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Li Z, Gu J, Li P, Hu J, Wang S, Wang P, Zhou L, Yun Y, Shi Y, Wang P. The relationship between social frailty and loneliness in community-dwelling older adults: a cross-sectional study. BMC Geriatr 2024; 24:73. [PMID: 38238657 PMCID: PMC10797967 DOI: 10.1186/s12877-024-04666-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Social frailty (SF) is associated with multiple adverse health outcomes, yet there has been an inadequate focus on social frailty. The convoy model portrays the social networks through the perspective of the life course, thus providing a framework to explain the occurrence of social frailty. This study aimd to figure out the prevalence of social frailty and loneliness among community-dwelling older adults and to explore their correlations based on convoy model. METHODS This was a cross-sectional study, and 295 older adults from 10 communities of Zhengzhou in Henan Province participated in the study. Social frailty and loneliness were assessed separately with the Social Frailty Scale and University of California at Los Angeles-Loneliness Scale. The scores of social frailty of the older adults in different characteristic communities were compared by independent sample t-test and single factor analysis of variance. The influencing factors of social frailty were analysed by multiple stepwise linear regression and the structural equation model. The correlation between social frailty and loneliness was analysed by Pearson correlation analysis. RESULTS The total scores of social frailty and loneliness of the older adults in the community were (2.09 ± 1.53) and (43.19 ± 8.91), respectively. There was a moderate positive correlation between social frailty and loneliness (r = 0.621, P < 0.01). The results of multiple stepwise linear regression analysis showed that age, living styles, balance of payments, and loneliness were the main influencing factors of the social frailty of older adults in the community (F = 27.180, P < 0.001). The structural equation model of social frailty fitted well (χ2 = 47.292, df = 26, χ2/df = 1.819, P = 0.007; RMSEA = 0.053, 95%CI (0.028, 0.076), P = 0.359; GFI = 0.971; AGFI = 0.939; NFI = 0.904; IFI = 0.955; TLI = 0.918; CFI = 0.953; SRMR = 0.0466). CONCLUSIONS The convoy model had certain applicability in explanation of the relationship between loneliness and social frailty among older adults in community. The incidence of social frailty among the older adults in the community was high, and loneliness was at a medium level. It is necessary to strengthen the intervention of social frailty and loneliness of the older adults in the community, improve the quality of life of the older adults, and promote the development of healthy aging.
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Affiliation(s)
- Zhixiao Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Jinjin Gu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Peiling Li
- Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Jiaqi Hu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shanshan Wang
- School of Nursing, the Hong Kong Polytechnic University, HongKong, China
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Lin Zhou
- Henan Electric Power Hospital, Zhengzhou, China
| | - Yi Yun
- Henan Electric Power Hospital, Zhengzhou, China
| | - Yan Shi
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.
| | - Peng Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.
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Khalil AH, Gobbens RJJ. What If the Clinical and Older Adults' Perspectives about Frailty Converge? A Call for a Mixed Conceptual Model of Frailty: A Traditional Literature Review. Healthcare (Basel) 2023; 11:3174. [PMID: 38132064 PMCID: PMC10742490 DOI: 10.3390/healthcare11243174] [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: 10/04/2023] [Revised: 11/01/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
Existing frailty models have enhanced research and practice; however, none of the models accounts for the perspective of older adults upon defining and operationalizing frailty. We aim to propose a mixed conceptual model that builds on the integral model while accounting for older adults' perceptions and lived experiences of frailty. We conducted a traditional literature review to address frailty attributes, risk factors, consequences, perceptions, and lived experiences of older adults with frailty. Frailty attributes are vulnerability/susceptibility, aging, dynamic, complex, physical, psychological, and social. Frailty perceptions and lived experience themes/subthemes are refusing frailty labeling, being labeled "by others" as compared to "self-labeling", from the perception of being frail towards acting as being frail, positive self-image, skepticism about frailty screening, communicating the term "frail", and negative and positive impacts and experiences of frailty. Frailty risk factors are classified into socio-demographic, biological, physical, psychological/cognitive, behavioral, and situational/environmental factors. The consequences of frailty affect the individual, the caregiver/family, the healthcare sector, and society. The mixed conceptual model of frailty consists of interacting risk factors, interacting attributes surrounded by the older adult's perception and lived experience, and interacting consequences at multiple levels. The mixed conceptual model provides a lens to qualify frailty in addition to quantifying it.
