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Yuan Y, Si H, Shi Z, Wang Y, Xia Y, Guan X, He P. Association of Cognitive Frailty With Subsequent All-Cause Mortality Among Middle-Aged and Older Adults in 17 Countries. Am J Geriatr Psychiatry 2024:S1064-7481(24)00436-6. [PMID: 39242332 DOI: 10.1016/j.jagp.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/11/2024] [Accepted: 08/15/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVES Cognitive frailty refers to the co-occurrence of cognitive impairment and frailty without concurrent Alzheimer's disease or dementia. Studies of cognitive frailty and mortality have been limited to single country or older people. However, frailty and cognitive decline may occur much earlier. We aimed to examine the association between different cognitive frailty status and subsequent all-cause mortality among middle-aged and older people in 17 countries. METHODS Participants aged 50 and over were drawn from six prospective cohorts of aging. We classified participants according to their cognitive impairment and frailty status into the following groups: none, only cognitive impairment, only frailty and cognitive frailty. Competing-risks regression models were used to evaluate the association of different cognitive frailty status at baseline with subsequent all-cause mortality. RESULTS The cognitive frailty group had a higher mortality risk compared to those without cognitive impairment and frailty groups. Meta-analysis results showed participants with cognitive frailty (pooled subhazard ratio [SHR] = 2.34, 95% confidence interval [CI]: 2.01-2.72, I2 = 68.0%) had a higher mortality risk compared with those with only cognitive impairment status (pooled SHR = 1.36, 95% CI: 1.25-1.48, I2 = 3.0%) or only frailty status (pooled SHR = 1.83, 95% CI: 1.72-1.95, I2 = 31.0%). The association between cognitive frailty and mortality were stronger among those who were aged 70 years and older, males, single and nonconsumers of alcohol. CONCLUSIONS Cognitive frailty, frailty or cognitive impairment alone, is associated with an increased risk of all-cause mortality in Asian, European and American countries. Physical and cognitive function screening should be conducted as early as possible in middle-aged and older people, and targeted intervention approaches should be developed to reduce the incidence of adverse health outcomes.
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Affiliation(s)
- Yemin Yuan
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Huaxin Si
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Zhenyu Shi
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Yanshang Wang
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Yiqi Xia
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Xiaolong Guan
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Ping He
- China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China.
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Gou D, Min C, Peng X, Wu H, Zhang L, Chen Y, Tao M. Associating factors of cognitive frailty among older people with chronic heart failure: Based on LASSO-logistic regression. J Adv Nurs 2024. [PMID: 39078209 DOI: 10.1111/jan.16352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 06/10/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024]
Abstract
AIM To analyse factors associated with cognitive frailty among older chronic heart failure patients in China. DESIGN A cross-sectional design. METHODS Between August 2021 and November 2022, a total of 421 chronic heart failure patients (age ≥60 years) were randomly selected from the cardiology department of the affiliated hospital of Zunyi Medical University. The FRAIL scale, Mini-Mental State Examination, 15-item Geriatric Depression Scale, Social Support Rating Scale, Short-form Mini Nutritional Assessment and Pittsburgh Sleep Quality Index were utilized for measurement and evaluation. The demographic and clinical characteristics of patients were collected. To select initial variables, the Least Absolute Shrinkage Selection Operator was applied, and then logistic regression analysis was used to confirm associating factors. RESULTS Among 421 elderly people with chronic heart failure, 83 cases (19.7%) showed cognitive frailty. Of 31 variables, seven were selected by Least Absolute Shrinkage Selection Operator regression. Finally, multivariate logistic regression revealed that the age, monthly salary, drinking, NYHA classification, length of hospital stay, depression and malnutrition risk/malnutrition were independently associated with cognitive frailty. CONCLUSION The high proportion of cognitive frailty in older people with chronic heart failure should be concerned. Additionally, in the setting of cognitive frailty, efforts to diagnose it and develop interventions to prevent or reverse cognitive frailty status among older chronic heart failure patients are necessary. IMPACT The findings of our study highlight the necessity to evaluate cognitive frailty in older people with chronic heart failure and provide a new perspective and scientific basis for medical staff to develop individualized and specific interventions to prevent or reverse cognitive frailty status. REPORTING METHOD This study has been reported in compliance with STROBE reporting guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Dengqun Gou
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Changhang Min
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Xiaofeng Peng
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Hemei Wu
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Lu Zhang
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Yu Chen
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Ming Tao
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
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Teng C, Ren R, Liu Z, Wang J, Shi S, Kang YE, Koo BS, Lu W, Shan Y. C15:0 and C17:0 partially mediate the association of milk and dairy products with bladder cancer risk. J Dairy Sci 2024; 107:2586-2605. [PMID: 38056566 DOI: 10.3168/jds.2023-24186] [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: 09/12/2023] [Accepted: 11/02/2023] [Indexed: 12/08/2023]
Abstract
The relationship between saturated fatty acids (SFA) and bladder cancer (BC) risk has been conflicting. Our aim was to investigate the relationship between erythrocyte membrane SFA and BC risk. A total of 404 participants were enrolled in the study (including 112 cases and 292 controls). A validated food frequency questionnaire was used to assess the food intake. The constitutive composition of fatty acids in the erythrocyte membrane was measured by gas chromatography. After adjustment for BC risk factors, SFA had no significant association with BC risk. However, C18:0 was positively linked with BC risk with an odds ratio (OR; 95% CI) of 2.99 (1.37-6.53). In contrast, very-long-chain saturated fatty acids (VLCSFA), especially C24:0, were negatively related to BC risk with an OR (95% CI) of 0.28 (0.12-0.65) for VLCSFA and 0.33 (0.15-0.75) for C24:0. Higher total odd-chain SFA (C15:0 and C17:0) were associated with a lower risk of BC with OR (95% CI) of 0.18 (0.076-0.44), 0.18 (0.068-0.47), 0.34 (0.14-0.81), respectively. After subgroup analysis, the protective effects C15:0 and C17:0 were still remained. Receiver operating characteristic analysis displayed that the combination of C15:0 and C17:0 indexes increased the accurate predictive rate of BC risk. Further mediation effect analysis showed that C15:0 and C17:0 could be used as partial mediation effectors for milk and dairy products and bladder carcinogenesis. Overall, the combination of odd-chain SFA (C15:0 and C17:0) in the erythrocyte membrane could serve as a reliable mediator and predictor, indicating a relationship between a high intake of milk and dairy products and a lower risk of BC.
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Affiliation(s)
- Chunying Teng
- Department of Food Science and Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China
| | - Rui Ren
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, China; Southern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou 325000, China
| | - Zhipeng Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, China
| | - Jiaxin Wang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, China
| | - Shengchao Shi
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, China
| | - Yea Eun Kang
- Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Bon Seok Koo
- Department of Otolaryngology-Head and Neck Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea
| | - Weihong Lu
- Department of Food Science and Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China.
| | - Yujuan Shan
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, China; Southern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou 325000, China.
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Panza F, Lozupone M, Dibello V. Multidimensional complex frailty phenotypes: epidemiological impact of oral frailty in older age. Eur Geriatr Med 2024; 15:505-507. [PMID: 38411772 DOI: 10.1007/s41999-024-00943-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Affiliation(s)
- Francesco Panza
- Department of Interdisciplinary Medicine, "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy.
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
| | - Vittorio Dibello
- Department of Interdisciplinary Medicine, "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Buchholz E, Gillespie NA, Hunt JF, Reynolds CA, Rissman RA, Schroeder A, Cortes I, Bell T, Lyons MJ, Kremen WS, Franz CE. Midlife cumulative deficit frailty predicts Alzheimer's disease-related plasma biomarkers in older adults. Age Ageing 2024; 53:afae028. [PMID: 38454901 PMCID: PMC10921085 DOI: 10.1093/ageing/afae028] [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: 07/04/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The study explores whether frailty at midlife predicts mortality and levels of biomarkers associated with Alzheimer's disease and related dementias (ADRD) and neurodegeneration by early old age. We also examine the heritability of frailty across this age period. METHODS Participants were 1,286 community-dwelling men from the Vietnam Era Twin Study of Aging at average ages 56, 62 and 68, all without ADRD at baseline. The cumulative deficit frailty index (FI) comprised 37 items assessing multiple physiological systems. Plasma biomarkers at age 68 included beta-amyloid (Aβ40, Aβ42), total tau (t-tau) and neurofilament light chain (NfL). RESULTS Being frail doubled the risk of all-cause mortality by age 68 (OR = 2.44). Age 56 FI significantly predicted age 68 NfL (P = 0.014), Aβ40 (P = 0.001) and Aβ42 (P = 0.023), but not t-tau. Age 62 FI predicted all biomarkers at age 68: NfL (P = 0.023), Aβ40 (P = 0.002), Aβ42 (P = 0.001) and t-tau (P = 0.001). Age 68 FI scores were associated with age 68 levels of NfL (P = 0.027), Aβ40 (P < 0.001), Aβ42 (P = 0.001) and t-tau (P = 0.003). Genetic influences accounted for 45-48% of the variance in frailty and significantly contributed to its stability across 11 years. CONCLUSIONS Frailty during one's 50s doubled the risk of mortality by age 68. A mechanism linking frailty and ADRD may be through its associations with biomarkers related to neurodegeneration. Cumulative deficit frailty increases with age but remains moderately heritable across the age range studied. With environmental factors accounting for about half of its variance, early interventions aimed at reducing frailty may help to reduce risk for ADRD.
