industries Central Hospital, Ube City, Japan
| | - Yasuhiro Morimoto
- Department of Anesthesiology, Ube Industries Central Hospital, Ube City, Japan
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Sato Osaki K, Huq KATME, Kazawa K, Kawai M, Moriyama M. Evaluate a comprehensive geriatric assessment service framework targeting frail older people who had high risk of requiring long-term care services in Japan: a community-based pilot study. BMC Geriatr 2024; 24:645. [PMID: 39090557 PMCID: PMC11293189 DOI: 10.1186/s12877-024-05200-0] [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: 04/05/2024] [Accepted: 07/03/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Frailty has become a key concern in an aging population. A comprehensive geriatric assessment (CGA) service framework was developed and evaluated aiming to target and connect frail older adults who are at high risk of requiring long-term care services. METHODS A community-based pilot study was conducted in fiscal year 2016 and 2017 in Kure city, Hiroshima, Japan. Participants aged 65 and over living in Kure city, and 393 persons were extracted from the Kihon Check List (KCL) responses. Among the eligible individuals, 101 consented to participate and received CGA and referred to services based on individual health needs. The efficacy was evaluated by referral rate of services, continuity of the service usage, evaluation of participant's health condition and the quality of life (QoL) after the 6-month follow-up. RESULTS Ninety-nine (98.0%) participants needed support for the instrumental activity of daily living, 97 (96.0%) were categorized as locomotive syndrome, and 64 (63.4%) had a depressive tendency. Afterward, 60 participants (59.4%) subsequently accepted the referral services, however, 34 (33.7%) used the services and the remaining 26 (25.7%) did not use the services. The health condition improvements in the service-uses group were statistically significant (p < 0.001), however, QoL score did not change between the baseline and 6th -month. CONCLUSION KCL extracted high-risks older people, and CGA revealed related diseases and health conditions. However, the high refusal rate of referral services indicates a necessity to modify the service framework such as by collaborating with community general support centers, which could increase the efficacy of service framework.
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Affiliation(s)
- Kanae Sato Osaki
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734- 8553, Japan
- Department of Nursing, Yasuda Women's University, 6-13-1, Yasu Higashi, Asaminami-Ku, Hiroshima, Hiroshima, 731-0531, Japan
| | - K A T M Ehsanul Huq
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734- 8553, Japan
| | - Kana Kazawa
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734- 8553, Japan
- Department of Nursing, Faculty of Health Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-ku, Okayama, 700- 8558, Japan
| | - Madoka Kawai
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734- 8553, Japan
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734- 8553, Japan.
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Honda T, Murakami H, Tanaka H, Nomura Y, Sakamoto T, Yagi N. Impact of frailty and prefrailty on the mid-term outcomes and rehabilitation course after cardiac surgery. Surg Today 2024; 54:882-891. [PMID: 38436719 PMCID: PMC11266388 DOI: 10.1007/s00595-024-02807-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: 10/26/2023] [Accepted: 12/12/2023] [Indexed: 03/05/2024]
Abstract
PURPOSE This study examined the impact of frailty and prefrailty on mid-term outcomes and rehabilitation courses after cardiac surgery. METHODS A total of 261 patients (median age: 73 years; 30% female) who underwent elective cardiac surgery were enrolled in this study. The Japanese version of the Cardiovascular Health Study Frailty Index classified 86, 131, and 44 patients into frailty, prefrailty, and robust groups, respectively. We examined the recovery of walking ability, outcomes at discharge, mid-term all-cause mortality, and rehospitalization related to major adverse cardiovascular and cerebrovascular events (MACCE) across the three cohorts. RESULTS The 3-year survival rates in the frailty, prefrailty, and robust groups were 87%, 97%, and 100%, respectively (p = 0.003). The free event rates of all-cause mortality and re-hospitalization related to MACCE were 59%, 79%, and 95%, respectively (p < 0.001), with a graded elevation in adjusted morbidity among patients in the prefrailty (hazard ratio [HR], 4.57; 95% confidence interval [CI], 1.08-19.4) and frailty (HR, 9.29; 95% CI 2.21-39.1) groups. Patients with frailty also experienced a delayed recovery of walking ability and a reduced number of patients with frailty were discharged home. CONCLUSION Frailty and prefrailty adversely affect the mid-term prognosis and rehabilitation course after cardiac surgery.
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Affiliation(s)
- Tasuku Honda
- Department of Cardiovascular Surgery, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264, Kamiya-Cho, Himeji, Hyogo, 670-8560, Japan.
| | - Hirohisa Murakami
- Department of Cardiovascular Surgery, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264, Kamiya-Cho, Himeji, Hyogo, 670-8560, Japan
| | - Hiroshi Tanaka
- Department of Cardiovascular Surgery, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264, Kamiya-Cho, Himeji, Hyogo, 670-8560, Japan
| | - Yoshikatsu Nomura
- Department of Cardiovascular Surgery, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264, Kamiya-Cho, Himeji, Hyogo, 670-8560, Japan
| | - Toshihito Sakamoto
- Department of Cardiovascular Surgery, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264, Kamiya-Cho, Himeji, Hyogo, 670-8560, Japan
| | - Naomi Yagi
- Advanced Medical Engineering Research Institute, University of Hyogo, 3-264, Kamiya-Cho, Himeji, Hyogo, 670-0836, Japan
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Suzuki M, Hasegawa Y, Tanabe H, Koinuma M, Funakoshi R. Exploring factors associated with bleeding events after open heart surgery in patients on dialysis - effects of the presence or absence of warfarin therapy. J Pharm Health Care Sci 2024; 10:38. [PMID: 38997775 PMCID: PMC11241945 DOI: 10.1186/s40780-024-00353-x] [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: 12/15/2023] [Accepted: 06/11/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Perioperative management of patients on dialysis is critical for controlling bleeding and thrombotic risk, in addition to infection control. Postoperative anticoagulation is often difficult to control, and different institutions have different policies. Therefore, in this study, we aimed to investigate factors associated with postoperative bleeding events and whether warfarin (WF) therapy affects the incidence of postoperative bleeding events, total mortality, and stroke. METHODS Patients who were admitted to the cardiovascular surgery department and underwent valve replacement or plasty were included, and those who underwent mechanical valve introduction were excluded. Thirty-nine patients were included in the study. The primary endpoint was to identify factors associated with the composite endpoint of postoperative bleeding events, and the secondary endpoint was to determine the effect size of WF therapy on postoperative bleeding events, all-cause mortality, and stroke and the strength of association between the crossed endpoints. The strength of the association between the crossed items was examined. RESULTS Low body weight (p = 0.038) was identified as a factor associated with the primary endpoint of postoperative bleeding events. The secondary endpoint of whether or not patients received WF therapy was largely unrelated to bleeding events, all-cause mortality, and postoperative stroke up to 90 days after surgery. CONCLUSIONS Preliminary studies suggest that low body weight is a risk factor for postoperative bleeding events in patients on dialysis, although further exploration of other factors will be necessary with the accumulation of similar cases.
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Affiliation(s)
- Masanori Suzuki
- Faculty of Pharmaceutical Sciences, Teikyo Heisei University, Tokyo, Japan.
- Department of Pharmacy, Kameda Medical Center, Chiba, Japan.
| | - Yuki Hasegawa
- Department of Cardiovascular surgery, Kameda Medical Center, Chiba, Japan
| | - Hiroaki Tanabe
- Department of Cardiovascular surgery, Kameda Medical Center, Chiba, Japan
| | - Masayoshi Koinuma
- Faculty of Pharmaceutical Sciences, Teikyo Heisei University, Tokyo, Japan
| | - Ryohkan Funakoshi
- Department of Pharmacy, Kameda Medical Center, Chiba, Japan
- Department of Pharmacy Administration, Kameda Medical Center, Chiba, Japan
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Iwasawa T, Aoyagi Y, Suda S, Ishiyama D, Toi K, Ohashi M, Kimura K. Prevalence and outcome of pre-onset frailty in patients with acute stroke. Top Stroke Rehabil 2024; 31:493-500. [PMID: 38108292 DOI: 10.1080/10749357.2023.2291898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Frailty in older individuals is an underappreciated condition that affects the incidence and/or prognosis of stroke. OBJECTIVES We evaluated the prevalence of pre-onset frailty in patients with acute first-onset and recurrent strokes and association between pre-onset frailty and functional disability at hospital discharge. METHODS This prospective cohort study included 210 acute stroke patients admitted to the Stroke Unit of Nippon Medical School Hospital during November 2021-June 2022. The mean participant age was 79.2 ± 7.4 years. Age, sex, pre-onset frailty, body mass index (BMI), stroke type, medical history, and National Institutes of Health Stroke Scale (NIHSS) score at admission were evaluated. Frailty was defined as a clinical frailty scale (CFS) score ≥ 5. Frailty prevalence was calculated for all patients, and scores of functional disabilities at discharge were evaluated using modified Rankin scale. RESULTS Overall frailty prevalence was 31% in all stroke patients, with 24% and 47% of first-onset and recurrent strokes, respectively. Pre-onset frailty, NIHSS score at admission, age, stroke type, previous stroke, sex, BMI, dyslipidemia, and atrial fibrillation were significantly associated with functional disability at discharge. Logistic regression analysis revealed that CFS score, NIHSS score at admission, and previous stroke were independent predictors of functional disability at discharge. CONCLUSIONS Approximately one-fourth of patients with first-onset stroke had pre-onset frailty; the rate doubled in recurrent stroke; these rates appear to be much larger than rate in healthy individuals. Pre-onset frailty, a negative independent factor affecting functional disability at discharge, is important for pre-onset frailty evaluation and rehabilitation intervention in acute stroke patients.
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Affiliation(s)
- Tatsuya Iwasawa
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Satoshi Suda
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Daisuke Ishiyama
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Kennosuke Toi
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Miho Ohashi
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazumi Kimura
- Department of Neurology, Nippon Medical School, Tokyo, Japan
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Hong YJ, Otsuka R, Song Z, Fukuda C, Tajima R, Lin J, Hibino M, Kobayashi M, He Y, Matsunaga M, Ota A, Nakano Y, Li Y, Tamakoshi K, Yatsuya H. Association between milk consumption in middle age and frailty in later life: The Aichi Workers' cohort study. Geriatr Gerontol Int 2024; 24:700-705. [PMID: 38828856 DOI: 10.1111/ggi.14916] [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: 10/20/2023] [Revised: 04/22/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
AIM Several studies have shown that dairy consumption in old age is effective in preventing frailty. However, there is a lack of evidence regarding the association between milk consumption during middle age and the development of frailty in old age. Therefore, we carried out an investigation to explore the association between milk consumption during middle age and development of frailty examined after over 15 years of follow up in a long-term cohort study in Japan. METHODS We studied 265 participants aged 60-79 years (212 men and 53 women) in 2018, who participated in both the baseline survey in 2002 and the frailty assessment in 2018. The amount of milk consumption (g/day) at baseline was age- and energy-adjusted, and classified into three categories (no, low and high consumption: 0 g/day, ≤135.86 g/day, >135.86 g/day in men and 0 g/day, ≤126.44 g/day, >126.44 g/day in women). Odds ratios (OR) and 95% confidence intervals (CI) for prefrailty/frailty after adjusting for lifestyles at baseline, stratified by sex, were estimated using logistic regression analysis. RESULTS The prevalence of prefrailty/frailty in 2018 was 37.7% and 28.3% in men and women, respectively. Milk consumption categories were inversely associated with the prevalence of prefrailty/frailty in men (OR 0.34, 95% CI 0.14-0.84 in low consumption; OR 0.31, 95% CI 0.10-0.95 in high consumption; P < 0.05), but not in women (OR 0.53, 95% CI 0.11-2.65; P = 0.44). CONCLUSIONS In this study, milk intake in middle-aged men was inversely associated with the prevalence of prefrailty/frailty later in life. Geriatr Gerontol Int 2024; 24: 700-705.
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Grants
- Japan Dairy Association
- Japan Atherosclerosis Prevention Fund
- 09470112 Japan Society for the Promotion of Science
- 12670352 Japan Society for the Promotion of Science
- 13470087 Japan Society for the Promotion of Science
- 13770192 Japan Society for the Promotion of Science
- 15689011 Japan Society for the Promotion of Science
- 15K08802 Japan Society for the Promotion of Science
- 16590499 Japan Society for the Promotion of Science
- 16K19278 Japan Society for the Promotion of Science
- 17390185 Japan Society for the Promotion of Science
- 17790384 Japan Society for the Promotion of Science
- 18590594 Japan Society for the Promotion of Science
- 18H03057 Japan Society for the Promotion of Science
- 19K19419 Japan Society for the Promotion of Science
- 20590641 Japan Society for the Promotion of Science
- 20790438 Japan Society for the Promotion of Science
- 20K10496 Japan Society for the Promotion of Science
- 22390133 Japan Society for the Promotion of Science
- 22H03349 Japan Society for the Promotion of Science
- 23590787 Japan Society for the Promotion of Science
- 23659346 Japan Society for the Promotion of Science
- 25893088 Japan Society for the Promotion of Science
- 26293153 Japan Society for the Promotion of Science
- 23JA1006 Ministry of Health, Labour and Welfare, Health and Labour Sciences research grants for Occupational Health
- Aichi Health Promotion Foundation
- Uehara Memorial Fund
- H26-Junkankitou[Seisaku]-Ippan-001 Ministry of Health, Labour and Welfare, Health and Labour Sciences research grants for Comprehensive Research on Cardiovascular and Life-Style Related Diseases
- H29-Junkankitou[Seishuu]-Ippan-003 Ministry of Health, Labour and Welfare, Health and Labour Sciences research grants for Comprehensive Research on Cardiovascular and Life-Style Related Diseases
- 20FA1002 Ministry of Health, Labour and Welfare, Health and Labour Sciences research grants for Comprehensive Research on Cardiovascular and Life-Style Related Diseases
- 23FA1006 Ministry of Health, Labour and Welfare, Health and Labour Sciences research grants for Comprehensive Research on Cardiovascular and Life-Style Related Diseases
- Noguchi Medical Research Institute
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Affiliation(s)
- Young Jae Hong
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rei Otsuka
- Department of Epidemiology of Aging, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Zean Song
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chisato Fukuda
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rina Tajima
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jingyi Lin
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mizuho Hibino
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mei Kobayashi
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yupeng He
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masaaki Matsunaga
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan
| | - Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoshihisa Nakano
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuanying Li
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koji Tamakoshi
- Department of Nursing, Nagoya University School of Health Sciences, Nagoya, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan
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Onishi K, Yakabi A, Ishizaka M, Hara T, Hashimoto N. Prevalence and characteristics of frailty in older adults in Japan: a cross-sectional study using data from the long-term care insurance system. J Phys Ther Sci 2024; 36:367-371. [PMID: 38952459 PMCID: PMC11214814 DOI: 10.1589/jpts.36.367] [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: 01/23/2024] [Accepted: 04/04/2024] [Indexed: 07/03/2024] Open
Abstract
[Purpose] Owing to rapid population aging, prevention of frailty in older adults and minimizing the burden on the long-term care insurance system are priorities for the Japanese government. However, limited data are available regarding the prevalence and characteristics of frailty among older adults requiring support in Japan. In this study, we investigated the prevalence and characteristics of frailty in older adults requiring support in Japan. [Participants and Methods] The study included 695 new users of preventive long-term care services certified as "requiring support" between 2011 and 2019. In this cross-sectional investigation, we used data obtained from a community comprehensive support center. Frailty prevalence was assessed using the Kihon Checklist, followed by a χ2 test. Logistic regression analysis was performed to identify the characteristics (basic information and service type) associated with frailty. [Results] A significantly large percentage of robust/pre-frail participants (72.7%) belonged to urban areas, although we observed no significant difference in robust participants with regard to residence. Furthermore, we observed significant intergroup differences in age and orthopedic conditions. [Conclusion] It is important to encourage older adults to access the long-term care insurance system and seek support at an early stage.