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Affiliation(s)
- Asya Hani Khalil
- Hariri School of Nursing, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Robbert J. J. Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands;
- Zonnehuisgroep Amstelland, 1186 AA Amstelveen, The Netherlands
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
- Tranzo, Tilburg University, 5037 DB Tilburg, The Netherlands
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Yi M, Zhang W, Zhang X, Zhou J, Wang Z. The effectiveness of Otago exercise program in older adults with frailty or pre-frailty: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 114:105083. [PMID: 37390692 DOI: 10.1016/j.archger.2023.105083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/19/2023] [Accepted: 05/29/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Frailty is a well-recognized risk factor for adverse health-related outcomes in aging population. However, little is known about the dynamic changing nature of frailty and the potential for it to be modified within the scope of exercise. Currently, there has not been a systematic review of the impact of Otago exercise program (OEP) implementation specifically for the frail or pre-frail older adults. OBJECTIVE To determine the effectiveness of Otago exercise program on the degree of frailty, physical balance ability, mobility, grip strength and health-related quality of life in older adults with frailty or pre-frailty. METHODS We conducted literature searching in seven electronic databases, as well as hand-search of reference of included studies from inception to December 2022. Eligible studies included clinical trials of pre-frail or frail elderly receiving OEP interventions reporting on the relevant outcomes. The effect size was evaluated using standardized mean differences (SMDs) and its 95% confidence interval with random effects models. Risk of bias was appraised independently by two authors. RESULTS 10 trials containing 8 RCTs and 2 non-RCTs studies were included. Five studies were evaluated with some concerns in the evidence quality. The results showed that the OEP intervention could possibly reduce the level of frailty (SMD=-1.14, 95% CI: -1.68∼-0.06, P < 0.01) and improve the mobility (SMD=-2.15, 95% CI: -3.35∼-0.94, P < 0.01) and physical balance ability (SMD=2.59, 95% CI: 1.07-4.11), P = 0.01), and enhance their grip strength (SMD=1.68, 95% CI=0.05∼3.31, P = 0.04). However, no statistically significant effect of OEP on quality of life (SMD=-1.517, 95% CI=-3.18∼0.15, P = 0.07) in frail elderly was found based on the current evidence. The subgroup analysis indicated that participant age, different intervention total duration and per min of each session have varying degrees of impact on frail or pre-frail older people. CONCLUSIONS The OEP intervention targeting older adults with frailty or pre-frailty are effective in reducing frailty, improving physical balance ability, mobility, and grip strength with low to moderate certainty. More rigorous and tailored research are still needed in the future to further enrich the evidence in these fields.
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Affiliation(s)
- Mo Yi
- School of Nursing, Peking University, China
| | | | - Xu Zhang
- School of Nursing, Peking University, China
| | - Jia Zhou
- School of Nursing, Peking University, China
| | - Zhiwen Wang
- School of Nursing, Peking University, China.
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Siegmund LA, Novosel L. Application of a new frailty care model. J Am Assoc Nurse Pract 2023; 35:306-314. [PMID: 36888915 DOI: 10.1097/jxx.0000000000000854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/08/2023] [Indexed: 03/10/2023]
Abstract
ABSTRACT Frailty is an age-related physiological deterioration that results in weakness, slowness of movement, fatigue, weight loss, and multimorbidity. These limitations lead to an inability to respond to stressors, which ultimately increase risk for poor outcomes including falls, disability, hospitalization, and mortality. Although many medical and physiology-based frailty screening tools and associated theories exist, none are specific to advanced practice nurses and the care of the older adult. For this reason, the authors present the case of a frail older adult and the application of the Frailty Care Model. The authors developed the Frailty Care Model which illustrates a theory that states: Frailty is a fluid condition of aging that will respond to interventions and will progress in the absence of interventions . It is an evidence-based model that helps the nurse practitioner (NP) screen for frailty; apply important nutritional, psychosocial, and physical frailty interventions; and evaluate the care provided to the older adult. The purpose of this article is to present the case of Maria, an 82-year-old woman with frailty, and demonstrate how the NP can apply the Frailty Care Model to inform care of the older adult. The Frailty Care Model is designed so that it can be easily integrated into the workflow of the medical encounter and require little additional time or resources. This case study describes specific examples of using the model to avoid, stabilize, and reverse frailty.
