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Okui N, Okui M. Frailty and the Correlation Between Total Testosterone Levels and Urinary Incontinence Among Elderly Women. Int Urogynecol J 2024:10.1007/s00192-024-05906-0. [PMID: 39215809 DOI: 10.1007/s00192-024-05906-0] [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: 06/03/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to explore the correlation between total testosterone levels and stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) in older patients, emphasizing frailty. METHODS This prospective cross-sectional study included 1,328 women over 60 years of age at an incontinence specialty clinic. Participants were assessed for UI, frailty, using the Japanese Frailty Scale, and total testosterone levels. Analysis of a logistic regression model was employed for age, body mass index (BMI), and vaginal deliveries adjustment, with association and multivariate analyses to evaluate the associations with SUI and UUI. RESULTS The frailty and nonfrailty groups each consisted of 664 individuals. After age, BMI, and the number of vaginal deliveries adjustment, the analysis showed a negative association between total testosterone levels and both SUI (p < 0.001) and UUI (p < 0.001) in the frailty group. Multivariate analysis revealed that, in the nonfrailty group, factors such as low total testosterone levels (p = 0.0145), diabetes (p = 0.0052), and cerebral infarction (p = 0.0254) were related to SUI, whereas no significant factors were associated with UUI. In the frailty group, factors associated with SUI included low total testosterone levels (p < 0.0001), the number of vaginal deliveries (p < 0.0001), smoking (p = 0.0240), chronic lung disease (p < 0.0248), and hypertension (p < 0.0265). Factors associated with UUI were age (p < 0.0001), low total testosterone levels (p = 0.0025), diabetes (p < 0.0001), and the number of vaginal deliveries (p = 0.0152). CONCLUSIONS The study highlights the significance of incorporating the assessment of frailty and testosterone levels in addressing UI among older women, particularly in the aged population, underscoring the need for tailored approaches in this demographic.
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Affiliation(s)
- Nobuo Okui
- Yokosuka Urogynecology and Urology Clinic, Ootaki 2-6, Yokosuka, Kanagawa, 238-0008, Japan.
- Kanagawa Dental University, Inaoka-Cyou 82, Yokosuka, Kanagawa, 238-0003, Japan.
| | - Machiko Okui
- Yokosuka Urogynecology and Urology Clinic, Ootaki 2-6, Yokosuka, Kanagawa, 238-0008, Japan
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Hanlon P, Wightman H, Politis M, Kirkpatrick S, Jones C, Andrew MK, Vetrano DL, Dent E, Hoogendijk EO. The relationship between frailty and social vulnerability: a systematic review. THE LANCET. HEALTHY LONGEVITY 2024; 5:e214-e226. [PMID: 38432249 DOI: 10.1016/s2666-7568(23)00263-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 03/05/2024] Open
Abstract
Both frailty (reduced physiological reserve) and social vulnerability (scarcity of adequate social connections, support, or interaction) become more common as people age and are associated with adverse consequences. Analyses of the relationships between these constructs can be limited by the wide range of measures used to assess them. In this systematic review, we synthesised 130 observational studies assessing the association between frailty and social vulnerability, the bidirectional longitudinal relationships between constructs, and their joint associations with adverse health outcomes. Frailty, across assessment type, was associated with increased loneliness and social isolation, perceived inadequacy of social support, and reduced social participation. Each of these social vulnerability components was also associated with more rapid progression of frailty and lower odds of improvement compared with the absence of that social vulnerability component (eg, more rapid frailty progression in people with social isolation vs those who were not socially isolated). Combinations of frailty and social vulnerability were associated with increased mortality, decline in physical function, and cognitive impairment. Clinical and public health measures targeting frailty or social vulnerability should, therefore, account for both frailty and social vulnerability.
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Affiliation(s)
- Peter Hanlon
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Heather Wightman
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Marina Politis
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Caitlin Jones
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Melissa K Andrew
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontological Research Center, Stockholm, Sweden
| | - Elsa Dent
- Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, SA, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, Netherlands
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Ayoob A, Janakiram C. Prevalence of physical and oral frailty in geriatric patients in Kerala, India. J Oral Biol Craniofac Res 2024; 14:158-163. [PMID: 38347898 PMCID: PMC10859288 DOI: 10.1016/j.jobcr.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
Background Physical frailty is a condition where a person has decreased physical reserve and resilience to stressors. Oral frailty, on the other hand, refers to a decline in oral function in conjunction with reductions in cognitive and physical functioning. Poor oral health, encompassing factors such as functional, physiological, psychosocial, and therapeutic aspects, can lead to physical frailty. Objectives Assess the prevalence of physical and oral frailty in geriatric patients attending health centres in Kerala, India. Methodology . Design Cross-sectional study. Setting Amrita Institute of Medical Sciences (Kochi), Amrita Kripa Charitable Hospital (Wayanad) and Amrita Urban Health Centre in (Kaloor). Participants 250 geriatric participants above 60 years. Measurements The participants' physical frailty was evaluated using Fried's Frailty Phenotype, the Reported Edmonton Frail Scale, and sarcopenia screening. The assessment of oral frailty was based on several factors such as current dental status, chewing ability, tongue pressure, the Repetitive Saliva-Swallowing Test, Oral Diadokinetic rates, Xerostomia, and the Oral and Maxillofacial Index. The evaluation was using a questionnaire and clinical examination. Bivariate analysis was performed for additional variables, and multivariate analysis was utilized to examine the relationship between oral and physical frailty. Results 56 % of study participants were males, and the mean age was 68 ± 6.02 years. 34.4 % were physically frail, and the remaining were pre-frail using Fried Frailty Phenotype. 67 % showed oral frailty using the Oral and Maxillofacial Frailty Index (OMFI). Using six domains of the oral frailty status (Tanaka) showed that 74 % of individuals had an increased risk of new onset of physical frailty. In the adjusted model, individuals with mild oral frailty had lesser chances of being frail (OR = 0.509, 95 % CI = 0.274-1.946, p-value = 0.033). Conclusion The prevalence of physical frailty was 34.4 %, and oral frailty status was 74 %. The findings implied a need to include oral frailty assessments in the comprehensive general health screening for geriatric patients.
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Affiliation(s)
- Aneesa Ayoob
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, 682041, India
| | - Chandrashekar Janakiram
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, 682041, India
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Nazari S, Bakhtiyary M, Shabestari A, Sharifi F, Afshar P. Relationship between Lifestyle and Frailty among Iranian Community-Dwelling Older Adults: Pilot Study. JAR LIFE 2023; 12:93-99. [PMID: 38046197 PMCID: PMC10690137 DOI: 10.14283/jarlife.2023.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/03/2023] [Indexed: 12/05/2023]
Abstract
Background Aging affects physical, mental, and social functions, which can lead to an increase in frailty. Old adults with frailty syndrome are prone to disabilities and hospitalization. Lifestyle is a context-based factor that has the potential to prevent frailty. Objectives This study aimed to assess the relationship between lifestyle and frailty among Iranian community-dwelling older adults. Design Setting This is a descriptive-analytical cross-sectional study. The participants were 513 older adults over 60 years by the convenience sampling method from the retirement center. Measurements Data were collected using Tilberg's frailty index, the Iranian elderly lifestyle questionnaire, and the Mini-Cog test. Data were analyzed with SPSS v.26 software by chi-square and logistic regression tests. Results The age of the participants was 66.43 ± 4.69 years. The male-to-female sex ratio was 1.5 (39.2% women). The lifestyle of 96 (19.3%) old adults was unfavorable. 18.7 percent of older adults had Frailty syndrome. The logistic regression test showed that moderate and favorable lifestyle (OR= 0.06; 95% CI: 0.02-0.16), age over 75 years (OR= 5.25; 95% CI: 2.35-11.69), retired employment status (OR= 0.13; 95% CI: 0.29-0.05) are factors that have a significant relationship with frailty (P< 0.05). Conclusion The findings showed that lifestyle can predict frailty. Therefore, it seems that an optimal lifestyle can prevent the frailty of older adults.
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Affiliation(s)
- S. Nazari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Bakhtiyary
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - A.N. Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - F. Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - P.F. Afshar
- Department of Gerontology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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Bozkurt ME, Catikkas NM, Erdogan T, Oren MM, Kilic C, Karan MA, Bahat G. Frailty and its associates in community-dwelling older adults. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230681. [PMID: 37971124 PMCID: PMC10645168 DOI: 10.1590/1806-9282.20230681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/26/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE While the literature contains several studies on the frailty assessed during hospitalization and/or outpatient settings and nursing homes, few studies have assessed frailty in community-dwelling older adults. We investigated the prevalence of frailty and associated factors among older adults in a sample of community-dwelling older adults. METHODS We included community-dwelling older adults >60 years living in the Fatih District of the Istanbul Province. We conducted the study between November 2014 and May 2015. We collected the data such as age, sex, number of diseases and drugs, functional status, frailty, the presence of geriatric syndromes, common diseases, and quality-of-life assessment. Frailty was evaluated by the FRAIL scale. RESULTS A total of 204 adults (mean age: 75.4±7.3 years) were included, of whom 30.4% were robust, 42.6% were pre-frail, and 27% were frail. In multivariate analyses, associated factors of frailty were the number of drugs [odds ratio (OR)=1.240, p=0.036], the presence of cognitive impairment (OR=0.300, p=0.016), and falls (OR=1.984, p=0.048). CONCLUSION The present study established the prevalence of frailty in a large district in the largest metropolis in the country through a valid screening method. Our results suggest that clinicians should consider frailty evaluation in patients with multiple drug usage, cognitive impairment, and falls.
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Affiliation(s)
- Meris Esra Bozkurt
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Nezahat Muge Catikkas
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Tugba Erdogan
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Meryem Merve Oren
- Istanbul University, Istanbul Medical School, Department of Public Health – İstanbul, Turkey
| | - Cihan Kilic
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Mehmet Akif Karan
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
| | - Gulistan Bahat
- Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics – İstanbul, Turkey
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Lin SL. Functional Disability Among Middle-Aged and Older Adults in China: The Intersecting Roles of Ethnicity, Social Class, and Urban/Rural Residency. Int J Aging Hum Dev 2023; 96:350-375. [PMID: 35422130 PMCID: PMC9932620 DOI: 10.1177/00914150221092129] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study explores how ethnicity, family income, and education level differentiate patterns of functional limitations among urban and rural Chinese (aged 45 ≥ years). Based on the 2018 China Family Panel Studies (CFPS) (n = 16,589), this nationwide study employed binary/multinomial logistic regression analyses, stratified by urban/rural residency, to estimate the likelihood of instrumental activities of daily living (IADLs) disability (0/1-2/≥3 limitations) by social determinants of health (SDoH). The estimated overall prevalence of IADLs disability was 14.3%. The multivariable analyses did not find significant ethnic disparity in IADLs disability in urban China, while in rural China, ethnic minorities were 44% more likely to have IADLs disability than Han Chinese. Among rural residents, Mongolians, Tibetans, and Yi minority more than tripled the odds of having ≥3 limitations than Han Chinese; and the intersections of ethnicity and social class were associated with functional limitations. Long-term care and anti-poverty programs should target minority aging populations in rural China.
