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Mitkin NA, Kirilkin GE, Unguryanu TN, Malyutina S, Cook S, Kudryavtsev AV. The relationship between physical performance and alcohol consumption levels in Russian adults. Sci Rep 2024; 14:1417. [PMID: 38228702 PMCID: PMC10792008 DOI: 10.1038/s41598-024-51962-3] [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: 09/02/2023] [Accepted: 01/11/2024] [Indexed: 01/18/2024] Open
Abstract
Investigating the relationship between alcohol consumption and physical performance, we used data from the 2015-2018 Know Your Heart study on 4215 adults aged 35-69 from Arkhangelsk and Novosibirsk, Russia. We classified participants' drinking status into non-drinking, non-problem drinking, hazardous drinking, and harmful drinking based on their self-reported drinking behaviors. To evaluate physical performance, we developed a Composite Physical Performance Scale (CPPS), which combined the results of three functional tests: grip strength (GS), closed-eyes balance, and chair rises (CR). We applied multivariable linear regression to assess the relationship between alcohol consumption and CPPS score, and ordinal logistic regression to explore the associations between alcohol consumption and the three functional tests separately. The results showed that harmful drinking was associated with lower CPPS scores compared to non-problem drinking. Among harmful drinking men, the decrease in CPPS scores was explained by all three tests equally and exceptionally by GS among women. Non-drinking was also associated with decreased CPPS, linked to lower GS and CR scores in men, and only lower GS scores in women. The study revealed a reduced physical performance in the non-drinking and harmful drinking groups compared to non-problem drinking.
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Affiliation(s)
- Nikita A Mitkin
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
- International Research Competence Centre, Northern State Medical University, Troitsky Ave., 51, Arkhangelsk, Russia, 163069.
| | - German E Kirilkin
- Department of Hygiene and Medical Ecology, Northern State Medical University, Troitsky Ave., 51, Arkhangelsk, Russia, 163069
| | - Tatiana N Unguryanu
- Department of Hygiene and Medical Ecology, Northern State Medical University, Troitsky Ave., 51, Arkhangelsk, Russia, 163069
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, B.Bogatkova Str., 175/1, Novosibirsk, Russia, 630089
- Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, Krasny Prospect, 52, Novosibirsk, Russia, 630091
| | - Sarah Cook
- School of Public Health, Imperial College London, White City Campus, 80-92 Wood Lane, London, W12 0BZ, UK
| | - Alexander V Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway
- International Research Competence Centre, Northern State Medical University, Troitsky Ave., 51, Arkhangelsk, Russia, 163069
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Nie X, Williams G, Verma A, Zhu Y, Fu H, Jia Y, Dai J, Gao J. Association between alcohol use and frailty among elder adults in three Chinese cities. J Public Health (Oxf) 2023; 45:i28-i34. [PMID: 38127560 DOI: 10.1093/pubmed/fdad200] [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: 09/27/2021] [Revised: 04/25/2023] [Accepted: 09/29/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Frailty is often described as a condition of the elderly and alcohol use is associated with frailty. The aim of this study is to examine the associations between alcohol use and frailty in three cities in elder adults. METHODS A cross-sectional study was conducted in three cities in China from June 2017 to October 2018. In total, 2888 residents aged ≥65 years old were selected by using a multi-level stage sampling procedure. Alcohol use was assessed by Focusing on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers (CAGE) four-item questionnaire. Frailty was measured by a validated Chinese version of the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) scale. Multinomial logistic regressions were used to examine the association of alcohol use with pre-frailty and frailty after controlling for varied covariates. RESULTS In general, the prevalence of pre-frailty and frailty was 38.64 and 20.26%, respectively. After controlling for covariates and interaction of age and problematic drinking, non-problematic drinkers neither had association with pre-frailty (OR: 1.15, 95%CI:0.86-1.52) nor with frailty (OR:0.90, 95%CI:0.60-1.36), and problematic drinkers neither had association with frailty (OR: 1.21, 95%CI:0.83-1.76), while problematic drinkers had high odd ratios of frailty (OR:3.28, 95%CI:2.02-5.33) compared with zero-drinker. CONCLUSIONS Our study found a positive association between problematic drinking and frailty, no relationship between non-problematic drinking and (pre-)frailty compared with zero-drinking among Chinese elder adults. Based on previous findings and ours, we conclude it is important for the prevention of frailty to advocate no problematic drinking among elder adults.