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Affiliation(s)
- Erik Buchholz
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center for Behavior Genetics of Aging, University of California, La Jolla, San Diego, CA 92093, USA
- Department of Information Science, University of Arkansas at Little Rock, Little Rock, AR 72204 USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, VA 23298, USA
| | - Jack F Hunt
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center for Behavior Genetics of Aging, University of California, La Jolla, San Diego, CA 92093, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA 92521, USA
| | - Robert A Rissman
- Department of Neurosciences, University of California, San Diego and VA San Diego Healthcare System, La Jolla, CA 92093, USA
- Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, CA 92121, USA
| | - Angelica Schroeder
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center for Behavior Genetics of Aging, University of California, La Jolla, San Diego, CA 92093, USA
| | - Isaac Cortes
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center for Behavior Genetics of Aging, University of California, La Jolla, San Diego, CA 92093, USA
| | - Tyler Bell
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center for Behavior Genetics of Aging, University of California, La Jolla, San Diego, CA 92093, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - William S Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center for Behavior Genetics of Aging, University of California, La Jolla, San Diego, CA 92093, USA
| | - Carol E Franz
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center for Behavior Genetics of Aging, University of California, La Jolla, San Diego, CA 92093, USA
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Xu J, Xiang L, Zhang H, Sun X, Xu D, Wu D, Chen C, Zhang Y, Gu Z. Prevalence and modifiable risk factors of cognitive frailty in patients with chronic heart failure in China: a cross-sectional study. BMC Cardiovasc Disord 2024; 24:93. [PMID: 38326774 PMCID: PMC10848518 DOI: 10.1186/s12872-024-03753-x] [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: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Cognitive frailty (CF) is currently a significant issue, and most of the associated factors discovered in current studies are not modifiable. Therefore, it is crucial to identify modifiable risk factors that can be targeted for interventions in patients with chronic heart failure (CHF). This study aimed to investigate the prevalence and modifiable risk factors of CF in CHF patients in China. METHODS In this cross-sectional study, we sequentially enrolled patients diagnosed with CHF. CF served as the dependent variable, assessed through the Montreal Cognitive Assessment (MoCA) Scale and the FRAIL Scale. The independent variable questionnaire encompassed various components, including general demographic information, the Social Support Rating Scale (SSRS), the Simplified Nutrition Appetite Questionnaire (SNAQ), the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA), and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Logistic regression analysis was employed to identify independent factors contributing to CF. RESULTS A total of 271 patients with CHF were included in the study. The overall prevalence of CF was found to be 49.4%, with 28.8% of patients exhibiting potentially reversible cognitive frailty and 20.7% showing reversible cognitive frailty. Among middle-young CHF patients, 10.7% had reversible cognitive frailty and 6.4% had potentially reversible cognitive frailty, with a prevalence of CF at 17.1%. Logistic regression analysis revealed that body mass index (OR = 0.826, 95%CI = 0.726-0.938), blood pressure level (OR = 2.323, 95%CI = 1.105-4.882), nutrition status (OR = 0.820, 95%CI = 0.671-0.979), and social support (OR = 0.745, 95%CI = 0.659-0.842) were independent factors associated with CF (p < 0.05). CONCLUSIONS We observed a relatively high prevalence of CF among Chinese patients diagnosed with CHF. Many factors including BMI, blood pressure level, nutrition status, and social support emerging as modifiable risk factors associated with CF. We propose conducting clinical trials to assess the impact of modifying these risk factors. The outcomes of this study offer valuable insights for healthcare professionals, guiding them in implementing effective measures to improve the CF status in CHF patients during clinical practice.
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Affiliation(s)
- Jiayi Xu
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing, Jiangsu, 210023, China
| | - Luwei Xiang
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing, Jiangsu, 210023, China
| | - Huichao Zhang
- The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China
| | - Xing Sun
- Nanjing Women and Children's Healthcare Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, China
| | - Dongmei Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - Die Wu
- Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, Jiangsu, 210029, China
- The First Clinical Medical College, Nanjing University of Chinese Medicine, 282 Hanzhong Road, Nanjing, Jiangsu, 210029, China
| | - Chen Chen
- School of Nursing, Nanjing Medical University, 101 Longmian Road, Nanjing, Jiangsu, 211166, China
| | - Yixiong Zhang
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing, Jiangsu, 210023, China.
| | - Zejuan Gu
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing, Jiangsu, 210023, China.
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
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Lozupone M, Solfrizzi V, Sardone R, Dibello V, Castellana F, Zupo R, Lampignano L, Bortone I, Daniele A, Panza F. The epigenetics of frailty. Epigenomics 2024; 16:189-202. [PMID: 38112012 DOI: 10.2217/epi-2023-0279] [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] [Indexed: 12/20/2023] Open
Abstract
The conceptual change of frailty, from a physical to a biopsychosocial phenotype, expanded the field of frailty, including social and behavioral domains with critical interaction between different frailty models. Environmental exposures - including physical exercise, psychosocial factors and diet - may play a role in the frailty pathophysiology. Complex underlying mechanisms involve the progressive interactions of genetics with epigenetics and of multimorbidity with environmental factors. Here we review the literature on possible mechanisms explaining the association between epigenetic hallmarks (i.e., global DNA methylation, DNA methylation age acceleration and microRNAs) and frailty, considered as biomarkers of aging. Frailty could be considered the result of environmental epigenetic factors on biological aging, caused by conflicting DNA methylation age and chronological age.
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Affiliation(s)
- Madia Lozupone
- Department of Translational Biomedicine & Neuroscience 'DiBraiN', University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Solfrizzi
- Cesare Frugoni Internal & Geriatric Medicine & Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | | | - Vittorio Dibello
- Cesare Frugoni Internal & Geriatric Medicine & Memory Unit, University of Bari Aldo Moro, Bari, Italy
- Department of Orofacial Pain & Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fabio Castellana
- Cesare Frugoni Internal & Geriatric Medicine & Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | - Roberta Zupo
- Cesare Frugoni Internal & Geriatric Medicine & Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | | | - Ilaria Bortone
- Department of Translational Biomedicine & Neuroscience 'DiBraiN', University of Bari Aldo Moro, Bari, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Francesco Panza
- Cesare Frugoni Internal & Geriatric Medicine & Memory Unit, University of Bari Aldo Moro, Bari, Italy
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Zupo R, Castellana F, Coelho Júnior HJ, De Pergola G, Clodoveo ML, Sardone R. Editorial: The role of nutrition in healthy aging. Front Med (Lausanne) 2023; 10:1335119. [PMID: 38111695 PMCID: PMC10726106 DOI: 10.3389/fmed.2023.1335119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/23/2023] [Indexed: 12/20/2023] Open
Affiliation(s)
- Roberta Zupo
- Department of Interdisciplinary Medicine (DIM), University of Bari Aldo Moro, Bari, Italy
| | - Fabio Castellana
- Department of Interdisciplinary Medicine (DIM), University of Bari Aldo Moro, Bari, Italy
| | - Hélio José Coelho Júnior
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Giovanni De Pergola
- Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine (DIM), University of Bari Aldo Moro, Bari, Italy
| | - Rodolfo Sardone
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
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Misu Y, Katayama O, Lee S, Makino K, Harada K, Tomida K, Morikawa M, Yamaguchi R, Nishijima C, Fujii K, Shimada H. Reciprocal relationship between physical and social frailty among community-dwelling older adults. Arch Gerontol Geriatr 2023; 114:105066. [PMID: 37245490 DOI: 10.1016/j.archger.2023.105066] [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: 03/13/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Both physical and social frailty are risk factors for major adverse health-related outcomes and influence each other. However, the longitudinal causal relationship between physical and social frailty has not been clarified. This study aimed to determine the reciprocal relationship between physical and social frailty by age group. METHODS This study analyzed longitudinal data from a cohort study of older adults aged 65 years or older living in Obu City, Aichi Prefecture, Japan. The study included 2568 participants who participated in both a baseline assessment in 2011 and a follow-up assessment four years later. Participants participated in assessments of physical and cognitive function. Physical frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria. Social frailty was assessed with five questions about daily social activities, social roles, and social relationships. A total frailty score was calculated for each frailty type and used in the cross-lagged panel analysis. The reciprocal relationship between physical and social frailty status was analyzed using a cross-lagged panel model in each of the young-old (n = 2006) and old-old (n = 562) groups. RESULTS In the old-old group, baseline physical frailty status predicted social frailty status four years later, and social frailty status at baseline predicted physical frailty status four years later. In the young-old group, the effect of social frailty status at baseline on physical frailty at four years was significant; however, the cross-lag effect from baseline physical frailty status to social frailty status at four years was insignificant, indicating that social frailty preceded physical frailty. CONCLUSION The reciprocal relationship between physical and social frailty differed by age group. The results of this study suggest the importance of considering age when planning strategies to prevent frailty. Although a causal relationship between both physical and social frailty was observed in old-old, social frailty preceded physical frailty in the young-old, suggesting that early prevention of social frailty is important for the prevention of physical frailty.
