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Haapanen MJ, Kananen L, Mikkola TM, Jylhävä J, Wasenius NS, Eriksson JG, von Bonsdorff MB. Frailty in Midlife as a Predictor of Changes in Body Composition from Midlife into Old Age: A Longitudinal Birth Cohort Study. Gerontology 2024; 70:831-841. [PMID: 38718772 PMCID: PMC11309068 DOI: 10.1159/000539204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/12/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Few studies have investigated the association between frailty and subsequent body composition. METHODS We performed separate linear mixed model analyses to study the associations between changes in the participant frailty status assessed by a frailty index (FI) and subsequent body mass index (BMI), lean mass index (LMI), fat mass index (FMI), and FMI to LMI ratio values assessed on three occasions over 17 years. The analyses were carried out among 996 participants spanning from age 57 to 84 years. RESULTS With advancing age, LMI and BMI decreased, whereas FMI and FMI to LMI ratio increased. Participants with "stable frailty," followed by those with "increasing frailty" experienced faster decreases in LMI and faster increases in FMI and FMI to LMI ratio values from midlife into old age relative to those in the group "stable not frail." Contrastingly, those in the highest third of absolute annual increase in FMI and FMI to LMI ratio became more frail faster from midlife into old age relative to those in the lowest third. CONCLUSIONS We found evidence of an adverse health outcome of frailty where lean indices declined faster and fat indices and fat-to-lean ratios increased faster from midlife into old age. The changes resembled those that occurred with aging, but at a faster pace. The relationship between body composition and frailty is likely bidirectional, where high or increasing levels of fat are associated with the risk of becoming more frail earlier, but where a longer duration of frailty may increase the risk of faster age-related changes to body composition.
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Affiliation(s)
- Markus J. Haapanen
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Laura Kananen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Faculty of Medicine and Health Technology, and Gerontology Research Center, Tampere University, Tampere, Finland
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Tuija M. Mikkola
- Folkhälsan Research Center, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Juulia Jylhävä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Niko S. Wasenius
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Johan G. Eriksson
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Yong Loo Lin School of Medicine, Department of Obstetrics and Gynecology and Human Potential Translational Research Programme, National University Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Mikaela B. von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Chehrehgosha M, Sharifi A, Meftah AM, Maleki H, Sajjadi-Jazi SM, Baharifar H, Khoshnevisan K, Sharifi F. Demographic and biological factors in interrelationships between physical, cognitive, psychological, and social frailty in community-dwelling older adults: Data from the Birjand Longitudinal Aging Study (BLAS). Maturitas 2024; 181:107905. [PMID: 38237276 DOI: 10.1016/j.maturitas.2023.107905] [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: 07/07/2023] [Revised: 12/23/2023] [Accepted: 12/30/2023] [Indexed: 02/05/2024]
Abstract
Complex interrelationships may exist among different types of frailty. This study aimed to evaluate the demographic and biological factors that influence the different types of frailty in community-dwelling older adults in Iran through a cross-sectional analysis of data obtained from the Birjand Longitudinal Aging Study. This study is an ongoing cohort study of people aged 60 years and over and employed a multistage stratified cluster random sampling. Anthropometric measures were obtained by nurses. The "Fried frailty phenotype" was defined as physical frailty. Cognitive frailty was assessed using the Mini-Mental State Examination. Social frailty was evaluated by some questions, and psychological frailty was assessed using a patient health questionnaire. Blood samples were taken after overnight fasting. All statistical analyses were performed using Stata12 (Texas, USA) and Python. Some type of frailty had been experienced by 62.27 % of the older adults. Cognitive frailty was the dominant type of frailty (55.69 %). Based on multivariate regression analysis, age, sex, education, and marital status were the influencing factors in all types of frailty. Network analysis revealed that physical, cognitive, psychological, and social frailty had synergistic effects on each other, and age and sex had dominant interactions with frailty types. Cognitive frailty was dominant compared with other types of frailty, indicating the need to detect cognitive frailty at the earliest stage and to implement an appropriate program to manage cognitive frailty in older adults.
