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Baek W, Min A, Ji Y, Park CG, Kang M. Impact of activity limitations due to fear of falling on changes in frailty in Korean older adults: a longitudinal study. Sci Rep 2024; 14:19121. [PMID: 39155281 PMCID: PMC11330968 DOI: 10.1038/s41598-024-69930-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/12/2024] [Indexed: 08/20/2024] Open
Abstract
This study investigated the frailty change patterns among Korean older adults during 2006-2020 and the effect of activity limitations induced by the fear of falling (FOF) on these patterns. We employed a descriptive longitudinal design utilizing data from Waves 1 to 8 of the Korean Longitudinal Study of Aging. The exclusion criteria were a baseline age < 65 years, frailty index (FI) captured only at baseline, and death or unknown survival status. Multilevel modeling, combining regression equations at two levels, was used to examine the effect of activity limitations due to FOF on frailty, adjusting for other confounding factors. An increase in FI (1.97; p < .001) was demonstrated in participants who had experienced falls versus those who had not in the past 2 years. Notably, those facing activity limitations due to FOF exhibited a more significant increase in FI (4.62; p < .001) compared with those without; frailty progression intensified over time in the former (0.54, p < .001). Activity limitations due to FOF had a more pronounced impact on frailty than falls; moreover, these activity limitations accelerated the progression of frailty. Healthcare providers must prioritize addressing FOF by employing both physical and psychological interventions to mitigate activity limitations and ultimately decelerate frailty.
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Affiliation(s)
- Wonhee Baek
- College of Nursing, Gyeongsang National University, Jinju, South Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Yoonjung Ji
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
- Brain Korea 21 FOUR Project, College of Nursing, Yonsei University, Seoul, South Korea
| | - Chang Gi Park
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Minkyung Kang
- College of Nursing, Research Institute of Nursing Science, Ajou University, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea.
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da Silva Sobrinho AC, Finzeto LC, de Almeida ML, da Silva Rodrigues G, Ribeiro de Lima JG, Pereira Rodrigues K, Alexandre Trapé Á, Prado L, Bueno Júnior CR. Which Variables Are Associated with the Magnitude of the Physical Fitness Response in Older Adults? An Analysis of Their Development and Influence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1075. [PMID: 39200684 PMCID: PMC11354969 DOI: 10.3390/ijerph21081075] [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: 05/22/2024] [Revised: 07/01/2024] [Accepted: 07/12/2024] [Indexed: 09/02/2024]
Abstract
Regular physical exercise has proven to be an effective strategy for enhancing the health and well-being of older adults. However, there are still gaps in our understanding of the impacts of exercise on older adults with different health conditions, as well as in the customization of training programs according to individual capabilities. This study aimed to analyze the variables that influence the response of physical capabilities in older adults, considering their development over the aging process, with the goal of assisting professionals in creating personalized training programs. To achieve this, we conducted a cohort study involving 562 previously inactive adults and older adults who underwent anthropometric assessments, blood pressure measurements, and comprehensive physical tests. These assessments were conducted before and after a 14-week training program. Results indicated no significant variations in variables such as waist circumference (p = 0.0455, effect size = 0.10), body mass index (p = 0.0215, effect size = 0.15), systolic (p < 0.0001, effect size = 0.35) and diastolic blood pressure (p < 0.0001, effect size = 0.25) pre- and post-intervention. Strength tests, agility, the 6 min walk test (6MWT), and the back scratch test (BS) showed significant improvements post-intervention, with p-values all below 0.0001 and effect sizes ranging from 0.30 to 0.50. Multiple linear regression analyses revealed that lower initial values in physical capabilities were associated with more significant improvements during training (R2 = 0.73, p < 0.001). These results underscore that individualized guidance in training can lead to clinically meaningful improvements in physical performance and health among older adults, with effect sizes indicating moderate-to-large benefits (effect size range = 0.30 to 0.50). Therefore, personalized training programs are essential to maximize health benefits in this population.
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Affiliation(s)
- Andressa Crystine da Silva Sobrinho
- Department of Graduate Studies in Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto Campus, Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (L.C.F.); (M.L.d.A.); (J.G.R.d.L.); (K.P.R.)
| | - Larissa Chacon Finzeto
- Department of Graduate Studies in Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto Campus, Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (L.C.F.); (M.L.d.A.); (J.G.R.d.L.); (K.P.R.)
| | - Mariana Luciano de Almeida
- Department of Graduate Studies in Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto Campus, Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (L.C.F.); (M.L.d.A.); (J.G.R.d.L.); (K.P.R.)
| | - Guilherme da Silva Rodrigues
- Department of Graduate Studies in Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto Campus, Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (L.C.F.); (M.L.d.A.); (J.G.R.d.L.); (K.P.R.)
| | - João Gabriel Ribeiro de Lima
- Department of Graduate Studies in Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto Campus, Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (L.C.F.); (M.L.d.A.); (J.G.R.d.L.); (K.P.R.)
| | - Karine Pereira Rodrigues
- Department of Graduate Studies in Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto Campus, Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (L.C.F.); (M.L.d.A.); (J.G.R.d.L.); (K.P.R.)
| | - Átila Alexandre Trapé
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (Á.A.T.); (L.P.)
| | - Lais Prado
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (Á.A.T.); (L.P.)
| | - Carlos Roberto Bueno Júnior
- Department of Graduate Studies in Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto Campus, Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (L.C.F.); (M.L.d.A.); (J.G.R.d.L.); (K.P.R.)
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil; (Á.A.T.); (L.P.)
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Veloso MP, Coelho VA, Sekercioglu N, Moyses RMA, Elias RM. Phosphate is associated with frailty in older patients with chronic kidney disease not on dialysis. Int Urol Nephrol 2024; 56:2725-2731. [PMID: 38498271 DOI: 10.1007/s11255-024-03985-y] [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: 11/14/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Frailty is common in older patients with chronic kidney disease (CKD) and has been considered an independent risk factor for adverse clinical outcomes in this population. CKD-associated mineral and bone metabolism (CKD-MBD) increases energy expenditure and causes malnutrition and inflammation leading to frailty. We investigated whether CKD-MBD markers and energy metabolism are associated with frailty in patients with advanced CKD on conservative management. METHODS In this cross-sectional study, we investigated factors associated with frailty in a sample of 75 patients ≥ 65 years, with stage 4 or 5 CKD. Collected data included age, sex, body mass index, physical activity status, educational level, Charlson Comorbidity Index, and laboratory markers. Frailty was evaluated according to Fried's classification. RESULTS Frailty was observed in 51.3% and pre-frailty in 47.3%. The frail population was significantly older, with a high proportion of females, more inactive, had lower educational levels, spent a long time sitting throughout the day, and had higher phosphate and fibroblast growth factor 21 (FGF-21). In the multivariate logistic analysis age (odds ratio 1.13, p = 0.026) and phosphate (odds ratio 3.38, p = 0.021) remained independently associated with frailty. CONCLUSION Serum phosphate seems to be a toxin associated with the frailty phenotype in older patients with CKD. Whether strategies to decrease serum phosphate would reduce the risk of frailty in this population deserves further evaluation.
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Affiliation(s)
- Mariana P Veloso
- Department of Medicine. Nephrology Service. Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo., São Paulo, Brazil
| | - Venceslau A Coelho
- Department of Medicine. Geriatric Division. Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | - Nigar Sekercioglu
- Department of Health Evidence and Impact, McMaster University, Hamilton, Canada
- Department of Medicine, Division of Nephrology, Health Sciences University, Istanbul, Turkey
| | - Rosa M A Moyses
- Department of Medicine. Nephrology Service. Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo., São Paulo, Brazil
| | - Rosilene M Elias
- Department of Medicine. Nephrology Service. Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo., São Paulo, Brazil.
- Universidade Nove de Julho. UNINOVE, São Paulo, Brazil.
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Hu FH, Feng LP, Jia YJ, Ge MW, Shen LT, Liu P, Chen HL. Frailty and all-cause and cancer-related mortality in cancer patients: A prospective cohort study. Eur J Oncol Nurs 2024; 71:102667. [PMID: 39003843 DOI: 10.1016/j.ejon.2024.102667] [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: 05/30/2024] [Revised: 07/03/2024] [Accepted: 07/10/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE To evaluate the associations between frailty and all-cause and cancer-related mortality. Additionally, the objective is to compare the magnitude of these associations between older adults and younger adults. METHODS We gathered baseline data from NHANES (1999-2018) and developed a cumulative index consisting of 39 items to evaluate frailty. The National Death Index database was utilized to track the survival status of individuals. The Cox regression model was employed to estimate the associations between frailty status and all-cause and cancer-related mortality. RESULTS Ultimately, 3398 cancer patients were included in the analysis, comprising 910 younger adults and 2488 older adults. Compared to non-frail patients, the elevated all-cause and cancer-related mortality among pre-frail patients was not statistically significant (HRs = 1.312, 95%CI: 0.956-1.800, P = 0.092; HRs = 1.462, 0.811-2.635, P = 0.207). However, a significant elevation of both all-cause and cancer-related mortality risk was observed among frail patients (HRs = 2.213, 1.617-3.030, P < 0.001; HRs = 2.463, 95%CI = 1.370-4.429, P = 0.003). Frailty individuals demonstrated a more pronounced association with the prediction of all-cause mortality in younger (HRs = 2.230, 1.073-4.634, P = 0.032) than in older adults (HRs = 2.090, 1.475-2.960, P < 0.001). Sensitivity analysis consistently revealed robust results. RCS plots suggested a progressively escalating dose-response correlation between frailty and both all-cause and cancer-related mortality risk. CONCLUSIONS Pre-frailty did not result in an increase in mortality risks compared to non-frailty. However, frailty caused a higher all-cause and cancer-related mortality risk than non-frailty. Identifying those at risk and implementing targeted interventions may contribute to extending healthy life expectancy, regardless of age.
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Affiliation(s)
- Fei-Hong Hu
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Li-Ping Feng
- Family-Centered Maternity Ward, Affiliated Hospital of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Yi-Jie Jia
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Meng-Wei Ge
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Lu-Ting Shen
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Peng Liu
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China.
| | - Hong-Lin Chen
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China.
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Danquah E, Asiamah N, Jnr RAM, Kouveliotis K. Association of frailty with workplace social activity, physical activity, and well-being among older employees: a moderated mediation in two income-variant samples. BMC Geriatr 2024; 24:574. [PMID: 38961322 PMCID: PMC11223269 DOI: 10.1186/s12877-024-05178-9] [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: 11/17/2023] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Research suggests that frailty is associated with lower physical activity and well-being in old age, but social activities at work may facilitate physical activity and its positive effect on well-being among older employees with frailty. This study, therefore, ascertained whether there is a moderated mediation of the association of frailty, Workplace Social Activity (WSA), and well-being by Physical Activity (PA). METHODS The study adopted a cross-sectional design with relevant sensitivity analyses for confounding. The participants were within two Ghanaian samples with different income levels (low-income, n = 897, and higher income, n = 530). The minimum samples were calculated, and the statistical models were tested with Haye's Process Model through structural equation modelling. RESULTS Frailty was negatively associated with PA, and this relationship was moderated by WSA in both samples. Higher frailty was directly and indirectly associated with lower well-being in the higher-income sample but only indirectly associated with lower well-being in the low-income sample. The mediation of PA in the frailty-well-being relationship is partial in the higher-income sample but complete in the low-income sample. There was evidence of moderated mediation in both samples. CONCLUSION WSA may reduce the strength of the negative association of frailty with PA and well-being among older employees in both samples. Workplace interventions aimed at enhancing WSA may encourage PA and enhance well-being among older employees with frailty.
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Affiliation(s)
- Emelia Danquah
- Research Directorate, Koforidua Technical University, E/R, Koforidua, Ghana
| | - Nestor Asiamah
- Division of Interdisciplinary Research and Practice, School of Health and Social Care, University of Essex, Colchester, Essex, CO4 3SQ, UK.
- Department of Gerontology and Geriatrics, Africa Centre for Epidemiology, P.O. Box AN 18462, Accra North, Accra, Ghana.
| | - Reginald Arthur-Mensah Jnr
- Department of Nursing and Midwifery, Faculty of Health and Allied Sciences, Pentecost University, P.O. Box KN 1739, Accra, Ghana
| | - Kyriakos Kouveliotis
- Berlin School of Business and Innovation, Academic Affairs, 97-99 Karl Marx Strasse, 12043, Berlin, Germany
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Dai W, Zhang D, Wei Z, Liu P, Yang Q, Zhang L, Zhang J, Zhang C, Xue H, Xie Z, Luo F. Whether weekend warriors (WWs) achieve equivalent benefits in lipid accumulation products (LAP) reduction as other leisure-time physical activity patterns? -Results from a population-based analysis of NHANES 2007-2018. BMC Public Health 2024; 24:1550. [PMID: 38853276 PMCID: PMC11163723 DOI: 10.1186/s12889-024-19070-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Obesity is characterized by excessive fat accumulation in the body. Physical activity (PA) is an effective intervention to combat obesity, but the effectiveness of different PA patterns on controlling obesity is unclear. Lipid accumulation product (LAP), derived from waist circumference and triglycerides, is a novel indicator for obesity evaluation. However, the association between PA patterns (i.e., weekend warriors and regularly active) and LAP remains unexplored. This study aims to elucidate the relationship between PA patterns and LAP in US adult population. METHODS Adult individuals with complete data on LAP, PA patterns, and other covariates from the National Health and Nutrition Examination Survey (NHANES) database (2007-2018) were included in this study. Multivariate linear regression models were utilized to explore the association between PA patterns and LAP. Subgroup analyses, interaction tests, restricted cubic spline (RCS) regression analyses, and threshold and saturation effect analyses were also performed to investigate the stability and nonlinearity of PA-LAP association, respectively. RESULTS A total of 11,212 participants were included in this study. After adjusting for all potential covariates, being regularly active (RA) (β=-8.85, P < 0.05) obtained significantly higher LAP reduction as opposed to being weekend warriors (WWs) (β=-4.70, P = 0.3841). Furthermore, subgroup analyses and interaction tests indicated that the PA-LAP association was more pronounced in individuals with higher education levels (P interaction = 0.0084) and diabetes (P interaction = 0.0062). Additionally, a significant, non-linear, and negative correlation between weekly total PA and LAP in non-inactive individuals was identified by RCS analysis (P for overall < 0.001, P for nonlinearity = 0.009). A threshold of 440 min in weekly total PA was found to arouse favorable LAP reduction. CONCLUSIONS Being regularly active obtained better LAP reduction as opposed to being WWs. For non-inactive adults, engaging in more than 440 min of PA per week helps to reduce LAP effectively.
