1
|
Wang L, Wang Y, Luo Y, Li Y, Li J. The mediating and moderating effect of health-promoting lifestyle on frailty and depressive symptoms for Chinese community-dwelling older adults: A cross-sectional study. J Affect Disord 2024; 361:91-96. [PMID: 38857627 DOI: 10.1016/j.jad.2024.06.011] [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: 02/06/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND This study aims to explore the mediating and moderating effect of health-promoting lifestyles on the relationship between frailty and depressive symptoms to provide a practical reference for effectively promoting the mental health of older adults. METHODS A cross-sectional survey of community-dwelling older adults (n = 3107) was conducted in three cities of Ningxia Province, China. Depressive symptoms, frailty, and health-promoting lifestyles were assessed through the 30-item Geriatric Depression Scale, frailty scale, and health-promoting Lifestyle profile-II, respectively. The Bootstrap methods PROCESS program is employed to test the mediation and moderation model. RESULTS The findings indicated that health-promoting lifestyles are negatively related to depressive symptoms and frailty, while frailty is positively associated with depressive symptoms. Health-promoting lifestyles have mediated the relationship between frailty and depressive symptoms. Besides, the health-promoting lifestyles weakened the positive relationship between frailty and depression symptoms; there existed a moderating effect of health-promoting lifestyles on the relationship between frailty and depression symptoms among older adults. LIMITATIONS Given the cross-sectional study, it is impossible to make causal inferences. CONCLUSIONS A health-promoting lifestyle might be a protective factor for older adults' health in China. The mediating and moderating effect of a health-promoting lifestyle on the relationship between frailty and depression symptoms among older adults should be integrated to achieve maximum utility. Healthcare practitioners and medical service personnel are recommended to advance health education and publicity, encouraging healthy lifestyles among community-dwelling older adults with frailty to prevent depressive symptoms and promote healthy aging.
Collapse
Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan 750004, China
| | - Yali Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan 750004, China
| | - Yiling Luo
- Department of Health Management Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, China
| | - Yan Li
- The Center for Disease Control and Prevention of Yinchuan City, Yinchuan 750011, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan 750004, China.
| |
Collapse
|
2
|
Biçak Ayik D, Cengiz Z, Isik K. The effect of frailty levels of older individuals on their mental well-being and depression levels. Psychogeriatrics 2024; 24:637-644. [PMID: 38467447 DOI: 10.1111/psyg.13110] [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: 09/22/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Frailty has become an important public health issue. This study was conducted to determine the effect of frailty levels of older individuals on their mental well-being and depression levels. METHODS This descriptive cross-sectional study was conducted with a total of 325 older individuals aged 60 years and over. A demographic questionnaire form, the FRAIL Frailty Scale, the Warwick-Edinburgh Mental Well-Being Scale, and the Geriatric Depression Scale-Short Form were used to collect data. Data were evaluated using the SPSS 25.0 package program. Number, percentage, mean, standard deviation, Chi-square, correlation, and multiple regression analyses were used. RESULTS The mean age of the older individuals was 69.56 ± 7.75 years, and the variables of age, education level, income status, the person they were living with, regular medication use, forgetting to take medication, urinary incontinence, hospitalisation, and accidents were found to affect both frailty and depression (P < 0.05). There was a positive correlation between frailty and depression (r: 0.460, P < 0.001) and a negative correlation between mental frailty and well-being (r: -0.391, P < 0.001). Socio-demographic variables, depression, and mental well-being had a 40% effect on frailty (P < 0.001). CONCLUSION Depression status and mental well-being level are related to frailty, so negativity in one of them negatively affects the other. In line with these results, it is recommended to determine the level of depression and mental well-being of older individuals with high risk of frailty, and according to the results of the research, to provide care and support regarding the predictors affecting frailty.
