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Zimmermann J. Impact of neighborhood context on self-rated health among very old adults living in Germany: a cross-sectional representative study. BMC Geriatr 2024; 24:581. [PMID: 38969988 PMCID: PMC11227241 DOI: 10.1186/s12877-024-05175-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: 12/18/2023] [Accepted: 06/25/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Increasingly, evidence has shown that different aspects of neighborhood context play a significant role in self-rated health, one of the key health indicators in advanced age. Nevertheless, very old adults are often under represented or excluded from such research. Therefore, the first aim of this study was to examine whether social, socioeconomic, and physical neighborhood context is associated with self-rated health in the very old population of Germany. The second objective was to explore whether the link of socioeconomic and physical neighborhood context with self-rated health is moderated by availability of social resources in neighborhoods. METHODS Data from the representative survey, "Old Age in Germany" (D80+) were employed. In total, the study sample of D80+ included 10,578 individuals aged 80 years and over. Additionally, the D80+ data were matched with the freely accessible regional dataset of the Federal Institute for Research on Building, Urban Affairs, and Spatial Development. Two self-rated items (place attachment and social cohesion) were used to assess social neighborhood context. Socioeconomic context of neighborhoods was operationalized by German index of socioeconomic deprivation. To evaluate physical context, perceived measures of building conditions and walkability were included. Using the maximum likelihood estimator with robust standard errors, logistic regression models were estimated to analyze the relationship between neighborhood context (social, socioeconomic, and physical context, as well as their interactions) and self-rated health. RESULTS Including 8,066 participants in the analysis, the findings showed that better condition of residential building, higher walkability, being closely attached to outdoor places, and higher social cohesion were associated with higher chance to report good self-rated health of very old adults. In the adjusted models, the German socioeconomic deprivation index was not related to self-rated health. The effect of socioeconomic and physical neighborhood context on self-rated health did not differ according available neighborhood social resources. CONCLUSIONS The results indicate that especially more favorable conditions in social and physical neighborhood context are associated with good self-rated health in the very old population of Germany. Further studies should consider multiple aspects of neighborhood context as well as their interplay when examining the neighborhood impact on self-rated health in older populations.
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Affiliation(s)
- Jaroslava Zimmermann
- Cologne Center for Ethics, Rights, Economics, and Social Science of Health (ceres), University of Cologne, Albertus- Magnus-Platz, 50923, Cologne, Germany.
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Shimizu T, Kodama A, Kume Y, Iwakura M, Iijima K, Ota H. Comparative Analysis of Frailty Risk and Associated Factors: Community-Based vs. Open Recruitment Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:611. [PMID: 38791825 PMCID: PMC11121682 DOI: 10.3390/ijerph21050611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Frailty leads to vulnerability to stress, impaired daily functioning, and an increased need for care. Frailty is considered reversible, and it is crucial to detect the risk of frailty early and investigate factors that may delay its progression. OBJECTIVES To identify tests that can explain frailty risk and compare the situation of local residents with and without frailty support. METHODS Participants were recruited in two ways: through public advertisements in Akita City (open recruitment group) and through invites from frailty supporters in their immediate communities (community-based group). We examined the differences in frailty risk and oral, motor, and social functions between the two groups and identified factors associated with frailty risk in both groups. RESULTS The community-based group exhibited a lower risk of frailty than the open recruitment group despite having more older members on average. Additionally, the community-based group demonstrated better social functioning than the open-recruitment group. Furthermore, factors such as oral diadochokinesis (ODK), one-leg stand test (OLS), and grip strength (GS) showed significant association with frailty risk. CONCLUSION The ODK, OLS, and GS were identified as factors explaining frailty risk, and Frailty Supporters may reduce the risk of frailty.
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Affiliation(s)
- Tatsunori Shimizu
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita 010-8543, Japan; (T.S.); (A.K.)
| | - Ayuto Kodama
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita 010-8543, Japan; (T.S.); (A.K.)
- Department of Occupational Therapy, Graduate School of Medicine, Akita University, Akita 010-8543, Japan;
| | - Yu Kume
- Department of Occupational Therapy, Graduate School of Medicine, Akita University, Akita 010-8543, Japan;
| | - Masahiro Iwakura
- Department of Environmental Health Science and Public Health, Akita University, Akita 010-8543, Japan;
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo 113-8656, Japan;
- Institute for Future Initiatives, The University of Tokyo, Tokyo 113-8656, Japan
| | - Hidetaka Ota
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita 010-8543, Japan; (T.S.); (A.K.)