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Affiliation(s)
- Shen Lamson Lin
- Factor-Inwentash Faculty of Social Work, 152790University of Toronto, Toronto, Canada
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ÇAVUŞOĞLU Ç. Inappropriate drug use determined by TIME criteria and the relation with frailty. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1136024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Amaç: Çalışmamızın amacı kırılganlık ile çoklu ilaç kullanımı, Potansiyel Uygunsuz İlaç Kullanımı (PUİK) ve Potansiyel Reçete İhmali (PRİ) ilişkisini değerlendirmektedir.
Gereç ve Yöntem: Geriatri polikliniğine 1 Ekim 2021 ve 1 Nisan 2022 ayaktan başvuran 65 yaş ve üzeri hastalar retrospektif değerlendirildi. Hastaların demografik verileri, kullandıkları ilaçların etken maddeleri, komorbid hastalıkları ve Klinik Kırılganlık Skalası (KKS) skoru kayıt edildi. KKS skoruna göre hastalar kırılgan ve kırılgan olmayan olarak ikiye ayrıldı. Turkish Inappropriate Medication use in the Elderly (TIME) to STOP kriterleri PUİK değerlendirmek için, TIME to START ise PRİ’yi belirlemek için kullanıldı.
Bulgular: Hastaların ortalama yaşı 75,9±8,7 olup, hastaların %63,1 kadın idi. Hastaların kullandığı ortanca ilaç sayısı 7 (0-17) iken, katılımcıların %79,6’sında polifarmasi mevcuttu. Kırılgan hastaların %69,5 (n=42)’ inde polifarmasi mevcut olup, kırılgan olmayan hastalarda bu oran %22,5 (n=18) idi. Kırılgan hastalarda oral beslenme ürünü, 3-hidroksi-3-metil-glutaril-KoA reduktaz inhibitörleri ve demans tedavisi reçete ihmali oranı anlamlı olarak normal popülasyondan daha fazla idi. Proton pompa inhibitörleri, antipsikotikler, asetilsalisilik asit ve betahistinin uygunsuz kullanım oranı kırılgan hastalarda, kırılgan olmayan hastalardan daha fazla idi.
Sonuç: Polifarmasi, PRİ ve PUİK hastalarda değerlendirilirken kırılganlık göz önünde bulundurulmalıdır ve her ülkenin farklı reçeteleme alışkanlığı olmasından dolayı ülkemize özel olan TIME kriterlerinin kullanımı önemli bir avantaj sağlayabilir.
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Affiliation(s)
- Çağatay ÇAVUŞOĞLU
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ŞANLIURFA MEHMET AKİF İNAN SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
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Liu Y, Qian P, Guo S, Liu S, Wang D, Yang L. Frailty and hearing loss: From association to causation. Front Aging Neurosci 2022; 14:953815. [PMID: 36158533 PMCID: PMC9490320 DOI: 10.3389/fnagi.2022.953815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundObservational studies suggest that frailty is associated with hearing loss (HL) but with inconsistent results. This study aims to examine such association and to assess its causality.Materials and methodsThe cross-sectional data from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression models were used to assess the association between HL and frailty index (FI). Genetic variants associated with the FI and HL were obtained from a large genome-wide association study (GWAS) meta-analysis and UK Biobank GWAS. The inverse variance weighting (IVW) method was used to estimate causal effects. Sensitivity analyses were performed to further validate the robustness of results.ResultsIn this cross-sectional analysis, results support the possibility that frailty may be associated with a higher risk of developing HL, with self-reported [odds ratio (OR) = 2.813; 95% CI, 2.386, 3.317; p < 0.001], speech frequency HL (OR = 1.975; 95% CI, 1.679–2.323; p < 0.001), and high frequency HL (OR = 1.748; 95% CI, 1.459–2.094; p < 0.001). In the adjusted model, frail participants remained at high risk of HL. Mendelian randomization (MR) studies showed a bidirectional causal association between genetically predicted FI and risk of HL (FI for exposure: OR = 1.051; 95% CI, 1.020–1.083; p = 0.001; HL for exposure: OR = 1.527; 95% CI, 1.227–1.901; p < 0.001).ConclusionOur observational study found that inter-individual differences in frailty were associated with the risk of developing HL. Genetic evidence suggests a potential bidirectional causal association between FI and HL. Furthermore, the potential mechanisms of this association require investigation.
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Affiliation(s)
- Yun Liu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Peiyi Qian
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shuli Guo
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shuangyan Liu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dahui Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Lei Yang,
| | - Lei Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Lei Yang,
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Huynh TQH, Pham TLA, Vo VT, Than HNT, Nguyen TV. Frailty and Associated Factors among the Elderly in Vietnam: A Cross-Sectional Study. Geriatrics (Basel) 2022; 7:geriatrics7040085. [PMID: 36005261 PMCID: PMC9407721 DOI: 10.3390/geriatrics7040085] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Frailty syndrome is common among older people and can lead to various adverse consequences such as falls, cognitive decline, disability, dependent living, increased mortality, excessive drug use, and prolonged hospital stays. OBJECTIVES This research determined the prevalence of frailty and associated factors among older adults in Vietnam. METHODS A cross-sectional study was conducted on 584 older adults across five Ho Chi Minh City wards from November 2020 to January 2021. Based on the modified Fried frailty scale, the participants were divided into three categories: robust, pre-frail, and frail. A chi-square test (or Fisher's test) examined the relationship between frailty categories and other variables. Multivariable logistic regression used variates with a cut-off of p ≤ 0.05 in the univariate analysis. RESULTS The prevalence rates of frailty and pre-frailty were 19% and 64%, respectively. The most common frailty component was weak grip strength (63.9%), followed by slowness (36.1%), weight loss (21.6%), low physical activity (19.5%), and exhaustion (18.5%). In addition, the prevalence of frailty was significantly associated with age, BMI levels, living alone, and sarcopenia. CONCLUSION The community's prevalence of frailty among older adults is high. Frailty can lead to many adverse consequences for the elderly. As there were some modifiable factors associated with frailty, it should be assessed in older people through community-based healthcare programs for early diagnosis and management.
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Affiliation(s)
- Trung Quoc Hieu Huynh
- Department of Graduate Training, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
- Correspondence: ; Tel.: +84-973-555-567
| | - Thi Lan Anh Pham
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Van Tam Vo
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Ha Ngoc The Than
- Department of Geriatrics & Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Tan Van Nguyen
- Department of Geriatrics & Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
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Uzun HG, Simsek E, Engin C, Yagdi T, Karapolat H, Ozbaran M, Nalbantgil S. Relation Between Frailty and 1-Year Outcomes After Implantation of a Left Ventricular Assist Device. Am J Cardiol 2022; 173:88-93. [PMID: 35361473 DOI: 10.1016/j.amjcard.2022.02.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022]
Abstract
Frailty has been associated with morbidity and mortality in patients with heart failure and those who underwent cardiac surgery. We aimed to study the effect of frailty on cardiovascular outcomes and the reversibility of frailty after the left ventricular assist device (LVAD) implantation. A total of 51 consecutive patients (44 men; aged 54 ± 10 years) scheduled to undergo LVAD implantation were assessed for frailty (Fried's phenotype, frail ≥3/5), cognitive function (using Mini-Cog), and depression (utilizing Patient Health Questionnaire-9) before the surgery and 3 months afterward. Patients were observed for mortality and adverse events [all-cause readmission, bleeding, renal dysfunction, and ventricular fibrillation (VF)/sustained ventricular tachycardia (VT)] for 12 months. More than half of the patients (54%) were designated as frail. Although there was no statistical difference in mortality among frail and nonfrail patients, frail ones were more likely to have a prolonged length of stay [adjusted odds ratio (AOR) 14.9, 95% confidence interval 1.6 to 132.5, p = 0.01]. At the 3-month reassessment after operation, frailty and cognition rates were better (frailty score [lower is better]: 3 vs 1.5, p <0.0001; cognition score [higher is better]: 4.5 vs 5, p = 0.001), and patients had less depression (Patient Health Questionnaire-9 score [lower is better]: 8 vs 4, p <0.0001). Of the secondary outcomes, only postoperative VF/sustained VT reached statistical significance in being more common among frail patients than nonfrail ones (p = 0.02). Although frailty was not associated with mortality at 1 year, prolonged length of stay occurred more with frail LVAD patients. Frailty status, cognitive function, and depressive mood all improved in most patients after LVAD.
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Affiliation(s)
| | | | | | | | - Hale Karapolat
- Physical Medicine and Rehabilitation, Ege University, Izmir, Turkey
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Low physical activity is the strongest factor associated with frailty phenotype and frailty index: data from baseline phase of Birjand Longitudinal Aging Study (BLAS). BMC Geriatr 2022; 22:498. [PMID: 35689187 PMCID: PMC9188172 DOI: 10.1186/s12877-022-03135-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Frailty is the most complicated expression of aging that is related to disability or multi-morbidity. The aim of the present study was to estimate the prevalence of frailty and its associated factors among community-dwelling aged population. Methods A total of 1529 eligible community- dwelling older adults (≥ 60 years) were enrolled in the baseline phase of Birjand Longitudinal Aging Study (BLAS) from 2019 to 2020. Their frailty status was assessed using the Fried’s frailty phenotype and frailty index. Sociodemographic factors, including sex, age, marital status, and education level, were collected. Health status assessment included the history of hypertension, diabetes mellitus, cardiovascular disease, Alzheimer’s diseases and dementia, and other health conditions. Furthermore, functional assessment (ADL, IADL) and anthropometric measurements including height, weight, waist, calf, and mid-arm circumference were made and the body mass index was calculated. The nutrition status and polypharmacy (use 3 or more medication) were also evaluated. Results The prevalence of frailty was 21.69% according to the frailty phenotype and 23.97% according to the frailty index. A multiple logistic regression model showed a strong association between low physical activity and frailty phenotype (OR = 36.31, CI = 16.99–77.56, P < 0.01), and frailty index (OR = 15.46, CI = 5.65–42.34, P < 0.01). Other factors like old age (≥80), female sex, malnutrition, polypharmacy, obesity, and arthritis were also associated with frailty. The Kappa coefficient of the agreement between these two instruments was 0.18. Conclusion It seems that low physical activity is the most important determinant of frailty. Low physical activity and some other factors may be preventable or modifiable and thus serve as clinically relevant targets for intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03135-y.
