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Wei X, Chen Y, Qin J, Yang Y, Yang T, Yan F, Zhang Z, Han L, Ma Y. Factors associated with the intrinsic capacity in older adults: A scoping review. J Clin Nurs 2024; 33:1739-1750. [PMID: 38345142 DOI: 10.1111/jocn.17017] [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: 08/01/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION In 2015, the term 'intrinsic capacity' (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain. AIM We aim to synthesise the factors connected with IC. METHODS This scoping review followed the five-stage framework of Arksey and O'Malley and was reported using PRISMA-ScR guidelines. RESULTS In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults. CONCLUSIONS This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults. RELEVANCE TO CLINICAL PRACTICE The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well-being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline. NO PATIENT OR PUBLIC CONTRIBUTION As this is a scoping review, no patient or public contributions are required.
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Affiliation(s)
- Xiaoqin Wei
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yajing Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Jiangxia Qin
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yiyi Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Tingting Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Fanghong Yan
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Ziyao Zhang
- Lanzhou University of Arts and Science, Lanzhou, Gansu Province, China
| | - Lin Han
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
- Nursing Department, Gansu Provincial Hospital, Lanzhou, Gansu Province, China
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
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Huang J, Shanmugam A, Huang X, van Dam RM, Hilal S. Association of diet quality with hand grip strength weakness and asymmetry in a multi-ethnic Asian cohort. Br J Nutr 2024; 131:1236-1243. [PMID: 37990416 PMCID: PMC10918521 DOI: 10.1017/s0007114523002647] [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: 07/20/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023]
Abstract
Hand grip strength (HGS) is an important diagnostic tool for sarcopenia and a reliable predictor for age-related chronic diseases and mortality. Interventions in nutrition have been shown as a low-cost strategy to maintain muscular strength and mass. However, there are limited data on the effect of diet on HGS in Southeast Asian populations. This study aims to investigate the association of diet quality with HGS weakness and asymmetry in a multi-ethnic population in Singapore. This cross-sectional study used data from the Singapore Multi-Ethnic Cohort (n = 1547). Dietary data were collected using a validated semi-quantitative FFQ and summarised as the Dietary Quality Index - International (DQI-I). HGS was calculated as the maximum value of six measurements from both hands. HGS weakness and asymmetry were defined using well-recognised criteria. Multivariable linear regression and logistic regression were utilised for continuous and binary outcomes, respectively, adjusting for age, sex, ethnicity, physical activity and smoking status. It was found that the highest quartile of DQI-I was significantly associated with higher HGS (β = 1·11; 95 % CI 0·41, 1·82; Pfor trend < 0·001) and lower odds of HGS asymmetry (OR = 0·71; 95 % CI 0·53, 0·94; Pfor trend = 0·035) and both HGS weakness and asymmetry (OR = 0·50; 95 % CI 0·32, 0·76; Pfor trend = 0·004). Among the different components of DQI-I, only dietary adequacy was significantly associated with higher HGS (Pfor trend < 0·001) and lower odds for both HGS weakness and asymmetry (Pfor trend = 0·006). Our findings support that DQI-I, an indicator of overall diet quality, can be used to provide dietary guidelines for prevention and management of muscle wasting, sarcopenia and frailty.
