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Roseti L, Borciani G, Grassi F, Desando G, Gambari L, Grigolo B. Nutraceuticals in osteoporosis prevention. Front Nutr 2024; 11:1445955. [PMID: 39416651 PMCID: PMC11479890 DOI: 10.3389/fnut.2024.1445955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 09/03/2024] [Indexed: 10/19/2024] Open
Abstract
Nutraceuticals are gaining popularity as they can contribute to bone health by delaying the onset or slowing down the progression of pathological bone loss. Osteoporosis's bone loss is a concern for older adults and a crucial aspect of aging. Maintaining healthy bones is the key to living a full and active life. Our review explores the current knowledge on the role of nutraceuticals in preventing osteoporosis by focusing on three main aspects. First, we provide an overview of osteoporosis. Second, we discuss the latest findings on natural nutraceuticals and their efficacy in reducing bone loss, emphasizing clinical trials. Third, we conduct a structured analysis to evaluate nutraceuticals' pros and cons and identify translational gaps. In conclusion, we must address several challenges to consolidate our knowledge, better support clinicians in their prescriptions, and provide people with more reliable nutritional recommendations to help them lead healthier lives.
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Affiliation(s)
| | - Giorgia Borciani
- RAMSES Laboratory, Rizzoli RIT-Research, Innovation & Technology Department, Istituto di Ricerca Codivilla Putti, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Urrunaga-Pastor D, Salazar-Talla L, Alcantara-Diaz AL, Camacho-Caballero K, Cuba-Ruiz S, Runzer-Colmenares FM, Parodi JF. Association between frailty and activities of daily living disability in older adults residing in a high-altitude Peruvian Andean community: the Aunqui-Andes study. BMC Geriatr 2024; 24:792. [PMID: 39342104 PMCID: PMC11438180 DOI: 10.1186/s12877-024-05381-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 09/13/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND The prevalence of frailty and activities of daily living (ADL) disability may be higher in high-altitude Andean regions, due to chronic hypoxia, malnutrition, and physical challenges. and their association is relevant. This study aimed to evaluate the association between frailty and ADL disability among older adults residing in the Totos district in Peru during the year 2022. METHODS A cross-sectional study was conducted in Totos district (mean altitude: 3286 m above sea level), located in Ayacucho, Peru, during 2022. A complete census was employed including residents aged 60 and above. The exposure variable was frailty, defined by fulfilling 3 or more criteria of the Fried phenotype. The outcome variable was ADL disability, defined as a score below 95 on the Barthel index. Generalized linear models with a Poisson family, logarithmic link function, and robust variances were employed to estimate crude prevalence ratios and adjusted prevalence ratios (aPRs), along with their corresponding 95% confidence intervals (CIs). RESULTS We evaluated 272 older adults with a mean age of 74 years, of whom 59.9% were female, 62.1% were cohabiting or married and 83.1% had not completed primary education. We found that 19.5% were frail, while 51.1% had ADL disability. In the adjusted regression model, we found frailty increased the prevalence of ADL disability (aPR = 1.77; 95%CI: 1.44-2.16; p < 0.001). CONCLUSION Frailty was associated with an increased prevalence of ADL disability. These findings could contribute to establishing government intervention plans to manage disability and frailty within the high-risk group comprising older adults living at high altitudes.
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Affiliation(s)
- Diego Urrunaga-Pastor
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru.
| | - Leslie Salazar-Talla
- Grupo Estudiantil de Investigación en Salud Mental (GISAM), Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martin de Porres, Lima, Peru
| | - Ana L Alcantara-Diaz
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Kiara Camacho-Caballero
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Sofia Cuba-Ruiz
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Lima, Peru
| | - Fernando M Runzer-Colmenares
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - José F Parodi
- Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad de San Martin de Porres, Lima, Peru
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Deeg DJH, Hoogendijk EO, van Schoor NM, Schaap LA, Lima Passos V. Joint Trajectories of Performance-Based and Self-Reported Physical Functioning in Older Adults: A 20-Year Longitudinal Study in the Netherlands. J Aging Health 2024:8982643241273298. [PMID: 39167684 DOI: 10.1177/08982643241273298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
BACKGROUND The well-known disablement process has been conceptualized as a series of transitions between progressive states of functional decline. We studied joint patterns of change within disablement states defined as walking speed, grip strength, and self-reported disability. METHODS 1702 participants aged 65 and over were included from the Longitudinal Aging Study Amsterdam, spanning seven waves over 20 years (1996-2016). Group-based multi-trajectory modeling yielded trajectory clusters (TCs) of different patterns of change, further characterized by baseline sociodemographic characteristics, physical and cognitive health, and survival rate. RESULTS Five TCs were identified, distinguished by increasing baseline age. Walking speed and disability showed generally concomitant trajectories. Women had poorer trajectories in grip strength than men, but not in walking speed and disability. Poor physical health distinguished especially the poorest, and cognitive impairment distinguished especially the one-before-poorest from the better TCs. DISCUSSION The findings suggest that the disablement states are not generally distinct or sequential.
