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Li X, Pan Y, Zhang L, Zhang Y, Tang Z, Ma L. Function Impairment Screening Tool predicts eight-year mortality in older adults: Beijing Longitudinal Study of Aging. J Nutr Health Aging 2024; 28:100384. [PMID: 39418749 DOI: 10.1016/j.jnha.2024.100384] [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: 08/19/2024] [Revised: 09/30/2024] [Accepted: 10/01/2024] [Indexed: 10/19/2024]
Abstract
PURPOSE Function impairment is an early stage of disability in older adults and requires timely intervention. We have previously developed Function Impairment Screening Tool (FIST) based on the Delphi method, which has good reliability and validity, but the predictive effect is unknown. Therefore, we aimed to explore the role of FIST in predicting long-term mortality in community-dwelling older adults. PARTICIPANTS AND METHODS Data were from the Beijing Longitudinal Study of Aging. A total of 1,833 older adults with 8 years of follow-up were included. Function impairment was assessed using FIST. Cox proportional hazards model was used to calculate the predictive effect of FIST on 8-year all-cause mortality. RESULTS According to FIST, approximately half of the older adults had function impairment (47.6%). The prevalence of function impairment varied across populations. Logistic regression analysis showed that age, female, rural, poor health satisfaction, not drinking tea, and low Mini-Mental State Examination and intrinsic capacity score were associated with function impairment. Furthermore, function impairment was associated with poor physical function and high mortality. Cox analysis showed that FIST could predict 8-year mortality (hazard ratio [HR] = 3.26, 95% confidence interval [CI] 2.74-3.87), and this relationship persisted after adjusting for age, sex, area, marital status, live alone, educational level, smoking, drinking alcohol, and chronic diseases (HR = 1.79, 95% CI 1.45-2.17). DISCUSSION FIST can predict 8-year mortality in community-dwelling older adults. More attention should be paid to older adults with function impairment and early intervention should be provided.
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Affiliation(s)
- Xiaxia Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
| | - Yiming Pan
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
| | - Li Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
| | - Yaxin Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing Institute of Geriatrics, Beijing 100053, China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Medicine, Beijing 100053, China.
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Jiang X, Chen F, Yang X, Yang M, Zhang X, Ma X, Yan P. Effects of personal and health characteristics on the intrinsic capacity of older adults in the community: a cross-sectional study using the healthy aging framework. BMC Geriatr 2023; 23:643. [PMID: 37817083 PMCID: PMC10566030 DOI: 10.1186/s12877-023-04362-7] [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: 10/22/2022] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Intrinsic capacity (IC) can better reflect the physical functioning of older adults. However, few studies have been able to systematically and thoroughly examine its influencing factors and provide limited evidence for the improvement of intrinsic capacity. The objective of this study was to provide a comprehensive description of the overall decline in intrinsic capacity among older persons in the community. Additionally, the study aimed to analyze the composition of the five domains of reduction, compare the rate of decline among older adults and investigate the factors that influence this decline. METHODS This was a cross-sectional study conducted in the Chinese community. The self-designed general characteristics questionnaire was created based on the healthy aging framework and a systematic review. Intrinsic capacity was assessed with the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), Community Health Record Management System (CHRMS), Mini Nutritional Assessment Brief Form (MNA-SF), and Short Physical Performance Battery (SPPB). The influencing factors of intrinsic capacity were investigated using stepwise logistic regression. RESULTS A total of 968 older adults with a mean age of 71.00 (68.00, 76.75) were examined, and 704 older adults (72.7%) showed a decline in intrinsic capacity. There was a decline in at least one domain in 39.3% of older adults, with reductions in each domain ranging from 5.3% (psychological) to 52.4% (sensory). The study examined the composition of domains that experienced a decline in intrinsic capacity. It was found that a combination of sensory and locomotor domains showed the most significant decrease in 44.5% (n = 106) of individuals who experienced a decline in the two domains. Furthermore, a combination of sensory, cognitive, and locomotor domains exhibited a significant decrease in 51.3% (n = 44) of individuals who experienced a reduction in three domains. Lastly, a combination of sensory, vitality, cognitive, and locomotor domains showed the most significant decline in four domains, accounting for 60.0% (n = 15) of the population. Older adults had a higher risk of intrinsic capacity decline if they were older (95% CI:1.158-2.310), had lower education, lived alone (95% CI: 1.133-3.216), smoked (95% CI: 1.163-3.251), high Charlson Comorbidity Index (95% CI: 1.243-1.807) scores, did not regular exercise (95% CI:1.150-3.084), with lower handgrip strength (95% CI: 0.945-0.982). CONCLUSIONS We found a relatively high prevalence of intrinsic capacity; more attention should be paid to older adults who are older, less educated, live alone, and have more comorbidities. It is imperative to prioritize a healthy lifestyle among older persons who exhibit smoking habits, lack regular exercise, and possess inadequate handgrip strength.