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Moradoghli F, Darvishpoor Kakhki A, Esmaeili R. The association between frailty and dignity in community-dwelling older people. BMC Geriatr 2022; 22:344. [PMID: 35440071 PMCID: PMC9019952 DOI: 10.1186/s12877-022-03056-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The population of people aged 60 and older is rapidly increasing in developing countries such as Iran due to declining birth rates and increased life expectancy. Old age is associated with increased risk for frailty and reduced dignity. Frailty is a clinical syndrome characterized by depletion of physical reserves and multiple system disorders, reducing the individual's ability to cope with stressful events. Dignity is an inherent characteristic of human beings and respecting dignity is an ethical principle. This study investigated the association of frailty with dignity among older people in Tehran, Iran. METHODS This correlational study was conducted on 200 individuals aged 60 years and older. Data collection relied on the Demographic Questionnaire, Frailty Index for Elders (FIFE) and the Patient Dignity Inventory (PDI). Data were analyzed with SPSS 25. RESULTS The mean age of the participants was 68 ± 5.05 years; 62% of the participants were at risk for frailty, and 69% had few dignity-related problems. The multiple regression results showed that frailty was significantly associated with dignity (ß = 0.571, p < 0.001). The association was significant across all the dimensions of dignity measured by the PDI. The highest predictors of frailty included dependency (ß = 0.584, p < 0.001), followed by existential distress (ß = 0.560, p < 0.001), symptom distress (ß = 0.400, p = 0.400), social support (ß = 0.391, p < 0.001), and peace of mind (ß = 0.338, p < 0.001) in dignity. CONCLUSIONS The results show that higher levels of frailty in older people are associated with decreases in their dignity, and frailty was the leading predictor of dignity. Providers should develop programs to prevent and reduce frailty in those at risk and to enhance the dignity of the already frail.
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Affiliation(s)
- Fereshteh Moradoghli
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Darvishpoor Kakhki
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Opposite to Rajaee Heart Hospital, Vali-Asr Avenue, Cross of Vali-Asr and Hashemi Rafsanjani Highway, 1996835119, Tehran, Iran.
| | - Roghayeh Esmaeili
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Opposite to Rajaee Heart Hospital, Vali-Asr Avenue, Cross of Vali-Asr and Hashemi Rafsanjani Highway, 1996835119, Tehran, Iran
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13
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Tian R, Trevenen M, Ford AH, Jayakody DMP, Hankey GJ, Yeap BB, Golledge J, Flicker L, Almeida OP. Hearing impairment and frailty in later life: The Health in Men Study (HIMS). Maturitas 2022; 156:30-36. [PMID: 35033231 DOI: 10.1016/j.maturitas.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/11/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine if hearing loss is associated with increased risk of frailty in later life. STUDY DESIGN Cross-sectional study of a community sample of 4,004 men aged 70 years and above living in the metropolitan region of Perth, Western Australia. Data were retrieved from the Health in Men Study (HIMS) and the Western Australian Data Linkage System (WADLS). Frailty was assessed using the FRAIL scale and the Frailty Index. Hearing loss was defined by self-report or by diagnosis recorded in the WADLS. We also collected demographic, lifestyle and social support information. MAIN OUTCOME MEASURES Frailty was assessed using the FRAIL scale and the Frailty Index. RESULTS The prevalence of frailty in the sample population was 16.1% and 25.4% when assessed using the FRAIL scale and the Frailty Index respectively. After adjusting for participant demographic, lifestyle and social factors, hearing loss was significantly associated with the prevalence of frailty when diagnosed by either measure (FRAIL scale: odds ratio [OR] 1.59, 95 CI% 1.32 to 1.91; Frailty Index: OR 1.76, 95 CI% 1.50 to 2.05). The proportion of men with hearing loss increased with increasing severity of frailty. CONCLUSION Hearing loss is associated with increased prevalence of frailty in older men when assessed using the FRAIL scale and the Frailty Index. Future longitudinal studies using objective measures of hearing will be helpful in determining if this association is likely to be causal.
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Affiliation(s)
- Rong Tian
- Medical School, University of Western Australia, Perth, Australia.
| | - Michelle Trevenen
- Medical School, University of Western Australia, Perth, Australia; School of Physics, Mathematics and Computing, University of Western Australia, Perth, Australia; WA Centre for Health and Ageing of the University of Western Australia, Perth, Australia
| | - Andrew H Ford
- Medical School, University of Western Australia, Perth, Australia; WA Centre for Health and Ageing of the University of Western Australia, Perth, Australia
| | - Dona M P Jayakody
- Medical School, University of Western Australia, Perth, Australia; Ear Science Institute Australia, Subiaco, Western Australia, Australia; Ear Sciences Centre, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - Graeme J Hankey
- Medical School, University of Western Australia, Perth, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia; Department of Vascular and Endovascular Surgery, The Townsville University Hospital, Townsville, Australia
| | - Leon Flicker
- Medical School, University of Western Australia, Perth, Australia; WA Centre for Health and Ageing of the University of Western Australia, Perth, Australia
| | - Osvaldo P Almeida
- Medical School, University of Western Australia, Perth, Australia; WA Centre for Health and Ageing of the University of Western Australia, Perth, Australia
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14
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Alqahtani BA, Alshehri MM, Elnaggar RK, Alsaad SM, Alsayer AA, Almadani N, Alhowimel A, Alqahtani M, Alenazi AM. Prevalence of Frailty in the Middle East: Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10010108. [PMID: 35052272 PMCID: PMC8775476 DOI: 10.3390/healthcare10010108] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/04/2023] Open
Abstract
(1) We aimed to systematically search available data on the prevalence of frailty among community-dwelling elders in Middle Eastern countries. The results from available studies are cumulated to provide comprehensive evidence for the prevalence of frailty. (2) Methods: A meta-analysis was done. A literature search was carried out using PRISMA guidelines in PubMed, Web of Science, and SCOPUS websites for studies up to 2020. Inclusion criteria entailed all primary studies conducted in Middle Eastern countries on frailty in community-dwelling older adults aged 60 years and older. (3) Results: A total of 10 studies were selected for this study. Random-effects meta-analysis of nine studies indicated there was a pooled prevalence rate of 0.3924 with a standard error of 0.037. This pooled prevalence point estimate of 0.3924 was statistically significant (p < 0.001). The Egger’s regression test and the trim-fill method for detecting publication bias did not detect any evidence of publication bias in the sample of included studies. The Egger’s regression test was not statistically significant. The trim-fill method indicated zero studies were missing on either side; (4) Conclusions: The study’s findings indicate that the prevalence of frailty is higher in Middle Eastern nations. Despite indications that many of these nations’ populations are rapidly ageing, we presently lack information on the incidence of frailty in these populations; this information is essential to health, policymakers, and social care planning.
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Affiliation(s)
- Bader A. Alqahtani
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (R.K.E.); (A.A.); (A.M.A.)
- Correspondence: ; Tel.: +966-580422762; Fax: +966-115882000
| | - Mohammed M. Alshehri
- Physical Therapy Department, Jazan University, Jazan 82412, Saudi Arabia;
- Medical Research Center, Jazan University, Jazan 45142, Saudi Arabia
| | - Ragab K. Elnaggar
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (R.K.E.); (A.A.); (A.M.A.)
- Department of Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Saad M. Alsaad
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ahmed A. Alsayer
- College of Science and Arts, Taibah University, Medina 42353, Saudi Arabia;
| | - Noura Almadani
- Community Health Nursing Department, Nursing College, Princess Nourah Bint Abdulrahman University, Riyadh 84428, Saudi Arabia;
| | - Ahmed Alhowimel
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (R.K.E.); (A.A.); (A.M.A.)
| | | | - Aqeel M. Alenazi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (R.K.E.); (A.A.); (A.M.A.)
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15
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Janakiram C, Ayoob A, Neelamana S. Impact of oral frailty on general frailty in geriatric population: A scoping review. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Slashcheva LD, Karjalahti E, Hassett LC, Smith B, Chamberlain AM. A systematic review and gap analysis of frailty and oral health characteristics in older adults: A call for clinical translation. Gerodontology 2021; 38:338-350. [PMID: 34331353 DOI: 10.1111/ger.12577] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/02/2021] [Accepted: 05/21/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This systematic review updates the evidence for association between oral health characteristics and frailty status, identifying gaps in translational dental research and application of frailty assessment into clinical practice. BACKGROUND Clinicians have little guidance on stage-appropriate dental treatment for medically complex older adults. Oral health characteristics have been associated with frailty status, determined through validated assessment tools representing a concise measure of health. Translation of frailty assessment into dental practice has not been the focus of previous reviews. METHODS Utilising the PRISMA framework for systematic reviews, a comprehensive database search identified articles describing the association of interest. Those included were cross-sectional or longitudinal, in English, included participants aged 50 years or older, used validated frailty assessments and measured clinically relevant oral health outcomes. From 835 screened articles, 26 full-text articles were eligible for quality appraisal and synthesis. RESULTS Frailty prevalence ranged from 8.5% to 66.0%. Most studies utilised the Fried frailty criteria. Qualitative synthesis of 17 cross-sectional and nine longitudinal studies demonstrated significant covariate-adjusted association between frailty status and number of teeth, chewing ability, prosthetic characteristics, dental caries, periodontitis, dental utilisation and oral health-related quality of life factors. Variability in findings reflected study sample diversity based on country of study origin, age at recruitment, sample size, frailty assessment type, use of clinical versus self-reported outcome measures and differences in statistical analysis. CONCLUSION Despite robust evidence of association with oral health characteristics, frailty assessment has yet to be sufficiently applied to translational dental research and clinical practice.
