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Shum ENY, Lau BHP, Cheung KSL, Chan CLW, Siu JCY, Luk JKH, Kwan JSK, Chan GMY, Pat LYC, Martin P. Multiple Roads to Success: A Latent Class Analysis on Successful Ageing Among Hong Kong Near-Centenarians and Centenarians (NCC). Int J Aging Hum Dev 2024; 99:152-178. [PMID: 37904549 DOI: 10.1177/00914150231208681] [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] [Indexed: 11/01/2023]
Abstract
Notwithstanding the oldest-old cohort being the fastest-growing population in most ageing societies, characterizing successful ageing in adults of advanced age, such as nonagenarians and centenarians, remains challenging. This study investigated the successful ageing subphenotypes using the data from Hong Kong Centenarian Study 2. Between April 2021 and September 2022, 146 family caregivers of community-dwelling older adults aged 95 or above were interviewed by phone. Latent class analysis identified three classes-Overall Frail (46.6%) with poor mobility, cognitive and functional health, Nonambulant (37.0%) but good functional health, and Robust (16.4%) with overall good health-from 11 indicators based on caregivers' reports. Although we found a low prevalence of fulfillment of all indicators of successful ageing, our findings will help care professionals appreciate the heterogeneity underlying partial successful ageing in this vulnerable cohort for segmented and targeted healthy longevity interventions.
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Affiliation(s)
- Eric Ngai-Yin Shum
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
| | - Bobo Hi-Po Lau
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
- Centre for Interdisciplinary Evidence-based Practice and Research (CIEBPR), Hong Kong Shue Yan University, Hong Kong, China
| | - Karen Siu-Lan Cheung
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
- Mindlink Research Centre, Hong Kong, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Joey Chung-Yue Siu
- Felizberta Lo Padilla Tong School of Social Sciences, Caritas Institute of Higher Education, Hong Kong, China
| | - James Ka-Hay Luk
- Department of Medicine and Geriatrics, Tung Wah Group of Hospitals Fung Yiu King Hospital, Hong Kong, China
| | | | | | - Lian Ying-Chun Pat
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
| | - Peter Martin
- Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
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Chen Y, Wang Y, Xu Y, Shi S, Tian Z, Jiang K, Jin L, Tao Y. Relationship between changes in late-life blood pressure and the risk of frailty and mortality among older population in China: a cohort study based on CLHLS. Hypertens Res 2024; 47:1881-1891. [PMID: 38600277 DOI: 10.1038/s41440-024-01674-y] [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: 06/25/2023] [Revised: 03/02/2024] [Accepted: 03/13/2024] [Indexed: 04/12/2024]
Abstract
The evidence regarding the effects of blood pressure changes on older individuals remains inconclusive, and the impact of frailty throughout the life course is not known. We investigated the associations of different change patterns of blood pressure during 3-year intervals with frailty and mortality. Participants included 7335 persons from 2008 to 2014 of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Change in blood pressure was calculated as the difference between follow-up and baseline. Frailty was evaluated using a 40-item frailty index. Mortality status was ascertained up to December 31, 2014. The mean age of participants was 82.6 ± 10.7 years. The optimal blood pressure level (SBP, 130-150 mmHg; DBP, 70-90 mmHg) was associated with the lowest risk of frailty while decreasing follow-up SBP and DBP were significantly correlated with frailty. Lower baseline blood pressure levels (SBP < 130 mmHg; DBP < 70 mmHg) were associated with decreased mortality risk when participants increased their blood pressure to optimal levels during follow-up SBP and DBP (0.78, 0.63-0.98), compared to maintaining a steady low SBP (< 130 mmHg) and DBP (< 70 mmHg). For those with DBP around 70-90 mmHg, decreasing follow-up DBP (< 70 mmHg) was associated with higher mortality (1.23, 1.07-1.42) compared to maintaining stable follow-up DBP (70-90 mmHg). These results remain significant after adjusting for frailty. Optimal blood pressure levels were associated with the lowest risk of frailty. The association between lower blood pressure and increased mortality risk persisted even after accounting for frailty. We used a nationally representative longitudinal cohort study by using 2008-2014 of the Chinese Longitudinal Healthy Longevity in China. Change in blood pressure was calculated as the difference between follow-up and baseline. We investigated the associations of different change patterns of blood pressure during 3-year intervals with frailty and mortality.
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Affiliation(s)
- Yana Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yanfang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Shunyao Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhong Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Kexin Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yuchun Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
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Lau BHP, Pat LYC, Siu JCY, Shum ENY. Positive Aspects of Caregiving in Familial Care for Nonagenarians and Centenarians: Findings from Hong Kong Centenarian Study. J Appl Gerontol 2024:7334648241261462. [PMID: 38902873 DOI: 10.1177/07334648241261462] [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: 06/22/2024] Open
Abstract
Caregiving for the fast-growing but vulnerable oldest-old population may involve distinct challenges but also gratification. We analyzed quantitative and qualitative data from family caregivers of community-dwelling older adults aged 95 or above in Hong Kong. Quantitative analysis of 143 caregivers revealed that higher age, dependence on basic activities of daily living, independence on instrumental activities of daily living, and intact hearing ability of the older adults, and absence of a domestic helper and better self-rated health of the caregivers were associated with more positive aspects of caregiving. Qualitative analysis of the 96 caregivers who mentioned at least a positive aspect from their caregiving identified three themes: acquiring caregiving skills, fulfilling family love and obligation, and preparing for graceful aging. Our findings elaborated the nature and mechanism of caregiving gains against the unique backdrop of exceptional longevity and the Chinese cultural expectations of filial piety.
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Affiliation(s)
- Bobo Hi-Po Lau
- Department of Counselling & Psychology, Hong Kong Shue Yan University, Hong Kong
| | - Lian Ying-Chun Pat
- Department of Counselling & Psychology, Hong Kong Shue Yan University, Hong Kong
| | - Joey Chung-Yue Siu
- Felizberta Lo Padilla Tong School of Social Sciences, Saint Francis University, Hong Kong
| | - Eric Ngai-Yin Shum
- Department of Counselling & Psychology, Hong Kong Shue Yan University, Hong Kong
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Wei K, Wang H, Yang J, Lin S, Li C. Nutritional risk and adverse health outcomes in Chinese community-dwelling older adults: A study based on the Elderly Nutritional Indicators for Geriatric Malnutrition Assessment (ENIGMA). Nutrition 2024; 126:112489. [PMID: 39096778 DOI: 10.1016/j.nut.2024.112489] [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: 01/20/2024] [Revised: 04/11/2024] [Accepted: 05/01/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVES Malnutrition and nutritional risk are risk factors for many adverse health outcomes in older adults, but they have rarely been assessed in China. The aim of this study was to evaluate the availability of Elderly Nutritional Indicators for Geriatric Malnutrition Assessment (ENIGMA), a nutritional scale originally developed to predict mortality, in assessing nutritional risks and predicting adverse health outcomes in Chinese community-dwelling older adults. METHODS This was a population-based longitudinal cohort study (Chinese Longitudinal Healthy Longevity Survey), with a 4-y follow-up of 2063 community-dwelling adults aged 65 y or older. Nutritional risks were assessed via the use of ENIGMA and Geriatric Nutritional Risk Index (GNRI) at baseline (the 2014 wave). Cognitive impairment, functional limitation, and frailty were evaluated using the Chinese version of the Mini-Mental State Examination, Instrumental Activities of Daily Living/Instrumental Activities of Daily Living scale, and Frailty Index, respectively, at baseline and 4-y follow-up (the 2018 wave). Mortality was measured by survival status and duration of exposure to death from baseline to follow-up. The associations of nutritional risks with prevalent/incident cognitive impairment, functional limitation and frailty, and 4-y mortality were estimated using logistic regression and Cox proportional hazards regression models, adjusting for confounders. The discriminatory accuracy of ENIGMA and GNRI for these adverse health outcomes were compared by receiver operating characteristic analyses. RESULTS According to ENIGMA, 48.6% of the Chinese community-dwelling older adults (age: 86.5±11.3 y) showed moderate and high nutritional risk. Nutritional risks defined by the ENIGMA were significantly associated with increased prevalence and incidence of cognitive impairment, functional limitation, and frailty (odds ratio ranging from 1.79 to 89.6, values ranging from P < 0.001 to 0.048) but were mostly insignificant for that defined by GNRI. With respect to 4-y mortality, nutritional risks as defined by GNRI showed better prediction effects than those defined by ENIGMA. Receiver operating characteristic analyses indicated that nutritional risks defined by ENIGMA had better discriminatory accuracy than those defined by GNRI for prevalent and incident cognitive impairment (C = 0.73 vs 0.64, P < 0.001; C = 0.65 vs 0.59, P = 0.015, respectively), functional limitation (C = 0.74 vs 0.63, P < 0.001 at baseline; C = 0.61 vs 0.56, P = 0.016 at follow-up), frailty (C = 0.85 vs 0.67, P < 0.001 at baseline; C = 0.64 vs 0.55, P < 0.001 at follow-up), and even 4-y mortality (C = 0.68 vs 0.64, P = 0.020). CONCLUSIONS ENIGMA could serve as a nutritional risk screening tool that has a robust role in predicting cognitive impairment, functional limitation, and frailty in Chinese community-dwelling older adults. It may be recommended for early nutritional risk screening and has the potential to guide early nutritional intervention in communities and primary care settings in China.