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Affiliation(s)
- Xin Jiang
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China
| | - Fenghui Chen
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China
| | - Xuanxuan Yang
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China
| | - Mei Yang
- Xingfu Road Branch of Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University (Xingfu Road Community Center), No.226, Xingfu Road, Tianshan District, Urumqi, 830002, China
| | - Xuehong Zhang
- Xingfu Road Branch of Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University (Xingfu Road Community Center), No.226, Xingfu Road, Tianshan District, Urumqi, 830002, China
| | - Xuan Ma
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China
| | - Ping Yan
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China.
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Functional Aging: Integrating Functionality to a Multidimensional Assessment of Healthy Aging. Curr Gerontol Geriatr Res 2023; 2023:9409918. [PMID: 36748046 PMCID: PMC9899138 DOI: 10.1155/2023/9409918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/15/2022] [Accepted: 01/20/2023] [Indexed: 01/29/2023] Open
Abstract
Worldwide, the number of old adults will peak in the coming decades. Relying solely on the chronological age to make treatment decisions and shape general or specific societal and medical considerations may reinforce ageism and lead to flawed reasoning. Defining physiological age using biological markers is not yet reliable, and an approach based on comorbidities without considering their impact on quality of life is inadequate. A multidimensional approach with strong integration of functionality is presented here to draw a real-world aging approach, easily accessible, clinically relevant, and of societal value.
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Yu R, Lai D, Leung G, Woo J. Trajectories of Intrinsic Capacity: Determinants and Associations with Disability. J Nutr Health Aging 2023; 27:174-181. [PMID: 36973922 DOI: 10.1007/s12603-023-1881-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Intrinsic capacity (IC) declines progressively with age, thereby increasing the risk of disability. However, it is less known whether IC trajectories are associated with disability. This study aims to identify the different patterns of IC trajectories in older people, and examine their determinants and associations with Instrumental Activities of Daily Living (IADL). DESIGN Cohort study. SETTING Community centres in different regions in Hong Kong. PARTICIPANTS AND MEASUREMENTS Longitudinal data from community-dwelling older people aged 60 years or above (n = 1371) collected between 2016 and 2021 was analysed. Their mean age was 74.5 years, and 78.7% of them were female. Repeated measurements of a set of 14 self-reported items were used to generate IC scores at four time points using a bi-factor model. Latent class growth analysis was performed to identify classes with distinct IC trajectories. The association between class membership and IADL disability was then examined using logistic regression. RESULTS Three distinct IC trajectories were identified. The 1st class included those with the highest level of baseline IC and the least declining trajectory, whereas the 3rd class was composed by those with the lowest level of baseline IC and the most declining trajectory. Older age, female gender, lower perceived financial adequacy, living in public or subsidized housing, and chronic diseases were associated with the 3rd class. After adjusting for demographic factors, socioeconomic status, and the number of chronic diseases, the 1st class was more likely to preserve IADL when compared against the 2nd class, with OR being 3.179 (95% CI: 2.152-4.793), whereas for the 3rd class, the OR was 0.253 (95% CI: 0.178-0.359). CONCLUSION Monitoring IC trajectories is of relevance to clinical practice, as it helps shift the focus from treating acute episodes of illness to preserving the functional ability of older people.