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Affiliation(s)
- Xin Nie
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Greg Williams
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Arpana Verma
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Yongkai Zhu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Hua Fu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yingnan Jia
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Junming Dai
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Junling Gao
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
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Moslemi M, Jannat B, Mahmoudzadeh M, Ghasemlou M, Abedi A. Detoxification activity of bioactive food compounds against ethanol-induced injuries and hangover symptoms: A review. Food Sci Nutr 2023; 11:5028-5040. [PMID: 37701198 PMCID: PMC10494618 DOI: 10.1002/fsn3.3520] [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: 08/13/2022] [Revised: 04/08/2023] [Accepted: 06/08/2023] [Indexed: 09/14/2023] Open
Abstract
Alcohol drinking is a popular activity among adolescents in many countries, largely due to its pleasant, relaxing effects. As a major concern, ethanol consumption put the drinkers at risk of nutrients' deficiency due to the disordered eating, anorexia, and malabsorption of nutrients. Moreover, alcohol drinking may lead to the development of hangover symptoms including diarrhea, thirsty, fatigue, and oxidative stress. A broad range of functional food components with antioxidant and/or anti-inflammatory properties including pectin, aloe vera polysaccharides, chito-oligosaccharides, and other herbal components have been explored due to their detoxification effects against ethanol. The underlying anti-hangover mechanisms include reducing the intestinal absorption of ethanol or its metabolites, increasing the activity of ethanol metabolizing enzymes, development of fatty acid β-oxidation in mitochondria, inhibition of inflammatory response, blocking the target receptors of ethanol in the body, and possession of antioxidant activity under the oxidative stress developed by ethanol consumption. Therefore, the development of bioactive food-based therapeutic formula can assist clinicians and also drinkers in the alleviation of alcohol side effects.
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Affiliation(s)
- Masoumeh Moslemi
- Halal Research Center of IRIMinistry of Health and Medical EducationTehranIran
| | - Behrooz Jannat
- Halal Research Center of IRIMinistry of Health and Medical EducationTehranIran
| | - Maryam Mahmoudzadeh
- Nutrition Research Center and Department of Food Science and Technology, Faculty of Nutrition and Food ScienceTabriz University of Medical SciencesTabrizIran
| | - Mehran Ghasemlou
- School of ScienceSTEM College, RMIT UniversityMelbourneVictoriaAustralia
| | - Abdol‐Samad Abedi
- Department of Research Deputy, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food TechnologyShahid Beheshti University of Medical SciencesTehranIran
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Guo X, Tang P, Zhang L, Li R. Tobacco and alcohol consumption and the risk of frailty and falling: a Mendelian randomisation study. J Epidemiol Community Health 2023; 77:349-354. [PMID: 37001985 DOI: 10.1136/jech-2022-219855] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/22/2023] [Indexed: 04/03/2023]
Abstract
BackgroundEpidemiological data have suggested that tobacco and alcohol consumption were associated with the risk of frailty and falling, but it is yet unclear whether these associations are of a causal nature. Thus, we conducted two-sample Mendelian randomisation analysis using genetic instruments to determine the causal associations of tobacco and alcohol consumption on frailty and falls.MethodsIndependent instrumental variables strongly (p<5E–09) associated with tobacco and alcohol consumption were obtained from the genome-wide association study (GWAS) and Sequencing Consortium of Alcohol and Nicotine use (up to 2 669 029 participants). Summary statistics of the frailty index (FI, N=175 226) and falling risk (N=451 179) were from the two latest published GWAS datasets on FI and falling risk.ResultsUsing the inverse-variance weighted method, our results showed that genetically determined initiation of smoking was significantly associated with an increased FI (β=0.34, 95% CI=0.29 to 0.40, p=5.48E–33) and risk of falling (OR=1.39, 95% CI=1.30 to 1.50, p=1.01E–20). In addition, the age of initiation of smoking and cigarettes consumption per day was negatively and positively associated with both FI and falls, respectively. Current smokers were prone to having a higher FI and falling risk than individuals who quit smoking. There was no significant causal association between alcohol use and the risk of frailty and falling. Similar results were obtained using other statistical approaches with good stability.ConclusionsOur findings demonstrate that tobacco use, but not alcohol drinking, significantly increases the risk of frailty and falling. Future studies are warranted to clarify the underlying physiopathological mechanisms.
