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Hong Y, Tian Z, Ji Z, Yang J, Wang C. A systematic review of the effect and mechanism of Daoyin therapy on improving mild cognitive impairment in older adults. Ageing Res Rev 2024:102526. [PMID: 39368667 DOI: 10.1016/j.arr.2024.102526] [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: 04/29/2023] [Revised: 09/27/2024] [Accepted: 09/27/2024] [Indexed: 10/07/2024]
Abstract
BACKGROUND Age-related cognitive decline is a pervasive problem in the aging population. Daoyin therapy is a mind-body movement characteristic of traditional Chinese medicine (TCM). Increasing evidence has reported its usefulness in improving cognitive function among different populations. However, there is no systematic review to assess the effect and mechanism of Daoyin therapy on mild cognitive dysfunction (MCI) in older adults. OBJECTIVE To systematically review the evidence on the effect and mechanism of Daoyin therapy on MCI in older adults. RESULTS Taichi, Baduanjin, and Yijinjing can improve cognitive function. Qigong and Wuqinxi can enhance the physical and cognitive functions related to balance, muscle strength, physical endurance, postural control, and flexibility. Taichi, Baduanjin, and Wuqinxi can improve the cognitive function of older adults and alleviate the symptoms associated with MCI through multiple mechanisms. The underlying mechanisms include activating the expression of signals and changing their connections in different brain regions, increasing brain capacity, and regulating brain-derived neurotropic and inflammatory factors. CONCLUSION In summary, the existing evidence from RCTs suggests that traditional Daoyin therapy, such as Taichi, Baduanjin, and Wuqinxi, is a promising strategy that can improve cognitive function and delay the onset of dementia in older adults with MCI by altering structural and neural activities and modulating other factors.
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Affiliation(s)
- Yanfang Hong
- Hunan University, Changsha City, Hunan Province, China
| | - Zuguo Tian
- Hunan University, Changsha City, Hunan Province, China
| | - Zhenfeng Ji
- Hunan University, Changsha City, Hunan Province, China
| | - Jia Yang
- Hunan University, Changsha City, Hunan Province, China
| | - Chaochao Wang
- Hunan University, Changsha City, Hunan Province, China
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2
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Fan X, Wang Y, Zhang Z, Yang R, Zhou Y, Gu J. Assessing the causal relationship between frailty and sex hormone-binding globulin or insulin-like growth factor-1 levels: A sex-stratified bidirectional Mendelian Randomization study. Exp Gerontol 2024; 195:112545. [PMID: 39154868 DOI: 10.1016/j.exger.2024.112545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 07/07/2024] [Accepted: 08/12/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND The association between frailty and sex hormone-binding globulin (SHBG) or insulin-like growth factor-1(IGF-1) levels demonstrates sex differences with inconsistent conclusions. This study aims to explore the causal relationship between frailty and SHBG or IGF-1 levels through bidirectional Mendelian randomization (MR). METHODS We conducted two-sample bidirectional sex-stratified MR analyses using summary-level data from genome-wide association studies (GWASs) to examine the causal relationship between frailty and IGF-1 or SHBG levels, as measured by frailty index (FI) and frailty phenotype (FP). We use the random-effects inverse-variance weighted (IVW), weighted median, MR-Egger, MR-Egger intercept, and leave-one-out approaches. RESULT The relationship between frailty and SHBG or IGF-1 levels is inversely related, with a significant decrease in SHBG levels in females. Specifically, SHBG levels significantly decrease with FI (β = -5.49; 95 % CI: -9.67 to -1.32; FDR = 0.02) and more pronounced with FP (β = -10.14; 95 % CI: -16.16 to -4.13; FDR = 0.01), as determined by the IVW approach. However, reverse analysis shows no significant effect of IGF-1 or SHBG levels on either FI or FP (p > 0.05). CONCLUSION Our study indicates a negative correlation between frailty and the levels of SHBG and IGF-1. It is suggested that further research is required to establish cut-off values for SHBG and IGF-1 levels in the frailty population. This is particularly important for females at higher risk, such as those undergoing menopause, to enable comprehensive assessment and early prevention efforts. While the findings imply that reduced IGF-1 and SHBG levels may not directly contribute to frailty, it is important not to overlook the underlying mechanisms through which they may indirectly influence frailty.
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Affiliation(s)
- Xinying Fan
- Department of General Practice, Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Yuxin Wang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang, China
| | - Zhaoyu Zhang
- Department of General Practice, Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Runjun Yang
- Department of Nuclear Medicine, Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Yajing Zhou
- Department of Biostatistics, NHC Key Laboratory for Health Technology Assessment, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Jie Gu
- Department of General Practice, Zhongshan Hospital of Fudan University, Shanghai 200032, China; International Medical Center, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
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3
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Holland C, Dravecz N, Owens L, Benedetto A, Dias I, Gow A, Broughton S. Understanding exogenous factors and biological mechanisms for cognitive frailty: A multidisciplinary scoping review. Ageing Res Rev 2024; 101:102461. [PMID: 39278273 DOI: 10.1016/j.arr.2024.102461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/15/2024] [Accepted: 08/15/2024] [Indexed: 09/18/2024]
Abstract
Cognitive frailty (CF) is the conjunction of cognitive impairment without dementia and physical frailty. While predictors of each element are well-researched, mechanisms of their co-occurrence have not been integrated, particularly in terms of relationships between social, psychological, and biological factors. This interdisciplinary scoping review set out to categorise a heterogenous multidisciplinary literature to identify potential pathways and mechanisms of CF, and research gaps. Studies were included if they used the definition of CF OR focused on conjunction of cognitive impairment and frailty (by any measure), AND excluded studies on specific disease populations, interventions, epidemiology or prediction of mortality. Searches used Web of Science, PubMed and Science Direct. Search terms included "cognitive frailty" OR (("cognitive decline" OR "cognitive impairment") AND (frail*)), with terms to elicit mechanisms, predictors, causes, pathways and risk factors. To ensure inclusion of animal and cell models, keywords such as "behavioural" or "cognitive decline" or "senescence", were added. 206 papers were included. Descriptive analysis provided high-level categorisation of determinants from social and environmental through psychological to biological. Patterns distinguishing CF from Alzheimer's disease were identified and social and psychological moderators and mediators of underlying biological and physiological changes and of trajectories of CF development were suggested as foci for further research.