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Affiliation(s)
- Lyubov D Slashcheva
- Department of Dental Specialties, Mayo Clinic, Rochester, MN, USA.,Apple Tree Dental, Rochester, MN, USA
| | - Erika Karjalahti
- Roseman University College of Dental Medicine, Henderson, NV, USA
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17
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Tian R, Almeida OP, Jayakody DMP, Ford AH. Association between hearing loss and frailty: a systematic review and meta-analysis. BMC Geriatr 2021; 21:333. [PMID: 34034656 PMCID: PMC8147347 DOI: 10.1186/s12877-021-02274-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/10/2021] [Indexed: 12/21/2022] Open
Abstract
Background Frailty is associated with poor health outcomes in later life. Recent studies suggested that hearing loss may be a potentially modifiable risk factor associated with frailty. Methods This systematic review and meta-analysis aimed to investigate the association between hearing loss and frailty in observational studies of adults aged 50 years or over. We included observational studies with participants ≥ 50 years old that have clear descriptions of hearing and frailty measurement methods. Meta-analyses were conducted using measurement of risk and 95 % confidence interval of each individual study. Quality assessment, risk of bias, heterogeneity and sensitivity analyses were also conducted. Our study followed PRISMA guidelines. Results Our search identified 4508 manuscripts published in English between 1 and 2000 and 9 February 2021. Sixteen articles reported acceptable measurements of both hearing loss and frailty. Two papers were not suitable for meta-analysis. Twelve sets of cross-sectional data involving 12,313 participants, and three sets of longitudinal data involving 3042 participants were used in the meta-analysis. Hearing loss was associated with an 87 % increase in the risk of frailty among cross-sectional studies (risk ratio [RR] 1.87; 95 %CI 1.63–2.13) and 56 % among longitudinal studies (RR 1.56; 95 %CI 1.29–1.88). There was considerable heterogeneity among studies, but their quality rating, sample size or approach used to assess hearing loss did not change the results substantially. Conclusions The findings of this systematic review and meta-analysis of observational studies suggest that hearing loss increases the risk of frailty in later life. Whether this relationship is causal remains to be determined. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02274-y.
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Affiliation(s)
- Rong Tian
- Medical School, University of Western Australia, 35 Stirling Highway, Western Australia, 6009, Perth, Australia.
| | - Osvaldo P Almeida
- Medical School, University of Western Australia, 35 Stirling Highway, Western Australia, 6009, Perth, Australia.,WA Centre for Health & Ageing, University of Western Australia, Perth, Western Australia, Australia
| | - Dona M P Jayakody
- Medical School, University of Western Australia, 35 Stirling Highway, Western Australia, 6009, Perth, Australia.,Ear Science Institute Australia, Subiaco, Western Australia, Australia.,Ear Sciences Centre, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - Andrew H Ford
- Medical School, University of Western Australia, 35 Stirling Highway, Western Australia, 6009, Perth, Australia.,WA Centre for Health & Ageing, University of Western Australia, Perth, Western Australia, Australia
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18
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Uragami Y, Takikawa K, Kareki H, Kimura K, Yamamoto K, Iihara N. Effect of number of medications and use of potentially inappropriate medications on frailty among early-stage older outpatients. J Pharm Health Care Sci 2021; 7:15. [PMID: 33934718 PMCID: PMC8091752 DOI: 10.1186/s40780-021-00195-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background Frailty is an urgent concern among an aging population worldwide. However, the relationship between frailty and number and types of medications has not been studied in detail among early-stage older patients, and it is unclear what prescriptions may have a role in preventing frailty. This study aimed to clarify the effects of number of medications and use of potentially inappropriate medications (PIMs) on frailty among early-stage older outpatients in Japan. Methods A cross-sectional study was undertaken. Frailty scores and medications of outpatients aged 65–74 years who regularly visited community pharmacies were investigated. Frailty scores were classified as 0 (non-frailty), 1–2 (pre-frailty), and ≥ 3 (frailty). The association between frailty and number of medications was analyzed by age and compared between PIM use and non-use groups. The proportion of patients who used PIMs was also analyzed by frailty score. Results Of 923 older outpatients, 49 (5.3%) and 318 (34.5%) patients had frailty and pre-frailty scores, respectively. The numbers of medications among patients with pre-frailty and frailty were significantly higher than among those with non-frailty (p < 0.001 for both). A similar increase was shown for PIM use groups aged 69–71 and 72–74 years, but not for the PIM use group aged 65–68 years and all groups without PIM use. An increasing linear trend was observed for the relationship between the proportion of patients who used any PIM, as well as some subcategories of PIMs (such as NSAIDs, benzodiazepines, loop diuretics and antithrombotic drugs) and frailty score. Conclusions Unnecessary medication use among early-stage older outpatients, especially patients aged ≥69 years who use PIMs and many medications, seems to be associated with frailty, but further research is needed to confirm these findings. Supplementary Information The online version contains supplementary material available at 10.1186/s40780-021-00195-x.
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Affiliation(s)
- Yuya Uragami
- Star Pharmacy Co., Ltd, 4113-1 Onohara Onohara-cho, Kagawa, 769-1611, Kanonji City, Japan.
| | - Kazuhiro Takikawa
- Star Pharmacy Co., Ltd, 4113-1 Onohara Onohara-cho, Kagawa, 769-1611, Kanonji City, Japan
| | - Hajime Kareki
- Star Pharmacy Co., Ltd, 4113-1 Onohara Onohara-cho, Kagawa, 769-1611, Kanonji City, Japan
| | - Koji Kimura
- Star Pharmacy Co., Ltd, 4113-1 Onohara Onohara-cho, Kagawa, 769-1611, Kanonji City, Japan
| | - Kazuyuki Yamamoto
- Star Pharmacy Co., Ltd, 4113-1 Onohara Onohara-cho, Kagawa, 769-1611, Kanonji City, Japan
| | - Naomi Iihara
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, 1314-1 Shido, Sanuki City, Kagawa, 769-2193, Japan
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Xu R, Li Q, Guo F, Zhao M, Zhang L. Prevalence and risk factors of frailty among people in rural areas: a systematic review and meta-analysis. BMJ Open 2021; 11:e043494. [PMID: 33906838 PMCID: PMC8088244 DOI: 10.1136/bmjopen-2020-043494] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Older people in rural areas are possibly more frail due to the limited medical resources and lower socioeconomic status. Given the negative healthy outcomes caused by frailty, knowing the epidemiology of frailty in rural areas is of great importance. We tried to synthesise the existing evidences for the prevalence and risk factors of frailty in rural areas. DESIGN A systematic review and meta-analysis. DATA SOURCES PubMed, Embase, MEDLINE, Cochrane Library, Web of Science and Scopus were used to identify the articles from inception to 30 April 2019. ELIGIBILITY CRITERIA Observational studies providing cross-sectional data on the prevalence of frailty in rural elderly were extracted. DATA EXTRACTION AND SYNTHESIS Two independent investigators selected studies, extracted data and assessed the methodological quality of included studies. The pool prevalence of frailty was calculated by the random effects model and the OR and 95% CI were used to calculate the risk factors. RESULTS The literature search yielded 2219 articles, of which 23 met the study criteria and were included in this analysis. The pooled prevalence of frailty and pre-frailty were 18% (95% CI 15% to 21%, I2=98.5%, p<0.001) and 50% (95% CI 45% to 56%, I2=98.4%, p<0.001), respectively. The pooled frailty prevalence was 15% for the Fried Phenotype, 18% for the Frailty Index and 23% for other criteria. The pooled prevalence of frailty was 17% for males and 26% for females. The pooled prevalence of frailty was 17% in developing countries and 23% in developed countries. Age, cognitive impairment, depressive symptom, risk of malnutrition, activity of daily living (ADL) disability and poor self-perception of health were associated with frailty. There was no publication bias. CONCLUSIONS Frailty influences almost one in five older people in rural areas, and increasing age, cognitive impairment, depressive symptom, risk of malnutrition, ADL disability and poor self-perception of health were all risk factors for frailty. We should be cautious about the research results due to the heterogeneity between studies.
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Affiliation(s)
- Rui Xu
- School of Nursing and Health of Zhengzhou University, Zhengzhou, China
| | - Qiufang Li
- School of Nursing and Health of Zhengzhou University, Zhengzhou, China
| | - Feifei Guo
- School of Nursing and Health of Zhengzhou University, Zhengzhou, China
| | - Maoni Zhao
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Luyao Zhang
- School of Nursing and Health of Zhengzhou University, Zhengzhou, China
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20
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Liu X, Wang C, Qiao X, Si H, Jin Y. Sleep quality, depression and frailty among Chinese community-dwelling older adults. Geriatr Nurs 2021; 42:714-720. [PMID: 33836251 DOI: 10.1016/j.gerinurse.2021.02.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 01/22/2023]
Abstract
We aimed to explore the relationship between sleep quality and frailty, and depression as a mediator and its interaction with sleep quality on frailty. This was a cross-sectional study among 936 Chinese community-dwelling adults aged≥60 years. Sleep quality, frailty and depression were measured by the Pittsburgh Sleep Quality Index (PSQI), the Frailty Phenotype and the 5-item Geriatric Depression Scale (GDS-5), respectively. We found that depression mediated the association between poor sleep quality and physical frailty, attenuating the association between poor sleep and physical frailty by 51.9%. Older adults with both poor sleep quality and depression had higher risk of frailty than those with poor sleep quality or depression alone. These results implicate multidisciplinary care for frail older adults with poor sleep quality.
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Affiliation(s)
- Xinyi Liu
- School of Nursing, Shandong University, 250012 Jinan, China
| | - Cuili Wang
- School of Nursing, Peking University, 100191 Beijing, China.
| | - Xiaoxia Qiao
- School of Nursing, Peking University, 100191 Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, 100191 Beijing, China
| | - Yaru Jin
- School of Nursing, Peking University, 100191 Beijing, China
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21
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Bortone I, Sardone R, Lampignano L, Castellana F, Zupo R, Lozupone M, Moretti B, Giannelli G, Panza F. How gait influences frailty models and health-related outcomes in clinical-based and population-based studies: a systematic review. J Cachexia Sarcopenia Muscle 2021; 12:274-297. [PMID: 33590975 PMCID: PMC8061366 DOI: 10.1002/jcsm.12667] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/30/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022] Open
Abstract
Aging is often associated with a decline in physical function that eventually leads to loss of autonomy in activities of daily living (ADL). Walking is a very common ADL, important for main determinants of quality of life in older age, and it requires the integration of many physiological systems. Gait speed has been described as the 'sixth vital sign' because it is a core indicator of health and function in aging and disease. We reviewed original studies up to June 2020 that assessed frailty in both longitudinal and cross-sectional observational studies, paying particular attention to how gait is measured in older population and how the gait parameter adopted may influence the estimated frailty models and the health-related outcomes of the various studies (i.e. clinical, cognitive, physical, and nutritional outcomes). Eighty-five studies met the search strategy and were included in the present systematic review. According to the frailty tools, more than 60% of the studies used the physical phenotype model proposed by Fried and colleagues, while one-third referred to multi-domain indexes or models and only 5% referred to other single-domain frailty models (social or cognitive). The great heterogeneity observed in gait measurements and protocols limited the possibility to directly compare the results of the studies and it could represent an important issue causing variability in the different outcome measures in both clinical-and population-based settings. Gait appeared to be an indicator of health and function also in frail older adults, and different gait parameters appeared to predict adverse health-related outcomes in clinical, cognitive, and physical domains and, to a lesser extent, in nutritional domain. Gait has the potential to elucidate the common basic mechanisms of cognitive and motor decline. Advances in technology may extend the validity of gait in different clinical settings also in frail older adults, and technology-based assessment should be encouraged. Combining various gait parameters may enhance frailty prediction and classification of different frailty phenotypes.