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Affiliation(s)
- Wei Dai
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - DongYang Zhang
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - ZhiYuan Wei
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Pan Liu
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - QianKun Yang
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Li Zhang
- Department of Neurosurgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Jie Zhang
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Chao Zhang
- Department of Orthopedics, The 75th Group Army Hospital of the PLA, Dali, 671003, China
| | - Hao Xue
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Zhao Xie
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), No.29 Gaotanyan St., Shapingba District, Chongqing, 400038, China.
| | - Fei Luo
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), No.29 Gaotanyan St., Shapingba District, Chongqing, 400038, China.
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Sato R, Vatic M, Peixoto da Fonseca GW, Anker SD, von Haehling S. Biological basis and treatment of frailty and sarcopenia. Cardiovasc Res 2024:cvae073. [PMID: 38828887 DOI: 10.1093/cvr/cvae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/23/2022] [Accepted: 12/20/2022] [Indexed: 06/05/2024] Open
Abstract
In an ageing society, the importance of maintaining healthy life expectancy has been emphasized. As a result of age-related decline in functional reserve, frailty is a state of increased vulnerability and susceptibility to adverse health outcomes with a serious impact on healthy life expectancy. The decline in skeletal muscle mass and function, also known as sarcopenia, is key in the development of physical frailty. Both frailty and sarcopenia are highly prevalent in patients not only with advanced age but also in patients with illnesses that exacerbate their progression like heart failure (HF), cancer, or dementia, with the prevalence of frailty and sarcopenia in HF patients reaching up to 50-75% and 19.5-47.3%, respectively, resulting in 1.5-3 times higher 1-year mortality. The biological mechanisms of frailty and sarcopenia are multifactorial, complex, and not yet fully elucidated, ranging from DNA damage, proteostasis impairment, and epigenetic changes to mitochondrial dysfunction, cellular senescence, and environmental factors, many of which are further linked to cardiac disease. Currently, there is no gold standard for the treatment of frailty and sarcopenia, however, growing evidence supports that a combination of exercise training and nutritional supplement improves skeletal muscle function and frailty, with a variety of other therapies being devised based on the underlying pathophysiology. In this review, we address the involvement of frailty and sarcopenia in cardiac disease and describe the latest insights into their biological mechanisms as well as the potential for intervention through exercise, diet, and specific therapies.
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Affiliation(s)
- Ryosuke Sato
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
| | - Mirela Vatic
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
| | - Guilherme Wesley Peixoto da Fonseca
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Stefan D Anker
- Department of Cardiology (CVK) of German Heart Center Charité; German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
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Pan N, Ossowski Z, Tong J, Li D, Gao S. Effects of Exercise on Frailty in Older People Based on ACSM Recommendations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med 2024; 13:3037. [PMID: 38892748 PMCID: PMC11173309 DOI: 10.3390/jcm13113037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/08/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: The objective of the study was to carry out an analysis of the methodological quality of clinical trials (effects of exercise on frailty in older people) based on ACSM recommendations. Methods: The search scope included PubMed, Embase, Web of Science, Cochrane, and literature that cannot be retrieved from the database. The topic was the impact of exercise on frailty in elderly people. Changes in five outcome measures (FP, BI, SPPB, GS, and BMI) were assessed using mean differences (MD) and 95% confidence intervals (95% CI). A random effects model (RE) was used to conduct a meta-analysis and compare the results between subgroups. Results: The intervention effects of exercise on the five outcome indicators of frailty in elderly people were all significant (p < 0.05). The effect of a high-consistency subgroup on outcome indicators FP and GS was more significant than that of the low- or uncertain-consistency subgroup (MD: -1.09 < -0.11, MD: 2.39 >1.1). There was no significant difference in the intervention effect as reflected in the outcome measures SPPB and BMI in the high-consistency subgroup (p = 0.07, p = 0.34). There was no significant difference in the impact of the intervention on the outcome measure BI between the two subgroups (p = 0.06, p = 0.14). Conclusions: Exercise prescriptions with high consistency with ACSM recommendations may be more effective in both FP and GS interventions than those with uncertain or low consistency. However, it is essential to note that the data derived from the meta-analysis is still subject to the small number of studies, the unknown degree of consistency of participants in individual studies, and the different mix of cases in the studies.
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Affiliation(s)
- Neng Pan
- Faculty of Physical Culture, Akademia Wychowania Fizycznego I Sportu, 80-336 Gdansk, Poland;
| | - Zbigniew Ossowski
- Faculty of Physical Culture, Akademia Wychowania Fizycznego I Sportu, 80-336 Gdansk, Poland;
| | - Jun Tong
- Department of Sport, Kunming Medical University, Kunming 650000, China;
| | - Dan Li
- Academy of Sport, Yunnan Normal University, Kunming 650000, China; (D.L.); (S.G.)
| | - Shan Gao
- Academy of Sport, Yunnan Normal University, Kunming 650000, China; (D.L.); (S.G.)
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Zhao C, Wang Y, Jia X, Fan J, Wang N, Yang Y, Shi X. Associations of Dietary Diversity Trajectories with Frailty among Chinese Older Adults: A Latent Class Trajectory Analysis Based on a CLHLS Cohort. Nutrients 2024; 16:1445. [PMID: 38794683 PMCID: PMC11124478 DOI: 10.3390/nu16101445] [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: 03/30/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND High dietary diversity has been found to be associated with frailty. However, the trajectory of dietary diversity intake in relation to frailty is unclear. METHODS Using the latent class trajectory modeling approach, we identified distinctive dietary variety trajectory groups among 2017 participants based on the Chinese Longitudinal Healthy Longevity Survey acquired at four time points within a 10-year period. Frailty status was assessed using a frailty index comprising 37 health deficits. Dietary diversity was quantified using the dietary variety score (DVS), based on food category consumption frequency. Logistic regression analyses were employed to explore the association between DVS change trajectories and frailty. RESULTS This study identified two distinct DVS trajectories: "Moderate-Slow decline-Slow growth", encompassing 810 (40.16%) individuals, and "Moderate-Slow growth-Accelerated decline", including 1207 (59.84%) individuals. After adjusting for covariates, the odds ratio for DVS in the "Moderate-Slow decline-Slow growth" group was 1.326 (95% confidence interval: 1.075-1.636) compared to the "Moderate-Slow growth-Accelerated decline" group. The "Moderate-Slow decline-Slow growth" trajectory continued to decrease and was maintained at a low level in the early stages of aging. CONCLUSION Sustaining a high dietary diversity trajectory over time, particularly in the early stages of aging, could potentially decrease the risk of frailty among older Chinese adults.
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Yu L, Guo Z, Long Q, Zhao X, Liu Y, Cao X, Zhang Y, Yan W, Qian QQ, Chen J, Teng Z, Zeng Y. Modifiable Lifestyle, Sedentary Behaviors and the Risk of Frailty: A Univariate and Multivariate Mendelian Randomization Study. Adv Biol (Weinh) 2024; 8:e2400052. [PMID: 38532244 DOI: 10.1002/adbi.202400052] [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: 01/29/2024] [Revised: 03/11/2024] [Indexed: 03/28/2024]
Abstract
This research conducted a two-sample univariate and multivariate Mendelian Randomization (MR) analysis to explore the causal link between different types of leisure sedentary behavior (LSB) and frailty. Independent instrumental variables significantly associated with sedentary behaviors (p < 5 × 10-8) are obtained from a genome-wide association study (GWAS) of 422,218 individuals, and Frailty Index (FI) are derived from the latest GWAS dataset of 175,226 individuals. MR analysis is conducted using inverse variance weighting, MR-Egger, weighted median, simple mode, and weighted mode, supplemented by MRAPSS. Univariate MR revealed that sedentary behaviors such as watching television increased the risk of frailty (OR, 1.271; 95% CI: 1.202-1.345; p = 6.952 × 10-17), as sedentary driving behaviors are done (OR, 1.436; 95% CI: 1.026-2.011; p = 0.035). Further validation through APSS, taking into account cryptic relatedness, stratification, and sample overlap, maintained the association between television viewing and increased frailty risk (OR, 1.394; 95% CI: 1.266-1.534; p = 1.143 × 10-11), while the association with driving dissipated. In multivariate inverse variance weighted (IVW) analysis, after adjusting for C-reactive protein (CRP) levels, television Sedentary behavior (SB) inversely affected frailty (OR, 0.782; 95% CI: 0.724-0.845; p = 4.820 × 10-10). This study indicates that televisio SB significantly increases the risk of frailty, suggesting potential biological heterogeneity behind specific sedentary activities. This process may interact with inflammation, influencing the development of frailty.
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Affiliation(s)
- Ling Yu
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Zeyi Guo
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Qing Long
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Xinling Zhao
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Yilin Liu
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Xiang Cao
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Yunqiao Zhang
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Weimin Yan
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Qing Qing Qian
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Jian Chen
- Department of Gastroenterology, Nanchong Central Hospital, Nanchong, Sichuan Province, 637000, China
| | - Zhaowei Teng
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Yong Zeng
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
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Pavasini R, Campo G, Serenelli M, Tonet E, Guiducci V, Escaned J, Moreno R, Casella G, Cavazza C, Varbella F, Sacchetta G, Arena M, Santos IA, Ibañes EG, Scarsini R, D'Amico G, Ruiz-Poveda FL, Díez Gil JL, Pignatelli G, Iannopollo G, Colaiori I, Santos RC, Marrone A, Fileti L, Rigattieri S, Barbato E, Ocaranza-Sanchez R, Biscaglia S. Impact of pre-admission physical activity on benefits of physiology-guided complete revascularization in older patients with myocardial infarction: insights from the FIRE trial. Eur J Prev Cardiol 2024:zwae069. [PMID: 38452238 DOI: 10.1093/eurjpc/zwae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/31/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024]
Abstract
AIMS The present analysis from the Functional Assessment in Elderly Myocardial Infarction Patients with Multivessel Disease (FIRE) trial aims to explore the significance of pre-admission physical activity and assess whether the benefits of physiology-guided complete revascularization apply consistently to sedentary and active older patients. METHODS AND RESULTS Patients aged 75 years or more with myocardial infarction (MI) and multivessel disease were randomized to receive physiology-guided complete revascularization or culprit-only strategy. The primary outcome was a composite of death, MI, stroke, or any revascularization within a year. Secondary endpoints included the composite of cardiovascular death or MI, as well as single components of the primary endpoint. Pre-admission physical activity was categorized into three groups: (i) absent (sedentary), (ii) light, and (iii) vigorous. Among 1445 patients, 692 (48%) were sedentary, whereas 560 (39%) and 193 (13%) performed light and vigorous physical activity, respectively. Patients engaging in light or vigorous pre-admission physical activity exhibited a reduced risk of the primary outcome compared with sedentary individuals [light hazard ratio (HR) 0.70, 95% confidence interval (CI) 0.55-0.91 and vigorous HR 0.14, 95% CI 0.07-0.91, respectively]. These trends were also observed for death, cardiovascular death, or MI. When comparing physiology-guided complete revascularization vs. culprit-only strategy, no significant interaction was observed for primary and secondary endpoints when stratified by sedentary or active status. CONCLUSION In older patients with MI, pre-admission physical activity emerges as a robust and independent prognostic determinant. Physiology-guided complete revascularization stands out an effective strategy in reducing ischaemic adverse events, irrespective of pre-admission physical activity status. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT03772743.