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Affiliation(s)
- Carol Holland
- Division of Health Research, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster LA1 4YW, UK.
| | - Nikolett Dravecz
- Division of Health Research, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster LA1 4YW, UK.
| | - Lauren Owens
- Division of Biomedical and Life Sciences, Furness College, Lancaster University, LA1 4YG, UK.
| | - Alexandre Benedetto
- Division of Biomedical and Life Sciences, Furness College, Lancaster University, LA1 4YG, UK.
| | - Irundika Dias
- Aston University Medical School, Aston University, Birmingham B4 7ET, UK.
| | - Alan Gow
- Centre for Applied Behavioural Sciences, Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK.
| | - Susan Broughton
- Division of Biomedical and Life Sciences, Furness College, Lancaster University, LA1 4YG, UK.
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Pu Y, Sun Z, Zhang H, Huang Q, Wang Z, Mei Z, Wang P, Kong M, Yang W, Lin C, Zhou X, Lin S, Huang Q, Huang L, Sun L, Yuan C, Xu Q, Tang H, Wang X, Zheng Y. Gut microbial features and circulating metabolomic signatures of frailty in older adults. NATURE AGING 2024; 4:1249-1262. [PMID: 39054372 DOI: 10.1038/s43587-024-00678-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/03/2024] [Indexed: 07/27/2024]
Abstract
Frailty, a multidimensional indicator of suboptimal aging, reflects cumulative declines across multiple physiological systems. Although age-related changes have been reported in gut microbiota, their role in healthy aging remains unclear. In this study, we calculated frailty index (FI) from 33 health-related items to reflect the overall health status of 1,821 older adults (62-96 years, 55% female) and conducted multi-omics analysis using gut metagenomic sequencing data and plasma metabolomic data. We identified 18 microbial species and 17 metabolites shifted along with frailty severity, with stronger links observed in females. The associations of nine species, including various Clostridium species and Faecalibacterium prausnitzii, with FI were reproducible in two external populations. Plasma glycerol levels, white blood cell count and kidney function partially mediated these associations. A composite microbial score derived from FI significantly predicted 2-year mortality (adjusted hazard ratio across extreme quartiles, 2.86; 95% confidence interval, 1.38-5.93), highlighting the potential of microbiota-based strategies for risk stratification in older adults.
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Affiliation(s)
- Yanni Pu
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhonghan Sun
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hui Zhang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingxia Huang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhengdong Wang
- Department of Gastroenterology, Rugao People's Hospital, Rugao, China
| | - Zhendong Mei
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Peilu Wang
- Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Mengmeng Kong
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wenjun Yang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chenhao Lin
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaofeng Zhou
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shuchun Lin
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiumin Huang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lili Huang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liang Sun
- Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Xu
- Institute of Gut Microbiota Research and Engineering Development, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huiru Tang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Xiaofeng Wang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China.
- Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
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Dinarvand D, Panthakey J, Heidari A, Hassan A, Ahmed MH. The Intersection between Frailty, Diabetes, and Hypertension: The Critical Role of Community Geriatricians and Pharmacists in Deprescribing. J Pers Med 2024; 14:924. [PMID: 39338179 PMCID: PMC11433409 DOI: 10.3390/jpm14090924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/21/2024] [Accepted: 08/27/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Frailty is a clinical syndrome prevalent among the elderly, characterised by a decline in physiological reserves and increased susceptibility to stressors, resulting in higher morbidity and mortality. Diabetes and hypertension are common in frail older individuals, often leading to polypharmacy. In this narrative review, we aimed to evaluate the relationship between frailty, diabetes, and hypertension and to identify effective management strategies and future research directions. Methods: This narrative review was conducted using the Scopus, Medline, PubMed, Cochrane Library, and Google Scholar databases. Results: Frailty significantly impacts the management and prognosis of diabetes and hypertension, which, in turn, affects the progression of frailty. Managing these conditions often involves multiple drugs to achieve strict glycaemic control and blood pressure targets, leading to polypharmacy and associated morbidities, including orthostatic hypotension, falls, fractures, hypoglycaemia, and reduced medication adherence. Identifying frailty and implementing strategies like deprescribing can mitigate the adverse effects of polypharmacy and improve outcomes and quality of life. Despite the availability of effective tools for identifying frailty, many frail individuals continue to be exposed to complex treatment regimens for diabetes and hypertension, leading to increased hospital admissions, morbidity, and mortality. Conclusions: Managing diabetes and hypertension in the frail ageing population requires a multidisciplinary approach involving hospital and community geriatricians and pharmacists. This is important due to the lack of sufficient clinical trials dedicated to diabetes and hypertension in the context of frailty. Future large population studies are needed to assess the best approaches for managing diabetes and hypertension in frail individuals.
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Affiliation(s)
- Daniel Dinarvand
- Department of Medicine, Ashford and St. Peter's Hospital NHS Foundation Trust, Surrey KT16 0PZ, UK
| | - Johann Panthakey
- Department of Medicine, Royal Surrey County Hospital NHS Foundation Trust, Guildford GU2 7XX, UK
| | - Amirmohammad Heidari
- Department of Trauma and Orthopaedics, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8YE, UK
| | - Ahmed Hassan
- Faculty of Medicine, Alexandria University, Alexandria 21321, Egypt
| | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
- Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
- Honorary Senior Lecturer of the Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham MK18 1EG, UK
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6
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Loureiro M, Elias A, Machado F, Bezerra M, Zimerer C, Mello R, Frizera A. Analysis of Gait Kinematics in Smart Walker-Assisted Locomotion in Immersive Virtual Reality Scenario. SENSORS (BASEL, SWITZERLAND) 2024; 24:5534. [PMID: 39275445 PMCID: PMC11398063 DOI: 10.3390/s24175534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/20/2024] [Accepted: 08/22/2024] [Indexed: 09/16/2024]
Abstract
The decline in neuromusculoskeletal capabilities of older adults can affect motor control, independence, and locomotion. Because the elderly population is increasing worldwide, assisting independent mobility and improving rehabilitation therapies has become a priority. The combination of rehabilitation robotic devices and virtual reality (VR) tools can be used in gait training to improve clinical outcomes, motivation, and treatment adherence. Nevertheless, VR tools may be associated with cybersickness and changes in gait kinematics. This paper analyzes the gait parameters of fourteen elderly participants across three experimental tasks: free walking (FW), smart walker-assisted gait (AW), and smart walker-assisted gait combined with VR assistance (VRAW). The kinematic parameters of both lower limbs were captured by a 3D wearable motion capture system. This research aims at assessing the kinematic adaptations when using a smart walker and how the integration between this robotic device and the VR tool can influence such adaptations. Additionally, cybersickness symptoms were investigated using a questionnaire for virtual rehabilitation systems after the VRAW task. The experimental data indicate significant differences between FW and both AW and VRAW. Specifically, there was an overall reduction in sagittal motion of 16%, 25%, and 38% in the hip, knee, and ankle, respectively, for both AW and VRAW compared to FW. However, no significant differences between the AW and VRAW kinematic parameters and no adverse symptoms related to VR were identified. These results indicate that VR technology can be used in walker-assisted gait rehabilitation without compromising kinematic performance and presenting potential benefits related to motivation and treatment adherence.