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Affiliation(s)
- R Yu
- Ruby Yu, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China, Tel: (852) 3943 5142, Fax: (852) 2637 9215, E-mail:
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Mateo-Abad M, Vrotsou K, Padilla Ruiz M, Montiel-Luque A, Saucedo Figueredo MDC, Machón M, Rivas Ruiz F, Vergara I. Use of health care services according to functional performance in community-dwelling older adults in Spain. An approach using GAMLSS models. PLoS One 2022; 17:e0277681. [PMID: 36395339 PMCID: PMC9671440 DOI: 10.1371/journal.pone.0277681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
Functional performance in older adults is a predictor of survival and other health outcomes and its measurement is highly recommended in primary care settings. Functional performance and frailty are closely related concepts, and frailty status is associated with the use of health care services. However, there is insufficient evidence on the utilization of services profile according to the functional performance of older adults. The aim of this study was to assess the relationship between functional performance and the use of a wide range of health services in community-dwelling older adults. Generalized additive models for location, scale and shape were used to study these complex data of services utilization, from primary to hospital care. A total of 749 participants from two Spanish regions were followed up for 2 years. Of those, 276 (37%) presented low functional performance and 473 (63%) normal performance according to the Timed Up and Go test. The results showed that even after adjusting for burden of comorbidity and polypharmacy, participants with low functional performance used primary and secondary care health services more intensively, visited emergency rooms more often, and were hospitalized more frequently and for longer periods of time. A negative binomial distribution and a variant thereof were found to be the best models to describe health service utilization data. In conclusion, functionality should be considered as an important health indicator for tailoring the provision of health services for older adults.
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Affiliation(s)
- Maider Mateo-Abad
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, Gipuzkoa, España
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- * E-mail:
| | - Kalliopi Vrotsou
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, Gipuzkoa, España
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
| | - María Padilla Ruiz
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España
| | - Alonso Montiel-Luque
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- Centro de Salud San Miguel, Distrito Sanitario Costa del Sol, Torremolinos, Málaga, España
| | - María del Carmen Saucedo Figueredo
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- Centro de Salud Los Boliches, Distrito Sanitario Costa del Sol, Fuengirola, Málaga, España
| | - Mónica Machón
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, Gipuzkoa, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
| | - Francisco Rivas Ruiz
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España
| | - Itziar Vergara
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, Gipuzkoa, España
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
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León S, Giacaman RA. Proposal for a Conceptual Framework for the Development of Geriatric Dentistry. J Dent Res 2021; 101:247-252. [PMID: 34581227 DOI: 10.1177/00220345211042268] [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] [Indexed: 01/16/2023] Open
Abstract
Demographic changes with an increasingly higher proportion of older adults worldwide and an epidemiologic transition resulting in more teeth retained and higher demand and expectations set up new scenarios for the oral health of the older population. Thus, geriatric dentistry must be reconfigured, transitioning from the traditional focus on prosthesis to a more holistic discipline, actively incorporating geriatric and gerontologic aspects. We describe some situations that provide the rationale for a new conceptual framework for the advancement of geriatric dentistry as a clinical specialty. On the basis of scientific evidence and our academic experience, we propose 4 concepts that should steer the discipline during the following years and become its structural pillars: minimal intervention dentistry, oral functionality, patient-centered care, and interdisciplinary teamwork. Since data and evidence are limited, a special focus on poor and developing countries is incorporated. Adjusting clinical guidelines and public health policies around these concepts will increase access to oral care for older people, including those with physical or social barriers, and will ensure better oral health-related quality of life and well-being. These concepts have deep consequences in the education and training of new dentists and specialists, at the public and private levels.