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Affiliation(s)
- Rita Pavasini
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
| | - Gianluca Campo
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
| | - Matteo Serenelli
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
| | - Elisabetta Tonet
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
| | - Vincenzo Guiducci
- Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, S. Maria Nuova Hospital, Viale Risorgimento 80, Reggio Emilia 42123, Italy
| | - Javier Escaned
- Cardiovascular Department, Hospital Clínico San Carlos IDISCC, Complutense University of Madrid, Calle del Prof Martin Lagos s/n, Madrid 28040, Spain
| | - Raul Moreno
- Interventional Cardiology, University Hospital La Paz, Paseo La Castellana, 261, 28046, Madrid, Spain
| | - Gianni Casella
- Cardiology Unit, Ospedale Maggiore, Largo Nigrisoli 2, Bologna 40133, Italy
| | - Caterina Cavazza
- Cardiovascular Department, Infermi Hospital, Viale Luigi Settembrini 2, Rimini 47923, Italy
| | - Ferdinando Varbella
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, and Rivoli Infermi Hospital ASLTO3, Rivoli (TO) 10098, Italy
| | - Giorgio Sacchetta
- Cardiology Unit, Umberto I Hospital, ASP Siracusa, Via Giuseppe Testaferrata, 1, 96100 Siracusa, Italy
| | - Marco Arena
- S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria, La Spezia 19124, Italy
| | - Ignacio Amat Santos
- Department of Cardiology, Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Enrique Gutiérrez Ibañes
- Department of Cardiology, Centro de Investigation Biomedica end Red en Enfermedades Cardiovasculares, H. Universitario y Politécnico La Fe, Valencia 46026, Spain
| | - Roberto Scarsini
- Cardiovascular Department, Azienda Ospedaliero Universitaria Integrata di Verona, Piazzale Aristide Stefani, 1 - 37126 Verona, Italy
| | - Gianpiero D'Amico
- Interventional Cardiology, Department of Cardio-Thoracic and Vascular Sciences, Ospedale dell'Angelo, Via Paccagnella, 12, 35128 Mestre (Venice), Italy
| | | | - José Luis Díez Gil
- Cardiology Unit, Hospital San Giovanni di Dio, Azienda Sanitaria Provinciale Agrigento, Agrigento 92100, Italy
| | - Gianluca Pignatelli
- Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, S. Maria Nuova Hospital, Viale Risorgimento 80, Reggio Emilia 42123, Italy
| | | | - Iginio Colaiori
- Cardiology Unit, Ospedale Santa Maria Goretti, Via Lucia Scaravelli, Latina 04100, Italy
| | - Ramon Calvino Santos
- Department of Interventional Cardiology, Complexo Hospitalario Universitario A Coruña (CHUAC), As Xubias, 84, 15006 A Coruña, Spain
| | - Andrea Marrone
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
| | - Luca Fileti
- Cardiology Department, S. Maria delle Croci Hospital, Viale Randi 5, Ravenna 48121, Italy
| | - Stefano Rigattieri
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Via di Grottarossa, 1035/1039 00189 Roma, Italy
| | - Emanuele Barbato
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Via di Grottarossa, 1035/1039 00189 Roma, Italy
| | | | - Simone Biscaglia
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
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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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Jerez-Roig J, Farrés-Godayol P, Yildirim M, Escribà-Salvans A, Moreno-Martin P, Goutan-Roura E, Rierola-Fochs S, Romero-Mas M, Booth J, Skelton DA, Giné-Garriga M, Minobes-Molina E. Prevalence of urinary incontinence and associated factors in nursing homes: a multicentre cross-sectional study. BMC Geriatr 2024; 24:169. [PMID: 38368318 PMCID: PMC10874568 DOI: 10.1186/s12877-024-04748-1] [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: 05/26/2023] [Accepted: 01/25/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) is a common geriatric syndrome with high health and socio-economic impacts in nursing home (NH) residents. OBJECTIVES To estimate the prevalence and types of UI and its associated factors in older people living in NHs in Central Catalonia (Spain). We also determined the proportion of residents who were receiving behavioural strategies to prevent/manage UI. DESIGN AND SETTING Cross-sectional study in 5 NHs conducted from January to March 2020. METHODS We included consenting residents aged 65 + permanently living in the NHs. Residents who were hospitalized, in a coma or palliative care were excluded. UI was assessed using Section H of the Minimum Data Set. Sociodemographic and health-related variables were examined. Descriptive, bivariate, and multivariate (logistic regression) analyses were performed. RESULTS We included 132 subjects (82.6% women), mean age of 85.2 (SD = 7.4) years. The prevalence of UI was 76.5% (95% CI: 68.60-82.93). The most common type was functional UI (45.5%), followed by urgency UI (11.4%). Only 46.2% of residents received at least one behavioural strategy to manage UI. Most sedentary behaviour (SB) variables presented a p-value lower than 0.001 in the bivariate analyses, but none remained in the final model. Moderate-severe cognitive impairment (OR = 4.44, p =.003), anticholinergic activity (OR = 3.50, p =.004) and risk of sarcopenia using SARC-F (OR = 2.75, p =.041) were associated with UI. CONCLUSIONS The prevalence of UI was high in this sample of NH residents compared to the literature, yet less than half received prompted voiding as a strategy to prevent/reduce UI.UI was associated with cognitive impairment, anticholinergic activity, and risk of sarcopenia.
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Affiliation(s)
- Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Pau Farrés-Godayol
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain.
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain.
| | - Meltem Yildirim
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Anna Escribà-Salvans
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Pau Moreno-Martin
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Ester Goutan-Roura
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
- Research group on Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic- Central University of Catalonia (UVic-UCC), Barcelona, Spain
| | - Sandra Rierola-Fochs
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Montse Romero-Mas
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Joanne Booth
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Maria Giné-Garriga
- Blanquerna Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, Barcelona, Spain
- Blanquerna Faculty of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
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Chen Y, Li W, Yang H. Determinants of physical activity behavior among older adults with subjective cognitive decline based on the capability, opportunity, motivation, and behavior model: mediating and moderating effects. Front Public Health 2024; 11:1338665. [PMID: 38264244 PMCID: PMC10805022 DOI: 10.3389/fpubh.2023.1338665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/19/2023] [Indexed: 01/25/2024] Open
Abstract
Background PA is vital for secondary prevention in older adults with subjective cognitive decline (SCD), but their physical activity (PA) levels are low, and the underlying interaction pathways among associated factors are poorly understood. This study aims to identify mediating and moderating effects of determinants on PA behavior in older adults with SCD using the capability, opportunity, motivation, and behavior model. Methods Following the STROBE checklist, we conducted a cross-sectional survey among 289 older adults with SCD. Path regression, mediation effects, and moderation effects were used to explore the associated factors of PA behavior and the associations among these variables. Results The prevalence of physical inactivity among older adults with SCD was high (40.3%). The path model fit indices were χ2/df = 1.145, GFI = 0.968, CFI = 0.988, and RMSEA = 0.022. Path regression revealed that frailty, physical and social support, PA motivation, and fall history had significant direct association with PA behavior. PA motivation not only partially mediates between frailty and PA behavior but also partially mediates between physical and social support and PA behavior. Additionally, fall history moderated the relationship between frailty and PA behavior. Conclusion PA behavior in older adults with SCD requires improvement. Healthcare professionals should devise more effective interventions to boost PA behavior by enhancing motivation. Screening for frailty and addressing fall history, while providing sufficient physical and social support, is crucial.
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Affiliation(s)
- Yiping Chen
- School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Wei Li
- International Medical Department, Peking Union Medical College Hospital (CAMS), Beijing, China
| | - Hui Yang
- School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China
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Thandi M, Wong ST, Price M, Baumbusch J. Perspectives on the representation of frailty in the electronic frailty index. BMC PRIMARY CARE 2024; 25:4. [PMID: 38166753 PMCID: PMC10759446 DOI: 10.1186/s12875-023-02225-z] [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: 09/05/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Frailty is a state of increased vulnerability from physical, social, and cognitive factors resulting in greater risk of negative health-related outcomes and increased healthcare expenditure. A 36-factor electronic frailty index (eFI) developed in the United Kingdom calculates frailty scores using electronic medical record data. There is currently no standardization of frailty screening in Canadian primary care. In order to implement the eFI in a Canadian context, adaptation of the tool is necessary because frailty is represented by different clinical terminologies in the UK and Canada. In considering the promise of implementing an eFI in British Columbia, Canada, we first looked at the content validation of the 36-factor eFI. Our research question was: Does the eFI represent frailty from the perspectives of primary care clinicians and older adults in British Columbia? METHODS A modified Delphi using three rounds of questionnaires with a panel of 23 experts (five family physicians, five nurse practitioners, five nurses, four allied health professionals, four older adults) reviewed and provided feedback on the 36-factor eFI. These professional groups were chosen because they closely work as interprofessional teams within primary care settings with older adults. Older adults provide real life context and experiences. Questionnaires involved rating the importance of each frailty factor on a 0-10 scale and providing rationale for ratings. Panelists were also given the opportunity to suggest additional factors that ought to be included in the screening tool. Suggested factors were similarly rated in two Delphi rounds. RESULTS Thirty-three of the 36 eFI factors achieved consensus (> 80% of panelists provided a rating of ≥ 8). Factors that did not achieve consensus were hypertension, thyroid disorder and peptic ulcer. These factors were perceived as easily treatable or manageable and/or not considered reflective of frailty on their own. Additional factors suggested by panelists that achieved consensus included: cancer, challenges to healthcare access, chronic pain, communication challenges, fecal incontinence, food insecurity, liver failure/cirrhosis, mental health challenges, medication noncompliance, poverty/financial difficulties, race/ethnic disparity, sedentary/low activity levels, and substance use/misuse. There was a 100% retention rate in each of the three Delphi rounds. CONCLUSIONS AND NEXT STEPS Three key findings emerged from this study: the conceptualization of frailty varied across participants, identification of frailty in community/primary care remains challenging, and social determinants of health affect clinicians' assessments and perceptions of frailty status. This study will inform the next phase of a broader mixed-method sequential study to build a frailty screening tool that could ultimately become a standard of practice for frailty screening in Canadian primary care. Early detection of frailty can help tailor decision making, frame discussions about goals of care, prevent advancement on the frailty trajectory, and ultimately decrease health expenditures, leading to improved patient and system level outcomes.
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Affiliation(s)
- Manpreet Thandi
- School of Nursing, University of British Columbia, T201 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
| | - Sabrina T Wong
- School of Nursing, University of British Columbia, T201 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
- Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Morgan Price
- Department of Family Practice, University of British Columbia, David Strangway Building, Suite 300, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Jennifer Baumbusch
- School of Nursing, University of British Columbia, T201 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
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Yang G, Cao X, Yu J, Li X, Zhang L, Zhang J, Ma C, Zhang N, Lu Q, Wu C, Chen X, Hoogendijk EO, Gill TM, Liu Z. Association of Childhood Adversity With Frailty and the Mediating Role of Unhealthy Lifestyle: A Lifespan Analysis. Am J Geriatr Psychiatry 2024; 32:71-82. [PMID: 37770350 PMCID: PMC11078585 DOI: 10.1016/j.jagp.2023.08.015] [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: 04/20/2023] [Revised: 08/10/2023] [Accepted: 08/23/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES Childhood adversity and lifestyle have been associated with frailty in later life, but not much is known about factors that may explain these associations. Therefore, this study aims to investigate the association of childhood adversity with frailty, and the mediating role of unhealthy lifestyle in the association. METHODS This lifespan analysis included 152,914 adults aged 40-69 years old from the UK Biobank. We measured childhood adversity with five items: physical neglect, emotional neglect, sexual abuse, physical abuse, and emotional abuse through online mental health survey. Frailty was measured by the frailty index; an unhealthy lifestyle score (range: 0-5) was calculated based on unhealthy body mass index, smoking, alcohol consumption, physical inactivity, and unhealthy diet at the baseline survey. Multiple logistic regression and mediation analysis were performed. RESULTS A total of 10,078 participants (6.6%) were defined as having frailty. Participants with any childhood adversity had higher odds of frailty. For example, in the fully adjusted model, with a one-point increase in cumulative score of childhood adversity, the odds of frailty increased by 38% (odds ratio: 1.38; 95% Confidence Interval: 1.36, 1.40). Unhealthy lifestyle partially mediated the associations of childhood adversity with frailty (mediation proportion: 4.4%-7.0%). The mediation proportions were largest for physical (8.2%) and sexual (8.1%) abuse. CONCLUSIONS Childhood adversity was positively associated with frailty, and unhealthy lifestyle partially mediated the association. This newly identified pathway highlights the potential of lifestyle intervention strategies among those who experienced childhood adversity (in particular, physical, and sexual abuse) to promote healthy aging.
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Affiliation(s)
- Gan Yang
- Second Affiliated Hospital, and School of Public Health (GY, XC, JY, XL, LZ, JZ, ZL), The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xingqi Cao
- Second Affiliated Hospital, and School of Public Health (GY, XC, JY, XL, LZ, JZ, ZL), The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jie Yu
- Second Affiliated Hospital, and School of Public Health (GY, XC, JY, XL, LZ, JZ, ZL), The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xueqin Li
- Second Affiliated Hospital, and School of Public Health (GY, XC, JY, XL, LZ, JZ, ZL), The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Liming Zhang
- Second Affiliated Hospital, and School of Public Health (GY, XC, JY, XL, LZ, JZ, ZL), The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jingyun Zhang
- Second Affiliated Hospital, and School of Public Health (GY, XC, JY, XL, LZ, JZ, ZL), The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chao Ma
- School of Economics and Management (CM), Southeast University, Nanjing, Jiangsu, China
| | - Ning Zhang
- Department of Social Medicine School of Public Health and Center for Clinical Big Data and Analytics Second Affiliated Hospital (NZ), Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qingyun Lu
- School of Public Health (QL), Nantong University, Nantong, JiangSu, China
| | - Chenkai Wu
- Global Health Research Center (CW), Duke Kunshan University, Kunshan, Jiangsu, China
| | - Xi Chen
- Department of Health Policy and Management (XC), Yale School of Public Health, New Haven, CT, USA; Department of Economics (XC), Yale University, New Haven, CT, USA
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science (EOH), Amsterdam Public Health research institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, The Netherlands
| | - Thomas M Gill
- Department of Internal Medicine (TMG), Yale School of Medicine, New Haven, CT, USA
| | - Zuyun Liu
- Second Affiliated Hospital, and School of Public Health (GY, XC, JY, XL, LZ, JZ, ZL), The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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da Cunha AN, Zanetti ML, Santos JLF, Rodrigues RAP. Frailty Syndrome and sarcopenia in older adults with and without type 2 diabetes mellitus in the municipality of Sinop, Mato Grosso: an epidemiological study. Rev Lat Am Enfermagem 2023; 31:e4076. [PMID: 38055592 PMCID: PMC10695296 DOI: 10.1590/1518-8345.6677.4076] [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: 01/10/2023] [Accepted: 09/06/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to relate Frailty Syndrome and sarcopenia in older adults with and without type 2 diabetes mellitus and identify potential risk factors for frailty and sarcopenia. METHOD this descriptive epidemiological study was conducted with 140 older adults in the municipality of Sinop, Mato Grosso, Brazil. The frailty phenotype was used for the assessment of Frailty Syndrome, and a physical assessment questionnaire with calf circumference measurement was used for the assessment of sarcopenia. RESULTS regarding Frailty Syndrome, a higher percentage was observed in older adults with type 2 diabetes mellitus compared to those without the disease (p = 0.00). Concerning the presence of sarcopenia, older adults with and without type 2 diabetes mellitus showed similar values, with no statistical significance (p = .74). Frailty Syndrome was associated with physical inactivity (95%CI: 3.29-56.55), age over 75 years (95%CI: 3.30- 27.82), low family income (95%CI: 1.80-50.98), and comorbidities (95%CI: 4.90-5.40). However, sarcopenia was associated with the presence of physical inactivity (95%CI: 1.26-10.44), low weight/ eutrophic (95%CI: 3.32-26.76), and malnutrition/nutritional risk (95%CI: 1.30-7.70) for older adults with and without type 2 diabetes mellitus. CONCLUSION older adults with diabetes have a higher vulnerability to develop Frailty Syndrome, necessitating the adoption of preventive measures in primary healthcare.