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Affiliation(s)
- Matheus Loureiro
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil
| | - Arlindo Elias
- Graduate Program in Physiotherapy, Estacio de Sa University, Vitória 29092-095, ES, Brazil
| | - Fabiana Machado
- Graduate Program in Informatics, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil
| | - Marcio Bezerra
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil
| | - Carla Zimerer
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil
| | - Ricardo Mello
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil
| | - Anselmo Frizera
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil
- Graduate Program in Informatics, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil
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7
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Yuan Y, Si H, Shi Z, Wang Y, Xia Y, Guan X, He P. Association of Cognitive Frailty With Subsequent All-Cause Mortality Among Middle-Aged and Older Adults in 17 Countries. Am J Geriatr Psychiatry 2024:S1064-7481(24)00436-6. [PMID: 39242332 DOI: 10.1016/j.jagp.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/11/2024] [Accepted: 08/15/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVES Cognitive frailty refers to the co-occurrence of cognitive impairment and frailty without concurrent Alzheimer's disease or dementia. Studies of cognitive frailty and mortality have been limited to single country or older people. However, frailty and cognitive decline may occur much earlier. We aimed to examine the association between different cognitive frailty status and subsequent all-cause mortality among middle-aged and older people in 17 countries. METHODS Participants aged 50 and over were drawn from six prospective cohorts of aging. We classified participants according to their cognitive impairment and frailty status into the following groups: none, only cognitive impairment, only frailty and cognitive frailty. Competing-risks regression models were used to evaluate the association of different cognitive frailty status at baseline with subsequent all-cause mortality. RESULTS The cognitive frailty group had a higher mortality risk compared to those without cognitive impairment and frailty groups. Meta-analysis results showed participants with cognitive frailty (pooled subhazard ratio [SHR] = 2.34, 95% confidence interval [CI]: 2.01-2.72, I2 = 68.0%) had a higher mortality risk compared with those with only cognitive impairment status (pooled SHR = 1.36, 95% CI: 1.25-1.48, I2 = 3.0%) or only frailty status (pooled SHR = 1.83, 95% CI: 1.72-1.95, I2 = 31.0%). The association between cognitive frailty and mortality were stronger among those who were aged 70 years and older, males, single and nonconsumers of alcohol. CONCLUSIONS Cognitive frailty, frailty or cognitive impairment alone, is associated with an increased risk of all-cause mortality in Asian, European and American countries. Physical and cognitive function screening should be conducted as early as possible in middle-aged and older people, and targeted intervention approaches should be developed to reduce the incidence of adverse health outcomes.
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Affiliation(s)
- Yemin Yuan
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Huaxin Si
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Zhenyu Shi
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Yanshang Wang
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Yiqi Xia
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Xiaolong Guan
- School of Public Health (YY, HS, ZS, YW, YX, XG), Peking University, Beijing, China; China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China
| | - Ping He
- China Center for Health Development Studies (YY, HS, ZS, YW, YX, XG, PH), Peking University, Beijing, China.
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Corley J, Pattie A, Batty GD, Cox SR, Deary IJ. Life-Course Pathways to Exceptional Longevity: Evidence From the Lothian Birth Cohort of 1921. J Gerontol A Biol Sci Med Sci 2024; 79:glae166. [PMID: 38941261 DOI: 10.1093/gerona/glae166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Longevity, a hallmark of successful aging, is a multifactorial trait with influences from birth onwards. However, limited evidence exists on the pathways linking diverse life-course exposures to longevity, especially within a single cohort. METHODS We investigated associations between life-course factors and longevity among community-dwelling adults aged 79 (N = 547) from the Lothian Birth Cohort 1921 with a mortality follow-up of 24 years. Cox proportional hazards and structural equation (path) models were used to explore how factors from early life (social class, childhood intelligence quotient [IQ], education), midlife (social class), and later life (health, lifestyle, psychosocial well-being), as well as sex, personality, and apolipoprotein E e4 status, influence survival time in days. RESULTS During follow-up (1999-2023), 538 participants (98%) died (mean age of death = 89.3 years) and 9 survived (mean age = 101.6 years). Factors associated with lower mortality risk in the multivariable Cox model were higher cognitive function (hazard ratio [HR] = 0.72; 95% confidence interval [CI]: 0.59-0.88), better physical function (HR = 0.61; 95% CI: 0.44-0.85), and greater physical activity (HR = 0.81; 95% CI: 0.71-0.92), while history of cancer was associated with higher mortality risk (HR = 1.84; 95% CI: 1.22-2.77). The life-course path model identified the same direct predictors, with additional contributions from female sex and nonsmoking status, to greater longevity. Early- and midlife factors (IQ, education, social class), and emotional stability, conscientiousness, and female sex, were indirectly and positively associated with survival trajectories via multiple dimensions of adult health. CONCLUSIONS In understanding why people live to very old ages it is necessary to consider factors from throughout the life course, and to include demographic, psychosocial, and health variables.