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Dammavalam V, Murphy J, Johnkutty M, Elias M, Corn R, Bergese S. Perioperative cognition in association with malnutrition and frailty: a narrative review. Front Neurosci 2023; 17:1275201. [PMID: 38027517 PMCID: PMC10651720 DOI: 10.3389/fnins.2023.1275201] [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: 08/09/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Postoperative delirium (POD) is a prevalent clinical entity characterized by reversible fluctuating altered mental status and cognitive impairment with acute and rapid onset a few days after major surgery. Postoperative cognitive decline (POCD) is a more permanent extension of POD characterized by prolonged global cognitive impairment for several months to years after surgery and anesthesia. Both syndromes have been shown to increase morbidity and mortality in postoperative patients making their multiple risk factors targets for optimization. In particular, nutrition imparts a significant and potentially reversible risk factor. Malnutrition and frailty have been linked as risk factors and predictive indicators for POD and less so for POCD. This review aims to outline the association between nutrition and perioperative cognitive outcomes as well as potential interventions such as prehabilitation.
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Affiliation(s)
- Vikalpa Dammavalam
- Department of Neurology, Stony Brook University Hospital, Stony Brook, NY, United States
| | - Jasper Murphy
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Meenu Johnkutty
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Murad Elias
- Department of Anesthesiology, Stony Brook University Hospital, Stony Brook, NY, United States
| | - Ryan Corn
- Department of Neurology, Stony Brook University Hospital, Stony Brook, NY, United States
| | - Sergio Bergese
- Department of Anesthesiology, Stony Brook University Hospital, Stony Brook, NY, United States
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Reid N, Young A, Shafiee Hanjani L, Hubbard RE, Gordon EH. Sex-specific interventions to prevent and manage frailty. Maturitas 2022; 164:23-30. [PMID: 35780633 DOI: 10.1016/j.maturitas.2022.05.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/20/2022] [Accepted: 05/28/2022] [Indexed: 12/15/2022]
Abstract
There is growing interest in interventions that delay, slow, and even reverse frailty. In this narrative review, we explore the evidence on exercise, nutrition, medication optimisation and social support interventions for frailty and consider how these relate to underlying frailty pathophysiology. We also consider pathophysiological mechanisms underpinning sex differences in frailty before evaluating the limited evidence for sex-specific frailty interventions that is currently available. Through this review of the literature, we generate a list of potential sex-specific interventions for frailty. While individual-level recommendations are certainly important, future work should turn the focus towards population-level interventions that take into account sex differences in frailty, including changes to healthcare and socioeconomic systems, as well as changes to the built environment to promote healthy behaviours.
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Affiliation(s)
- Natasha Reid
- Faculty of Medicine, The University of Queensland, Queensland, Australia.
| | - Adrienne Young
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Royal Brisbane and Women's Hospital, Metro North Health, Queensland, Australia
| | | | - Ruth E Hubbard
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Princess Alexandra Hospital, Metro South Health, Queensland, Australia
| | - Emily H Gordon
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Princess Alexandra Hospital, Metro South Health, Queensland, Australia
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The partner in the plate: the association between changes in partnership status and protein consumption among older people in Europe. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Experiencing a change in partnership status at older ages might have detrimental effects on an individual's habits, including eating behaviours. Prior studies presented evidence that widowhood is related to altered diets with a decrease in the amount of protein consumed, which is considered to be an important risk factor of frailty among older people. Using data from Waves 4–8 of the Survey of Health, Ageing and Retirement in Europe (N = 134,313), we investigate the association between stability and changes in partnership status and changes in the frequency of protein consumption at older ages. We also explore the potential moderating role played by changes in economic resources. Having never been married, being divorced and being widowed were significantly associated with a lower frequency of protein consumption among both men and women. The transition to widowhood was significantly associated with a reduction in the frequency of protein consumption, while this same association was not found in the transition to divorce. Subjective evaluation of economic resources did not moderate the relationship between changes in partnership status and frequency of protein consumption. In short, changes in eating behaviours after having experienced the loss of a partner due to widowhood might contribute to accounting for health differentials between those ageing alone and those with a partner.