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Affiliation(s)
- Ilaria Bortone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Rodolfo Sardone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Luisa Lampignano
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Fabio Castellana
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Roberta Zupo
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Madia Lozupone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Biagio Moretti
- Orthopaedics and Trauma Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Gianluigi Giannelli
- Scientific DirectionNational Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Francesco Panza
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
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22
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Aksüt M, Günay D, Özer T, Yerlikhan ÖA, Selçuk E, Kırali MK. In-Hospital and Long-Term outcomes after Open-Heart Surgery in Turkish Octogenarians: a Single-Center Study. Braz J Cardiovasc Surg 2021; 36:64-70. [PMID: 33594862 PMCID: PMC7918391 DOI: 10.21470/1678-9741-2020-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective We aimed to analyze the early and long-term results of open-heart surgery in Turkish patients aged 80 years or older who were operated on at our center. Methods All patients aged 80 years or older who underwent surgery between January 2000 and December 2013 at a high-level heart center were included in the study. The in-hospital data of study patients were obtained from the electronic database and from the hospital files. Survival data were analyzed as a long-term outcome. Results A total of 245 patients aged 80-93 years were evaluated in the study. The patients were followed up 5.4±3.7 years after open-heart surgery. In-hospital mortality rates were 10% in elective cases and 15.1% overall. Age ≥85 years, chronic kidney disease, chronic obstructive pulmonary disease, and emergency surgery were independent predictors of in-hospital mortality. The median survival time was found to be 4.4±0.3 years for all participants. The long-term survival of patients who underwent emergency cardiac surgery was significantly lower than that of elective patients (log-rank <0.001). Conclusion Octogenarians have satisfactory long-term outcomes after open-heart surgery when operated electively. On the other hand, patients operated under emergency conditions have worse in-hospital outcomes and long-term follow-up results.
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Affiliation(s)
- Mehmet Aksüt
- Cardiovascular Surgery Department, Kartal Kosuyolu Research and Education Hospital, Istanbul, Turkey
| | - Deniz Günay
- Cardiovascular Surgery Department, Kartal Kosuyolu Research and Education Hospital, Istanbul, Turkey
| | - Tanıl Özer
- Cardiovascular Surgery Department, Kartal Kosuyolu Research and Education Hospital, Istanbul, Turkey
| | - Özge Altaş Yerlikhan
- Cardiovascular Surgery Department, Kartal Kosuyolu Research and Education Hospital, Istanbul, Turkey
| | - Emre Selçuk
- Cardiovascular Surgery Department, Medical Faculty of Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Kaan Kırali
- Cardiovascular Surgery Department, Kartal Kosuyolu Research and Education Hospital, Istanbul, Turkey
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Düzgün G, Üstündağ S, Karadakovan A. Assessment of Frailty in the Elderly. Florence Nightingale Hemsire Derg 2021; 29:2-8. [PMID: 34263218 PMCID: PMC8137729 DOI: 10.5152/fnjn.2021.414736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 03/09/2020] [Indexed: 11/22/2022] Open
Abstract
AIM This study aimed to evaluate frailty in older individuals and to identify factors related to frailty. METHOD The descriptive, and cross-sectional study was conducted with 111 elderly patients who received inpatient treatment in a university hospital between January and September 2016. Ethics committee approval, institutional consent, and informed patient consent were obtained for the study. Along with the Edmonton Frail Scale, a data form was used to collect data about the patient's sociodemographics, disease status, and fall incidents. The data were collected through face-to-face interviews. RESULTS The prevalence of severe frailty was 19.8%. Significant relationships were found between frailty and advanced age, low education, low income, continuous use of medicines, and a history of falls within the last year. CONCLUSION Elderly individuals included in the study were categorized as "vulnerable" (Edmonton Frail Scale score of 6.84±3.83) and were at the borderline for "mild frailty" (Edmonton Frail Scale score of 7-8). The factors associated with frailty were advanced age, low education, and income level, continuous use of medicines, and the history of falls within the last year.
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Affiliation(s)
- Gönül Düzgün
- Department of First and Emergency Aid, İzmir Tınaztepe University Vocational School of Health Services, İzmir, Turkey
| | - Sema Üstündağ
- Department of Internal Medicine Nursing, Kutahya Health Sciences University Faculty of Health Sciences, Kütahya, Turkey
| | - Ayfer Karadakovan
- Department of Internal Medicine Nursing, Ege University Faculty of Nursing, İzmir, Turkey
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Rahman MM, Hamiduzzaman M, Akter MS, Farhana Z, Hossain MK, Hasan MN, Islam MN. Frailty indexed classification of Bangladeshi older adults' physio-psychosocial health and associated risk factors- a cross-sectional survey study. BMC Geriatr 2021; 21:3. [PMID: 33402094 PMCID: PMC7786917 DOI: 10.1186/s12877-020-01970-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 12/16/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Frailty is associated with healthy ageing, and it has been identified as a means of measuring older adults' physio-psychosocial health. We know about the ageing trends and common diseases of older adults living in South Asia, but literature to date does not widely feature their health status based on frailty, especially in Bangladesh. This study aims to understand the prevalence of frailty in Bangladeshi older adults; classify their health status; and investigate associated risk factors. METHODS A cross-sectional study was conducted in the north-eastern region (i.e. Sylhet City Corporation) of Bangladesh. Four hundred participants aged 55 years and above were randomly selected, attended a health assessment session and completed a multi-indicator survey questionnaire. We developed a 30-indicator Frailty Index (FI30) to assess the participant's health status and categorized: good health (no-frailty/Fit); slightly poor health (mild frailty); poor health (moderate frailty); and very poor health (severe frailty). Pearson chi-square test and binary logistic regression analysis were conducted. RESULTS The participants' mean age was 63.6 years, and 61.6% of them were assessed in poor to very poor health (moderate frailty/36.3% - severe frailty/25.3%). The eldest, female and participants from lower family income were found more frailty than their counterparts. Participants aged 70 years and above were more likely (adjusted OR: 4.23, 95% CI: 2.26-7.92, p < 0.0001) to experience frailty (medical conditions) than the pre-elderly age group (55-59 years). Female participants were more vulnerable (adjusted OR = 1.487, 95% CI: 0.84-2.64, p < 0.0174) to frailty (medical conditions) than male. Also, older adults who had higher family income (Income>$473.3) found a lower risk (adjusted OR: 0.294, 95% CI: 0.11-0.76, p < 0.011) of frailty (poor health). CONCLUSION Our study results confirm the prevalence of frailty-related disorders in Bangladeshi older adults and highlight the importance of targeted clinical and community-led preventive care programs.
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Affiliation(s)
- Mohammad Meshbahur Rahman
- Biomedical Research Foundation, Dhaka, 1230, Bangladesh.
- Basic Science Division, World University of Bangladesh, Dhaka, 1230, Bangladesh.
| | - Mohammad Hamiduzzaman
- Flinders University Rural Health SA, College of Medicine & Public Health, Flinders University, Bedford, South Australia, Australia
| | | | - Zaki Farhana
- Bangladesh Bank-The Central Bank of Bangladesh, Dhaka, 1215, Bangladesh
| | - Mohammad Kamal Hossain
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Md Nazrul Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
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Mohd Suffian NI, Adznam SN‘A, Abu Saad H, Chan YM, Ibrahim Z, Omar N, Murat MF. Frailty Intervention through Nutrition Education and Exercise (FINE). A Health Promotion Intervention to Prevent Frailty and Improve Frailty Status among Pre-Frail Elderly-A Study Protocol of a Cluster Randomized Controlled Trial. Nutrients 2020; 12:E2758. [PMID: 32927741 PMCID: PMC7551317 DOI: 10.3390/nu12092758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 12/04/2022] Open
Abstract
The ageing process has been associated with various geriatric issues including frailty. Without early prevention, frailty may cause multiple adverse outcomes. However, it potentially may be reversed with appropriate interventions. The aim of the study is to assess the effectiveness of nutritional education and exercise intervention to prevent frailty among the elderly. A 3-month, single-blind, two-armed, cluster randomized controlled trial of the frailty intervention program among Malaysian pre-frail elderly will be conducted. A minimum of total 60 eligible respondents from 8 clusters (flats) of Program Perumahan Rakyat (PPR) flats will be recruited and randomized to the intervention and control arm. The intervention group will receive a nutritional education and a low to moderate multi-component exercise program. To date, this is the first intervention study that specifically targets both the degree of frailty and an improvement in the outcomes of frailty using both nutritional education and exercise interventions among Malaysian pre-frail elderly. If the study is shown to be effective, there are major potential benefits to older population in terms of preventing transition to frailty. The findings from this trial will potentially provide valuable evidence and serve as a model for similar future interventions designed for elderly Malaysians in the community.