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Affiliation(s)
| | - Maria Lucia Zanetti
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | | | - Rosalina Aparecida Partezani Rodrigues
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
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Knoop V, Costenoble A, Debain A, Van der Meulen K, De Vriendt P, Gorus E, Bravenboer B, Jansen B, Scafoglieri A, Bautmans I. Impact of COVID-19 on Physical Activity, Fatigue, and Frailty in Community-Dwelling Older Adults: A Cross-Sectional Study. J Aging Phys Act 2023; 32:172-184. [PMID: 38016449 DOI: 10.1123/japa.2021-0366] [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: 02/18/2022] [Revised: 05/27/2023] [Accepted: 08/21/2023] [Indexed: 11/30/2023]
Abstract
This study aimed to describe the level of physical activity and its relation to fatigue and frailty during the COVID-19 pandemic in community-dwelling older adults aged 80 years and over. Three hundred and ninety-one older adults (aged 86.5 ± 3.00) completed a survey including physical activity, the Mobility Tiredness scale, and the FRAIL scale. Linear regression analysis was conducted to assess whether the variables age, sex, and physical activity (independent factors) were significantly related to fatigue and frailty. Respectively, 30.5% and 24.7% of the participants reported a decrease in walking and in energy-intensive activities; 25.4% reported increased sedentary behavior. A lower level of physical activity was associated with higher levels of fatigue and increased frailty risk (p < .05), independently from psychological symptoms. These results are important because participants with lower levels of physical activity and more sedentary behavior are more likely to feel fatigued and have higher risk to be frail.
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Affiliation(s)
- Veerle Knoop
- Department of Gerontology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Aging (FRIA) Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Axelle Costenoble
- Department of Gerontology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Aging (FRIA) Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Aziz Debain
- Department of Gerontology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Aging (FRIA) Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Kristof Van der Meulen
- Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Patricia De Vriendt
- Department of Gerontology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Aging (FRIA) Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Arteveldehogeschool, Ghent, Belgium
| | - Ellen Gorus
- Department of Gerontology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Aging (FRIA) Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Bert Bravenboer
- Frailty in Aging (FRIA) Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Bart Jansen
- Department of Electronics and Informatics ETRO, Vrije Universiteit Brussel (VUB), Elsene, Belgium
- IMEC, Leuven, Belgium
| | - Aldo Scafoglieri
- Frailty in Aging (FRIA) Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Supporting Clinical Science Department and Research Department of Experimental Anatomy (EXAN), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ivan Bautmans
- Department of Gerontology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Aging (FRIA) Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
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Farrés-Godayol P, Ruiz-Díaz MÁ, Dall P, Skelton DA, Minobes-Molina E, Jerez-Roig J, Giné-Garriga M. Determining minimum number of valid days for accurate estimation of sedentary behaviour and awake-time movement behaviours using the ActivPAL3 in nursing home residents. Eur Rev Aging Phys Act 2023; 20:19. [PMID: 37805448 PMCID: PMC10559597 DOI: 10.1186/s11556-023-00329-0] [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: 04/06/2023] [Accepted: 09/24/2023] [Indexed: 10/09/2023] Open
Abstract
INTRODUCTION Scarce evidence is available about the minimum number of valid days wearing the activPAL3 to obtain a precise estimate of sedentary behaviour (SB) and awake-time movement behaviours (ATMB) in nursing home (NH) residents. The study aimed to determine the minimum number of valid days required for accurately estimate SB and ATMB using the activPAL3 device in NH residents. It also investigated how the starting point of a day (the 24-h period) impacted reliability. METHODS Participants wore an activPAL3 for 7 consecutive days. The data was classified in two-time blocks (00:00 Ante Meridiem (AM)-00:00 AM midnight vs 12:00 Post Meridiam (PM) -12:00 PM midday) and the sample was stratified into two groups according to their capacity to stand and walk, to examine if timing of sampling or physical functioning affected minimum wear time. SB, ATMB, sociodemographic, and health-related variables were collected. Sensitivity of the time-blocks were tested through the dispersion frequencies and differences between blocks through Kolmogorov-Smirnov test for normality; parametric variables through two-related means T-test and Wilcoxon test for non-parametric data. Reliability was assessed with the Cronbach's Alpha and the intra-class correlation coefficient (ICC), using a one-factor model estimating the reliability for each measurement day loading in the same latent factor. RESULTS Ninety-five NH residents (81.1% women; age = 85.8 ± 7.2 years) were included. The midnight block had higher reliability, sensitivity and no statistically significant differences between days were found. At least three consecutive days of monitoring were necessary to achieve a reliability of ICC ≥ 0.8 for those NH residents able to stand and walk and six days for those unable. CONCLUSIONS NH residents who are able to stand and walk require a minimum of three consecutive days wearing the device, while those who are unable require at least six days due to their highly homogenous daily routines and sensitivity to PA events. Regardless of the activPAL3 recording start time, data processing should reference the midnight time block.
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Affiliation(s)
- Pau Farrés-Godayol
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Miguel Ángel Ruiz-Díaz
- Department of Social Psychology and Methodology, Psychology Faculty, Universidad Autónoma de Madrid, Madrid, Spain
| | - Philippa Dall
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Vic, 08500, Spain.
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain.
| | - Maria Giné-Garriga
- Blanquerna Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, Barcelona, Spain
- Blanquerna Faculty of Health Sciences, Ramon Llull University, Barcelona, Spain
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Delaire L, Courtay A, Humblot J, Aubertin-Leheudre M, Mourey F, Racine AN, Gilbert T, Niasse-Sy Z, Bonnefoy M. Implementation and Core Components of a Multimodal Program including Exercise and Nutrition in Prevention and Treatment of Frailty in Community-Dwelling Older Adults: A Narrative Review. Nutrients 2023; 15:4100. [PMID: 37836384 PMCID: PMC10574358 DOI: 10.3390/nu15194100] [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: 07/31/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.
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Affiliation(s)
- Leo Delaire
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Aymeric Courtay
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Joannès Humblot
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Mylène Aubertin-Leheudre
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W5, Canada;
- Groupe de Recherche en Activité Physique Adaptée, Département des Sciences de l’Activité Physique, Université du Québec à Montréal (UQÀM), Montréal, QC H2L 2C4, Canada
| | - France Mourey
- Laboratoire CAPS (Cognition, Action, et Plasticité Sensorimotrice), Inserm U1093, UFR STAPS, Université de Bourgogne, Campus Universitaire, BP 27877, 21078 Dijon, France;
| | | | - Thomas Gilbert
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- RESHAPE Research on Healthcare Professionals and Performance, Inserm U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France
| | - Zeinabou Niasse-Sy
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Marc Bonnefoy
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Inserm U1060-CarMeN, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
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Ding L, Miao X, Jiang X, Chen L, Lu J, Zhu H, Guo Y, Zhu S, Xu X, Hu J, Xu Q. Adverse outcomes and health-ecological influencing factors of preoperative frailty among elderly patients with gastric cancer. J Cancer Res Clin Oncol 2023; 149:7043-7051. [PMID: 36862157 DOI: 10.1007/s00432-023-04651-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/14/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE Frailty is defined as a state of decreased physiologic reserves arising from cumulative deficits in multiple homeostatic systems, which is important in the field of clinical oncology. We aimed to explore the relationship between preoperative frailty and adverse outcomes, and systematically analyze the factors influencing frailty based on the health ecology model among elderly gastric cancer patients. METHODS A observational study was conducted to select 406 elderly patients who would undergo gastric cancer surgery at a tertiary hospital. The logistic regression model was used to examine the relationship between preoperative frailty and adverse outcomes, including total complications, prolonged length of stay (PLOS), and 90-day hospital readmission. Based on the health ecology model, the factors which may influence frailty were collected from four levels. Univariate and multivariate analysis were utilized to determine the factors influencing preoperative frailty. RESULTS Preoperative frailty was associated with total complications (odds ratio [OR] 2.776, 95% confidence interval [CI] 1.588-4.852), PLOS (OR 2.338, 95%CI 1.342-4.073), and 90-day hospital readmission (OR 2.640, 95% CI 1.275-5.469). Besides, nutritional risk (OR 4.759, 95% CI 2.409-9.403), anemia (OR 3.160, 95% CI 1.751-5.701), number of comorbidity ≥ 2 (OR 2.318, 95% CI 1.253-4.291), low physical activity level (OR 3.069, 95% CI 1.164-8.092), apathetic attachment (OR 2.656, 95% CI 1.457-4.839), personal monthly income ≤ 1000 yuan (OR 2.033, 95% CI 1.137-3.635) and anxiety (OR 2.574, 95% CI 1.311-5.053) were independent risk factors for frailty. High physical activity level (OR 0.413, 95% CI 0.208-0.820) and improved objective support (OR 0.818, 95% CI 0.683-0.978) were independent protective factors for frailty. CONCLUSIONS Preoperative frailty was associated with multiple adverse outcomes and could be affected by factors of different dimensions from the health ecology perspective, including nutrition, anemia, comorbidity, physical activity, attachment style, objective support, anxiety, and income, which can guide the formation of a comprehensive prehabilitation for frailty among elderly gastric cancer patients.
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Affiliation(s)
- Lingyu Ding
- School of Nursing, Nanjing Medical University, 101Longmian Avenue, Jiangning District, Nanjing, 211166, China
- Department of Colorectal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Xueyi Miao
- School of Nursing, Nanjing Medical University, 101Longmian Avenue, Jiangning District, Nanjing, 211166, China
| | - Xiaoman Jiang
- School of Nursing, Nanjing Medical University, 101Longmian Avenue, Jiangning District, Nanjing, 211166, China
| | - Li Chen
- Department of Gastric Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Jinling Lu
- Department of Gastric Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, 101Longmian Avenue, Jiangning District, Nanjing, 211166, China
| | - Yinning Guo
- School of Nursing, Nanjing Medical University, 101Longmian Avenue, Jiangning District, Nanjing, 211166, China
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, 101Longmian Avenue, Jiangning District, Nanjing, 211166, China
| | - Xinyi Xu
- Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove Queensland, Brisbane, 4059, Australia.
| | - Jieman Hu
- School of Nursing, Nanjing Medical University, 101Longmian Avenue, Jiangning District, Nanjing, 211166, China.
| | - Qin Xu
- School of Nursing, Nanjing Medical University, 101Longmian Avenue, Jiangning District, Nanjing, 211166, China.
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Lee JS, Park M, Kim YH. Sedentary Behavior and Physical Activity of Community-Dwelling Korean Breast Cancer Survivors: A Nationwide Study. Healthcare (Basel) 2023; 11:1974. [PMID: 37444808 DOI: 10.3390/healthcare11131974] [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: 06/13/2023] [Revised: 06/25/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to investigate the contemporary characteristics of sedentary behavior and physical activity levels in breast cancer survivors. The cross-sectional data of 10,073 community-dwelling Korean women aged ≥50 years in the Korea National Health and Nutrition Examination Survey were analyzed. The differences in sedentary behavior, walking activity, and moderate-to-vigorous physical activity (MVPA) levels between breast cancer survivors, other cancer survivors, and women with no history of cancer were compared by complex-sample general linear models. Breast cancer survivors spent significantly less mean time in sedentary behavior than other cancer survivors and women with no history of cancer; however, among them, 48.34% spent a long sedentary time of ≥420 min/day. Breast cancer survivors had a significantly higher level of walking activity and similar total MVPA levels compared to women with no history of cancer. When comparing domain-specific MVPA levels, breast cancer survivors showed significantly lower work-related MVPA levels than women with no history of cancer. In recent years, community-dwelling Korean breast cancer survivors were less sedentary, walked more, and had equivalent MVPA levels compared with women with no history of cancer. Considering the growing emphasis on healthy lifestyles, our results may reflect more contemporary behavior trends of breast cancer survivors.