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A Pilot Survey: Oral Function as One of the Risk Factors for Physical Frailty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106136. [PMID: 35627673 PMCID: PMC9141329 DOI: 10.3390/ijerph19106136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND The aim of this study was to examine the association of the multiple facets of oral, motor, and social functions in community-dwelling older adults, to identify factors that might influence the risk of frailty. METHODS Of the 82 participants included in the study, 39 (5 males and 34 females) were young-old adults, with an average age of 70.5 ± 2.8 years, and 43 (14 males and 29 females) were old-old adults, with an average age of 78.7 ± 2.9 years. We assessed the risk factors for frailty among oral, motor, and social functions. RESULTS Statistical analysis showed a significant difference in the oral diadochokinesis between the groups (p = 0.006). According to the Spearman correlation analysis, a significant association was observed with age and oral diadochokinesis (rs = -0.262, p = 0.018), and social support (rs = -0.219, p = 0.049). Moreover, binomial logistic regression analysis revealed a significant association of frailty with the occlusal force (odds ratio, 0.031; 95% confidence interval (95% CI), 0.002-0.430; p = 0.010), General Oral Health Index (odds ratio, 0.930; 95% CI, 0.867-0.999, p = 0.046), and availability of social support (odds ratio, 0.803, 95% CI, 0.690-0.934, p = 0.004). CONCLUSIONS To prevent frailty at an early stage, assessments of oral functions, and also that of the availability of social support, are important.
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Lyu W, Tanaka T, Son BK, Akishita M, Iijima K. Associations of multi-faceted factors and their combinations with frailty in Japanese community-dwelling older adults: Kashiwa Cohort Study. Arch Gerontol Geriatr 2022; 102:104734. [DOI: 10.1016/j.archger.2022.104734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/29/2022] [Accepted: 05/11/2022] [Indexed: 12/31/2022]
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Abe T, Nofuji Y, Seino S, Hata T, Narita M, Yokoyama Y, Amano H, Kitamura A, Shinkai S, Fujiwara Y. Behavior changes and functional capacity Physical, social, and dietary behavioral changes during the COVID-19 crisis and their effects on functional capacity in older adults. Arch Gerontol Geriatr 2022; 101:104708. [PMID: 35489311 PMCID: PMC9022396 DOI: 10.1016/j.archger.2022.104708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022]
Abstract
Background This two-year follow-up study aimed to identify factors associated with unhealthy behaviors during the COVID-19 pandemic and examine their impact on functional capacity in older adults. Methods Altogether, 536 adults aged ≥65 years participated in this study. The frequency of going out, exercise habits, face-to-face and non-face-to-face interactions, social participation, and eating habits were examined as behavioral factors before and after the first declaration of a state of emergency in Japan. Functional capacity was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Results Using latent class analysis considering changes in the six behaviors, the participants were divided into healthy (n = 289) and unhealthy (n = 247) behavior groups. The male sex was associated with 2.36 times higher odds, diabetes with 2.19 times higher odds, depressive mood with 1.83 times higher odds, poor subjective economic status with 2.62 times higher odds, and living alone with 44% lower odds of being unhealthy. The unhealthy behavior group showed significantly decreased functional capacity (B =−1.56 [−1.98, −1.14]) than the healthy behavior group. For each behavior, negative changes in going out (B =−0.99 [−1.60, −0.37]), face-to-face interaction (B =−0.65 [−1.16, −0.13]), and non-face-to-face interactions (B =−0.80 [−1.36, −0.25]) were associated with a decline in functional capacity. Conclusion Our results showed four factors associated with engaging in unhealthy lifestyle behaviors and how behavioral changes affect functional capacity decline during the COVID-19 pandemic, which will help to develop public health approaches
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Affiliation(s)
- Takumi Abe
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan; Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan; Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC 3122, Australia.