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Affiliation(s)
- Maryam Chehrehgosha
- Department of Surgical Technology, Paramedical School, Golestan University of Medical Sciences, Gorgan 4934174515, Iran; Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran 1411713137, Iran
| | - Ali Sharifi
- Master of Artificial Intelligence, Faculty of Electronic and Computer Engineering, Tarbiat Modarres University, Tehran, Iran
| | | | - Hassan Maleki
- Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sayed Mahmoud Sajjadi-Jazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran 1411713137, Iran
| | - Hadi Baharifar
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Kamyar Khoshnevisan
- Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran 1411713137, Iran.
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Hart A, Cordova-Rivera L, Barker F, Sayer AA, Granic A, Yarnall AJ. The prevalence of sarcopenia in Parkinson's disease and related disorders- a systematic review. Neurol Sci 2023; 44:4205-4217. [PMID: 37594550 PMCID: PMC10641055 DOI: 10.1007/s10072-023-07007-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND The prevalence of sarcopenia (reduced skeletal muscle strength and mass), Parkinson's disease (PD) and Parkinson's related disorders (PRD) all increase with age. They also share risk factors and pathogenetic features. An increased prevalence of sarcopenia in PD and PRD than the general population was thus postulated. METHODS Four databases were searched using predefined literature search strategies. Studies conducted in participants with PD or PRD reporting the prevalence of sarcopenia and those providing data to compute the prevalence were included. Pre-sarcopenia, probable/possible sarcopenia and confirmed sarcopenia were defined according to the main sarcopenia working groups. Risk of bias was assessed using the AXIS tool. RESULTS 1978 studies were identified; 97 assessed in full; 14 met inclusion criteria. The median study quality score was 15/20. The range of probable sarcopenia was 23.9 to 66.7%, and it did not change after excluding PRD participants. The prevalence of confirmed sarcopenia in participants with any parkinsonian disorder ranged from 2 to 31.4%. Including just PD participants, the range was 10.9 to 31.4%. In studies with controls, sarcopenia was more prevalent in PD and PRD. There was a positive non-significant trend between severity of motor symptoms and prevalence of sarcopenia or components of sarcopenia. High heterogeneity precluded meta-analysis, therefore there was insufficient evidence to conclude whether sarcopenia is more prevalent in PD or PRD. CONCLUSIONS Probable and confirmed sarcopenia are common in PD and PRD and they may be associated with disease severity. This co-occurrence supports the value of screening for sarcopenia in parkinsonian populations.
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Affiliation(s)
- Ashley Hart
- Brain and Movement Research Group, Campus for Ageing and Vitality, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Laura Cordova-Rivera
- Brain and Movement Research Group, Campus for Ageing and Vitality, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
- School of Health and Life Sciences, Centre for Rehabilitation, Teesside University, Middlesbrough, UK
| | - Fred Barker
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne, UK
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Avan A Sayer
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Antoneta Granic
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne, UK
| | - Alison J Yarnall
- Brain and Movement Research Group, Campus for Ageing and Vitality, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
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Huang WC, Huang YC, Lee MS, Doong JY, Pan WH, Chang HY. The Combined Effects of Dietary Diversity and Frailty on Mortality in Older Taiwanese People. Nutrients 2022; 14:nu14183825. [PMID: 36145199 PMCID: PMC9502423 DOI: 10.3390/nu14183825] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess the prospective association between frailty and dietary diversity on mortality. METHOD This prospective cohort study used the 2005-2008 Nutrition and Health Survey in Taiwan (N = 330; age ≥ 65 years) and this was linked to the Death Registry where we used the data that was recorded up to 31 January 2020. Dietary intake information was assessed using a 24-h dietary recall and food-frequency questionnaire, which were calculated a dietary diversity score (DDS; range, 0-6) and food consumption frequency. Assessment of frailty phenotypes was based on FRAIL scale which was proposed by the International Academy on Nutrition and Aging. RESULTS Frail older adults had a higher risk of all-cause mortality when they were compared to those with robust physiologies (hazard ratio [HR]: 3.73, 95% confidence interval [CI]: 2.13-6.52). Frailty and a lower DDS were associated with a higher risk of mortality (joint adjusted HR: 2.30, 95% CI: 1.11-4.75) which, compared with a robust physiology and higher DDS, were associated with a lower risk of mortality. CONCLUSIONS Frailty and a lower DDS were associated with a higher mortality. Prefrailty and frailty with a higher DDS were associated with a lower risk of mortality when compared with those with prefrailty and frailty and a lower DDS. These results suggest that eating a wide variety of foods might reduce the risk of mortality in older adults with prefrailty and frailty.