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Affiliation(s)
- Dorly J H Deeg
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Emiel O Hoogendijk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Laura A Schaap
- Faculty of Science, Department of Health Sciences, Amsterdam Public Health Research Institute/Ageing and Later Life program, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Valéria Lima Passos
- Maastricht University, Faculty of Health, Medicine and Life Sciences, Department of Methodology and Statistics, CAPHRI Care and Public Health Research Institute, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons, Dublin, Ireland
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Chen L, Wang J, Geng L, Li Y. Development and validation of a risk prediction model for physical frailty in older adults who are disabled. Geriatr Nurs 2024; 58:26-38. [PMID: 38733746 DOI: 10.1016/j.gerinurse.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024]
Abstract
Physical frailty is highly prevalent among the older adults who are disabled. The aim of this study was to explore the risk factors for physical frailty in older adults who are disabled and construct a nomogram prediction model. The data source was the China Health and Retirement Longitudinal Study (CHARLS). The prediction model was validated with a cohort of 1183 older adults who are disabled. The results showed that sleep quality, depression, fatigue, and chronic disease were the best predictive factors. These factors were used to construct the nomogram model, which showed good concordance and accuracy. The prediction model yielded an Area under the curve (AUC) value of 0.760. Calibration curves showed significant agreement between the nomogram model and actual observations. Receiver operating characteristic (ROC) and Decision curve analysis (DCA) showed that the nomogram had good predictive performance. The nomogram is contributed to the screening of specific populations by clinicians.
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Affiliation(s)
- Lijing Chen
- The Fifth People's Hospital of Zhuhai, Zhuhai, China
| | - Jiaxian Wang
- Zhuhai Campus of Zunyi Medical University, Zhuhai, China
| | - Li Geng
- The Fifth People's Hospital of Zhuhai, Zhuhai, China
| | - Yi Li
- The Fifth People's Hospital of Zhuhai, Zhuhai, China.
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Azevedo PS, de Melo RC, de Souza JT, Frost R, Gavin JP, Robinson K, Boas PJFV, Minicucci MF, Aprahamian I, Wachholz PA, Hinslif-Smith K, Gordon AL. Frailty identification and management among Brazilian healthcare professionals: a survey. BMC Geriatr 2024; 24:486. [PMID: 38831274 PMCID: PMC11149253 DOI: 10.1186/s12877-024-05020-2] [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: 12/18/2023] [Accepted: 04/29/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND National and international guidelines on frailty assessment and management recommend frailty screening in older people. This study aimed to determine how Brazilian healthcare professionals (HCPs) identify and manage frailty in practice. METHODS An anonymous online survey on the assessment and management of frailty was circulated virtually through HCPs across Brazil. RESULTS Most of the respondants used non-specific criteria such as gait speed (45%), handgrip strength (37.6%), and comprehensive geriatric assessment (33.2%). The use of frailty-specific criteria was lower than 50%. The most frequently used criteria were the Frailty Index (19.1%), Frailty Phenotype (13.2%), and FRAIL (12.5%). Only 43.5% felt confident, and 40% had a plan to manage frailty. In the multivariate-adjusted models, training was the most crucial factor associated with assessing frailty, confidence, and having a management plan (p < 0.001 for all). Those with fewer years of experience were more likely to evaluate frailty (p = 0.009). Being a doctor increased the chance of using a specific tool; the opposite was true for dietitians (p = 0.03). Those who assisted more older people had a higher likelihood of having a plan (p = 0.011). CONCLUSION Frailty assessment was heterogeneous among healthcare professions groups, predominantly using non-specific criteria. Training contributed to frailty assessment, use of specific criteria, confidence, and having a management plan. This data informs the need for standardized screening criteria and management plans for frailty, in association with increasing training at the national level for all the HCPs who assist older people.
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Affiliation(s)
- Paula Schmidt Azevedo
- Botucatu Medical School, São Paulo State University (Unesp), District of Rubião Junior, no number, Botucatu, SP, 18618-970, Brazil
| | | | - Juli Thomaz de Souza
- Botucatu Medical School, São Paulo State University (Unesp), District of Rubião Junior, no number, Botucatu, SP, 18618-970, Brazil
| | - Rachael Frost
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - James P Gavin
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Katie Robinson
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), University of Nottingham, Nottingham, UK
| | - Paulo José Fortes Villas Boas
- Botucatu Medical School, São Paulo State University (Unesp), District of Rubião Junior, no number, Botucatu, SP, 18618-970, Brazil
| | - Marcos Ferreira Minicucci
- Botucatu Medical School, São Paulo State University (Unesp), District of Rubião Junior, no number, Botucatu, SP, 18618-970, Brazil
| | | | - Patrick Alexander Wachholz
- Botucatu Medical School, São Paulo State University (Unesp), District of Rubião Junior, no number, Botucatu, SP, 18618-970, Brazil
| | - Kathryn Hinslif-Smith
- Leicester School of Nursing and Midwifery, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Adam Lee Gordon
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), University of Nottingham, Nottingham, UK.
- NIHR Applied Research Collaboration - East Midlands (ARC-EM), Nottingham, UK.