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Affiliation(s)
- Xingzhi Guo
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an, Shaanxi, China
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Peng Tang
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an, Shaanxi, China
| | - Lina Zhang
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an, Shaanxi, China
| | - Rui Li
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an, Shaanxi, China
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, Shaanxi, China
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Borges MK, Jeuring HW, Marijnissen RM, van Munster BC, Aprahamian I, van den Brink RHS, Hoogendijk EO, Oude Voshaar RC. Frailty and affective disorders throughout adult life: A 5-year follow-up of the Lifelines Cohort Study. J Am Geriatr Soc 2022; 70:3424-3435. [PMID: 36054011 PMCID: PMC10086828 DOI: 10.1111/jgs.18021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/09/2022] [Accepted: 08/09/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Frailty is an important concept for risk stratification in clinical practice, but it is hardly acknowledged at all in mental healthcare settings. This paper aims to assess the impact of frailty on the course of depression and anxiety, and the impact of these affective disorders on the course of frailty. METHODS Lifelines, a prospective population-based cohort study, evaluated 167,729 people living in the northern Netherlands. Frailty was based on the deficit accumulation model, which resulted in a 60-item frailty index (FI) at baseline and a 35-item FI at baseline and 5-year follow-up. Current depressive and anxiety disorders were assessed with the Mini International Neuropsychiatric Interview according to DSM-IV criteria. Bidirectional associations between frailty and affective disorders were investigated using separate multivariable regression analyses in younger (<60 years) and older adults (≥60 years). RESULTS The FI was associated with the onset of a depressive disorder (younger adults: odds ratio [OR] = 1.12; 95% confidence interval [CI] 1.11-1.13; older adults: OR = 1.13; 95% CI 1.09-1.16) as well as any anxiety disorder (younger adults: OR = 1.10; 95% CI 1.09-1.10; older adults: OR = 1.07; 95% CI 1.04-1.09). The other way around, depressive disorder and anxiety disorders were associated with an accelerated increase of frailty over time (depressive disorder: younger adults: beta [β] = 0.03, p < 0.001; older adults: β = 0.04, p < 0.001; and any anxiety disorder: younger adults: β = 0.02, p < 0.001; older adults: β = 0.01, p < 0.142), although the effect of anxiety disorders was less equivocal among older adults. CONCLUSIONS Affective disorders are reciprocally related to frailty. Results with respect to the impact of anxiety disorders on frailty suggest most impact at lower levels of frailty. Our results might imply that interventions to slow biological aging should be broadened towards younger and middle-aged people as well as non-frail older patients. To develop targeted treatment, future clinical and epidemiologic studies on the underlying pathways of this bidirectional association are needed.
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Affiliation(s)
- Marcus K Borges
- Department of Psychiatry, Universidade Federal do Paraná, Curitiba, Brazil
| | - Hans W Jeuring
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Radboud M Marijnissen
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Barbara C van Munster
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ivan Aprahamian
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil
| | - Rob H S van den Brink
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Emiel O Hoogendijk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - VU University Medical Center, Amsterdam, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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6
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Reid N, Weerasekera S, Hubbard RE, Gordon EH. Frailty in ethnic minority women. Maturitas 2021; 152:26-31. [PMID: 34674805 DOI: 10.1016/j.maturitas.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 11/25/2022]
Abstract
In majority populations in high- and middle-income countries, women live longer yet experience higher levels of frailty than men of the same age. It is unclear whether this 'sex-frailty paradox' is present in ethnic minority populations. In this narrative review, we explore biological, behavioural and social factors associated with mortality, morbidity and frailty in women, particularly ethnic minority women. We ascertain that natural menopause occurs earlier in women of particular ethnicities. Ethnic minority women (living in high-income countries) have more children and higher rates of chronic disease and disability, all of which are associated with frailty. In some ethnic minorities, women are less likely to engage in deleterious health behaviours such as smoking and alcohol consumption. However, in others the reverse is true. Women from migrant ethnic minorities tend to have lower levels of physical activity. With time, they can also adopt adverse behavioural patterns of the majority population. Although the evidence is sparse, sex differences in health reporting and social assets, as well as gender roles, are likely to contribute to sex differences in frailty in ethnic minorities. Overall, ethnic minority women are a particularly vulnerable group, but the majority of risk factors for frailty appear to be mutable rather than fixed. Future research may examine interventions that target frailty in different races and ethnicities at individual, population and global levels.