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Affiliation(s)
- Kohei Onishi
- Otawara-shi Chuo Community Comprehensive Support Center,
Japan
- Department of Physical Therapy, Graduate School of Health
and Welfare Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru,
Otawara 324-8501, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, Graduate School of Health
and Welfare Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru,
Otawara 324-8501, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, Graduate School of Health
and Welfare Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru,
Otawara 324-8501, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, Graduate School of Health
and Welfare Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru,
Otawara 324-8501, Japan
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Hayashi T, Sato R, Tamura K. Relationships among tooth loss, prefrailty, and dietary patterns in community-dwelling older Japanese females: a cross-sectional study. Nutr Res Pract 2024; 18:387-399. [PMID: 38854469 PMCID: PMC11156762 DOI: 10.4162/nrp.2024.18.3.387] [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: 12/22/2023] [Revised: 03/22/2024] [Accepted: 04/08/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND/OBJECTIVES Poor oral health has been predicted the development of frailty and sarcopenia as well as the subsequent need for long-term care. This cross-sectional study examined the relationships among tooth loss, prefrailty, and dietary patterns in community-dwelling older Japanese females. SUBJECTS/METHODS Information on the number of teeth, food consumption, and lifestyle factors was collected from 271 participants aged ≥ 65 yrs using a questionnaire. The number of teeth was self-reported and classified into 2 groups: natural teeth ≥ 20 and natural teeth < 20. Prefrailty was assessed using the Japanese version of the Cardiovascular Health Study. Three dietary patterns ("vegetables and dairy products" [VD], "rice and fish and shellfish" [RF], and "bread and beverages") were adopted from a cluster analysis of the intakes of 20 foods evaluated using the Food Frequency Questionnaire. The odds ratios (ORs) for prefrailty and dietary patterns were calculated using a binary logistic regression analysis. RESULTS A total of 267 participants were analyzed, excluding those with frailty (n = 4). The rates of natural teeth < 20 and prefrailty were 57.3 and 37.4%, respectively. Natural teeth < 20 was positively correlated with prefrailty (OR, 4.66; 95% confidence interval [CI], 2.54-8.52) and inversely correlated with VD pattern (OR, 0.43; 95% CI, 0.27-0.69). Furthermore, both VD (OR, 0.38; 95% CI, 0.16-0.91) and RF (OR, 0.26; 95% CI, 0.11-0.62) patterns were inversely correlated with prefrailty. CONCLUSIONS Maintaining the number of natural teeth ≥ 20 into old age plays an important role in preventing a prefrailty. The promotion of VD and RF dietary patterns has potential as an effective nutritional strategy for preventing tooth loss and prefrailty.
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Affiliation(s)
- Tatsumi Hayashi
- Faculty of Economics, Shimonoseki City University, Shimonoseki 751-8510, Japan
- Faculty of Food and Nutrition, Kyushu Nutrition Welfare University, Kitakyushu 803-8511, Japan
| | - Rumi Sato
- Community Health Division, Council of Social Welfare, Bungo Ono City 879-7153, Japan
| | - Kazuo Tamura
- Research Promotion Division, Fukuoka University, Fukuoka 814-0180, Japan
- NPO Clinical Hematology Oncology Treatment Study Group, Fukuoka 819-0030, Japan
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Yokoyama K, Ihira H, Matsuzaki-Kihara Y, Mizumoto A, Tashiro H, Shimada K, Yama K, Miyajima R, Sasaki T, Kozuka N, Ikeda N. Development of the Self-Assessment Self-Disclosure Questionnaire to Examine the Association between Self-Disclosure and Frailty among Community-Dwelling Older Adults in Japan. Geriatrics (Basel) 2024; 9:67. [PMID: 38920423 PMCID: PMC11202530 DOI: 10.3390/geriatrics9030067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/24/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Self-disclosure is the attitude of communicating one's experiences and condition to others and is an indicator of mental health and an open personality. Frailty, characterized by reduced physical and psychological resistance, predicts the incidence of dependency and mortality. Although low self-disclosure may be associated with frailty, there is no scale to measure older adults' self-disclosure. This cross-sectional study assessed the validity of a self-assessment self-disclosure questionnaire and examined the association between the content of self-disclosures to friends and acquaintances and frailty among community-dwelling older adults. A total of 237 adults aged ≥65 in Japan were surveyed using a mailed self-administered questionnaire in 2021. The self-disclosure scale consisted of 10 items and showed adequate validity. Participants were classified into a robust group (n = 117, women 57.3%) and a frailty group (n = 120, women 73.3%) using the Kihon Checklist. After adjusting for covariates, multivariate-adjusted logistic regression models revealed frailty was associated with lower self-disclosure of recent positive events, motivation and strengths (indicating strong points) in life, relationships with family and relatives, experiences of work and social activities, and financial status. The proposed questionnaire must still be further tested in other populations, but our initial results may contribute to preventing frailty and improving mental health among community-dwelling older adults.
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Affiliation(s)
- Kazuki Yokoyama
- Department of Occupational Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Hikaru Ihira
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | | | - Atsushi Mizumoto
- Department of Physical Therapy, Faculty of Human Science, Hokkaido Bunkyo University, Eniwa 061-1449, Japan
| | - Hideyuki Tashiro
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Kiyotaka Shimada
- Department of Neuropsychiatry, School of Medicine, Sapporo Medical University, Sapporo 060-8543, Japan
| | - Kosuke Yama
- N Field Home-Visit Nursing Station Dune Sapporo, Sapporo 003-0808, Japan
| | | | - Takeshi Sasaki
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Naoki Kozuka
- Department of Rehabilitation, Hokkaido Chitose College of Rehabilitation, Chitose 066-0055, Japan
| | - Nozomu Ikeda
- Department of Occupational Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
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10
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Ha B, Han M, So WY, Kim S. Sex differences in the association between sleep duration and frailty in older adults: evidence from the KNHANES study. BMC Geriatr 2024; 24:434. [PMID: 38755549 PMCID: PMC11100248 DOI: 10.1186/s12877-024-05004-2] [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: 12/10/2023] [Accepted: 04/23/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Frailty is a pervasive clinical syndrome among the older population. It is associated with an increased risk of diverse adverse health outcomes including death. The association between sleep duration and frailty remains unclear. Therefore, the aim of this study was to investigate the relationship between sleep duration and frailty in community-dwelling Korean older adults and to determine whether this relationship is sex-dependent. METHODS Data on 3,953 older adults aged ≥ 65 years were obtained from the 7th (2016-2018) Korea National Health and Nutrition Examination Survey (KNHANES). Frailty was defined using the Fried phenotype with criteria customized for the KNHANES dataset. Self-reported sleep duration was classified as short sleep duration (≤ 6 h), middle sleep duration (6.1-8.9 h), and long sleep duration (≥ 9 h). Complex samples multivariate logistic regression analysis was conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The percentage of male participants with short, middle, and long sleep durations was 34.9%, 62.1%, and 16.8%, respectively, while that of female participants was 26.1%, 59.2%, and 14.7%. The prevalence of frailty in the middle sleep duration group was lower than that in the short and long sleep duration groups in both men (short, 14.7%; middle, 14.2%; long, 24.5%; p < 0.001) and women (short, 42.9%; middle, 27.6%; long, 48.6%; p < 0.001). Both short (OR = 2.61, 95% CI = 1.91 - 4.83) and long (OR = 2.57, 95% CI = 1.36 - 3.88) sleep duration groups had a significantly higher OR for frailty than the middle sleep duration group even after adjusting for confounding variables among women, but not among men. CONCLUSION Short and long sleep durations were independently associated with frailty in community-dwelling Korean older adult women. Managing sleep problems among women should be prioritized, and effective interventions to prevent frailty should be developed accordingly.
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Affiliation(s)
- Beomman Ha
- Armed Forces Medical Command, Seongnam-si, 13574, Republic of Korea
| | - Mijin Han
- Chungbuk National University Hospital, Cheongju-si, 28644, Republic of Korea
| | - Wi-Young So
- Department of Sports Medicine, College of Humanities, Korea National University of Transportation, 50 Daehak-ro, Chungbuk, Chungju-si, 27469, Republic of Korea.
| | - Seonho Kim
- Department of Nursing and Research Institute of Nursing Science, College of Medicine, Chungbuk National University, Cheongju-si, 28644, Republic of Korea.
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11
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Shimizu T, Kodama A, Kume Y, Iwakura M, Iijima K, Ota H. Comparative Analysis of Frailty Risk and Associated Factors: Community-Based vs. Open Recruitment Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:611. [PMID: 38791825 PMCID: PMC11121682 DOI: 10.3390/ijerph21050611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Frailty leads to vulnerability to stress, impaired daily functioning, and an increased need for care. Frailty is considered reversible, and it is crucial to detect the risk of frailty early and investigate factors that may delay its progression. OBJECTIVES To identify tests that can explain frailty risk and compare the situation of local residents with and without frailty support. METHODS Participants were recruited in two ways: through public advertisements in Akita City (open recruitment group) and through invites from frailty supporters in their immediate communities (community-based group). We examined the differences in frailty risk and oral, motor, and social functions between the two groups and identified factors associated with frailty risk in both groups. RESULTS The community-based group exhibited a lower risk of frailty than the open recruitment group despite having more older members on average. Additionally, the community-based group demonstrated better social functioning than the open-recruitment group. Furthermore, factors such as oral diadochokinesis (ODK), one-leg stand test (OLS), and grip strength (GS) showed significant association with frailty risk. CONCLUSION The ODK, OLS, and GS were identified as factors explaining frailty risk, and Frailty Supporters may reduce the risk of frailty.
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Affiliation(s)
- Tatsunori Shimizu
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita 010-8543, Japan; (T.S.); (A.K.)
| | - Ayuto Kodama
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita 010-8543, Japan; (T.S.); (A.K.)
- Department of Occupational Therapy, Graduate School of Medicine, Akita University, Akita 010-8543, Japan;
| | - Yu Kume
- Department of Occupational Therapy, Graduate School of Medicine, Akita University, Akita 010-8543, Japan;
| | - Masahiro Iwakura
- Department of Environmental Health Science and Public Health, Akita University, Akita 010-8543, Japan;
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo 113-8656, Japan;
- Institute for Future Initiatives, The University of Tokyo, Tokyo 113-8656, Japan
| | - Hidetaka Ota
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita 010-8543, Japan; (T.S.); (A.K.)
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12
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Liu J, Zhu Y, Tan JK, Ismail AH, Ibrahim R, Hassan NH. Factors Associated with Frailty in Older Adults in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis. J Clin Med 2024; 13:2382. [PMID: 38673654 PMCID: PMC11050860 DOI: 10.3390/jcm13082382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them.
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Affiliation(s)
- Jia Liu
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Yuezhi Zhu
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Jen Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Azera Hasra Ismail
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Roszita Ibrahim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nor Haty Hassan
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
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Iwasaki M, Shirobe M, Motokawa K, Tanaka T, Ikebe K, Ueda T, Minakuchi S, Akishita M, Arai H, Iijima K, Sasai H, Obuchi S, Hirano H. Prevalence of oral frailty and its association with dietary variety, social engagement, and physical frailty: Results from the Oral Frailty 5-Item Checklist. Geriatr Gerontol Int 2024; 24:371-377. [PMID: 38390632 DOI: 10.1111/ggi.14846] [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: 12/03/2023] [Revised: 01/30/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
AIM This cross-sectional study had two aims: to assess the prevalence of oral frailty (OF), according to the Oral Frailty 5-Item Checklist (OF-5), among community-dwelling older adults; and to examine the associations among oral frailty, dietary variety, social engagement, and physical frailty. METHODS We pooled data from two population-based studies (the Otassha Study and the Itabashi Longitudinal Study on Aging). With the OF-5, OF is characterized by the presence of two or more of the following: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. We calculated the OF prevalence for each sex. We assessed dietary variety, social engagement, and physical frailty. Generalized structural equation modeling was employed to investigate the associations among oral frailty, low dietary variety (dietary variety score ≤3), social isolation (Lubben Social Network Scale score <12), and physical frailty (Japanese version of the Cardiovascular Health Study score ≥3). RESULTS A total of 1206 individuals (626 women and 580 men) with a mean age of 74.7 years were included. The prevalence of OF was 36.7%, and it increased with age; however, there was no significant sex difference. OF was significantly indirectly associated with physical frailty via low dietary variety (odds ratio, 1.43; 95% confidence interval, 1.04-1.97) and social isolation (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). CONCLUSIONS Two of five community-dwelling older adults exhibited OF. Low dietary variety and social isolation are potential underlying mechanisms through which OF is indirectly associated with physical frailty. Geriatr Gerontol Int 2024; 24: 371-377.