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Affiliation(s)
- Wei-Ching Huang
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114201, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan
| | - Yi-Chen Huang
- Department of Nutrition, China Medical University, Taichung 406040, Taiwan
| | - Meei-Shyuan Lee
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114201, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 114201, Taiwan
| | - Jia-Yau Doong
- Department of Nutritional Science, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Wen-Harn Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei 11529, Taiwan
| | - Hsing-Yi Chang
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114201, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan
- Correspondence: ; Tel.: +886-037-206-166 (ext. 36333)
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Kołodziej M, Sebastjan A, Ignasiak Z. Appendicular skeletal muscle mass and quality estimated by bioelectrical impedance analysis in the assessment of frailty syndrome risk in older individuals. Aging Clin Exp Res 2021; 34:2081-2088. [PMID: 34118025 PMCID: PMC9464172 DOI: 10.1007/s40520-021-01879-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM The rising aging index of many populations necessitates the continuous evolution of geriatric assessment methods, especially the ones used to identify frailty and the risk of frailty. An appropriately early diagnosis of adverse changes in skeletal muscles can reduce the risk of functional limitations in elderly persons. The aim of this study was to assess the correlation between the appendicular skeletal muscle mass and quality, estimated by the bioelectrical impedance analysis method, and the risk of prevalence of the pre-frailty state in elderly persons. METHODS One-thousand-and-fifteen subjectively healthy persons aged 60-87 years were tested. Anthropometric measurements and physical fitness and activity measurements were carried out and the frailty phenotype was evaluated. Appendicular skeletal muscle mass was estimated using the bioelectrical impedance analysis method. Muscle quality was assessed through an index correcting strength relative to muscle mass and through the impedance phase angle. The correlation between the muscle mass and quality estimating parameters and the probability of identifying pre-frailty was checked using multiple logistic regression. RESULTS The prevalence of pre-frailty was 38%. The pre-frail persons were found to have a significantly lower muscle mass and quality than the non-frail persons, with the difference in the case of the muscle quality index nearly twice larger than for the muscle mass index. A significant logit model was obtained for pre-frailty prevalence, which was strongly dependent on the appendicular skeletal muscle mass (adjusted odds ratio (OR): 0.43, 95% CI 0.36-0.52, p < 0.001) and functional quality (adjusted OR: 0.26, 95% CI 0.18-0.38, p < 0.001) and less on age (adjusted OR: 1.10, 95% CI 1.07-1.13, p < 0.001). CONCLUSION The strong correlation between the frailty phenotype and appendicular skeletal muscle mass and functional quality suggests that the two variables should be included in routine geriatric assessment with regard to frailty.
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Affiliation(s)
- Małgorzata Kołodziej
- Department of Biostructure, University School of Physical Education in Wroclaw, Al. I. J. Paderewskiego 35, 51-612, Wroclaw, Poland
| | - Anna Sebastjan
- Department of Biostructure, University School of Physical Education in Wroclaw, Al. I. J. Paderewskiego 35, 51-612, Wroclaw, Poland.
| | - Zofia Ignasiak
- Department of Biostructure, University School of Physical Education in Wroclaw, Al. I. J. Paderewskiego 35, 51-612, Wroclaw, Poland
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