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Affiliation(s)
- Jiannan Huang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 117549Singapore
| | - Aarathi Shanmugam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 117549Singapore
| | - Xiangyuan Huang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 117549Singapore
| | - Rob M. van Dam
- Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Saima Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 117549Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Shang X, Wu G, Wang W, Zhu Z, Zhang X, Huang Y, Hu Y, He M, Yu H. Associations of vision impairment and eye diseases with frailty in community-dwelling older adults: a nationwide longitudinal study in China. Br J Ophthalmol 2024; 108:310-316. [PMID: 36535748 DOI: 10.1136/bjo-2022-322048] [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: 06/20/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
AIMS To test whether vision impairment and major ophthalmic conditions are predictive of frailty. METHODS The analysis included 5321 participants aged 60-95 years at baseline from the China Health and Retirement Longitudinal Study. Participants were enrolled in 2011 and followed up in 2013, and 2015 through a face-to-face interview. Distance/near vision impairment was defined by reporting poor eyesight and reporting excellent, very good, good or fair eyesight was used as the reference. A history of cataract surgery and glaucoma were also self-reported. Frailty was defined as the presence of ≥3 of the five components of the Fried phenotype: weakness, slowness, exhaustion, inactivity and shrinking. RESULTS In the cross-sectional analysis, both near (odds ratio [OR] (95% confidence interval [CI]): 1.62 (1.30 to 2.00)) and distance (1.59 (1.30 to 1.96)) vision impairment was associated with a higher prevalence of frailty independent of confounders. In the longitudinal analysis, the multivariable-adjusted OR (95% CI) for incident frailty associated with glaucoma, distance vision impairment, near vision impairment and vision problem was 3.41 (1.46 to 7.99), 1.59 (1.17 to 2.17), 1.62 (1.17 to 2.23) and 2.11 (1.41 to 3.15), respectively. Vision problem was associated with decreased handgrip strength (β (95% CI): -1.47 (-2.20 to -0.75) kg) during follow-up. Individuals with glaucoma (-0.11 (-0.16 to -0.05) m/s), distance vision impairment (-0.02 (-0.03 to 0.00) m/s) or vision problem (-0.02 (-0.05 to 0.00) m/s) had decreased gait speed compared with the control group. CONCLUSIONS Vision problem, vision impairment and glaucoma are important predictors of frailty in older adults.
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Affiliation(s)
- Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Guanrong Wu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, Guangdong, China
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, Guangdong, China
| | - Xueli Zhang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yu Huang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yijun Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Mingguang He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, Guangdong, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Harsi ELMEL, Izel O, Benksim A, Cherkaoui M. Factors influencing older adults' satisfaction with caregivers' communication. Dement Neuropsychol 2023; 17:e20230069. [PMID: 38053648 PMCID: PMC10695440 DOI: 10.1590/1980-5764-dn-2023-0069] [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: 07/20/2023] [Revised: 08/28/2023] [Accepted: 09/20/2023] [Indexed: 12/07/2023] Open
Abstract
Effective communication skills are crucial for caregivers to provide quality care and meet the unique needs of patients of all ages. However, older patients have specific communication requirements, and their satisfaction depends on several factors. Objective This study aimed to evaluate the level of satisfaction among older adults in Marrakech, Morocco, regarding the communication skills of their caregivers, and to identify the factors influencing this satisfaction. Methods This is a cross-sectional study conducted between March and July 2022 among 204 people aged 60 years and older who presented to the Mouhamed VI University Hospital of Marrakech, Morocco, for various care services. The older adults' satisfaction with caregivers' communication was assessed by the American Board of Internal Medicine (ABIM) patient satisfaction questionnaire. Sociodemographic and clinical characteristics of the participants were collected through interview and consultation of medical records. Multiple linear regression was used to determine potential factors influencing the total satisfaction score. Results The total satisfaction score of older adults with caregiver' communication was 2.55±0.95 and the mean scores of the lowest subscales were answering questions, greeting and listening. Analysis revealed that having visual disorders (B=-0.276±0.12; p=0.029) and receiving affective touch from caregivers (B=0.745±0.12; p=0.001) were the main factors associated with older adults' satisfaction with caregiver' communication. Conclusion Older people are not sufficiently satisfied with caregivers' communication skills, especially those with vision problems and those who have not received affective touch from caregivers. Caregivers need to be aware of the specific needs of older patients and use appropriate communication techniques.