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Affiliation(s)
- Natasha Reid
- Faculty of Medicine, The University of Queensland, Queensland, Australia.
| | - Shavini Weerasekera
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Princess Alexandra Hospital, Metro South Health Hospital and Health Service, Queensland, Australia; School of Medicine, Griffith University, Queensland, Australia
| | - Ruth E Hubbard
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Princess Alexandra Hospital, Metro South Health Hospital and Health Service, Queensland, Australia
| | - Emily H Gordon
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Princess Alexandra Hospital, Metro South Health Hospital and Health Service, Queensland, Australia
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7
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Kresovich JK, Martinez Lopez AM, Garval EL, Xu Z, White AJ, Sander DP, Taylor JA. Alcohol consumption and methylation-based measures of biological age. J Gerontol A Biol Sci Med Sci 2021; 76:2107-2111. [PMID: 34038541 DOI: 10.1093/gerona/glab149] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
Epigenetic age acceleration is considered a measure of biological aging based on genome-wide patterns of DNA methylation. Although age acceleration has been associated with incidence of diseases and death, less is known about how it is related to lifestyle behaviors. Among 2,316 women, we evaluate associations between self-reported alcohol consumption and various metrics of epigenetic age acceleration. Recent average alcohol consumption was defined as the mean number of drinks consumed per week within the past year; lifetime average consumption was estimated as the mean number of drinks per year drinking. Whole blood genome-wide DNA methylation was measured with HumanMethylation450 BeadChips and used to assess four epigenetic clocks (Hannum, Horvath, PhenoAge, GrimAge) and their corresponding metrics of epigenetic age acceleration (Hannum AgeAccel, Horvath AgeAccel, PhenoAgeAccel, GrimAgeAccel). Although alcohol consumption showed little association with most age acceleration metrics, both lifetime and recent average consumption measures were positively associated with GrimAgeAccel (lifetime, per additional 135 drinks/year: β=0.30 years, 95% CI: 0.11, 0.48, p=0.002; recent, per additional 5 drinks/week: β=0.19 years, 95% CI: 0.01, 0.37, p=0.04). In a mutually adjusted model, only average lifetime alcohol consumption remained associated with GrimAgeAccel (lifetime, per additional 135 drinks/year: β=0.27 years, 95% CI: 0.04, 0.50, p=0.02; recent, per 5 additional drinks/week: β=0.05 years, 95% CI: -0.16, 0.26, p=0.64). Although alcohol use does not appear to be strongly associated with biological age measured by most epigenetic clocks, lifetime average consumption is associated with higher biological age assessed by the GrimAge epigenetic clock.
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Affiliation(s)
- Jacob K Kresovich
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | | | - Emma L Garval
- Keck Science Department, Scripps College, Claremont, CA
| | - Zongli Xu
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | - Dale P Sander
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | - Jack A Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC.,Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
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Kong L, Zhao H, Fan J, Wang Q, Li J, Bai J, Mao J. Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey. BMJ Open 2021; 11:e041578. [PMID: 33664069 PMCID: PMC7934736 DOI: 10.1136/bmjopen-2020-041578] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes. DESIGN A cross-sectional design. SETTING Two community health centres in central China. PARTICIPANTS 291 community-dwelling older adults aged ≥65 years with type 2 diabetes. MAIN OUTCOME MEASURES Data were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty. RESULTS The prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884). CONCLUSIONS A high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.