Collapse
Affiliation(s)
- Derya Biçak Ayik
- Faculty of Health Sciences, Department of Internal Medicine Nursing, Mardin Artuklu University, Mardin, Turkey
| | - Zeliha Cengiz
- Faculty of Nursing, Department of Fundamentals Nursing, Inönü University, Malatya, Turkey
| | - Kevser Isik
- Faculty of Health Science, Department of Public Health Nursing, Gaziantep University, Gaziantep, Turkey
| |
Collapse
|
3
|
Yuan C, Zhang Y. Modifiable risk factors of cognitive frailty in community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Knowl 2024; 35:177-185. [PMID: 37378541 DOI: 10.1111/2047-3095.12437] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To perform a meta-analysis identifying the modifiable risk factors of cognitive frailty in the elderly. METHODS We systematically searched databases including PubMed, EMBASE, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform from January 01, 2017 to March 26, 2022. Quantitative, original research reporting associated factors were included. FINDINGS 7,854 records in total were identified, of which 14 articles (1 prospective, 13 cross-sectional) with 36 factors were included. Studies on cognitive frailty included 20,390 community-dwellers (≥60 years) from three countries. Meta-analysis indicated that depression [OR = 3.60, 95%CI (2.25,5.78), p < 0.01] and sleep problems [OR = 2.36, 95%CI (1.62,3.43), p < 0.01] were associated with cognitive frailty. CONCLUSIONS Effective interventions targeting depression and sleep problems may lower the risk of cognitive frailty in the community seniors but need further study in high-quality, prospective studies. IMPLICATIONS FOR NURSING PRACTICE Building on previous work, the objectives of this systematic review and meta-analysis were to explore potential modifiable risk factors for cognitive frailty in community-dwelling older adults, which is expected to throw light on the prevention of cognitive frailty.
Collapse
Affiliation(s)
- Chen Yuan
- Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yixiong Zhang
- Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| |
Collapse
|
4
|
Ramos-Pozón S, Terribas-Sala N, Falcó-Pegueroles A, Román-Maestre B. Persons with mental disorders and assisted dying practices in Spain: An overview. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 87:101871. [PMID: 36871498 DOI: 10.1016/j.ijlp.2023.101871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
On 25 June 2021, the Law on Euthanasia in Spain came into force, providing for two modes of helping an individual end their life: euthanasia and/or medically assisted suicide. Among the requisites that a request for euthanasia has to fulfil are that the individual must be suffering a severe, chronic and debilitating condition or a severe and incurable disease, at the same time as that person shows the necessary competence to decide. The possibility exists that a patient suffering mental health problems submits such a request; however, the specific characteristics of a mental health disorder make such a request considerably more complex. In this article, based on a narrative review of the law itself and the related literature, the requisites established under the law are analysed from an ethical-legal perspective with the aim of defining when a request for euthanasia from a person with a mental health disorder may be deemed legitimate and in line with legal provisions. This should help clinicians make rational, reasoned decisions when dealing with a request of this type.