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Affiliation(s)
- Yuka Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan.
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Ryo Yamaguchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
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Qiu Y, Li G, Zheng L, Liu W, Li X, Wang X, Chen L. Relationship Between Cognitive Frailty and Mortality in Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:1637-1644.e8. [PMID: 37660724 DOI: 10.1016/j.jamda.2023.08.001] [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: 03/14/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To synthesize the pooled mortality risk estimate and determine whether cognitive frailty is a predictor of mortality. DESIGN A systematic review and meta-analysis. SETTING AND PARTICIPANTS The participants were community-dwelling older adults aged ≥60 years. METHODS PubMed, Web of Science, Embase, CINAHL, and the Cochrane Library databases were systematically searched. Two researchers independently screened potentially eligible literature, evaluated the quality of the included studies, and then extracted the data. We used STATA, version 15.0 to perform the all data. RESULTS Nineteen studies were included. The association between cognitive frailty and a higher risk of death was statistically significant [hazard ratio (HR), 2.01; 95% CI, 1.84-2.19; P < .001]. The outcomes indicated that cognitive frailty was a critical risk factor for predicting mortality (OR, 4.82; 95% CI, 1.59-14.57; P < .01). Based on different models of cognitive frailty, the results of subgroup analyses revealed that the risk of mortality was the highest in the Frail + mild cognitive impairment group (HR, 2.35; 95% CI, 2.05-2.70; P < .001). The subgroup analyses by region demonstrated that mortality risk was lowest in the European group (HR, 1.63; 95% CI, 1.4-1.87; P < .001). CONCLUSIONS AND IMPLICATIONS This study quantitatively portrays the pooled mortality risk estimate of cognitive frailty. The results suggest that in older adults, cognitive frailty can be a predictor of mortality. The findings could alert health care providers to pay more attention to cognitive frailty.
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Affiliation(s)
- Yiming Qiu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Guichen Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Lufang Zheng
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Wei Liu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xin Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xinxin Wang
- The First Hospital of Jilin University, Changchun, Jilin, China.
| | - Li Chen
- School of Nursing, Jilin University, Changchun, Jilin, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, China.
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11
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Solfrizzi V, Scafato E, Custodero C, Piazzolla G, Capogna L, Procaccio A, Gandin C, Galluzzo L, Ghirini S, Matone A, Dibello V, Sardone R, Daniele A, Lozupone M, Panza F. Biopsychosocial frailty and mild cognitive impairment subtypes: Findings from the Italian project on the epidemiology of Alzheimer's disease (IPREA). Alzheimers Dement 2023; 19:3306-3315. [PMID: 36757048 DOI: 10.1002/alz.12944] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Frailty is a critical intermediate status of the aging process including physical, cognitive, and psychosocial phenotypes. We operationalized a biopsychosocial frailty construct, estimating its association with mild cognitive impairment (MCI) and its subtypes. METHODS In 1980, older individuals from the population-based Italian PRoject on the Epidemiology of Alzheimer's disease (IPREA), we investigated cross-sectional associations among biopsychosocial frailty, MCI, and its subtypes. RESULTS Participants with biopsychosocial frailty showed an increased odds ratio (OR) of MCI [OR: 4.36; 95% confidence interval (CI): 2.60-7.29; Fisher's exact p < 0.01], particularly for nonamnestic MCI single domain (naMCI-SD, OR:3.28; 95% CI: 1.35-7.97; Fisher's exact p = 0.02) and for nonamnestic MCI multiple domain (naMCI-MD, OR:6.92; 95% CI: 3.37-14.21; Fisher's exact p < 0.01). No statistically significant associations between amnestic MCI single or multiple domain and biopsychosocial frailty were observed. DISCUSSION In a large, older Italian cohort, a biopsychosocial frailty phenotype was associated with MCI, in particular, could be associated with some of its subtypes, that is, naMCI-SD, and naMCI-MD.
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Affiliation(s)
- Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Emanuele Scafato
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Custodero
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Giuseppina Piazzolla
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Lavinia Capogna
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Annagrazia Procaccio
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Claudia Gandin
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Galluzzo
- Department of Cardiovascular, Endocrine-Metabolic Diseases, and Aging, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Silvia Ghirini
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Alice Matone
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBrain", University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
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12
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Zupo R, Donghia R, Castellana F, Bortone I, De Nucci S, Sila A, Tatoli R, Lampignano L, Sborgia G, Panza F, Lozupone M, Colacicco G, Clodoveo ML, Sardone R. Ultra-processed food consumption and nutritional frailty in older age. GeroScience 2023; 45:2229-2243. [PMID: 36826622 PMCID: PMC10651811 DOI: 10.1007/s11357-023-00753-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Frailty is a multidisciplinary public health issue and nutrition is key concern. Given the scientific consistency about inflammation as shared pathway to poor nutrition and frailty, food processing seems a suitable target to gain evidence in frailty prevention nutrition settings. This study aimed to assess diet in relation to nutritional frailty using the NOVA classification. Browsing the dataset of the Salus in Apulia, 2185 older adults were found to have completed the nutritional assessment, providing eligible data for this study goal. A validated construct, based on the co-presence of physical frailty by CHS criteria plus nutritional imbalance, was applied to characterize nutritional frailty phenotypes. Using the NOVA classification, daily food and beverage intakes from an 85-item self-administered FFQ were assigned to three categories, and effect sizes were tested among groups according to nutritional frailty status (presence/absence). Raw and adjusted logistic regression models were run to assess associations between NOVA food categories by quintiles of daily exposure (very-low, low, mild, moderate, high) and nutritional frailty. Nutritional frailty prevalence was 27%, being more frequent in males. Eating more unprocessed or minimally processed foods was inversely related to nutritional frailty, even after adjustment (OR: 0.10, 95%CI 0.07-0.16), showing a downward ORs behavior toward lower consumption quintiles. Listing in the quintile of moderate consumption of processed foods meant a nearly 50% increase in nutritional frailty probability (OR: 1.46, 95%CI 1.03-2.06), while the probability was double for the highest quintile against the lowest (OR: 3.22, 95%CI 2.27-4.58). A growing probability of nutritional frailty was found for increasing consumption of ultra-processed foods, but significance was lacking. The contribution of food processing to poor nutrition needs to be considered when promoting a better understanding of effective nutritional screening in aging. Therefore, food processing should be accounted for when composing diet guidelines for the older population within the framework of multidisciplinary efforts to ease the frailty healthcare burden.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy.
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Institute of Clinical Physiology, National Research Council (IFC-CNR), Pisa, Italy
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Annamaria Sila
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Rossella Tatoli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Giancarlo Sborgia
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Colacicco
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari Aldo Moro, Bari, Italy
| | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
- Local Healthcare Authority of Taranto, Taranto, Italy
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Panza F, Solfrizzi V, Sardone R, Dibello V, Castellana F, Zupo R, Stallone R, Lampignano L, Bortone I, Mollica A, Berardino G, Ruan Q, Altamura M, Bellomo A, Daniele A, Lozupone M. Depressive and Biopsychosocial Frailty Phenotypes: Impact on Late-life Cognitive Disorders. J Alzheimers Dis 2023:JAD230312. [PMID: 37355907 DOI: 10.3233/jad-230312] [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: 06/26/2023]
Abstract
In older age, frailty is a detrimental transitional status of the aging process featuring an increased susceptibility to stressors defined by a clinical reduction of homoeostatic reserves. Multidimensional frailty phenotypes have been associated with all-cause dementia, mild cognitive impairment (MCI), Alzheimer's disease (AD), AD neuropathology, vascular dementia, and non-AD dementias. In the present article, we reviewed current evidence on the existing links among depressive and biopsychosocial frailty phenotypes and late-life cognitive disorders, also examining common pathways and mechanisms underlying these links. The depressive frailty phenotype suggested by the construct of late-life depression (LLD) plus physical frailty is poorly operationalized. The biopsychosocial frailty phenotype, with its coexistent biological/physical and psychosocial dimensions, defines a biological aging status and includes motivational, emotional, and socioeconomic domains. Shared biological pathways/substrates among depressive and biopsychosocial frailty phenotypes and late-life cognitive disorders are hypothesized to be inflammatory and cardiometabolic processes, together with multimorbidity, loneliness, mitochondrial dysfunction, dopaminergic neurotransmission, specific personality traits, lack of subjective/objective social support, and neuroendocrine dysregulation. The cognitive frailty phenotype, combining frailty and cognitive impairment, may be a risk factor for LLD and vice versa, and a construct of depressive frailty linking physical frailty and LLD may be a good dementia predictor. Frailty assessment may enable clinicians to better target the pharmacological and psychological treatment of LLD. Given the epidemiological links of biopsychosocial frailty with dementia and MCI, multidomain interventions might contribute to delay the onset of late-life cognitive disorders and other adverse health-related outcomes, such as institutionalization, more frequent hospitalization, disability, and mortality.