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Affiliation(s)
- Lee Anne Siegmund
- Office of Nursing Research and Innovation, and Consultant Staff, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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Sajeev S, Champion S, Maeder A, Gordon S. Machine learning models for identifying pre-frailty in community dwelling older adults. BMC Geriatr 2022; 22:794. [PMID: 36221059 PMCID: PMC9554971 DOI: 10.1186/s12877-022-03475-9] [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: 01/24/2022] [Accepted: 09/15/2022] [Indexed: 04/11/2023] Open
Abstract
Background There is increasing evidence that pre-frailty manifests as early as middle age. Understanding the factors contributing to an early trajectory from good health to pre-frailty in middle aged and older adults is needed to inform timely preventive primary care interventions to mitigate early decline and future frailty. Methods A cohort of 656 independent community dwelling adults, aged 40–75 years, living in South Australia, undertook a comprehensive health assessment as part of the Inspiring Health cross-sectional observational study. Secondary analysis was completed using machine learning models to identify factors common amongst participants identified as not frail or pre-frail using the Clinical Frailty Scale (CFS) and Fried Frailty Phenotype (FFP). A correlation-based feature selection was used to identify factors associated with pre-frailty classification. Four machine learning models were used to derive the prediction models for classification of not frail and pre-frail. The class discrimination capability of the machine learning algorithms was evaluated using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, precision, F1-score and accuracy. Results Two stages of feature selection were performed. The first stage included 78 physiologic, anthropometric, environmental, social and lifestyle variables. A follow-up analysis with a narrower set of 63 variables was then conducted with physiologic factors associated with the FFP associated features removed, to uncover indirect indicators connected with pre-frailty. In addition to the expected physiologic measures, a range of anthropometric, environmental, social and lifestyle variables were found to be associated with pre-frailty outcomes for the cohort. With FFP variables removed, machine learning (ML) models found higher BMI and lower muscle mass, poorer grip strength and balance, higher levels of distress, poor quality sleep, shortness of breath and incontinence were associated with being classified as pre-frail. The machine learning models achieved an AUC score up to 0.817 and 0.722 for FFP and CFS respectively for predicting pre-frailty. With feature selection, the performance of ML models improved by up to + 7.4% for FFP and up to + 7.9% for CFS. Conclusions The results of this study indicate that machine learning methods are well suited for predicting pre-frailty and indicate a range of factors that may be useful to include in targeted health assessments to identify pre-frailty in middle aged and older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03475-9.
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Affiliation(s)
- Shelda Sajeev
- School of Business and Information Systems, Torrens University, 88 Wakefield St, Adelaide, SA, 5000, Australia. .,Centre for Artificial Intelligence Research and Optimisation, Torrens University, Adelaide, Australia. .,Flinders Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
| | - Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, South, 5042, Australia
| | - Anthony Maeder
- Flinders Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, South, 5042, Australia
| | - Susan Gordon
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, South, 5042, Australia
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Choi S, Ko H. Social Frailty among Community-Dwelling Older Adults during the COVID-19 Pandemic in Korea: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11963. [PMID: 36231267 PMCID: PMC9564660 DOI: 10.3390/ijerph191911963] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Social frailty among older adults has become a growing concern from a public health perspective in the context of the coronavirus disease 2019 (COVID-19) pandemic. This study's aim was to investigate the influence of various aspects of social frailty in community-dwelling older adults during the COVID-19 pandemic. This study carried out a secondary analysis of data collected from the 2020 National Survey of Older Koreans and performed multinomial logistic regression analysis to identify the predictive factors of social frailty. The affected factors for the social frailty group were health conditions (depression), behavioral and metabolic risk factors (exercise, nutritional status, current smoking status, drinking frequency), intrinsic capacity (cognitive functions, activities of daily living), and digital literacy (use of smartphone or tablet PCs). Since multidimensional factors could affect older adults' social frailty, comprehensive strategies are urgently needed to reduce their rate of social frailty.
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Abstract
ABSTRACT BACKGROUND: Surgical frailty is a condition in which patients are weak with varied recovery of various organ functions after surgery resulting in unpleasant outcomes. Frailty studies have been conducted in several populations with a limited knowledge on postoperative brain tumor patients. This study aimed to examine factors predicting frailty in brain tumor patients after craniotomy. METHODS: This study was a cross-sectional predictive study. The sample included 85 patients who were 18 years or older and underwent craniotomy with tumor removal from 1 university hospital in Bangkok, Thailand, between February and October 2021. Data were analyzed using descriptive statistic, Pearson correlation, and multiple linear regression, which determined significance level at .05. RESULTS: The prevalence of frailty among participants was 50.6%. Postoperative symptom and mood state were positively associated with frailty (r = 0.410 and r = 0.448, respectively; P < .01). Postoperative symptom, mood state, age, tumor type, and income could explain the variance of frailty in brain tumor patients after craniotomy by 40.3% (R2 = 0.403, P < .01). CONCLUSION: Healthcare providers should plan for discharge planning including assessment and develop the intervention for managing postoperative symptoms and psychological symptoms to promote recovery from frailty that generally occurs after brain tumor surgery.