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Affiliation(s)
- Kai Wei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China.
| | - Hongyan Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Junjie Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Shaohui Lin
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China
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Liu J, Zhu Y, Tan JK, Ismail AH, Ibrahim R, Hassan NH. Factors Associated with Frailty in Older Adults in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis. J Clin Med 2024; 13:2382. [PMID: 38673654 PMCID: PMC11050860 DOI: 10.3390/jcm13082382] [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: 02/06/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them.
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Affiliation(s)
- Jia Liu
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Yuezhi Zhu
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Jen Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Azera Hasra Ismail
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Roszita Ibrahim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nor Haty Hassan
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
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Wang Y, Luo X, Long X, Shao Y, Zhang S, Zhang Y, Wang Y. Association between housework and the risk of dementia among older Chinese adults: a prospective cohort study. Front Psychol 2023; 14:1228059. [PMID: 37554140 PMCID: PMC10406521 DOI: 10.3389/fpsyg.2023.1228059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/11/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES Physical activity (PA) is known to improve physical functioning and mental health and to reduce the incidence of dementia. However, studies of the effects of non-recreational PA on the incidence of dementia, especially in East Asian populations, remain limited. In this study, we evaluate the association of doing housework with the risk of dementia among participants in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHODS The analysis was conducted with data from 7,237 CLHLS participants age over 65 obtained in 2008/2009, 2011/2012, 2014, and 2018. The frequency of housework performance was classified into four groups. A Cox proportional-hazards model was used to examine the association of the baseline housework frequency with the incidence of dementia, with adjustment for demographic and socioeconomic characteristics and lifestyle and health conditions. RESULTS The adjusted multivariate model showed that the incidence of dementia was lower among participants who did housework almost every day than among those who rarely or never did housework (hazard ratio = 0.49; 95% confidence interval, 0.39-0.61). The subgroup and sensitivity analyses yielded similar results. CONCLUSION A high frequency of housework performance was associated with a reduced incidence of dementia among older Chinese adults, especially those who did not exercise regularly. The encouragement of engagement in housework would be a cost-effective measure promoting healthy aging in the Chinese population.
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Affiliation(s)
- Yuanlong Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Xinxin Luo
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Xiangyun Long
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yuan Shao
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Song Zhang
- Anning Mental Rehabilitation Hospital, Changchun, China
| | - Yingli Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yongjun Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
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Takele MD, Sany K, Getie K, Wayessa DI, Jember G, Gobezie M, Abich Y, Kibret AK. Prevalence and associated factors of frailty among community dweller older adults living in Gondar town, northwest, Ethiopia: a community based cross-sectional study. BMC Public Health 2023; 23:1309. [PMID: 37420164 PMCID: PMC10329322 DOI: 10.1186/s12889-023-16201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Frailty is a multidimensional geriatric condition that increases vulnerability to stressors, increases the risk of negative health outcomes, and lowers quality of life in older people. However, little attention has been paid to frailty in developing countries, particularly in Ethiopia. Therefore, the aim of the study was to investigate the prevalence of frailty syndrome and the sociodemographic, lifestyle, and clinical factors associated with it. METHODS A community-based cross-sectional study design was conducted from April to June 2022. A total of 607 study participants were included using a single cluster sampling technique. The Tilburg frailty indicator, which is a self-reported schedule for assessment of frailty, required respondents to answer 'yes' or 'no' and the total attainable score ranged from 0 to 15. An individual with a score of ≥ 5 considered frail. Data were collected by interviewing the participants using a structured questionnaire, and the data collection tools were pre-tested before the actual data collection period to check for the accuracy of responses, language clarity, and appropriateness of the tools. Statistical analyses were performed using the binary logistic regression model. RESULTS More than half of the study participants were male, and the median age of the study participants was 70, with an age range of 60-95 years. The prevalence of frailty was 39% (CI 95%, 35.51-43.1). In the final multivariate analysis model, the following factors associated with frailty were obtained: older age (AOR = 6.26 CI (3.41-11.48), presence of two or more comorbidities (AOR = 6.05 CI (3.51-10.43), activity of daily life dependency (AOR = 4.12 CI (2.49-6.80), and depression (AOR = 2.68 CI (1.55-4.63) were found to be significant factors. CONCLUSION AND RECOMMENDATIONS Our study provides epidemiological characteristics and the risk factors of frailty in the study area. Efforts to promote physical, psychological, and social health in older adults are a core objective of health policy, especially for older adults aged 80 and above years, and those with two or more comorbidities.
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Affiliation(s)
- Mihret Dejen Takele
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Kedir Sany
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Kefale Getie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Dechasa Imiru Wayessa
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Gashaw Jember
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Melese Gobezie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
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Zhou F, Zhou W, Wang W, Fan C, Chen W, Ling L. Associations between Frailty and Ambient Temperature in Winter: Findings from a Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:513. [PMID: 36612832 PMCID: PMC9819953 DOI: 10.3390/ijerph20010513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Frailty is an accumulation of deficits characterized by reduced resistance to stressors and increased vulnerability to adverse outcomes. However, there is little known about the effect of ambient temperature in winter on frailty among older adults, a population segment with the highest frailty prevalence. Thus, the objective of this study is to investigate the associations between frailty and ambient temperature in winter among older adults. This study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) of older adults aged ≥65 years from the 2005, 2008, 2011, and 2014 waves. The 39-item accumulation of frailty index (FI) was used to assess the frailty status of the participants. The FI was categorized into three groups as follows: robust (FI ≤ 0.10), prefrail (FI > 0.10 to <0.25), and frail (FI ≥ 0.25). Generalized linear mixed models (GLMMs) were conducted to explore the associations between frailty and ambient temperature in winter. A generalized estimating equation (GEE) modification was applied in the sensitivity analysis. A total of 9421 participants were included with a mean age of 82.81 (SD: 11.32) years. Compared with respondents living in the highest quartile (≥7.5 °C) of average temperature in January, those in the lowest quartile (<−1.9 °C) had higher odds of prefrailty (OR = 1.35, 95% CI 1.17−1.57) and frailty (OR = 1.61, 95%CI 1.32−1.95). The associations were stronger among the low-education groups, agricultural workers before retirement, and non-current exercisers. Additionally, results from the GEE model reported consistent findings. Lower levels of ambient temperature in winter were associated with higher likelihoods of prefrailty and frailty. The findings on vulnerability characteristics could help improve public health practices to tailor cold temperature health education and warning information.