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Zhong Y, Feng C, Hou L, Yang M, Zhang X, Wu J, Dong B, Jia P, Yang S, Dou Q. Disability level's impact on blood pressure-mortality association in older long-term care adults: evidence from a large Chinese cohort study. BMC Geriatr 2024; 24:478. [PMID: 38822230 PMCID: PMC11143654 DOI: 10.1186/s12877-024-05094-y] [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: 03/12/2024] [Accepted: 05/20/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Evidence of the optimal blood pressure (BP) target for older adults with disability in long-term care is limited. We aim to analyze the associations of BP with mortality in older adults in long-term care setting with different levels of disability. METHODS This prospective cohort study was based on the government-led long-term care programme in Chengdu, China, including 41,004 consecutive disabled adults aged ≥ 60 years. BP was measured during the baseline survey by trained medical personnel using electronic sphygmomanometers. Disability profile was assessed using the Barthel index. The association between blood pressure and mortality was analyzed with doubly robust estimation, which combined exposure model by inverse probability weighting and outcome model fitted with Cox regression. The non-linearity was examined by restricted cubic spline. The primary endpoint was all-cause mortality, and the secondary endpoints were cardiovascular and non-cardiovascular mortality. RESULTS The associations between systolic blood pressure (SBP) and all-cause mortality were close to a U-shaped curve in mild-moderate disability group (Barthel index ≥ 40), and a reversed J-shaped in severe disability group (Barthel index < 40). In mild-moderate disability group, SBP < 135 mmHg was associated with elevated all-cause mortality risks (HR 1.21, 95% CI, 1.10-1.33), compared to SBP between 135 and 150 mmHg. In severe disability group, SBP < 150 mmHg increased all-cause mortality risks (HR 1.21, 95% CI, 1.16-1.27), compared to SBP between 150 and 170 mmHg. The associations were robust in subgroup analyses in terms of age, gender, cardiovascular comorbidity and antihypertensive treatment. Diastolic blood pressure (DBP) < 67 mmHg (HR 1.29, 95% CI, 1.18-1.42) in mild-moderate disability group and < 79 mmHg (HR 1.15, 95% CI, 1.11-1.20) in severe disability group both demonstrated an increased all-cause mortality risk. CONCLUSION The optimal SBP range was found to be higher in older individuals in long-term care with severe disability (150-170mmHg) compared to those with mild to moderate disability (135-150mmHg). This study provides new evidence that antihypertensive treatment should be administered cautiously in severe disability group in long-term care setting. Additionally, assessment of disability using the Barthel index can serve as a valuable tool in customizing the optimal BP management strategy. TRIAL REGISTRATION Chinese Clinical Trial Registry (Registration Number: ChiCTR2100049973).
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Affiliation(s)
- Yue Zhong
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Chuanteng Feng
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hongkong Polytechnic University, Chengdu, Sichuan, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lisha Hou
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Yang
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xinjun Zhang
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jinhui Wu
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
| | - Qingyu Dou
- National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
- West China Hospital of Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan, China.
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Katsumata Y, Toyoshima K, Tamura Y, Murao Y, Sato M, Watanabe S, Kodera R, Oba K, Ishikawa J, Chiba Y, Awata S, Araki A. Categorization using the Dementia Assessment Sheet for Community-Based Integrated Care System 8-items (DASC-8) based on cognitive function and activities of daily living predicts frailty, disability and mortality in older adults. Geriatr Gerontol Int 2024; 24 Suppl 1:150-155. [PMID: 37872859 DOI: 10.1111/ggi.14715] [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: 08/25/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023]
Abstract
AIM This longitudinal study aimed to determine whether categorization by the Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) is associated with risk of frailty onset, disability, and mortality. METHODS We analyzed longitudinal data from outpatients aged 65 years and older evaluated for the DASC-8 at the Frailty Clinic. The outcomes during the 3-year follow-up period were (Study A) frailty onset (Kihon Checklist ≥8) and (Study B) disability (new certification of nursing care needs) or mortality. Multivariate Cox regression analyses were performed to examine independent associations between the DASC-8 category and outcomes, and hazard ratios and 95% confidence intervals (CIs) were calculated after adjustment for age, sex, and the presence or absence of diabetes, hypertension, and dyslipidemia. RESULTS (Study A) Out of the 216 patients without frailty in Categories I or II at baseline, 40 (20.4%) and 11 (55.0%) developed frailty, respectively. The adjusted hazard ratio was 3.62 (95% CI: 1.69-7.76, P < 0.001). (Study B) Out of the 350 patients who did not require long-term care at baseline, disability or death occurred for 20 (7.3%) in Category I, 14 (23.0%) in Category II, and 9 (56.3%) in Category III. The adjusted hazard ratios were 2.40 (Category I vs. II; 95% CI: 1.13-5.11, P = 0.023) and 5.43 (Category I vs. III; 95% CI: 2.23-13.3, P < 0.001). CONCLUSION Categorization according to DASC-8 is associated with the risk of frailty, disability, and mortality in older patients. Geriatr Gerontol Int 2024; 24: 150-155.