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Yu X, Shi Z, Wang D, Niu Y, Xu C, Ma Y, Liu H, Guo H, Li M, Zhang Y. Prevalence and associated factors of frailty among community dwelling older adults in Northwest China: a cross-sectional study. BMJ Open 2022; 12:e060089. [PMID: 35914908 PMCID: PMC9345078 DOI: 10.1136/bmjopen-2021-060089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of the comprehensive frailty and its associated factors among community dwelling older adults. DESIGN A cross-sectional study. SETTING Six community healthcare centres in Xi'an City, Northwest China. PARTICIPANTS A total of 2647 community dwelling older adults completed the study between March and August 2021. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the prevalence of frailty, measured with the Comprehensive Frailty Assessment Instrument. The secondary outcomes were potential factors associated with frailty, measured with a social-demographic and health-related information sheet, the Short-Form Mini-Nutritional Assessment and the Pittsburgh Sleep Quality Index. RESULTS The participants averaged 27.77±10.13 in the total score of the Comprehensive Frailty Assessment Instrument. According to the cut-off points defining the classification of frailty, the majority of the participants were with mild (n=1478, 55.8%) or high (n=390, 14.8%) frailty. Multivariate stepwise linear regression analysis demonstrated that older age, lower educational level, empty nesters, higher level of self-perceived medical burden, abnormal body weight, physical inactivity, medication taking, increased number of clinic visit, undernutrition and poor sleep quality are associated with higher total score in the Comprehensive Frailty Assessment Instrument, indicating higher level of frailty. Multivariate multinomial logistic regression analysis exhibited similar findings but further captured female gender as a risk factor for the presence of mild and high frailty compared with no-low frailty. CONCLUSION The prevalence of the comprehensive frailty and frailty in the physiological, psychological, social and environmental domains is high. A variety of social-demographic, health-related and behavioural factors were associated with the comprehensive frailty. Further investigations on frailty prevalence and its associated factors based on comprehensive assessments are desirable.
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Affiliation(s)
- Xingfeng Yu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Zhengyan Shi
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Dan Wang
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yaqi Niu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Cuixiang Xu
- Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Yunmiao Ma
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Hongmei Liu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Hua Guo
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Minjie Li
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Yulian Zhang
- The Director's Office, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
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Social Frailty and Health-Related Quality of Life in Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095659. [PMID: 35565056 PMCID: PMC9100126 DOI: 10.3390/ijerph19095659] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022]
Abstract
This study aimed to identify the association between social frailty and health-related quality of life (HRQoL) and to identify the factors influencing HRQoL in community-dwelling older adults in South Korea. This was a secondary analysis of a cross-sectional survey study of 735 older adults. HRQoL was measured using the EuroQoL-5 Dimension, and social frailty was measured using five items. The differences in HRQoL according to sociodemographic characteristics, health-related characteristics, and social frailty of subjects were tested using the Mann−Whitney test, Kruskal−Wallis test, and χ2 test. A Tobit regression model was used to identify the influencing factor of HRQoL. About 31.0% of the older adults were in a social pre-frailty state, and 48.4% were in a social frailty state. Of the five components of social frailty, going out less compared to the previous year and being alone were frequently observed. Older adults who had social frailty had lower HRQoL scores than those who were robust after controlling for sociodemographic and health-related characteristics (BT = −0.04, p < 0.001). Researchers need to consider older adults’ social frailty as well as health status and sociodemographic status in future interventions to improve the HRQoL of older adults.
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Kume Y, Kodama A, Takahashi T, Lee S, Makizako H, Ono T, Shimada H, Ota H. Social frailty is independently associated with geriatric depression among older adults living in northern Japan: A cross-sectional study of ORANGE registry. Geriatr Gerontol Int 2021; 22:145-151. [PMID: 34935256 DOI: 10.1111/ggi.14330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/05/2021] [Accepted: 11/30/2021] [Indexed: 12/26/2022]
Abstract
AIM To clarify prevalence of social frailty among older adults living in a rural Japanese community, and factors associated with social frailty status. METHODS In total, 322 adults aged ≥65 years living in a Japanese rural community took part in the study from 2018 to 2020. Social frailty was defined as deficiencies of: (i) living alone; (ii) talking with someone every day; (iii) feeling helpful to friends or family; (iv) going out less frequently compared with last year; and (v) visiting friends sometimes. Social frail status was categorized as robust (0), social prefrail (1), and social frail (≥2), according to the summated score of Makizako's criteria. Multiple logistic regression analysis was applied to clarify factors associated with social frailty status. RESULTS Final samples were classified into 68 persons with social frailty, 98 persons with social prefrailty and 147 persons as robust. We observed the prevalence of social frailty (21.7%) and social prefrailty (31.3%) and the GDS-15 had significantly high scores in the social frail groups. Social frailty was significantly associated with the GDS-15 score (odds ratio, 1.33; 95% CI, 1.19-1.49) and TMT-A (odds ratio, 1.04; 95% CI, 1.01-1.08) and GDS-15 (odds ratio, 1.13; 95% CI, 1.03-1.26) were extracted as independent variables of social prefrail status, with adjustment for demographics, polypharmacy and lifestyle-related diseases. CONCLUSIONS Our results suggest that social frailty tends to be increasing gradually in a Japanese rural area, and social prefrailty might be potentially associated with attentional function, as well as the GDS-15 score. Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Yu Kume