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Affiliation(s)
- S León
- Gerodontology and Cariology Units, Department of Oral Rehabilitation, Faculty of Health Sciences, University of Talca, Talca, Chile.,Chilean Society for Geriatric Dentistry, Talca, Chile.,Interuniversity Center on Healthy Aging, Chile
| | - R A Giacaman
- Gerodontology and Cariology Units, Department of Oral Rehabilitation, Faculty of Health Sciences, University of Talca, Talca, Chile.,Chilean Society for Geriatric Dentistry, Talca, Chile.,Interuniversity Center on Healthy Aging, Chile
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Saint-Criq V, Lugo-Villarino G, Thomas M. Dysbiosis, malnutrition and enhanced gut-lung axis contribute to age-related respiratory diseases. Ageing Res Rev 2021; 66:101235. [PMID: 33321253 DOI: 10.1016/j.arr.2020.101235] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/23/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
Older people are at an increased risk of developing respiratory diseases such as chronic obstructive pulmonary diseases, asthma, idiopathic pulmonary fibrosis or lung infections. Susceptibility to these diseases is partly due to the intrinsic ageing process, characterized by genomic, cellular and metabolic hallmarks and immunosenescence, and is associated with changes in the intestinal microbiota. Importantly, in the lungs, ageing is also associated with a dysbiosis and loss of resilience of the resident microbiota and alterations of the gut-lung axis. Notably, as malnutrition is often observed in the elderly, nutrition is one of the most accessible modifiable factors affecting both senescence and microbiota. This article reviews the changes affecting the lung and its resident microbiota during ageing, as well as the interconnections between malnutrition, senescence, microbiota, gut-lung axis and respiratory health. As the communication along the gut-lung axis becomes more permissive with ageing, this review also explores the evidence that the gut and lung microbiota are key players in the maintenance of healthy lungs, and as such, are potential targets for nutrition-based preventive strategies against lung disease in elderly populations.
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8
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Camafort M, Kario K. Hypertension, heart failure, and frailty in older people: A common but unclear situation. J Clin Hypertens (Greenwich) 2020; 22:1763-1768. [PMID: 32815630 DOI: 10.1111/jch.14004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 01/16/2023]
Abstract
Hypertension and heart failure are common conditions in older people. Comorbidity, together with aging, is commonly associated with frailty, which is a cause of a worse prognosis, more hospitalizations, increased dependency, and mortality. Despite being increasingly common conditions, data on the prevalence and influence of frailty in hypertensive older patients with HF are lacking. This may be due to the multidimensional aspects of frailty and the differing tools used to evaluate it. Nevertheless, in clinical practice, it is common to see frail hypertensive patients with HF but the specific characteristics of this group of patients, including multimorbidity and frailty, and the lack of data from registries or randomized clinical trials make the diagnosis and management of these patients more difficult than in those of other ages. This review focuses on what is known and on where future investigations should focus in this common but unclear situation.
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Affiliation(s)
- Miguel Camafort
- Hypertension and Heart Failure Units, Department of Internal Medicine, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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9
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Batko-Szwaczka A, Wilczyński K, Hornik B, Janusz-Jenczeń M, Włodarczyk I, Wnuk B, Szołtysek J, Durmała J, Szuster-Kowolik K, Antoniak-Sobczak K, Dulawa J, Szewieczek J. Predicting Adverse Outcomes in Healthy Aging Community-Dwelling Early-Old Adults with the Timed Up and Go Test. Clin Interv Aging 2020; 15:1263-1270. [PMID: 32801674 PMCID: PMC7402859 DOI: 10.2147/cia.s256312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/26/2020] [Indexed: 11/23/2022] Open
Abstract
Background Simple, easy-to-perform, safe and cost-effective methods for the prediction of adverse outcomes in older adults are essential for the identification of patients who are most likely to benefit from early preventive interventions. Methods The study included 160 community-dwelling individuals aged 60-74 years, with 44.4% women. A comprehensive geriatric assessment was performed in all participants. Bioimpedance body composition analysis included 149 subjects. Among other tests, functional assessment included the Barthel Index of Activities of Daily Living (Barthel Index), Mini-Mental State Examination (MMSE), Timed Up and Go (TUG) and Fried frailty phenotype. Follow-up by telephone was made after at least 365 days. The composite endpoint (CE) included fall, hospitalization, institutionalization and death. Results Cohort characteristics: age 66.8±4.2 years (mean±SD), 3.81±2.23 diseases, 4.29±3.60 medications or supplements, and good functional status (MMSE 29.0±1.5, Barthel Index 98.1±8.2, prevalence of Fried frailty phenotype 2.5%). During one-year follow-up, 34 subjects (21.3%; 95% confidence interval [CI] =14.9-27.6%) experienced CE: hospitalizations (13.8%; 95% CI=8.41-19.1), falls (9.38%; 95% CI=4.86-13.9), death (0.63%; 95% CI=0-1.85) and no institutionalization. A higher probability of CE was associated with age ≥70 years (P=0.018), taking any medication or supplements (P=0.007), usual pace gait speed ≤0.8 m/s (P=0.028) and TUG >9 s (P<0.002). TUG was the only independent measure predicting one-year CE occurrence (OR=1.22, 95% CI=1.07-1.40, P=0.003) in multivariate logistic regression. However, its predictive power was poor; the area under the receiver operating characteristic curve was 0.659 (95% CI 0.551-0.766, P=0.004) and Youden's J statistic for a TUG cut-off of 9.0 s was 0.261 (sensitivity 0.618 and specificity 0.643). Conclusion The TUG test was superior to frailty phenotype measures in predicting one-year incidence of a CE consisting of fall, hospitalization, institutionalization and death in a cohort of healthy-aging community-dwelling early-old adults, although its value as a stand-alone test was limited.