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Affiliation(s)
- Yuu Katsumata
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kenji Toyoshima
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshiaki Tamura
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuji Murao
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Motoya Sato
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - So Watanabe
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Remi Kodera
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazuhito Oba
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Joji Ishikawa
- Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuko Chiba
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Atsushi Araki
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Makino K, Raina P, Griffith LE, Lee S, Harada K, Chiba I, Katayama O, Tomida K, Morikawa M, Makizako H, Shimada H. Physical frailty and survival time after the onset of functional disability: Is there a sex difference? J Am Geriatr Soc 2024; 72:399-409. [PMID: 38126965 DOI: 10.1111/jgs.18725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 09/30/2023] [Accepted: 10/13/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Physical frailty accelerates the timing of both subsequent disability and death; however, evidence regarding the impact of frailty on the period from disability onset to death and sex differences of this impact is lacking. The aim of this study was to examine the relationship among physical frailty, disability, death, and sex differences. METHODS This Japanese cohort study included 10,524 community-dwelling people aged ≥65 years. Physical frailty was operationalized by key phenotypes as per Fried's criteria (slowness, weakness, exhaustion, weight loss, and low activity) at baseline. We calculated hazard ratios (HRs) with 95% confidence intervals (CIs) for disability onset and post-disability survival according to the frailty status. RESULTS During a 5-year follow-up, the risk of disability onset for pre-frailty (HR: 1.74, 95% CI: 1.51-2.00) and frailty (HR: 3.27, 95% CI: 2.77-3.87) were significantly higher than that for robust people. Furthermore, among participants who developed disabilities within 5 years (n = 1481), the risk of post-disability death for pre-frailty was not different from that for robust (HR: 1.49, 95% CI: 0.99-2.24), but frailty showed a higher risk of post-disability death than did robust people. (HR: 1.75, 95% CI: 1.13-2.72). In the sex-stratified analysis, although the female group showed no association between frailty status and post-disability death (HR: 1.21, 95% CI: 0.63-2.33 in pre-frailty; HR: 1.24, 95% CI: 0.60-2.57 in frailty), the male group showed higher risk of post-disability death in both pre-frailty (HR: 1.74, 95% CI: 1.03-2.96) and frailty (HR: 2.32, 95% CI: 1.32-4.09). CONCLUSIONS Physical frailty shortens the period from disability onset to death. Additionally, the impact of frailty on post-disability death is greater for males than for females. Our findings suggest that physical frailty is an important clinical indicator distinct from disability and that interventions to prevent and address frailty in men need further investigation.
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Affiliation(s)
- Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Canada
| | - Parminder Raina
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Canada
| | - Lauren E Griffith
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Canada
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hyuma Makizako
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Costenoble A, Knoop V, Debain A, Bautmans I, Van Laere S, Lieten S, Rossi G, Verté D, Gorus E, De Vriendt P. Transitions in robust and prefrail octogenarians after 1 year: the influence of activities of daily living, social participation, and psychological resilience on the frailty state. BMC Geriatr 2023; 23:485. [PMID: 37563561 PMCID: PMC10416541 DOI: 10.1186/s12877-023-04178-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 07/17/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Knowledge opportunities lie ahead as everyday activities, social participation, and psychological resilience might be important predictors for frailty state transitioning in the oldest old. Therefore, this article aims to examine whether changes in basic-, instrumental-, advanced- activities of daily living (b-, i-, a-ADLs), social participation, and psychological resilience predict both a transition from robustness to prefrailty or frailty and vice versa among community-dwelling octogenarians over a follow-up period of one year. METHODS To evaluate worsened and improved frailty transitions after one year in 322 octogenarians (Mage = 83.04 ± 2.78), the variables sex, ADLs (b-ADL-DI, i-ADL-DI, a-ADL-DI as baseline and as difference after 6 months values), the CD-RISC (Connor-Davidson Resilience Scale, as baseline and as difference after 6 months), the social participation variables (total participation score, being a member, total number of memberships, level of social participation, being a board member, volunteering, and formal participation as baseline and as difference after 6 months values), were included in a logistic regression analysis. RESULTS Limitations in a-ADLs at baseline (OR: 1.048, 95% confidence interval, 1.010-1.090) and an increment of limitations in a-ADLs after 6 months (OR: 1.044, 95% confidence interval, 1.007-1.085) were predictors to shift from robust to a worsened frailty state after one year follow-up. Additionally, being a woman (OR: 3.682, 95% confidence interval, 1.379-10.139) and social participation, specifically becoming a board member in 6 months (OR: 4.343, 95% confidence interval, 1.082-16.347), were protectors of robustness and thus related to an improved frailty transition after one year. CONCLUSIONS Encouraging healthy lifestyle behaviors to help the maintenance of ADLs, possibly leading to more social participation, could be promising in the prevention of frailty.
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Affiliation(s)
- Axelle Costenoble
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
| | - Veerle Knoop
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
- SOMT University of Physiotherapy, Amersfoort, The Netherlands
| | - Aziz Debain
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
- Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
- Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Sven Van Laere
- Interfaculty Center Data Processing and Statistics, VUB, Brussels, Belgium
| | - Siddhartha Lieten
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Gina Rossi
- Personality and Psychopathology Research Group, Faculty of Psychology and Educational Sciences, VUB, Brussels, Belgium
| | - Dominique Verté
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Belgian Ageing Studies Research Group, VUB, Brussels, Belgium
| | - Ellen Gorus
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
- Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Patricia De Vriendt
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
- Gerontology Department, VUB, Brussels, Belgium.
- Arteveldehogeschool, Ghent, Belgium.