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Affiliation(s)
- Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Hamada S, Sasaki Y, Son BK, Tanaka T, Lyu W, Tsuchiya-Ito R, Kitamura S, Dregan A, Hotopf M, Iwagami M, Iijima K. Association of coexistence of frailty and depressive symptoms with mortality in community-dwelling older adults: Kashiwa Cohort Study. Arch Gerontol Geriatr 2024; 119:105322. [PMID: 38171032 DOI: 10.1016/j.archger.2023.105322] [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: 10/24/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES This study aimed to determine the longitudinal associations of the coexistence of frailty and depressive symptoms with mortality among older adults. METHODS The study participants were community-dwelling older adults aged ≥65 years who participated in the baseline survey of the Kashiwa Cohort Study in Japan in 2012. We used Fried's frailty phenotype criteria to classify participants as non-frail (score = 0), pre-frail (1 or 2), or frail (≥3). Depressive symptoms were assessed using the GDS-15 (≥6 points). Cox proportional hazards models were used to evaluate the association of co-occurring frailty and depressive symptoms with all-cause mortality, after adjusting for sociodemographic and clinical characteristics. RESULTS The study included 1920 participants, including 810 non-frail, 921 pre-frail, and 189 frail older adults, of which 9.0 %, 15.7 %, and 36.0 %, respectively, had depressive symptoms. Ninety-one (4.7 %) participants died during the average follow-up period of 4.8 years. Compared with non-frail participants without depressive symptoms, frail participants had greater adjusted hazard ratios for mortality: 2.47 (95 % CI, 1.16 to 5.25) for frail participants without depressive symptoms and 4.34 (95 % CI, 1.95 to 9.65) for frail participants with depressive symptoms. However, no statistically significant associations were observed in non-frail or pre-frail participants irrespective of depressive symptoms. CONCLUSION Frail older adults with depressive symptoms have a substantially greater risk of mortality. Screening for depressive symptoms and frailty in older adults should be incorporated into health checkups and clinical practice to identify high-risk populations.
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Affiliation(s)
- Shota Hamada
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Home Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Yui Sasaki
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; Policy Promotion Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan
| | - Bo-Kyung Son
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan; Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Weida Lyu
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Rumiko Tsuchiya-Ito
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan
| | - Satomi Kitamura
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan
| | - Alex Dregan
- Department of Psychological Medicine, Institute of Psychiatry, Psychological and Neurosciences, King's College London, London, United Kingdom
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychological and Neurosciences, King's College London, London, United Kingdom
| | - Masao Iwagami
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan; Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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15
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Inoue Y, Nakatani H, Ono I, Peng X. Factors related to a sense of economic insecurity among older adults who participate in social activities. PLoS One 2024; 19:e0301280. [PMID: 38547217 PMCID: PMC10977778 DOI: 10.1371/journal.pone.0301280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 03/12/2024] [Indexed: 04/02/2024] Open
Abstract
Japan has the highest life expectancy worldwide. Older adults who experience economic insecurity may refrain from seeking medical consultation or using long-term care insurance, and these behaviors may increase the incidence and progression of frailty. This study conducted a cross-sectional survey to identify factors related to a sense of economic insecurity among older adults who participate in social activities, and identified support measures. In total, 1,351 older adults aged ≥65 years who had participated in social activities voluntarily completed an anonymous self-administered questionnaire. The questionnaire encompassed their physical, cognitive, social, and psychological conditions, and economic insecurity. We performed univariate analysis considering a sense of economic insecurity as the dependent variable, and conducted multiple logistic regression analysis (forced entry method) considering the independent variables with p<0.1 as the covariates. Among the 872 filled questionnaires, 717 were analyzed as they had no missing data with respect to the responses to survey questions (valid response rate was 53.1%). Analysis results showed that 43.6% of the older adults had a sense of economic insecurity, which was most common among those aged 75-84 years, accounting for 47.3%, followed by those aged 65-74 years accounting for 44.1%, and those aged ≥85 years accounting for 31.5% (p<0.05). The sense of economic insecurity was not associated with physical conditions, subjective symptoms of dementia, or social conditions; however, it grew with increased loneliness (OR: 1.71, 1.002-2.92, p = 0.049) and decreased with an increased subjective sense of well-being (OR: 0.86, 0.81-0.92, <0.001). Economic insecurity among older adults was not associated with physical, cognitive, or social aspects, as reported in previous studies. The survey respondents constituted older adults who participate in social activities. Maintaining interactions within the community, even in old age, may prevent loneliness and improve subjective health.
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Affiliation(s)
- Yuriko Inoue
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
| | - Hisae Nakatani
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
| | - Ichie Ono
- Department of Nursing, Yasuda Women’s University, Hiroshima City, Hiroshima, Japan
| | - Xuxin Peng
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
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Suganuma M, Furutani M, Hosoyama T, Mitsumori R, Otsuka R, Takemura M, Matsui Y, Nakano Y, Niida S, Ozaki K, Satake S, Shigemizu D. Identification of Potential Blood-Based Biomarkers for Frailty by Using an Integrative Approach. Gerontology 2024; 70:630-638. [PMID: 38484720 DOI: 10.1159/000538313] [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: 06/30/2023] [Accepted: 03/05/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Although frailty is a geriatric syndrome that is associated with disability, hospitalization, and mortality, it can be reversible and preventable with the appropriate interventions. Additionally, as the current diagnostic criteria for frailty include only physical, psychological, cognitive, and social measurements, there is a need for promising blood-based molecular biomarkers to aid in the diagnosis of frailty. METHODS To identify candidate blood-based biomarkers that can enhance current diagnosis of frailty, we conducted a comprehensive analysis of clinical data, messenger RNA-sequencing (RNA-seq), and aging-related factors using a total of 104 older adults aged 65-90 years (61 frail subjects and 43 robust subjects) in a cross-sectional case-control study. RESULTS We identified two candidate biomarkers of frailty from the clinical data analysis, nine from the RNA-seq analysis, and six from the aging-related factors analysis. By using combinations of the candidate biomarkers and clinical information, we constructed risk prediction models. The best models used combinations that included skeletal muscle mass index measured by dual-energy X-ray absorptiometry (adjusted p = 0.026), GDF15 (adjusted p = 1.46E-03), adiponectin (adjusted p = 0.012), CXCL9 (adjusted p = 0.011), or apelin (adjusted p = 0.020) as the biomarker. These models achieved a high area under the curve of 0.95 in an independent validation cohort (95% confidence interval: 0.79-0.97). Our risk prediction models showed significantly higher areas under the curve than did models constructed using only basic clinical information (Welch's t test p < 0.001). CONCLUSION All five biomarkers showed statistically significant correlations with components of the frailty diagnostic criteria. We discovered several potential biomarkers for the diagnosis of frailty. Further refinement may lead to their future clinical use.
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Affiliation(s)
- Mutsumi Suganuma
- Medical Genome Center, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Motoki Furutani
- Medical Genome Center, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tohru Hosoyama
- Geroscience Research Center, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Risa Mitsumori
- Medical Genome Center, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Rei Otsuka
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Marie Takemura
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Shumpei Niida
- Core Facility Administration, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kouichi Ozaki
- Medical Genome Center, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Shosuke Satake
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Daichi Shigemizu
- Medical Genome Center, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
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Christensen MG, Jacobsen KK, Nilsson C, Jepsen R, Thygesen L, Suetta C, Holm EA. Prevalence and population characteristics associated with frailty in a rural low socioeconomic area in Denmark: the Lolland-Falster Health Study. BMJ Open 2024; 14:e073754. [PMID: 38453201 PMCID: PMC10921517 DOI: 10.1136/bmjopen-2023-073754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 02/09/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Frailty is a major geriatric syndrome that predicts increased vulnerability to minor stressor events and adverse outcomes such as falls, fractures, disability and death. The prevalence of frailty among individuals above the age of 65 varies widely with an overall weighted prevalence of 10.7%. OBJECTIVES The purpose of this study was to examine the prevalence of prefrailty and frailty in community-dwelling older adults from the regions of Lolland-Falster, which is one of the most socioeconomically disadvantaged areas of Denmark with lower income and lower life expectancy compared with the general Danish population. Moreover, the objective was to find selected individual characteristics associated with frailty. DESIGN An observational, cross-sectional registry-based population study with data from the regions of Lolland-Falster collected between February 2016 and February 2020. RESULTS The study included 19 000 individuals. There were 10 154 above the age of 50 included for analysis. Prevalence of frailty in the age group of 50-64 years was 4.7% and 8.7% in the age group of 65 years and above.The study demonstrates associations between frailty and high age, female gender, low education level, low income, smoking, living alone, frequency of seeing one's children and getting help when needed. These associations are comparable with findings from other studies. CONCLUSION The syndrome of frailty consists of not only physiological and medical issues but also education, life conditions such as living alone and living in poverty and how you evaluate your own health.
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Affiliation(s)
| | - Katja Kemp Jacobsen
- Department of Technology, Faculty of Health and Technology, University College Copenhagen, Copenhagen, Denmark
| | - Charlotte Nilsson
- Public Health, University of Copenhagen, København K, Denmark
- Institut for Folkesundhedsvidenskab, Københavns Universitet, Kobenhavns, Denmark
| | - Randi Jepsen
- Lolland-Falster Health Study, Nykøbing F Sygehus, Nykobing, Denmark
| | | | - Charlotte Suetta
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Kobenhavn, Denmark
- Geriatric Research Unit, Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, Kobenhavn, Denmark
| | - Ellen Astrid Holm
- Internal Medicine, Zealand University Hospital Koge, Koge, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Kobenhavns, Denmark
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18
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Nakatsuka K, Ono R, Murata S, Akisue T, Fukuda H. Claims-based Frailty Index in Japanese Older Adults: A Cohort Study Using LIFE Study Data. J Epidemiol 2024; 34:112-118. [PMID: 36967119 PMCID: PMC10853043 DOI: 10.2188/jea.je20220310] [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: 11/02/2022] [Accepted: 02/21/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND We aimed to assess whether the United States-developed Claims-based Frailty Index (CFI) can be implemented in Japanese older adults using claims data. METHODS We used the monthly claims data and certification of long-term care (LTC) insurance data of residents from 12 municipalities from April 2014 to March 2019. The 12 months from first recording was defined as the "baseline period," and the time thereafter as the "follow-up period". Participants aged ≥65 years were included, and those with no certified LTC insurance or who died at baseline were excluded. New certification of LTC insurance and all-cause mortality during the follow-up period were defined as outcome events. CFI categorization consisted of three steps including: 1) using 12 months deficit-accumulation approach that assigned different weights to each of the 52 items; 2) the accumulated score to derive the CFI; and 3) categorizing the CFI as "robust" (<0.15), "prefrail" (0.15-0.24), and "frail" (≥0.25). Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the association between CFI and outcomes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. RESULTS There were 519,941 participants in total. After adjusting for covariates, the severe CFI category had a high risk of certification of LTC insurance (prefrail: HR 1.33; 95% CI, 1.27-1.39 and frail: HR 1.60; 95% CI, 1.53-1.68) and all-cause mortality (prefrail: HR 1.44; 95% CI, 1.29-1.60 and frail: HR 1.84; 95% CI, 1.66-2.05). CONCLUSION This study suggests that CFI can be implemented in Japanese claims data to predict the certification of LTC insurance and mortality.
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Affiliation(s)
- Kiyomasa Nakatsuka
- Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Rei Ono
- Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, National Institute of Health and Nutrition, Tokyo, Japan
| | - Shunsuke Murata
- Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | | | - Haruhisa Fukuda
- Kyushu University Graduate School of Medical Sciences, Department of Health Care Administration and Management, Fukuoka, Japan
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Zuo C, Li X, Guan Y, Fan L, Li J, Tian D, Chen C, Li X, Gu Z, Zhang C, Bian X, Lv Q. Influence of Aging on Outcomes of Sacubitril/Valsartan in Hypertensive Patients with Heart Failure: A Multicenter Retrospective Study. Anatol J Cardiol 2024; 28:194-200. [PMID: 38430112 PMCID: PMC11017677 DOI: 10.14744/anatoljcardiol.2023.3857] [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: 09/11/2023] [Accepted: 12/26/2023] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate the influence of aging on the effectiveness and tolerance of sacubitril/valsartan (sac/val) among hypertensive patients complicated with heart failure in a real-world setting. METHODS This multicenter, retrospective study included patients (≥18 years old) admitted with a diagnosis of hypertension and heart failure, starting sac/val therapy between January 2020 and December 2021 from 3 medical centers. Patients were grouped by the cutoff age of 65 years. Outcomes were collected 31-365 days after the initiation of sac/val and were compared in a matched cohort after 1: 1 propensity score matching (PSM). RESULTS A total of 794 patients were finally analyzed. Blood pressure and cardiac functions improved significantly compared with values at baseline. There were 269 patients in each cohort (<65 years and ≥65 years) after PSM. After PSM, the incidence of hyperuricemia and hypotension in the elderly patients (≥65 years) was significantly higher than in those <65 years of age. Kaplan-Meier estimate suggested that the cumulative incidence of new or recurrent cardiovascular events increased significantly at the age of ≥65 years after the point of 3 months (log-rank P =.00087). CONCLUSION Sac/val benefited patients in both cohorts by improving blood pressure and cardiac function. Elderly patients (≥65 years) were susceptible to hypotension, low diastolic blood pressure, hyperuricemia, and underwent cardiac-related readmissions more frequently.