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Affiliation(s)
- Nurul Izzati Mohd Suffian
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
| | - Siti Nur ‘Asyura Adznam
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
- Malaysian Research Institute of Ageing, (My Ageing) Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Hazizi Abu Saad
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
- Sports Academy, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
- Malaysian Research Institute of Ageing, (My Ageing) Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Zuriati Ibrahim
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
| | - Noraida Omar
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
- Malaysian Research Institute of Ageing, (My Ageing) Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Muhammad Faizal Murat
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
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Tan BKJ, Man REK, Gan ATL, Fenwick EK, Varadaraj V, Swenor BK, Gupta P, Wong TY, Trevisan C, Lorenzo-López L, Millán-Calenti JC, Schwanke CHA, Liljas A, Al Snih S, Tokuda Y, Lamoureux EL. Is Sensory Loss an Understudied Risk Factor for Frailty? A Systematic Review and Meta-analysis. J Gerontol A Biol Sci Med Sci 2020; 75:2461-2470. [DOI: 10.1093/gerona/glaa171] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Indexed: 12/26/2022] Open
Abstract
AbstractBackgroundAge-related sensory loss and frailty are common conditions among older adults, but epidemiologic research on their possible links has been inconclusive. Clarifying this relationship is important because sensory loss may be a clinically relevant risk factor for frailty.MethodsIn this systematic review and meta-analysis, we searched 3 databases for observational studies investigating 4 sensory impairments—vision (VI), hearing (HI), smell (SI), and taste (TI)—and their relationships with frailty. We meta-analyzed the cross-sectional associations of VI/HI each with pre-frailty and frailty, investigated sources of heterogeneity using meta-regression and subgroup analyses, and assessed publication bias using Egger’s test.ResultsWe included 17 cross-sectional and 7 longitudinal studies in our review (N = 34,085) from 766 records. Our cross-sectional meta-analyses found that HI and VI were, respectively, associated with 1.5- to 2-fold greater odds of pre-frailty and 2.5- to 3-fold greater odds of frailty. Our results remained largely unchanged after subgroup analyses and meta-regression, though the association between HI and pre-frailty was no longer significant in 2 subgroups which lacked sufficient studies. We did not detect publication bias. Longitudinal studies largely found positive associations between VI/HI and frailty progression from baseline robustness, though they were inconclusive about frailty progression from baseline pre-frailty. Sparse literature and heterogenous methods precluded meta-analyses and conclusions on the SI/TI–frailty relationships.ConclusionsOur meta-analyses demonstrate significant cross-sectional associations between VI/HI with pre-frailty and frailty. Our review also highlights knowledge gaps on the directionality and modifiability of these relationships and the impact of SI/TI and multiple sensory impairments on frailty.
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Affiliation(s)
- Benjamin Kye Jyn Tan
- Yong Loo Lin School of Medicine (YLLSoM), National University of Singapore (NUS)
| | - Ryan Eyn Kidd Man
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre (SNEC)
- Duke-NUS Medical School, Singapore
| | | | - Eva K Fenwick
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre (SNEC)
- Duke-NUS Medical School, Singapore
| | - Varshini Varadaraj
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Bonnielin K Swenor
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Preeti Gupta
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre (SNEC)
| | - Tien Yin Wong
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre (SNEC)
- Duke-NUS Medical School, Singapore
| | - Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy
| | - Laura Lorenzo-López
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - José Carlos Millán-Calenti
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Carla Helena Augustin Schwanke
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Ann Liljas
- Department of Public Health Science, Karolinska Institute, Sweden
| | - Soham Al Snih
- Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston
- Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston
| | - Yasuharu Tokuda
- Muribushi Okinawa Center for Teaching Hospitals, Urasoe City, Japan
| | - Ecosse Luc Lamoureux
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre (SNEC)
- Duke-NUS Medical School, Singapore
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Maştaleru A, Ilie AC, Stefaniu R, Leon-Constantin MM, Sandu IA, Pislaru AI, Abdulan IM, Alexa ID. Evaluation of frailty and its impact on geriatric assessment. Psychogeriatrics 2020; 20:321-326. [PMID: 31957166 DOI: 10.1111/psyg.12506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/01/2019] [Accepted: 12/09/2019] [Indexed: 01/14/2023]
Abstract
AIM Frailty has become an increasingly important topic, being directly correlated with ageing, presence of comorbidities, and also with other factors. It is a state of high vulnerability and is a consequence of ageing-related decline in whole body functioning. In order to initiate preventive and therapeutic measures, we need to identify the characteristics of current frail older adults. To identify the characteristics of frailty depending on age, area of residence and to assess the relationship between frailty and disability, cognitive impairment, malnutrition, depression and comorbidities. METHODS Included in the study were 663 consecutively admitted patients over the age of 65. Frailty was evaluated using the Fried criteria and a comprehensive geriatric assessment. The mean age of the subjects enrolled in this study was 76.58 ± 6.5 years, most of the patients residing in rural areas (62.4%). RESULTS A diagnosis of frailty was made in 73% of the study patients. The presence of frailty was found to be negatively correlated, statistically significant with cognitive function assessed by Mini-Mental State Examination (P = 0.039, r = -0.094) and malnutrition assessed by Mini Nutritional Assessment (P = 0.001, r = -0.151). Also, the presence of frailty was positively correlated, statistically significant with depression evaluated by Geriatric Depression Scale (P = 0.046, r = 0.093). CONCLUSIONS Frailty is a common condition in the surveyed elderly population. It is associated with the presence of other geriatric syndromes such as malnutrition, cognitive impairment, depression, and is influenced by age.
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Affiliation(s)
- Alexandra Maştaleru
- Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Adina Carmen Ilie
- Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Ramona Stefaniu
- Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | | | - Ioana Alexandra Sandu
- Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Anca Iuliana Pislaru
- Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Irina Mihaela Abdulan
- Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Ioana Dana Alexa
- Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, Iaşi, Romania
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Vetrano DL, Palmer K, Marengoni A, Marzetti E, Lattanzio F, Roller-Wirnsberger R, Lopez Samaniego L, Rodríguez-Mañas L, Bernabei R, Onder G. Frailty and Multimorbidity: A Systematic Review and Meta-analysis. J Gerontol A Biol Sci Med Sci 2020; 74:659-666. [PMID: 29726918 DOI: 10.1093/gerona/gly110] [Citation(s) in RCA: 320] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/30/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Multimorbidity and frailty are complex syndromes characteristics of aging. We reviewed the literature and provided pooled estimations of any evidence regarding (a) the coexistence of frailty and multimorbidity and (b) their association. METHODS We searched PubMed and Web of Science for relevant articles up to September 2017. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Homogeneity (I2), risk of bias, and publication bias were assessed. PROSPERO registration: 57890. RESULTS A total of 48 studies involving 78,122 participants were selected, and 25 studies were included in one or more meta-analyses. Forty-five studies were cross-sectional and 3 longitudinal, with the majority of them including community-dwelling participants (n = 35). Forty-three studies presented a moderate risk of bias and five a low risk. Most of the articles defined multimorbidity as having two or more diseases and frailty according to the Cardiovascular Health Study criteria. In meta-analyses, the prevalence of multimorbidity in frail individual was 72% (95% confidence interval = 63%-81%; I2 = 91.3%), and the prevalence of frailty among multimorbid individuals was 16% (95% confidence interval = 12%-21%; I2 = 96.5%). Multimorbidity was associated with frailty in pooled analyses (odds ratio = 2.27; 95% confidence interval = 1.97-2.62; I2 = 47.7%). The three longitudinal studies suggest a bidirectional association between multimorbidity and frailty. CONCLUSIONS Frailty and multimorbidity are two related conditions in older adults. Most frail individuals are also multimorbid, but fewer multimorbid ones also present frailty. Our findings are not conclusive regarding the causal association between the two conditions. Further longitudinal and well-designed studies may help to untangle the relationship between frailty and multimorbidity.
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Affiliation(s)
- Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden.,Department of Geriatrics, Catholic University of Rome, Italy
| | | | | | | | - Fabrizia Lattanzio
- Scientific Direction, Italian National Research Centre on Aging, Ancona, Italy
| | | | - Luz Lopez Samaniego
- Andalusian Public Foundation of Progress and Health, Regional Ministry of Health of Andalusia, Spain
| | | | | | - Graziano Onder
- Department of Geriatrics, Catholic University of Rome, Italy
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Nguyen AT, Nguyen LH, Nguyen TX, Nguyen TTH, Nguyen HTT, Nguyen TN, Pham HQ, Tran BX, Latkin CA, Ho CSH, Ho RCM, Pham T, Vu HTT. Frailty Prevalence and Association with Health-Related Quality of Life Impairment among Rural Community-Dwelling Older Adults in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203869. [PMID: 31614836 PMCID: PMC6843267 DOI: 10.3390/ijerph16203869] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 12/23/2022]
Abstract
Measuring health-related quality of life (HRQOL) is critical to evaluate the burden of frailty in the older population.This study explored the prevalence of frailty among Vietnamese older people in rural communities, determined the factors associated with frailty, and examined the differences in HRQOL between non-frail, pre-frail, and frail people. A cross-sectional study was conducted on older adults (≥60 years old) residing in Soc Son district, northern Vietnam. Non-frailty, pre-frailty, and frailty conditions were evaluated using Fried’s frailty criteria. The EuroQol-5 Dimensions-5 Levels(EQ-5D-5L) instrument was employed to measure HRQOL. Socioeconomic, behavioral, health status, and healthcare utilization characteristics were collected as covariates. Among 523 older adults, 65.6% were pre-frail, and 21.7% were frail. The mean EQ-5D-5L indexes of the non-frailty, pre-frailty, and frailty groups were 0.70 (SD = 0.18), 0.70 (SD = 0.19), and 0.58 (SD = 0.20), respectively. The differences were found between non-frailty and frailty groups (p < 0.01), as well as the pre-frailty and frailty groups (p<0.01). After adjusting for covariates, the estimated mean difference in the HRQOL between the non-frailty and frailty groups was −0.10 (95%CI= −0.17; −0.02) (R2 = 45.2%), showing a 10% reduction of the maximum EQ-5D-5L index.This study emphasized the high prevalence of frailty among older adults in the rural communities of Vietnam. Frailty was found to be associated with a small reduction of HRQOL in this population.
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Affiliation(s)
- Anh Trung Nguyen
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam; (T.X.N.); (T.T.H.N.); (H.T.T.N.); (T.N.N.); (T.P.); (H.T.T.V.)
- Department of Gerontology, Hanoi Medical University, Hanoi 100000, Vietnam
- Correspondence: ; Tel.: +84-(0)-903480774
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (L.H.N.); (R.C.M.H.)
| | - Thanh Xuan Nguyen
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam; (T.X.N.); (T.T.H.N.); (H.T.T.N.); (T.N.N.); (T.P.); (H.T.T.V.)
- Department of Gerontology, Hanoi Medical University, Hanoi 100000, Vietnam
- Dinh Tien Hoang Institute of Medicine, Hanoi 100000, Vietnam
| | - Thu Thi Hoai Nguyen
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam; (T.X.N.); (T.T.H.N.); (H.T.T.N.); (T.N.N.); (T.P.); (H.T.T.V.)
- Department of Gerontology, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Huong Thi Thu Nguyen
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam; (T.X.N.); (T.T.H.N.); (H.T.T.N.); (T.N.N.); (T.P.); (H.T.T.V.)
- Department of Gerontology, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Tam Ngoc Nguyen
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam; (T.X.N.); (T.T.H.N.); (H.T.T.N.); (T.N.N.); (T.P.); (H.T.T.V.)
- Department of Gerontology, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam;
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Roger C. M. Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (L.H.N.); (R.C.M.H.)
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Thang Pham
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam; (T.X.N.); (T.T.H.N.); (H.T.T.N.); (T.N.N.); (T.P.); (H.T.T.V.)