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Affiliation(s)
- Linglin Kong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Nursing, Hubei University of Science and Technology, Xianning, China
| | - Huimin Zhao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junyao Fan
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Quan Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Masters MC, Perez J, Wu K, Ellis RJ, Goodkin K, Koletar SL, Andrade A, Yang J, Brown TT, Palella FJ, Sacktor N, Tassiopoulos K, Erlandson KM. Baseline Neurocognitive Impairment (NCI) Is Associated With Incident Frailty but Baseline Frailty Does Not Predict Incident NCI in Older Persons With Human Immunodeficiency Virus (HIV). Clin Infect Dis 2021; 73:680-688. [PMID: 34398957 DOI: 10.1093/cid/ciab122] [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: 08/12/2020] [Accepted: 02/08/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Neurocognitive impairment (NCI) and frailty are more prevalent among persons with human immunodeficiency virus (HIV, PWH) compared to those without HIV. Frailty and NCI often overlap with one another. Whether frailty precedes declines in neurocognitive function among PWH or vice versa has not been well established. METHODS AIDS Clinical Trials Group (ACTG) A5322 is an observational cohort study of older PWH. Participants undergo annual assessments for NCI and frailty. ACTG A5322 participants who developed NCI as indexed by tests of impaired executive functioning and processing speed during the first 3 years were compared to persons who maintained normal cognitive function; those who demonstrated resolution of NCI were compared to those who had persistent NCI. Participants were similarly compared by frailty trajectory. We fit multinomial logistic regression models to assess associations between baseline covariates (including NCI) and frailty, and associations between baseline covariates (including frailty) and NCI. RESULTS In total, 929 participants were included with a median age of 51 years (interquartile range [IQR] 46-56). At study entry, 16% had NCI, and 6% were frail. Over 3 years, 6% of participants developed NCI; 5% developed frailty. NCI was associated with development of frailty (odds ratio [OR] = 2.06; 95% confidence interval [CI] = .94, 4.48; P = .07). Further adjustment for confounding strengthened this association (OR = 2.79; 95% CI = 1.21, 6.43; P = .02). Baseline frailty however was not associated with NCI development. CONCLUSIONS NCI was associated with increased risk of frailty, but frailty was not associated with development of NCI. These findings suggest that the presence of NCI in PWH should prompt monitoring for the development of frailty and interventions to prevent frailty in this population.
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Affiliation(s)
- Mary Clare Masters
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jeremiah Perez
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kunling Wu
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ronald J Ellis
- University of California, San Diego, San Diego, California, USA
| | - Karl Goodkin
- University of Nebraska Medical Center, Omaha, Omaha, Nebraska, USA
| | | | | | | | - Todd T Brown
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Frank J Palella
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ned Sacktor
- Johns Hopkins University, Baltimore, Maryland, USA
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10
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Dorrington N, Fallaize R, Hobbs DA, Weech M, Lovegrove JA. A Review of Nutritional Requirements of Adults Aged ≥65 Years in the UK. J Nutr 2020; 150:2245-2256. [PMID: 32510125 DOI: 10.1093/jn/nxaa153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/24/2020] [Accepted: 05/05/2020] [Indexed: 01/16/2023] Open
Abstract
Appropriate dietary choices in later life may reduce the risk of chronic diseases and rate of functional decline, however, there is little well-evidenced age-specific nutritional guidance in the UK for older adults, making it challenging to provide nutritional advice. Therefore, the aim of this critical review was to propose evidence-based nutritional recommendations for older adults (aged ≥65 y). Nutrients with important physiological functions in older adults were selected for inclusion in the recommendations. For these nutrients: 1) recommendations from the UK Scientific Advisory Committee for Nutrition (SACN) reports were reviewed and guidance retained if recent and age-specific, and 2) a literature search conducted where SACN guidance was not sufficient to set or confirm recommendations for older adults, searching Web of Science up to March 2020. Data extracted from a total of 190 selected publications provided evidence to support age-specific UK recommendations for protein (1.2 g·kg-1·d-1), calcium (1000 mg·d-1), folate (400 μg·d-1), vitamin B-12 (2.4 μg·d-1), and fluid (1.6 L·d-1 women, 2.0 L·d-1 men) for those ≥65 y. UK recommendations for carbohydrates, free sugars, dietary fiber, dietary fat and fatty acids, sodium, and alcohol for the general population are likely appropriate for older adults. Insufficient evidence was identified to confirm or change recommendations for all other selected nutrients. In general, significant gaps in current nutritional research among older adults existed, which should be addressed to support delivery of tailored nutritional guidance to this age group to promote healthy aging.