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Affiliation(s)
- EL Mahjoub EL Harsi
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech 40000, Morocco
- Regional Health Directorate, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Nursing Care Department, Marrakech 40000, Morocco
| | - Ouafa Izel
- Regional Health Directorate, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Nursing Care Department, Marrakech 40000, Morocco
| | - Abdelhafid Benksim
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech 40000, Morocco
- Regional Health Directorate, Higher Institute of Nursing Professions and Health Techniques (ISPITS-M), Nursing Care Department, Marrakech 40000, Morocco
| | - Mohamed Cherkaoui
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech 40000, Morocco
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Hu X, Ruan J, Zhang W, Chen J, Bao Z, Ruan Q, Yu Z. The overall and domain-specific quality of life of Chinese community-dwelling older adults: the role of intrinsic capacity and disease burden. Front Psychol 2023; 14:1190800. [PMID: 37691818 PMCID: PMC10485271 DOI: 10.3389/fpsyg.2023.1190800] [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: 03/21/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Objective This study aimed to investigate the impact of the different domains of intrinsic capacity (IC) and chronic disease burden on health-related quality of life (HRQoL) and domain-specific HRQoL in Chinese community-dwelling older adults. Design A cross-sectional observational study of a community-based cohort. Participants We evaluated Chinese older adults (n = 429, mean age, 72.91 ± 7.014 years; female proportion, 57.30%). Measurements IC contains five domains, namely locomotion, vitality, cognition, psychological, and sensory capacity. Locomotion dysfunction was defined as grip and/or gait decline. Vitality decline was defined if two of the following three parameters were present: fatigue, physical inactivity, and weight loss or overweight. Cognition was classified into normal cognition, pre-mild cognitive impairment (pre-MCI), and MCI according to the normative z-scores of the neuropsychological test battery. Psychological dysfunction was diagnosed based on depressive symptoms. Sensory dysfunction was defined as hearing and/or vision impairment. HRQoL was assessed using the AQoL-8D scale, which comprised physical (including independent living, senses, and pain) and psychosocial (including mental health, happiness, self-worth, coping, and relationships) dimensions. Low HRQoL (HRQoL score or subscores in the highest quintile) was used as a dependent variable in logistic regression analyses adjusted for demographic, health-related, and psychological confounders. Results Sensory impairment was an independent determinant of senses, and locomotion impairment was significantly associated with overall HRQoL, independent living, and pain in the physical dimension of HRQoL. Cognition was an independent determinant of the senses. Vitality was independently associated with overall HRQoL, senses, and pain in the physical dimension and mental health and relationships in the psychological dimension of HRQoL. The psychological domain of IC was independently associated with overall and domain-specific HRQoL apart from senses after adjustment for all confounders. The number of multimorbidities mainly had a significant impact on independent living after adjustment for all confounders. Conclusion IC domains and chronic disease burden had heterogeneous influences on overall and domain-specific HRQoL. The impairment of sensory and locomotion domains had a synergistic impact on the overall and physical dimensions of HRQoL. The vitality and psychological domains of IC had more profound effects on HRQoL. Older people with high morbidity might have a higher risk of poor independent living.