- Department of Occupational Therapy, Graduate School of Medicine, Akita University, Akita, Japan
| | - Ayuto Kodama
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita, Japan
| | - Tomoko Takahashi
- Integrated Community Support Center, Public Health and Welfare Department, City Hall of Yokote, Akita, Japan
| | - Sangyoon Lee
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | | | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidetaka Ota
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita, Japan
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Li Q, Zhang Q, Zhang S, Du M, Wang X, Hu S, Li L. Relationship between frailty and cognitive decline in Chinese older patients with Alzheimer's disease: The mediating role of social contact. Geriatr Nurs 2021; 43:175-181. [PMID: 34911018 DOI: 10.1016/j.gerinurse.2021.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/13/2022]
Abstract
This study aimed to evaluate the effects of frailty and social contact on cognitive decline among Chinese older patients with Alzheimer's disease (AD), and examine the mediating role of social contact between frailty and cognitive decline. A total of 205 eligible participants were recruited from a tertiary A hospital in Anhui province, China. A structural equation modeling was conducted to test the hypothetical mediating model. Frailty and cognitive decline were significantly and negatively correlated with social contact. Meanwhile, frailty exerted a significant positive effect on cognitive decline. The indirect effect of frailty on the cognitive decline through social contact was 0.401. Social contact could exert a partial mediating effect on the relationship between frailty and cognitive decline in this population. These findings could help guide effective interventions to improve the cognitive abilities of AD patients, thereby reducing the burden of this population on their caregivers.
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Affiliation(s)
- Qingfeng Li
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Qianqian Zhang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Shuping Zhang
- Department of Emergency Surgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei 230011, China
| | - Mingchao Du
- Department of Information Centre, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Xia Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Shaohua Hu
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Lunlan Li
- Department of Personnel, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
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Bessa B, Coelho T, Ribeiro Ó. Social frailty dimensions and frailty models over time. Arch Gerontol Geriatr 2021; 97:104515. [PMID: 34597877 DOI: 10.1016/j.archger.2021.104515] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Social frailty is a complex concept and there is still no consensus on the criteria that best define it, nor on the role that social dimensions play in well-established frailty models. AIM To analyse the predictive value of social frailty dimensions on distinct frailty models. METHOD A non-probabilistic sample of 193 community-dwelling adults aged 65 years and over was recruited in 2016 and followed for three years. Frailty was assessed by the Tilburg Frailty Indicator, the Groningen Frailty Indicator, and the Fried Phenotype criteria. Questions about living alone, social network, social support, loneliness, and frequency of social activities engagement were used to assess social criteria. Bivariate correlations and sequential multiple hierarchical logistic regression analyses were performed. RESULTS At baseline, 22.2% older adults lived alone, 47.2% reported missing people around them, 21.1% reported lack of social support, 26.1% reported having reduced their participation in social activities recently and 52.2% reported loneliness. The percent of frail individuals varied across frailty measures, and social criteria showed significant correlations and increased the prediction of frailty status. Loneliness and social activities engagement were associated with frailty as assessed by the Tilburg frailty Indicator and by the Fried Phenotype criteria; the lack of social support is associated with frailty as assessed by the Groningen Frailty Indicator. Living alone and lack of social relationships did not predict frailty. CONCLUSION Including social dimensions in a frailty model needs a consensual theoretical basis as they have different roles in predicting frailty, varying over time and across assessment tools.
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Affiliation(s)
- Bruno Bessa
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS.UP), Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, 4200-450, Porto, Portugal.
| | - Tiago Coelho
- School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal; Psychosocial Rehabilitation Lab, Center for Rehabilitation Research (CIR), Rua Dr. António Bernardino de Almeida 400, 4200-072, Porto, Portugal
| | - Óscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, 4200-450, Porto, Portugal; Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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13
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Direct and Indirect Effects of COVID-19 in Frail Elderly: Interventions and Recommendations. J Pers Med 2021; 11:jpm11100999. [PMID: 34683141 PMCID: PMC8539433 DOI: 10.3390/jpm11100999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/23/2021] [Accepted: 09/30/2021] [Indexed: 12/13/2022] Open
Abstract
Frailty is a state of vulnerability to stressors because of a decreased physiological reserve, resulting in poor health outcomes. This state is related to chronic conditions, many of which are risk factors for outcomes in elderly patients having SARS-COV-2. This review aims to describe frailty as a physiological vulnerability agent during the COVID-19 pandemic in elderly patients, summarizing the direct and indirect effects caused by the SARS-COV-2 infection and its prognosis in frail individuals, as well as the interventions and recommendations to reduce their effects. Cohort studies have shown that patients with a Clinical Frailty Scale higher than five have a higher risk of mortality and use of mechanical ventilation after COVID-19; nonetheless, other scales have also associated frailty with longer hospital stays and more severe forms of the disease. Additionally, the indirect effects caused by the pandemic have a negative impact on the health status of older people. Due to the above, a holistic intervention is proposed based on a comprehensive geriatric assessment for frail patients (preventive or post-infection) with emphasis on physical activity and nutritional recommendations, which could be a potential preventive intervention in viral infections by COVID-19.