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Zhu W, Lin H, Zhang J, Sheng M, Kathleen Y, Zheng P, Jiang S. Real-world association of self-reported sleep duration and quality with falls among older adults: A representative nationwide study of China. Sleep Med 2022; 100:212-218. [PMID: 36115140 DOI: 10.1016/j.sleep.2022.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/07/2022] [Accepted: 08/25/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Falls are the leading cause of injury-related morbidity and mortality among older adults (aged ≥65 years) worldwide. However, previous studies examining sleep and falls were confined to community subpopulations, and few studies included both sleep quality and sleep duration when discussing risk factors of falls. This nationwide representative study aimed to examine the links between sleep duration, sleep quality and falls among Chinese community-dwelling older adults. METHOD Cross-sectional analyses were conducted with 14,681 older individuals (aged ≥65 years) from 23 Chinese provinces from the Chinese Longitudinal Healthy and Longevity Study (CLHLS) in 2018. Individual variables, including sociodemographic factors, lifestyle, and behavioral factors, were measured using a self-reported questionnaire. Falls were confirmed through face-to-face interviews. Three multivariate logistic regression models were conducted to assess the association between sleep duration and sleep quality with falls. RESULTS There were 21.7% (95%CI: 21.0-22.4%) participants who had experienced falls in the past year. After controlling demographic and individual variables, falls in older adults were associated with self-reported sleep quality and self-reported sleep duration. Those who reported poor sleep quality were more likely to fall (OR = 1.149; 95%CI = 1.004,1.316). Participants who reported sleep duration that was too short (<5) (OR = 1.349; 95% CI = 1.191 to 1.528) or too long (>8) (OR = 1.267; 95% CI = 1.151 to 1.394) were both associated with higher fall prevalence. CONCLUSION Nearly one-fifth of older adults in this study had experienced falls in the past year. The study found that falls were significantly associated with less sleep duration, longer sleep duration, and overall poor sleep quality among the old Chinese population.
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Affiliation(s)
- Weimin Zhu
- Department of Gastroenterology, Zhejiang Hospital, China
| | - Hao Lin
- School of Humanities and Management, Zhejiang Chinese Medical University, China
| | - Jiahui Zhang
- School of Humanities and Management, Zhejiang Chinese Medical University, China
| | - Mingyuan Sheng
- School of Humanities and Management, Zhejiang Chinese Medical University, China
| | - Young Kathleen
- Department of Health Sciences, MPH and Public Health Education Programs, California State University, Northridge, CA, USA
| | - Peifen Zheng
- Department of Gastroenterology, Zhejiang Hospital, China.
| | - Shuhan Jiang
- School of Humanities and Management, Zhejiang Chinese Medical University, China.
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Cheng A, Leung Y, Brodaty H. A systematic review of the associations, mediators and moderators of life satisfaction, positive affect and happiness in near-centenarians and centenarians. Aging Ment Health 2022; 26:651-666. [PMID: 33645362 DOI: 10.1080/13607863.2021.1891197] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Results from studies investigating life satisfaction, positive affect and happiness of near-centenarians (95+) and centenarians are inconsistent. This is the first systematic review to summarise the extant literature on the subjective well-being of this unique age group. METHOD Seven electronic databases (PubMed, MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science and the Cochrane database for systematic reviews) were systematically searched. Subjective well-being was defined as life satisfaction, positive affect and happiness. A narrative synthesis of relevant articles was undertaken. RESULTS Of 28 studies eligible for inclusion in this review, 20 predominantly examined life satisfaction, 11 positive affect and 4 happiness. Sex and other demographic variables were not significant predictors of subjective well-being. In contrast, greater perceived health was significantly associated with higher levels of life satisfaction and positive affect. Fatigue and visual impairment were significantly correlated with lower levels of life satisfaction and positive affect. However, there was considerable heterogeneity in the findings on physical, cognitive and social associations, mediators and moderators. CONCLUSION The large discrepancy of results in the literature may be explained by methodological differences between studies. Centenarian research needs a clearer definition of life satisfaction, positive affect and happiness as their operationalisation is inconsistent. An international consortium of centenarian studies could facilitate cross-cultural comparisons on subjective well-being. Future research should be directed towards interventions that promote subjective well-being in the oldest-old.
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Affiliation(s)
- Adrian Cheng
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Yvonne Leung
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,School of Psychology, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Sydney, Australia
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11
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Govoni S, Fagiani F, Lanni C, Allegri N. The Frailty Puzzle: Searching for Immortality or for Knowledge Survival? Front Cell Neurosci 2022; 16:838447. [PMID: 35250489 PMCID: PMC8891148 DOI: 10.3389/fncel.2022.838447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/25/2022] [Indexed: 12/18/2022] Open
Abstract
What is the value of assessing the biological age and frailty and predicting residual lifespan and health status? The benefit is obvious if we have means to alter the pace of aging and the development of frailty. So far, limited but increasing examples of interventions altering the predicted status indicate that, at least in some cases, this is possible through interventions spanning from the economic-social through drug treatments. Thus, why searching for biological markers, when some clinical and socio-economic indicators do already provide sufficiently accurate predictions? Indeed, the search of frailty biomarkers and of their biological clocks helps to build up a mechanistic frame that may orientate the design of interventions and the time window of their efficacy. Among the candidate biomarkers identified, several studies converge to indicate epigenetic clocks as a promising sensitive biomarker of the aging process. Moreover, it will help to establish the relationship between personal aging and health trajectories and to individuate the check points beyond which biological changes are irreversible.
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Affiliation(s)
- Stefano Govoni
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
| | - Francesca Fagiani
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
| | - Cristina Lanni
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
| | - Nicola Allegri
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
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Wei K, Yang J, Yang B, Jiang L, Jiang J, Cao X, Li C. Living Preference Modifies the Associations of Living Arrangements With Loneliness Among Community-Dwelling Older Adults. Front Public Health 2022; 9:794141. [PMID: 35127625 PMCID: PMC8814323 DOI: 10.3389/fpubh.2021.794141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
ObjectivesLiving arrangement has been reported to have a significant influence on feelings of loneliness in older adults, but their living preferences may confound the association. This study aimed to investigate whether the associations of living arrangements with loneliness differ in community-dwelling older adults according to different living preferences.MethodsIn the 2008/2009 (baseline) and 2011/2012 (follow-up) waves of the Chinese Longitudinal Healthy Longevity Survey, living arrangements [living with children mainly (LWC), living with spouse only (LWS), and living alone (LA)], living preferences [preferring living with children (PreLWC) and preferring living alone/only with spouse (PreLA)], and feelings of loneliness were assessed. The effect modifications of living preferences in the associations of living arrangements with loneliness were estimated using logistic regression models, and corresponding odds ratios (ORs) were calculated.ResultsLiving preferences significantly modified the associations of living arrangements with loneliness at baseline (p for interaction = 0.009 for LWS and = 0.015 for LA). Compared with LWC, LWS was protective for loneliness only in the PreLA older adults at baseline (OR = 0.53, 95% CI = 0.45–0.64, p < 0.001), and LA was significantly associated with loneliness especially in the PreLWC older adults, compared with their PreLA counterparts (at baseline, ORs = 2.89 vs. 2.15; at follow-up, ORs = 1.68 vs. 1.51).ConclusionLiving preference modifies the associations of living arrangements with loneliness, and those who prefer living with children but live alone are more likely to feel lonely. It is recommended that living preferences should be considered when managing loneliness in community-dwelling older adults.