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Affiliation(s)
- Janie Corley
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Alison Pattie
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Simon R Cox
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
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9
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Ko Y, Choi K. Exploring the Role of Social Factors in Cognitive Frailty among South Korean Older Adults. Healthcare (Basel) 2024; 12:1394. [PMID: 39057536 PMCID: PMC11275848 DOI: 10.3390/healthcare12141394] [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: 05/07/2024] [Revised: 06/26/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Cognitive frailty, which is characterized by the co-occurrence of physical frailty and cognitive impairment, poses significant risks to the well-being and independence of elderly individuals. Previous research has established that demographic, health-related, and social factors contribute to both physical frailty and cognitive decline. However, the role of social factors in influencing cognitive frailty remains unclear. This study aims to identify the relationship between social factors and cognitive frailty among Korean older adults living in the community. We performed secondary analyses of data from the 2020 Survey on Older Adults. After entering demographic factors and health-related factors into the logistic model as covariates, this study explored the association between cognitive frailty and social factors, including living arrangements, social support, the frequency of engagement in social activities per week, and satisfaction with friends and community. Among participants, approximately 2.9% had cognitive frailty, 3.2% had only physical frailty, and 21.9% had only cognitive decline. Lower levels of satisfaction with friends and the community and infrequent participation in social activities were strongly correlated with cognitive frailty. These findings emphasize the necessity of public health programs that encourage older individuals' social involvement. A supportive social environment can be fostered through initiatives that promote community events, group activities, and volunteerism. Public health policies should prioritize the development and maintenance of social activity centers that offer various programs to prevent progression to cognitive frailty in older adults.
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Affiliation(s)
- Young Ko
- College of Nursing, Gachon University, Incheon 21936, Gyeonggi, Republic of Korea;
| | - Kyungwon Choi
- Department of Nursing, Korea National University of Transportation, Jeungpyeong-gun 27909, Chungbuk, Republic of Korea
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10
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Chu H, Huang C, Guan Y, Xie F, Chen M, Guo Q. The associations between nutritional status and physical frailty and Alzheimer's disease plasma biomarkers in older cognitively unimpaired adults with positive of amyloid-β PET. Clin Nutr 2024; 43:1647-1656. [PMID: 38810424 DOI: 10.1016/j.clnu.2024.05.024] [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: 02/01/2024] [Revised: 05/06/2024] [Accepted: 05/12/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND & AIMS It has been revealed good nutritional status and no physical frailty, which are modifiable lifestyle factors, are linked to less cognitive decline and a lower risk of Alzheimer's disease (AD). We aimed to investigate the associations between nutritional status and physical frailty and plasma AD biomarkers, especially the Tau-associated biomarkers in older cognitively unimpaired (CU) adults with higher β-amyloid (Aβ) burden. METHODS The nutritional status and physical frailty were assessed via Mini-Nutritional Assessment Short-Form (MNA-SF) and Fried frailty index. The participants underwent the examination of plasma AD biomarkers and 18F-florbetapir PET scan as well as 18F-MK6240 PET in the validation cohort. Correlation and multiple linear regression analyses were used to investigate the associations between nutritional status and frailty and AD biomarkers. RESULTS Two cohorts were included in our study. A total of 129 participants with Aβ-PET positive were enrolled in the development cohort. Multiple linear regression analysis showed MNA-SF scores, normal nutritional status, Fried frailty index scores, frailty and some domains of frailty including weight loss, maximal grip strength and exhaustion were associated with plasma p-Tau-181. Furthermore, weight loss, Fried frailty index scores and frailty were associated with higher Aβ-PET standard uptake value ratio. We further performed subgroup analyses stratified by age, sex and apolipoprotein E ε4 genotype to investigate the beneficial characteristics of nutrition and frailty in the special subgroups. Validation cohort contained 38 Aβ-PET positive participants. MNA-SF scores, normal nutritional status, Fried frailty index scores and frailty were associated with Tau burden evaluated by 18F-MK6240 PET Braak-like stages. CONCLUSIONS Our data indicates that normal nutritional status and no physical frailty may be associated with expected trend of plasma AD biomarkers, especially less Tau pathology in older CU adults with Aβ deposition. Adjusting to these characteristics of nutrition and physical frailty may help reduce the risk of AD development.
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Affiliation(s)
- Heling Chu
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuyi Huang
- Health Management Center, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Fang Xie
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Meirong Chen
- Department of Neurorehabilitation High Dependency Unit, Jiangwan Hospital, Shanghai, China.
| | - Qihao Guo
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Ye Y, Wan M, Lin H, Xia R, He J, Qiu P, Zheng G. Effects of Baduanjin exercise on cognitive frailty, oxidative stress, and chronic inflammation in older adults with cognitive frailty: a randomized controlled trial. Front Public Health 2024; 12:1385542. [PMID: 38846613 PMCID: PMC11153822 DOI: 10.3389/fpubh.2024.1385542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/10/2024] [Indexed: 06/09/2024] Open
Abstract
Background Oxidative stress and chronic inflammation play an important role in the pathogenesis process of cognitive frailty (CF). Regular Baduanjin exercise could improve cognitive frailty in older adults, but it is unclear whether the effect of Baduanjin exercise on improving CF is mediated by modulating circulating oxidative stress and inflammatory process. Method A total of 102 community-dwelling older adults with CF were recruited and randomly allocated into a 24-week Baduanjin exercise training group or no specific exercise intervention control group at an equal rate. Cognitive function and physical frailty index were assessed using the Montreal Cognitive Assessment (MoCA) and the Edmonton Frail Scale (EFS), as well as the oxidative stress and inflammatory cytokines were measured at baseline and after intervention. Result After 24 weeks of intervention, the increased MoCA score (2.51 ± 0.32 points, p < 0.001) and the decreased EFS scores (1.94 ± 0.20 points, p = 0.012) in the Baduanjin group were significantly higher than those in the control group. Serum antioxidant SOD levels were increased by 10.03 ± 4.73 U/mL (p < 0.001), and the prooxidative MDA and 8-iso-PGF2α levels were decreased by -1.08 ± 0.80 nmol/mL (p = 0.030) and -86.61 ± 15.03 ng/L (p < 0.001) in the Baduanjin training group; while inflammatory cytokines IFN-γ, IL-2 and IL-4 levels were increased (1.08 ± 0.33 pg./mL, p = 0.034, 2.74 ± 0.75 pg./mL, p = 0.04 and 1.48 ± 0.35 pg./mL, p = 0.042). In addition, a mediation effect that Baduanjin training improved cognitive ability mediated by an increase of circulating IFN-γ and IL-2 levels were observed in this study. Conclusion Regular Baduanjin exercise training could improve the cognitive frailty of the community-dwelling older adults with CF, and modulate oxidative stress and inflammatory processes by reducing circulating pro-oxidative MDA and 8-iso-PGF2α levels and increasing anti-oxidative SOD levels, as well as impacting inflammatory cytokines IFN-γ, IL-2, and IL-4 levels. Nevertheless, the mechanism of Baduanjin exercise mediating oxidative stress and inflammatory processes should be cautious to be explained. Clinical trial registration http://www.chictr.org.cn/index.aspx, ChiCTR1800020341.