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10
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Yang G, Wan L, Dong H, Liang X, He Y. Utilisation willingness for institutional care by the disabled elderly and its influencing factors based on Andersen's model: a cross-sectional survey of Henan, China. BMJ Open 2022; 12:e064949. [PMID: 36600340 PMCID: PMC9743373 DOI: 10.1136/bmjopen-2022-064949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To explore the factors that influence institutional care for the disabled elderly in China and the key factors that influence individuals based on the Andersen model. DESIGN Cross-sectional survey. SETTING The research was conducted in 18 cities in Henan Province, China. MAIN OUTCOME MEASURES A multistage, stratified sampling design was employed. The χ2 test was used to compare the differences in basic information of the disabled elderly. A binary Logit model was used to examine the factors influencing the willingness to institutionalise elderly people with disabilities. The determinants of willingness to care in an institution were also explored in a stratified study by gender, age and region to identify the key differences affecting institutionalisation. The Andersen model was used as the theoretical framework to infer the impact strength of each model. RESULTS Of the 2810 disabled elderly people in Henan, China, 7.4% of the elderly had a willingness for institutional care. In the binary logistic regression analysis, whether living alone (OR (95% CI)=0.596 (0.388 to 0.916)), medical payment method (basic medical insurance for urban employees: OR (95% CI)=2.185 (1.091 to 4.377)), having mental illness (OR (95% CI)=2.078 (1.044 to 4.137)) had a statistically significant difference (p<0.05) on the impact on the willingness of the disabled elderly to receive institutional care. Validation of the fitted coefficients of the model revealed that the needs factor had the most significant effect on the enabling variable, while the predisposing factor had more minerally effect. CONCLUSIONS Several factors influence the willingness of the disabled elderly to institutionalise. Therefore, it is recommended that relevant authorities take targeted measures to focus on the disabled elderly to identify more precise elderly care services to deal with the ageing crisis.
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Affiliation(s)
- Guangmei Yang
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Leping Wan
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Haiying Dong
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaoxiao Liang
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yan He
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
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11
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Zamudio-Rodríguez A, Avila-Funes JA, Tabue-Teguo M, Dartigues JF, Amieva H, Pérès K. Towards an approach of disability along a continuum from robustness, pre-frailty, frailty to disability. Age Ageing 2022; 51:6540135. [PMID: 35231091 DOI: 10.1093/ageing/afac025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND frailty and disability are very prevalent in older age and although both are distinct clinical entities, they are commonly used indistinctly in order to identify vulnerable older adults. OBJECTIVE to propose a hierarchical indicator between frailty and disability among older adults along a single continuum. DESIGN population-based cohort study. SETTING the Bordeaux Three-City Study and the Aging Multidisciplinary Investigation (AMI) cohort. SUBJECTS the sample included 1800 participants aged 65 and older. METHODS an additive hierarchical indicator was proposed by combining the phenotype of frailty (robustness, pre-frailty and frailty), instrumental activities of daily living (IADL) and basic activities of daily living (ADL). To test the relevance of this indicator, we estimated the 4-year mortality risk associated with each stage of the indicator. RESULTS in total, 34.0% were Robust (n = 612), 29.9% were Pre-frail (n = 538), 3.2% were Robust with IADL-disability (n = 58), 4.6% had pure Frailty (no disability) (n = 82), 11.9% were Pre-frail + IADL (n = 215), 8.6% were Frail + IADL (n = 154) and 7.8% Frail + IADL + ADL (n = 141). After grouping grades with similar mortality risks, we obtained a five-grade hierarchical indicator ranging from robustness to severe stage of the continuum. Each state presented a gradually increasing risk of dying compared to the robust group (from Hazard Ratio (HR) = 2.20 [1.49-3.25] to 15.10 [9.99-22.82]). CONCLUSIONS We confirmed that combining pre-frailty, frailty, IADL- and ADL-disability into a single indicator may improve our understanding of the aging process. Pre-frailty identified as the 'entry door' into the process may represent a key stage that could offer new opportunities for early, targeted, individualized and tailored interventions and care in clinical geriatrics.
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Affiliation(s)
| | - José Alberto Avila-Funes
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Maturin Tabue-Teguo
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- CHU de Pointe-à-Pitre (Guadeloupe), Equipe LAMIA, Université des Antilles (Guadeloupe), Pointe-à-Pitre, France
| | - Jean-François Dartigues
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Hélène Amieva
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Karine Pérès
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
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12
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Takechi H, Tsuzuki A, Matsumoto K, Fukui A, Kawakita H, Yoshino H, Kanada Y. Differences in the frequency of subjective geriatric complaints along with aging and their associations with physical function, multimorbidity, and mood: A cross-sectional study. PLoS One 2022; 17:e0263889. [PMID: 35148335 PMCID: PMC8836324 DOI: 10.1371/journal.pone.0263889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background In this study, we investigated subjective geriatric complaints (SGCs) as conditions regarding health concerns in community-dwelling older people and analyzed their frequencies with aging and relationships with other factors. Methods This cross-sectional study enrolled 10,434 older people living in a community with a representative aging population in Japan. A questionnaire was sent by mail to those who had not applied for formal care needs certification. The presence of and concern for symptoms common in old age were asked as SGCs, as were physical function levels, multimorbidity, and depression. Categorical principal component analysis (CATPCA) of the symptoms was performed, and the association between the obtained components and other factors was analyzed. Results The mean age of the participants was 73.7 ± 6.1 years, and 52.5% were women. On average, they had 1.72 ± 1.57 SGCs, which showed a gradual increase with age. The results of the CATPCA revealed four components: SGC1, excretory/circulatory/swallowing complaints; SGC2, audiovisual complaints; SGC3, neurological complaints; and SGC4, musculoskeletal complaints. All SGC components were independently associated with physical function, multimorbidity, and depression. Conclusions Each SGC showed various frequencies and differences along with aging, and SGCs were classified into four components that were thought to share a common background. These findings could contribute to the planning of better health management strategies for older people.
