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Qi X, Li Y, Hu J, Meng L, Zeng P, Shi J, Jia N, Zeng X, Li H, Zhang Q, Li J, Liu D. Prevalence of social frailty and its associated factors in the older Chinese population: a national cross-sectional study. BMC Geriatr 2023; 23:532. [PMID: 37658332 PMCID: PMC10474699 DOI: 10.1186/s12877-023-04241-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Social frailty has not been comprehensively studied in China. Our objective is to investigate the prevalence of social frailty among the older population in China, as well as identify relevant factors and urban-rural differences. METHODS We obtained data from the Fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) database. The study employed a multistage, stratified, cluster-sampling method, recruiting a total of 224,142 adults aged 60 years or older. Participants were interviewed to gather demographic data and information on family, health and medical conditions, health care service status, living environment conditions, social participation, protected rights status, spiritual and cultural life, and health. Social frailty was assessed using the HALFE Social Frailty Index. A score of three or above indicated social frailty. RESULTS We analyzed a total of 222,179 cases, and the overall prevalence of social frailty was found to be 15.2%. The highest prevalence was observed among participants aged 75-79 years (18.0%). The prevalence of social frailty was higher in rural older populations compared to urban older populations (19.9% in rural vs. 10.9% in urban, P < 0.0001). In urban areas, women had a higher prevalence than men (11.7% in women vs. 9.9% in men, P < 0.0001), while in rural areas, men had a higher prevalence than women (20.6% in men vs. 19.2% in women, P < 0.0001). Multivariate regression analysis revealed that living in a rural/urban environment (OR 1.789, 95% CI 1.742-1.837), absence of a spouse/spousal presence (OR 4.874, 95% CI 4.743-5.009), self-assessed unhealthy/health status (OR 1.696, 95% CI 1.633-1.761), and housing dissatisfaction/satisfaction (OR 2.303, 95% CI 2.233-2.376) were all significantly associated with social frailty. CONCLUSIONS Using the HALFE social frailty index, we found a prevalence of 15.2% among older people in China, with the highest prevalence observed in the 75-79 age group. Social frailty was more prevalent in rural areas than in urban areas. Various factors, including spousal presence, housing satisfaction, health status, and urban-rural residential differences, were significantly associated with social frailty. These findings highlight the modifiable and non-modifiable factors that contribute to social frailty among older individuals in China.
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Affiliation(s)
- Xin Qi
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Yingying Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Jiabin Hu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Lingbing Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Ping Zeng
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Na Jia
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Xuezhai Zeng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Hui Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China
| | | | - Juan Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China.
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Qi X, Jia N, Hu J, Meng LB, Zeng P, Liu J, Shi J, Zeng X, Li H, Zhang Q, Li J, Liu D. Analysis of the status of social frailty in Chinese older adults with cardiovascular and cerebrovascular diseases: a national cross-sectional study. Front Public Health 2023; 11:1022208. [PMID: 37293616 PMCID: PMC10244724 DOI: 10.3389/fpubh.2023.1022208] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 05/05/2023] [Indexed: 06/10/2023] Open
Abstract
Background Social frailty is one type of frailty. Physical frailty with cardiovascular and cerebrovascular diseases (CCVD) have been studied a lot, but less research on social frailty. Objectives To study the prevalence, related risk factors and regional differences of social frailty with CCVD in Chinese older adults. Methods SSAPUR was a national cross-sectional survey. Participants aged 60 years or older were recruited in August 2015. Demographic data and information regarding family, health and medical conditions, living environment conditions, social participation, spiritual and cultural life, and health condition were obtained. Social frailty was assessed in five areas (HALFE Social Frailty Index) including inability to help others, limited social participation, loneliness, financial difficulty, and living alone. The prevalence of CCVD with social frailty, related risk factors and regional differences in CCVD with social frailty were studied. Results A total of 222,179 participants were enrolled. 28.4% of them had CCVD history. The prevalence of social frailty in the CCVD group was 16.03%. In CCVD participants, compared with the group without social frailty, there were significant differences in gender, age, urban-rural distribution, ethnicity, marital status, and education levels in the social frailty group. Significant differences were also found in physical exercise participation, health status, cataract, hypertension, diabetes mellitus, hospitalization within 1 year, self-assessed health status, crutch or wheelchair usage, urinary and fecal incontinence, need for care from others, fall history, housing satisfaction, and self-assessed happiness in the social frailty group. Women with CCVD had a higher prevalence of social frailty than men. By age in CCVD with social frailty, the highest prevalence was found in participants 75-79 years old. The prevalence of CCVD was significant difference between social frailty in urban and rural group. The prevalence of social frailty with CCVD was significantly different in different regions. The highest prevalence was 20.4% in southwest area, and the lowest prevalence was 12.5% in northeast with area. Conclusion The prevalence of social frailty among the CCVD older adults is high. Factors such as gender, age, region, urban-rural residence, and the state of the disease may be associated with social frailty.