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Toshiki Hata
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan; Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Setagaya, Tokyo 156-8502, Japan
| | - Miki Narita
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Yuri Yokoyama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Hidenori Amano
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan; Health Town Development Science Centre, Yao City Health Centre, 1-1-1 Honmachi, Yao City, Osaka 581-0003, Japan
| | - Shoji Shinkai
- Department of Nutrition, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado, Saitama 350-0288, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
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Prevalence and risk factors of preoperative frailty in Chinese elderly inpatients with gastric and colorectal cancer undergoing surgery: a single-center cross-sectional study using the Groningen Frailty Indicator. Support Care Cancer 2022; 30:677-686. [PMID: 34363109 DOI: 10.1007/s00520-021-06483-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/29/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Frailty is emerging as an important determinant for health. Compared with Western countries, research in the field of frailty started at a later stage in China and mainly focused on older community dwellers. Little is known about frailty in Chinese cancer patients, nor the risk factors of frailty. This study aimed at investigating the prevalence of frailty and its risk factors in elderly inpatients with gastric and colorectal cancer. METHODS This cross-sectional study was conducted at a tertiary hospital in China from Mar. 2020 to Nov. 2020. The study enrolled 265 eligible inpatients aged 60 and older with gastric and colorectal cancer who underwent surgery. Demographic and clinical characteristics, biochemical laboratory parameters, and anthropometric data were collected from all patients. The Groningen Frailty Indicator was applied to assess the frailty status of patients. A multivariate logistic regression model analysis was performed to identify the risk factors of frailty and to estimate their 95% confidence intervals. RESULTS The prevalence of frailty in elderly inpatients with gastric and colorectal cancer was 43.8%. A multivariate logistic regression analysis showed that older age (OR = 1.065, 95% CI: 1.001-1.132, P = 0.045), low handgrip strength (OR = 4.346, 95% CI: 1.739-10.863, P = 0.002), no regular exercise habit (OR = 3.228, 95% CI: 1.230-8.469, P = 0.017), and low MNA-SF score (OR = 11.090, 95% CI: 5.119-24.024, P < 0.001) were risk factors of frailty. CONCLUSIONS This study suggested a relatively high prevalence of frailty among elderly inpatients with gastric and colorectal cancer. Older age, low handgrip strength, no regular exercise habit, and low MNA-SF score were identified as risk factors of frailty.
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Seino S, Nofuji Y, Yokoyama Y, Abe T, Nishi M, Yamashita M, Narita M, Hata T, Shinkai S, Kitamura A, Fujiwara Y. Combined impacts of physical activity, dietary variety, and social interaction on incident functional disability in older Japanese adults. J Epidemiol 2021. [PMID: 34924454 DOI: 10.2188/jea.je20210392] [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] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This 3.6-year prospective study examined combined impacts of physical activity, dietary variety, and social interaction on incident disability and estimated population-attributable fraction for disability reduction in older adults. METHODS Participants were 7,822 initially non-disabled residents (3,966 men; 3,856 women) aged 65-84 years of Ota City, Tokyo, Japan. Sufficiency of moderate-to-vigorous-intensity physical activity (MVPA) ≥150 min/week, dietary variety score (DVS) ≥3 (median), and social interaction (face-to-face and/or non-face-to-face) ≥1 time/week was assessed using self-administered questionnaires. Disability incidence was prospectively identified using the long-term care insurance system's nationally unified database. RESULTS During a follow-up of 3.6 years, 1,046 (13.4%) individuals had disabilities. Independent multivariate-hazard ratios (HRs) and 95% confidence intervals of MVPA, DVS, and social interaction sufficiency for incident disability were 0.68 (0.59-0.78), 0.87 (0.77-0.99), and 0.91 (0.79-1.03), respectively. Incident disability HRs (95% CIs) gradually reduced with increased frequency of satisfying these behaviors (any one: 0.82, 0.65-1.03; any two: 0.65, 0.52-0.82; and all three behaviors: 0.54, 0.43-0.69), in an inverse dose-response manner (P < 0.001 for trend). Population-attributable fraction for disability reduction in satisfying any one, any two, and all three behaviors were 4.0% (-0.2, 7.9), 9.6% (4.8-14.1), and 16.0% (8.7-22.8), respectively. CONCLUSION Combining active physical activity, dietary variety, and social interaction substantially enhances the impacts on preventing disability among older adults, with evidence of an inverse dose-response manner. Adding the insufficient behavior element to individual habits and preexisting social group activities may be effective in preventing disability in the community.