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Affiliation(s)
- Xiuhua Hu
- Laboratory of Aging, Anti-aging and Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian Ruan
- Department of Otolaryngology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weibin Zhang
- Laboratory of Aging, Anti-aging and Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jie Chen
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
| | - Zhijun Bao
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
| | - Qingwei Ruan
- Laboratory of Aging, Anti-aging and Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhuowei Yu
- Laboratory of Aging, Anti-aging and Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
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Ripa M, Schipa C, Rizzo S, Sollazzi L, Aceto P. Is the visual impairment a risk factor for frailty in older adults? A systematic review and meta-analysis of 10-year clinical studies. Aging Clin Exp Res 2023; 35:227-244. [PMID: 36367632 DOI: 10.1007/s40520-022-02296-5] [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: 06/16/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Frailty is linked to poor health outcomes later in life. Recent research suggests that visual loss is a possible modifiable risk factor for frailty. AIMS To analyze the relationship between visual impairment (VI) and frailty and investigate whether it can increase the risk of frailty in older adults. METHODS We performed a systematic review and meta-analysis of cohort studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched PubMed, Embase, and Scopus databases for relevant studies published between 2012 and 2022 that clearly described VI and frailty measurement methods. Cross-sectional and longitudinal studies that examined the associations between VI and the existence of frailty in adults aged 65 years or older were synthesized. Meta-analyses were conducted using the measurement of risk and a 95% confidence interval for each study. Quality assessment using the Newcastle-Ottawa Scale (NOS), risk of bias, heterogeneity, and sensitivity analyses were also conducted. RESULTS Our search identified 1074 manuscripts published in the English language between 1 January 2012 and 9 June 2022. After studies screening, seventeen articles, including 22,192 participants and 3624 cases of frailty, were selected. A random-effect meta-analysis demonstrated a significant association between visual impairment and the risk of frailty (OR 2.13; 95% CI 1.67-2.72). The quality rating of the cross-sectional studies averaged 8.33 (95% CI 7.77-8.89) of the maximum score on the NOS. CONCLUSIONS Visual impairment increases the risk of frailty in later life and should be accurately assessed in frail older adults.
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Affiliation(s)
- Matteo Ripa
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Chiara Schipa
- Catholic University "Sacro Cuore", Rome, Italy.
- Department of Emergency, Anesthesiological and Reanimation Sciences, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - Stanislao Rizzo
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
| | - Liliana Sollazzi
- Catholic University "Sacro Cuore", Rome, Italy
- Department of Emergency, Anesthesiological and Reanimation Sciences, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Paola Aceto
- Catholic University "Sacro Cuore", Rome, Italy
- Department of Emergency, Anesthesiological and Reanimation Sciences, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
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Hou T, Liu M, Zhang J. Bidirectional association between visual impairment and frailty among community-dwelling older adults: a longitudinal study. BMC Geriatr 2022; 22:672. [PMID: 35971062 PMCID: PMC9377125 DOI: 10.1186/s12877-022-03365-0] [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: 03/04/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Vision impairment is common among older adults, and it may be related to frailty. However, the longitudinal relationship between visual impairment and frailty is still unclear. Methods We used data from Round 1 to Round 5 from the National Health and Aging Trend Study. Two samples were community-dwelling older adults, sample 1 (without visual impairment) was classified according to whether they have pre-frailty/frailty at R1 (N = 3013) and sample 2 (without pre-frailty/frailty) was classified according to whether they have visual impairment at R1 (N = 1422), respectively. Frailty was measured using five criteria: experiencing exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength. Visual impairment was assessed by asking participants if they had any visual impairment. Generalized estimating equation models were used to examine the concurrent and lagged association between visual impairment and frailty. Results The participants were on average 76 ± 7 years old, female (59%), non-Hispanic white (74%) with less than bachelor educated (73%), and 44% were pre-frail/frail in the older adults without visual impairment. Approximately 5% of participants had visual impairment at R1, and they tended to be female and non-Hispanic White in the older adults without frailty. The concurrent (OR, 95% CI = 1.55, 1.17-2.02) and lagged (OR, 95% CI = 1.79, 1.25-2.59) associations between frailty and visual impairment were significantly after controlling the covariates. Similarly, the concurrent (OR, 95% CI = 1.63, 1.32-2.04) and lagged (OR, 95% CI = 1.49, 1.20-1.87) associations between visual impairment and frailty were also significant. Conclusions Overall, this study provides evidence for a longitudinal, bidirectional association between self-reported visual impairment and frailty. Future intervention programs to delay frailty progression should include strategies that may reduce the incidence of visual impairment.