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Affiliation(s)
- Agnieszka Batko-Szwaczka
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Wilczyński
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Hornik
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Janusz-Jenczeń
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Iwona Włodarczyk
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bartosz Wnuk
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Szołtysek
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jacek Durmała
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Karolina Szuster-Kowolik
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Antoniak-Sobczak
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Dulawa
- Department of Internal Medicine and Metabolic Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Szewieczek
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Michel JP, Ecarnot F. Integrating functional ageing into daily clinical practice. J Frailty Sarcopenia Falls 2020; 4:30-35. [PMID: 32300715 PMCID: PMC7155303 DOI: 10.22540/jfsf-04-030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2019] [Indexed: 12/20/2022] Open
Abstract
The analysis of the ageing trajectory clearly demonstrates the constant involvement of functional ability in daily life, from its development in youth, to its preservation through midlife into very old age. While maintaining function appears to be largely related to persistent regular exercise, the risk factors for functional decline are extremely diverse, ranging from a decrease or discontinuation of physical activity, to nutritional/metabolic disturbances, chronic diseases and unfavourable socio-demographic and socio-economic contexts. Prevention of functional decline is a major public health challenge, both for individuals and for society as a whole, and needs to be urgently addressed. Engaging citizens to be conscious of their responsibility for, and role in their own ageing process is equally as important as reinforcing the involvement of society in promoting healthy ageing through enhanced basic and health education, promotion of a healthy diet, long term practice of moderate physical activity, and the continual battle against deleterious life habits and behaviours. The success of these combined actions would be quite simply demonstrated by a change from the current pandemics of morbidity, to the compression of disability, which is expected by all.
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Affiliation(s)
- Jean-Pierre Michel
- University of Geneva, Switzerland and French Academy of Medicine, Paris, France
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11
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Alcañiz M, Solé-Auró A. Feeling good in old age: factors explaining health-related quality of life. Health Qual Life Outcomes 2018. [PMID: 29534708 PMCID: PMC5851254 DOI: 10.1186/s12955-018-0877-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Sustained growth in longevity raises questions as to why some individuals report a good quality of life in older ages, while others seem to suffer more markedly the effects of natural deterioration. Health-related quality of life (HRQL) is mediated by several easily measurable factors, including socio-demographics, morbidity, functional status and lifestyles. This study seeks to further our knowledge of these factors in order to outline a profile of the population at greater risk of poor ageing, and to identify those attributes that might be modified during younger stages of the life course. Methods We use nationally representative data for Catalonia (Spain) to explain the HRQL of the population aged 80-plus. Cross-sectional data from 2011 to 2016 were provided by an official face-to-face survey. HRQL was measured using EQ-VAS – the EuroQol-5D visual analogue scale – which summarizes current self-perceived health. Multivariate linear regression was used to identify variables influencing the EQ-VAS score. Results Sociodemographic factors, including being older, female, poorly educated and belonging to a low social class, were related with poor HRQL at advanced ages. The presence of severe mobility problems, pain/discomfort, and anxiety/depression were highly correlated to the HRQL of the elderly, while problems of self-care and with usual activities had a weaker association. Conclusions Encouraging the young to stay in education, as well as to adopt healthier lifestyles across the lifespan, might ensure better HRQL when individuals reach old age. More multidisciplinary research is required to understand the multifaceted nature of quality of life in the oldest-old population.