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Affiliation(s)
- Jung Soo Lee
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Mina Park
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yeo Hyung Kim
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Huang TY, Chou MY, Liang CK, Lin YT, Chen RY, Wu PF. Physical activity plays a crucial role in multidomain intervention for frailty prevention. Aging Clin Exp Res 2023; 35:1283-1292. [PMID: 37101084 PMCID: PMC10132799 DOI: 10.1007/s40520-023-02412-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/12/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND AND AIMS Taiwan is one of the most rapidly aging countries worldwide. Both physical activity and frailty affect older adults, and multidomain interventions prevent frailty. This study investigated the associations between physical activity, frailty, and the effects of multidomain intervention. METHODS This study enrolled individuals aged 65 years or older. The physical activity level was assessed using the Physical Activity Scale for the Elderly (PASE). Enrollees participated in a multidomain intervention program that consisted of twelve 120-min sessions administered over a 12-week period that included health education, cognitive training, and exercise programs. The effects of the intervention were evaluated using the instrumental activities of daily living scale (IADL), Mini Nutritional Assessment short form (MNA-SF), five-item Geriatric Depression Scale (GDS-5), Mini-Mental State Examination (MMSE), timed up and go test (TUGT), and Fried's frailty phenotype. RESULTS In total, 106 older adults (aged 65-96 years) were enrolled in this study. The mean age was 77.47 ± 7.19 years, and 70.8% of participants were women. PASE scores were significantly lower among participants who were of older age, frail, and had a history of falls in the last 12 months. Frailty could be improved by multidomain interventions and was significantly positively correlated with depression, and negatively correlated with physical activity, mobility, cognition and daily living skills. Moreover, daily living skills were significantly positively correlated with cognition, mobility and physical activity, and negatively correlated with age, sex, and frailty. However, multidomain interventions did not affect daily living skills suggesting daily living skills may need to be maintained from a young age. Finally, results from multiple regressions suggest that physical activity, mobility and depression may be predictors of frailty. CONCLUSIONS Physical activity has an important role in frailty, may be a predictor of frailty, and strongly contributes to reducing frailty through multidomain intervention. Policies that encourage healthy aging should focus on increasing physical activity, maintaining basic daily living skills and reducing frailty.
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Affiliation(s)
- Tzu-Ya Huang
- Department of Family Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Kaohsiung, 813414, Taiwan
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Kaohsiung, 813414, Taiwan
- Department of Kinesiology, Health, and Leisure Studies, National University of Kaohsiung, 700, Kaohsiung University Rd., Kaohsiung, 811726, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Kaohsiung, 813414, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Kaohsiung, 813414, Taiwan
- Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Kaohsiung, 813414, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Kaohsiung, 813414, Taiwan
- Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Kaohsiung, 813414, Taiwan
| | - Ru-Yih Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Kaohsiung, 813414, Taiwan
- Department of Business Management, Institute of Health Care Management, National Sun Yat-sen University, No.70 Lienhai Rd., Kaohsiung, 804201, Taiwan
| | - Pei-Fung Wu
- Department of Kinesiology, Health, and Leisure Studies, National University of Kaohsiung, 700, Kaohsiung University Rd., Kaohsiung, 811726, Taiwan.
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Corral-Pérez J, Ávila-Cabeza-de-Vaca L, González-Mariscal A, Espinar-Toledo M, Ponce-González JG, Casals C, Vázquez-Sánchez MÁ. Risk and Protective Factors for Frailty in Pre-Frail and Frail Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3123. [PMID: 36833817 PMCID: PMC9961851 DOI: 10.3390/ijerph20043123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
This study aims to evaluate the differences in body composition, physical function, and physical activity between pre-frail/frail older adults and to detect risk and protective factors against frailty and physical frailty. Fried's criteria for frailty and physical frailty using the short-performance physical battery (SPPB) were measured in 179 older participants (75.3 ± 6.4 years old). Body weight, height, and waist, arm, and leg circumferences were obtained as body composition variables. Daily accelerometer outcomes (physical activity and inactivity) were obtained. Pre-frail participants showed overall better physical function and spent more time in physical activity and less time in long inactivity periods than frail participants (p < 0.05). Risk frailty factors were higher waist perimeter (Odds Ratio [OR]: 1.032, 95%CI: 1.003-1.062), low leg performance (OR: 1.025, 95%CI: 1.008-1.043), and inactivity periods longer than 30 min (OR:1.002, 95%CI: 1.000-1.005). Protective factors were standing balance (OR:0.908, 95%CI: 0.831-0.992) and SPPB score (OR: 0.908, 95%CI: 0.831-0.992) for frailty, handgrip strength (OR: 0.902, 95%CI: 0.844-0.964) for physical frailty, and light (OR: 0.986, 95%CI: 0.976-0.996) and moderate-to-vigorous (OR: 0.983, 95%CI: 0.972-0.996) physical activity for both. Our findings suggest that handgrip strength, balance, and physical activity are protective frailty factors and can be monitored in pre-frail older adults. Moreover, poor lower body performance and long inactivity periods are frailty risk factors, which highlights their importance in frailty assessment.
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Affiliation(s)
- Juan Corral-Pérez
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Laura Ávila-Cabeza-de-Vaca
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Andrea González-Mariscal
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Milagrosa Espinar-Toledo
- Clinical Management Unit, Malaga-Guadalhorce Health District, Rincón de la Victoria, 29730 Malaga, Spain
| | - Jesús G. Ponce-González
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Cristina Casals
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - María Ángeles Vázquez-Sánchez
- Department of Nursing, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- PASOS Research Group, UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, 29071 Malaga, Spain
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25
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Yang G, Cao X, Yu J, Li X, Zhang L, Zhang J, Ma C, Zhang N, Lu Q, Wu C, Chen X, Hoogendijk EO, Gill TM, Liu Z. Association of childhood adversity with frailty and the mediating role of unhealthy lifestyle: Findings from the UK biobank. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.08.23285634. [PMID: 36798168 PMCID: PMC9934802 DOI: 10.1101/2023.02.08.23285634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Background Childhood adversity and lifestyle have been associated with frailty in later life, but not much is known about factors that may explain these associations. An unhealthy lifestyle may play an important role in the pathway from childhood adversity to frailty. Therefore, this study aims to investigate the association of childhood adversity with frailty, and the mediating role of unhealthy lifestyle in the association. Methods This lifespan analysis included 152914 adults aged 40-69 years old from the UK Biobank. We measured childhood adversity with five items: physical neglect, emotional neglect, sexual abuse, physical abuse, and emotional abuse through online mental health survey. Frailty was measured by the frailty index; an unhealthy lifestyle score (range: 0-5) was calculated based on unhealthy body mass index, smoking, drinking, physical inactivity, and unhealthy diet at the baseline survey. Multiple logistic regression and mediation analysis were performed. Results A total of 10078 participants (6.6%) were defined as having frailty. Participants with any childhood adversity had higher odds of frailty. For example, in the fully adjusted model, with a one-point increase in cumulative score of childhood adversity, the odds of frailty increased by 41% (Odds Ratio: 1.41; 95% Confidence Interval: 1.39, 1.44). Unhealthy lifestyle partially mediated the associations of childhood adversity with frailty (mediation proportion: 4.4%-7.0%). The mediation proportions were largest for physical (8.2%) and sexual (8.1%) abuse. Conclusions Among this large sample, childhood adversity was positively associated with frailty, and unhealthy lifestyle partially mediated the association. This newly identified pathway highlights the potential of lifestyle intervention strategies among those who experienced childhood adversity (in particular, physical and sexual abuse) to promote healthy aging.
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Affiliation(s)
- Gan Yang
- School of Public Health and Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Xingqi Cao
- School of Public Health and Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Jie Yu
- School of Public Health and Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Xueqin Li
- School of Public Health and Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Liming Zhang
- School of Public Health and Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Jingyun Zhang
- School of Public Health and Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Chao Ma
- School of Economics and Management, Southeast University, Nanjing 211189, Jiangsu, China
| | - Ning Zhang
- Department of Social Medicine School of Public Health and Center for Clinical Big Data and Analytics Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Qingyun Lu
- School of Public Health, Nantong University, Nantong 226007, JiangSu, China
| | - Chenkai Wu
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT 06520, United States of America
- Department of Economics, Yale University, New Haven, CT 06520, United States of America
| | - Emiel O. Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC – location VU University medical center, Amsterdam, the Netherlands
| | - Thomas M. Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, United States of America
| | - Zuyun Liu
- School of Public Health and Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
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26
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Wanigatunga AA, Chiu V, Cai Y, Urbanek JK, Mitchell CM, Miller ER, Christenson RH, Rebuck H, Michos ED, Juraschek SP, Walston J, Xue QL, Bandeen-Roche K, Appel LJ, Schrack JA. Patterns of Daily Physical Movement, Chronic Inflammation, and Frailty Incidence. Med Sci Sports Exerc 2023; 55:281-288. [PMID: 36170549 PMCID: PMC9840658 DOI: 10.1249/mss.0000000000003048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Low physical activity is a criterion of phenotypic frailty defined as an increased state of vulnerability to adverse health outcomes. Whether disengagement from daily all-purpose physical activity is prospectively associated with frailty and possibly modified by chronic inflammation-a pathway often underlying frailty-remains unexplored. METHODS Using the Study to Understand Fall Reduction and Vitamin D in You data from 477 robust/prefrail adults (mean age = 76 ± 5 yr; 42% women), we examined whether accelerometer patterns (activity counts per day, active minutes per day, and activity fragmentation [broken accumulation]) were associated with incident frailty using Cox proportional hazard regression. Baseline interactions between each accelerometer metric and markers of inflammation that include interleukin-6, C-reactive protein, and tumor necrosis factor-alpha receptor 1 were also examined. RESULTS Over an average of 1.3 yr, 42 participants (9%) developed frailty. In Cox regression models adjusted for demographics, medical conditions, and device wear days, every 30 min·d -1 higher baseline active time, 100,000 more activity counts per day, and 1% lower activity fragmentation was associated with a 16% ( P = 0.003), 13% ( P = 0.001), and 8% ( P < 0.001) lower risk of frailty, respectively. No interactions between accelerometer metrics and baseline interleukin-6, C-reactive protein, or tumor necrosis factor-alpha receptor 1 were detected (interaction P > 0.06 for all). CONCLUSIONS Among older adults who are either robust or prefrail, constricted patterns of daily physical activity (i.e., lower total activity minutes and counts, and higher activity fragmentation) were prospectively associated with higher risk of frailty but not modified by frailty-related chronic inflammation. Additional studies, particularly trials, are needed to understand if this association is causal.
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Affiliation(s)
- Amal A. Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD
| | - Venus Chiu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Yurun Cai
- Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA
| | | | - Christine M. Mitchell
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, MD
| | - Edgar R. Miller
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Heather Rebuck
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD
| | - Erin D. Michos
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Stephen P. Juraschek
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, MA
| | - Jeremy Walston
- Division of Geriatric Medicine, Johns Hopkins University and Medical Institutions, Baltimore, MD
| | - Qian-Li Xue
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of Geriatric Medicine, Johns Hopkins University and Medical Institutions, Baltimore, MD
| | - Karen Bandeen-Roche
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of Geriatric Medicine, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lawrence J. Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD
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27
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Martins GS, Galvão LL, Tribess S, Meneguci J, Virtuoso JS. Isotemporal substitution of sleep or sedentary behavior with physical activity in the context of frailty among older adults: a cross-sectional study. SAO PAULO MED J 2023; 141:12-19. [PMID: 35920530 PMCID: PMC9808996 DOI: 10.1590/1516-3180.2021.0420.r3.03032022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 03/03/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Frailty syndrome is associated with various physical, cognitive, social, economic, and environmental factors. Although frailty syndrome occurs progressively with age, prevention and treatment are possible. Reducing or eliminating risks and increasing protective factors may be potential strategies for reducing the prevalence of injuries related to frailty. One of the most effective actions is to decrease the time spent in sedentary behavior (SB) by increasing regular physical activity (PA). OBJECTIVE To examine the hypothetical effect of substitution of the time spent in sleep or SB with an equivalent time spent performing moderate or vigorous PA on frailty syndrome in the older population. DESIGN AND SETTING An analytical cross-sectional study conducted using exploratory methods of survey, carried out in Alcobaça city, Bahia, Brazil. METHODS A total of 456 older adults of both sexes, aged ≥ 60 years, participated in this study. Frailty syndrome was identified according to the criteria of the Study of Osteoporotic Fractures. PA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. The effects of time substitution on these behaviors were verified using Poisson regression. RESULTS The replacement of 60 min/day of SB (prevalence ratio, PR = 0.52; 95% confidence interval, CI: 0.28-0.96) or sleep (PR = 0.52; 95% CI: 0.27-0.98) with 60 min/day of moderate PA (MPA) was associated with a 48% reduction in the prevalence of frailty syndrome. CONCLUSIONS Replacing the time spent sitting or sleeping with the same amount of MPA time may reduce frailty; the longer the duration of time spent in the substitution of sleep or SB with MPA, the greater the benefits.
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Affiliation(s)
- Giovana Silva Martins
- MSc. Physical Education Professional, Postgraduate Student in Physical Education, Department of Sports Sciences, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Lucas Lima Galvão
- MSc. Physical Education Professional, Postgraduate Student in Physical Education, Department of Sports Sciences, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Sheilla Tribess
- PhD. Physical Education Professional, Associate Professor and Coordinator, Postgraduate Course in Physical Education, Department of Sports Sciences, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Joilson Meneguci
- PhD. Physical Education Professional Support Service and Dean, Research and Scientific Production, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Jair Sindra Virtuoso
- PhD. Physical Education Professional and Associate Professor II, Department of Sports Sciences, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
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28
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Chang SH, Chiang CC, Chien NH. Efficacy of a multicomponent exercise training program intervention in community-dwelling older adults during the COVID-19 pandemic: A cluster randomized controlled trial. Geriatr Nurs 2023; 49:148-156. [PMID: 36528997 PMCID: PMC9757806 DOI: 10.1016/j.gerinurse.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused changes in lifestyle for older adults such as reduced physical activity and community participation. Community activity centers were randomly assigned to the intervention (n = 82) or control arm (n = 85). The intervention comprised one 60 min group exercise session per week in weeks 1-8 and an online home exercise program in weeks 9-16. Physical activity, physical performance, and prefrailty rates were assessed at baseline and 16 weeks. At 16 weeks, compared to the control arm, the intervention arm exhibited improved (p < 0.05) leisure-time physical activity (phi = 0.571), vigorous physical activity (phi = 0.534), and moderate-vigorous physical activity (phi = 0.344); prefrailty rates (phi = 0.179); and short physical performance battery results (η2p = 0.113). The intervention thus effectively improved physical activity levels, physical performance, and prefrailty rates in community-dwelling older adults during the COVID-19 pandemic.