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Affiliation(s)
- Kai Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
| | - Junjie Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bixi Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiangling Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Neurocognitive Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xinyi Cao
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Chunbo Li
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13
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Wei K, Liu Y, Yang J, Gu N, Cao X, Zhao X, Jiang L, Li C. Living arrangement modifies the associations of loneliness with adverse health outcomes in older adults: evidence from the CLHLS. BMC Geriatr 2022; 22:59. [PMID: 35038986 PMCID: PMC8764854 DOI: 10.1186/s12877-021-02742-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/16/2021] [Indexed: 01/02/2023] Open
Abstract
Background Although it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements. Methods In the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 13,738 community-dwelling older adults (≥65 years) were included for analyses. Living arrangements and loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The effect modificaitons of loneliness on adverse health outcomes by living arrangements were estimated using logistic regression or Cox proportional hazards regression models. Results Living alone older adults were significantly more likely to be lonely at baseline (52% vs 29.5%, OR = 1.90, 95% CI = 1.67–2.16, P < 0.001), compared with those living with others. Loneliness in older adults was a significant risk factor for prevalent cognitive impairment and frailty, and 3-year mortality, especially among those who lived with others (OR = 1.32, 95% CI = 1.15–1.52, P < 0.001; OR = 1.39, 95% CI = 1.24–1.57, P < 0.001; HR = 1.14, 95% CI = 1.05–1.24, P = 0.002, respectively). In contrast, among the living alone older adults, loneliness was only significantly associated with higher prevalence of frailty (OR = 1.42, 95% CI = 1.07–1.90, P = 0.017). Living arrangement significantly modified the associations of loneliness with prevalent cognitive impairment and 3-year mortality (P values for interaction = 0.005 and 0.026, respectively). Conclusions Living arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population and more social services should be developed to reduce adverse health outcomes, in order to improve their quality of life and promote successful aging. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02742-5.
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Affiliation(s)
- Kai Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Yong Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Junjie Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Nannan Gu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Xudong Zhao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China. .,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China. .,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, People's Republic of China. .,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
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Abstract
OBJECTIVES The study aimed to apply the frailty index (FI) to assess frailty status among Chinese centenarians and analyse its associated factors. DESIGN The study was a cross-sectional study. SETTING AND PARTICIPANTS The study included 1043 centenarians (742 females and 301 males) aged ≥100 years from the 2018 wave of the China Longitudinal Healthy Longevity Survey. MEASUREMENTS All participants were assessed for frailty by the FI. Basic characteristics, including age, height, weight, calf circumference, waist circumference, hip circumference, sex, years of education, financial status, exercise, fall status, coresidence, smoking, alcohol consumption, number of natural teeth, denture use, toothache, and tooth brushing, were collected. Multivariate logistic regression was used to analyse the associations between risk factors and frailty. RESULTS The average age of the participants was 102.06±2.55 years (range: 100-117 years). The FI ranged between 0.00 and 0.63. The mean FI for all participants was 0.27±0.13 (median 0.25; interquartile range 0.20-0.35). Participants were divided into quartiles. The number of natural teeth and denture use, coresidence, sex, exercise, and financial status showed significant associations with frailty classes (all P<0.05). Multivariate logistic regression analysis indicated that having ≤20 natural teeth without dentures (OR, 95% CI= 1.89(0.004-1.246), P<0.05), having ≤20 natural teeth with dentures (OR, 95% CI=2.21(0.158,1.432), P=0.015), living alone or in an institution (OR, 95% CI=1.68(0.182-0.849), P=0.002), lacking exercise (OR, 95% CI=2.54(0.616-1.246), P<0.001), having insufficient financial resources (OR, 95% CI=2.9(0.664-1.468), P<0.001), and being female (OR, 95% CI=1.47(0.137,0.634), P=0.002) were independent risk factors for frailty. CONCLUSION Chinese centenarian women are frailer than men. Having fewer natural teeth, living alone or in an institution, lacking exercise, and having insufficient financial resources were the factors associated with frailty among Chinese centenarians. Family conditions and healthy lifestyles may be important for frailty status in centenarians.
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Affiliation(s)
- J Zhang
- Liyu Xu, Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, People's Republic of China, Tel +86 13486183817, Fax +86 0571 87985201, Email
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Wang Q, Dai X, Liu J, Chen Z, Yu Y, Liu X, Yuan P. [Pravelance and risk factors of frailty in community-dwelling Chinese elderly population]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1719-1724. [PMID: 34916200 DOI: 10.12122/j.issn.1673-4254.2021.11.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate the incidence of frailty in community-dwelling Chinese elderly population and explore the risk factors and protective factors of frailty in the elderly. METHODS This study was conducted based on the 2011-2015 survey data provided by the China Health and Retirement Longitudinal Study (CHARLS). A research cohort was established consisting of non-debilitated elderly individuals aged 60 years and above at the 2011 baseline survey to assess the incidence of debilitation in the cohort population followed up till 2015. A nested case-control study was conducted to analyze the contributing factors to frailty in the elderly. RESULTS In this study, the cohort population was followed up for a total of 14351 person-years. A total of 248 individuals had newly developed frailty during the follow-up period, resulting in an incidence of 17.28/1000 person-years; the incidence was lower in elderly men than in elderly women (14.63/1000 vs 20.14/1000 person-years). The incidence of debilitation increased progressively with ageing: 8.90/1000 person-years in 60-64 years group, 16.77/ 1000 person-years in 65-69 years group, 24.04/1000 person-years in 70-74 years group, and 64.67/1000 person-years in 80 years or older group. Multivariate conditional logistic regression analysis showed that depressive symptoms (OR=2.534, 95% CI: 1.714-3.748), smoking (OR=1.713, 95% CI: 1.081-2.715) and self-care difficulties (OR=1.684, 95% CI: 1.155-2.456) were the risk factors contributing to frailty in the elderly; the marital status (unmarried, divorced and widowed) (OR=0.432, 95%CI: 0.278-0.673), a high cognitive function score (OR=0.919, 95% CI: 0.870-0.970), a primary school education (OR=0.453, 95% CI: 0.254- 0.806) and drinking (OR=0.520, 95%CI: 0.323-0.837) were the protective factors against frailty in the elderly. CONCLUSIONS The incidence of frailty in community-dwelling Chinese elderly population is lower than the average incidence globally. The incidence of frailty in the elderly differs with gender and age, and depressive symptoms, smoking, and self-care difficulties are the main risk factors for frailty in the community-dwelling elderly.
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Affiliation(s)
- Q Wang
- Department of Epidemiology and Health Statistics//West China Fourth Hospital and West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - X Dai
- Department of Epidemiology and Health Statistics//West China Fourth Hospital and West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - J Liu
- Department of Epidemiology and Health Statistics//West China Fourth Hospital and West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - Z Chen
- Department of Epidemiology and Health Statistics//West China Fourth Hospital and West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - Y Yu
- Department of Epidemiology and Health Statistics//West China Fourth Hospital and West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - X Liu
- Department of Epidemiology and Health Statistics//West China Fourth Hospital and West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - P Yuan
- Department of Epidemiology and Health Statistics//West China Fourth Hospital and West China School of Public Health, Sichuan University, Chengdu 610041, China
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Irshad CV, Dash U, Muraleedharan VR. Healthy Ageing in India; A Quantile Regression Approach. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09340-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Xu X, Zhao Y, Gu D, Pei Y, Wu B. Health Behaviors and Self-Reported Oral Health among Centenarians in Nanjing, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7285. [PMID: 34299735 PMCID: PMC8304003 DOI: 10.3390/ijerph18147285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/01/2022]
Abstract
The role of health behaviors in oral health conditions in individuals of extremely old age remains understudied. This study included 185 participants aged 100 years or older from the Nanjing Centenarians Study (NCS) to examine the associations between health behaviors and oral health and investigate the potential moderating role of education and living arrangements in such relationships. The oral health status as an outcome included the self-reported oral health status and edentulous status. Health behavior variables included smoking, eating fruits, eating vegetables, participating in leisure activities, and practicing oral hygiene behaviors. Sociodemographic characteristics and health status were considered as confounders. Descriptive statistics, ordinal regression, and logistic regression models were used to address the research questions. Results showed that better oral health was reported by centenarians who were non-smokers, participated in more leisure activities, and practiced higher frequency of oral hygiene behaviors. Those who ate fruits daily and practiced more frequently oral hygiene behaviors were more likely to be dentate. The positive association of oral hygiene behaviors was stronger for centenarians who were formally educated and co-resided with family members. The results suggest that effective interventions should consider health behaviors and living arrangements in this growing population to improve their oral health status.