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Affiliation(s)
- Manuela Alcañiz
- Riskcenter, Department of Econometrics, Statistics and Applied Economy, Universitat de Barcelona, Av. Diagonal 690, 08034, Barcelona, Spain. .,Faculty of Economics and Business, Universitat Oberta de Catalunya, Av. Tibidabo 39-43, 08035, Barcelona, Spain.
| | - Aïda Solé-Auró
- DemoSoc Research Group, Department of Political and Social Sciences, Universitat Pompeu Fabra, C/ Ramon Trias Fargas, 25-27, 08005, Barcelona, Spain
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12
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Functional ability: An effective biomarker of healthy ageing independently of multimorbidity. Maturitas 2017. [DOI: 10.1016/j.maturitas.2017.03.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jover J, Abasolo L. Early intervention to restore function and maintain healthy trajectory. Best Pract Res Clin Rheumatol 2017; 31:275-288. [DOI: 10.1016/j.berh.2017.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 10/31/2017] [Indexed: 01/13/2023]
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Beard JR, Officer A, de Carvalho IA, Sadana R, Pot AM, Michel JP, Lloyd-Sherlock P, Epping-Jordan JE, Peeters GMEEG, Mahanani WR, Thiyagarajan JA, Chatterji S. The World report on ageing and health: a policy framework for healthy ageing. Lancet 2016; 387:2145-2154. [PMID: 26520231 PMCID: PMC4848186 DOI: 10.1016/s0140-6736(15)00516-4] [Citation(s) in RCA: 1357] [Impact Index Per Article: 169.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although populations around the world are rapidly ageing, evidence that increasing longevity is being accompanied by an extended period of good health is scarce. A coherent and focused public health response that spans multiple sectors and stakeholders is urgently needed. To guide this global response, WHO has released the first World report on ageing and health, reviewing current knowledge and gaps and providing a public health framework for action. The report is built around a redefinition of healthy ageing that centres on the notion of functional ability: the combination of the intrinsic capacity of the individual, relevant environmental characteristics, and the interactions between the individual and these characteristics. This Health Policy highlights key findings and recommendations from the report.
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Affiliation(s)
- John R Beard
- Ageing and Life Course, World Health Organization, Geneva, Switzerland.
| | - Alana Officer
- Ageing and Life Course, World Health Organization, Geneva, Switzerland
| | | | - Ritu Sadana
- Ageing and Life Course, World Health Organization, Geneva, Switzerland
| | - Anne Margriet Pot
- Ageing and Life Course, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Wahyu Retno Mahanani
- Health statistics and information systems, World Health Organization, Geneva, Switzerland
| | | | - Somnath Chatterji
- Health statistics and information systems, World Health Organization, Geneva, Switzerland
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Affiliation(s)
- John R Beard
- Department of Ageing and Life Course, WHO, Geneva, Switzerland.
| | - David E Bloom
- Harvard School of Public Health, Harvard University, Boston MA, USA
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Noble S, Frangos E, Samaras N, Ellenberger C, Frangos C, Cikirikcioglu M, Bendjelid K, Frei A, Myers P, Licker M, Roffi M. Transcatheter aortic valve implantation in nonagenarians: effective and safe. Eur J Intern Med 2013; 24:750-5. [PMID: 23932885 DOI: 10.1016/j.ejim.2013.07.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/01/2013] [Accepted: 07/05/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND The number of nonagenarians is rising dramatically. These patients often develop severe aortic stenosis for which transcatheter aortic valve implantation (TAVI) is an attractive option. The aim of this study was to analyze the outcome of TAVI performed in a cohort of nonagenarian patients. METHODS Between August 2008 and November 2012, 23 consecutive patients in their 90th year of age or older underwent TAVI in our institution after having been assessed by the local heart team. Data concerning baseline characteristics, procedural details and outcome were prospectively entered into a dedicated database. Transthoracic echocardiography and clinical follow-up were performed pre-procedure, at discharge, at 6 and 12 months and then annually post TAVI. RESULTS Patients were male in 52% with a mean age of 90.3 ± 2.3 years. Mean logistic EuroSCORE and STS score were 26.6 ± 14.5% and 8.7 ± 2.9%, respectively. Transcatheter heart valve (THV) could be implanted in all but one patient. Mortality at 30 days was 8.7% overall and 4.8% for transfemoral approach. At 30 days the rate of stroke was 4.3%, paravalvular leak grade ≥ 2 was 8.7%, life-threatening bleeding was 13.0% and pacemaker implantation was 13%. Device success was 73.9%. The rate of all-cause mortality increased to 27.3% at one-year follow-up and 42.8% at a median follow-up of 417 days. CONCLUSIONS TAVI is safe and effective even in a selected population of nonagenarians. Consequently, these patients should not be refused such a procedure based only on their age. Multi-disciplinary assessment is essential in order to properly select candidates.