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Affiliation(s)
- Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Yuri Yokoyama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology
| | - Mariko Nishi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Mari Yamashita
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology
| | - Miki Narita
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Toshiki Hata
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Department of Nutrition Sciences, Kagawa Nutrition University
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Health Town Development Science Center, Yao City Health Center
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology
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Effect of frailty on physical activity levels and walking capacity in patients with peripheral artery disease: A cross-sectional study. JOURNAL OF VASCULAR NURSING 2021; 39:84-88. [PMID: 34507705 DOI: 10.1016/j.jvn.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/24/2021] [Accepted: 07/05/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study aimed to analyze the effect of frailty on walking capacity and physical activity levels of patients with peripheral artery disease (PAD). METHODS A cross-sectional study including 216 symptomatic PAD patients (e.g. claudication) was conducted. Moreover, the frailty profile was established, for which six-minute walk test, Walking Impairment Questionnaire (WIQ), and physical activity level were evaluated. RESULTS Frailty was prevalent in 13.4%, 72.2%, and 14.4% of frail, pre-frail, and not-frail patients, respectively. Walking capacity was lower in frail patients than in not-frail patients (p < 0.024). The domains of distance and speed of WIQ were lower in frail patients than in not-frail patients, and these domains were also lower in pre-frail than in not-frail patients (p < 0.050 for all). The domain of stairs was lower in frail patients than in not-frail and pre-frail patients (p = 0.016). Physical activity levels were similar among groups (p > 0.050). CONCLUSION Frailty is associated with further walking impairment in patients with PAD.
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Saadeh M, Prinelli F, Vetrano DL, Xu W, Welmer AK, Dekhtyar S, Fratiglioni L, Calderón-Larrañaga A. Mobility and muscle strength trajectories in old age: the beneficial effect of Mediterranean diet in combination with physical activity and social support. Int J Behav Nutr Phys Act 2021; 18:120. [PMID: 34496869 PMCID: PMC8425101 DOI: 10.1186/s12966-021-01192-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 08/23/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Decline in physical function varies substantially across older individuals due to several extrinsic modifiable factors such as dietary patterns, physical activity and social support. We aimed to determine the association of these factors and their interaction with mobility and muscle strength decline. METHODS We analyzed data from 1686 functionally healthy individuals aged 60 + from the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K). The Mediterranean Diet Score (MDS) was calculated based on a validated food frequency questionnaire. Self-reported physical activity was categorized based on current recommendations, and social support was measured according to participants' perceived material and psychological support from relatives and friends. Participants' physical function was assessed over 12 years through changes in walking speed (m/s) and chair stand time (s). Linear mixed models adjusted for socio-demographic and clinical factors were used. In order to explore the combined effect of the different exposures, two indicator variables were created by cross-classifying individuals' levels of Mediterranean diet adherence and social support or physical activity. RESULTS Participants with a high adherence to Mediterranean diet were primarily < 78 years (82.3%), women (56.1%), married (61.1%), with university education (52.8%), high levels of social support (39.3%) and health-enhancing levels of physical activity (51.5%). A one-point increase in MDS (score range 0-9) was associated with less annual deterioration in walking speed (β*time[year] = 0.001; p = 0.024) and chair-stand time (β*time[year] = -0.014; p = 0.008). The potential protective effect of Mediterranean diet was highest among participants reporting high social support (β*time[year] = -0.065, p = 0.026 for chair stands) and high physical activity (β*time[year] = 0.010, p = 0.001 for walking speed), beyond the effect of each exposure individually. CONCLUSION A higher adherence to Mediterranean diet, especially in combination with recommended levels of physical activity and high social support, may contribute to delay the decline in physical function observed with aging.
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Affiliation(s)
- Marguerita Saadeh
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden.