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Affiliation(s)
- Xin Xu
- Population Research Institute, Nanjing University of Posts and Telecommunications, Nanjing 210042, China;
| | - Yuan Zhao
- Population Research Institute, Nanjing University of Posts and Telecommunications, Nanjing 210042, China;
- Ginling College, Nanjing Normal University, Nanjing 210023, China
| | - Danan Gu
- Independent Researcher, New York, NY 10010, USA;
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA;
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA;
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Song Y, Deng Y, Li J, Hao B, Cai Y, Chen J, Shi H, Xu W. Associations of falls and severe falls with blood pressure and frailty among Chinese community-dwelling oldest olds: The Chinese Longitudinal Health and Longevity Study. Aging (Albany NY) 2021; 13:16527-16540. [PMID: 34160365 PMCID: PMC8266320 DOI: 10.18632/aging.203174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/31/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Falls are a leading cause of death among Chinese oldest olds. However, studies on Chinese community-dwelling older adults are lacking. We aimed to identify the associations of falls and severe falls with blood pressure and frailty among Chinese community-dwelling oldest olds. METHODS Cross-sectional analyses were conducted with 6,595 community-dwelling oldest olds (aged ≥80 years) from 22 Chinese provinces from the Chinese Longitudinal Health and Longevity Study (CLHLS). Systolic BP (SBP) and diastolic BP (DBP) were measured twice at participants' homes, and a 38-item frailty index was used to assess the frailty status of participants. Falls and severe falls were confirmed through face-to-face interviews. Multivariate logistic regression was used to investigate the associations of BP and frailty with falls and severe falls. RESULTS The mean participant age was 91.0 years, and 56.1% were female. In total, 24.2% participants had a history of fall and 8.3% had a history of severe falls. The multivariate-adjusted odds ratio (OR) for falls among the oldest old with SBP ≥140 mm Hg compared to those with an SBP of 120-129 mm Hg was 1.20 (95% confidence interval [CI], 1.01-1.44). The adjusted OR for falls among frail participants compared to robust participants was 1.39 (95% CI, 1.02-1.89). DBP and pre-frailty were not associated with falls after multivariate adjustment. SBP, DBP, and frailty status were not associated with severe falls after multivariate adjustment. CONCLUSIONS SBP and frailty but not DBP and pre-frailty are associated with increased odds of falls among Chinese community-dwelling oldest olds.
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Affiliation(s)
- Yujian Song
- Graduate School of Medical School of Chinese PLA, Beijing 100853, China
| | - Yujiao Deng
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Jianhua Li
- Department of Geriatric Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Benchuan Hao
- Department of Geriatric Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Yulun Cai
- Department of Geriatric Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Jianqiao Chen
- Department of Geriatric Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Haiyan Shi
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Weihao Xu
- Haikou Cadre's Sanitarium of Hainan Military Region, Haikou 570203, China
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Bacalini MG, Gentilini D, Monti D, Garagnani P, Mari D, Cesari M, Ogliari G, Passarino G, Franceschi C, Pirazzini C, Arosio B. No association between frailty index and epigenetic clocks in Italian semi-supercentenarians. Mech Ageing Dev 2021; 197:111514. [PMID: 34098514 DOI: 10.1016/j.mad.2021.111514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
Centenarians experience successful ageing, although they still present high heterogeneity in their health status. The frailty index is a biomarker of biological age, able to capture such heterogeneity, even at extreme old age. At the same time, other biomarkers (e.g., epigenetic clocks) may be informative the biological age of the individual and potentially describe the ageing status in centenarians. In this article, we explore the relationship between epigenetic clocks and frailty index in a cohort of Italian centenarians. No association was reported, suggesting that these two approaches may describe different aspects of the same ageing process.
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Affiliation(s)
| | - Davide Gentilini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Bioinformatics and Statistical Genomics Unit, Istituto Auxologico Italiano IRCCS, Cusano Milanino, Milan, Italy
| | - Daniela Monti
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Paolo Garagnani
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy; Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate), University of Bologna, Bologna, Italy; Department of Laboratory Medicine, Clinical Chemistry, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; CNR Institute of Molecular Genetics "Luigi Luca Cavalli-Sforza", Unit of Bologna, Bologna, Italy
| | - Daniela Mari
- Laboratorio Sperimentale di Ricerche di Neuroendocrinologia Geriatrica ed Oncologica, Istituto Auxologico Italiano, IRCCS, Milano, Italy
| | - Matteo Cesari
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Milan, Italy
| | - Giulia Ogliari
- Department of Health Care for Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, Nottinghamshire, NG7 2UH, UK
| | - Giuseppe Passarino
- Dipartimento di Biologia, Ecologia e Scienze della Terra, Università della Calabria, Rende, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy; Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky University, Nizhniy Novgorod, Russia
| | - Chiara Pirazzini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
| | - Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Zhang Q, Zhao X, Liu H, Ding H. Frailty as a predictor of future falls and disability: a four-year follow-up study of Chinese older adults. BMC Geriatr 2020; 20:388. [PMID: 33023480 PMCID: PMC7539482 DOI: 10.1186/s12877-020-01798-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Frailty, which is defined as aging-related multisystem impairments, can lead to adverse health outcomes. However, evidence for such a connection in Chinese older adults remains lacking. This study examined the association between frailty and future falls and disability among community-dwelling Chinese older adults. METHODS Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were aged 60 years and above at baseline in 2011 and completed the follow-up survey in 2015. Outcome measures were future falls, incident disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and worsening performance of ADLs and IADLs. A multivariate logistic regression was conducted to examine the association between frailty phenotype and falls, incident disability, and worsening disability during a four-year period. RESULTS We found that frail participants were at increased risk at follow-up for: falls (OR 1.54, 95% CI, 1.14-2.08); developing new ADL difficulties (OR 4.10, 95% CI, 2.79-6.03) and IADL difficulties (OR 3.06, 95% CI, 2.03-4.61); and worsening ADLs performance (OR 2.27, 95% CI, 1.27-4.06), after adjusting for potential confounders. Prefrailty was also significantly associated with future falls, incident disability in ADLs and IADLs, but with a lower magnitude of effect. CONCLUSIONS Frailty phenotype is an independent predictor of future falls, incident disability, and worsening performance in ADLs among Chinese older adults. The association suggests the need to pay special attention in caring for frail and prefrail elders and improving individuals' frailty status.
