Frailty affects employment outcomes in patients with schizophrenia in noncompetitive employment: A 4-year longitudinal study

Shared genetic architecture and causal relationship between frailty and schizophrenia

The complex relationship between frailty and schizophrenia has yet to be fully understood. This study aims to clarify their relationship by investigating their genetic links. We hypothesize a shared genetic architecture and a bidirectional causal relationship between the two conditions. Utilizing summary genetic data from European genome-wide association studies, we analyzed genetic associations through global and local correlations, shared genomic loci, tissue enrichments, and functional genes. Bidirectional Mendelian Randomization (MR) was employed to infer causality. Our findings show a positive genetic correlation between frailty and schizophrenia (LDSC: rg = 0.117, p = 6.686 × 10-7; HDL: rg = 0.101, p = 5.63 × 10-13) and local correlations in three genomic regions (chr9: 94167203-96671698, p = 2.21 × 10-6; chr11: 112459488-114257728, p = 1.01 × 10-5; and chr18: 77149991-78017158, p = 9.57 × 10-6). We identified 111 genomic loci associated with both conditions and demonstrated that genetic variants for frailty and schizophrenia share tissue enrichments and functional genes in brain. MR analysis suggests that frailty increases the likelihood of schizophrenia (OR: 1.763, 95% CI: 1.259-2.468, p = 0.001) and vice versa (β: 0.012, 95% CI: 0.006-0.018, p < 0.001). Our research supports the presence of a shared genetic basis and bidirectional causality between frailty and schizophrenia. These findings necessitate further investigation in diverse populations to confirm and expand on this genetic understanding.

Frailty and severe mental illness: A systematic review and narrative synthesis

OBJECTIVE

Emerging evidence suggests that people with severe mental illness (SMI) have an increased risk of frailty. We conducted a systematic review to investigate the prevalence and correlates of frailty, as well as the efficacy of frailty interventions, in this population.

METHODS

We searched databases from inception to 21 September 2021 for studies that assessed or intervened for frailty in relation to an SMI diagnosis. A narrative synthesis explored the characteristics and adverse health outcomes associated with frailty and the efficacy of interventions. The prevalence of frailty was investigated, and its relationship with age was analysed by a meta-regression.

RESULTS

Twenty-five studies involving 2499 patients, primarily older adults, were included in the narrative synthesis. Frailty was associated with higher rates of physical comorbidity, cognitive deficits, falls and mortality among those with SMI. The efficacy of a yoga intervention was investigated in one study, without sustained reductions in frailty. The prevalence of frailty varied between 10.2 and 89.7% and was high in comparison to the general population.

CONCLUSIONS

The prevalence of frailty was high in those with SMI and ranged widely due to heterogeneity of study populations. Assessing frailty enables the identification of patients who could benefit from interventions and assists in treatment-related decision making. Further research is required to develop appropriate frailty interventions for this population.

Labor Participation of Retirement-Aged Workers: Understanding the Influencing Mechanism of Health Status and Social Pension Insurance Participation

BACKGROUND

Delayed retirement initiative is taken as one of the proposed solutions to population aging. Rare research attention has been paid to determinants in decisions-making of late retirement.

METHOD

This study applies data from CHARLS survey (2018) that traces the health status among older adults in China, and implements the stepwise multiple regression analysis adjusted with robust standard errors on individual level.

RESULTS

The difficulty in instrumental activities of daily living (IADLs) and chronic conditions could increase the intention of retirement-aged workers to withdraw from late career participation; and the overlay of both would interact to reinforce such intention. Besides, the employment-related social pension participation could further strengthen the jointly contributing effect of both on withdrawal from late career participation.

CONCLUSION

The triple interaction mechanism in retirement-aged workers' decisions of late retirement needs considering in the policy formulation of delayed retirement initiative.

Frailty among inpatients with Schizophrenia: Status, influencing factors, and their correlation with quality of life

OBJECTIVE

This study aimed to understand frailty and its influencing factors in inpatients with Schizophrenia in Chengdu and to explore correlations between frailty and quality of life.

METHODS

From May to July 2022, inpatients with Schizophrenia were surveyed using a general information questionnaire, frailty phenotype (FP) scoring, the Self-Rating Depression Scale (SDS), the Mini-Mental State Examination (MMSE), and the SZ Quality of Life Scale (SQLS). Multivariate logistic regression was conducted to assess factors influencing frailty and multivariate linear regression was conducted to assess the factors influencing quality of life.

RESULTS

A total of 556 hospitalized patients with Schizophrenia were included and divided into three groups according to the degree of frailty, of which 153 cases (27.5%) were without frailty, 348 cases (62.6%) were in early frailty, and 55 cases (9.9%) were in frailty. Univariate analysis of age, history of falls during hospitalization, polypharmacy, compulsory treatment during hospitalization, self-reported health status, activity level, cognitive impairment, depressive symptoms, "psychology and society," "motivation and energy" and "symptoms and side-effects" showed statistically significant differences between the groups. Multinomial logistic regression showed that age, BMI, self-reported health, activity, cognitive impairment, motivation and energy, and symptoms and side-effects were influencing factors for frailty in hospitalized patients with Schizophrenia. Correlation analysis shows that frailty score positively correlated with SQLS score.

CONCLUSION

We found that frailty was prevalent and that frailty was positively correlated with SQLS scores in inpatients with Schizophrenia. To effectively manage the frailty of hospitalized patients with Schizophrenia, medical staff should pay attention to its influencing factors and quality of life.