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Affiliation(s)
- Nicole Dorrington
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Ditte A Hobbs
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Michelle Weech
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute of Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
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11
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Shin J, Kim KJ, Choi J. Smoking, alcohol intake, and frailty in older Korean adult men: cross-sectional study with nationwide data. Eur Geriatr Med 2020; 11:269-277. [PMID: 32297188 DOI: 10.1007/s41999-019-00271-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/19/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE Smoking and alcohol intake are major causes of negative health outcomes and may be co-inherited traits. However, little is known about the association of frailty with smoking and alcohol intake in older adults. METHODS Community-dwelling older men (N = 1426) aged 70-84 years were divided into four groups: 1) non-smoking (< 100 cigarettes in life-time) and non-alcohol intake (< one time/month); 2) smoking (≥ 100 cigarettes) and alcohol intake (≥ one time/month); 3) non-smoking with alcohol intake; and 4) smoking and no alcohol intake. Frailty was assessed with a modified version of the Cardiovascular Health Study (CHS) frailty index, the Korean version of the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight (KFRAIL) index, the Korean Frailty Index (KFI), and the Study of Osteoporotic Fracture (SOF) frailty index. Frailty risks were estimated with multiple logistic regression models after adjusting for age, income, education, residence, marital status, hospitalization, physical activity, comorbidities, and levels of vitamin B12, aspartate aminotransferase, and gamma-glutamyl transferase. RESULTS Frailty differed according to smoking and alcohol status. Frailty in the smoking and non-alcohol-intake group was significantly higher according to the CHS frailty index (Odds ratio = 1.592; 95% confidence interval [CI] 1.032-2.455), KFRAIL (CI 1.613, 1.037-2.509), and KFI (CI 1.869, 1.115-3.131) compared with the non-smoking and alcohol-intake group. However, there was no increased frailty risk in the other study groups. CONCLUSION Frailty prevalence differed depending on smoking status and alcohol intake in older Korean men. Therefore, we should adopt a comprehensive approach to understanding frailty in older adults that considers both smoking and alcohol intake.
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Affiliation(s)
- Jinyoung Shin
- Department of Family Medicine, Research Institute on Healthy Aging, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea
| | - Kyoung Jin Kim
- Department of Family Medicine, Research Institute on Healthy Aging, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea
| | - Jaekyung Choi
- Department of Family Medicine, Research Institute on Healthy Aging, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea.
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12
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Abstract
Frailty describes an individual's vulnerability to adverse health outcomes and is a useful construct that assists health professionals to understand the heterogeneity of the ageing population. While the pathophysiological pathways that lead to frailty are not well defined, an individual's sex appears to be a key factor influencing the ageing trajectory. Compared with age-matched men, women tend to have poorer health status (ie, they are more frail) but longer life expectancy (ie, they are more resilient). It seems likely that a combination of biological, behavioural and social factors underpin this male-female health-survival paradox. Randomised controlled trial data for frailty interventions in older adults are emerging, with multicomponent programs incorporating exercise and nutrition-based strategies showing promise. Pharmaceutical and other innovative therapeutic strategies for frailty are highly anticipated. Sex differences in the effectiveness of frailty interventions have not been addressed in the research literature to date. In the future, successful interventions may target many (if not all) biopsychosocial domains, with careful consideration of issues relevant to each sex.