- Department of Gerontology, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Huyen Thi Thanh Vu
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam; (T.X.N.); (T.T.H.N.); (H.T.T.N.); (T.N.N.); (T.P.); (H.T.T.V.)
- Department of Gerontology, Hanoi Medical University, Hanoi 100000, Vietnam
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Siriwardhana DD, Weerasinghe MC, Rait G, Falcaro M, Scholes S, Walters KR. Prevalence of frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka: a population-based cross-sectional study. BMJ Open 2019; 9:e026314. [PMID: 30782757 PMCID: PMC6352797 DOI: 10.1136/bmjopen-2018-026314] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Our main objective was to describe the prevalence and associated sociodemographic factors of frailty and pre-frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka. DESIGN Community-based cross-sectional study. SETTING The study was conducted in rural areas of Kegalle district in Sri Lanka. PARTICIPANTS A total of 746 community-dwelling older adults aged ≥60 years were included in the study. RESULTS The prevalence of frailty and pre-frailty in rural Kegalle district was 15.2% (95% CI 12.3% to 18.6%) and 48.5% (95% CI 43.8% to 53.2%), respectively. We found a strong association between age and both frailty and pre-frailty. There were strong associations between longest-held occupation and frailty and education level and pre-frailty. CONCLUSIONS The prevalence of frailty in this rural Sri Lankan older population was high compared with high-income and upper middle-income countries. The profile of health and social care services in Sri Lanka needs to address frailty and its consequences.
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Affiliation(s)
- Dhammika Deepani Siriwardhana
- Research Department of Primary Care and Population Health, University College London, London, UK
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | | | - Greta Rait
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Milena Falcaro
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Kate R Walters
- Research Department of Primary Care and Population Health, University College London, London, UK
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Atakul E, Akyar İ. Frailty Prevalence and Characteristics in Older Adults with Hematologic Cancer: a Descriptive Study. Asia Pac J Oncol Nurs 2019; 6:43-49. [PMID: 30599015 PMCID: PMC6287383 DOI: 10.4103/apjon.apjon_35_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective: This study investigated the prevalence of frailty in older patients with hematologic cancer and assessed the association between older patients’ characteristics and frailty. Methods: This descriptive study enrolled 90 older patients undergoing treatment for hematological malignancies at an oncology hospital. Frailty was assessed with the Edmonton Frailty Scale as not frail (0–4), apparently vulnerable (5–6), mildly frail (7–8), moderately frail (9–10), and severely frail (11–17). The association of frailty and older patient characteristics and diagnosis was assessed by logistic regression. Results: The prevalence of frailty (mild, moderately, and severely) was 42.2%, and “apparently vulnerable” frailty was 60%. The mean scale score was 5.59 ± 3.13. Frailty was more prevalent in patients who were ≥75 years of age, had ≥4 children, were diagnosed with leukemia, and were diagnosed for ≥2 years. Gender, diagnosis, and employment were factors associated with the presence of frailty. Female gender and lack of employment were factors associated with a high risk of frailty. A diagnosis of multiple myeloma was associated with a low risk of frailty. Conclusions: The prevalence of frailty was high in older patients. Female and unemployed patients were at high risk for frailty. Frailty characteristics of older patients with hematologic cancer highlighted the need for comprehensive geriatric assessment and frailty screening, provided prevalence and characteristics of frailty in this group of patients during treatment, and highlighted the need for holistic care approach.
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Affiliation(s)
- Esra Atakul
- Bone Marrow Transplantation Unit, Dr. Abdurrahman Yurtaslan Oncology Education and Training Hospital, Health Sciences University, Demetevler, Ankara, Turkey
| | - İmatullah Akyar
- Medical Nursing Department, Faculty of Nursing, Hacettepe University, Samanpazari, Ankara, Turkey
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Binotto MA, Lenardt MH, Rodríguez-Martínez MDC. Physical frailty and gait speed in community elderly: a systematic review. Rev Esc Enferm USP 2018; 52:e03392. [PMID: 30570081 DOI: 10.1590/s1980-220x2017028703392] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 06/04/2018] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To identify the outcomes of studies on gait speed and its use as a marker of physical frailty in community elderly. METHOD Systematic review of the literature performed in the following databases: LILACS, SciELO, MEDLINE/PubMed, ScienceDirect, Scopus and ProQuest. The studies were evaluated by STROBE statement, and the PRISMA recommendations were adopted. RESULTS There were 6,303 studies, and 49 of them met the inclusion criteria. Of the total number of studies, 91.8% described the way of measuring gait speed. Of these, 28.6% used the distance of 4.6 meters, and 34.7% adopted values below 20% as cutoff points for reduced gait speed, procedures in accordance with the frailty phenotype. Regarding the outcomes, in 30.6% of studies, there was an association between gait speed and variables of disability, frailty, sedentary lifestyle, falls, muscular weakness, diseases, body fat, cognitive impairment, mortality, stress, lower life satisfaction, lower quality of life, napping duration, and poor performance in quantitative parameters of gait in community elderly. CONCLUSION The results reinforce the association between gait speed, physical frailty and health indicator variables in community elderly.
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Affiliation(s)
- Maria Angélica Binotto
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brasil.,Universidade Estadual do Centro-Oeste, Departamento de Educação Física, Guarapuava, PR, Brasil
| | - Maria Helena Lenardt
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brasil
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Palmer K, Villani ER, Vetrano DL, Cherubini A, Cruz-Jentoft AJ, Curtin D, Denkinger M, Gutiérrez-Valencia M, Guðmundsson A, Knol W, Mak DV, O'Mahony D, Pazan F, Petrovic M, Rajkumar C, Topinkova E, Trevisan C, van der Cammen TJM, van Marum RJ, Wehling M, Ziere G, Bernabei R, Onder G. Association of polypharmacy and hyperpolypharmacy with frailty states: a systematic review and meta-analysis. Eur Geriatr Med 2018; 10:9-36. [PMID: 32720270 DOI: 10.1007/s41999-018-0124-5] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/24/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate: (1) the cross-sectional association between polypharmacy, hyperpolypharmacy and presence of prefrailty or frailty; (2) the risk of incident prefrailty or frailty in persons with polypharmacy, and vice versa. METHODS A systematic review and meta-analysis was performed according to PRISMA guidelines. We searched PubMed, Web of Science, and Embase from 01/01/1998 to 5/2/2018. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Homogeneity was assessed with the I2 statistic and publication bias with Egger's and Begg's tests. RESULTS Thirty-seven studies were included. The pooled proportion of polypharmacy in persons with prefrailty and frailty was 47% (95% CI 33-61) and 59% (95% CI 42-76), respectively. Increased odds ratio of polypharmacy were seen for prefrail (pooled OR = 1.52; 95% CI 1.32-1.79) and frail persons (pooled OR = 2.62, 95% CI 1.81-3.79). Hyperpolypharmacy was also increased in prefrail (OR = 1.95; 95% CI 1.41-2.70) and frail (OR = 6.57; 95% CI 9.57-10.48) persons compared to robust persons. Only seven longitudinal studies reported data on the risk of either incident prefrailty or frailty in persons with baseline polypharmacy. A significant higher odds of developing prefrailty was found in robust persons with polypharmacy (pooled OR = 1.30; 95% CI 1.12-1.51). We found no papers investigating polypharmacy incidence in persons with prefrailty/frailty. CONCLUSIONS Polypharmacy is common in prefrail and frail persons, and these individuals are also more likely to be on extreme drug regimens, i.e. hyperpolypharmacy, than robust older persons. More research is needed to investigate the causal relationship between polypharmacy and frailty syndromes, thereby identifying ways to jointly reduce drug burden and prefrailty/frailty in these individuals. PROSPERO REGISTRATION NUMBER CRD42018104756.
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Affiliation(s)
- Katie Palmer
- Fondazione Ospedale San Camillo IRCCS, Via Alberoni 70, 30126, Venezia, Italia.
| | - Emanuele R Villani
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide L Vetrano
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.,Aging Research Center, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | | | - Denis Curtin
- Department of Medicine, Department of Geriatric Medicine, University College Cork, Cork University Hospital, Cork, Ireland
| | - Michael Denkinger
- Agaplesion Bethesda Clinic Ulm, Geriatric Center Ulm/Alb-Donau and Geriatric Research Unit, Ulm University, Ulm, Germany
| | - Marta Gutiérrez-Valencia
- Department of Pharmacy, Navarrabiomed, Universidad Pública de Navarra (UPNA), Complejo Hospitalario de Navarra (CHN), IdiSNA, Pamplona, Navarra, Spain
| | - Adalsteinn Guðmundsson
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Department of Geriatrics, Landspitali University Hospital, Reykjavík, Iceland
| | - Wilma Knol
- Department of Geriatric Medicine, Expertise Centre Pharmacotherapy in Old Persons, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Diane V Mak
- Department of Geriatric Medicine, Expertise Centre Pharmacotherapy in Old Persons, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Denis O'Mahony
- Department of Medicine, Department of Geriatric Medicine, University College Cork, Cork University Hospital, Cork, Ireland
| | - Farhad Pazan
- Institute for Clinical Pharmacology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Mirko Petrovic
- Department of Internal Medicine, Section of Geriatrics, Ghent University, Ghent, Belgium
| | - Chakravarthi Rajkumar
- Department of Medicine, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University, General Faculty Hospital, Prague, Czech Republic
| | - Catarina Trevisan
- Department of Medicine, Geriatrics Division, University of Padova, Padua, Italy
| | - Tischa J M van der Cammen
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands.,Department of Internal Medicine, Division of Geriatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, East Sussex, UK
| | - Rob J van Marum
- Department of General Practice and Old Age Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Geriatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Martin Wehling
- Medical Faculty Mannheim, Clinical Pharmacology, University of Heidelberg, Heidelberg, Germany
| | - Gijsbertus Ziere
- Department of Internal Medicine, Division of Geriatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Roberto Bernabei
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Graziano Onder
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
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Rossetti ES, Terassi M, Ottaviani AC, Santos-Orlandi AAD, Pavarini SCI, Zazzetta MS. FRAGILIDADE, SINTOMAS DEPRESSIVOS E SOBRECARGA DE IDOSOS CUIDADORES EM CONTEXTO DE ALTA VULNERABILIDADE SOCIAL. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-07072018003590016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: analisar a relação entre fragilidade, sintomas depressivos e sobrecarga de idosos cuidadores em contexto de alta vulnerabilidade social. Método: estudo correlacional, de corte transversal, com abordagem quantitativa, realizado com 73 idosos cuidadores primários de outros idosos cadastrados em Unidades de Saúde da Família inseridas em contextos de alta vulnerabilidade social de um município do interior paulista (Brasil). Os dados foram coletados por meio de entrevista individual, utilizando-se um questionário para caracterização sociodemográfica, o Inventário de Sobrecarga de Zarit, a Escala de Depressão Geriátrica e avaliação da Fragilidade, segundo o Fenótipo de Fried. Resultados: a maioria dos cuidadores idosos estava inserida na faixa etária de 60 a 69 anos, era do sexo feminino e apresentava de um a quatro anos de escolaridade. Em relação à fragilidade, 37% eram frágeis, 54,8% pré-frágeis e 8,2% não frágeis. Os cuidadores idosos apresentaram, em sua maioria, pequena sobrecarga (68,5%) e ausência de indícios de sintomas depressivos (67,1%). Houve correlação positiva e de moderada magnitude (r=0,460, p=0,000) entre fragilidade e sintomas depressivos, ou seja, à medida que os níveis de fragilidade aumentam, os sintomas depressivos se tornam mais prevalentes. Conclusão: houve correlação entre fragilidade e sintomas depressivos. Diante disso, faz-se necessária a abordagem dos profissionais de saúde no sentido de identificar precocemente a fragilidade e os sintomas depressivos de cuidadores idosos a fim de evitar intervenções tardias. Atenção especial deve ser dada aos cuidadores inseridos em contextos de alta vulnerabilidade social.