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Affiliation(s)
- Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Vittorio Dibello
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Stallone
- Neuroscience and Education, Human Resources Excellence in Research, University of Foggia, Foggia, Italy
| | - Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Qingwei Ruan
- Laboratory of Aging, Anti-aging & Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Shanghai Medical 14 College, Fudan University, Shanghai, China
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
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14
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Cano-Escalera G, Graña M, Irazusta J, Labayen I, Gonzalez-Pinto A, Besga A. Mortality Risks after Two Years in Frail and Pre-Frail Older Adults Admitted to Hospital. J Clin Med 2023; 12:jcm12093103. [PMID: 37176544 PMCID: PMC10179017 DOI: 10.3390/jcm12093103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/11/2023] [Accepted: 04/06/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Frailty is characterized by a progressive decline in the physiological functions of multiple body systems that lead to a more vulnerable condition, which is prone to the development of various adverse events, such as falls, hospitalization, and mortality. This study aims to determine whether frailty increases mortality compared to pre-frailty and to identify variables associated with a higher risk of mortality. MATERIALS Two cohorts, frail and pre-frail subjects, are evaluated according to the Fried phenotype. A complete examination of frailty, cognitive status, comorbidities and pharmacology was carried out at hospital admission and was extracted through electronic health record (EHR). Mortality was evaluated from the EHR. METHODS Kaplan-Meier estimates of survival probability functions were calculated at two years censoring time for frail and pre-frail cohorts. The log-rank test assessed significant differences between survival probability functions. Significant variables for frailty (p < 0-05) were extracted by independent sample t-test. Further selection was based on variable significance found in multivariate logistic regression discrimination between frail and pre-frail subjects. Cox regression over univariate t-test-selected variables was calculated to identify variables associated with higher proportional hazard risks (HR) at two years. RESULTS Frailty is associated with greater mortality at two years censoring time than pre-frailty (log-rank test, p < 0.0001). Variables with significant (p < 0.05) association with mortality identified in both cohorts (HR 95% (CI in the frail cohort) are male sex (0.44 (0.29-0.66)), age (1.05 (1.01-1.09)), weight (0.98 (0.96-1.00)), and use of proton-pump inhibitors (PPIs) (0.60 (0.41-0.87)). Specific high-risk factors in the frail cohort are readmission at 30 days (0.50 (0.33-0.74)), SPPB sit and stand (0.62 (0.45-0.85)), heart failure (0.67 (0.46-0.98)), use of antiplatelets (1.80 (1.19-2.71)), and quetiapine (0.31 (0.12-0.81)). Specific high-risk factors in the pre-frail cohort are Barthel's score (120 (7.7-1700)), Pfeiffer test (8.4; (2.3-31)), Mini Nutritional Assessment (MNA) (1200 (18-88,000)), constipation (0.025 (0.0027-0.24)), falls (18,000 (150-2,200,000)), deep venous thrombosis (8400 (19-3,700,000)), cerebrovascular disease (0.01 (0.00064-0.16)), diabetes (360 (3.4-39,000)), thyroid disease (0.00099 (0.000012-0.085)), and the use of PPIs (0.062 (0.0072-0.54)), Zolpidem (0.000014 (0.0000000021-0.092)), antidiabetics (0.00015 (0.00000042-0.051)), diuretics (0.0003 (0.000004-0.022)), and opiates (0.000069 (0.00000035-0.013)). CONCLUSIONS Frailty is associated with higher mortality at two years than pre-frailty. Frailty is recognized as a systemic syndrome with many links to older-age comorbidities, which are also found in our study. Polypharmacy is strongly associated with frailty, and several commonly prescribed drugs are strongly associated with increased mortality. It must be considered that frail patients need coordinated attention where the diverse specialist taking care of them jointly examines the interactions between the diversity of treatments prescribed.
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Affiliation(s)
- Guillermo Cano-Escalera
- Department of Computer Science and Artificial Intelligence, University of the Basque Country (UPV/EHU), 20018 Donostia-San Sebastian, Spain
- Computational Intelligence Group, University of the Basque Country (UPV/EHU), 20018 Donostia-San Sebastian, Spain
| | - Manuel Graña
- Department of Computer Science and Artificial Intelligence, University of the Basque Country (UPV/EHU), 20018 Donostia-San Sebastian, Spain
- Computational Intelligence Group, University of the Basque Country (UPV/EHU), 20018 Donostia-San Sebastian, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Bilbao, Spain
- BioCruces Health Research Institute, 48903 Barakaldo, Spain
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, 31006 Pamplona, Spain
| | - Ana Gonzalez-Pinto
- BioAraba, Health Research Institute, Department of Medicine, Hospital Universitario de Araba, 01004 Vitoria, Spain
- Biomedical Research Centre in Mental Health Network (CIBERSAM), 28029 Madrid, Spain
| | - Ariadna Besga
- BioAraba, Health Research Institute, Department of Medicine, Hospital Universitario de Araba, 01004 Vitoria, Spain
- Biomedical Research Centre in Mental Health Network (CIBERSAM), 28029 Madrid, Spain
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15
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Scafato E, Solfrizzi V, Custodero C, Casieri G, Falco C, Maggipinto R, Gandin C, Galluzzo L, Ghirini S, Matone A, Dibello V, Sardone R, Daniele A, Lozupone M, Panza F. Associations of a biopsychosocial frailty phenotype with all-cause dementia, Alzheimer's disease, vascular dementia, and other dementias: the Italian PRoject on the Epidemiology of Alzheimer's disease (IPREA). GeroScience 2023:10.1007/s11357-023-00781-x. [PMID: 37014539 PMCID: PMC10400737 DOI: 10.1007/s11357-023-00781-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/23/2023] [Indexed: 04/05/2023] Open
Abstract
Frailty is a critical intermediate status of the aging process including physical, cognitive, and psychosocial domains/phenotypes. We operationalized a new biopsychosocial frailty construct, estimating its impact on the odds of all-cause dementia, Alzheimer's disease (AD), vascular dementia (VaD), and other dementias in 2838 older individuals from the population-based Italian PRoject on the Epidemiology of Alzheimer's disease (IPREA). Biopsychosocial frailty operationalization was based on the results of a previous comprehensive geriatric assessment and the presence of physical frailty. In this cross-sectional study, participants with biopsychosocial frailty showed an increased odds ratio of all-cause dementia [odds ratio (OR): 5.55, 95% confidence interval (CI): 3.72-8.28, p < 0.001], in particular for probable AD (OR: 3.62, 95% CI: 1.55-8.45, p < 0.001), probable VaD (OR: 10.05, 95% CI: 5.05-19.97, p < 0.001), and possible VaD (OR: 17.61, 95% CI: 6.42-48.32, p < 0.001). No statistically significant association was found between this biopsychosocial frailty phenotype and possible AD (OR: 2.84, 95% CI: 0.81-9.97, p = 0.09) or other dementias (OR: 1.77, 95% CI: 0.75-0.21, p = 0.19). In conclusion, in a large cohort of Italian older individuals, a biopsychosocial frailty model was associated to all-cause dementia, probable AD, and probable and possible VaD. In the next future, other large and prospective population-based studies evaluating the association between the biopsychosocial frailty phenotype and incident all-cause dementia, AD, and VaD are needed, addressing also potential bias and confounding sources.
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Affiliation(s)
- Emanuele Scafato
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy.
| | - Carlo Custodero
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Giovanna Casieri
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Claudia Falco
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Rosselia Maggipinto
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Claudia Gandin
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Galluzzo
- Department of Cardiovascular, Endocrine-Metabolic Diseases, and Aging, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Silvia Ghirini
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Alice Matone
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy.