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Affiliation(s)
- Emily H Gordon
- Centre for Health Services Research, University of Queensland, Brisbane, QLD
| | - Ruth E Hubbard
- Centre for Health Services Research, University of Queensland, Brisbane, QLD
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13
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Ofori-Asenso R, Chin KL, Mazidi M, Zomer E, Ilomaki J, Zullo AR, Gasevic D, Ademi Z, Korhonen MJ, LoGiudice D, Bell JS, Liew D. Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2:e198398. [PMID: 31373653 PMCID: PMC6681553 DOI: 10.1001/jamanetworkopen.2019.8398] [Citation(s) in RCA: 257] [Impact Index Per Article: 51.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Frailty is a common geriatric syndrome of significant public health importance, yet there is limited understanding of the risk of frailty development at a population level. OBJECTIVE To estimate the global incidence of frailty and prefrailty among community-dwelling adults 60 years or older. DATA SOURCES MEDLINE, Embase, PsycINFO, Web of Science, CINAHL Plus, and AMED (Allied and Complementary Medicine Database) were searched from inception to January 2019 without language restrictions using combinations of the keywords frailty, older adults, and incidence. The reference lists of eligible studies were hand searched. STUDY SELECTION In the systematic review, 2 authors undertook the search, article screening, and study selection. Cohort studies that reported or had sufficient data to compute incidence of frailty or prefrailty among community-dwelling adults 60 years or older at baseline were eligible. DATA EXTRACTION AND SYNTHESIS The methodological quality of included studies was assessed using The Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence and Incidence Studies. Meta-analysis was conducted using a random-effects (DerSimonian and Laird) model. MAIN OUTCOMES AND MEASURES Incidence of frailty (defined as new cases of frailty among robust or prefrail individuals) and incidence of prefrailty (defined as new cases of prefrailty among robust individuals), both over a specified duration. RESULTS Of 15 176 retrieved references, 46 observational studies involving 120 805 nonfrail (robust or prefrail) participants from 28 countries were included in this systematic review. Among the nonfrail individuals who survived a median follow-up of 3.0 (range, 1.0-11.7) years, 13.6% (13 678 of 100 313) became frail, with the pooled incidence rate being 43.4 (95% CI, 37.3-50.4; I2 = 98.5%) cases per 1000 person-years. The incidence of frailty was significantly higher in prefrail individuals than robust individuals (pooled incidence rates, 62.7 [95% CI, 49.2-79.8; I2 = 97.8%] vs 12.0 [95% CI, 8.2-17.5; I2 = 94.9%] cases per 1000 person-years, respectively; P for difference < .001). Among robust individuals in 21 studies who survived a median follow-up of 2.5 (range, 1.0-10.0) years, 30.9% (9974 of 32 268) became prefrail, with the pooled incidence rate being 150.6 (95% CI, 123.3-184.1; I2 = 98.9%) cases per 1000 person-years. The frailty and prefrailty incidence rates were significantly higher in women than men (frailty: 44.8 [95% CI, 36.7-61.3; I2 = 97.9%] vs 24.3 [95% CI, 19.6-30.1; I2 = 8.94%] cases per 1000 person-years; prefrailty: 173.2 [95% CI, 87.9-341.2; I2 = 99.1%] vs 129.0 [95% CI, 73.8-225.0; I2 = 98.5%] cases per 1000 person-years). The incidence rates varied by diagnostic criteria and country income level. The frailty and prefrailty incidence rates were significantly reduced when accounting for the risk of death. CONCLUSIONS AND RELEVANCE Results of this study suggest that community-dwelling older adults are prone to developing frailty. Increased awareness of the factors that confer high risk of frailty in this population subgroup is vital to inform the design of interventions to prevent frailty and to minimize its consequences.
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Affiliation(s)
- Richard Ofori-Asenso
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ken L. Chin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Mohsen Mazidi
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Ella Zomer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jenni Ilomaki
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Andrew R. Zullo
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island
- Center of Innovation in Long Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, Rhode Island
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Maarit J. Korhonen
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Dina LoGiudice
- Department of Aged Care, Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - J. Simon Bell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
- Centre for Research Excellence in Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Gordon EH, Hubbard RE. Do sex differences in chronic disease underpin the sex-frailty paradox? Mech Ageing Dev 2019; 179:44-50. [PMID: 30825457 DOI: 10.1016/j.mad.2019.02.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/17/2019] [Accepted: 02/26/2019] [Indexed: 12/21/2022]
Abstract
The 'male-female health-survival paradox' is a well-described clinical phenomenon. More recently, it has been conceptualized as a 'sex-frailty paradox': females may be considered to be more frail (because they have poorer health status) but also less frail (because they are less vulnerable to death) than males of the same age. Here, we review potential biological, behavioral and social mechanisms underpinning sex differences in morbidity, mortality and frailty before considering the question at the center of the sex paradox - why is it that females are able to tolerate poor health better than males? We explore, in detail, a frequently cited explanation for the sex paradox that centers on sex differences in chronic disease and conclude by presenting a new approach to this old hypothesis.