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Affiliation(s)
- Chengchun Zuo
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoye Li
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yingyun Guan
- Department of Pharmacy, Ruijin Hospital School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Linlin Fan
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Li
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dan Tian
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Can Chen
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoyu Li
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhichun Gu
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Chi Zhang
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaolan Bian
- Department of Pharmacy, Ruijin Hospital School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Qianzhou Lv
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
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20
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Lyu W, Tanaka T, Bo-Kyung S, Yoshizawa Y, Akishita M, Iijima K. Integrated effects of nutrition-related, physical, and social factors on frailty among community-dwelling older adults: A 7-year follow-up from the Kashiwa cohort study. Geriatr Gerontol Int 2024; 24 Suppl 1:162-169. [PMID: 37984854 DOI: 10.1111/ggi.14734] [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: 08/24/2023] [Revised: 10/10/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
AIM To investigate the impact of nutrition-related, physical, and social factors as well as their transitions on frailty over a 7-year follow-up period among community-dwelling older adults. METHODS Participants were 868 non-frail older adults. Frailty was assessed using the Cardiovascular Health Study index. Nutrition-related, physical, and social factors have been defined in our previous study. Cox regression analysis was conducted to investigate the association between the three factors at baseline and new-onset frailty during a 7-year follow-up period. Furthermore, transitions in the three factors over two/three consecutive years and their association with frailty were investigated using lagged generalized estimating equations. RESULTS The mean age was 73.8 ± 4.8 years (women, 47.0%), and the incidence of frailty was 12.5% during the 7-year follow-up period. Compared with participants who met the three factors' criteria at baseline, those who met two, one, and none showed associations with greater adjusted hazard ratios of new-onset frailty (1.73, 95% confidence interval 0.87-3.42; 2.04 [1.01-4.12]; and 5.69 [2.82-11.47]). Generalized estimating equation analysis showed that, compared with older adults who maintained all the three criteria met, those who improved the quantity of criteria met, who maintained the less than three criteria met, and who decreased the quantity of criteria met showed (marginally) significant associations with greater adjusted odds ratios of frailty (2.86 [0.88-9.31], 3.70 [1.10-12.45], and 4.75 [1.42-15.85]). CONCLUSIONS Practicing and maintaining all three factors in daily life are crucial for frailty prevention. Future research should explore strategies to motivate behavioral modifications in these factors at the population level. Geriatr Gerontol Int 2024; 24: 162-169.
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Affiliation(s)
- Weida Lyu
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Son Bo-Kyung
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Yasuyo Yoshizawa
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Department of Healthy Life Expectancy, Graduate School of Medicine Juntendo University, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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21
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Kawase F, Masaki Y, Ozawa H, Imanaka M, Sugiyama A, Wada H, Kobayashi S, Tsukahara T. Association of resting energy expenditure with phase angle in hospitalized older patients: a cross-sectional analysis. Eur J Clin Nutr 2024; 78:187-192. [PMID: 37990127 DOI: 10.1038/s41430-023-01370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND/OBJECTIVES Resting energy expenditure (REE) constitutes the largest component of total energy expenditure and undergoes an age-related decline that is unexplained by decreased fat-free mass. Phase angle (PhA) is a cellular health indicator that is possibly associated with REE. We investigated the association of REE and PhA in hospitalized older adults. SUBJECTS/METHODS This single-center, cross-sectional analysis utilized the baseline data from a prospective longitudinal study and included 131 eligible patients aged ≥70 years. The REE was measured using indirect calorimetry, and PhA and body composition were assessed using bioelectrical impedance. The association between REE, PhA, and body composition was examined, and REE was compared using previously reported PhA cutoff values. RESULTS In this cohort with a mean (±standard deviation) age of 87.4 (±7.0) years, 34.4% of the participants were men. REE and PhA correlated strongly (r: 0.562, p < 0.001) and significantly after adjusting for age and sex (r: 0.433, p < 0.001). Multivariate analysis showed a significant independent association between REE and PhA and skeletal muscle mass (standardized β [95% CI]; 28.072 [2.188-53.956], p = 0.035) without any significant interaction between PhA and age on REE. The low PhA group had a significantly lower REE (kcal/day; 890 [856-925] vs. 1077 [1033-1122], p < 0.001), and this remained significant after adjusting for age, sex, and skeletal muscle mass index. CONCLUSIONS PhA is associated with REE in older adults. Adjusting REE calculation algorithms based on PhA values and correcting predicted REE according to PhA may aid in determining more accurate energy requirements.
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Affiliation(s)
- Fumiya Kawase
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan.
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan.
| | - Yoshiyuki Masaki
- Department of Internal Medicine, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
- Department of Community-Based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroko Ozawa
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Manami Imanaka
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Aoi Sugiyama
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Hironari Wada
- Department of Rehabilitation Therapy, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Shinya Kobayashi
- Department of Internal Medicine, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Takayoshi Tsukahara
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan
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22
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Ahmad SS, Choi I. Current situation and publication trends of skeletal muscle related research: A bibliometric analysis. Heliyon 2024; 10:e24942. [PMID: 38317977 PMCID: PMC10838779 DOI: 10.1016/j.heliyon.2024.e24942] [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: 09/26/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/07/2024] Open
Abstract
Skeletal muscle (SM) is a highly plastic and dynamic tissue of the body and is largely responsible for body maintenance. SM is primarily responsible for body balance, movement, postural support, thermogenesis, and blood glucose homeostasis. SM regeneration depends on the activation of muscle satellite (stem) cells (MSCs) under the regulation of several muscle regulatory factors that regulate myogenesis. Bibliometric analysis involves the quantitative and qualitative assessments of research and scientific progress that provides researchers access to recent publications, research directions, and thus generates ideas that can be implemented to guide future research. In this analysis, the Web of Science database was searched for articles using the search term "skeletal muscle AND myogenesis AND muscle satellite cell", and 1777 articles (original research/review articles) published from the year 1997 to June 2023 were retrieved. After applying several other exclusion and inclusion criteria, 129 articles were considered for analysis. Types of research, keywords, journals, authors, years, institutions, funding agencies, and average annual citations were analyzed. Muscle regeneration, satellite cell, and myogenesis were often used keywords and exhibited increasing trends in research articles over the decades. Some journals were found to strongly support research publications with high impact factors and citation scores. This study aimed to examine research ideas and growth in the skeletal muscle related field for atrophy and aging improvement.
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Affiliation(s)
- Syed Sayeed Ahmad
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan 38541, South Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan 38541, South Korea
| | - Inho Choi
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan 38541, South Korea
- Research Institute of Cell Culture, Yeungnam University, Gyeongsan 38541, South Korea
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23
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Murayama A, Higuchi D, Saida K, Tanaka S, Shinohara T. Fall Risk Prediction for Community-Dwelling Older Adults: Analysis of Assessment Scale and Evaluation Items without Actual Measurement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:224. [PMID: 38397713 PMCID: PMC10888445 DOI: 10.3390/ijerph21020224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
The frequency of falls increases with age. In Japan, the population is aging rapidly, and fall prevention measures are an urgent issue. However, assessing fall risk during the coronavirus disease pandemic was complicated by the social distancing measures implemented to prevent the disease, while traditional assessments that involve actual measurements are complicated. This prospective cohort study predicted the risk of falls in community-dwelling older adults using an assessment method that does not require actual measurements. A survey was conducted among 434 community-dwelling older adults to obtain data regarding baseline attributes (age, sex, living with family, use of long-term care insurance, and multimorbidity), Frailty Screening Index (FSI) score, and Questionnaire for Medical Checkup of Old-Old (QMCOO) score. The participants were categorized into fall (n = 78) and non-fall (n = 356) groups. The binomial logistic regression analysis showed that it is better to focus on the QMCOO sub-item score, which focuses on multiple factors. The items significantly associated with falls were Q5 (odds ratio [OR] 1.95), Q8 (OR 2.33), and Q10 (OR 3.68). Our results were similar to common risk factors for falls in normal times. During the pandemic, being able to gauge the risk factors for falls without actually measuring them was important.
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Affiliation(s)
- Akihiko Murayama
- Department of Physical Therapy, Faculty of Rehabilitation, Gunma University of Health and Welfare, Maebashi Plaza Genki 21 6-7F, 2-12-1 Hon-machi, Maebashi-shi 371-0023, Japan
| | - Daisuke Higuchi
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, 501 Naka Orui-machi, Takasaki-shi 370-0033, Japan; (D.H.); (K.S.); (S.T.); (T.S.)
| | - Kosuke Saida
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, 501 Naka Orui-machi, Takasaki-shi 370-0033, Japan; (D.H.); (K.S.); (S.T.); (T.S.)
| | - Shigeya Tanaka
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, 501 Naka Orui-machi, Takasaki-shi 370-0033, Japan; (D.H.); (K.S.); (S.T.); (T.S.)
| | - Tomoyuki Shinohara
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, 501 Naka Orui-machi, Takasaki-shi 370-0033, Japan; (D.H.); (K.S.); (S.T.); (T.S.)
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24
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Noji Y, Inoue S, Watanabe K, Obara S. Perioperative loss of the psoas major muscle area index in elderly patients with hip fracture: spinal anesthesia versus general anesthesia-a retrospective cohort study. J Anesth 2024; 38:57-64. [PMID: 37955708 DOI: 10.1007/s00540-023-03278-1] [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: 06/19/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE In hip fracture patients aged ≥ 80 years, we investigated whether the perioperative reduction in the psoas major muscle index (PMI) for spinal anesthesia was less than that for general anesthesia. METHODS A total of 262 patients surgically treated for intertrochanteric or femoral neck fractures between August 2015 and August 2022 were enrolled. After adjusting for propensity score matching, 50 patients were included in this analysis. After matching, patients were divided into those receiving spinal or general anesthesia. We measured the psoas major muscle area (PMA) by adjusting for the patient's height as PMA (cm2) divided by height (m) squared. The adjusted PMA was defined as the PMI. We calculated the variability in PMI (ΔPMI) before and after surgery. The primary outcome was the proportion of patients with a > 10% reduction in ΔPMI. The secondary outcomes were the mean ΔPMI and estimated factors affecting the postoperative reduction in the PMI. We compared the primary and secondary outcomes between spinal and general anesthesia. RESULTS The proportion with a > 10% reduction in ΔPMI did not differ between spinal and general anesthesia (36.0% vs. 40.0%, odds ratio:1.19, 95% CI:0.38-3.72, p = 0.31). The ΔPMI did not differ between spinal and general anesthesia (- 8.7% ± 7.9% vs. - 8.9% ± 8.3%, p = 0.93). The factors affecting the postoperative reduction in the PMI were male sex, preoperative non-sarcopenia, and intramedullary nailing. CONCLUSION There was no significant difference in ΔPMI between hip fracture patients ≥ 80 years of age receiving spinal versus general anesthesia undergoing surgical treatment.
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Affiliation(s)
- Yoshie Noji
- Department of Anesthesiology, Aidu Chuo Hospital, 1-1, Tsuruga-Machi, Aizuwakamatsu, Fukushima, 965-8611, Japan.
- Department of Anesthesiology, Fukushima Medical University, Fukushima, Japan.
| | - Satoki Inoue
- Department of Anesthesiology, Fukushima Medical University, Fukushima, Japan
| | - Kazuhiro Watanabe
- Department of Anesthesiology, Aidu Chuo Hospital, 1-1, Tsuruga-Machi, Aizuwakamatsu, Fukushima, 965-8611, Japan
| | - Shinju Obara
- Department of Anesthesiology, Fukushima Medical University, Fukushima, Japan
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Nishida Y, Yamada Y, Sasaki S, Kanda E, Kanno Y, Anzai T, Takahashi K, Yamauchi K, Katsukawa F. Effect of overweight/obesity and metabolic syndrome on frailty in middle-aged and older Japanese adults. Obes Sci Pract 2024; 10:e714. [PMID: 38264004 PMCID: PMC10804331 DOI: 10.1002/osp4.714] [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: 07/04/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 01/25/2024] Open
Abstract
Background The potential for developing frailty exists in middle-aged and older adults. While obesity and metabolic syndrome (MetS) increase the risk of frailty in older adults, this relationship remains unclear in middle-aged adults, who are prone to developing lifestyle-related diseases. Objective To examine the effect of overweight/obesity and MetS on frailty development in middle-aged and older Japanese adults using real-world data. Methods This nationwide cohort study used exhaustive health insurance claims data of 3,958,708 Japanese people from 2015 to 2019 provided by the Japan Health Insurance Association. Participants aged ≥35 and < 70 years who received health checkups in 2015 were included. Multivariate logistic regression was used to assess the effect of body mass index (BMI) and MetS or MetS components (i.e., diabetes, hypertension, and dyslipidemia) in 2015 on frailty risk assessed using the hospital frailty risk score in 2019. Additionally, a subgroup analysis was performed to examine the interaction effects of MetS components and 4-year weight change (%) on frailty risk among participants who were overweight and obese (BMI ≥25 kg/m2). Results In 2019, 7204 (0.2%) and 253,671 (6.4%) participants were at high and intermediate frailty risks, respectively. Obesity and MetS were independently associated with intermediate/high frailty risk (odds ratio (OR) 1.36, p < 0.05; OR 1.23, p < 0.05, respectively) and high frailty risk (OR 1.80, p < 0.05; OR 1.37, p < 0.05, respectively) in all participants. Although all MetS components were frailty risk factors, these effects diminished with age in both sexes. Subgroup analysis of patients with diabetes revealed that 5%-10% weight loss was associated with reduced frailty risk in both sexes. Conclusions Obesity, MetS, and MetS components were independent frailty risk factors in middle-aged and older Japanese adults. Weight loss of up to 10% over 4 years prevented frailty in patients with diabetes who were overweight and obese.