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Abstract
Background Since older adults spend much time in their home environment (HE), frailty may occur as a consequence of a maladaptation to the HE. The aim of this study was to describe the prevalence of frailty in the very old population of North Rhine-Westphalia, and to examine the association between the HE and the frailty levels of these individuals. Methods Data from a cross-sectional representative study were used, including data on 1577 community-dwelling individuals and nursing home residents aged ≥ 80 years. Objective and subjective HE aspects were included. Frailty was defined according to four criteria: exhaustion, unintentional weight loss, weakness, and low physical activity. Adjusted multinomial regression modelling was used to analyze the link between the HE and frailty levels. Results Of the very old individuals, 24.3% were robust, 57.0% were prefrail, and 18.7% were frail. Adjusting for relevant sociodemographic and health characteristics, being not closely attached to the HE was linked with an increased probability of being prefrail and frail. An improvement of the residential area was associated with a decrease in odds of being frail. Living in communities with less than 50,000 and with 100,000–499,999 inhabitants decreased the odds of being frail. Discussion Frailty prevalence is shown to be higher in the very old population than in the younger age groups in Germany. Early identification of frailty and tailored interventions focused on improving objective and subjective attributes of the HE are needed to reduce the risk of frailty. Supplementary Information The online version of this article (10.1007/s00391-021-01969-6) contains supplementary material, which is available to authorized users.
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15
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Imani M, Khajeh M, Khosravi A, Ebrahimi H. Validation of the Persian version of the comprehensive frailty assessment instrument plus in community-dwelling older adults. Geriatr Nurs 2021; 42:1287-1293. [PMID: 34560522 DOI: 10.1016/j.gerinurse.2021.09.001] [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: 06/01/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to examine the validity and reliability of the Persian Version of the Comprehensive Frailty Assessment Instrument Plus (CFAI-Plus) among community-dwelling older adults. It was completed by 340 older adults ≥60 years. The content and face validity were confirmed based on the opinion of the target group and experts. In the exploratory factor analysis, seven factors were extracted, explaining 62.8% of the total variance. Confirmatory factor analysis showed acceptable fit indices (Root Mean Square Error of Approximation = 0.045; Comparative Fit Index = 0.93; Tucker-Lewis Index = 0.92). Internal consistency was adequate for factors (Cronbach's alpha: range 0.47 to 0.88), and the test-retest reliability was acceptable (intra-class correlation coefficient: range 0.76 to 0.92). A higher CFAI-Plus score were found in those who were older, female, less-educated, single, lived alone, and had inadequate income. This study supports the reliability and validity of the Persian CFAI-Plus in community-dwelling older adults.
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Affiliation(s)
- Maryam Imani
- Student Research Committee, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahboobeh Khajeh
- School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ahmad Khosravi
- Department of Epidemiology and Biostatistics, School of public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Ebrahimi
- Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.
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16
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Parodi JF, Runzer-Colmenares FM. [Impact of social support on limited mobility in older people in high Andean communities in PeruImpacto do apoio social na mobilidade reduzida em idosos de comunidades do altiplano andino no Peru]. Rev Panam Salud Publica 2021; 45:e88. [PMID: 34475884 PMCID: PMC8369112 DOI: 10.26633/rpsp.2021.88] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/16/2021] [Indexed: 12/25/2022] Open
Abstract
Objetivo. Determinar si existe relación entre la movilidad física y la falta de soporte social en personas mayores que viven en comunidades altoandinas de Perú. Métodos. Estudio observacional, analítico y retrospectivo a partir de la base de datos de una investigación previa de corte trasversal con información de 449 personas de 60 años o más participantes en el proyecto ANDES-FRAIL. La variable dependiente fue la movilidad, evaluada según el instrumento Short Physical Performance Battery; la variable independiente fue el soporte social, evaluado mediante un ítem del cuestionario de fragilidad de Edmonton. Como covariables se utilizaron parámetros sociodemográficos, comorbilidades, el número de fármacos de consumo habitual y los puntajes recibidos en varios instrumentos: el índice de Barthel para determinar la funcionalidad en personas mayores, el cuestionario de Yesavage para evaluar la depresión en ancianos, entre otros. Se calcularon las frecuencias y los porcentajes de las variables categóricas. Se elaboró un modelo ajustado con las variables que resultaron estadísticamente significativas en el análisis de regresión logística bifactorial. Resultados. La frecuencia de movilidad limitada en la población estudiada fue 58,6% (n = 263) y la de inadecuado soporte social fue 58,1% (n = 261). Los participantes con inadecuado soporte social tuvieron una frecuencia de movilidad limitada del 70,7% (n = 186). Según el modelo de regresión ajustado, el soporte social inadecuado incrementaría en 2,5 veces (IC95%: 1,3-4,5) las probabilidades de tener movilidad limitada, independientemente de las covariables confusoras. Conclusiones. La falta de apoyo social está asociada con la movilidad limitada de las personas mayores que habitan en comunidades altoandinas peruanas.