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Affiliation(s)
- Shu-Hung Chang
- Graduate Institute of Gerontology and Health Care Management, Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Gastroenterology and Hepatology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - Ching-Cheng Chiang
- Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Nai-Hui Chien
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Cook MJ, Verstappen SMM, Lunt M, O'Neill TW. Increased Frailty in Individuals With Osteoarthritis and Rheumatoid Arthritis and the Influence of Comorbidity: An Analysis of the UK Biobank Cohort. Arthritis Care Res (Hoboken) 2022; 74:1989-1996. [PMID: 34235888 DOI: 10.1002/acr.24747] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/21/2021] [Accepted: 07/06/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To determine the association between osteoarthritis (OA), rheumatoid arthritis (RA), and frailty and to determine whether comorbidities interact with OA and RA to further increase the likelihood of frailty. METHODS Participants of the UK Biobank age 40-69 years at baseline were included. Demographic, lifestyle, and clinical data were collected at baseline and follow-up in a subset. Frailty was assessed using a frailty index (FI) (continuous) and a modified frailty phenotype (robust, pre-frail, frail). The association between RA and OA and frailty at baseline and follow-up was assessed using multiple regression models. We looked at whether comorbidities, including cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease, and depression interacted additively with OA and RA to increase the likelihood of frailty. RESULTS In total, 457,561 participants contributed data. Those with (versus without) RA (n = 4,894) and OA (n = 35,884), respectively, were more likely to be frail (adjusted relative risk ratio 10.7 [95% confidence interval (95% CI) 9.7, 11.7] and 3.4 [95% CI 3.3, 3.6]) and were more likely to have a higher FI at baseline. There was evidence of additive interaction between RA, OA, and common comorbidities increasing the occurrence of prevalent frailty. Among 25,163 participants included in longitudinal analysis, patients with RA (n = 202) and OA (n = 1,811) at baseline had an increased adjusted frailty incidence rate ratio (2.8 [95% CI 1.7, 4.6] and 1.7 [95% CI 1.3, 2.1], respectively) and also a higher FI during follow-up. CONCLUSION Individuals with RA and OA are more likely to have, or develop, frailty. Common comorbidities interact with OA and RA to further increase the likelihood of frailty.
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Affiliation(s)
- Michael J Cook
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, University of Manchester, and NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Mark Lunt
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, University of Manchester, and NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Brustio PR, Mulasso A, D’Emanuele S, Zia G, Feletti L, Del Signore S, Rainoldi A. Indoor Mobility, Frailty, and Disability in Community-Dwelling Older Adults: A Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11386. [PMID: 36141659 PMCID: PMC9517026 DOI: 10.3390/ijerph191811386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/18/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
The general population, but especially older adults, were forced or encouraged to stay home during the recent COVID-19 pandemic. In this context, indoor mobility (IM, the number of steps performed daily at home) may be informative about the general health status of older adults. The present study aimed at evaluating the relationship between IM, frailty (loss of functional reserve including both physical and psychosocial domains), and disability (loss of autonomy measured as activities of daily life, ADLs) in a sample of community-dwelling Italian older adults. Specifically, the primary objective was to investigate IM and disability differences between robust and frail older adults. The secondary objective was to test if frailty is in the causal sequence between IM and disability, i.e., as a mediator in their relationship. Thirty-two participants (mean age = 70 ± 6 years; 56.2% women) were recruited. Frailty and disability were evaluated using the Tilburg Frailty Indicator and the Groningen Activity Restriction Scale, respectively. IM at home was measured via an Adamo wristwatch (a connected accelerometer). One-way analyses of covariance, controlling for age and gender, showed that robust participants, classified according to a score higher than five points in the Tilburg Frailty Indicator, performed significantly more IM (F1,28 = 4.639; p = 0.04) and presented lower disability grade than frail ones (F1,28 = 4.342; p =0.046). Only physical frailty was a mediator in the relationship between IM and disability (F2,29 = 8.538, p < 0.001), with a fully mediated model (z = -2.073, p < 0.04). Conversely, the total frailty score was not a mediator in the same relationship, but with IM accounted for the variance in disability (F2,29 = 8.538, p < 0.001; R2 = 33.7%). Our results suggested that frail older adults restricted their IM more and presented a higher level of disability compared to robust older adults. Moreover, data suggest that IM reduction may have a negative impact on physical frailty and indirectly increase disability.
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Affiliation(s)
- Paolo Riccardo Brustio
- NeuroMuscularFunction, Research Group, School of Exercise & Sport Sciences, University of Torino, 10126 Torino, Italy
- Department of Neuroscience, Biomedicine and Movement, University of Verona, 37124 Verona, Italy
- Department of Clinical and Biological Sciences, University of Torino, 10126 Torino, Italy
| | - Anna Mulasso
- NeuroMuscularFunction, Research Group, School of Exercise & Sport Sciences, University of Torino, 10126 Torino, Italy
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy
| | - Samuel D’Emanuele
- Department of Neuroscience, Biomedicine and Movement, University of Verona, 37124 Verona, Italy
| | | | | | | | - Alberto Rainoldi
- NeuroMuscularFunction, Research Group, School of Exercise & Sport Sciences, University of Torino, 10126 Torino, Italy
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy
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31
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van der Valk AM, Theou O, Wallace LM, Andrew MK, Godin J. Physical demands at work and physical activity are associated with frailty in retirement. Work 2022; 73:695-705. [DOI: 10.3233/wor-210859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The relationship between occupational physical activity and frailty is complex and understudied. OBJECTIVE: We explore whether moderate-vigorous physical activity (MVPA) in retirement and main lifetime occupation physical demands (OPD) are associated with frailty in retirement. METHODS: Retired adults aged 50 + who participated in waves 3-4 of the Survey of Health, Ageing and Retirement in Europe were included. We constructed a 65-item frailty index (FI; Wave 4). Linear regressions tested the independent associations between OPD (Wave 3) and retirement MVPA (Wave 4) with FI (B: 95% CI) controlling for occupation characteristics (Wave 3) and demographics (Wave 4). These models were repeated across country groups (Nordic; Mediterranean; Continental) and sexes. RESULTS: We included 8,411 adults (51.1% male) aged 72.4 years (SD 8.0). Frequent MVPA was consistently associated with lower FI (-0.09 : 0.10–-0.08, p < .001) while OPD was associated with higher FI (0.02 : 0.01-0.03, p < .001). The MVPA*OPD interaction (-0.02: -0.04–-0.00, p = .043) was weakly associated with FI, but did not explain additional model variance or was significant among any country group or sex. CONCLUSIONS: For a sample of European community-dwelling retirees, a physically demanding main lifetime occupation independently predicts worse frailty, even in individuals who are physically active in retirement.
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Affiliation(s)
| | - Olga Theou
- Geriatric Medicine Research, Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS, Canada
- Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | - Lindsay M.K. Wallace
- Geriatric Medicine Research, Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS, Canada
| | - Melissa K. Andrew
- Geriatric Medicine Research, Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS, Canada
| | - Judith Godin
- Geriatric Medicine Research, Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS, Canada
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32
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Li N, Huang F, Li H, Lin S, Yuan Y, Zhu P. Examining the independent and interactive association of physical activity and sedentary behaviour with frailty in Chinese community-dwelling older adults. BMC Public Health 2022; 22:1414. [PMID: 35879692 PMCID: PMC9313602 DOI: 10.1186/s12889-022-13842-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While physical inactivity or prolonged sitting has been linked to an increased risk of frailty, the interaction between sitting time (ST), physical activity (PA) and frailty is not well understood. The aim of this study was to examine the dose-response relationship between PA, ST and frailty and further to evaluate the interaction effect of PA and ST on frailty in the context of regular COVID-19 epidemic prevention and control in China. METHODS A cross-sectional analysis was performed on 1458 participants (age ≥ 60) enrolled from a prospective cohort study of frailty in elderly people of Fujian Province. PA and ST levels were assessed using the International Physical Activity Questionnaire. A 40-item frailty index (FI) quantified frailty. Multivariable logistic regression and linear regression models were applied to examine the dose-response relationship between PA or ST and frailty level. Interaction plots were used to visualise the interaction effects of PA and ST on frailty. RESULTS Compared with light PA, the odds ratios (ORs) for frailty were significantly lower for moderate PA (OR, 0.609 [95% CI, 0.419, 0.885], P < .001) and vigorous PA (OR, 0.399 [95% CI, 0.236,0.673], P < .001). Comparing subjects with ST < 4 h/day, those with ST ≥ 8 h/day were significantly more likely to be diagnosed with frailty (OR, 3.140 [95% CI, 1.932, 5.106], P < .001), 6-8 h/day (OR, 1.289 [95% CI, 0.835, 1.989], P >0.05), and 4-6 h/day (OR, 1.400 [95% CI, 0.972, 2.018], P >0.05). Each one unit increase in metabolic equivalents (h/day) of PA was related to an average 0.928 (0.887, 0.971) decrease in prevalence of frailty, while each one unit increase in sitting time (h/day) was related to average 1.114 (1.046,1.185) increase in prevalence of frailty. Negative interactive effects of PA and ST on frailty were observed (P < 0.001). CONCLUSION There are nonlinear and linear dose-response relationships between PA, SB and frailty respectively. In addition, excess ST may counteract the beneficial effects of PA on frailty. Interventions that focus on reducing excess ST may be effective strategies to reduce the risk of frailty and should be taken seriously by public health authorities, especially in the context of regular epidemic prevention and control in China.
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Affiliation(s)
- Na Li
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
- Department of Nursing, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Feng Huang
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
- Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Hong Li
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
- Department of Nursing, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
| | - Siyang Lin
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
- Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Yin Yuan
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
- Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Pengli Zhu
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.
- Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.
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Risk factors and a nomogram for frailty in Chinese older patients with Alzheimer's disease: A single-center cross-sectional study. Geriatr Nurs 2022; 47:47-54. [PMID: 35850031 DOI: 10.1016/j.gerinurse.2022.06.012] [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: 05/17/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/20/2022]
Abstract
This study aimed to determine the risk factors of frailty in Chinese older patients with Alzheimer's disease (AD) and then construct a nomogram for frailty in this population. A total of 205 eligible older AD patients were recruited. Patients' general demographic characteristics were collected through a self-designed questionnaire. A nomogram was constructed for frailty based on the risk factors identified from the multivariate analysis. The discrimination and calibration capabilities of this nomogram were assessed with the C-index and calibration curve, respectively. The results showed that older age, no regular exercise habit, severe cognitive decline, and low social support were identified as important risk factors of frailty in AD patients. The C-index of the nomogram was 0.884 by bootstrapping validation, and the calibration curve of the nomogram showed high coherence between the predicted and actual probabilities of frailty. In conclusion, this nomogram was validated to have favorable discrimination and calibration capabilities.
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Quach J, Theou O, Pérez-Zepeda MU, Godin J, Rockwood K, Kehler DS. Effect of a physical activity intervention and frailty on frailty trajectory and major mobility disability. J Am Geriatr Soc 2022; 70:2915-2924. [PMID: 35779276 DOI: 10.1111/jgs.17941] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Physical activity (PA) interventions may reduce the burden of frailty and can prevent mobility disability for older adults. We explored whether a 2-year PA intervention would improve frailty trajectory, lead to clinically meaningful frailty changes (CMC), or impact major mobility disability (MMD) across baseline frailty levels. METHODS We analyzed data for 1635 community-dwelling participants who were 70-89 years old (mean baseline age [SD]: 78.9 [5.2] years, 67.2% female) from the Lifestyle Interventions and Independence Study. Participants were randomized to either PA or health education (HE) intervention. A 44-item frailty index (FI) was constructed at baseline and 0.5, 1, 1.5, and 2 years after baseline. CMC was defined as change in FI of ≥0.03. MMD was the inability to complete a 400 m-walk within 15 min without assistance. Mixed-effects models were used to estimate frailty trajectory and CMC. Cox regression models were used to determine whether the effect of PA on the composite of MMD or death differed by baseline FI. RESULTS Mean FI (SD) at baseline for both the PA and HE groups was 0.18 (0.10). Two years after baseline, mean FIs were 0.23 (0.12) for PA and 0.24 (0.12) for HE. The MMD rates were 30.1% (246/818) and 35.5% (290/817) for PA and HE, respectively. There was no time-by-intervention interaction for frailty trajectory or for CMC. Regarding the composite MMD and death, there was no FI-by-intervention interaction. Simple association analyses revealed that when baseline FI was centered at 0.15 or higher, the PA intervention was associated with lower risk of MMD or death compared to HE (HR [CI] range for FI ≥ 0.15: 0.65-0.81 [0.43-0.67, 0.90-0.98]). CONCLUSION Participants in both groups showed similar frailty trajectories and CMC. Those who were frailer benefitted more from the PA intervention regarding MMD and death and may be a focus of recruitments for future PA program.