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Gok Metin Z, Karadas C, Balci C, Cankurtaran M. The Perceived Caregiver Burden Among Turkish Family Caregivers Providing Care for Frail Older Adults. J Transcult Nurs 2018; 30:222-230. [DOI: 10.1177/1043659618790041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Purpose: The older population has reached to 8.5%, and the prevalence of frailty is reported as 39.2% in Turkey. The purpose of the study was to assess caregiver burden in families who care for frail older adults in Turkish culture. Method: This descriptive study was conducted in Turkey between June and October 2017. Frail older adults who had no severe cognitive impairment were included. Data were measured using the Older Adult Information Form, Edmonton Frailty Scale, Caregiver Information Form, and Zarit Burden Interview. Results: In total, 131 older person/caregiver dyads were analyzed; the Zarit Burden Interview mean score was 37.59 ± 18.20. Caregivers with less education and providing care more than 8 hours experienced a higher burden ( p < .05). The severity of frailty significantly correlated with the caregiver scores ( R = .36, p < .01). Conclusion: The caregiver burden in Turkish family caregivers was found mild to moderate and correlated with the degree of frailty. Policymakers should focus on culture-specific formal caregiver services.
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36
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Marengoni A, Vetrano DL, Manes-Gravina E, Bernabei R, Onder G, Palmer K. The Relationship Between COPD and Frailty: A Systematic Review and Meta-Analysis of Observational Studies. Chest 2018; 154:21-40. [PMID: 29477493 DOI: 10.1016/j.chest.2018.02.014] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Frailty is common in seniors and is characterized by diminished physiological reserves and increased vulnerability to stressors. Frailty can change the prognosis and treatment approach of several chronic diseases, including COPD. The association between frailty and COPD has never been systematically reviewed. OBJECTIVES The goal of this study was to conduct a systematic review and meta-analysis assessing the association of COPD with frailty and pre-frailty. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used when reporting this review. We searched PubMed, Web of Science, and Embase from January 1, 2002, to October 6, 2017. The quality of the studies was evaluated by using the Newcastle Ottawa Scale. Two assessors independently rated each study: scores > 7 were considered a low risk of bias; 5 to 7, a moderate risk of bias; and < 5, a high risk of bias. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Homogeneity (I2) and publication bias were assessed. RESULTS A total of 27 studies were selected: 23 cross-sectional, three longitudinal, and one both. The pooled prevalence of pre-frailty in individuals with COPD was 56% (95% CI, 52-60; I2 = 80.8%); it was 19% (95% CI, 14-24; I2 = 94.4%) for frailty. Patients with COPD had a two-fold increased odds of frailty (pooled OR, 1.97 [95% CI, 1.53-2.53]; I2 = 0.0%). Three longitudinal studies, presenting heterogeneous aims and methods, suggested a bidirectional association between COPD and frailty. CONCLUSIONS Frailty and pre-frailty are common in individuals with COPD. Older subjects with COPD have a two-fold increased odds of frailty. These results may have clinical implications, as they identify the need to assess frailty in individuals with COPD and to further investigate any potential negative effects associated with the co-occurrence of these conditions. Longitudinal research that examines temporal associations between COPD and frailty are needed to further clarify this relationship and to assess if treatment of COPD may prevent the onset of frailty. TRIAL REGISTRY PROSPERO registration No.: 58302; URL: https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Davide L Vetrano
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Ester Manes-Gravina
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberto Bernabei
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Graziano Onder
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
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Matsushita E, Okada K, Ito Y, Satake S, Shiraishi N, Hirose T, Kuzuya M. Characteristics of physical prefrailty among Japanese healthy older adults. Geriatr Gerontol Int 2016; 17:1568-1574. [DOI: 10.1111/ggi.12935] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 07/24/2016] [Accepted: 09/20/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Eiji Matsushita
- School of Nutritional Sciences; Nagoya University of Arts and Sciences; Nisshin Japan
- Department of Community Healthcare and Geriatrics; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Kiwako Okada
- School of Nutritional Sciences; Nagoya University of Arts and Sciences; Nisshin Japan
| | - Yui Ito
- School of Nutritional Sciences; Nagoya University of Arts and Sciences; Nisshin Japan
| | - Shosuke Satake
- Section of Frailty Prevention, Department of Frailty Research, Center for Gerontology and Social Science; National Center for Geriatrics and Gerontology; Obu Japan
| | - Nariaki Shiraishi
- Department of Rehabilitation, Faculty of Health Science; Nihon Fukushi University; Handa Japan
| | - Takahisa Hirose
- Department of Comprehensive Community Medical Cooperation Center; Nagoya University Hospital; Nagoya Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics; Nagoya University Graduate School of Medicine; Nagoya Japan
- Institution for Future Society, NAGOYA COI STREAM; Nagoya University; Nagoya Japan
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García-Esquinas E, Pérez-Hernández B, Guallar-Castillón P, Banegas JR, Ayuso-Mateos JL, Rodríguez-Artalejo F. Housing conditions and limitations in physical function among older adults. J Epidemiol Community Health 2016; 70:954-60. [PMID: 27225681 DOI: 10.1136/jech-2016-207183] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/15/2016] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Housing conditions are an important social determinant of health. However, to the best of our knowledge, no previous study has systematically assessed the association between housing conditions and physical function limitations in older adults; moreover, whether this association is independent of the socioeconomic status achieved earlier in life is still uncertain. METHODS Cross-sectional analysis conducted among 2012 non-institutionalised individuals aged ≥60 years, who participated in the Seniors-ENRICA cohort. Participants reported the following poor housing conditions: living in a walk-up building, lacking heating, or feeling cold frequently. We assessed lower extremity performance with the Short Physical Performance Battery (SPPB), mobility or agility limitations with standardised questions, frailty according to the Fried criteria, and disability in instrumental activities of daily living (IADL) with the Lawton and Brody questionnaire. RESULTS In analyses adjusting for demographic, behavioural and comorbidity variables, when compared with those living in homes without poor housing conditions, those with ≥2 poor conditions showed worse scores in the SPPB (β -1.06; 95% CI -1.46 to -0.65) and a higher frequency of agility limitation (OR 1.62; 95% CI 1.00 to 2.61) and frailty (OR 8.78; 95% CI 3.00 to 25.60). These associations held after adjustment for educational and occupational levels. Living in a walk-up building was associated with a higher frequency of frailty, while lacking heating was linked to lower scores in the 3 SPPB tests, as well as with an increased frequency of frailty and 4 of its components (exhaustion, slow walking speed, low physical activity and weakness). Feeling cold was linked to increased exhaustion. No association was found between housing conditions and IADL disability. CONCLUSIONS Poor housing conditions, particularly living in a walk-up building and lacking heating, are independently associated with limitations in physical function in older adults. This entails serious inequalities in functional status, which should be firmly addressed.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Bibiana Pérez-Hernández
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid/Instituto de Investigación del Hospital de la Princesa and CIBER of Mental Health (CIBERSAM), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Çakmur H. Health Status of Elderly Adults Living in Rural Turkey. J Am Geriatr Soc 2016; 64:677-8. [DOI: 10.1111/jgs.14005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hülya Çakmur
- Department of Family Medicine; School of Medicine; University of Kafkas; Kars Turkey
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Fougère B, Vellas B, Billet S, Martin PJ, Gallucci M, Cesari M. Air Pollution modifies the association between successful and pathological aging throughout the frailty condition. Ageing Res Rev 2015; 24:299-303. [PMID: 26462883 DOI: 10.1016/j.arr.2015.09.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 09/23/2015] [Accepted: 09/28/2015] [Indexed: 01/27/2023]
Abstract
The rapid growth in the number of older adults has many implications for public health, including the need to better understand the risks posed by environmental exposures. Aging leads to a decline and deterioration of functional properties at the cellular, tissue and organ level. This loss of functional properties yields to a loss of homeostasis and decreased adaptability to internal and external stress. Frailty is a geriatric syndrome characterized by weakness, weight loss, and low activity that is associated with adverse health outcomes. Frailty manifests as an age-related, biological vulnerability to stressors and decreased physiological reserves. Ambient air pollution exposure affects human health, and elderly people appear to be particularly susceptible to its adverse effects. The aim of this paper is to discuss the role of air pollution in the modulation of several biological mechanisms involved in aging. Evidence is presented on how air pollution can modify the bidirectional association between successful and pathological aging throughout the frailty conditions.
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Affiliation(s)
- Bertrand Fougère
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France.
| | - Bruno Vellas
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Sylvain Billet
- Unité de Chimie Environnementale et Interactions sur le Vivant (EA4492), Université du Littoral Côte d'Opale, Dunkerque, France
| | - Perrine J Martin
- Unité de Chimie Environnementale et Interactions sur le Vivant (EA4492), Université du Littoral Côte d'Opale, Dunkerque, France
| | - Maurizio Gallucci
- Cognitive Impairment Centre, General Hospital of Treviso, Piazza Ospedale, 1, I-31100 Treviso, Italy; FORGEI, Interdisciplinary Geriatric Research Foundation, Viale Trento Trieste 19, I-31100 Treviso, Italy
| | - Matteo Cesari
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
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