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Affiliation(s)
- Yu Ye
- College of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
- Department of Rehabilitation Medicine, The Second Medical Center, Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Mingyue Wan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huiying Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Rui Xia
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jianquan He
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Pingting Qiu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
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12
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Tian Q, Greig EE, Walker KA, Fishbein KW, Spencer RG, Resnick SM, Ferrucci L. Plasma metabolomic markers underlying skeletal muscle mitochondrial function relationships with cognition and motor function. Age Ageing 2024; 53:afae079. [PMID: 38615247 DOI: 10.1093/ageing/afae079] [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: 11/16/2023] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Lower skeletal muscle mitochondrial function is associated with future cognitive impairment and mobility decline, but the biological underpinnings for these associations are unclear. We examined metabolomic markers underlying skeletal muscle mitochondrial function, cognition and motor function. METHODS We analysed data from 560 participants from the Baltimore Longitudinal Study of Aging (mean age: 68.4 years, 56% women, 28% Black) who had data on skeletal muscle oxidative capacity (post-exercise recovery rate of phosphocreatine, kPCr) via 31P magnetic resonance spectroscopy and targeted plasma metabolomics using LASSO model. We then examined which kPCr-related markers were also associated with cognition and motor function in a larger sample (n = 918, mean age: 69.4, 55% women, 27% Black). RESULTS The LASSO model revealed 24 metabolites significantly predicting kPCr, with the top 5 being asymmetric dimethylarginine, lactic acid, lysophosphatidylcholine a C18:1, indoleacetic acid and triacylglyceride (17:1_34:3), also significant in multivariable linear regression. The kPCr metabolite score was associated with cognitive or motor function, with 2.5-minute usual gait speed showing the strongest association (r = 0.182). Five lipids (lysophosphatidylcholine a C18:1, phosphatidylcholine ae C42:3, cholesteryl ester 18:1, sphingomyelin C26:0, octadecenoic acid) and 2 amino acids (leucine, cystine) were associated with both cognitive and motor function measures. CONCLUSION Our findings add evidence to the hypothesis that mitochondrial function is implicated in the pathogenesis of cognitive and physical decline with aging and suggest that targeting specific metabolites may prevent cognitive and mobility decline through their effects on mitochondria. Future omics studies are warranted to confirm these findings and explore mechanisms underlying mitochondrial dysfunction in aging phenotypes.
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Affiliation(s)
- Qu Tian
- Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Erin E Greig
- Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Keenan A Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Kenneth W Fishbein
- Laboratory of Clinical Investigation, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Richard G Spencer
- Laboratory of Clinical Investigation, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD 21224, USA
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Momtaz D, Prabhakar G, Gonuguntla R, Ahmad F, Ghali A, Kotzur T, Nagel S, Chaput C. The 8-item Modified Frailty Index Is an Effective Risk Assessment Tool in Anterior Cervical Decompression and Fusion. Global Spine J 2024; 14:914-921. [PMID: 36112749 PMCID: PMC11192130 DOI: 10.1177/21925682221127229] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Case-control study; Level of evidence, 3. OBJECTIVE Anterior cervical discectomy and fusion (ACDF) is one of the most common procedures for cervical diseases often with reliable outcomes. However, morbidity rates can be as high as 19.3% so appropriate patient selection and risk stratification is imperative. Our modified frailty index (MFI) predicts postoperative complications after other orthopaedic procedures. We hypothesized that this index would predict complications in a large cohort of ACDF patients. METHODS We reviewed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database, including patients who underwent ACDF from 2015-2020. An 8-item MFI score was calculated for each patient. We recorded 30-days postoperative complications, readmission, and reoperation rates, adjusting for baseline features using standard multivariate regression. This project was approved of by the University of Texas Health Science Center Institutional Review Board and an IRB exception was granted. RESULTS We identified 17 662 ACDF cases. Patients with MFI of 5 or greater had a 37.53 times increased odds of incurring postoperative complications compared to patients with MFI of 0 (P < .001) even when age, sex, race, and ethnicity were controlled for. Specifically, life-threatening Clavien-Dindo IV complications, as well as wound, cardiac, renal, and pulmonary complications were significantly increased in patients with an MFI of 5 or greater. Also, as MFI increased from 1-2 to 3-4 to 5 or greater, the odds of readmission increased from 1.36 to 2.31 to 5.42 times (P < .001) and odds of reoperation from 1.19 (P = .185) to 2.3 to 6.54 times (P < .001). Frailty was still associated with increased complications, readmission, and reoperation after controlling for demographic data, including age, as well as operative time and length of stay. CONCLUSION Frailty is highly predictive of postoperative complications, readmission, and reoperation following ACDF. Employing a simple frailty evaluation can guide surgical decision-making and patient counseling for cervical disease.