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Affiliation(s)
- Jack Quach
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada.,Geriatric Medicine, Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Olga Theou
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada.,Geriatric Medicine, Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Mario U Pérez-Zepeda
- Geriatric Medicine, Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Judith Godin
- Geriatric Medicine, Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Kenneth Rockwood
- Geriatric Medicine, Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Dustin S Kehler
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada.,Geriatric Medicine, Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada
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Yang F, Li N, Yang L, Chang J, Yan A, Wei W. Association of Pre-stroke Frailty With Prognosis of Elderly Patients With Acute Cerebral Infarction: A Cohort Study. Front Neurol 2022; 13:855532. [PMID: 35711265 PMCID: PMC9196308 DOI: 10.3389/fneur.2022.855532] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Frailty is a state of cumulative degradation of physiological functions that leads to adverse outcomes such as disability or mortality. Currently, there is still little understanding of the prognosis of pre-stroke frailty status with acute cerebral infarction in the elderly. Objective We investigated the association between pre-stroke frailty status, 28-day and 1-year survival outcomes, and functional recovery after acute cerebral infarction. Methods Clinical data were collected from 314 patients with acute cerebral infarction aged 65–99 years. A total of 261 patients completed follow-up in the survival cohort analysis and 215 patients in the functional recovery cohort analysis. Pre-stroke frailty status was assessed using the FRAIL score, the prognosis was assessed using the modified Rankin Scale (mRS), and disease severity using the National Institutes of Health Stroke Scale (NIHSS). Results Frailty was independently associated with 28-day mortality in the survival analysis cohort [hazard ratio (HR) = 4.30, 95% CI 1.35–13.67, p = 0.014]. However, frailty had no independent effect on 1-year mortality (HR = 1.47, 95% CI 0.78–2.79, p = 0.237), but it was independently associated with advanced age, the severity of cerebral infarction, and combined infection during hospitalization. Logistic regression analysis after adjusting for potential confounders in the functional recovery cohort revealed frailty, and the NIHSS score was significantly associated with post-stroke severe disability (mRS > 2) at 28 days [pre-frailty adjusted odds ratio (aOR): 8.86, 95% CI 3.07–25.58, p < 0.001; frailty aOR: 7.68, 95% CI 2.03–29.12, p = 0.002] or 1 year (pre-frailty aOR: 8.86, 95% CI 3.07–25.58, p < 0.001; frailty aOR: 7.68, 95% CI 2.03–29.12, p = 0.003). Conclusions Pre-stroke frailty is an independent risk factor for 28-day mortality and 28-day or 1-year severe disability. Age, the NIHSS score, and co-infection are likewise independent risk factors for 1-year mortality.
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Affiliation(s)
- Fuxia Yang
- Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Nan Li
- Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Lu Yang
- Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Jie Chang
- Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Aijuan Yan
- Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Wenshi Wei
- Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
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Assessment of Physical Fitness and Risk Factors for the Occurrence of the Frailty Syndrome among Social Welfare Homes' Residents over 60 Years of Age in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127449. [PMID: 35742694 PMCID: PMC9223572 DOI: 10.3390/ijerph19127449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 11/21/2022]
Abstract
The study aimed at assessing physical fitness and occurrence of the frailty syndrome among social welfare homes’ residents as well as defining factors which determine the level of frailty and its occurrence. The examination included 198 residents (115 females and 83 males of average age 75.5 ± 10.21) and was carried out with the use of the Short Physical Performance Battery (SPPB) test with the following cut-off points: 0−6—frail, 7−9—pre-frail, 10−12—non-frail. The research additionally collected data regarding age, gender, number of chronic diseases, education level, type of prior work and current physical activity. In addition, the height and weight of the respondents were measured. The frailty syndrome was found in more than a half of the examinees (104; 52.53%), the pre-frailty state in 30.30% (n = 60) and 17.17% (n = 34) were non-frail. The average result of the SPPB test was 6.52 ± 2.73, which proves a moderate limitation of the sample group’s fitness. No significant differences were noted between female and male respondents (p = 0.27). The multifactorial linear regression model showed that independent and direct frailty syndrome predicators included age, number of chronic diseases and regular physical activity (p < 0.05). In conclusion, promoting and encouraging regular, age and interest-related forms of physical activity among seniors might foster the maintenance of their physiological reservoir and functional efficiency.
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Young HML, Yates T, Dempsey PC, Herring LY, Henson J, Sargeant J, Curtis F, Sathanapally H, Highton PJ, Hadjiconstantinou M, Pritchard R, Lock S, Singh SJ, Davies MJ. Physical activity and sedentary behaviour interventions for people living with both frailty and multiple long-term conditions: a scoping review protocol. BMJ Open 2022; 12:e061104. [PMID: 35508347 PMCID: PMC9073409 DOI: 10.1136/bmjopen-2022-061104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The number of people living with multiple long-term conditions (MLTCs) is predicted to rise. Within this population, those also living with frailty are particularly vulnerable to poor outcomes, including decreased function. Increased physical activity, including exercise, has the potential to improve function in those living with both MLTCs and frailty but, to date, the focus has remained on older people and may not reflect outcomes for the growing number of younger people living with MLTCs and frailty. For those with higher burdens of frailty and MLTCs, physical activity may be challenging. Tailoring physical activity in response to symptoms and periods of ill-health, involving family and reducing sedentary behaviour may be important in this population. How the tailoring of interventions has been approached within existing studies is currently unclear. This scoping review aims to map the available evidence regarding these interventions in people living with both frailty and MLTCs. METHODS AND ANALYSIS We will use a six-stage process: (1) identifying the research questions; (2) identifying relevant studies (via database searches); (3) selecting studies; (4) charting the data; (5) collating and summarising and (6) stakeholder consultation. Studies will be critically appraised using the Mixed Methods Appraisal Tool. ETHICS AND DISSEMINATION All data in this project will be gathered through database searches. Stakeholder consultation will be undertaken with an established patient and public involvement group. We will disseminate our findings via social media, publication and engagement meetings.
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Affiliation(s)
- Hannah M L Young
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Paddy C Dempsey
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Louisa Y Herring
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Joseph Henson
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Jack Sargeant
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Ffion Curtis
- NIHR Applied Research Collaboration East Midlands, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Harini Sathanapally
- NIHR Applied Research Collaboration East Midlands, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Patrick J Highton
- NIHR Applied Research Collaboration East Midlands, University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Rebecca Pritchard
- NIHR Leicester BRC, University Hospitals of Leicester NHS Trust, Leicester, UK
- Medical School, University of Edinburgh, Edinburgh, UK
| | - Selina Lock
- Library Research Services, University of Leicester, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Centre for Exercise and Rehabilitation Science, Leicester Biomedical Research Unit, Leicester, UK
| | - Melanie J Davies
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
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Fritz H, Hu YL. Habit Formation Intervention to Reduce Frailty Risk Factors: A Feasibility Study. Am J Occup Ther 2022; 76:23276. [PMID: 35616653 DOI: 10.5014/ajot.2022.045948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Frailty is common, detrimental, and costly in later life. Interventions can reduce the risk for frailty. OBJECTIVE To assess the feasibility of a frailty prevention intervention. DESIGN A two-arm, prospective randomized controlled trial with blinded participant allocation and data collection at baseline and 1 wk postintervention by data collectors blinded to participant assignment. SETTING Community. PARTICIPANTS Thirty community-dwelling, English-speaking, older African-Americans who were classified as prefrail were randomly recruited from a university research subject registry. INTERVENTION The habit formation treatment was delivered face to face during 12 weekly home-based sessions approximately 45 min in length. OUTCOMES AND MEASURES We assessed feasibility as reflected in participant recruitment, retention, session attendance, and program satisfaction. Clinical outcomes included sedentary time and dietary quality (primary) as well as frailty status, physical activity, physical function, depression, quality of life, and anthropometry (secondary). Habit formation (mechanism of change) was assessed in the treatment group only. RESULTS Twenty women (M age = 73.5 yr) completed the study. The recruitment rate was 69.8%, and we retained 95.2% of participants through the end of the study, with session attendance rates of 98.1% and 88.6% for the treatment and control groups, respectively, and mean acceptability scores of 30.3 and 28.0 for the treatment and control groups, respectively. Changes in primary and secondary clinical outcomes were largely in the expected direction. CONCLUSIONS AND RELEVANCE The intervention was feasible to deliver. Although future efficacy studies are needed, our preliminary data suggest the potential of an occupational therapy intervention to reduce frailty risk. What This Article Adds: Although it may be possible to slow or prevent the progression to frailty by modifying existing habits and occupations, few occupational therapy interventions address frailty. Our data provide new and much-needed insights about the potential feasibility of an occupational therapy intervention to reduce frailty risk.
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Affiliation(s)
- Heather Fritz
- Heather Fritz, PhD, OTR/L, CHC, is Associate Professor and Founding Director, School of Occupational Therapy, Pacific Northwest University of Health Sciences, Yakima, WA;
| | - Yi-Ling Hu
- Yi-Ling Hu, PhD, OTR, is Assistant Professor, Department of Occupational Therapy, Chang Gung University, Taoyuan City, Taiwan
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Lyu W, Tanaka T, Son BK, Akishita M, Iijima K. Associations of multi-faceted factors and their combinations with frailty in Japanese community-dwelling older adults: Kashiwa Cohort Study. Arch Gerontol Geriatr 2022; 102:104734. [DOI: 10.1016/j.archger.2022.104734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/29/2022] [Accepted: 05/11/2022] [Indexed: 12/31/2022]
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Hu S, Jin C, Li S. Association between social capital and frailty and the mediating effect of health-promoting lifestyles in Chinese older adults: a cross-sectional study. BMC Geriatr 2022; 22:175. [PMID: 35236279 PMCID: PMC8889641 DOI: 10.1186/s12877-022-02815-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To explore the association between social capital and frailty and the mediating effect of health-promoting lifestyles among Chinese older adults, while providing scientific evidence for frailty intervention. METHODS In May 2021, a cross-sectional study was conducted among 674 Chinese older adults in Changsha city. Data was collected using the Chinese Shortened Social Capital Scale (comprising structural social capital and cognitive social capital as two subscales), a simplified version of the Health-Promoting Lifestyle Profile and the Tilburg Frailty Indicator. Linear regression analysis was used to examine the association between social capital and frailty. Structural equation modeling was used to test the mediating effect of health-promoting lifestyles. RESULTS Cognitive social capital was significantly negatively associated with frailty and its three dimensions (physical, psychological, and social frailty), but structural social capital was not. Health-promoting lifestyles played a mediating role in the associations of cognitive social capital with frailty, physical and psychological frailty, but not with social frailty. CONCLUSIONS Higher cognitive social capital was associated with a reduced likelihood of frailty. The health-promoting lifestyles partially mediated the association between cognitive social capital and frailty. The use of health-promoting lifestyles or appropriate cognitive social capital interventions may reduce frailty among older adults.
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Affiliation(s)
- Shan Hu
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Canhuan Jin
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Shaojie Li
- Department of Social Medicine and Health Service Management, Xiangya School of Public Health, Central South University, Changsha, 410078, China.
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Association between physical activity & sedentary time on frailty status in males and females living with diabetes mellitus: A cross-sectional analysis. Exp Gerontol 2022; 161:111741. [PMID: 35150826 DOI: 10.1016/j.exger.2022.111741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Physical activity (PA) is a cornerstone for the prevention and the treatment of diabetes mellitus (DM) and frailty. However, no consensus exists on which intensities and types of PA are associated with frailty status among individuals living with DM. To investigate the association between different intensities and types of PA on frailty status in males and females living with DM. METHODS A cross-sectional analysis of the 2003-2006 cycles from the National Health and Nutrition Examination Survey (NHANES) was performed in 711 participants living with DM. Frailty status was measured using the 43-item deficit model and DM was self-reported. Weekly PA levels were measured by accelerometer, while resistance training (RT) was measured via questionnaire. Linear and logistic regressions were performed to investigate the associations between different intensities and types of PA and frailty status. RESULTS Total time spent performing light PA was associated with a better frailty status in males (ß - 0.041 ± 0.012; p < 0.001) and females (ß - 0.070 ± 0.010; p < 0.0001), while total moderate-to-vigorous PA (MVPA) was associated with a better frailty status in females only (ß-0.235 ± 0.061; p < 0.05). However, once fully adjusted, the different intensities and types of PA were associated more with frailty status for female. When investigating whether different intensities and types of PA were associated with being considered frail, total time spent at MVPA and light PA were associated with higher odds along with total sedentary time for female (all p < 0.01). CONCLUSION Each minute engaged in PA was associated with a better frailty status in males and females living with DM, although RT does not appear associated with a better frailty status in adults with DM. Replacing sedentary time with PA is important, especially for females living with DM to have a better frailty status. These results are important as they provide insights into the prevention and the management of frailty in individuals living with DM.
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What Is the Relationship between Lifestyle and Frailty Status? Data from the Portuguese Multicentre Descriptive Study. NURSING REPORTS 2022; 12:39-49. [PMID: 35225891 PMCID: PMC8883975 DOI: 10.3390/nursrep12010005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 12/02/2022] Open
Abstract
This observational and descriptive study attempted, within the scope of the ModulEn Research Project, to determine associations between lifestyle-related variables and frailty involving 160 community-dwelling older adults aged between 65 and 80 years living in the Central Region of Portugal. Forty-three percent of the study participants were pre-frail and 18% were frail. More than 50% of the frail people had slight cognitive decline, and the frailty condition was more frequently observed in women. As the literature highlights, there is potential for greater reversibility in the pre-frailty condition. To contribute to this reversibility, it is necessary to resort to interventions that promote physical activity and cognitive stimulation, apply adequate eating habits, and/or encourage the adoption of an active and socially integrated lifestyle. A healthy lifestyle implies good sleep and eating habits, and correct metabolic control that allows for effective surveillance of dyslipidemia, diabetes, and blood pressure.