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Affiliation(s)
- E H Gordon
- Centre for Health Services Research, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia.
| | - R E Hubbard
- Centre for Health Services Research, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia
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15
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Gao J, Jia Y, Dai J, Fu H, Wang Y, Yan H, Zhu Y, Nie X. Association of Fruit and Vegetable Intake and Frailty among Chinese Elders: A Cross-Sectional Study in Three Cities. J Nutr Health Aging 2019; 23:890-895. [PMID: 31641741 DOI: 10.1007/s12603-019-1236-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To examine the association of FVI and frailty in Chinese elders. DESIGN A sectional study was conducted in three cities (Shanghai, Zhengzhou, and Baoji) in China from June 2017 to June 2018. PARTICIPANTS A total of 5699 participants from 49 districts were included in the current study by two-stage sampling methods. MEASUREMENTS Frailty was measured by a validated Chinese version of the FRAIL scale. FVI per day was measured by two single questions. RESULTS The sample proportion with sufficient fruit intake was 36.7%, and 44.7% reported sufficient vegetable intake. The sample proportions that were robust, pre-frail, and frail were 43.6%, 38.3%, and 18.1%, respectively. Compared with low FVI, after including covariates, the odds ratio (OR) of frailty was 0.84 (95% CI: 0.73-0.97) for moderate fruit intake and 0.81 (95% CI: 0.70-0.94) for enough fruit intake; the OR of frailty was 0.83 (95% CI: 0.68-0.91) for moderate vegetable intake and 0.77 (95% CI: 0.64-0.93) for enough vegetable intake. CONCLUSION High FVI was negatively associated with the OR of frailty in Chinese elders. This finding implies it is important to promote FVI among adults to prevent frailty.
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Affiliation(s)
- J Gao
- Junling Gao, Po BOX 248, 138 Yixueyuan Road, 200032 Shanghai, 86-21542377779,
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16
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Affiliation(s)
- Jennifer Moye
- a New England GRECC , VA Boston Healthcare System , Jamaica Plain , Massachusetts , USA
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17
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Lasebikan VO, Ayinde O, Odunleye M, Adeyefa B, Adepoju S, Fakunle S. Prevalence of alcohol consumption and alcohol use disorders among outdoor drinkers in public open places in Nigeria. BMC Public Health 2018; 18:400. [PMID: 29580226 PMCID: PMC5870070 DOI: 10.1186/s12889-018-5344-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 03/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a rapid shift in the social context of drinking, with a large proportion of regular drinkers favouring outdoor-open space drinking, such as motor-parks, by the road sides, the majority of which are unlicensed premises for drinking. METHOD This study determined the prevalence and determinants of harmful or hazardous alcohol use and possible dependence, defined as a "likely alcohol use disorder" (AUD) in a community sample of 1119 patrons of open space drinking places in Ibadan, Nigeria, using the AUDIT. Scores of 8 and above signified a likely AUD. The associations between a likely AUD and demographic characteristics were sought using Chi square statistics and binary regression analysis was used to determine the effects of multiple confounding variables on a likely AUD using the SPSS version 20.0 software. RESULTS Of the entire population, the prevalence of likely AUD was 39.5%, and 44.4% out of the drinking population Multivariate analysis showed that Islamic religion was a negative predictor for likely AUD, OR = 0.13, 95% CI (0.06-0.26), while rural residence, OR = 1.84, 95% CI (1.34-2.53) and cigarette smoking OR = 1.81, 95% CI (1.37-2.40) were predictive of likely AUD. CONCLUSION Outdoor-open space drinkers are likely to have AUD compared with the general population. Open space drinking has a huge public health implication because of the associated health risks and injuries.
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Affiliation(s)
- Victor O Lasebikan
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, PMB 5116, Nigeria.
| | - Olatunde Ayinde
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Mayokun Odunleye
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Babajide Adeyefa
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Samson Adepoju
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Shina Fakunle
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
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