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16
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Dibello V, Lobbezoo F, Lozupone M, Sardone R, Ballini A, Berardino G, Mollica A, Coelho-Júnior HJ, De Pergola G, Stallone R, Dibello A, Daniele A, Petruzzi M, Santarcangelo F, Solfrizzi V, Manfredini D, Panza F. Oral frailty indicators to target major adverse health-related outcomes in older age: a systematic review. GeroScience 2023; 45:663-706. [PMID: 36242694 PMCID: PMC9886742 DOI: 10.1007/s11357-022-00663-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/14/2022] [Indexed: 02/03/2023] Open
Abstract
A well-preserved oral function is key to accomplishing essential daily tasks. However, in geriatric medicine and gerodontology, as age-related physiological decline disrupts several biological systems pathways, achieving this objective may pose a challenge. We aimed to make a systematic review of the existing literature on the relationships between poor oral health indicators contributing to the oral frailty phenotype, defined as an age-related gradual loss of oral function together with a decline in cognitive and physical functions, and a cluster of major adverse health-related outcomes in older age, including mortality, physical frailty, functional disability, quality of life, hospitalization, and falls. Six different electronic databases were consulted by two independent researchers, who found 68 eligible studies published from database inception to September 10, 2022. The risk of bias was evaluated using the National Institutes of Health Quality Assessment Toolkits for Observational Cohort and Cross-Sectional Studies. The study is registered on PROSPERO (CRD42021241075). Eleven different indicators of oral health were found to be related to adverse outcomes, which we grouped into four different categories: oral health status deterioration; decline in oral motor skills; chewing, swallowing, and saliva disorders; and oral pain. Oral health status deterioration, mostly number of teeth, was most frequently associated with all six adverse health-related outcomes, followed by chewing, swallowing, and saliva disorders associated with mortality, physical frailty, functional disability, hospitalization, and falls, then decline in oral motor skills associated with mortality, physical frailty, functional disability, hospitalization, and quality of life, and finally oral pain was associated only with physical frailty. The present findings could help to assess the contribution of each oral health indicator to the development of major adverse health-related outcomes in older age. These have important implications for prevention, given the potential reversibility of all these factors.
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Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario Ernesto Quagliariello, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Hélio José Coelho-Júnior
- School of Physical Education, University of Campinas, Cidade Universitaria Zeferino Vaz, Barao Geraldo, Campinas, Brazil
| | - Giovanni De Pergola
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Roberta Stallone
- Neuroscience and Education, Human Resources Excellence in Research, University of Foggia, Foggia, Italy
| | - Antonio Dibello
- Accident and Emergency Department (AED), F. Perinei Hospital, Altamura, Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
- Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, Section of Dentistry, University of Bari Medical School, Bari, Italy
| | | | - Vincenzo Solfrizzi
- Cesare Frugoni Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy.
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17
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De Nucci S, Zupo R, Donghia R, Castellana F, Lofù D, Aresta S, Guerra V, Bortone I, Lampignano L, De Pergola G, Lozupone M, Tatoli R, Sborgia G, Tirelli S, Panza F, Di Noia T, Sardone R. Dietary profiling of physical frailty in older age phenotypes using a machine learning approach: the Salus in Apulia Study. Eur J Nutr 2023; 62:1217-1229. [PMID: 36484807 PMCID: PMC10030526 DOI: 10.1007/s00394-022-03066-9] [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: 03/07/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Growing awareness of the biological and clinical value of nutrition in frailty settings calls for further efforts to investigate dietary gaps to act sooner to achieve focused management of aging populations. We cross-sectionally examined the eating habits of an older Mediterranean population to profile dietary features most associated with physical frailty. METHODS Clinical and physical examination, routine biomarkers, medical history, and anthropometry were analyzed in 1502 older adults (65 +). CHS criteria were applied to classify physical frailty, and a validated Food Frequency Questionnaire to assess diet. The population was subdivided by physical frailty status (frail or non-frail). Raw and adjusted logistic regression models were applied to three clusters of dietary variables (food groups, macronutrients, and micronutrients), previously selected by a LASSO approach to better predict diet-related frailty determinants. RESULTS A lower consumption of wine (OR 0.998, 95% CI 0.997-0.999) and coffee (OR 0.994, 95% CI 0.989-0.999), as well as a cluster of macro and micronutrients led by PUFAs (OR 0.939, 95% CI 0.896-0.991), zinc (OR 0.977, 95% CI 0.952-0.998), and coumarins (OR 0.631, 95% CI 0.431-0.971), was predictive of non-frailty, but higher legumes intake (OR 1.005, 95%CI 1.000-1.009) of physical frailty, regardless of age, gender, and education level. CONCLUSIONS Higher consumption of coffee and wine, as well as PUFAs, zinc, and coumarins, as opposed to legumes, may work well in protecting against a physical frailty profile of aging in a Mediterranean setting. Longitudinal investigations are needed to better understand the causal potential of diet as a modifiable contributor to frailty during aging.
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Affiliation(s)
- Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy.
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Domenico Lofù
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Simona Aresta
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Vito Guerra
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Madia Lozupone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Rossella Tatoli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giancarlo Sborgia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Sarah Tirelli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Francesco Panza
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Tommaso Di Noia
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
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Teixeira TV, Da Silva ACF, Rodrigues CDSC, Brito FDSB, Canella DS, Citelli M. Food Consumption of People with Sickle Cell Anemia in a Middle-Income Country. Nutrients 2023; 15:nu15061478. [PMID: 36986208 PMCID: PMC10054003 DOI: 10.3390/nu15061478] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Sickle cell anemia (SCA) is a genetic and hemolytic disease globally characterized by social vulnerability. Food consumption has been insufficiently analyzed in SCA. Secondary iron overload is often observed. This leads to unreliable recommendations for dietary iron restriction. We assessed food consumption and iron intake among adults with SCA. Considering the guidelines for healthy eating, foods were grouped according to the NOVA classification. This transversal study included 74.4% of eligible patients who were registered in the reference center for SCA treatment in Rio de Janeiro, Brazil, in 2019. Data on food consumption were collected through 24 h recall. The monthly household income of 82.3% of patients was less than $770. The consumption of fresh or minimally processed foods was directly associated with monthly household income (p < 0.0001; η2 = 0.87). Ultra-processed foods provided more than one-third of the total energy intake (35.2%). The prevalence of inadequate iron intake was about 40% among women, while that of iron intake above the tolerable upper limit was 0.8%. People from lower socioeconomic classes had the lowest iron intake. Strategies to encourage the consumption of fresh or minimally processed foods are needed considering the requirement of an antioxidant diet in SCA. These findings highlight the need for health equity to ensure food security and healthy eating in SCA.
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Affiliation(s)
- Tamara Vilhena Teixeira
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil
| | | | | | | | - Daniela Silva Canella
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil
| | - Marta Citelli
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil
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19
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Perna S, Gasparri C, Allehdan S, Riva A, Petrangolini G, Ferraris C, Guido D, Alalwan TA, Rondanelli M. Discovering the Physio-Pathological Mechanisms of Interaction between Bone Mineral Density, Muscle Mass, and Visceral Adipose Tissue in Female Older Adults through Structural Equation Modeling. J Clin Med 2023; 12:jcm12062269. [PMID: 36983268 PMCID: PMC10053048 DOI: 10.3390/jcm12062269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
This study aims to examine the relation between visceral adipose tissue (VAT), as a proxy for metabolically unhealthy obesity, muscle, as a proxy for muscle quality and sarcopenia, and bone, as a proxy for bone mineral density and osteoporosis. Other variables, such metabolic syndrome, nutritional status, number of diseases, kidney and liver function and inflammation were assessed as direct or indirect effects. This study used structural equation modeling (SEM) in a sample of 713 older women (mean age 82.1 ± 6.3). The results indicate a positive statistically significant association between bone and muscle mass (β = 0.195, <0.001) and nutritional status and muscle mass (β = 0.139, p < 0.001), but negative association between age with muscle mass (β = −0.509, p < 0.001) and nutritional status (estimates: −2.264, p < 0.001). A negative association between VAT and muscle mass was also reported (β = −1.88, p < 0.001). A negative statistically significant association was reported between bone mineral density and functional status (β = −1.081, p < 0.001), and a positive association between functional status and muscle mass (β = 9.000, p < 0.001). In addition, functional status was positively statistically associated with cognitive performance (β = 0.032, p < 0.001). The SEM method demonstrates that the VAT, muscle mass and bone mineral density are associated, but the form of the relation is different in relation to different factors, such as nutritional status, mental and functional status, age, and number of pathologies, having different impacts on metabolic outcomes. SEM is a feasible technique for understanding the complex mechanisms of frailty in the elderly.