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Saadeh M, Calderón-Larrañaga A, Vetrano DL, von Rosen P, Fratiglioni L, Welmer AK. Associations of pre-pandemic levels of physical function and physical activity with COVID-19-like symptoms during the outbreak. Aging Clin Exp Res 2022; 34:235-247. [PMID: 34716912 PMCID: PMC8556821 DOI: 10.1007/s40520-021-02006-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/15/2021] [Indexed: 01/14/2023]
Abstract
Background One’s physical function and physical activity levels can predispose or protect from the development of respiratory infections. We aimed to explore the associations between pre-pandemic levels of physical function and physical activity and the development of COVID-19-like symptoms in Swedish older adults. Methods We analyzed data from 904 individuals aged ≥ 68 years from the population-based Swedish National study on Aging and Care in Kungsholmen. COVID-19-like symptoms were assessed by phone interview (March–June 2020) and included fever, cough, sore throat and/or a cold, headache, pain in muscles, legs and joints, loss of taste and/or odor, breathing difficulties, chest pain, gastrointestinal symptoms, and eye inflammation. Muscle strength, mobility, and physical activity were examined in 2016–2018 by objective testing. Data were analyzed using logistic regression models in the total sample and stratifying by age. Results During the first outbreak of the pandemic, 325 (36%) individuals from our sample developed COVID-19-like symptoms. Those with slower performance in the chair stand test had an odds ratio (OR) of 1.5 (95% confidence interval [CI] 1.1–2.1) for presenting with COVID-19-like symptoms compared to better performers, after adjusting for potential confounders. The association was even higher among people aged ≥ 80 years (OR 2.6; 95% CI 1.5–4.7). No significant associations were found between walking speed or engagement in moderate-to-vigorous physical activity and the likelihood to develop COVID-19-like symptoms. Conclusion Poor muscle strength, a possible indicator of frailty, may predispose older adults to higher odds of developing COVID-19-like symptoms, especially among the oldest-old.
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Affiliation(s)
- Marguerita Saadeh
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden.
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
- Centro di Medicina dell'Invecchiamento, 11 IRCCS Fondazione Policlinico "A. Gemelli" and Catholic University of Rome, Rome, Italy
| | - Philip von Rosen
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
- Centro di Medicina dell'Invecchiamento, 11 IRCCS Fondazione Policlinico "A. Gemelli" and Catholic University of Rome, Rome, Italy
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
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44
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Mediterranean Diet and Physical Activity for Successful Aging: An Update for Nutritionists and Endocrinologists. ENDOCRINES 2021. [DOI: 10.3390/endocrines2040034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The constant advancement in the medical field has allowed for the diagnosis and treatment of several health conditions. It has also contributed to increasing the average human lifespan, which is considered an outstanding achievement in history. Nevertheless, the impact of this in an ever-increasing aged population with chronic diseases and, most of the time, with limited and poor quality of life was not considered. Thus, it is imperative to establish strategies to age successfully. In order to do have a better understanding of this crucial issue, this review will analyze the endocrine changes in the elderly. It will present common conditions found in this population, chronic inflammation, and oxidative stress. Additionally, we will explain aging-related metabolic and physical performance decline related to hormone changes and lifestyle modifications. We will propose the Mediterranean diet and some specific guidelines about physical activity as part of the plan to have an active and successful aging process.
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Tolley APL, Ramsey KA, Rojer AGM, Reijnierse EM, Maier AB. Objectively measured physical activity is associated with frailty in community-dwelling older adults: A systematic review. J Clin Epidemiol 2021; 137:218-230. [PMID: 33915264 DOI: 10.1016/j.jclinepi.2021.04.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/10/2021] [Accepted: 04/20/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The later-age shift towards physical inactivity and sedentary behaviour is associated with comorbidity and reduced function: markers of frailty. Whether these behaviours relate to frailty has yet to be thoroughly studied using objective measurements. This study aimed to summarise the associations of objectively measured habitual physical activity and sedentary behaviour with frailty in community-dwelling older adults. STUDY DESIGN AND SETTING Six databases were searched from inception to July 21st 2020. Articles analyzing objectively measured physical activity and/or sedentary behaviour with frailty in community-dwelling adults ≥60 years old were included. Synthesis of included articles was performed using effect direction heat maps and albatross plots. RESULTS The search identified 23 articles across 18 cohorts, including 7,696 total participants with a mean age of 69.3±8.1 years, and 56.9% female. All but one article were cross-sectional. Lower moderate-to-vigorous and total physical activity, steps, postural transitions, and energy expenditure were associated with frailty. The use of multifactorial or physical frailty definitions did not alter associations. Median effect sizes for the associations of all physical activity and sedentary behaviour measures with frailty were β = -0.272 [-0.381, -0.107] and β = 0.100 [0.001, 0.249], respectively. CONCLUSION Objective measures of physical activity are associated with frailty, regardless of frailty definition.
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Affiliation(s)
- Alec P L Tolley
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Keenan A Ramsey
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anna G M Rojer
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
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46
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Elam C, Aagaard P, Slinde F, Svantesson U, Hulthén L, Magnusson PS, Bunketorp-Käll L. The effects of ageing on functional capacity and stretch-shortening cycle muscle power. J Phys Ther Sci 2021; 33:250-260. [PMID: 33814713 PMCID: PMC8012187 DOI: 10.1589/jpts.33.250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022] Open
Abstract
[Purpose] To examine the effects of age and gender in an ageing population with respect
to functional decline and the relationship between muscle power and functional capacity.
[Participants and Methods] The cohort (N=154) was subdivided into youngest-old
(65–70 years.; n=62), middle-old (71–75 years.; n=46), and oldest-old (76–81 years.;
n=46). Measures of mechanical muscle function included countermovement jump height, muscle
power, leg strength and grip strength. Functional performance-based measures included
heel-rise, postural balance, Timed Up and Go, and gait speed. [Results] The oldest-old
performed significantly worse than the middle-old, whereas the youngest-old did not
outperform the middle-old to the same extent. Increased contribution of muscle power was
observed with increasing age. Males had consistently higher scores in measures of
mechanical muscle function, whereas no gender differences were observed for functional
capacity. [Conclusion] The age-related decline in functional capacity appears to
accelerate when approaching 80 years of age and lower limb muscle power seems to
contribute to a greater extent to the preservation of functional balance and gait capacity
at that stage. Males outperform females in measures of mechanical muscle function
independent of age, while the findings give no support for the existence of gender
differences in functional capacity.
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Affiliation(s)
- Cecilia Elam
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg: Gothenburg, Sweden
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Frode Slinde
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Sweden
| | - Ulla Svantesson
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg: Gothenburg, Sweden
| | - Lena Hulthén
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Peter S Magnusson
- Department of Physical Therapy, Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Denmark.,Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Lina Bunketorp-Käll
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg: Gothenburg, Sweden
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47
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Yin Z, Li S, Land WM, Ullevig SL, Juarez F, Hernández AE, Ortega C, Patel NK, Simmonds MJ. Higher levels of physical activity buffered the negative effect of pain severity on physical frailty in older Latinx adults. Geriatr Nurs 2021; 42:460-466. [PMID: 33714025 DOI: 10.1016/j.gerinurse.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/22/2022]
Abstract
This cross-sectional study examined whether and to what extent physical activity (PA) mediated the effect of chronic pain on physical frailty in a sample of predominantly older Latinx adults. Study participants were 118 community-dwelling older adults in southwest United States. Physical frailty was measured by a summary score of physical function tests. Pain severity and pain interference were measured by the Brief Pain Inventory. PA levels were defined as meeting the PA recommendation by 7-day accelerometry. Pain outcomes and PA were associated with physical frailty, respectively. Hierarchical regression analysis revealed that PA mediated the relationship between pain severity and physical frailty. However, no mediation effect of PA was found in the relationship between pain interference and physical frailty scores. Higher levels of PA buffered the negative effect of pain severity on physical frailty. Future studies should pay attention to PA promotion to prevent the negative consequences of frailty in older minority adults.
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Affiliation(s)
- Zenong Yin
- Department of Public Health, The University of Texas at San Antonio, United States.
| | - Shiyu Li
- School of Nursing, UT Health San Antonio, United States
| | - William M Land
- Department of Kinesiology, The University of Texas at San Antonio, United States
| | - Sarah L Ullevig
- College for Health, Community and Policy, The University of Texas at San Antonio, United States
| | - Fernando Juarez
- Department of Public Health, The University of Texas at San Antonio, United States
| | - Arthur E Hernández
- Dreeben School of Education, University of the Incarnate Word, United States
| | - Catherine Ortega
- Department of Public Health, The University of Texas at San Antonio, United States
| | - Neela K Patel
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, United States
| | - Maureen J Simmonds
- Department of Public Health, The University of Texas at San Antonio, United States
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48
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Lefferts EC, Bakker EA, Carbone S, Lavie CJ, Lee DC. Associations of total and aerobic steps with the prevalence and incidence of frailty in older adults with hypertension. Prog Cardiovasc Dis 2021; 67:18-25. [PMID: 33640357 DOI: 10.1016/j.pcad.2021.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To examine the associations of total steps/day and faster aerobic steps/day (≥60 steps/min) with the development of frailty in older adults with hypertension (HTN) using a two-phased cross-sectional and prospective approach. METHODS The sample consisted of 427 older adults with HTN from the Physical Activity and Aging Study (PAAS), aged ≥65 years, with valid step data from an accelerometer-based pedometer. Participants were classified into tertiles of total steps/day (low, mid, high) and three categories of aerobic steps/day (none, low, high). Frailty was defined using a modified Fried score with 5 subdomains including shrinking, weakness, slowness, low physical activity (PA), and exhaustion. RESULTS We observed a negative dose-response relationship across categories of total steps/day and aerobic steps/day for the prevalence of frailty and the subdomains of slowness, low PA, and exhaustion (all p for trends <0.05). Greater aerobic steps/day, but not total steps/day, was associated with lower incidence of developing frailty in the 241 participants with a follow-up examination who had no frailty at baseline. CONCLUSION Higher aerobic steps/day were more strongly associated with the lower prevalence and incidence of frailty compared to total steps/day, suggesting that faster aerobic walking may potentially provide greater benefits regarding frailty in older adults with HTN.
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Affiliation(s)
- Elizabeth C Lefferts
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, United States
| | - Esmée A Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Salvatore Carbone
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, United States
| | - Carl J Lavie
- Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Duck-Chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, United States.
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49
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Chang SH, Chien NH, Pui-Man Wai J, Chiang CC, Yu CY. Examining the links between regular leisure-time physical activity, sitting time and prefrailty in community-dwelling older adults. J Adv Nurs 2021; 77:2761-2773. [PMID: 33619783 DOI: 10.1111/jan.14807] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/28/2020] [Accepted: 02/02/2021] [Indexed: 12/25/2022]
Abstract
AIMS To examine the relationship between leisure-time physical activity, sitting time and prefrailty in community-dwelling older adults. DESIGN Cross-sectional study. METHODS Between February and July 2019, 539 individuals over age 60 were recruited in northern Taiwan. Demographic, medical history, physical activity and frailty data were analysed using descriptive statistics, chi-square tests and logistic regression. RESULTS The prevalence of prefrailty was 24.4%; 33.2% had regular leisure-time physical activity, and 14.7% reported >6 hrs daily sitting time. Compared with individuals having regular leisure-time physical activity and shorter sitting times (daily average ≤6 hrs), those having no regular leisure-time physical activity and also shorter sitting times (adjusted OR, 1.80; 95% CI, 1.12, 2.92), or those also having regular leisure-time physical activity but longer sitting times (adjusted OR, 4.42; 95% CI, 2.22, 8.79) had an increased prefrailty risk. CONCLUSIONS Having no regular leisure-time physical activity or longer sitting times is associated with a higher risk of prefrailty. For sedentary older adults to prevent prefrailty, they can become more active, sit less or better yet, commit to both.
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Affiliation(s)
- Shu-Hung Chang
- Graduate Institute of Gerontology and Health Care Management, Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Department of Gastroenterology and Hepatology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Nai-Hui Chien
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Jackson Pui-Man Wai
- Graduate Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Ching-Cheng Chiang
- Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ching-Yi Yu
- Department of Social Service, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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50
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Netz Y, Ben-Zaken S, Zeev A, Dunsky A. Correlates of Early-Stage Frailty-Sleep, Fitness, Oxidative Stress, and BMI. Front Med (Lausanne) 2021; 7:594710. [PMID: 33521015 PMCID: PMC7838330 DOI: 10.3389/fmed.2020.594710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
Frailty reflects a decreased reserve in multiple systems resulting from cumulative decline. Frailty markers should be identified as early as possible to attenuate the loss of reserve. The aim of this study was to identify potentially modifiable correlates of frailty in relatively healthy older adults. Volunteers (n = 122) were recruited from local councils and, based on gender and age, were divided into one group of men aged 77.0 (±5.3), and two groups of women, aged 68.8 (±3.6) and aged 78.4 (±3.4). Frailty was assessed by a Frailty Index. The examined correlates were: physical activity, physical fitness (predicted peak VO2), sleep quality, oxidative stress (hydrogen peroxide-H2O2) and depression. Both groups of women had poor scores on physical fitness compared to women's norms. In order to examine the contribution of each of the potential correlates to explaining the variance of frailty, stepwise regressions were performed for each group separately. Based on the results, none of the suggested correlates significantly explained the variability of frailty in the men. In the younger-aged women, predicted peak VO2 and sleep quality explained 22.4% of the variability of frailty. In the older women, Body Mass Index (BMI), oxidative stress and sleep quality explained 34.9% of the variance. It is possible that increased aerobic fitness and interventions for improving sleep quality in older, seemingly healthy women will slow down the frailty process. Further research is needed to assess potential correlates of frailty, and to initiate suitable interventions to mitigate the signs of frailty at an early stage.
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Affiliation(s)
- Yael Netz
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Sigal Ben-Zaken
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Aviva Zeev
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Ayelet Dunsky
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
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