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Affiliation(s)
- Quan Zhang
- School of Health Humanities, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China.,National School of Development, Peking University, No. 5 Yiheyuan Road, Beijing, 100871, China
| | - Xinyi Zhao
- School of Health Humanities, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China.
| | - Huiying Liu
- Department of Sociology, Central South University, No. 932 Lushannan Road, Changsha, 410083, Hunan Province, China.,Social Survey and Opinion Research Centre, Central South University, No. 932 Lushannan Road, Changsha, 410083, Hunan Province, China
| | - Hua Ding
- Institute of Social Science Survey, Peking University, No. 5 Yiheyuan Road, Beijing, 100871, China
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Beker N, Sikkes SAM, Hulsman M, Tesi N, van der Lee SJ, Scheltens P, Holstege H. Longitudinal Maintenance of Cognitive Health in Centenarians in the 100-plus Study. JAMA Netw Open 2020; 3:e200094. [PMID: 32101309 PMCID: PMC7137688 DOI: 10.1001/jamanetworkopen.2020.0094] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
IMPORTANCE Some individuals who reach ages beyond 100 years in good cognitive health may be resilient against risk factors associated with cognitive decline. Exploring the processes underlying resilience may contribute to the development of therapeutic strategies that help to maintain cognitive health while aging. OBJECTIVE To identify individuals who escape cognitive decline until extreme ages and to investigate the prevalence of associated risk factors. DESIGN, SETTING, AND PARTICIPANTS The 100-plus Study is a prospective observational cohort study of community-based Dutch centenarians enrolled between 2013 and 2019 who were visited annually until death or until participation was no longer possible. The centenarians self-reported their cognitive health, as confirmed by a proxy. Of the 1023 centenarians approached for study inclusion, 340 fulfilled the study criteria and were included in analyses. Data analysis was performed from April 2019 to December 2019. MAIN OUTCOMES AND MEASURES Cognition was assessed using the Mini-Mental State Examination (MMSE). To identify centenarians who escape cognitive decline, this study investigated the association of baseline cognition with survivorship and cognitive trajectories for at least 2 years of follow-up using linear mixed models, adjusted for sex, age, and education. This study investigated the prevalence of apolipoprotein E (APOE) genotypes and cardiovascular disease as risk factors associated with cognitive decline. RESULTS At baseline, the median age of 340 centenarians was 100.5 years (range, 100.0-108.2 years); 245 participants (72.1%) were female. The maximum survival estimate plateaued at 82% per year (95% CI, 77% to 87%) across centenarians who scored 26 to 30 points on the baseline MMSE (hazard ratio, 0.56; 95% CI, 0.42 to 0.75; P < .001), suggesting that an MMSE score of 26 or higher is representative of both cognitive and physical health. Among the 79 centenarians who were followed up for 2 years or longer, those with baseline MMSE score less than 26 experienced a decline in MMSE score of 1.68 points per year (95% CI, -2.45 to -0.92 points per year; P = .02), whereas centenarians with MMSE scores of 26 or higher at baseline experienced a decline of 0.71 point per year (95% CI, -1.08 to -0.35 points per year). For 73% of the centenarians with baseline MMSE scores of 26 or higher, no cognitive changes were observed, which often extended to ensuing years or until death. It is estimated that this group is representative of less than 10% of Dutch centenarians. In this group, 18.6% carried at least 1 APOE-ε4 allele, compared with 5.6% of the centenarians with lower and/or declining cognitive performance. CONCLUSIONS AND RELEVANCE Most centenarians who scored 26 or higher on the MMSE at baseline maintained high levels of cognitive performance for at least 2 years, in some cases despite the presence of risk factors associated with cognitive decline. Investigation of this group might reveal the processes underlying resilience against risk factors associated with cognitive decline.
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Affiliation(s)
- Nina Beker
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Clinical Psychology, Neuropsychology, and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marc Hulsman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Niccolò Tesi
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Sven J. van der Lee
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Henne Holstege
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
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Zhang X, Liu Y, Van der Schans CP, Krijnen W, Hobbelen JSM. Frailty among older people in a community setting in China. Geriatr Nurs 2020; 41:320-324. [PMID: 31959415 DOI: 10.1016/j.gerinurse.2019.11.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 12/19/2022]
Abstract
Frailty is the most common manifestation of serious health issues in the world, and it is becoming more prevalent worldwide as the aging population grows. Changes that occur in an individual during the aging process have physical, psychological, social, and environmental aspects that make an individual more frail. In China, older people may live in communities for aging individuals. This study aimed to describe the presence and severity of frailty and to analyze influencing factors among this population in China. The Frailty Index 35 (FI-35) scale, which includes 35 items in physical, psychological, social, and environmental domains, was used to investigate frailty. The FI-35 score ranges from zero to one, with a score closer to one indicating greater frailty. Biographical, socioeconomic, and lifestyle factors were measured as potential determinants of frailty. We relied on the November 2017-February 2018 waves of the Chinese cross-sectional study survey that comprised a sample of 513 adults, aged 60 or older, who were living in China. Linear regression was performed to identify factors associated with FI-35 scores. We categorized the determinants of frailty into three models: Model 1: biographical variables; Model 2: biographical and socioeconomic variables; and Model 3: biographical, economic, and lifestyle variables. Frailty scores ranged from 0.00 to 0.89, with a median of 0.31, and the prevalence of frailty was 67.6%. The final model obtained after variable selection included age, minority status, marriage status, income, diet, and exercise. The adjusted R-squared indicated that the analysis explained 13.8% of the variance in frailty scores. Adding household, marriage status, education level, medical insurance, and income as elements in Model 2 explained 25.7%. Adding diet, smoking, drinking, exercise, and hobbies in Model 3 explained 27.9%. The degree of frailty varies considerably among Chinese community-dwelling older people and is partly determined by biographical, socioeconomic, and lifestyle factors.
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Affiliation(s)
- Xiaohong Zhang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China; Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands
| | - Yanhui Liu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - C P Van der Schans
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Health Psychology, Groningen, the Netherlands
| | - W Krijnen
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands
| | - J S M Hobbelen
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands.
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[Review: biomedical aspect of supercentenarians]. Nihon Ronen Igakkai Zasshi 2018; 55:578-583. [PMID: 30542023 DOI: 10.3143/geriatrics.55.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Tomita MR, Fisher NM, Nair S, Ramsey D, Persons K. Impact of Physical Activities on Frailty in Community-Dwelling Older Women. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018; 36:107-119. [PMID: 30880864 DOI: 10.1080/02703181.2018.1443194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Aims The aim of the study was to determine whether increased physical activities (PA) affect frailty for old women, 75 years and older (OO), compared to 60-74 years old (YO). Methods This crosssectional study measured 19 frailty indicators (muscle strength and endurance, balance, gait characteristics, and function), using 46 community-dwelling women. PA were divided into three levels by caloric expenditure per week (<2,000 kcal/week, 2,000-3,999 kcal/week,>4,000 kcal/week). Results As PA level increased, a gap (=difference) between OO and YO narrowed for step length and function, but for quadriceps strength and endurance, a gap widened. Conclusions Frailty progresses with aging but older women who engage in a high level of physical activity (>4,000 kcal/week) can increase mobility and functional capacity, but not for muscle strength and endurance. Starting regular resistance training activities early in the aging process is critical to improve or maintain muscle quality to offset age-related frailty.