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Affiliation(s)
- Simone Perna
- Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20122 Milano, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy
- Correspondence:
| | - Sabika Allehdan
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Bahrain
| | | | | | - Cinzia Ferraris
- Food Education and Sport Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | | | - Tariq A. Alalwan
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Bahrain
| | - Mariangela Rondanelli
- IRCCS Mondino Foundation, 27100 Pavia, Italy
- Unit of Human and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
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20
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Li T, Wang X, Liu Z, Zhang Z, Zhang Y, Wang Z, Feng Y, Wang Q, Guo X, Tang X, Xu J, Song Y, Chen Y, Xu N, Yao Y, Liu R, Zhu P, Han Y, Yuan J. Prevalence and Prognostic Significance of Malnutrition in Patients with Abnormal Glycemic Status and Coronary Artery Disease: A Multicenter Cohort Study in China. Nutrients 2023; 15:nu15030732. [PMID: 36771438 PMCID: PMC9920677 DOI: 10.3390/nu15030732] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
This study sought to investigate the prevalence and prognostic significance of malnutrition in patients with an abnormal glycemic status and coronary artery disease (CAD). This secondary analysis of a multicenter prospective cohort included 5710 CAD patients with prediabetes and 9328 with diabetes. Four objective tools were applied to assess the nutritional status of the study population. The primary endpoint was all-cause death. The association of malnutrition with clinical outcomes was examined using Cox proportional hazards regression. The proportion of malnutrition varied from 8% to 57% across the assessment tools. Diabetic patients were more likely to be malnourished than prediabetic patients. During a median follow-up of 2.1 years, 456 all-cause deaths occurred. The adjusted hazard ratios and 95% confidence interval for all-cause deaths of moderate-severe malnutrition defined by different tools ranged from 1.59 (1.03, 2.46) to 2.08 (0.92, 4.73) in prediabetic patients and 1.51 (1.00, 2.34) to 2.41 (1.78, 3.27) in diabetic patients. In conclusion, malnutrition is not rare in CAD patients with abnormal glycemic status. Moderate-severe malnutrition strongly predicted all-cause death regardless of the assessment tool. Assessing the nutritional status for all CAD patients with prediabetes and diabetes to identify individuals at high risk of all-cause death may help the risk assessment and prognosis improvement.
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Affiliation(s)
- Tianyu Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiaozeng Wang
- Cardiovascular Research Institute & Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Zhenyu Liu
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zheng Zhang
- Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Yongzhen Zhang
- Department of Cardiology, Peking University Third Hospital, Beijing 100191, China
| | - Zhifang Wang
- Department of Cardiology, Xinxiang Central Hospital, Xinxiang 453002, China
| | - Yingqing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangzhou 510100, China
| | - Qingsheng Wang
- Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao 066000, China
| | - Xiaogang Guo
- Department of Cardiology, The First Affiliated Hospital of Zhejiang University, Hangzhou 314400, China
| | - Xiaofang Tang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jingjing Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ying Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yan Chen
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Na Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yi Yao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ru Liu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Pei Zhu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yaling Han
- Cardiovascular Research Institute & Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
- Correspondence: (Y.H.); (J.Y.)
| | - Jinqing Yuan
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
- Correspondence: (Y.H.); (J.Y.)
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21
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Kashtanova DA, Erema VV, Gusakova MS, Sutulova ER, Yakovchik AY, Ivanov MV, Taraskina AN, Terekhov MV, Matkava LR, Rumyantseva AM, Yudin VS, Akopyan AA, Strazhesko ID, Kordiukova IS, Akinshina AI, Makarov VV, Tkacheva ON, Kraevoy SA, Yudin SM. Mortality and survival in nonagenarians during the COVID-19 pandemic: Unstable equilibrium of aging. Front Med (Lausanne) 2023; 10:1132476. [PMID: 36936206 PMCID: PMC10018166 DOI: 10.3389/fmed.2023.1132476] [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: 12/27/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Aging puts the human body under an immense stress and makes it extremely susceptible to many diseases, often leading to poor outcomes and even death. Long-living individuals represent a unique group of people who withstood the stress of time and offer an abundance of information on the body's ability to endure the pressure of aging. In this study, we sought to identify predictors of overall one-year mortality in 1641 long-living individuals. Additionally, we analyzed risk factors for COVID-19-related morality, since statistics demonstrated an extreme vulnerability of older adults. Methods We conducted a two-stage evaluation, including a comprehensive geriatric assessment for major aging-associated: frailty, cognitive impairment, frontal lobe dysfunction, chronic pain, anxiety, risk of falls, sensory deficit, depression, sarcopenia, risk of malnutrition, fecal and urinary incontinence, dependence in Activities of Daily Living, dependence in Instrumental Activities of Daily Living, polypragmasia, and orthostatic hypotension; extensive blood testing, a survey, and a one-year follow-up interview. Results The most reliable predictors of overall mortality were cognitive impairment, malnutrition, frailty, aging-associated diseases and blood markers indicating malnutrition-induced metabolic dysfunctions (decreased levels of protein fractions, iron, 25-hydroxyvitamin D, and HDL), and aging biomarkers, such as IGF-1 and N-terminal pro b-type natriuretic peptide. In post-COVID 19 participants, the most significant mortality predictors among geriatric syndromes were depression, frontal lobe dysfunction and frailty, and similar to overall mortality blood biomarkers - 25-hydroxyvitamin D, IGF-1, HDL as well as high white blood cell, neutrophils counts and proinflammatory markers. Based on the results, we built a predictive model of overall mortality in the long-living individuals with f-score=0.76. Conclusion The most sensitive and reliable predictors of mortality were modifiable. This is another evidence of the critical importance of proper geriatric care and support for individuals in their "golden years". These results could facilitate geriatric institutions in their pursuit for providing improved care and could aid physicians in detecting early signs of potentially deadly outcomes. Additionally, our findings could be used in developing day-to-day care guidelines, which would greatly improve prevention statistics.
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Affiliation(s)
- Daria A. Kashtanova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
- *Correspondence: Daria A. Kashtanova,
| | - Veronika V. Erema
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Maria S. Gusakova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Ekaterina R. Sutulova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Anna Yu. Yakovchik
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Mikhail V. Ivanov
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Anastasiia N. Taraskina
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Mikhail V. Terekhov
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Lorena R. Matkava
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Antonina M. Rumyantseva
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Vladimir S. Yudin
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Anna A. Akopyan
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Irina D. Strazhesko
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Irina S. Kordiukova
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Alexandra I. Akinshina
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Valentin V. Makarov
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Olga N. Tkacheva
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Sergey A. Kraevoy
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Sergey M. Yudin
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
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22
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Dibello V, Lozupone M, Sardone R, Ballini A, Dibello A, Daniele A, Panza F. Clinical Indicators of Oral Frailty: A Domain-Specific Frailty Phenotype. Curr Top Med Chem 2022; 22:2391-2394. [PMID: 35708086 DOI: 10.2174/1568026622666220615145647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/09/2022] [Accepted: 03/18/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Rodolfo Sardone
- Department of Epidemiology, Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario "Ernesto Quagliariello", University of Bari Aldo Moro, Bari, Italy
| | - Antonio Dibello
- Accident and Emergency Department (AED), F. Perinei Hospital, Altamura, Bari, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy.,Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Francesco Panza
- Department of Epidemiology, Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Castellana Grotte, Bari, Italy
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Huang H, Chen Z, Chen L, Cao S, Bai D, Xiao Q, Xiao M, Zhao Q. Nutrition and sarcopenia: Current knowledge domain and emerging trends. Front Med (Lausanne) 2022; 9:968814. [PMID: 36388910 PMCID: PMC9643490 DOI: 10.3389/fmed.2022.968814] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Non-pharmacological management like nutrient supplements has shown positive impacts on muscle mass and strength, which has burgeoned clinical and research interest internationally. The aim of this study was to analyze the current knowledge domain and emerging trends of nutrition-related research in sarcopenia and provide implications for future research and strategies to prevent or manage sarcopenia in the context of aging societies. Materials and methods Nutrition- and sarcopenia-related research were obtained from the Web of Science Core Collection (WoSCC) database from its inception to April 1, 2022. Performance analysis, science mapping, and thematic clustering were performed by using the software VOSviewer and R package “bibliometrix.” Bibliometric analysis (BA) guideline was applied in this study. Results A total of 8,110 publications were extracted and only 7,510 (92.60%) were selected for final analysis. The production trend in nutrition and sarcopenia research was promising, and 1,357 journals, 107 countries, 6,668 institutions, and 31,289 authors were identified in this field till 2021. Stable cooperation networks have formed in the field, but they are mostly divided by region and research topics. Health and sarcopenia, metabolism and nutrition, nutrition and exercise, body compositions, and physical performance were the main search themes. Conclusions This study provides health providers and scholars mapped out a comprehensive basic knowledge structure in the research in the field of nutrition and sarcopenia over the past 30 years. This study could help them quickly grasp research hotspots and choose future research projects.