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Affiliation(s)
- Tianxue Hou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Kaifu District, Changsha, Hunan, 410008, People's Republic of China.,Central South University Xiangya School of Nursing, Changsha, Hunan, China
| | - Minhui Liu
- Central South University Xiangya School of Nursing, Changsha, Hunan, China.,Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Jinghui Zhang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Kaifu District, Changsha, Hunan, 410008, People's Republic of China. .,Central South University Xiangya School of Nursing, Changsha, Hunan, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, People's Republic of China.
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Exploring Shared Effects of Multisensory Impairment, Physical Dysfunction, and Cognitive Impairment on Physical Activity: An Observational Study in a National Sample. J Aging Phys Act 2022; 30:572-580. [PMID: 34611055 PMCID: PMC9843725 DOI: 10.1123/japa.2021-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/14/2021] [Accepted: 08/23/2021] [Indexed: 01/19/2023]
Abstract
Multisensory, physical, and cognitive dysfunction share age-related physiologic disturbances and may have common health effects. We determined whether the effect of multisensory impairment on physical activity (PA) is explained by physical (timed up and go) or cognitive (Short Portable Mental Status Questionnaire) dysfunction. A National Social Life, Health, and Aging Project participant subset (n = 507) underwent objective sensory testing in 2005-2006 and wrist accelerometry in 2010-2011. We related multisensory impairment to PA using multivariate mixed-effects linear regression and compared the effect magnitude after adjusting for physical then cognitive dysfunction. Worse multisensory impairment predicted lower PA across three scales (Global Sensory Impairment: β = -0.04, 95% confidence interval [-0.07, -0.02]; Total Sensory Burden: β = -0.01, 95% confidence interval [-0.03, -0.003]; and Number of Impaired Senses: β = -0.02, 95% confidence interval [-0.04, -0.004]). Effects were similar after accounting for physical and cognitive dysfunction. Findings suggest that sensory, physical, and cognitive dysfunction have unique mechanisms underlying their PA effects.
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Yau PN, Foo CJE, Cheah NLJ, Tang KF, Lee SWH. The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis. Epidemiol Health 2022; 44:e2022058. [PMID: 35843601 PMCID: PMC9754909 DOI: 10.4178/epih.e2022058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/12/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region. METHODS A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis. RESULTS Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life. CONCLUSIONS Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.
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Affiliation(s)
- Phei Nie Yau
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | | | | | - Kar Foong Tang
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia,School of Pharmacy, Taylor’s University, Subang Jaya, Malaysia,Correspondence: Shaun Wen Huey Lee School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Malaysia E-mail:
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López-Ortiz S, Lista S, Peñín-Grandes S, Pinto-Fraga J, Valenzuela PL, Nisticò R, Emanuele E, Lucia A, Santos-Lozano A. Defining and assessing intrinsic capacity in older people: A systematic review and a proposed scoring system. Ageing Res Rev 2022; 79:101640. [PMID: 35569785 DOI: 10.1016/j.arr.2022.101640] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/30/2022] [Accepted: 05/07/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The World Health Organization has introduced the term 'intrinsic capacity' (IC) as a marker of healthy ageing. However, controversy exists on the definition and assessment of IC. We aimed to review the definitions and methods used for the assessment of IC in older adults. In addition, we proposed a new IC scoring method. METHODS A systematic search was performed in PubMed, Web of Science, Cochrane Library, Scopus and SPORTDiscus (up to February 10th, 2022) for studies assesing IC in older adults (>60 years). RESULTS Thirty-three studies were included. There is overall consensus on the definition of IC as well as on its different dimensions, that is: locomotion, vitality, sensory, cognition and psychological. However, the methods for assessing each of these five dimensions differ substantially across studies and there is no consensus on the best method to compute an eventual global compound score to evaluate IC taking into account all its different dimensions. CONCLUSIONS The IC represents a highly relevant clinical concept that has been unfortunately underutilized. We propose a standardization for the assessment of each dimension of IC, with a global 0 (worst) to 10 (highest) score.