- SWEAH, Department of Health Sciences, Lund University, Lund, Sweden.
| | - Federica Prinelli
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
- Institute of Biomedical Technologies-National Research Council, Milan, Italy
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
- Centro Di Medicina Dell'Invecchiamento, IRCCS Fondazione Policlinico "A. Gemelli" and Catholic University of Rome, Rome, Italy
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
- Functional Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Solna, Sweden
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Oberndorfer M, Mogg C, Haider S, Grabovac I, Drgac D, Dorner T. Partner loss and its effect on frailty trajectories: results from the 13-year follow-up Survey of Health, Ageing and Retirement in Europe (SHARE). J Epidemiol Community Health 2021; 76:209-215. [PMID: 34452953 DOI: 10.1136/jech-2021-216637] [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: 02/09/2021] [Accepted: 08/05/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Frailty is a geriatric syndrome closely linked to a variety of adverse health outcomes. Thus, it is important to identify factors associated with the development of frailty. It was the aim of this study to examine, if, and to what extent partner loss, a highly stressful life event, affects frailty trajectories of community dwelling adults aged 50 or older. METHODS Using six waves of panel data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigated the effect of partner loss on frailty trajectories estimating growth curve models. Our sample included 183 502 observations of 83 494 community-dwelling individuals aged 50 or older from 21 European countries collected between 2004 and 2017. Frailty was measured using the validated sex-specific SHARE-Frailty-Instrument including muscular weakness, unintended weight loss, decrease in walking capacity, low physical activity and exhaustion. RESULTS Our sample contained 79 874 participants who lived in a partnership during their entire observational period and 3620 participants who lost their partner during their observational period. Both men (β=0.184 (95% CI: -0.017 to 0.386), p=0.073) and women (β=0.237 (95% CI: 0.106 to 0.369), p<0.001) showed initial effects of partner loss on frailty, but while only women gradually recovered over time (β=-0.023 (95% CI: -0.039 to -0.008), p=0.002), among men, the effect of partner loss persisted (β<0.001 (95% CI: -0.029 to 0.029), p=0.998). CONCLUSION This study revealed that partner loss is followed by elevated frailty. However, while women's frailty tended to recover from partner loss over time, men's frailty remained elevated. Notable individual differences in the response of frailty trajectories to partner loss suggest the existence of effect modifiers.
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Affiliation(s)
- Moritz Oberndorfer
- Department of Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Vienna, Austria
| | - Christina Mogg
- Department of Sport Science, University of Vienna, Vienna, Austria
| | - Sandra Haider
- Department of Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Vienna, Austria
| | - Deborah Drgac
- Department of Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Vienna, Austria
| | - Thomas Dorner
- Department of Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Vienna, Austria.,Karl-Landsteiner Institute for Health Promotion Research, BVAEB-Health Promotion Facility Resilienzpark Sitzenberg, Sitzenberg-Reidling, Austria
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14
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Ni Lochlainn M, Cox NJ, Wilson T, Hayhoe RPG, Ramsay SE, Granic A, Isanejad M, Roberts HC, Wilson D, Welch C, Hurst C, Atkins JL, Mendonça N, Horner K, Tuttiett ER, Morgan Y, Heslop P, Williams EA, Steves CJ, Greig C, Draper J, Corish CA, Welch A, Witham MD, Sayer AA, Robinson S. Nutrition and Frailty: Opportunities for Prevention and Treatment. Nutrients 2021; 13:2349. [PMID: 34371858 PMCID: PMC8308545 DOI: 10.3390/nu13072349] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023] Open
Abstract
Frailty is a syndrome of growing importance given the global ageing population. While frailty is a multifactorial process, poor nutritional status is considered a key contributor to its pathophysiology. As nutrition is a modifiable risk factor for frailty, strategies to prevent and treat frailty should consider dietary change. Observational evidence linking nutrition with frailty appears most robust for dietary quality: for example, dietary patterns such as the Mediterranean diet appear to be protective. In addition, research on specific foods, such as a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods are consistent, with healthier profiles linked to lower frailty risk. Few dietary intervention studies have been conducted to date, although a growing number of trials that combine supplementation with exercise training suggest a multi-domain approach may be more effective. This review is based on an interdisciplinary workshop, held in November 2020, and synthesises current understanding of dietary influences on frailty, focusing on opportunities for prevention and treatment. Longer term prospective studies and well-designed trials are needed to determine the causal effects of nutrition on frailty risk and progression and how dietary change can be used to prevent and/or treat frailty in the future.
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Affiliation(s)
- Mary Ni Lochlainn
- Department of Twin Research and Genetics, King’s College London, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK;
| | - Natalie J. Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO17 1BJ, UK; (N.J.C.); (H.C.R.)