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Affiliation(s)
- Yuki Nishida
- Department of BiostatisticsM&D Data Science CenterTokyo Medical and Dental UniversityTokyoJapan
- Graduate School of Health ManagementKeio UniversityFujisawaKanagawaJapan
- Sports Medicine Research CenterKeio UniversityFujisawaKanagawaJapan
| | - Yosuke Yamada
- National Institute of Health and NutritionNational Institutes of Biomedical Innovation, Health, and NutritionOsakaJapan
| | - Satoshi Sasaki
- Department of Social and Preventive EpidemiologyGraduate School of MedicineThe University of TokyoTokyoJapan
| | - Eiichiro Kanda
- Medical ScienceKawasaki Medical SchoolKurashikiOkayamaJapan
| | | | - Tatsuhiko Anzai
- Department of BiostatisticsM&D Data Science CenterTokyo Medical and Dental UniversityTokyoJapan
| | - Kunihiko Takahashi
- Department of BiostatisticsM&D Data Science CenterTokyo Medical and Dental UniversityTokyoJapan
| | - Keita Yamauchi
- Graduate School of Health ManagementKeio UniversityFujisawaKanagawaJapan
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26
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Ohta R, Yakabe T, Sano C. Frailty Syndrome in Rural Communities: A Narrative Review and Interviews With Rural Individuals. Cureus 2024; 16:e55088. [PMID: 38558598 PMCID: PMC10978152 DOI: 10.7759/cureus.55088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Background With the global increase in aging populations, frailty syndrome, characterized by decreased strength, endurance, and physiological function, has become a critical issue. This study focuses on rural Japanese communities, where the prevalence of frailty syndrome can be notably high due to factors such as multimorbidity, polypharmacy, and a significant population of elderly individuals. This research addresses the gap in understanding frailty's manifestations and impacts in rural settings, considering unique challenges such as social isolation, limited healthcare access, and the broader social determinants of health. Methodology The study employs a narrative review with PubMed and a thematic analysis of semi-structured interviews with 21 elderly community workers in Unnan City. The analysis used the framework of frailty syndrome affected by physiological, social, psychological, and economic factors. The analysis focused on identifying themes related to the social determinants of health affecting frailty and potential solutions. Results The following five themes emerged from the analysis: Aging, Rural Contexts, Isolation, Lack of Knowledge of Frailty Syndrome, and Lack of Help-Seeking Behavior for Frailty Syndrome. Four solution-oriented themes were identified, namely, Public Dialogue and Educational Workshops, Frailty Syndrome Health Meetings, Social Engagement Activities, and Political Advocacy for Accessibility to Community Centers. These findings highlight the critical role of community engagement, education, and infrastructure improvements in addressing frailty syndrome in rural areas. Conclusions This study underscores the complexity of frailty syndrome in rural Japanese communities, emphasizing the need for targeted interventions that address the unique challenges faced by these populations. By fostering public dialogue, improving healthcare access, and enhancing social support, it is possible to mitigate the impacts of frailty syndrome and improve the quality of life for elderly residents in rural settings. This research contributes to a deeper understanding of frailty in aging societies and the importance of considering social determinants of health in developing effective solutions.
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Affiliation(s)
| | | | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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27
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Hirose T, Sawaya Y, Ishizaka M, Hashimoto N, Kubo A, Urano T. Prevalence and factors associated with changes in frailty among community-dwelling older adults in Japan during the COVID-19 pandemic: A prospective cohort study from 2020 to 2022. Geriatr Gerontol Int 2024; 24:40-47. [PMID: 38009433 DOI: 10.1111/ggi.14748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 11/28/2023]
Abstract
AIM This study aimed to ascertain the prevalence of frailty during the pandemic and to determine factors associated with changes in frailty status. METHODS In May-June of 2020-2022, we assessed the frailty of 549 participants using the Kihon Checklist. Furthermore, we classified participant residences as urban, suburban, and rural and investigated participants' engagement in hobbies and community activities in 2020 and 2022. Cochran's Q test was used to analyze the proportions of frailty status. Subsequently, we conducted a binomial logistic regression analysis with the improvement/deterioration of frailty status from 2020 to 2022 as the dependent variable, and engagement in hobbies and community activities as the independent variables. RESULTS Significant changes were observed among participants in urban areas, where an increase in pre-frailty and a decrease in robust individuals from 2020 to 2021 were noted. Focusing on item no. 17 (going out), the decreasing frequency had recovered by 2022 in the group of all groups. Continued engagement in only hobbies or only community activities, and continued engagement in both were associated with remained robust/frailty-status improvement. Moreover, not engaging in either hobbies or community activities was associated with remained frail/frailty-status deterioration. CONCLUSIONS During the early stages, the COVID-19 pandemic impacted the frailty of older adults in densely populated areas. The results also suggest an attenuation in the decline in older adult activity in 2022. Continuous engagement in hobbies and community activities was crucial for improving and preventing deterioration in frailty status during the COVID-19 pandemic. Geriatr Gerontol Int 2024; 24: 40-47.
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Affiliation(s)
- Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | | | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences at Odawara, International University of Health and Welfare, Odawara, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan
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28
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Nagatomi A, Wakatake H, Masui Y, Fujitani S. Prognostic factors in mobility disability among elderly patients in the emergency department: A single-center retrospective study. Acute Med Surg 2024; 11:e951. [PMID: 38638890 PMCID: PMC11024440 DOI: 10.1002/ams2.951] [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: 12/20/2023] [Accepted: 04/04/2024] [Indexed: 04/20/2024] Open
Abstract
Aim We aimed to evaluate the clinical characteristics and outcomes of elderly critically ill patients and identify prognostic factors for mobility disability at discharge. Methods This single-center, retrospective cohort study investigated the period from April 2020 to January 2021. Patients ≥75 years old transferred to our emergency department and admitted to the intensive care unit (ICU) or intermediate unit in our hospital were eligible. Demographics, clinical characteristics, nutritional indicators, and nutritional screening scores were collected from chart reviews and analyzed. The primary outcome was the prevalence of mobility disability, compared to that of no mobility disability. Results A total of 124 patients were included in this present study. Median age was 83.0 years (interquartile range [IQR], 79.8-87.0 years) and 48 patients (38.7%) were female. Fifty-two patients (41.9%) could not walk independently at discharge (mobility disability group). The remaining 72 patients were in the no mobility disability group. Multiple logistic regression analyses revealed clinical frailty scale (CFS) score ≥5 (odds ratio [OR] = 6.63, 95% confidence interval [CI] = 2.51-17.52, p < 0.001), SOFA score ≥6 (OR = 6.11, 95% CI = 1.57-23.77, p = 0.009), and neurological disorder as the main cause on admission (OR = 4.48, 95% CI = 1.52-13.20, p = 0.006) were independent and significant prognostic factors for mobility disability at discharge. Conclusion Among elderly patients admitted to the emergency department, CFS ≥5, SOFA ≥6, and neurological disorders were associated with mobility disability at hospital discharge.
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Affiliation(s)
- Akiyoshi Nagatomi
- Department of Emergency and Critical Care MedicineSt. Marianna University Yokohama City Seibu HospitalYokohamaJapan
- Department of Emergency and Critical Care MedicineSt. Marianna University, School of MedicineKawasakiJapan
| | - Haruaki Wakatake
- Department of Emergency and Critical Care MedicineSt. Marianna University Yokohama City Seibu HospitalYokohamaJapan
| | - Yoshihiro Masui
- Department of Emergency and Critical Care MedicineSt. Marianna University Yokohama City Seibu HospitalYokohamaJapan
| | - Shigeki Fujitani
- Department of Emergency and Critical Care MedicineSt. Marianna University, School of MedicineKawasakiJapan
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Shen C, Lin YC, Lin HY, Chen LK, Hsiao FY. Effects of declines in personal mastery on self-perceived mobility, physical function, cognitive function, and depressive symptoms: a 6-year follow-up study from the Social Environment and Biomarkers of Aging Study. Aging Clin Exp Res 2023; 35:3215-3226. [PMID: 38070123 DOI: 10.1007/s40520-023-02613-6] [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: 06/06/2023] [Accepted: 11/01/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES As the psychosocial competence, personal mastery helps individuals to cope with stressful life events, and this study aims to examine impacts of declines in personal mastery on healthy aging among community-dwelling middle-aged and older adults using a nationally representative cohort. METHODS Data from 648 study participants in the Social Environment and Biomarkers of Aging Study (SEBAS) were retrieved for analysis. All participants were divided into four groups based on their baseline and changes of personal mastery (measured by the Pearlin mastery score) during the 6-year follow-up. Multivariate logistic regression models were adopted to examine associations between declines in personal mastery and indicators for healthy aging (declines in self-perceived mobility, physical function (activities of daily living (ADLs) and instrumental activities of daily living (IADLs)), cognitive function and depressive symptoms). RESULTS After adjustments for demographics and comorbidities, those with declines in personal mastery were associated with greater risks of declines in self-perceived mobility (adjusted odds ratio (aOR) 1.50 [95% confidence interval 1.01-2.22], p < 0.05). Although the point estimate in the unadjusted models indicated similar associations between declines in personal mastery and declines in ADLs, IADLs, cognitive function or depressive symptoms, these outcomes did not reach statistical significance in the adjusted model. CONCLUSIONS Declines in personal mastery were negatively associated with indicators related to healthy aging (particularly locomotion) in a 6-year follow-up. Further investigations are needed to explore the effects of preventing declines in personal mastery in promoting healthy aging over time.
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Affiliation(s)
- Chieh Shen
- School of Pharmacy, National Taiwan University, Taipei, Taiwan
| | - Yi-Chin Lin
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Room 220, 33, Linsen S. Rd, Taipei, 10050, Taiwan
| | - Hung-Yu Lin
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Room 220, 33, Linsen S. Rd, Taipei, 10050, Taiwan
| | - Liang-Kung Chen
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2 Shih-Pai Road, Taipei, Taiwan.
- Taipei Municipal Gan-Dau Hospital (Managed By Taipei Veterans General Hospital), Taipei, Taiwan.
| | - Fei-Yuan Hsiao
- School of Pharmacy, National Taiwan University, Taipei, Taiwan.
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Room 220, 33, Linsen S. Rd, Taipei, 10050, Taiwan.
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
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Saeki N, Mizutani M, Tanimura S, Nishide R. Types and frequency of social participation and comprehensive frailty among community-dwelling older people in Japan. Prev Med Rep 2023; 36:102443. [PMID: 38021414 PMCID: PMC10656264 DOI: 10.1016/j.pmedr.2023.102443] [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: 05/10/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Although research has established social participation as important for preventing frailty in older people, the association between the type and frequency of social participation and comprehensive frailty remains unclear. This study aimed to reveal the associations between types and frequency of social participation and comprehensive frailty among community-dwelling older people. This was a cross-sectional study conducted in four cities and towns (Inabe City, Nabari City, Odai Town, and Kiho Town) of Mie Prefecture, Japan, among adults who were: (i) aged ≥65 years and (ii) not certified as needing long-term care. We measured comprehensive frailty using the participants' total scores on the Kihon Checklist, developed by Ministry of Health, Labour and Welfare of Japan, which divides frailty status into three categories: robust (0-3 points), prefrail (4-7), and frail (8-25). Types and frequency of social participation were explanatory variables, and ordered logistic regression analysis adjusted for potential confounding factors identified the associations. The frailty status of the 296 participants (age 65-74 years: 44.3 %; female: 74.0 %) was as follows: frail, 21.3 %; prefrail, 40.2 %; and robust, 38.5 %. Lower level of frailty was associated with interaction using smartphones 2-3 times per month, participating in sports ≥4 times per week, participating in local improvement activities several times per year, and engaging in activities for children 2-4 times per month. Social participation among older adults at appropriate frequencies were associated with the lower level of comprehensive frailty. However, future longitudinal studies are needed using populations from more diverse countries or regions and from different cultures.
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Affiliation(s)
- Nanako Saeki
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Mayumi Mizutani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Susumu Tanimura
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Ritsuko Nishide
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
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Xu L, Wang W, Xu Y, Yang B. Efficacy of a modified FRAIL scale in predicting the peri-operative outcome of hepatectomy in older adults (aged ≥ 75 years): a model development study. BMC Geriatr 2023; 23:770. [PMID: 37996846 PMCID: PMC10668370 DOI: 10.1186/s12877-023-04488-8] [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: 03/30/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The FRAIL scale for evaluating frailty consists of five items: fatigue, resistance, aerobic, illness, and loss of weight. However, it is difficult to obtain a specific weight loss value. Since the Timed Up and Go Test (TUGT) is simple, accurate, and easy to perform, we replaced weight loss with the TUGT in the FRAIL scale, with the remaining four items unchanged, and named it the FRAIT scale. The aim of this study was to determine the value of the FRAIT scale in predicting the peri-operative outcome of hepatectomy. METHODS This model development study was conducted between January 2017 and December 2021. The reliability, validity and area under the curve (AUC) of the FRAIL/FRAIT scales were calculated. The frailty status of patients aged ≥ 75 years who underwent hepatectomy was measured using the FRAIL/FRAIT scales. Logistic regression was used to compare the relationship between FRAIL/FRAIT scores/grades and perioperative outcomes. RESULTS The AUCs for predicting operation duration, intraoperative bleeding, complications, and death based on the FRAIL score were 0.692, 0.740, 0.709, and 0.733, respectively, and those based on the FRAIT score were 0.700, 0.745, 0.708, and 0.724, respectively. The AUCs for predicting operation duration, intraoperative bleeding, complications, and death based on the FRAIL grade were 0.693, 0.735, 0.695, and 0.755, respectively, and those based on the FRAIT grades were 0.700, 0.758, 0.699, and 0.750, respectively. The FRAIL score has three effective predictors (intraoperative bleeding, complications, and death), while the FRAIT score has four effective predictors (operation duration, intraoperative bleeding, complications, and death). The FRAIL grade has two effective predictors (intraoperative bleeding and death), while the FRAIT grade has three effective predictors (operation duration, intraoperative bleeding, and death). CONCLUSIONS This study describes a new and more effective tool for the assessment of preoperative frailty in older adults undergoing hepatectomy. The items of the FRAIT scale are easier to obtain than those of the FRAIL scale, and the predictive effect of the FRAIT scale is stronger than that of the FRAIL scale.
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Affiliation(s)
- Lining Xu
- Department of General Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Weiyu Wang
- Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, National Quality Control Center for Donated Organ Procurement, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, 430071, China
| | - Yingying Xu
- Department of Internal Medicine, Henan Cancer Hospital, Zhengzhou, 450003, China
| | - Bo Yang
- Department of Radiology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
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Uemura K, Kamitani T, Yamada M. Frailty and Environmental Attributes in Older Adults: Insight from an Ecological Model. Phys Ther Res 2023; 26:71-77. [PMID: 38125292 PMCID: PMC10730123 DOI: 10.1298/ptr.r0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/26/2023] [Indexed: 12/23/2023]
Abstract
Many studies on frailty have primarily focused on individual-level risk factors such as demographics and lifestyle. While guidelines for frailty management recommend modifications to an individual's lifestyle, their lifestyle behaviors are significantly influenced by their surroundings. Recently, the association between frailty and environmental attributes has drawn attention as a result of the increase in evidence that multiple factors affect health conditions and behaviors associated with frailty. These findings can be organized based on an ecological model involving five nested levels that influence an individual's behaviors, namely, an intrapersonal/individual core (age, education, and attitude), an interpersonal level (persons and groups), an organizational/institutional level (organization and workplace), a community level (natural, built, and social environments), and a system/public policy level (public policies from local to national). This study reviewed possible factors associated with frailty from the onset and its progression at each level of the ecological model and their implications regarding frailty prevention. Additionally, we introduce a policy-level approach for frailty prevention in Japan-which encourages residents to engage in the local society by participating in community places or groups that are referred to as "Kayoi-no-ba"-and aggregate its status from a government report. This perspective on community building is consistent with the concept of an ecological model. However, few studies have verified the effects of policy- or system-level approaches on disability and frailty prevention. Further studies from an ecological perspective are needed to fulfill multilevel interventions for frailty prevention.