Collapse
Affiliation(s)
- Sergio Ramos-Pozón
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | | | | | | |
Collapse
|
5
|
Cousin Cabrolier L, Di Beo V, Marcellin F, Rousset Torrente O, Mahe V, Valderas JM, Chassany O, Carrieri PM, Duracinsky M. Negative representations of night-shift work and mental health of public hospital healthcare workers in the COVID-19 era (Aladdin survey). BMC Health Serv Res 2023; 23:187. [PMID: 36814276 PMCID: PMC9946706 DOI: 10.1186/s12913-023-09101-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/24/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Many risk factors impact the health of hospital night workers, which can lead to physical and mental health disorders. During the recent period, night hospital workers have been particularly stressed. This study therefore aims to: (i) To document the prevalence of depression, anxiety, sleep disorders, and symptoms suggestive of post-traumatic stress disorder in night shift workers (NSHW) working in Parisian public hospitals after France's first COVID-19 wave ended; (ii) To estimate the effect of negative representations and perceptions of night shift work on these mental health outcomes. METHODS An observational cross-sectional online survey of NSHW (June to September 2020) in 39 public hospitals in Paris, France. Standard scales were used to measure mental health outcomes. Weighted multinomial logistic regression models supported the identification of predictors of depression (score > 10 on the Hospital Anxiety and Depression Scale, HADS, for depression), anxiety (score > 10 on the HADS for anxiety), severe insomnia (score > 21 on the Insomnia Severity Index, ISI) and symptoms suggestive of post-traumatic stress disorder (score > 36 on the Impact of Event Scale-Revised, IES-R). RESULTS The weighted prevalence rates [95% confidence interval] of depression, anxiety, severe insomnia, and symptoms of post-traumatic stress disorder were, respectively, 18.9% [16.5-21.2], 7.6% [6.0-9.1], 8.6% [6.9-10.2] and 11.7% [9.7-13.6]. After multiple adjustment, organizational changes in NSHW professional lives due to the COVID-19 pandemic (such as moving to another hospital department and modified schedules) and NSHW-perceived negative representations of night work were significantly associated with all studied mental health outcomes. CONCLUSION Our findings confirm the importance of monitoring mental health and sleep quality among NSHW in Parisian public hospitals, even more during health crises. Multilevel interventions aiming at reducing negative representations and improving work organization are urgently needed to improve overall health of this frontline healthcare providers group.
Collapse
Affiliation(s)
- Lorraine Cousin Cabrolier
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France ,grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Vincent Di Beo
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Fabienne Marcellin
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Olivia Rousset Torrente
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France
| | - Véronique Mahe
- Service de Santé Au Travail, Hôpitaux Lariboisière-Fernand Widal, AP-HP Nord, Paris, France
| | - José Maria Valderas
- grid.4280.e0000 0001 2180 6431Department of Medicine, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Olivier Chassany
- grid.411394.a0000 0001 2191 1995Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004 Paris, France ,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010 France
| | - Patrizia Maria Carrieri
- grid.464064.40000 0004 0467 0503Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, 75004, Paris, France. .,Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France, Paris, 75010, France. .,Département de Médecine Interne Et d'immunologie Clinique, Hôpital Bicêtre, AP-HP, 94275, Kremlin Bicêtre, France.
| |
Collapse
|
6
|
Tadevosyan NE, Khachunts AS, Gohargani M, Sahakyan AA, Tumanyan AA. Voluntary Attention and Quality of Life in Patients With Type 1 and Type 2 Diabetes Mellitus: Differences in Changes Depending on Disease Type and Duration. J EVOL BIOCHEM PHYS+ 2022. [DOI: 10.1134/s0022093022020247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
7
|
Pearson E, Siskind D, Hubbard RE, Gordon EH, Coulson EJ, Warren N. Frailty and severe mental illness: A systematic review and narrative synthesis. J Psychiatr Res 2022; 147:166-175. [PMID: 35051715 DOI: 10.1016/j.jpsychires.2022.01.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/02/2022] [Accepted: 01/06/2022] [Indexed: 12/29/2022]
Abstract
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.
Collapse
Affiliation(s)
- Ella Pearson
- School of Biomedical Sciences, University of Queensland, Brisbane, Queensland, Australia.