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Affiliation(s)
- Machiko R Tomita
- Department of Rehabilitation Science, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Nadine M Fisher
- Department of Rehabilitation Science, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Sujata Nair
- Department of Rehabilitation Science, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Dan Ramsey
- D'Youville College, School of Health Professions Education, Buffalo, NY, USA
| | - Kimberley Persons
- Department of Rehabilitation Science, University at Buffalo, State University of New York, Buffalo, NY, USA
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Abstract
BACKGROUND Physical frailty and depression are common comorbid conditions that have important impact on older adults. Few studies however have examined their co-occurrence in centenarians. This paper explores the relationship between the two conditions and the most characteristic depressive symptoms associated with the frailty syndrome. METHODS Data come from two Portuguese Centenarian Studies. Frailty was measured using Fried's phenotype, which includes at least three clinical signs: exhaustion, weight loss, weakness, slowness, and low physical activity level; the Geriatric Depression Scale was used to assess depression. Descriptive comparison and binary logistic regression models were used for data analysis. RESULTS The final sample comprised 91 centenarians (mean age = 101.0, SD = 1.3; 85.7% female). From these, 5.5% were classified as robust, 42.9% as pre-frail, and 51.6% as frail. The prevalence of depression in the whole sample was 35.2% (51.1% in frail centenarians; 21.1% in pre-frail centenarians; 0% in robust centenarians). Frail centenarians presented higher risk of depression (OR = 3.92; 95% CI 1.48-10.4) when compared to pre-frail centenarians. Findings from the multivariable model (gender, living arrangements, education, cognition, subjective health, current illness, and functionality) revealed that only subjective health remained significant. CONCLUSION It seems that depression is a comorbid clinical independent condition that is frequent in frail and pre-frail centenarians.
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Socioeconomic Status, Frailty, and All-Cause Mortality in Korean Older Adults: A 3-Year Population-Based Prospective Study. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1903589. [PMID: 29387717 PMCID: PMC5745684 DOI: 10.1155/2017/1903589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/01/2017] [Accepted: 11/20/2017] [Indexed: 12/13/2022]
Abstract
Background Little is known regarding the effects of socioeconomic status (SES) and frailty on mortality in Korea. Objective This study investigated the combined impact of low SES and frailty on all-cause mortality in Korean older adults. Methods Study sample at baseline comprised 7,960 community-dwelling adults (56.8% women) aged 65 years and older. The Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of low SES and frailty for all-cause mortality. Results Overall, low SES plus frailty resulted in an increased risk of all-cause mortality (HR = 1.56, 95% CI = 1.09–2.23, P = 0.015) even after adjustments for all the measured covariates, as compared with high SES plus nonfrailty (HR = 1). Among older adults aged 65–75 years, the increased mortality risk of either low SES plus nonfrailty (HR = 1.37, 95% CI = 1.02–1.84, P = 0.038) or high SES plus frailty (HR = 2.09, 95% CI = 1.12–3.91, P = 0.021) remained significant even after adjustments for all the covariates, as compared with high SES plus nonfrailty (HR = 1). Conclusion The current findings suggest that either low SES or frailty is significantly associated with increased all-cause mortality in Korean older adults.
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Ma L, Tang Z, Zhang L, Sun F, Li Y, Chan P. Prevalence of Frailty and Associated Factors in the Community-Dwelling Population of China. J Am Geriatr Soc 2017; 66:559-564. [PMID: 29168883 DOI: 10.1111/jgs.15214] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Lina Ma
- Beijing Geriatric Healthcare Center; Xuanwu Hospital; Capital Medical University; Beijing Institute of Geriatrics; Key Laboratory on Neurodegenerative Disease of Ministry of Education; Beijing Institute for Brain Disorders; Beijing China
- Department of Geriatrics; Xuanwu Hospital; Capital Medical University; China National Clinical Research Center for Geriatric Medicine; Beijing China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center; Xuanwu Hospital; Capital Medical University; Beijing Institute of Geriatrics; Key Laboratory on Neurodegenerative Disease of Ministry of Education; Beijing Institute for Brain Disorders; Beijing China
| | - Li Zhang
- Department of Geriatrics; Xuanwu Hospital; Capital Medical University; China National Clinical Research Center for Geriatric Medicine; Beijing China
| | - Fei Sun
- Beijing Geriatric Healthcare Center; Xuanwu Hospital; Capital Medical University; Beijing Institute of Geriatrics; Key Laboratory on Neurodegenerative Disease of Ministry of Education; Beijing Institute for Brain Disorders; Beijing China
| | - Yun Li
- Department of Geriatrics; Xuanwu Hospital; Capital Medical University; China National Clinical Research Center for Geriatric Medicine; Beijing China
| | - Piu Chan
- Department of Geriatrics; Xuanwu Hospital; Capital Medical University; China National Clinical Research Center for Geriatric Medicine; Beijing China
- Department of Neurology and Neurobiology; Xuanwu Hospital; Capital Medical University; Beijing China
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Brandão D, Ribeiro O, Afonso R, Paúl C. Escaping most common lethal diseases in old age: Morbidity profiles of Portuguese centenarians. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ritt M, Ritt JI, Sieber CC, Gaßmann KG. Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards. Clin Interv Aging 2017; 12:293-304. [PMID: 28223787 PMCID: PMC5308479 DOI: 10.2147/cia.s124342] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Studies evaluating and comparing the power of frailty, comorbidity, and disability instruments, together and in parallel, for predicting mortality are limited. OBJECTIVE This study aimed to evaluate and compare the measures of frailty, comorbidity, and disability in predicting 1-year mortality in geriatric inpatients. DESIGN Prospective cohort study. PATIENTS AND SETTING A total of 307 inpatients aged ≥65 years in geriatric wards of a general hospital participated in the study. MEASUREMENTS The patients were evaluated in relation to different frailty, comorbidity, and disability instruments during their hospital stays. These included three frailty (the seven-category Clinical Frailty Scale [CFS-7], a 41-item frailty index [FI], and the FRAIL scale), two comorbidity (the Cumulative Illness Rating Scale for Geriatrics [CIRS-G] and the comorbidity domain of the FI [Comorbidity-D-FI]), and two disability instruments (disability in basic activities of daily living [ADL-Katz] and the instrumental and basic activities of daily living domains of the FI [IADL/ADL-D-FI]). The patients were followed-up over 1 year. RESULTS Using FI, CIRS-G, Comorbidity-D-FI, and ADL-Katz, this study identified a patient group with a high (≥50%) 1-year mortality rate in all of the patients and the two patient subgroups (ie, patients aged 65-82 years and ≥83 years). The CFS-7, FI, FRAIL scale, CIRS-G, Comorbidity-D-FI, and IADL/ADL-D-FI (analyzed as full scales) revealed useful discriminative accuracy for 1-year mortality (ie, an area under the curve >0.7) in all the patients and the two patient subgroups (all P<0.001). Thereby, CFS-7 (in all patients and the two patient subgroups) and FI (in the subgroup of patients aged ≥83 years) showed greater discriminative accuracy for 1-year mortality compared to other instruments (all P<0.05). CONCLUSION All the different instruments emerged as suitable tools for risk stratification in geriatric inpatients. Among them, CFS-7, and in those patients aged ≥83 years, also the FI, might most accurately predict 1-year mortality in the aforementioned group of individuals.