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Affiliation(s)
- Kazuki Uemura
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Japan
| | - Tsukasa Kamitani
- Section of Education for Clinical Research, Kyoto University Hospital, Japan
| | - Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, Japan
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Bozkurt ME, Catikkas NM, Erdogan T, Oren MM, Kilic C, Karan MA, Bahat G. Frailty and its associates in community-dwelling older adults. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230681. [PMID: 37971124 PMCID: PMC10645168 DOI: 10.1590/1806-9282.20230681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/26/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE While the literature contains several studies on the frailty assessed during hospitalization and/or outpatient settings and nursing homes, few studies have assessed frailty in community-dwelling older adults. We investigated the prevalence of frailty and associated factors among older adults in a sample of community-dwelling older adults. METHODS We included community-dwelling older adults >60 years living in the Fatih District of the Istanbul Province. We conducted the study between November 2014 and May 2015. We collected the data such as age, sex, number of diseases and drugs, functional status, frailty, the presence of geriatric syndromes, common diseases, and quality-of-life assessment. Frailty was evaluated by the FRAIL scale. RESULTS A total of 204 adults (mean age: 75.4±7.3 years) were included, of whom 30.4% were robust, 42.6% were pre-frail, and 27% were frail. In multivariate analyses, associated factors of frailty were the number of drugs [odds ratio (OR)=1.240, p=0.036], the presence of cognitive impairment (OR=0.300, p=0.016), and falls (OR=1.984, p=0.048). CONCLUSION The present study established the prevalence of frailty in a large district in the largest metropolis in the country through a valid screening method. Our results suggest that clinicians should consider frailty evaluation in patients with multiple drug usage, cognitive impairment, and falls.
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Affiliation(s)
- Meris Esra Bozkurt
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Nezahat Muge Catikkas
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Tugba Erdogan
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Meryem Merve Oren
- Istanbul University, Istanbul Medical School, Department of Public Health – İstanbul, Turkey
| | - Cihan Kilic
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Mehmet Akif Karan
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Gulistan Bahat
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
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Yakabi A, Watanabe M, Ishizaka M, Itokazu M, Kubo A. Improvement of frailty prevalence: difference in factors affecting frailty prevalence among 75 year-old individuals between 2006 and 2019. J Phys Ther Sci 2023; 35:727-732. [PMID: 37915455 PMCID: PMC10618012 DOI: 10.1589/jpts.35.727] [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: 06/29/2023] [Accepted: 08/09/2023] [Indexed: 11/03/2023] Open
Abstract
[Purpose] This study aimed to examine and compare the prevalence of frailty in 75 year-old people sampled in two remote years, namely 2006 and 2019. [Participants and Methods] A total of 910 participants aged 75 years were included (502 people in 2006 and 408 people in 2019). We compared the total score of the Kihon checklist and each question for males and females between the two years. [Results] The prevalence of frailty decreased from 24.3% in 2006 to 15.2% in 2019. The comparison of the 2006 and 2019 Kihon checklists revealed significant differences in activities of daily living, physical function, oral function, outdoor activities, and cognitive function. [Conclusion] Frailty among 75 year-old individuals improved in 2019 compared to that in 2006. Improved activities of daily living, physical function, outdoor activities, and cognitive function were major causes of improved frailty in 2019.
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Affiliation(s)
- Akihiro Yakabi
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara, Tochigi
324-8501, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara, Tochigi
324-8501, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara, Tochigi
324-8501, Japan
| | - Masafumi Itokazu
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara, Tochigi
324-8501, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences
at Odawara, International University of Health and Welfare, Japan
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35
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Misu Y, Katayama O, Lee S, Makino K, Harada K, Tomida K, Morikawa M, Yamaguchi R, Nishijima C, Fujii K, Shimada H. Reciprocal relationship between physical and social frailty among community-dwelling older adults. Arch Gerontol Geriatr 2023; 114:105066. [PMID: 37245490 DOI: 10.1016/j.archger.2023.105066] [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: 03/13/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Both physical and social frailty are risk factors for major adverse health-related outcomes and influence each other. However, the longitudinal causal relationship between physical and social frailty has not been clarified. This study aimed to determine the reciprocal relationship between physical and social frailty by age group. METHODS This study analyzed longitudinal data from a cohort study of older adults aged 65 years or older living in Obu City, Aichi Prefecture, Japan. The study included 2568 participants who participated in both a baseline assessment in 2011 and a follow-up assessment four years later. Participants participated in assessments of physical and cognitive function. Physical frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria. Social frailty was assessed with five questions about daily social activities, social roles, and social relationships. A total frailty score was calculated for each frailty type and used in the cross-lagged panel analysis. The reciprocal relationship between physical and social frailty status was analyzed using a cross-lagged panel model in each of the young-old (n = 2006) and old-old (n = 562) groups. RESULTS In the old-old group, baseline physical frailty status predicted social frailty status four years later, and social frailty status at baseline predicted physical frailty status four years later. In the young-old group, the effect of social frailty status at baseline on physical frailty at four years was significant; however, the cross-lag effect from baseline physical frailty status to social frailty status at four years was insignificant, indicating that social frailty preceded physical frailty. CONCLUSION The reciprocal relationship between physical and social frailty differed by age group. The results of this study suggest the importance of considering age when planning strategies to prevent frailty. Although a causal relationship between both physical and social frailty was observed in old-old, social frailty preceded physical frailty in the young-old, suggesting that early prevention of social frailty is important for the prevention of physical frailty.
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Affiliation(s)
- Yuka Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan.
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Ryo Yamaguchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
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WATANABE S, YOSHIDA N, BABA K, YAMASAKI H, SHINOZAKI NO, OGAWA M, YAMASHITA T, TAKEDA AK. Gut microbial stability in older Japanese populations: insights from the Mykinso cohort. BIOSCIENCE OF MICROBIOTA, FOOD AND HEALTH 2023; 43:64-72. [PMID: 38188657 PMCID: PMC10767323 DOI: 10.12938/bmfh.2022-047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/19/2023] [Indexed: 01/09/2024]
Abstract
Gut microbiota imbalance plays an important role in the pathogenesis of various diseases. Here, we determined microbe-microbe interactions and gut microbiome stability in a Japanese population with varying body mass indices (BMIs) and enterotypes. Using 16S ribosomal RNA gene sequencing, we analyzed gut microbial data from fecal samples obtained from 3,365 older Japanese individuals. The individuals were divided into lean, normal, and obese groups based on their BMIs. They were further categorized according to their gut microbiota enterotypes: Bacteroides (enterotype B), Prevotella (enterotype P), and Ruminococcus (enterotype R). We obtained data on different host factors, such as age, BMI, and disease status, using a survey questionnaire evaluated by the Mykinso gut microbiome testing service. Subsequently, we evaluated the co-occurrence network. Individual differences in BMI were associated with differences in co-occurrence networks. By exploring the network topology based on BMI status, we observed that the network density was lower in the lean group than that in the normal group. Furthermore, a simulation-based stability analysis revealed a lower resistance index in the lean group than those in the other two groups. Our results provide insights into various microbe-microbe interactions and gut microbial stability and could aid in developing appropriate therapeutic strategies targeting gut microbiota modulation to manage frailty.
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Affiliation(s)
| | - Naofumi YOSHIDA
- Division of Cardiovascular Medicine, Department of Internal
Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku,
Kobe-shi, Hyogo 650-0017, Japan
| | - Kairi BABA
- Cykinso, Inc., 1-36-1 Yoyogi, Shibuya-ku, Tokyo 151-0053,
Japan
| | | | | | - Masato OGAWA
- Division of Rehabilitation Medicine, Kobe University
Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe-shi, Hyogo 650-0017, Japan
| | - Tomoya YAMASHITA
- Division of Cardiovascular Medicine, Department of Internal
Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku,
Kobe-shi, Hyogo 650-0017, Japan
| | - Aya K. TAKEDA
- Cykinso, Inc., 1-36-1 Yoyogi, Shibuya-ku, Tokyo 151-0053,
Japan
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Uematsu T, Kawakami Y, Nojiri S, Saito T, Irie Y, Kasai T, Hiratsuka Y, Ishijima M, Kuroki M, Daida H, Nishizaki Y. Association between number of medications and hip fractures in Japanese elderly using conditional logistic LASSO regression. Sci Rep 2023; 13:16831. [PMID: 37803071 PMCID: PMC10558461 DOI: 10.1038/s41598-023-43876-3] [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: 02/08/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023] Open
Abstract
To examine the association between hip fracture and associated factors, including polypharmacy, and develop an optimal predictive model, we conducted a population-based matched case-control study using the health insurance claims data on hip fracture among Japanese patients. We included 34,717 hospitalized Japanese patients aged ≥ 65 years with hip fracture and 34,717 age- and sex- matched controls who were matched 1:1. This study included 69,434 participants. Overall, 16 variable comorbidities and 60 variable concomitant medications were used as explanatory variables. The participants were added to early elderly and late elderly categories for further analysis. The odds ratio of hip fracture increased with the number of medications only in the early elderly. AUC was highest for early elderly (AUC, 0.74, 95% CI 0.72-0.76). Use of anti-Parkinson's drugs had the largest coefficient and was the most influential variable in many categories. This study confirmed the association between risk factors, including polypharmacy and hip fracture. The risk of hip fracture increased with an increase in medication number taken by the early elderly and showed good predictive accuracy, whereas there was no such association in the late elderly. Therefore, the early elderly in Japan should be an active target population for hip fracture prevention.
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Affiliation(s)
- Takuya Uematsu
- Clinical Translational Science, Juntendo University School of Medicine Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Hospital Pharmacy, Juntendo University Hospital, Tokyo, Japan
| | - Yuta Kawakami
- Clinical Research and Trial Center, Juntendo University, Tokyo, Japan
- Graduate School of Engineering Science, Yokohama National University, Kanagawa, Japan
| | - Shuko Nojiri
- Clinical Translational Science, Juntendo University School of Medicine Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan.
| | - Tomoyuki Saito
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Yoshiki Irie
- Clinical Research and Trial Center, Juntendo University, Tokyo, Japan
- Graduate School of Engineering Science, Tokyo University of Science, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiology, Juntendo University School of Medicine Graduate School of Medicine, Tokyo, Japan
| | - Yoshimune Hiratsuka
- Department of Ophthalmology, Juntendo University School of Medicine Graduate School of Medicine, Tokyo, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University School of Medicine Graduate School of Medicine, Tokyo, Japan
| | - Manabu Kuroki
- Graduate School of Engineering Science, Yokohama National University, Kanagawa, Japan
| | - Hiroyuki Daida
- Department of Cardiology, Juntendo University School of Medicine Graduate School of Medicine, Tokyo, Japan
| | - Yuji Nishizaki
- Clinical Translational Science, Juntendo University School of Medicine Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
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Deng Y, Zhang K, Zhu J, Hu X, Liao R. Healthy aging, early screening, and interventions for frailty in the elderly. Biosci Trends 2023; 17:252-261. [PMID: 37612123 DOI: 10.5582/bst.2023.01204] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
With the intensification of population aging worldwide, the health problems of the elderly have become a particular concern. Functional disability is a prominent problem in the aging of this population, resulting in the decreased quality of life of senile people. Risk factors for functional disability in the elderly include geriatric syndromes and the associated diseases such as frailty. The influence of frailty on the health of the elderly has been a hot topic in recent years. As a dynamic and reversible geriatric syndrome, it has become one of the important public health problems emerging around the world. Frailty lies between self-reliance and the need for care and is reversible. Reasonable preventive interventions can restore the elderly to an independent life. If no interventions are implemented, the elderly will face a dilemma. There is no gold standard for frailty screening around the world. In order to alleviate frailty in the elderly, many countries have conducted early screening for frailty, mainly focusing on nutrition, physical activity, and social participation, in order to detect and prevent frailty earlier and to reduce the incidence of frailty. This topic provides an overview of the current status of frailty, early screening for frailty, and the interventions for frailty in most countries of the world.
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Affiliation(s)
- Yi Deng
- Department of Geriatric Nursing, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Keming Zhang
- Department of Hepatobiliary Surgery, Peking University International Hospital, Beijing, China
| | - Jiali Zhu
- Department of Hepatobiliary Surgery, Peking University International Hospital, Beijing, China
| | - Xiaofeng Hu
- Department of Hepatobiliary Surgery, First Hospital Affiliated with Chongqing Medical University, Chongqing, China
| | - Rui Liao
- Department of Hepatobiliary Surgery, First Hospital Affiliated with Chongqing Medical University, Chongqing, China
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Lee YH, Lin CH, Wu WR, Chiu HY, Huang HC. Virtual reality exercise programs ameliorate frailty and fall risks in older adults: A meta-analysis. J Am Geriatr Soc 2023; 71:2946-2955. [PMID: 37165743 DOI: 10.1111/jgs.18398] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/23/2023] [Accepted: 04/08/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Virtual reality (VR) technology constitutes a promising rehabilitation strategy, but its effect on frailty in older adults remains inconclusive. This study examined the effects of interactive VR training programs on lower-limb muscle strength, walking speed, balance, and fall risks in older adults with frailty. METHODS Various electronic databases comprising PubMed, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, Embase, the Chinese Electronic Periodical Service, the Chinese National Knowledge Infrastructure, and gray literature were searched from their inception through December 31, 2022 for relevant studies. Randomized controlled trials that examined the effects of interactive VR training programs on lower-limb muscle strength, balance, walking speed, and fall risks as measured by validated scales or methods. in older adults aged 65 years and older with frailty were included. A random-effects model was employed to examine the overall effect size, and the trim-and-fill method was adopted to examine publication bias. RESULTS For those studies that defined frailty using fall risks, substantial evidence demonstrated that interactive VR training interventions increased lower-limb muscle strength (Hedges' g = 0.35, p = 0.015), walking speed (Hedges' g = 0.29, p = 0.003), balance (Hedges' g = 0.62, p = 0.011), and fall risks (Hedges' g = -0.61, p < 0.001). Studies that defined frailty in accordance with the Fried frailty phenotype criteria indicated that interactive VR training interventions only increased walking speed (Hedges' g = 0.28, p = 0.023) and balance (Hedges' g = 0.27, p = 0.049). CONCLUSIONS Interactive VR training programs may benefit older adults with frailty with respect to walking speed and balance. More studies with good study quality are required to validate the effects of interactive VR exercise training on these frailty-related parameters in older adults.