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Wang Q, Zhang S, Wang Y, Zhao D, Chen X, Zhou C. The Effect of Dual Sensory Impairment and Multimorbidity Patterns on Functional Impairment: A Longitudinal Cohort of Middle-Aged and Older Adults in China. Front Aging Neurosci 2022; 14:807383. [PMID: 35462686 PMCID: PMC9028763 DOI: 10.3389/fnagi.2022.807383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/16/2022] [Indexed: 11/26/2022] Open
Abstract
Objective There is an urgent need to evaluate the contribution of several co-existing diseases on health. This study aims to explore the combined effect of dual sensory impairment (DSI) and multimorbidity patterns on functional impairment among middle-aged and older adults in China. Methods Data were from 10,217 adults aged 45 or older from four waves of the China Health and Retirement Longitudinal Study (CHARLS). Sensory impairments were self-reported measures. Multimorbidity patterns were identified by using k-means cluster analyses. Functional impairment was defined using activities of daily living (ADL) scale and instrumental activities of daily living (IADL) scale. Generalized estimating equation models were estimated to assess the effect of co-occurring DSI and multimorbidity on functional impairment. Results DSI prevalence was 50.4%, and multimorbidity prevalence was 37.7% at the baseline. The simultaneous presence of DSI and multimorbidity was associated with increased odds of ADL limitations (OR = 2.27, 95% CI: 2.11–2.43) and IADL limitations (OR = 1.89, 95% CI: 1.77–2.02). Five multimorbidity patterns were identified: the cardio-cerebrovascular pattern, the stomach-arthritis pattern, the respiratory pattern, the hepatorenal pattern, and the unspecified pattern. Compared to DSI only, DSI plus the hepatorenal pattern was most strongly associated with functional impairment (for ADL: OR = 2.70, 95% CI: 2.34–3.12; for IADL: OR = 2.04, 95% CI: 1.77–2.36). Conclusion Middle-aged and older adults with co-occurrence of DSI and multimorbidity are at increased risk of functional impairment, especially those with multimorbidity characterized by the hepatorenal pattern. These findings imply that integrated care for DSI and multimorbidity may be a potent pathway in improving functional status.
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Affiliation(s)
- Qiong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shimin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States
- Department of Economics, Yale University, New Haven, CT, United States
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- *Correspondence: Chengchao Zhou,
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Ho KC, Gupta P, Fenwick EK, Man REK, Gan ATL, Lamoureux EL. Association between age-related sensory impairment with sarcopenia and its related components in older adults: a systematic review. J Cachexia Sarcopenia Muscle 2022; 13:811-823. [PMID: 35229470 PMCID: PMC8977955 DOI: 10.1002/jcsm.12930] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/29/2021] [Accepted: 12/30/2021] [Indexed: 12/12/2022] Open
Abstract
Sensory impairments and sarcopenia are both highly prevalent age-related conditions, with the former having been postulated to contribute to the pathogenesis of the latter condition. Confirming this hypothesis may therefore help to better inform strategies for early treatment and intervention of sarcopenia. We performed a systematic review of the current literature examining the relationships between four major sensory impairments [vision (VI), hearing (HI), smell (SI), and taste (TI)] with (i) sarcopenia; and (ii) its associated components (low handgrip strength, slow gait speed, and low muscle mass). PubMed, EMBASE, CINAHL, and Cochrane Library databases were searched for observational studies investigating the relationship of VI, HI, SI, and TI with sarcopenia, low handgrip strength, slow gait speed, and low muscle mass, in adults aged 50 years or older, from inception until 24 May 2021. The risk of bias of the included studies was assessed using the Newcastle-Ottawa Scale. This study was registered with PROSPERO, reference CRD42021247967. Ten cross-sectional and three longitudinal population-based studies of community-dwelling adults (N = 68 235) were included, with five studies investigating more than one sensory impairment. In total, 8, 6, 3, and 1 studies investigated the relationship between VI, HI, SI, and TI and sarcopenia and its related components, respectively. Follow-up duration for the longitudinal studies ranged from 4 to 11 years. All studies had a low or moderate risk of bias. We found that the presence of VI and SI, but not TI, independently increased the odds of sarcopenia. In addition, VI and SI were each independently associated with low muscle mass; and VI, HI, and SI were each independently associated with slow gait speed. However, we found inconclusive evidence for the associations between VI, HI and SI, and low handgrip strength. Our systematic review suggests a potential association between the presence of single or multiple sensory impairments and a greater likelihood of sarcopenia and/or deficits in its associated components, especially for VI, HI, and SI. Prospective studies are needed to untangle the relationship between sensory impairment and sarcopenia to better inform clinical guidelines for disease prevention and management.