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Affiliation(s)
- Hajime Takechi
- Department of Geriatrics and Cognitive Disorders, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
- * E-mail:
| | - Akira Tsuzuki
- Faculty of Rehabilitation, School of Health Science, Fujita Health University, Toyoake, Aichi, Japan
| | - Komaki Matsumoto
- Department of Community Care, Toyoake City Municipal Office, Toyoake, Aichi, Japan
| | - Akane Fukui
- Department of Community Care, Toyoake City Municipal Office, Toyoake, Aichi, Japan
| | - Hitomi Kawakita
- Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Yoshino
- Department of Geriatrics and Cognitive Disorders, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yoshikiyo Kanada
- Department of Community Care, Toyoake City Municipal Office, Toyoake, Aichi, Japan
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13
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Costenoble A, Rossi G, Knoop V, Debain A, Smeys C, Bautmans I, Verté D, De Vriendt P, Gorus E. Does psychological resilience mediate the relation between daily functioning and prefrailty status? Int Psychogeriatr 2021; 34:1-10. [PMID: 34629136 DOI: 10.1017/s1041610221001058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Understanding of prefrailty's relationship with limitations in activities of daily living (ADLs) moderated by psychological resilience is needed, as resilience might support ADLs' maintenance and thus protect against frailty. Therefore, this study aims to analyze the influence of psychological resilience (using the Connor-Davidson Resilience Scale; CD-RISC) on the relation between ADLs and frailty status of older individuals (i.e. prefrail versus robust). DESIGN Cross-sectional design. SETTING UZ Brussels, Belgium. PARTICIPANTS Robust (Fried 0/4;n = 214; Age = 82.3 ± 2.1yrs) and prefrail (Fried 1-2/4; n = 191; Age = 83.8 ±3.2yrs) community-dwelling older individuals were included. MEASUREMENTS Frailty scores were obtained from weight loss, exhaustion, gait speed, and grip strength. A total Disability Index (DI) expressed dependency for basic (b-), instrumental (i-), and advanced (a-)ADLs. Mediation was investigated by estimating direct and indirect effects of all levels of ADLs and CD-RISC total score on prefrailty/robustness using a stepwise multiple regression approach. RESULTS Prefrailty/robustness significantly correlated with a-ADL-DI (point-biserial correlation (rpb) = 0.098; p<0.05). Adjusted for age and gender, the a-ADL-DI (p<0.05) had a significant protective direct effect against prefrailty. No effects were found with the CD-RISC total score. CONCLUSIONS Less limitation in a-ADLs is a directly correlated factor of prefrailty and might represent a higher likelihood of robustness.
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Affiliation(s)
- Axelle Costenoble
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
| | - Gina Rossi
- Personality and Psychopathology Research Group, Faculty of Psychology and Educational Sciences, VUB, Brussels, Belgium
| | - Veerle Knoop
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
| | - Aziz Debain
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Celeste Smeys
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Dominique Verté
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Belgian Ageing Studies Research Group, VUB, Brussels, Belgium
| | - Patricia De Vriendt
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Arteveldehogeschool, Ghent, Belgium
| | - Ellen Gorus
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
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14
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Reppermund S. The role of frailty and functional impairment in healthy ageing. Int Psychogeriatr 2021; 34:1-7. [PMID: 34622753 DOI: 10.1017/s1041610221002593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Simone Reppermund
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
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15
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Chuy V, Gentreau M, Artero S, Berticat C, Rigalleau V, Pérès K, Helmer C, Samieri C, Féart C. Simple carbohydrate intake and higher risk for physical frailty over 15 years in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2021; 77:10-18. [PMID: 34417799 DOI: 10.1093/gerona/glab243] [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: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Insulin resistance is a major mechanism involved in the onset of physical frailty (PF). Although rich carbohydrate diets may promote insulin resistance, few studies have examined their association with PF risk. This study aimed to investigate the spectrum of carbohydrate exposure, including carbohydrate intake (simple, complex, and total), glycemic load (measure of the diet-related insulin-demand), and adherence to a low-carbohydrate diet with the incident risk of PF in community-dwelling older adults. Baseline carbohydrate exposure was assessed in non-frail participants of the Three-City-Bordeaux cohort using a 24H dietary recall. Over 15 years of follow-up, participants were screened for PF, defined by the FRAIL scale (≥3 criteria out of Fatigue, Resistance, Ambulation, Illnesses, and weight Loss). Associations were estimated using mixed-effects logistic models adjusted for sex, age, education, smoking status, alcohol consumption, depressive symptomatology, global cognitive performances, and protein and energy intakes. The sample included 1,210 participants (62% females, mean age 76 years). Over the follow-up, 295 (24%) incident cases of PF were documented (28% in females, 18% in males). Higher intake of simple carbohydrates was significantly associated with greater odds of incident PF (per 1-SD increased: OR = 1.29; 95% CI = 1.02-1.62), specifically among males (OR = 1.52; 95% CI = 1.04-2.22). No association was observed with complex or total carbohydrate intake, glycemic load, or low-carbohydrate diet. Among the whole carbohydrate exposure, only higher consumption of simple carbohydrates in older age was associated with a higher risk of developing PF. Further studies are required to explore underlying mechanisms.