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Affiliation(s)
- Yueh-Hua Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Chueh-Ho Lin
- International Ph.D. Program in Gerontology and Long-Term Care, Taipei Medical University, Taipei City, Taiwan
- Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Wan-Ru Wu
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei City, Taiwan
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei City, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
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Sawa R, Doi T, Tsutsumimoto K, Nakakubo S, Kurita S, Kiuchi Y, Nishimoto K, Shimada H. Overlapping status of frailty and fear of falling: an elevated risk of incident disability in community-dwelling older adults. Aging Clin Exp Res 2023; 35:1937-1944. [PMID: 37337077 DOI: 10.1007/s40520-023-02474-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: 03/04/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Although overlapping frailty and fear of falling (FoF) are likely to increase with population aging, the combined effect of frailty and FoF on incident disability is not yet well understood. AIMS The purpose of this study is to examine whether frailty combined with FoF increased the risk of incident disability in older adults. Our secondary purpose was to clarify the synergistic effect of frailty and FoF on incident disability. METHODS This is a prospective study. Participants were 9372 older adults (mean age 73.5 years). Frailty status was assessed using the Japanese Cardiovascular Health Study index, and FoF was measured using two closed questions. Incident disability was prospectively monitored by their long-term care insurance records. RESULTS During the follow-up period (mean duration 23.4 months), 487 (5.2%) participants developed disability. The proportion of incident disability linearly increased according to FoF level regardless of baseline frailty status. Frail participants with FoF had a higher risk of incident disability than those with frailty only or neither (adjusted hazard ratio [HR] 2.63, 95% confidence interval [CI] 1.95-3.54). Frailty in combination with excessive FoF further increased the risk of incident disability (adjusted HR 4.30, 95% CI 2.56-7.23) although no synergistic effect was observed (relative excessive risk due to interaction 1.69, 95% CI - 0.55, 3.93). CONCLUSION The overlapping status of frailty and FoF, especially excessive FoF, increases the risk of incident disability in older adults.
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Affiliation(s)
- Ryuichi Sawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, 3-2-12 Hongo Bunkyo-Ku, Tokyo, 113-0033, Japan.
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan.
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
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Liu Q, Yang L, Shi Z, Yu J, Si H, Jin Y, Bian Y, Li Y, Ji L, Qiao X, Wang W, Liu H, Zhang M, Wang C. Development and validation of a preliminary clinical support system for measuring the probability of incident 2-year (pre)frailty among community-dwelling older adults: A prospective cohort study. Int J Med Inform 2023; 177:105138. [PMID: 37516037 DOI: 10.1016/j.ijmedinf.2023.105138] [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: 12/06/2022] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To develop the wed-based system for predicting risk of (pre)frailty among community-dwelling older adults. MATERIALS AND METHODS (Pre)frailty was determined by physical frailty phenotype scale. A total of 2802 robust older adults aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS) 2013-2015 survey were randomly assigned to derivation or internal validation cohort at a ratio of 8:2. Logistic regression, Random Forest, Support Vector Machine and eXtreme Gradient Boosting (XGBoost) were used to construct (pre)frailty prediction models. The Grid search and 5-fold cross validation were combined to find the optimal parameters. All models were evaluated externally using the temporal validation method via the CHARLS 2011-2013 survey. The (pre)frailty predictive system was web-based and built upon representational state transfer application program interfaces. RESULTS The incidence of (pre)frailty was 34.2 % in derivation cohort, 34.8 % in internal validation cohort, and 32.4 % in external validation cohort. The XGBoost model achieved better prediction performance in derivation and internal validation cohorts, and all models had similar performance in external validation cohort. For internal validation cohort, XGBoost model showed acceptable discrimination (AUC: 0.701, 95 % CI: [0.655-0.746]), calibration (p-value of Hosmer-Lemeshow test > 0.05; good agreement on calibration plot), overall performance (Brier score: 0.200), and clinical usefulness (decision curve analysis: more net benefit than default strategies within the threshold of 0.15-0.80). The top 3 of 14 important predictors generally available in community were age, waist circumference and cognitive function. We embedded XGBoost model into the server and this (pre)frailty predictive system is accessible at http://www.frailtyprediction.com.cn. A nomogram was also conducted to enhance the practical use. CONCLUSIONS A user-friendly web-based system was developed with good performance to assist healthcare providers to measure the probability of being (pre)frail among community-dwelling older adults in the next two years, facilitating the early identification of high-risk population of (pre)frailty. Further research is needed to validate this preliminary system across more controlled cohorts.
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Affiliation(s)
- Qinqin Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Liming Yang
- School of Computer Science, Peking University, Beijing 100871, China
| | - Zhuming Shi
- School of Electronics Engineering and Computer Science, Peking University, Beijing 100871, China
| | - Jiaqi Yu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Huaxin Si
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yaru Jin
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanhui Bian
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanyan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Lili Ji
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Xiaoxia Qiao
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Wenyu Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Hongpeng Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Ming Zhang
- School of Computer Science, Peking University, Beijing 100871, China
| | - Cuili Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
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Yoshikoshi S, Yamamoto S, Suzuki Y, Imamura K, Harada M, Yamabe S, Matsunaga Y, Osada S, Tagaya H, Matsunaga A. Association between Physical Frailty and Sleep Disturbances among Patients on Hemodialysis: A Cross-Sectional Study. Nephron Clin Pract 2023; 148:152-159. [PMID: 37586328 DOI: 10.1159/000533418] [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: 04/27/2023] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
INTRODUCTION Among patients on hemodialysis (HD), physical frailty and sleep disturbances are not only common but also associated with adverse outcomes. The aim of this study was to evaluate the association between physical frailty and sleep disturbances in patients on HD. METHODS This cross-sectional study was conducted from June 2017 to March 2021, with outpatients receiving HD 3 times a week at two dialysis facilities in Japan. Sleep disturbances were identified with the Athens Insomnia Scale (AIS). Physical frailty was defined using the Fried Frailty Phenotype. Patients were classified as "non-frailty (number of frailty components: 0-2)" or "frailty (3-5)." We examined the association of sleep disturbances with physical frailty and its components by performing a logistic regression analysis. RESULTS We analyzed 360 patients (mean age 65.6 years; 62% men). Eighty-one patients (23%) were classified into the group with frailty, and the mean AIS score was 5.2 ± 4.2 points. After adjusting for clinical characteristics, increasing the AIS score per 1 point was associated with higher odds of physical frailty (odds ratio, 1.12; 95% confidence interval, 1.05-1.20; p < 0.01). As for the frailty components, exhaustion, low physical activity, and weak grip strength showed an association with sleep disturbances (all p < 0.05). CONCLUSIONS Sleep disturbances were independently associated with physical frailty in patients on HD. Future studies are warranted to investigate the causality between physical frailty and sleep disturbances in this population.
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Affiliation(s)
- Shun Yoshikoshi
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan,
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan,
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuta Suzuki
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan
| | - Keigo Imamura
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Manae Harada
- Department of Rehabilitation, Sagami Circulatory Organ Clinic, Sagamihara, Japan
| | - Sachi Yamabe
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Yusuke Matsunaga
- Department of Clinical Psychology, Tsurukawa Sanatorium Hospital, Tokyo, Japan
| | - Shiwori Osada
- Department of Nephrology, Tokyo Ayase Kidney Center, Tokyo, Japan
| | - Hirokuni Tagaya
- Department of Health Sciences, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
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Kosoku A, Iwai T, Kabei K, Nishide S, Machida Y, Uchida J. Frailty and sarcopenia in older kidney transplant recipients: a cross-sectional study. Eur Geriatr Med 2023; 14:861-868. [PMID: 37219724 DOI: 10.1007/s41999-023-00803-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: 03/02/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE The aging of the kidney transplant population is accelerating, and measures against geriatric syndromes including frailty and sarcopenia, which elevate the risk of needing long-term care and even death, are being considered important. Recently, both the frailty and sarcopenia criteria for Asians were revised based on various research reports and clinical experiences. The purpose of this study is twofold: firstly, to investigate the prevalence of frailty based on the revised Japanese version of the Cardiovascular Health Study (J-CHS) criteria and the Kihon Checklist (KCL) and that of sarcopenia based on the Asian Working Group for Sarcopenia (AWGS) 2019 as well as the relationship between frailty and sarcopenia, and secondly, to determine the concurrent validity of the KCL with the revised J-CHScriteria in older kidney transplant recipients. METHODS This study was a single-center cross-sectional investigation carried out on older kidney transplant recipients who visited our hospital from August 2017 to February 2019. The diagnosis of frailty was assessed using the revised J-CHS criteria and the KCL. The diagnosis of sarcopenia was made by low skeletal muscle mass and either low physical performance or low muscle strength based on the AWGS 2019. To examine the relationship between frailty and sarcopenia, categorical variables were compared using chi-squared test and continuous variables Mann-Whitney U test. Spearman's correlation analysis was used to investigate the correlation between the KCL score and the revised J-CHS score. The concurrent validity of the KCL for estimating frailty based on the revised J-CHS criteria was evaluated using the receiver operating characteristics (ROC) curve analysis. RESULTS A total of 100 older kidney transplant recipients were enrolled in this study. The median age was 67, 63 (63%) were males, and the median time after transplant was 95 months. The prevalence of frailty based on the revised J-CHS criteria and the KCL, and sarcopenia based on the AWGS 2019 was 15%, and 19%, and 16% respectively. Sarcopenia was significantly associated with frailty based on the KCL (p = 0.016), while not with frailty based on the revised J-CHS criteria (p = 0.11). The KCL score significantly correlated with the revised J-CHS score (p < 0.001). The area under the ROC curve was 0.91. CONCLUSION Frailty and sarcopenia are interrelated complex geriatric syndromes that are risk factors for adverse health outcomes. In older kidney transplant recipients, frailty and sarcopenia were highly prevalent and frequently co-existed. Furthermore, the KCL was verified as a useful tool for frailty screening in these patient. Easy identification of patients with frailty, which is reversible, can help clinicians institute appropriate corrective measures for kidney transplant recipients to improve transplant outcomes.
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Affiliation(s)
- Akihiro Kosoku
- Department of Urology, Meijibashi Hospital, 1-358-3, Miyakenishi, Matsubara, 580-0045, Japan.
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
| | - Tomoaki Iwai
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Kazuya Kabei
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Shunji Nishide
- Department of Urology, Osaka City General Hospital, 2-13-22, Miyakojima-Hondori, Miyakojima-Ku, Osaka, 534-0021, Japan
| | - Yuichi Machida
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Junji Uchida
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
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Ghosh A, Kundu M, Devasenapathy N, Woodward M, Jha V. Frailty among middle-aged and older women and men in India: findings from wave 1 of the longitudinal Ageing study in India. BMJ Open 2023; 13:e071842. [PMID: 37524559 PMCID: PMC10391831 DOI: 10.1136/bmjopen-2023-071842] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES Few studies have examined frailty in Indian adults, despite an increasing population of older adults and an escalating burden of chronic diseases. We aimed to study the prevalence and correlates of frailty in middle-aged and older Indian adults. SETTING Cross-sectional data from Wave 1 of Longitudinal Ageing Study in India, conducted in 2017-2018 across all states and union territories, were used. PARTICIPANTS The final analytical sample included 57 649 participants aged 45 years and above who had information on frailty status. PRIMARY OUTCOME MEASURE The deficits accumulation approach to measuring frailty was employed, creating a frailty index between 0 and 1, based on 40 deficits. Individuals with a frailty index of 0.25 or more were defined as 'frail'. RESULTS Prevalence of frailty among 45+ adults was 30%. 60+ women were two times as likely to be frail compared with 60+ men, after adjusting for a wide range of sociodemographic, economic and lifestyle factors. The sex difference was more pronounced in adults aged 45-59 years. Odds of hospitalisation in the last 12 months, and having falls in the past 2 years, were two times as high in frail adults compared with non-frail adults. Frail middle-aged and older adults had 33% and 39% higher odds, respectively, of having poor cognition than non-frail adults. The relative increase was higher in women for all three outcomes, although not statistically significant. CONCLUSIONS There needs to be careful consideration of sex differences when addressing frailty, particularly for optimising frailty interventions. Frailty, although typically assessed in older adults, was shown in this study to be also prevalent and associated with adverse outcomes in middle-aged Indian adults. More research into assessment of frailty in younger populations, its trajectory and correlates may help develop public health measures for prevention of frailty.