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Affiliation(s)
- Xin Qi
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Na Jia
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiabin Hu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Ling-bing Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ping Zeng
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Junmeng Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuezhai Zeng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Juan Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Evaluation of pro-inflammatory cytokines in frail Tunisian older adults. PLoS One 2020; 15:e0242152. [PMID: 33166358 PMCID: PMC7652286 DOI: 10.1371/journal.pone.0242152] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
The present study was undertaken to evaluate serum levels of pro-inflammatory cytokines in Tunisian older adults and to examine the relationships between inflammatory marker levels, geriatric, and biochemical parameters. A cross-sectional study was conducted in a population of Tunisian older adults (N = 141, aged 65 and over). Patients were recruited from the Department of Internal Medicine, Fattouma Bourguiba University Hospital (Monastir, Tunisia) and from a nursing home (Sousse, Tunisia). Comprehensive geriatric assessment, history taking and examination including functional and nutritional assessment were done for each participant. Enzyme-linked immunosorbent assay (ELISA) test was used to measure serum cytokine (TNF-α, IL-8, IL-6) levels. The modified Short Emergency Geriatric Assessment score (SEGAm) were used to classify patients as 51 very-frail, 40 frail, and 50 non-frail. The age of the participants (80 men, 61 women) ranged from 65 to 97 years. Serum levels of TNF-α, IL-8 and C-reactive protein (CRP) were significantly higher in very-frail participants compared to frail and non-frail ones. However, no significant differences in IL-6 levels were detected among frailty groups. After adjustment for age, CRP and IL-8 levels remained significantly associated with frailty. Analysis of the receiver operating characteristic (ROC) curve corresponding to IL-8 showed an area under the curve of 0.7 (p = 0.003; 95% CI [0.58-0.81]) and a predictive threshold of 5.27 pg/ml. Positive correlations were found between frailty score, IL-6, and IL-8 levels. In addition, a significant positive correlation was observed between IL-8 levels and Timed Up and Go test results. However, a negative correlation was observed between Mini Nutritional Assessment Short-Form score, IL-6 and CRP levels, as well as between Activities of Daily Living score and serum levels of TNF-α, IL-6, and CRP. In conclusion, the key findings of this study collectively support a role of pro-inflammatory cytokines, TNF-α, CRP, and especially IL-8 in the development of frailty in older adults.
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Máximo RDO, Lopes IC, Brigola AG, Luchesi BM, Gratão ACM, Inouye K, Pavarini SCI, Alexandre TDS. Pre-frailty, frailty and associated factors in older caregivers of older adults. Rev Saude Publica 2020; 54:17. [PMID: 32022145 PMCID: PMC6986866 DOI: 10.11606/s1518-8787.2020054001655] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/09/2019] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Providing care to an older adult is an activity that requires considerable physical effort and can cause stress and psychological strain, which accentuate factors that trigger the cycle of frailty, especially when the caregiver is also an older adult. However, few studies have analyzed the frailty process in older caregivers. OBJECTIVES To investigate the prevalence of pre-frailty, frailty and associated factors in older caregivers of older adults. METHODS A cross-sectional study was conducted including 328 community-dwelling older caregivers. Frailty was identified using frailty phenotype. Socio-demographic, behavioral and clinical aspects, characteristics related to care and functioning were covariables in the multinomial logistic regression. RESULTS The prevalence of pre-frailty and frailty were 58.8% and 21.1%, respectively. An increased age, female sex, not having a conjugal life, depressive symptoms and pain were commonly associated with pre-frailty and frailty. Sedentary lifestyle was exclusively associated with pre-frailty, whereas living in an urban area, low income and the cognitive decline were associated with frailty. A better performance on instrumental activities of daily living reduced the chance of frailty. CONCLUSION Many factors associated with the frailty syndrome may be related to the act of providing care, which emphasizes the importance of the development of coping strategies for this population.