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Affiliation(s)
- Kam Chun Ho
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre, Singapore.,Discipline of Optometry and Vision Science, Faculty of Health, University of Canberra, Australia.,School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Preeti Gupta
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Ryan E K Man
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Alfred T L Gan
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore.,Department of Ophthalmology, National University of Singapore, Singapore.,Department of Surgery and Medicine, University of Melbourne, Australia
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Gui H, Tseng B, Hu W, Wang SY. Looking for low vision: Predicting visual prognosis by fusing structured and free-text data from electronic health records. Int J Med Inform 2022; 159:104678. [PMID: 34999410 PMCID: PMC8792365 DOI: 10.1016/j.ijmedinf.2021.104678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/24/2021] [Accepted: 12/25/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Low vision rehabilitation improves quality-of-life for visually impaired patients, but referral rates fall short of national guidelines. Automatically identifying, from electronic health records (EHR), patients with poor visual prognosis could allow targeted referrals to low vision services. The purpose of this study was to build and evaluate deep learning models that integrate EHR data that is both structured and free-text to predict visual prognosis. METHODS We identified 5547 patients with low vision (defined as best documented visual acuity (VA) less than 20/40) on ≥ 1 encounter from EHR from 2009 to 2018, with ≥ 1 year of follow-up from the earliest date of low vision, who did not improve to greater than 20/40 over 1 year. Ophthalmology notes on or prior to the index date were extracted. Structured data available from the EHR included demographics, billing and procedure codes, medications, and exam findings including VA, intraocular pressure, corneal thickness, and refraction. To predict whether low vision patients would still have low vision a year later, we developed and compared deep learning models that used structured inputs and free-text progress notes. We compared three different representations of progress notes, including 1) using previously developed ophthalmology domain-specific word embeddings, and representing medical concepts from notes as 2) named entities represented by one-hot vectors and 3) named entities represented as embeddings. Standard performance metrics including area under the receiver operating curve (AUROC) and F1 score were evaluated on a held-out test set. RESULTS Among the 5547 low vision patients in our cohort, 40.7% (N = 2258) never improved to better than 20/40 over one year of follow-up. Our single-modality deep learning model based on structured inputs was able to predict low vision prognosis with AUROC of 80% and F1 score of 70%. Deep learning models utilizing named entity recognition achieved an AUROC of 79% and F1 score of 63%. Deep learning models further augmented with free-text inputs using domain-specific word embeddings, were able to achieve AUROC of 82% and F1 score of 69%, outperforming all single- and multiple-modality models representing text with biomedical concepts extracted through named entity recognition pipelines. DISCUSSION Free text progress notes within the EHR provide valuable information relevant to predicting patients' visual prognosis. We observed that representing free-text using domain-specific word embeddings led to better performance than representing free-text using extracted named entities. The incorporation of domain-specific embeddings improved the performance over structured models, suggesting that domain-specific text representations may be especially important to the performance of predictive models in highly subspecialized fields such as ophthalmology.
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Affiliation(s)
- Haiwen Gui
- Stanford University School of Medicine, Stanford, United States
| | - Benjamin Tseng
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, United States
| | - Wendeng Hu
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, United States
| | - Sophia Y Wang
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, United States.