| | - Dan Siskind
- Metro South Addiction and Mental Health Services, Brisbane, Queensland, Australia; School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia; Department of Geriatrics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Emily H Gordon
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia; Department of Geriatrics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Elizabeth J Coulson
- School of Biomedical Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Nicola Warren
- Metro South Addiction and Mental Health Services, Brisbane, Queensland, Australia; School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
8
|
Canever JB, Cândido LM, Wagner KJP, Danielewicz AL, Avelar NCPD. As diferentes tipologias do comportamento sedentário estão associadas ao histórico de problemas no sono em idosos comunitários? CAD SAUDE PUBLICA 2022. [DOI: 10.1590/0102-311x00156521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Alterações no sono são comuns em idosos e alguns fatores de risco podem agravar essa condição. Entender a associação do comportamento sedentário com o histórico de problemas de sono poderá auxiliar na elaboração de programas de intervenção. Verificar a associação entre tipologias do comportamento sedentário e histórico de problemas no sono em idosos comunitários brasileiros. Estudo transversal, com dados de 43.554 idosos participantes da Pesquisa Nacional de Saúde (PNS), de 2019. As tipologias do comportamento sedentário foram avaliadas por: (1) tempo assistindo televisão; (2) atividades de lazer; e (3) tempo despendido total (televisão + lazer). O comportamento sedentário foi categorizado em < 3; 3-6 e > 6 horas/dia. O desfecho foi histórico de problemas de sono (dificuldade para adormecer, acordar frequentemente à noite ou dormir mais do que de costume) avaliados por meio do autorrelato nos últimos 15 dias. As associações foram verificadas pela regressão logística multivariável. Idosos que permaneceram tempo > 6 horas/dia em comportamento sedentário assistindo televisão tiveram 13% (OR = 1,13; IC95%: 1,02; 1,26) maiores probabilidades de relatarem problemas de sono. Referente ao comportamento sedentário total, idosos que permaneceram entre 3-6 horas e mais do que 6 horas/dia apresentaram 13% (OR = 1,13; IC95%: 1,04; 1,22) e 11% (OR = 1,11; IC95%: 1,01; 1,23) maiores probabilidades de problemas de sono, respectivamente. Os idosos amostrados que relataram permanecer por períodos superiores a 6 horas por dia em comportamento sedentário assistindo à televisão e > 3 horas em comportamento sedentário total tiveram maiores chances de terem problemas no sono. Estes achados podem contribuir nas orientações sobre a necessidade de redução no comportamento sedentário em idosos.
Collapse
|
9
|
Gilmore N, Kehoe L, Bauer J, Xu H, Hall B, Wells M, Lei L, Culakova E, Flannery M, Grossman VA, Sardari RA, Subramanya H, Kadambi S, Belcher E, Kettinger J, O'Rourke MA, Dib EG, Vogelzang NJ, Dale W, Mohile S. The Relationship Between Frailty and Emotional Health in Older Patients with Advanced Cancer. Oncologist 2021; 26:e2181-e2191. [PMID: 34510642 DOI: 10.1002/onco.13975] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/24/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Aging-related deficits that eventually manifest as frailty may be associated with poor emotional health in older patients with advanced cancer. This study aimed to examine the relationship between frailty and emotional health in this population. METHODS This was a secondary analysis of baseline data from a nationwide cluster randomized trial. Patients were aged ≥70 years with incurable stage III/IV solid tumors or lymphomas, had ≥1 geriatric assessment (GA) domain impairment, and had completed the Geriatric Depression Scale, Generalized Anxiety Disorder-7, and Distress Thermometer. Frailty was assessed using a Deficit Accumulation Index (DAI; range 0-1) based on GA, which did not include emotional health variables (depression and anxiety), and participants were stratified into robust, prefrail, and frail categories. Multivariate logistic regression models examined the association of frailty with emotional health outcomes. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported. RESULTS Five hundred forty-one patients were included (mean age: 77 years; 70-96). DAI ranged from 0.04 to 0.94; 27% of patients were classified as robust, 42% prefrail, and 31% frail. Compared with robust patients, frail patients had an increased risk of screening positive for depression (aOR = 12.8; 95% CI = 6.1-27.0), anxiety (aOR = 6.6; 95% CI = 2.2-19.7), and emotional distress (aOR = 4.62; 95% CI = 2.9-8.3). Prefrail compared with robust patients also had an increased risk of screening positive for depression (aOR = 2.22; 95% CI = 1.0-4.8) and distress (aOR = 1.71; 95% CI = 1.0-2.8). CONCLUSION In older patients with advanced cancer, frailty is associated with poorer emotional health, which indicates a need for an integrated care approach to treating these patients. IMPLICATIONS FOR PRACTICE A relationship exists between frailty and poor emotional health in older adults with advanced cancer. Identifying areas of frailty can prompt screening for emotional health and guide delivery of appropriate interventions. Alternatively, attention to emotional health may also improve frailty.