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Affiliation(s)
- Martin Ritt
- Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Nürnberg; Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St Francis Sisters of Vierzehnheiligen, Erlangen
| | - Julia Isabel Ritt
- Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St Francis Sisters of Vierzehnheiligen, Erlangen
| | - Cornel Christian Sieber
- Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Nürnberg; Department of Internal Medicine and Geriatrics, Hospital of the Order of St John of God, Regensburg, Germany
| | - Karl-Günter Gaßmann
- Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Nürnberg; Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St Francis Sisters of Vierzehnheiligen, Erlangen
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Gu D, Brown BL, Qiu L. Self-perceived uselessness is associated with lower likelihood of successful aging among older adults in China. BMC Geriatr 2016; 16:172. [PMID: 27716182 PMCID: PMC5053349 DOI: 10.1186/s12877-016-0348-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 09/29/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Plenty of evidence has shown that self-perceived uselessness among older adults is negatively associated with successful aging in terms of good health in Western societies. It is unclear whether these findings are valid in China where living into older age is more selective due to high mortality at younger ages. METHODS Using five waves (2000, 2002, 2005, 2008/2009 and 2011/2012) of a large nationally representative survey in China with 29,954 observations from 19,070 older adults aged 65 and older, this study aimed to investigate the association between self-perceived uselessness and successful aging. Self-perceived uselessness was measured by a single item "with age, do you feel more useless?" with six answers: always, often, sometimes, seldom, never, and unable to answer. Successful aging was measured by independence in activities of daily living (ADL), independence in instrumental activities of daily living (IADL), unimpaired cognition, good life satisfaction, and good self-rated health. Logistic regression models were applied to each successful aging indicator after controlling for a rich set of covariates that included demographics, socioeconomic status, family/social support, and health practices. The models also adjusted for intraperson correlations across waves. RESULTS We found that self-perceived uselessness was negatively associated with successful aging among older adults aged 65 or older. Specifically, compared to never having self-perceived uselessness, always having such a perception was associated with 16-42 % lower odds of being ADL independent, IADL independent, cognitively unimpaired, and having good life satisfaction and good self-rated health. Often or sometimes having such a perception also reduced odds of aging successfully, although such reductions were less pronounced. The associations were similar among the oldest-old aged 80 or older with one exception for the case of IADL independence. CONCLUSIONS Self-perceived uselessness is negatively associated with successful aging among Chinese older adults as well as among the oldest-old. Our findings could be informative for China in the development of public health programs that aim to improve self-perceptions about aging and promote successful aging.
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Affiliation(s)
- Danan Gu
- United Nations Population Division, Two UN Plaza, DC2-1910, New York, USA.
| | - Bethany L Brown
- Health and Human Rights Division, Human Rights Watch, New York, USA
| | - Li Qiu
- Independent Researcher, New York, USA
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Lau BHP, Kwan JSK, Cheung KSL, Martin P. Depression Moderates the Frailty-Subjective Health Link among Chinese Near Centenarians and Centenarians. Am J Geriatr Psychiatry 2016; 24:753-61. [PMID: 27423304 DOI: 10.1016/j.jagp.2016.05.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 04/19/2016] [Accepted: 05/20/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Very old adults may be physically frail, but they do not necessarily experience poor subjective health. The authors hypothesized that the relationship between frailty and subjective health is moderated by depression for very old people. METHODS In a cross-sectional study, a survey administered was by a face-to-face interview to 129 community-dwelling older adults aged 95-108. Measurements included the five-item FRAIL scale, the Geriatric Depression Scale Short-Form (GDS), and a subjective health rating. Hierarchical multiple regressions were conducted to test the moderation effects, adjusting for age, gender, living arrangement, perceived socioeconomic status, and cognition. RESULTS The interaction effect between frailty and depression was significant. Inspection of the simple slopes revealed that those who were more depressed had a more negative frailty-subjective health relationship. There was no significant moderation effect for a withdrawal-apathy-vigor dimension of the GDS. CONCLUSION Our findings suggest a protective psychological mechanism may enable very old adults to maintain an optimistic view of their health despite their increasing physical and functional limitations.
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Affiliation(s)
- Bobo Hi-Po Lau
- Faculty of Social Sciences, University of Hong Kong, Hong Kong
| | | | - Karen Siu-Lan Cheung
- Department of Social Work and Social Administration & Sau Po Centre on Ageing, University of Hong Kong, Hong Kong
| | - Peter Martin
- Human Development and Family Studies, College of Human Sciences, Iowa State University, Ames, IA
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Gu D, Yang F, Sautter J. Socioeconomic status as a moderator between frailty and mortality at old ages. BMC Geriatr 2016; 16:151. [PMID: 27506542 PMCID: PMC4979157 DOI: 10.1186/s12877-016-0322-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/26/2016] [Indexed: 12/28/2022] Open
Abstract
Background Despite the well-established power of frailty to predict mortality, and the known associations of socioeconomic status (SES) with mortality, it is largely unknown whether the linkage between frailty and mortality varies across different SES groups. This study aims to investigate whether SES moderates the association between frailty and mortality. Methods We relied on the 2008/2009 and 2011/2012 waves of the Chinese Longitudinal Healthy Longevity Survey, a nationwide sample of 13,731 adults aged 65 or older in China. Frailty was constructed using a cumulative index of 38 items (with 39 deficits) reflecting different dimensions of health; the index or the proportion of deficits ranges from 0 to 1, with greater scores indicating poorer health condition. SES was measured by a socioeconomic vulnerability index (SEVI) also from a similar cumulative approach consisting of 6 deficits; the proportion of deficits ranges from 0 to 1 with higher scores indicating lower SES. Eight Weibull hazard regression models were performed to examine how SES moderates the linkage between frailty and mortality. Results We found that a one percentage point increase in the frailty index was associated with an increased hazard ratio (HR) by 2.7 % (HR = 1.027, 95 % CI: 1.025–1.027); a one percentage point increase in SEVI score was associated with an increased hazard ratio by 0.6 % (HR = 1.006, 95 % CI: 1.004–1.008) controlling for demographics. When interactions between SEVI and frailty index were modeled, the increased mortality risk associated with frailty was weaker among people with lower SES than among people with higher SES (HR = 0.983, 95 % CI: 0.967–0.992). However, the moderating role of SES was diminished when interactions between SES and age and between frailty and age were modeled. With increasing age, the increased mortality risks associated with frailty and socioeconomic vulnerability weakened. Conclusions Frailty was a stronger predictor of mortality among individuals with higher SES than those with lower SES. The increased mortality risks associated with socioeconomic vulnerability and frailty weakened with age. Public health programs aimed at improving SES and promoting healthy longevity should start early in old age, or even earlier, and target poor and frail older adults for maximum impact.
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Affiliation(s)
- Danan Gu
- United Nations Population Division, Two UN Plaza, DC2-1910, New York, NY, 20012, USA.
| | - Fang Yang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Jessica Sautter
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, USA
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Yang F, Gu D. Predictability of frailty index and its components on mortality in older adults in China. BMC Geriatr 2016; 16:145. [PMID: 27455962 PMCID: PMC4960861 DOI: 10.1186/s12877-016-0317-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/14/2016] [Indexed: 01/09/2023] Open
Abstract
Background Frailty represents an increased vulnerability to external stressors due to decreased physiological reserve and dysfunction in multiple bodily systems. The relationship between frailty and mortality has been well-documented in the literature. However, less is known about the predictive powers of frailty index and its components on mortality when they are simultaneously present. This study aimed to examine the predictive powers of frailty index and its multiple components on mortality in a nationally representative sample of older adults in China. Methods We used a sample of 13,731 older adults from the 2008/2009 and 2011/2012 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Frailty was measured using the cumulative deficit approach, and was constructed from 38 health variables (39 deficits). We selected 8 major sets of components: activities of daily living (ADL) (6 deficits), instrumental ADL (IADL) (8 deficits), functional limitations (5 deficits), overall cognitive functioning (1 deficit), chronic disease conditions (11 deficits), self-reported health (2 deficits), hearing and vision impairment (2 deficits), and psychological distress (1 deficit). Survival analysis was used to examine the roles of the frailty and its components in mortality. Results Results showed that almost all the components of the frailty index (except chronic diseases) were significant predictors of mortality when examined individually. Among the components, ADL and IADL disabilities remained significant when considering all the components simultaneously. When the frailty and its components were simultaneously analyzed, the frailty remained a robust predictor of mortality across the age and sex groups, while most components lost their significance except ADL, IADL, and cognitive function components in some cases. Conclusions Frailty measured by cumulative deficits has a stronger predictive power on mortality than its all individual components. ADL and IADL disability play a greater role in mortality than other components when considering all the components of frailty.
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Affiliation(s)
- Fang Yang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Danan Gu
- United Nations Population Division, Two UN Plaza, DC2-1910, New York, NY, 10017, USA.
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