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Affiliation(s)
- Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Huanhuan Huang,
| | - Zhiyu Chen
- Department of Orthopedic, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lijuan Chen
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Songmei Cao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Nursing, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Dingqun Bai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Xiao
- Department of Geriatric, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Qinghua Zhao,
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Liquori G, De Leo A, De Nuzzo D, D’Inzeo V, Arancio RM, Di Simone E, Dionisi S, Giannetta N, Ricciardi F, Fabbian F, Orsi GB, Di Muzio M, Napoli C. Management Strategies and Nursing Activities for Nutritional Care in Hospitalized Patients with Cognitive Decline: A Scoping Review. Nutrients 2022; 14:nu14194036. [PMID: 36235687 PMCID: PMC9573259 DOI: 10.3390/nu14194036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Cognitive impairment and dementia can negatively impact the nutritional capacities of older people. Malnutrition is common in hospitalized frail elderly people with cognitive impairment and negatively affects prognosis. Malnutrition worsens the quality of life and increases morbidity and mortality. This scoping review aimed to identify factors affecting the risk of malnutrition and preventive strategies in hospitalized patients with cognitive impairment, focusing on nursing interventions. The authors researched population, context, and concept in international databases of nursing interest. Full texts that met the inclusion criteria were selected and reviewed. The extracted data were subject to thematic analysis. A five-stage approach, already reported in the scientific literature, was utilized in the following scoping review. Of 638 articles yielded, 9 were included. Two focus areas were identified as follows: (1) prevalence and risk factors of malnutrition in older patients with cognitive decline; (2) nursing strategies used to enhance clinical outcomes. Nursing health interventions aim to recognize and reduce malnutrition risk, positively impacting this phenomenon. A multidisciplinary team is essential to meet the nutritional needs of these patients.
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Affiliation(s)
- Gloria Liquori
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Aurora De Leo
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy
- Nursing, Technical, Rehabilitation, Assistance and Research Direction—IRCCS Istituti Fisioterapici Ospitalieri—IFO, 00144 Rome, Italy
| | - Daniele De Nuzzo
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Victoria D’Inzeo
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Rosario Marco Arancio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Di Simone
- Nursing, Technical, Rehabilitation, Assistance and Research Direction—IRCCS Istituti Fisioterapici Ospitalieri—IFO, 00144 Rome, Italy
| | - Sara Dionisi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Noemi Giannetta
- School of Nursing, UniCamillus—Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
| | - Francesco Ricciardi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabio Fabbian
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy
| | - Marco Di Muzio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Christian Napoli
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-06-3377-5529
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Liu J, Liu J, Wang J, Yan Z, Liang Q, Wang X, Wang Z, Liu M, Luan X. Prevalence and impact of malnutrition on readmission among hospitalized patients with heart failure in China. ESC Heart Fail 2022; 9:4271-4279. [PMID: 36125306 PMCID: PMC9773638 DOI: 10.1002/ehf2.14152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/04/2022] [Accepted: 09/05/2022] [Indexed: 01/19/2023] Open
Abstract
AIMS Malnutrition is common in patients with heart failure (HF) and is associated with poorer quality of life and increased mortality; however, an effective screening tool for malnutrition and its impact on the readmission of patients with HF is uncertain. Our objectives were to study (i) the nutritional status of Chinese hospitalized patients with HF and its impact on readmission and (ii) the validity of seven malnutrition screening tools. METHODS AND RESULTS In this study, univariate and multivariate analyses of Cox proportional hazards regression were used to determine important predictors of readmission. The endpoint was readmission due to HF or non-HF. A total of 402 patients were included (66.4% male, median age 62 years [range: 20-92 years], median NT-proBNP 5,229 ng/L). During a median follow-up of 159 days, 150 patients (37%) were readmitted to the hospital. After adjusting for confounders, only malnutrition assessed using the Controlling Nutritional Status (CONUT) nutrition score was independently associated with readmission (P = 0.0293). A base model for predicting readmission with a C-statistic of 0.680 and subsequent addition of various nutritional screening tools improved its performance over the base model. Patients with malnutrition had a twofold increased risk of readmission. CONCLUSIONS We found that the prevalence of malnutrition among hospitalized patients with HF in China is very high and that malnutrition significantly increases the risk of readmission in these patients. CONUT is a validated screening tool for malnutrition and may provide valuable prognostic information.
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Affiliation(s)
- Jian Liu
- School of Nursing and Rehabilitation, Cheeloo College of MedicineShandong University250012JinanShandongChina
| | - Jing Liu
- School of Nursing and Rehabilitation, Cheeloo College of MedicineShandong University250012JinanShandongChina
| | - Jiurui Wang
- School of Nursing and Rehabilitation, Cheeloo College of MedicineShandong University250012JinanShandongChina
| | - Zeping Yan
- School of Nursing and Rehabilitation, Cheeloo College of MedicineShandong University250012JinanShandongChina,University of Health and Rehabilitation Sciences266071QingdaoShandongChina
| | - Qian Liang
- School of Nursing and Rehabilitation, Cheeloo College of MedicineShandong University250012JinanShandongChina
| | - Xiaoli Wang
- School of Nursing and Rehabilitation, Cheeloo College of MedicineShandong University250012JinanShandongChina
| | - Zhiwei Wang
- School of Nursing and Rehabilitation, Cheeloo College of MedicineShandong University250012JinanShandongChina
| | - Mengqi Liu
- School of Nursing and Rehabilitation, Cheeloo College of MedicineShandong University250012JinanShandongChina
| | - Xiaorong Luan
- Department of Infection ControlQilu Hospital of Shandong UniversityWenhua West Road#107250012JinanShandongChina
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Mazeaud S, Castellana F, Coelho-Junior HJ, Panza F, Rondanelli M, Fassio F, De Pergola G, Zupo R, Sardone R. Coffee Drinking and Adverse Physical Outcomes in the Aging Adult Population: A Systematic Review. Metabolites 2022; 12:metabo12070654. [PMID: 35888778 PMCID: PMC9318773 DOI: 10.3390/metabo12070654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 02/01/2023] Open
Abstract
Declining physical functioning covers a prominent span of later life and, as a modifiable driver to be leveraged, lifestyle plays a critical role. This research aimed to undertake a systematic review investigating the association between levels of coffee consumption and declining conditions of physical functioning during aging, such as sarcopenia, frailty, weakness, falls, and disability, while trying to explain the underlying mechanisms, both from a metabolic and social angle. The literature was reviewed from inception to May 2022 using different electronic databases, not excluding the grey literature. Two independent researchers assessed the eligibility of 28 retrieved articles based on inclusion criteria; only 10 met the eligibility requirements. Different levels of coffee consumption were considered as exposure(s) and comparator(s) according to PECO concepts, while middle age was an inclusion criterion (40+ years). No limitations were set on the tool(s) assessing physical functioning, type of dietary assessment(s), study setting, general health status, country, and observational study design (cohort, cross-sectional). The cross-sectional design outnumbered the longitudinal (90%, n = 9/10). The overall quality rating was judged poor (70%) to good (30%). It was found that higher exposure to coffee drinking is strongly associated with better physical functioning outcomes, and the findings showed consistency in the direction of association across selected reports. Countering physical decline is a considerable challenge in easing the burden of population aging. For preventive models that aim to allow a better lifestyle, it has to be kept in mind that increased coffee consumption does not lead to poor physical functioning.
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Affiliation(s)
- Simon Mazeaud
- UFR of Biology, Campus Universitaire des Cézeaux, University of Clermont Auvergne (UCA), 63000 Clermont-Ferrand, France;
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, Department of Basic Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy; (F.C.); (R.S.)
| | - Hélio José Coelho-Junior
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas 13083-970, Brazil;
- Department of Geriatrics, Neurosciences, and Orthopedics, Teaching Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70013 Bari, Italy;
| | - Mariangela Rondanelli
- Unit of Human and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Federico Fassio
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy;
| | - Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, Department of Basic Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy; (F.C.); (R.S.)
- Correspondence:
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, Department of Basic Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy; (F.C.); (R.S.)