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Affiliation(s)
- Stephane Noble
- Cardiology Division, Interventional Cardiology Unit, University Hospital of Geneva, Switzerland.
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Takata Y, Ansai T, Soh I, Awano S, Nakamichi I, Akifusa S, Goto K, Yoshida A, Sonoki K. Activities of daily living dependency and disease-specific mortality during 12-year follow-up in an 80-year-old population. Aging Clin Exp Res 2013; 25:193-201. [PMID: 23739905 DOI: 10.1007/s40520-013-0029-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 07/10/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Although total mortality is likely to be higher in elderly individuals with frailty or impaired activities of daily living (ADL), little is known about the relationships between disease-specific mortality and ADL dependency in the elderly. Therefore, we examined whether 12-year disease-specific mortality may be associated with ADL dependency in an 80-year-old population. METHODS In 1998, of 1,282 community-dwelling residents of Japan's Fukuoka Prefecture, 824 (64.3 %) (309 males and 515 females) participated, the remaining 458 subjects did not participate, and their deaths and causes of death were followed up for 12 years after the baseline examination. ADL dependency was determined according to the guidelines for disabled elderly from the Health, Labor, and Welfare Ministry of Japan, and ADL dependency was measured only at baseline. RESULTS During the 12-year follow-up, 506 died, 276 did not die, and 42 were lost. Of the 506 who died, 128 died due to cardiovascular disease, 96 to respiratory tract disease, 87 to cancer, and 51 to senility. The subjects were classified into three groups as follows: ADL-1 (independent group, n = 600), ADL-2 (almost-independent group, n = 113), and ADL-3 (dependent group, n = 93).Total-cause mortality was 2.8 times higher in ADL-3 subjects, respiratory disease mortality was 4.1 times higher in ADL-3 subjects, and senility mortality was 5.7 times higher in ADL-3 subjects than in ADL-1 subjects, after adjusting for various confounding factors. There was no association between mortality due to cancer or cardiovascular disease and ADL dependency. CONCLUSIONS We found an independent association between ADL dependency and mortality due to all causes, respiratory disease or senility, but no association with mortality due to cancer or cardiovascular disease. These findings suggest that improving ADL dependency may reduce all mortality and mortality due to respiratory disease or senility.
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Affiliation(s)
- Yutaka Takata
- Division of General Internal Medicine, Kyushu Dental College, Manazuru 2-6-1, Kokurakita-ku, Kitakyushu, 803-8580, Japan.
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Noble S, Frangos E, Frei A, Roffi M. Transcatheter Aortic Valve Implantation in a 99-Year-Old Woman: Are We Going Too Far? J Am Geriatr Soc 2012; 60:1774-5. [DOI: 10.1111/j.1532-5415.2012.04133.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Stephane Noble
- Cardiology Division; Interventional Cardiology Unit; University Hospital of Geneva; Geneva; Switzerland
| | | | - Angela Frei
- Cardiology Division; Interventional Cardiology Unit; University Hospital of Geneva; Geneva; Switzerland
| | - Marco Roffi
- Cardiology Division; Interventional Cardiology Unit; University Hospital of Geneva; Geneva; Switzerland
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