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Affiliation(s)
- Virginie Chuy
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France.,Univ. Bordeaux, CHU Bordeaux, Department of Dentistry and Oral Health, Bordeaux, France
| | - Mélissa Gentreau
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Sylvaine Artero
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Claire Berticat
- ISEM, University of Montpellier, CNRS, EPHE, IRD, Montpellier, France
| | - Vincent Rigalleau
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France.,Univ. Bordeaux, CHU Bordeaux, Department of Endocrinology, Bordeaux, France
| | - Karine Pérès
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France
| | - Catherine Helmer
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France.,Clinical and Epidemiological Research Unit, INSERM CIC1401, Bordeaux, France
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16
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Yaghi N, Yaghi C, Abifadel M, Boulos C, Feart C. Dietary Patterns and Risk Factors of Frailty in Lebanese Older Adults. Nutrients 2021; 13:2188. [PMID: 34202045 PMCID: PMC8308408 DOI: 10.3390/nu13072188] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 12/13/2022] Open
Abstract
Factors associated with frailty, particularly dietary patterns, are not fully understood in Mediterranean countries. This study aimed to investigate the association of data-driven dietary patterns with frailty prevalence in older Lebanese adults. We conducted a cross-sectional national study that included 352 participants above 60 years of age. Sociodemographic and health-related data were collected. Food frequency questionnaires were used to elaborate dietary patterns via the K-mean cluster analysis method. Frailty that accounted for 15% of the sample was twice as much in women (20%) than men (10%). Identified dietary patterns included a Westernized-type dietary pattern (WDP), a high intake/Mediterranean-type dietary pattern (HI-MEDDP), and a moderate intake/Mediterranean-type dietary pattern (MOD-MEDDP). In the multivariate analysis, age, waist to height ratio, polypharmacy, age-related conditions, and WDP were independently associated with frailty. In comparison to MOD-MEDDP, and after adjusting for covariates, adopting a WDP was strongly associated with a higher frailty prevalence in men (OR = 6.63, 95% (CI) (1.82-24.21) and in women (OR = 11.54, 95% (CI) (2.02-65.85). In conclusion, MOD-MEDDP was associated with the least prevalence of frailty, and WDP had the strongest association with frailty in this sample. In the Mediterranean sample, a diet far from the traditional one appears as the key deleterious determinant of frailty.
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Affiliation(s)
- Nathalie Yaghi
- Department of Nutrition & Dietetics, Faculty of Pharmacy, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon; (N.Y.); (C.B.)
| | - Cesar Yaghi
- Department of Gastroenterology, Faculty of Medicine, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon;
- Hotel-Dieu de France of Beirut University Hospital, P.O. Box 166830, Alfred Naccache Blvd, Beirut, Lebanon
| | - Marianne Abifadel
- Laboratory of Biochemistry and Molecular Therapeutics, Faculty of Pharmacy, Pôle Technologie-Santé, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon;
| | - Christa Boulos
- Department of Nutrition & Dietetics, Faculty of Pharmacy, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon; (N.Y.); (C.B.)
| | - Catherine Feart
- LEHA team, INSERM U1219, Université de Bordeaux, F-33000 Bordeaux, France
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17
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Moreno-Lacalle R. Frailty as part of the disablement process: calling for health economic interventions. Evid Based Nurs 2021; 25:55. [PMID: 33958350 PMCID: PMC8961766 DOI: 10.1136/ebnurs-2020-103393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 12/02/2022]
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18
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Søvde BE, Sandvoll AM, Natvik E, Drageset J. In the borderland of the body: How home-dwelling older people experience frailty. Scand J Caring Sci 2021; 36:255-264. [PMID: 33939195 DOI: 10.1111/scs.12984] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/14/2021] [Indexed: 01/10/2023]
Abstract
RATIONALE The increasing number of frail home-dwelling older people has sharpened the focus on discovering and implementing suitable treatment and care in clinical practice, aiming to prevent loss of physical functioning and preserve their autonomy and well-being. People's embodied experiences may yield rich descriptions to help to understand frailty. Thoroughly understanding older people's individual perceptions is especially relevant because the numbers of home-dwelling older people are increasing, and people tend to develop more health problems and become frailer as they age. Their perspectives are important to develop knowledge and high-quality care. AIM To explore the lived experiences of frail home-dwelling older people. METHODS We conducted a phenomenological study to obtain in-depth descriptions of the phenomenon. We interviewed 10 home-dwelling older adults (seven women and three men, 72-90 years old) in depth about their lived experience of frailty. We analysed the data using a hermeneutic phenomenological approach described by van Manen. FINDINGS The lived experience of frailty is described in one essential theme: frailty as being in the borderland of the body, including three interrelated subthemes: (1) the body shuts down; (2) living on the edge; and (3) not giving up. CONCLUSIONS Our study gives insight into lived experiences with frailty among home-dwelling older people related to their own body. Older people's experience of meaningful activities strengthened their feeling of being themselves, despite their frail and deteriorating body. Healthcare providers must consider the strategies of frail older people to consider both their vulnerabilities and self-perceived strengths. The resources and deficits of frail older people present in the state of being frail need to be recognised.