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Affiliation(s)
- José F Parodi
- Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad de San Martín de Porres Lima Perú Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad de San Martín de Porres, Lima, Perú
| | - Fernando M Runzer-Colmenares
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur Lima Perú CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
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17
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Liotta G, Madaro O, Scarcella P, Inzerilli MC, Frattini B, Riccardi F, Accarino N, Mancinelli S, Terracciano E, Orlando S, Marazzi MC. Assessing the Impact of A Community-Based Pro-Active Monitoring Program Addressing the need for Care of Community-Dwelling Citizens aged more than 80: Protocol for a Prospective Pragmatic Trial and Results of the Baseline Assessment. TRANSLATIONAL MEDICINE AT UNISA 2021. [PMID: 34447708 PMCID: PMC8370536 DOI: 10.37825/2239-9747.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this paper is to describe the protocol of a study assessing the impact of a Community-based pro-Active Monitoring Program, by measuring the effect in counteracting the adverse outcomes related to frailty. Methods a prospective pragmatic trial will be carried out to describe the impact of an intervention on people aged>80, adjusted for relevant parameters: demographic variables, comorbidities, disability and bio-psycho-social frailty. They have been assessed with the Functional Geriatric Evaluation questionnaire that is a validated tool. Mortality, Acute Hospital Admission rates, Emergency Room Visit rates and Institutionalization rates are the main outcomes to be evaluated annually, over three years. Two groups of patients, made up by 578 cases (undergoing the intervention under study) and 607 controls have been enrolled and interviewed. Results at baseline the two groups are quite similar for age, living arrangement, comorbidity, disability and cognitive status. They differ in education, economic resources and physical status (that are better in the control group) and in social resources (that is better in the case group). The latter was expected since the intervention is focused on increasing social capital at individual and community level and aimed at improving survival among the cases as well as reducing the recourse to hospital and residential Long Term Care. Conclusion The proposed study addresses a crucial issue: assessing the impact of a bottom up care service consisting of social and health interventions aimed at reducing social isolation and improving access to health care services.
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Affiliation(s)
- G Liotta
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - O Madaro
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - P Scarcella
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - M C Inzerilli
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - B Frattini
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - F Riccardi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - N Accarino
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - S Mancinelli
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - E Terracciano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - S Orlando
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - M C Marazzi
- LUMSA University, Via della Traspontina 21, 00193, Rome, Italy
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18
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Wang H, Wang J, Xie B, Liu B, Wang J. Multi-dimensional frailty and its risk factors among older residents in long-term care facilities in Shanghai, China. Int J Nurs Sci 2021; 8:298-303. [PMID: 34307778 PMCID: PMC8283709 DOI: 10.1016/j.ijnss.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives The integrated model of frailty shifted the physiologically-dominated view to an integrated and multidisciplinary view of frailty and adopted an integrated and holistic approach to the complex challenges facing frail older adults and their caregivers. There is an urgent need for researchers to identify multi-faceted frailty among older adults and to explore contributors to it. We assessed the level of frailty among older residents in long-term care (LTC) facilities in Shanghai, China and explored risk factors of multiple dimensions of frailty among older residents. Methods It is a cross-sectional descriptive study. We interviewed 218 older residents from nine LTC facilities. We used Tilburg Frailty Indicator to assess older residents’ physiological, psychological, and social frailty. The Geriatric Depression Scale, Mini-Mental state examination, Athens Insomnia Scale, and Activity of Daily Living (ADL) Scale were used to assess their depressive symptoms, cognitive function, sleep quality and ADL abilities, respectively. Results Older residents have a moderate level of frailty in physiological, psychological and social domains. There is a high correlation among dimensions of frailty. Older residents’ depressive symptoms have remained positively associated with their overall and each domain of frailty. Older residents’ actual activity participation and exercise in LTC facilities are negatively associated with older residents’ overall, physiological and social frailty. Conclusions Frailty is a multi-dimensional concept and is prevalent among older residents in LTC facilities. It is important to take an integrated view on frailty and carry out appropriate and comprehensive interventions to prevent adverse outcomes and provide holistic care for frail older residents in LTC facilities. There is an urgent need to improve the quality and expand the number of activities offered within LTC facilities that would engage older residents in a person-centered way, despite their age, ADL abilities, frailty and functional limitations.