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Affiliation(s)
- Arpita Ghosh
- The George Institute for Global Health India, Delhi, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
- University of New South Wales, Sydney, New South Wales, Australia
| | - Monica Kundu
- The George Institute for Global Health India, Delhi, India
| | | | - Mark Woodward
- University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Newtown, New South Wales, Australia
- School of Public Health, Imperial College London, London, UK
| | - Vivekanand Jha
- The George Institute for Global Health India, Delhi, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
- University of New South Wales, Sydney, New South Wales, Australia
- School of Public Health, Imperial College London, London, UK
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Wada Y, Shojima K, Tamaki K, Mori T, Kusunoki H, Onishi M, Tsuji S, Matsuzawa R, Nagai K, Sano K, Hashimoto K, Goto M, Nagasawa Y, Shinmura K. Association Between Timed Up-and-Go Test and Future Changes in the Frailty Status in a Longitudinal Study of Japanese Community-Dwelling Older Adults. Clin Interv Aging 2023; 18:1191-1200. [PMID: 37534233 PMCID: PMC10392805 DOI: 10.2147/cia.s413513] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose This study aimed to evaluate the relationship between timed up-and-go (TUG) test time and changes in frailty status in a longitudinal cohort study of rural Japanese older adults. Patients and Methods This prospective cohort study included 545 community-dwelling older adults. Initial and 2-year follow-up surveys were conducted. We compared the number of the Japanese version of the Cardiovascular Health Study components during the follow-up period and classified the participants into three groups: the favorable change, unchanged as prefrail, and unfavorable change groups. Associations between changes in frailty status and TUG time in the first survey were examined. The predictive ability of the TUG test was determined using the receiver operating characteristic (ROC) curve. Results The favorable change group comprised 315 individuals (57.8%), the unchanged as prefrail group 105 (19.2%), and the unfavorable change group 125 (22.9%). TUG time was associated with the favorable and unfavorable changes after adjustment for covariates (OR 0.79, 95% CI 0.68-0.92, P=0.001 and OR 1.27, 95% CI 1.09-1.49, P=0.002). The ROC curve of TUG time as a predictor of unfavorable changes showed an area under the curve of 0.59. A cut-off point of TUG was calculated as 6.3 s with 49.6% sensitivity and 66.0% specificity. Conclusion TUG time in the first survey was significantly associated with changes in frailty status 2 years later. However, its predictive value as a stand-alone test is limited and has the potential to predict future changes in the frailty status in older adults in combination with other tests.
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Affiliation(s)
- Yosuke Wada
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Roppou Clinic, Toyooka, Hyogo, Japan
| | - Kensaku Shojima
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Kayoko Tamaki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Takara Mori
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Amagasaki Medical COOP Honden Clinic, Amagasaki, Hyogo, Japan
| | - Hiroshi Kusunoki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of Internal Medicine, Osaka Dental University, Hirakata, Japan
| | - Masaaki Onishi
- Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Shotaro Tsuji
- Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of Orthopedic Surgery, Tatsuno City Hospital, Tatsuno, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Kyoko Sano
- Takarazuka Rehabilitation Hospital, Takarazuka, Japan
| | - Kana Hashimoto
- School of Pharmacy, Hyogo Medical University, Kobe, Japan
| | - Masashi Goto
- Department of General Medicine and Community Health Science, Hyogo Medical University, Sasayama Medical Center, Tambasasayama, Japan
| | - Yasuyuki Nagasawa
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Ken Shinmura
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of General Medicine and Community Health Science, Hyogo Medical University, Sasayama Medical Center, Tambasasayama, Japan
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Ito A, Igawa T, Ishizaka M, Hashimoto N, Hara T. Relationship between Total Kihon Checklist Score and Age-Specific Deaths among Late-Stage Older Adults in Otawara City (Aged 75 and Older) over a 15-Year Period. Gerontology 2023; 69:1095-1103. [PMID: 37494922 DOI: 10.1159/000532061] [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: 07/27/2022] [Accepted: 07/10/2023] [Indexed: 07/28/2023] Open
Abstract
INTRODUCTION While the Japanese long-term care insurance system supports an ageing society, there are concerns about the shortage of financial resources and labour force. Further, extending healthy life expectancy and narrowing the gap with the average life expectancy are important issues. In this study, we aimed to examine, over a 15-year period, the relationship between the total Kihon Checklist (t-KCL) score and age-specific deaths among late-stage older adults aged 75 and older who were not certified for long-term care insurance. METHODS The participants were older adults residing in Otawara City, Tochigi Prefecture, who were aged 75 years or older as of 2006. The participants, who were not certified by the long-term care insurance system, were asked to complete the KCL by a community welfare committee member. Based on their t-KCL scores, the participants were classified as robust (0-3 points), pre-frail (4-7 points), and frail (≥8 points). The deaths of those aged 75-89 years who had completed the KCL were investigated. Information on deaths was obtained from local authorities. Statistics were examined for the risk of robust, pre-frail, and frail mortality using a Cox proportional hazards model with age and gender as covariates for the 75-79, 80-84, and 85-89 age groups. RESULTS Of the 7,924 participants, 3,423 (75-79 years: 1,990, 80-84 years: 1,059, 85-89 years: 374) were ultimately eligible for the study. Of these, 2,450 (75-79 years: 1,238, 80-84 years: 861, 85-89 years: 351) died over the 15-year study period. Hazard ratios for death in frailty as determined by the t-KCL score were 1.337 (95% confidence interval [CI], 1.162-1.540) for the pre-frail group and 2.012 (95% CI, 1.7756-2.305) for the frail group at 75-79 years, respectively, compared with the robust group; 1.511 (95% CI, 1.271-1.797) at 80-84 years only in the frail group; and 1.567 (95% CI, 1.140-2.154) at 85-89 years, also in the frail group. DISCUSSION The relationship between frailty and mortality weakens after age 80. The results suggest that factors other than frailty may have a stronger influence on mortality risk after the age of 80.
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Affiliation(s)
- Akihiro Ito
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Otawara-shi, Japan
| | - Tatsuya Igawa
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Otawara-shi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Otawara-shi, Japan
| | | | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Otawara-shi, Japan
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Zeng XZ, Meng LB, Li YY, Jia N, Shi J, Zhang C, Hu X, Hu JB, Li JY, Wu DS, Li H, Qi X, Wang H, Zhang QX, Li J, Liu DP. Prevalence and factors associated with frailty and pre-frailty in the older adults in China: a national cross-sectional study. Front Public Health 2023; 11:1110648. [PMID: 37554734 PMCID: PMC10406229 DOI: 10.3389/fpubh.2023.1110648] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 07/06/2023] [Indexed: 08/10/2023] Open
Abstract
Objective Frailty increases poor clinical outcomes in older adults, the aim of this study was to investigate the prevalence and factors associated with frailty and pre-frailty in older adults in China. Research design and methods Data were obtained from the Sample Survey of the Aged Population in Urban and Rural China in 2015, which was a cross-sectional study involving a nationally representative sample of older adults aged 60 years or older from 31 provinces/autonomous regions/municipalities in mainland China. The frailty index (FI) based on 33 potential deficits was used to classify individuals as robust (FI < 0.12), pre-frail (FI ≧0.12 and <0.25) and frail (FI ≥0.25). Results A total of 208,386 older people were included in the study, and the age-sex standardised prevalence of frailty and pre-frailty among older adults in China was 9.5% (95% CI 9.4-9.7) and 46.1% (45.9-46.3) respectively. The prevalence of frailty and pre-frailty was higher in female than in male older adults, higher in rural than in urban older adults, and higher in northern China than in southern China. The multinomial analysis revealed similar risk factors for frailty and pre-frailty, including increased age, being female, living in a rural area, low educational attainment, poor marital status, living alone, difficult financial status, poor access to medical reimbursement, and living in northern China. Conclusion Frailty and pre-frailty are very common among older adults in China and differ significantly between southern and northern China, men and women, and rural and urban areas. Appropriate public health prevention strategies should be developed based on identified risk factors in frail and pre-frail populations. The management of frailty and pre-frailty should be optimised according to regional and gender differences in prevalence and associated factors, such as strengthening the integrated management of chronic diseases, increasing reimbursement rates for medical costs, and focusing on vulnerable groups such as the disabled, economically disadvantaged, living alone and those with low literacy levels, in order to reduce the burden of frailty among older adults in China.
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Affiliation(s)
- Xue-zhai Zeng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 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
| | - Ying-ying Li
- 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
| | - Jing Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Xing Hu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Jia-bin Hu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Jian-yi Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Di-shan Wu
- 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
| | - Xin Qi
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hua Wang
- 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
| | - De-ping 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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Takele MD, Sany K, Getie K, Wayessa DI, Jember G, Gobezie M, Abich Y, Kibret AK. Prevalence and associated factors of frailty among community dweller older adults living in Gondar town, northwest, Ethiopia: a community based cross-sectional study. BMC Public Health 2023; 23:1309. [PMID: 37420164 PMCID: PMC10329322 DOI: 10.1186/s12889-023-16201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Frailty is a multidimensional geriatric condition that increases vulnerability to stressors, increases the risk of negative health outcomes, and lowers quality of life in older people. However, little attention has been paid to frailty in developing countries, particularly in Ethiopia. Therefore, the aim of the study was to investigate the prevalence of frailty syndrome and the sociodemographic, lifestyle, and clinical factors associated with it. METHODS A community-based cross-sectional study design was conducted from April to June 2022. A total of 607 study participants were included using a single cluster sampling technique. The Tilburg frailty indicator, which is a self-reported schedule for assessment of frailty, required respondents to answer 'yes' or 'no' and the total attainable score ranged from 0 to 15. An individual with a score of ≥ 5 considered frail. Data were collected by interviewing the participants using a structured questionnaire, and the data collection tools were pre-tested before the actual data collection period to check for the accuracy of responses, language clarity, and appropriateness of the tools. Statistical analyses were performed using the binary logistic regression model. RESULTS More than half of the study participants were male, and the median age of the study participants was 70, with an age range of 60-95 years. The prevalence of frailty was 39% (CI 95%, 35.51-43.1). In the final multivariate analysis model, the following factors associated with frailty were obtained: older age (AOR = 6.26 CI (3.41-11.48), presence of two or more comorbidities (AOR = 6.05 CI (3.51-10.43), activity of daily life dependency (AOR = 4.12 CI (2.49-6.80), and depression (AOR = 2.68 CI (1.55-4.63) were found to be significant factors. CONCLUSION AND RECOMMENDATIONS Our study provides epidemiological characteristics and the risk factors of frailty in the study area. Efforts to promote physical, psychological, and social health in older adults are a core objective of health policy, especially for older adults aged 80 and above years, and those with two or more comorbidities.
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Affiliation(s)
- Mihret Dejen Takele
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Kedir Sany
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Kefale Getie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Dechasa Imiru Wayessa
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Gashaw Jember
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Melese Gobezie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
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Oe S, Yamato Y, Hasegawa T, Yoshida G, Banno T, Arima H, Ide K, Yamada T, Kurosu K, Nakai K, Niwa H, Matsuyama Y. The relationship between frailty and spinal alignment in the elderly general population: a two-year longitudinal study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:2266-2273. [PMID: 37191677 DOI: 10.1007/s00586-023-07759-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/10/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE Frailty is caused by age-related decline in physical function, which may contribute to worsening spinal alignment. Cardiovascular Health Study (CHS)-criteria for assessing physical function seem more appropriate than frailty index which evaluate comorbiduty. However, there have been no reports investigating the relationship between frailty and spinal alignment using the CHS criteria. This study aimed to examine spinal radiographic parameters using the CHS criteria in volunteers participating in a health screening study. METHODS The subjects were 211 volunteers (71 males and 140 females) aged 60-89 years old who participated in the TOEI study in 2018 and 2020. They were divided into three groups (R: robust, PF: pre-frailty, and F: frailty) according to the score of the Japanese version of the CHS (J-CHS) criteria in 2018. The radiographic parameters were evaluated using a whole-spine standing X-ray. RESULTS There were 67 volunteers in group R, 124 volunteers in group PF, and 20 volunteers in group F. Of the five items in the J-CHS criteria, low activity was the most common in the PF group (64%). Low activity was also the most common in the F group (100%). Regarding spinal alignment, significant differences were found in C7SVA in 2020 (R:PF:F = 26:31:62 mm, P = 0.047), C2SVA in 2018 (20:34:63 mm, P = 0.019), and C2SVA in 2020 (37:47:78 mm, P = 0.041). CONCLUSION Frailty was associated with a worsening in global alignment along the 2- year follow up. The frailty may begin with a decrease in activity and progression of exhaustion; preventing this progression is important through motivation to exercise. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Shin Oe
- Department of Orthopedic Surgery and Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Yu Yamato
- Department of Orthopedic Surgery and Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Tomohiko Hasegawa
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Go Yoshida
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomohiro Banno
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideyuki Arima
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Koichiro Ide
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomohiro Yamada
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kenta Kurosu
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Keiichi Nakai
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Haruo Niwa
- Department of General Medicine, Toei Hospital, Toei Town, Japan
| | - Yukihiro Matsuyama
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Imai N, Yoda T, Horigome Y, Murakami R, Wakasugi M, Fujii T, Ohashi M, Kawashima H. Determining factors that maintain physical function or increase frailty using the Kihon checklist among community-dwelling older adults: a six-year longitudinal study in Agano, Japan. BMC Geriatr 2023; 23:336. [PMID: 37254108 DOI: 10.1186/s12877-023-04055-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/21/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND A significant increase in the older adult population in Japan will significantly increase healthcare costs. This study aimed to examine the risk factors contributing to robustness transitioning to frailty in older residents. METHODS Participants were aged 70 in 2016 and 76 in 2022. Participants were evaluated using the Kihon Checklist (KCL). RESULTS Participants for this longitudinal study included 444 older persons who completed the KCL surveys in 2016 and 2022. The follow-up rate was 80.6%; therefore, 358 participants were included in the analysis. The median KCL score increased significantly from 2 to 2016 to 3 in 2022 (p < 0.001). The prevalence of robustness significantly decreased from 60.9 to 48.6% (p = 0.042). In a stepwise logistic regression analysis, robustness was independently associated with regular continuous walks for 15 min and a body mass index of above 18.5%. The following variables were associated with the transition to prefrailty: experiencing a fall in the past year and not going out at least once a week. For the transition to frailty, the variables were turned to family or friends for advice, experienced a fall in the past year, and felt helpless in the last two weeks. The independent factor for the transition from prefrailty to frailty was having a BMI of less than 18.5. In contrast, the independent factor for improving from frailty to robustness or prefrailty was going out at least once a week. CONCLUSIONS We recommend maintaining continuous walking for more than 15 min, maintaining a BMI of at least 18.5, and going out more than once a week to improve being house-bounded and depressive mood, not only to prevent the transition to prefrailty or frailty but also to improve frailty.
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Affiliation(s)
- Norio Imai
- Division of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.
| | - Takuya Yoda
- Division of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Yoji Horigome
- Division of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Reiko Murakami
- Division of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Masashi Wakasugi
- Department of Orthopedic Surgery, Agano City Hospital, Agano City, Japan
| | - Toshihide Fujii
- Department of Orthopedic Surgery, Agano City Hospital, Agano City, Japan
| | - Masayuki Ohashi
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
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