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Affiliation(s)
- Bente Egge Søvde
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Anne Marie Sandvoll
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Eli Natvik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Jorunn Drageset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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19
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Pérès K, Zamudio-Rodriguez A, Dartigues JF, Amieva H, Lafitte S. Prospective pragmatic quasi-experimental study to assess the impact and effectiveness of an innovative large-scale public health intervention to foster healthy ageing in place: the SoBeezy program protocol. BMJ Open 2021; 11:e043082. [PMID: 33926977 PMCID: PMC8094369 DOI: 10.1136/bmjopen-2020-043082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION With the accelerating pace of ageing, healthy ageing has become a major challenge for all societies worldwide. Based on that Healthy Ageing concept proposed by the WHO, the SoBeezy intervention has been designed through an older person-centred and integrated approach. The programme creates the environments that maximise functional ability to enable people to be and do what they value and to stay at home in best possible conditions. METHODS AND ANALYSIS Five levers are targeted: tackling loneliness, restoring feeling of usefulness, finding solutions to face material daily life difficulties, promoting social participation and combating digital divide. Concretely, the SoBeezy programme relies on: (1) a digital intelligent platform available on smartphone, tablet and computer, but also on a voice assistant specifically developed for people with digital divide; (2) a large solidarity network which potentially relies on everyone's engagement through a participatory intergenerational approach, where the older persons themselves are not only service receivers but also potential contributors; (3) an engagement of local partners and stakeholders (citizens, associations, artisans and professionals). Organised as a hub, the system connects all the resources of a territory and provides to the older person the best solution to meet his demand. Through a mixed, qualitative and quantitative (before/after analyses and compared to controls) approach, the research programme will assess the impact and effectiveness on healthy ageing, the technical usage, the mechanisms of the intervention and conditions of transferability and scalability. ETHICS AND DISSEMINATION Inserm Ethics Committee and the Comité Éthique et Scientifique pour les Recherches, les Études et les Évaluations dans le domaine de la Santé approved this research and collected data will be deposited with a suitable data archive.
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Affiliation(s)
- Karine Pérès
- Univ. Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | | | | | - Hélène Amieva
- Univ. Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | - Stephane Lafitte
- University Hospital Centre Bordeaux Cardiology Hospital Anaesthesiology and Reanimation, Pessac, Nouvelle-Aquitaine, France
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Struijk EA, Rodríguez-Artalejo F, Fung TT, Willett WC, Hu FB, Lopez-Garcia E. Sweetened beverages and risk of frailty among older women in the Nurses' Health Study: A cohort study. PLoS Med 2020; 17:e1003453. [PMID: 33290392 PMCID: PMC7723265 DOI: 10.1371/journal.pmed.1003453] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/29/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Consumption of sugar-sweetened beverages (SSBs) has been consistently associated with a higher risk of obesity, type 2 diabetes, cardiovascular disease, and premature mortality, whereas evidence for artificially sweetened beverages (ASBs) and fruit juices on health is less solid. The aim of this study was to evaluate the consumption of SSBs, ASBs, and fruit juices in association with frailty risk among older women. METHODS AND FINDINGS We analyzed data from 71,935 women aged ≥60 (average baseline age was 63) participating in the Nurses' Health Study (NHS), an ongoing cohort study initiated in 1976 among female registered nurses in the United States. Consumption of beverages was derived from 6 repeated food frequency questionnaires (FFQs) administered between 1990 and 2010. Frailty was defined as having at least 3 of the following 5 criteria from the FRAIL scale: fatigue, poor strength, reduced aerobic capacity, having ≥5 chronic illnesses, and weight loss ≥5%. The occurrence of frailty was assessed every 4 years from 1992 to 2014. During 22 years of follow-up, we identified 11,559 incident cases of frailty. Consumption of SSBs was associated with higher risk of frailty after adjustment for diet quality, body mass index (BMI), smoking status, and medication use, specifically, the relative risks (RRs) and 95% confidence interval (95% CI) for ≥2 serving/day versus no SSB consumption was 1.32 (1.10, 1.57); p-value <0.001. ASBs were also associated with frailty [RR ≥2 serving/day versus no consumption: 1.28 (1.17, 1.39); p-value <0.001]. Orange juice was associated with lower risk of frailty [RR ≥1 serving/day versus no consumption: 0.82 (0.76, 0.87); p-value <0.001], whereas other juices were associated with a slightly higher risk [RR ≥1 serving/day versus no consumption: 1.15 (1.03, 1.28); p-value <0.001]. A limitation of this study is that, due to self-reporting of diet and frailty, certain misclassification bias cannot be ruled out; also, some residual confounding may persist. CONCLUSIONS In this study, we observed that consumption of SSBs and ASBs was associated with a higher risk of frailty. However, orange juice intake showed an inverse association with frailty. These results need to be confirmed in further studies using other frailty definitions.
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Affiliation(s)
- Ellen A. Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- * E-mail:
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Teresa T. Fung
- Department of Nutrition, Simmons University, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
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