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Affiliation(s)
- Huihui Wang
- School of Nursing, Fudan University, Shanghai, China
| | - Jing Wang
- School of Nursing, Fudan University, Shanghai, China.,UNC Chapel Hill School of Nursing, Chapel Hill, NC, USA
| | - Boqin Xie
- School of Nursing, Fudan University, Shanghai, China
| | - Bangzhong Liu
- Department of Rehabilitation, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Junqiao Wang
- School of Nursing, Fudan University, Shanghai, China
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19
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Gobbens RJJ, van der Ploeg T. Frailty at Risk Scale (FARS): development and application. Eur J Ageing 2021; 19:301-308. [DOI: 10.1007/s10433-021-00628-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 10/21/2022] Open
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20
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Bloemhoff A, Schoon Y, Smulders K, Akkermans R, Vloet LCM, van den Berg K, Berben SAA. Older persons are frailer after an emergency care visit to the out-of-hours general practitioner cooperative in the Netherlands: a cross-sectional descriptive TOPICS-MDS study. BMC FAMILY PRACTICE 2020; 21:171. [PMID: 32819281 PMCID: PMC7441648 DOI: 10.1186/s12875-020-01220-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/14/2020] [Indexed: 12/02/2022]
Abstract
Background In the Netherlands, community-dwelling older people with primary care emergency problems contact the General Practitioner Cooperative (GPC) after hours. However, frailty remains an often unobserved hazard with adverse health outcomes. The aim of this study was to provide insight into differences between older persons with or without GPC emergency care visits (reference group) regarding frailty and healthcare use. Methods A cross-sectional descriptive study design was based on data from the public data repository of The Older Persons and Informal Caregivers Survey Minimum Dataset (TOPICS-MDS). Frailty in older persons (65+ years, n = 32,149) was measured by comorbidity, functional and psychosocial aspects, quality of life and a frailty index. Furthermore, home care use and hospital admissions of older persons were identified. We performed multilevel logistic and linear regression analyses. A random intercept model was utilised to test differences between groups, and adjustment factors (confounders) were used in the multilevel analysis. Results Compared to the reference group, older persons with GPC contact were frailer in the domain of comorbidity (mean difference 0.52; 95% CI 0.47–0.57, p < 0.0001) and functional limitations (mean difference 0.53; 95% CI 0.46–0.60, p < 0.0001), and they reported less emotional wellbeing (mean difference − 4.10; 95% CI -4.59- -3.60, p < 0.0001) and experienced a lower quality of life (mean difference − 0.057; 95% CI -0.064- -0.050, p < 0.0001). Moreover, older persons more often reported limited social functioning (OR = 1.50; 95% CI 1.39–1.62, p < 0.0001) and limited perceived health (OR = 1.50, 95% CI 1.39–1.62, p < 0.0001). Finally, older persons with GPC contact more often used home care (OR = 1.37; 95% CI 1.28–1.47, p < 0.0001) or were more often admitted to the hospital (OR = 2.88; 95% CI 2.71–3.06, p < 0.0001). Conclusions Older persons with out-of-hours GPC contact for an emergency care visit were significantly frailer in all domains and more likely to use home care or to be admitted to the hospital compared to the reference group. Potentially frail older persons seemed to require adequate identification of frailty and support (e.g., advanced care planning) both before and after a contact with the out-of-hours GPC.
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Affiliation(s)
- Anneke Bloemhoff
- Eastern Regional Emergency Healthcare Network, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Yvonne Schoon
- Department of Emergency Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Geriatrics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kien Smulders
- General Practitioners Cooperative Gelderse Vallei, Ede, The Netherlands
| | - Reinier Akkermans
- Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lilian C M Vloet
- Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Karin van den Berg
- Eastern Regional Emergency Healthcare Network, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Sivera A A Berben
- Eastern Regional Emergency Healthcare Network, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.,Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
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Freer K. Falling through the cracks: a case study of how a timely integrated approach can reverse frailty. Br J Community Nurs 2020; 25:382-387. [PMID: 32757895 DOI: 10.12968/bjcn.2020.25.8.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The article 'Social frailty: the importance of social and environmental factors in predicting frailty in older adults' published in the British Journal of Community Nursing in 2019 reviewed the concept and models of frailty and how the role of social and environmental circumstances interplay. To better inform interventions within the community, the impact of social isolation and environmental disorder on frailty and the wellbeing of an individual patient are further explored. This paper describes the case of a 76-year-old man, Tommy, who was living with frailty and how an individualised care plan was undertaken, evidencing the positive effects that an integrated approach from health, social care, housing and the voluntary sector can offer. Multifaceted interventions are described, which were used to reverse frailty and change Tommy's future for the better.
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Affiliation(s)
- Karen Freer
- Occupational therapist, Bolton NHS Foundation Trust
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