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Zupo R, Castellana F, De Nucci S, Sila A, Aresta S, Buscemi C, Randazzo C, Buscemi S, Triggiani V, De Pergola G, Cava C, Lozupone M, Panza F, Sardone R. Role of Dietary Carotenoids in Frailty Syndrome: A Systematic Review. Biomedicines 2022; 10:632. [PMID: 35327434 PMCID: PMC8945528 DOI: 10.3390/biomedicines10030632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 02/07/2023] Open
Abstract
Unbalanced diets and altered micronutrient intake are prevalent in the aging adult population. We conducted a systematic review to appraise the evidence regarding the association between single (α-carotene, β-carotene, lutein, lycopene, β-cryptoxanthin) or total carotenoids and frailty syndrome in the adult population. The literature was screened from study inception to December 2021, using six different electronic databases. After establishing inclusion criteria, two independent researchers assessed the eligibility of 180 retrieved articles. Only 11 fit the eligibility requirements, reporting five carotenoid entries. No exclusion criteria were applied to outcomes, assessment tools, i.e., frailty constructs or surrogates, recruitment setting, general health status, country, and study type (cohort or cross-sectional). Carotenoid exposure was taken as either dietary intake or serum concentrations. Cross-sectional design was more common than longitudinal design (n = 8). Higher dietary and plasma levels of carotenoids, taken individually or cumulatively, were found to reduce the odds of physical frailty markedly, and the evidence showed consistency in the direction of association across all selected studies. Overall, the methodological quality was rated from moderate (27%) to high (73%). Prevention of micronutrient deficiencies has some potential to counteract physical decline. Considering carotenoids as biological markers, when monitoring micronutrient status, stressing increased fruit and vegetable intake may be part of potential multilevel interventions to prevent or better manage disability.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Annamaria Sila
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Simona Aresta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Carola Buscemi
- Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90127 Palermo, Italy; (C.B.); (C.R.); (S.B.)
| | - Cristiana Randazzo
- Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90127 Palermo, Italy; (C.B.); (C.R.); (S.B.)
| | - Silvio Buscemi
- Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90127 Palermo, Italy; (C.B.); (C.R.); (S.B.)
- Unit of Gastroenterology, Section of Obesity, Metabolic Diseases and Clinical Nutrition, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
| | - Vincenzo Triggiani
- Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, 70124 Bari, Italy;
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Claudia Cava
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Via F. Cervi 93, 20131 Milan, Italy;
| | - Madia Lozupone
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70124 Bari, Italy; (M.L.); (F.P.)
| | - Francesco Panza
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70124 Bari, Italy; (M.L.); (F.P.)
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
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28
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Frailty and outcome after traumatic brain injury. Lancet Neurol 2022; 21:107-108. [DOI: 10.1016/s1474-4422(21)00418-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022]
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Tang H, Zhu H, Sun Q, Qin H, Wang S. Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study. Front Aging Neurosci 2021; 13:774268. [PMID: 34924997 PMCID: PMC8672135 DOI: 10.3389/fnagi.2021.774268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/04/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Frailty is a multidimensional concept, including physical, cognitive, social, sensorial, psychological, and nutritional phenotypes. Among these phenotypes, cognitive frailty is the most widely investigated, which is related to many adverse health outcomes in older individuals. Whether cognitive frailty is dynamic or how these frail phenotypes interact remains an open issue. We studied the rate of these changes over time and their associated factors in a 6-year follow-up cohort. Methods: A total of 426 Chinese community-living older adults in Dujiangyan aged 65 years or older were involved and followed up in three visits 6 years apart. Frailty and cognitive function were assessed using the FRAIL scale and the Mini-Mental State Examination scale. Demographic information, geriatric syndrome, and social interaction status were studied. Rates of transitions in cognitive frailty states and associated risk factors were studied. We used the stepwise logistic regression model to analyze risk factors. Results: At baseline, 18.8% of participants were only in the physical frailty (PF) or mild cognitive impairment (MCI) group, and 0.09% of participants were in the cognitive frailty group. By the end of 6 years, 62 (14.5%) participants had died, and the rates of only PF or MCI group and cognitive frailty group increased to 36.2 and 3.3%, respectively. Also, 199 (46.7%) participants had deteriorated compared with the baseline. The multivariate regression analysis showed that older (OR = 1.12, 95% CI = 1.07 − 1.16, P < 0.001), smoker (OR = 2.15, 95% CI = 1.37 − 3.39, P = 0.001), poor self-evaluation health status (OR = 1.93, 95% CI = 1.06 − 3.51, P = 0.033), and malnutrition (OR = 2.07, 95% CI = 1.21 − 3.52, P = 0.008) were risk factors for worsening, whereas willing to make new friends (OR = 0.61, 95% CI = 0.38 − 0.96, P = 0.032) was associated with 39% lower chance of deterioration. Conclusion: Cognitive frailty is a dynamically changing state, where transitions may be influenced by multidimensions. Multidimensional monitoring of a wide range of events occurring in aging may be the best way to act early. We hope our study may serve as a starting point for redefining the definition of cognitive frailty by covering different frailty domains.
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Affiliation(s)
- Huiyu Tang
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Huan Zhu
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qianqian Sun
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Hai Qin
- Internal Medicine Department, Pingyi Community Health Service Center, Dujiangyan, China
| | - Shuang Wang
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Sugimoto T, Arai H, Sakurai T. An update on cognitive frailty: Its definition, impact, associated factors and underlying mechanisms, and interventions. Geriatr Gerontol Int 2021; 22:99-109. [PMID: 34882939 DOI: 10.1111/ggi.14322] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 11/02/2021] [Accepted: 11/17/2021] [Indexed: 01/10/2023]
Abstract
Since the concept and operational definition of "cognitive frailty" (simultaneous presence of physical frailty and cognitive impairment without concurrent dementia) were proposed by the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics, cognitive frailty has been widely investigated. This review is intended to address the operational definition of cognitive frailty, its consequences, contributing factors and underlying mechanisms, as well as interventions for cognitive frailty. Although the definitions and assessments of cognitive frailty vary among researchers, older adults with both physical frailty and cognitive impairment are shown to be at higher risk of adverse health outcomes, including death, disability, hospitalization and incident dementia, than those with either condition alone. While the underlying mechanisms of cognitive frailty are still unclear, factors shown to be associated with cognitive frailty include sociodemographic factors, social status, nutritional status, geriatric syndrome, physical and cognitive activities, functional status, comorbidities, medication use, gut-derived metabolites and structural changes in the brain. Accumulating evidence indicates the need for comprehensive geriatric assessment that helps identify the possible causes of cognitive frailty and develop a multimodal individualized intervention to prevent adverse health outcomes for older adults with cognitive frailty. Further studies are required to clarify the mechanisms through which physical frailty and cognitive impairment interact to accelerate adverse health outcomes, particularly cognitive outcomes. In addition, for older adults with cognitive frailty, an effective flow diagram from primary screening through comprehensive assessment to multidimensional intervention needs to be developed for future implementation in both clinical and community settings. Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Taiki Sugimoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.,Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.,Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Pohl A, Schünemann F, Bersiner K, Gehlert S. The Impact of Vegan and Vegetarian Diets on Physical Performance and Molecular Signaling in Skeletal Muscle. Nutrients 2021; 13:3884. [PMID: 34836139 PMCID: PMC8623732 DOI: 10.3390/nu13113884] [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: 10/13/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 12/12/2022] Open
Abstract
Muscular adaptations can be triggered by exercise and diet. As vegan and vegetarian diets differ in nutrient composition compared to an omnivorous diet, a change in dietary regimen might alter physiological responses to physical exercise and influence physical performance. Mitochondria abundance, muscle capillary density, hemoglobin concentration, endothelial function, functional heart morphology and availability of carbohydrates affect endurance performance and can be influenced by diet. Based on these factors, a vegan and vegetarian diet possesses potentially advantageous properties for endurance performance. Properties of the contractile elements, muscle protein synthesis, the neuromuscular system and phosphagen availability affect strength performance and can also be influenced by diet. However, a vegan and vegetarian diet possesses potentially disadvantageous properties for strength performance. Current research has failed to demonstrate consistent differences of performance between diets but a trend towards improved performance after vegetarian and vegan diets for both endurance and strength exercise has been shown. Importantly, diet alters molecular signaling via leucine, creatine, DHA and EPA that directly modulates skeletal muscle adaptation. By changing the gut microbiome, diet can modulate signaling through the production of SFCA.
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Affiliation(s)
- Alexander Pohl
- Department of Biosciences of Sport Science, Institute of Sport Science, University of Hildesheim, 31141 Hildesheim, Germany; (F.S.); (K.B.); (S.G.)
| | - Frederik Schünemann
- Department of Biosciences of Sport Science, Institute of Sport Science, University of Hildesheim, 31141 Hildesheim, Germany; (F.S.); (K.B.); (S.G.)
| | - Käthe Bersiner
- Department of Biosciences of Sport Science, Institute of Sport Science, University of Hildesheim, 31141 Hildesheim, Germany; (F.S.); (K.B.); (S.G.)
| | - Sebastian Gehlert
- Department of Biosciences of Sport Science, Institute of Sport Science, University of Hildesheim, 31141 Hildesheim, Germany; (F.S.); (K.B.); (S.G.)
- Department for Molecular and Cellular Sports Medicine, German Sports University Cologne, 50933 Cologne, Germany
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How many frailties exist? – Authors' reply. THE LANCET. HEALTHY LONGEVITY 2021; 2:e616. [DOI: 10.1016/s2666-7568(21)00231-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 11/18/2022] Open
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