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Affiliation(s)
- David Momtaz
- Orthopaedics, The University of Texas Health Science Center at San Antonio, TX, USA
| | - Gautham Prabhakar
- Orthopaedics, The University of Texas Health Science Center at San Antonio, TX, USA
| | - Rishi Gonuguntla
- Orthopaedics, The University of Texas Health Science Center at San Antonio, TX, USA
| | - Farhan Ahmad
- Orthopaedics, Rush University Medical Center, Chicago, IL, USA
| | - Abdullah Ghali
- Orthopaedics, Baylor College of Medicine, Houston, TX, USA
| | - Travis Kotzur
- Orthopaedics, The University of Texas Health Science Center at San Antonio, TX, USA
| | - Sarah Nagel
- Orthopaedics, The University of Texas Health Science Center at San Antonio, TX, USA
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Moore DJ, Sun-Suslow N, Nichol AA, Paolillo EW, Saloner R, Letendre SL, Iudicello J, Morgan EE. The clinical utility of three frailty measures in identifying HIV-associated neurocognitive disorders. AIDS 2024; 38:645-655. [PMID: 38051787 PMCID: PMC10939888 DOI: 10.1097/qad.0000000000003805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVE Frailty measures vary widely and the optimal measure for predicting HIV-associated neurocognitive disorders (HAND) is unclear. DESIGN A study was conducted to examine the clinical utility of three widely used frailty measures in identifying HIV-associated neurocognitive disorders. METHODS The study involved 284 people with HIV (PWH) at least 50 years enrolled at UC San Diego's HIV Neurobehavioral Research Program. Frailty measurements included the Fried Phenotype, the Rockwood Frailty Index, and the Veterans Aging Cohort Study (VACS) Index. HAND was diagnosed according to Frascati criteria. ANOVAs examined differences in frailty severity across HAND conditions. ROC analyses evaluated sensitivity and specificity of each measure to detect symptomatic HAND [mild neurocognitive disorder (MND) and HIV-associated dementia (HAD)] from no HAND. RESULTS Across all frailty measures, frailty was found to be higher in HAD compared with no HAND. For Fried and Rockwood (not VACS), frailty was significantly more severe in MND vs. no HAND and in HAD vs. ANI (asymptomatic neurocognitive impairment). For discriminating symptomatic HAND from no HAND, Fried was 37% sensitive and 92% specific, Rockwood was 85% sensitive and 43% specific, and VACS was 58% sensitive and 65% specific. CONCLUSION These findings demonstrate that Fried and Rockwood outperform VACS in predicting HAND. However, ROC analyses suggest none of the indices had adequate predictive validity in detecting HAND. The results indicate that the combined use of the Rockwood and Fried indices may be an appropriate alternative.
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Affiliation(s)
- David J Moore
- Department of Psychiatry, University of California San Diego
| | - Ni Sun-Suslow
- Department of Psychiatry, University of California San Diego
| | | | | | - Rowan Saloner
- Department of Psychiatry, University of California San Diego
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego
- Deparment of Psychiatry and Behavioral Sciences, University of California San Francisco
| | - Scott L Letendre
- Department of Psychiatry, University of California San Diego
- Department of Medicine
| | | | - Erin E Morgan
- Department of Psychiatry, University of California San Diego
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Yuan C, Zhang Y. Modifiable risk factors of cognitive frailty in community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Knowl 2024; 35:177-185. [PMID: 37378541 DOI: 10.1111/2047-3095.12437] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To perform a meta-analysis identifying the modifiable risk factors of cognitive frailty in the elderly. METHODS We systematically searched databases including PubMed, EMBASE, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform from January 01, 2017 to March 26, 2022. Quantitative, original research reporting associated factors were included. FINDINGS 7,854 records in total were identified, of which 14 articles (1 prospective, 13 cross-sectional) with 36 factors were included. Studies on cognitive frailty included 20,390 community-dwellers (≥60 years) from three countries. Meta-analysis indicated that depression [OR = 3.60, 95%CI (2.25,5.78), p < 0.01] and sleep problems [OR = 2.36, 95%CI (1.62,3.43), p < 0.01] were associated with cognitive frailty. CONCLUSIONS Effective interventions targeting depression and sleep problems may lower the risk of cognitive frailty in the community seniors but need further study in high-quality, prospective studies. IMPLICATIONS FOR NURSING PRACTICE Building on previous work, the objectives of this systematic review and meta-analysis were to explore potential modifiable risk factors for cognitive frailty in community-dwelling older adults, which is expected to throw light on the prevention of cognitive frailty.
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Affiliation(s)
- Chen Yuan
- Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yixiong Zhang
- Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Ijaz N, Jamil Y, Brown CH, Krishnaswami A, Orkaby A, Stimmel MB, Gerstenblith G, Nanna MG, Damluji AA. Role of Cognitive Frailty in Older Adults With Cardiovascular Disease. J Am Heart Assoc 2024; 13:e033594. [PMID: 38353229 PMCID: PMC11010094 DOI: 10.1161/jaha.123.033594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 02/21/2024]
Abstract
As the older adult population expands, an increasing number of patients affected by geriatric syndromes are seen by cardiovascular clinicians. One such syndrome that has been associated with poor outcomes is cognitive frailty: the simultaneous presence of cognitive impairment, without evidence of dementia, and physical frailty, which results in decreased cognitive reserve. Driven by common pathophysiologic underpinnings (eg, inflammation and neurohormonal dysregulation), cardiovascular disease, cognitive impairment, and frailty also share the following risk factors: hypertension, diabetes, obesity, sedentary behavior, and tobacco use. Cardiovascular disease has been associated with the onset and progression of cognitive frailty, which may be reversible in early stages, making it essential for clinicians to diagnose the condition in a timely manner and prescribe appropriate interventions. Additional research is required to elucidate the mechanisms underlying the development of cognitive frailty, establish preventive and therapeutic strategies to address the needs of older patients with cardiovascular disease at risk for cognitive frailty, and ultimately facilitate targeted intervention studies.
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Affiliation(s)
- Naila Ijaz
- Thomas Jefferson University HospitalPhiladelphiaPAUSA
| | - Yasser Jamil
- Yale University School of MedicineNew HavenCTUSA
| | | | | | - Ariela Orkaby
- New England GRECC, VA Boston Healthcare SystemBostonMAUSA
- Division of AgingBrigham & Women’s Hospital, Harvard Medical SchoolBostonMAUSA
| | | | | | | | - Abdulla A. Damluji
- Johns Hopkins University School of MedicineBaltimoreMDUSA
- The Inova Center of Outcomes ResearchInova Heart and Vascular InstituteFalls ChurchVAUSA
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Huang L, Chen H, Gao M, Shen J, Tao Y, Huang Y, Lv R, Xie R, Lv X, Xu X, Xu X, Yuan C. Dietary factors in relation to the risk of cognitive impairment and physical frailty in Chinese older adults: a prospective cohort study. Eur J Nutr 2024; 63:267-277. [PMID: 37930363 DOI: 10.1007/s00394-023-03260-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/27/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE The study aimed to investigate the independent associations of dietary factors with cognitive impairment (CI) and physical frailty (PF) among Chinese older adults. METHODS This study included 10,734 participants (mean age = 78.7 years) free of CI and PF at baseline from the Chinese Longitudinal Health Longevity Survey. Dietary intake was collected using a simplified food frequency questionnaire every 3-4 years. The Chinese version Mini-Mental State Examination was used to assess cognition function, participants with a score below 18 were defined as CI. PF was defined using the activities of daily living, instrumental activities of daily living, and functional limitation-related questions. The outcome was defined as the first onset of either CI or PF. Competing risk models were used to estimate the corresponding hazard ratios (HRs) and the 95% confidence intervals (95% CIs). RESULTS During the study follow-up (mean = 8.1 years), a total of 1220 CI cases and 1451 PF cases were newly identified. Higher frequency of fruits intake was associated with a lower hazard of CI (HR = 0.75, 95% CI 0.58-0.97), whereas higher intake of preserved vegetables demonstrated an opposite association (HR = 1.23, 95% CI 1.07-1.42). In terms of PF, we observed a lower risk associated with higher meat and poultry intake (HR = 0.72, 95% CI 0.61-0.88). In particular, a significant protective association of fish and aquatic products intake with PF was observed among participants with ≥ 28 natural teeth (HR = 0.52, 95% CI 0.27-0.99). CONCLUSION Our findings suggest divergent roles of major dietary factors in the development of CI and PF among Chinese older adults.