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Thomas Wilson
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth SY23 3DA, UK; (T.W.); (J.D.)
| | - Richard P. G. Hayhoe
- Department of Epidemiology & Public Health, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (R.P.G.H.); (A.W.)
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford CM1 1SQ, UK
| | - Sheena E. Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.E.R.); (N.M.)
| | - Antoneta Granic
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Masoud Isanejad
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK;
| | - Helen C. Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO17 1BJ, UK; (N.J.C.); (H.C.R.)
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Daisy Wilson
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (D.W.); (C.W.)
| | - Carly Welch
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (D.W.); (C.W.)
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham B15 2TT, UK;
| | - Christopher Hurst
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Janice L. Atkins
- Epidemiology & Public Health Group, University of Exeter Medical School, Exeter EX1 2LU, UK;
| | - Nuno Mendonça
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.E.R.); (N.M.)
- EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, 1150-082 Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
| | - Katy Horner
- School of Public Health, Physiotherapy and Sport Science and UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland; (K.H.); (C.A.C.)
| | - Esme R. Tuttiett
- The Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing and The Department of Oncology and Metabolism, The University of Sheffield, Sheffield S10 2RX, UK; (E.R.T.); (E.A.W.)
| | - Yvie Morgan
- EDESIA PhD Programme, University of East Anglia Norwich Research Park, Norwich NR4 7TJ, UK;
| | - Phil Heslop
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
| | - Elizabeth A. Williams
- The Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing and The Department of Oncology and Metabolism, The University of Sheffield, Sheffield S10 2RX, UK; (E.R.T.); (E.A.W.)
| | - Claire J. Steves
- Department of Twin Research and Genetics, King’s College London, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK;
| | - Carolyn Greig
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham B15 2TT, UK;
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham and NIHR Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham B15 2TT, UK
| | - John Draper
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth SY23 3DA, UK; (T.W.); (J.D.)
| | - Clare A. Corish
- School of Public Health, Physiotherapy and Sport Science and UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland; (K.H.); (C.A.C.)
| | - Ailsa Welch
- Department of Epidemiology & Public Health, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (R.P.G.H.); (A.W.)
| | - Miles D. Witham
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Avan A. Sayer
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Sian Robinson
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
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Lackinger C, Grabovac I, Haider S, Kapan A, Winzer E, Stein KV, Dorner TE. Adherence Is More Than Just Being Present: Example of a Lay-Led Home-Based Programme with Physical Exercise, Nutritional Improvement and Social Support, in Prefrail and Frail Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4192. [PMID: 33920981 PMCID: PMC8071284 DOI: 10.3390/ijerph18084192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Little is known about the implementation of lifestyle interventions in frail, community-dwelling people. This study highlights different domains of adherence to explain an effectively delivered home-based intervention. METHODS Eighty prefrail and frail persons (≥65 years) participated in a physical training, nutritional, and social support intervention over 24 weeks. A detailed log book was kept for comprehensive documentation in order to assess adherence and further organizational, exercise, and nutritional parameters. RESULTS Participants reached an adherence rate (performed home visits/number of planned visits) of 84.0/80.5% from week 1-12/13-24. Out of those, 59% carried out ≥75% of the offered visits. Older age was associated with a higher adherence rate. A mean of 1.5 (0.6) visits/week (2 were planned) were realized lasting for a mean of 1.5 (0.9) hours (154% of the planned duration). Per visit, 1.2 (0.6) circuits of strength training were performed (60.5% of the planned value) and 0.5 (0.3) nutritional interventions (47%). After twelve months, 4.2% still carried out the home visits regularly and 25.0% occasionally. CONCLUSION Adherence is much more than "being there". Adherence rate and category are limited parameters to describe the implementation of a complex lifestyle intervention, therefore a comprehensive documentation is needed.
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Affiliation(s)
- Christian Lackinger
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria; (K.V.S.); (T.E.D.)
- Social Insurance Fund for Public Service, Railway and Mining Industries, Gesundheitseinrichtung Sitzenberg-Reidling, 3454 Sitzenberg-Reidling, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
| | - Sandra Haider
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
| | - Ali Kapan
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
| | - Eva Winzer
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
| | - K. Viktoria Stein
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria; (K.V.S.); (T.E.D.)