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Affiliation(s)
| | - Ingrid Cristina Lopes
- Universidade Federal de São Carlos. Departamento de Gerontologia. São Carlos, SP, Brasil
| | - Allan Gustavo Brigola
- Universidade Federal de São Carlos. Programa de Pós-Graduação em Enfermagem. São Carlos, SP, Brasil
| | - Bruna Moretti Luchesi
- Universidade Federal do Mato Grosso do Sul. Curso de Medicina. Três Lagoas. MS, Brasil
| | - Aline Cristina Martins Gratão
- Universidade Federal de São Carlos. Departamento de Gerontologia. São Carlos, SP, Brasil.,Universidade Federal de São Carlos. Programa de Pós-Graduação em Enfermagem. São Carlos, SP, Brasil.,Universidade Federal de São Carlos, Programa de Pós-Graduação em Gerontologia, São Carlos, SP, Brasil
| | - Keika Inouye
- Universidade Federal de São Carlos. Departamento de Gerontologia. São Carlos, SP, Brasil.,Universidade Federal de São Carlos, Programa de Pós-Graduação em Gerontologia, São Carlos, SP, Brasil
| | - Sofia Cristina Iost Pavarini
- Universidade Federal de São Carlos. Departamento de Gerontologia. São Carlos, SP, Brasil.,Universidade Federal de São Carlos. Programa de Pós-Graduação em Enfermagem. São Carlos, SP, Brasil.,Universidade Federal de São Carlos, Programa de Pós-Graduação em Gerontologia, São Carlos, SP, Brasil
| | - Tiago da Silva Alexandre
- Universidade Federal de São Carlos. Programa de Pós-Gradução em Fisioterapia. São Carlos, SP, Brasil.,Universidade Federal de São Carlos. Departamento de Gerontologia. São Carlos, SP, Brasil.,Universidade Federal de São Carlos, Programa de Pós-Graduação em Gerontologia, São Carlos, SP, Brasil
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Park J, Park JH, Park H. Association Between Carotid Artery Intima-Media Thickness and Combinations of Mild Cognitive Impairment and Pre-Frailty in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162978. [PMID: 31430926 PMCID: PMC6719246 DOI: 10.3390/ijerph16162978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/10/2019] [Accepted: 08/11/2019] [Indexed: 12/22/2022]
Abstract
Carotid intima-media thickness (CIMT) has been proposed as a surrogate marker of cardiovascular disease. Mild cognitive impairment (MCI) and pre-frailty are reportedly associated with increased CIMT. As the evidence on the association of CIMT with combinations of MCI and pre-frailty is limited, this association is examined. A total of 231 older adults participated. MCI was defined according to clinical consensus or psychometric criteria by a dementia specialist, and considering detailed neuropsychological assessments. Also, pre-frailty was defined as subjects with frail component of 1 or 2. Carotid variables were measured using a B-mode ultrasound. The analysis of covariance (ANCOVA) was performed to assess independent differences in CIMT among the four groups, according to the cognitive function and frailty status after a multivariate adjustment. Increased CIMT is associated with combinations of MCI and pre-frailty. ANCOVA showed that CIMTs were significantly different among the four groups according to the cognitive function and frailty status. CIMTmax combined with MCI and pre-frailty was the thickest (1.04 ± 0.3 mm), whereas the CIMT of no MCI and no pre-frailty was the thinnest (0.82 ± 0.2 mm). The results suggest that combinations of MCI and pre-frailty are associated with increased CIMT in older adults.
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Affiliation(s)
- Jinkee Park
- Department of Sport Rehabilitation, Dong-Ju College, Busan 49318, Korea
| | - Jong-Hwan Park
- Health Convergence Medicine Research Group, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-Ro, Seo-Gu, Busan 49241, Korea
| | - Hyuntae Park
- Department of Health Care Science, Dong-A University, Busan 49315, Korea.
- Institute of Convergence Bio-Health, Dong-A University, Busan 49201, Korea.
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de Jesus ITM, Orlando FDS, Zazzetta MS. Frailty and cognitive performance of elderly in the context of social vulnerability. Dement Neuropsychol 2018; 12:173-180. [PMID: 29988366 PMCID: PMC6022987 DOI: 10.1590/1980-57642018dn12-020010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Elderly who live in the context of social vulnerability have lower education and socioeconomic status. Objective To analyze cognitive performance as a factor associated with frailty status in elderly living in contexts of social vulnerability. Methods An exploratory, comparative, cross-sectional study using a quantitative method was conducted with elderly people registered at Social Assistance Reference Centers. A semi-structured interview, the Edmonton Frail Scale and Montreal Cognitive Assessment were applied. The project was approved by the Research Ethics Committee. To analyze the data, a logistic regression was performed considering two groups (frail and non-frail). Results 247 elderly individuals participated in the study, with a mean age of 68.52 (±SD =7.28) years and education of 1-4 years (n=133). All the elderly evaluated resided in vulnerable regions. Regarding frailty, 91 (36.8%) showed frailty at some level (mild, moderate or severe) and 216 (87.4%) had cognitive impairment. On the regression analysis, frailty was associated with number of diseases (OR:1.60; 95%CI: 1.28-1.99) and cognition (OR:0.93; 95%CI: 0.89-0.98). Conclusion Identifying level of frailty and cognition in socially vulnerable elderly reinforces the need for early detection in both these conditions by the public services that provide care for this population with a focus on prevention.
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Affiliation(s)
| | - Fabiana de Sousa Orlando
- Assistente Social, Cargo de Professor Adjunto II pelo Departamento de Gerontologia da Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Marisa Silvana Zazzetta
- Enfermeira, cargo de Professor Adjunto II pelo Departamento de Gerontologia da Universidade Federal de São Carlos, São Carlos, SP, Brazil
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Chang SF. Frailty Is a Major Related Factor for at Risk of Malnutrition in Community-Dwelling Older Adults. J Nurs Scholarsh 2016; 49:63-72. [DOI: 10.1111/jnu.12258] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Shu-Fang Chang
- Professor, Department of Nursing, College of Nursing; National Taipei University of Nursing and Health Sciences; Taiwan
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Chang SF, Lin PL. Prefrailty in community-dwelling older adults is associated with nutrition status. J Clin Nurs 2016; 25:424-33. [DOI: 10.1111/jocn.13063] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2015] [Indexed: 01/09/2023]
Affiliation(s)
- Shu-Fang Chang
- School of Nursing; College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - Pei-Ling Lin
- Department of Nursing; College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
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