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Affiliation(s)
- Liyan Huang
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Hui Chen
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Mengyan Gao
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Jie Shen
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Yang Tao
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Yuhui Huang
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Rongxia Lv
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Renxiang Xie
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Xiaozhen Lv
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Peking University Institute of Mental Health (Sixth Hospital), Beijing, 100191, China
| | - Xin Xu
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Xiaolin Xu
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China.
| | - Changzheng Yuan
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
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Willbanks A, Seals M, Karmali R, Roy I. Harnessing the Systemic Biology of Functional Decline and Cachexia to Inform more Holistic Therapies for Incurable Cancers. Cancers (Basel) 2024; 16:360. [PMID: 38254849 PMCID: PMC10814065 DOI: 10.3390/cancers16020360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Options for treatment of incurable cancer remain scarce and are largely focused on limited therapeutic mechanisms. A new approach specific to advanced cancers is needed to identify new and effective treatments. Morbidity in advanced cancer is driven by functional decline and a number of systemic conditions, including cachexia and fatigue. This review will focus on these clinical concepts, describe our current understanding of their underlying biology, and then propose how future therapeutic strategies, including pharmaceuticals, exercise, and rehabilitation, could target these mechanisms as an alternative route to addressing incurable cancer.
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Affiliation(s)
| | - Mina Seals
- Shirley Ryan AbilityLab, Chicago, IL 60611, USA
| | - Reem Karmali
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA
| | - Ishan Roy
- Shirley Ryan AbilityLab, Chicago, IL 60611, USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL 60611, USA
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Liu CH, Peng CH, Huang LY, Chen FY, Kuo CH, Wu CZ, Cheng YF. Comparison of multiple linear regression and machine learning methods in predicting cognitive function in older Chinese type 2 diabetes patients. BMC Neurol 2024; 24:11. [PMID: 38166825 PMCID: PMC10759520 DOI: 10.1186/s12883-023-03507-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION The prevalence of type 2 diabetes (T2D) has increased dramatically in recent decades, and there are increasing indications that dementia is related to T2D. Previous attempts to analyze such relationships principally relied on traditional multiple linear regression (MLR). However, recently developed machine learning methods (Mach-L) outperform MLR in capturing non-linear relationships. The present study applied four different Mach-L methods to analyze the relationships between risk factors and cognitive function in older T2D patients, seeking to compare the accuracy between MLR and Mach-L in predicting cognitive function and to rank the importance of risks factors for impaired cognitive function in T2D. METHODS We recruited older T2D between 60-95 years old without other major comorbidities. Demographic factors and biochemistry data were used as independent variables and cognitive function assessment (CFA) was conducted using the Montreal Cognitive Assessment as an independent variable. In addition to traditional MLR, we applied random forest (RF), stochastic gradient boosting (SGB), Naïve Byer's classifier (NB) and eXtreme gradient boosting (XGBoost). RESULTS Totally, the test cohort consisted of 197 T2D (98 men and 99 women). Results showed that all ML methods outperformed MLR, with symmetric mean absolute percentage errors for MLR, RF, SGB, NB and XGBoost respectively of 0.61, 0.599, 0.606, 0.599 and 0.2139. Education level, age, frailty score, fasting plasma glucose and body mass index were identified as key factors in descending order of importance. CONCLUSION In conclusion, our study demonstrated that RF, SGB, NB and XGBoost are more accurate than MLR for predicting CFA score, and identify education level, age, frailty score, fasting plasma glucose, body fat and body mass index as important risk factors in an older Chinese T2D cohort.
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Affiliation(s)
- Chi-Hao Liu
- Department of Medicine, Division of Nephrology, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, R.O.C
| | - Chung-Hsin Peng
- Department of Urology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan, R.O.C
| | - Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Department of Medical Education, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C
| | - Fang-Yu Chen
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Fu Jen Catholic University Hospital, New Taipei City, Taiwan, R.O.C
| | - Chun-Heng Kuo
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C
| | - Chung-Ze Wu
- Department of Internal Medicine, Division of Endocrinology, Shuang Ho Hospital, New Taipei City, 23561, R.O.C
- Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan, R.O.C
| | - Yu-Fang Cheng
- Department of Endocrinology and Metabolism, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua City, 50006, Taiwan, R.O.C..
- Department of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C..
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Guseva OV, Zhukova NG. [Criteria of syndrome frailty in Parkinson´s disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:52-56. [PMID: 38529863 DOI: 10.17116/jnevro202412403152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
OBJECTIVE To evaluate syndrome frailty by the Fried phenotype in patients with Parkinson's disease (PD). MATERIAL AND METHODS Seventy-three patients over 65 years of age with Hoehn and Yahr stage 2-4 PD were tested for the presence of subjective criteria of the Fried phenotype of syndrome frailty: fatigue, difficulty in performing habitual activities, weight loss and objective criteria: grip strength and walking speed. The relationships of the objective criteria of Fried with indicators of age, sex, sports history, prescription of PD, the number of medications, blood pressure and MDS UPDRS part III scores, the severity of depression on the Beck scale and cognitive disorders on the MOCA were evaluated. RESULTS All patients complained of fatigue, difficulties in performing habitual activities. Four people noted a decrease in body weight of more than 5 kg per year. Objective criteria of Fried were absent in 38 (51%) patients, 23 (32%) people had one objective criterion: reduced walking speed (less than 0.8 m/s) or hand strength (less than 16 kg for women and 26 kg for men), in 12 (17%) people both objective criteria were reduced. The values of objective criteria of weakness were correlated with age, sex and MDS UPDRS part III total scores. CONCLUSION Frailty syndrome is difficult to diagnose in patients with PD due to the coincidence of complaints of the underlying disease and the syndrome. Objective criteria of the Fried phenotype suggest the presence of syndrome frailty in patients. The increase in the age of the patient, the female sex and the severity of PD are interrelated with the presence of objective criteria for the frailty of an elderly person.