Collapse
Affiliation(s)
- Nikesha Gilmore
- University of Rochester Medical Center, Rochester, New York, USA
| | - Lee Kehoe
- University of Rochester Medical Center, Rochester, New York, USA
| | - Jessica Bauer
- University of Rochester Medical Center, Rochester, New York, USA
| | - Huiwen Xu
- University of Rochester Medical Center, Rochester, New York, USA
| | - Bianca Hall
- University of Rochester Medical Center, Rochester, New York, USA
| | - Megan Wells
- University of Rochester Medical Center, Rochester, New York, USA
| | - Lianlian Lei
- University of Michigan, Ann Arbor, Michigan, USA
| | - Eva Culakova
- University of Rochester Medical Center, Rochester, New York, USA
| | - Marie Flannery
- University of Rochester Medical Center, Rochester, New York, USA
| | - Valerie Aarne Grossman
- University of Rochester Medical Center, Rochester, New York, USA.,SCOREboard Stakeholder Advisory Group, University of Rochester Medical Center, Rochester, New York, USA
| | | | - Himal Subramanya
- University of Rochester Medical Center, Rochester, New York, USA
| | - Sindhuja Kadambi
- University of Rochester Medical Center, Rochester, New York, USA
| | | | | | - Mark A O'Rourke
- Cancer Centers of the Carolinas, Greenville, South Carolina, USA
| | - Elie G Dib
- Michigan Cancer Research Consortium, Ypsilanti, Michigan, USA
| | | | - William Dale
- City of Hope National Medical Center, Duarte, California, USA
| | - Supriya Mohile
- University of Rochester Medical Center, Rochester, New York, USA
| |
Collapse
|
10
|
Palermo S. Covid-19 Pandemic: Maximizing Future Vaccination Treatments Considering Aging and Frailty. Front Med (Lausanne) 2020; 7:558835. [PMID: 33072783 PMCID: PMC7530612 DOI: 10.3389/fmed.2020.558835] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/02/2020] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic is proving to be a multiplier of inequalities. Especially toward the elderly population. A voiceless scream that comes from geriatrics, nursing homes, hospices from all over Italy. They call it the silent massacre: from North to South, the bulletin of coronavirus positive—or already deceased—elderly people continues to grow exponentially without a chance to counter it. Population aging and chronicity are a question that needs to be addressed. Frailty is the most challenging expression of population aging, with major consequences for public health and clinical practice. It is a geriatric syndrome which consists in a state of higher vulnerability to stressors attributed to a lower homeostatic reserve due to an age-related multisystem physiological change. People over 60, and especially over 80, are particularly vulnerable to severe or fatal infection. Moreover, the age-related dysregulation of the immune system in the elderly (i.e., immunosenescence and inflammaging) results in poorer responses to vaccination. Physical frailty is an effective health indicator and it has previously shown to predict the response to the seasonal flu vaccine. These findings suggest that assessing frailty in the elderly may identify those who are less likely to respond to immunization and be at higher risk for COVID-19 and its complications. Moreover, cognitive frailty and neurocognitive disorders, mental health and reduced awareness of illness negatively impact on adherence to complex medication regimens among elderly patients. A worldwide research and development blueprint have been initiated to accelerate the development of vaccines and therapeutics for the COVID-19 outbreak. Considered the above, I suggest the importance to consider aging in thinking about future Civud-19 vaccination and treatment, focusing on the possible impact of physical and cognitive frailty.
Collapse
Affiliation(s)
- Sara Palermo
- Department of Psychology, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Aging, Bruxelles, Belgium
| |
Collapse
|
11
|
Kawada T. Sleep quality, frailty and cognition in middle aged to older adults. Int Psychogeriatr 2020; 32:1. [PMID: 32024559 DOI: 10.1017/s1041610220000083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Bunkyo-Ku, Tokyo113-8602, Japan
| |
Collapse
|