- Social Insurance Fund for Public Service, Railway and Mining Industries, Gesundheitseinrichtung Sitzenberg-Reidling, 3454 Sitzenberg-Reidling, Austria
| | - Thomas E. Dorner
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria; (K.V.S.); (T.E.D.)
- Social Insurance Fund for Public Service, Railway and Mining Industries, Gesundheitseinrichtung Sitzenberg-Reidling, 3454 Sitzenberg-Reidling, Austria
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
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16
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Jang AR, Yoon JY. Multilevel Factors Associated with Frailty among the Rural Elderly in Korea Based on the Ecological Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084146. [PMID: 33920050 PMCID: PMC8071005 DOI: 10.3390/ijerph18084146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022]
Abstract
Frailty is prevalent in the rural elderly and, as a result, they are vulnerable to serious health problems. The purpose of this study was to examine the multilevel factors affecting frailty among the rural elderly using the ecological model. A total of 386 participants aged 65 years or older from 60 rural areas were included in the study. Frailty was measured using the Cardiovascular Health Study frailty index. Multilevel logistic regression analysis was used to identify the factors affecting frailty among the rural elderly. The results show that the levels of prevalence for robust, pre-frailty, and frailty groups were 81 (21%), 216 (56%), and 89 (23%), respectively. As for intrapersonal factors, old age, lower than middle school education, low and moderate levels of physical activity, depressive symptoms, and cognitive dysfunction significantly increased the risk of frailty; however, no interpersonal and community factors were significant in affecting frailty. The findings indicate that individualized strategies to encourage physical activity, prevent depressive symptoms, and preserve cognitive function are needed to prevent frailty in the rural elderly.
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Affiliation(s)
- Ah Ram Jang
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul 03080, Korea;
| | - Ju Young Yoon
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul 03080, Korea;
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea
- Correspondence:
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17
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Bortone I, Sardone R, Lampignano L, Castellana F, Zupo R, Lozupone M, Moretti B, Giannelli G, Panza F. How gait influences frailty models and health-related outcomes in clinical-based and population-based studies: a systematic review. J Cachexia Sarcopenia Muscle 2021; 12:274-297. [PMID: 33590975 PMCID: PMC8061366 DOI: 10.1002/jcsm.12667] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/30/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022] Open
Abstract
Aging is often associated with a decline in physical function that eventually leads to loss of autonomy in activities of daily living (ADL). Walking is a very common ADL, important for main determinants of quality of life in older age, and it requires the integration of many physiological systems. Gait speed has been described as the 'sixth vital sign' because it is a core indicator of health and function in aging and disease. We reviewed original studies up to June 2020 that assessed frailty in both longitudinal and cross-sectional observational studies, paying particular attention to how gait is measured in older population and how the gait parameter adopted may influence the estimated frailty models and the health-related outcomes of the various studies (i.e. clinical, cognitive, physical, and nutritional outcomes). Eighty-five studies met the search strategy and were included in the present systematic review. According to the frailty tools, more than 60% of the studies used the physical phenotype model proposed by Fried and colleagues, while one-third referred to multi-domain indexes or models and only 5% referred to other single-domain frailty models (social or cognitive). The great heterogeneity observed in gait measurements and protocols limited the possibility to directly compare the results of the studies and it could represent an important issue causing variability in the different outcome measures in both clinical-and population-based settings. Gait appeared to be an indicator of health and function also in frail older adults, and different gait parameters appeared to predict adverse health-related outcomes in clinical, cognitive, and physical domains and, to a lesser extent, in nutritional domain. Gait has the potential to elucidate the common basic mechanisms of cognitive and motor decline. Advances in technology may extend the validity of gait in different clinical settings also in frail older adults, and technology-based assessment should be encouraged. Combining various gait parameters may enhance frailty prediction and classification of different frailty phenotypes.
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Affiliation(s)
- Ilaria Bortone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Rodolfo Sardone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Luisa Lampignano
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Fabio Castellana
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Roberta Zupo
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Madia Lozupone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Biagio Moretti
- Orthopaedics and Trauma Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Gianluigi Giannelli
- Scientific DirectionNational Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Francesco Panza
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
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