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14
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In the Quest of a Standard Index of Intrinsic Capacity. A Critical Literature Review. J Nutr Health Aging 2020. [DOI: 10.1007/s12603-020-1503-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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15
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Taburee W, Sirilak S, Khotcharrat R, Anekpunyakul P, Dilokthornsakul P, Lukkahatai N, Boongird C. Health-Related Problems and Drivers of Health-Related Quality of Life Among Community-Dwelling Older Adults. J Prim Care Community Health 2020; 11:2150132720913724. [PMID: 32189548 PMCID: PMC7082868 DOI: 10.1177/2150132720913724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: The aims of this study were to explore prevalence of health-related problems and identify factors associated with health-related quality of life (HRQOL) among community-dwelling older adults (CDOAs) in rural Thailand. Methods: A total of 384 CDOAs with mean age of 71 years (SD = 7.6) were recruited. The Thai Ministry of Public Health’s comprehensive geriatric assessment (CGA) was used to measure the CDOAs’ health conditions in the primary care unit of community hospitals. HRQOL of the participants was assessed by using the EQ-5D questionnaire. Results: The results showed that the most common health-related problems were risk of glaucoma (89.6%) and hypertension (64.6%). The HRQOL were predicted by the incidence of falls (β = −0.076, P < .001), Timed Up and Go Test (β = −0.087, P < .001), and age (β = −0.667, P = .002). Discussion: This study highlighted the need to incorporate CGA in family practice, which included risk of falls assessment by measuring TUG test, fall prevention, and to provide resources for caring older adults at home which ultimately will improve CDOAs’ quality of life.
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Swenor BK, Lee MJ, Tian J, Varadaraj V, Bandeen-Roche K. Visual Impairment and Frailty: Examining an Understudied Relationship. J Gerontol A Biol Sci Med Sci 2020; 75:596-602. [PMID: 31419280 PMCID: PMC7328203 DOI: 10.1093/gerona/glz182] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Older adults with visual impairments are at increased risk of negative health outcomes. Here, we investigate the association between visual impairment and frailty. METHODS Cross-sectional and longitudinal relationships between visual impairment (distance visual acuity) and frailty (frailty phenotype criteria) were examined using data from the National Health and Nutrition Examination Survey (NHANES, 1999-2002, ≥60 years) and the Women's Health and Aging Studies (WHAS III). Imbalance of potential confounders, particularly age, was addressed using propensity score-based adjustment. Multinomial logistic regression determined the odds of prefrailty and frailty at baseline in NHANES and ordinal logistic regression examined the odds of baseline and incident frailty over 3 years in WHAS III after adjustment for confounders and probability weighting (survey weights × inverse propensity scores). RESULTS In NHANES (n = 2,639, 9% vision impairment), participants with visual impairment were more likely to be prefrail (odds ratio [OR] = 3.2; 95% confidence interval [CI]: 1.9-5.3) and frail (OR = 3.7; 95% CI: 1.5-9.2) than those without visual impairment. In WHAS III (n = 796, 26% mild, 37% moderate/severe vision impairment), participants with mild and moderate/severe vision impairment were more likely to be frail (OR = 2.0; 95% CI: 1.5-2.5; OR = 5.5; 95% CI: 4.2-7.2, respectively). A one-line worse visual acuity (0.1 logMAR increase) was associated with greater odds of frailty (OR = 1.5; 95% CI: 1.4-1.7). Of those non-frail at baseline (n = 549), moderate/severe visual impairment and one-line worse visual acuity was associated with greater odds of incident frailty (OR = 3.5; 95% CI: 1.4-8.4; OR = 1.3; 95% CI: 1.1-1.5, respectively) over 3 years. CONCLUSIONS Visual impairment may be an important, yet understudied risk factor for frailty.
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Affiliation(s)
- Bonnielin K Swenor
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Moon J Lee
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jing Tian
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Varshini Varadaraj
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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