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Affiliation(s)
- O V Guseva
- Siberian State Medical University, Tomsk, Russia
| | - N G Zhukova
- Siberian State Medical University, Tomsk, Russia
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21
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Li X, Ma L. From biological aging to functional decline: Insights into chronic inflammation and intrinsic capacity. Ageing Res Rev 2024; 93:102175. [PMID: 38145874 DOI: 10.1016/j.arr.2023.102175] [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: 05/18/2023] [Revised: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 12/27/2023]
Abstract
Intrinsic capacity is the sum of an individual's physical and mental capacities, which helps determine functional ability. Intrinsic capacity decline is an important predictor of adverse health outcomes and can identify individuals at higher risk of functional decline. Aging is characterized by a decrease in physiological reserves and functional abilities. Chronic inflammation, a mechanism of aging, is associated with decreased intrinsic capacity, which may mirror the broader relationship between aging and functional ability. Therefore, it is crucial for maintaining functional ability and promoting healthy aging to study the mechanisms of intrinsic capacity decline, identify easily available markers, and make targets for intervention from the perspective of chronic inflammation. We reviewed the current research on chronic inflammation, inflammation-related markers, and intrinsic capacity. To date, there is still no inflammatory markers with high specificity and sensitivity to monitor intrinsic capacity decline. Interleukin-6, C-reactive protein, and tumor necrosis factor-alpha may potentially indicate changes in intrinsic capacity, but their results with intrinsic capacity or each intrinsic capacity domain are inconsistent. Considering the variations in individual responses to changes in inflammatory markers, it may be beneficial to explore the use of multiple analytes instead of relying on a single marker. This approach could be valuable in monitoring the decline of intrinsic capacity in the future.
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Affiliation(s)
- Xiaxia Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China.
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22
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Deore HS, Taranikanti M, Gaur A, Varatharajan S, John NA, Katta R, Taranikanti SS, Umesh M, Ganji V, Medala K. Comprehensive, continuous, and compulsory monitoring of frailty in elderly. J Family Med Prim Care 2023; 12:3194-3199. [PMID: 38361887 PMCID: PMC10866276 DOI: 10.4103/jfmpc.jfmpc_233_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 02/17/2024] Open
Abstract
Background The increasing elderly population makes frailty an increasing concern in society with vulnerability to stress and functional decline. Unrecognised comorbidities are common among the elderly due to lack of mention by the patients. Physicians should be equipped with effective interviewing skills along with the use of screening tools to assess any impairments in activities of daily living, cognition and signs of depression. Objectives To measure the degree of independence or dependence using scales and stratify patients based on Clinical Frailty Scale (CFS) so as to recommend it as a routinely usable tool. Materials and Methods In total, 191 elderly subjects above the age of 65 years were recruited for geriatric assessment. Tools that assess performance in daily living activities and cognition were used. The prevalidated CFS was used to score frailty to stratify patients into frail and non-frail groups, and the parameters were compared. Results Mean age of the study population was 69.54 years with 53.4% males and 46.6% females. Mean Katz index and mean Lawton score were >5. The mean Global Deterioration Scale (GDS) score was 1.5, and the mean clinical frailty score was 3.55. Significantly high number of male individuals were found in the frailty group. Hypertension was significantly higher in the frail group. The mean Katz scores were significantly lower, and mean GDS scores were significantly higher in the frailty group. Multivariable logistic regression has shown gender to be an important determinant of frailty with an odds ratio of 0.05 (CI-0.01-0.20). The higher Lawton score and GDS scores were significantly associated with frailty with an odds ratio of 0.33 (CI: 0.21-0.52) and 2.62 (CI: 1.14-6.02), respectively. Conclusion Men are more frail than women and co-morbidities like hypertension and coronary artery disease contribute to frailty with cognitive decline and decreased autonomy. A comprehensive assessment to identify frailty will provide a holistic view of well being among the elderly.
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Affiliation(s)
- Hiranya S. Deore
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Madhuri Taranikanti
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Archana Gaur
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Sakthivadivel Varatharajan
- Department of General Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Nitin A. John
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Roja Katta
- Department of Physiology, ESIC Medical College and Hospital, Hyderabad, Telangana, India
| | - Sai Shriya Taranikanti
- Department of General Medicine, Agartala Government Medical College and GB Pant Hospital, Agartala, Tripura, India
| | - Madhusudhan Umesh
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Vidya Ganji
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Kalpana Medala
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
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Nader MM, Cosarderelioglu C, Miao E, Whitson H, Xue QL, Grodstein F, Oh E, Ferrucci L, Bennett DA, Walston JD, George C, Abadir PM. Navigating and diagnosing cognitive frailty in research and clinical domains. NATURE AGING 2023; 3:1325-1333. [PMID: 37845509 PMCID: PMC10936574 DOI: 10.1038/s43587-023-00504-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
While physical frailty has been recognized as a clinical entity for some time, the concept of cognitive frailty (CF) is now gaining increasing attention in the geriatrics research community. CF refers to the co-occurrence of physical frailty and cognitive impairment in older adults, which has been suggested as a potential precursor to both dementia and adverse physical outcomes. However, this condition represents a challenge for researchers and clinicians, as there remains a lack of consensus regarding the definition and diagnostic criteria for CF, which has limited its utility. Here, using insights from both the physical frailty literature and cognitive science research, we describe emerging research on CF. We highlight areas of agreement as well as areas of confusion and remaining knowledge gaps, and provide our perspective on fine-tuning the current construct, aiming to stimulate further discussion in this developing field.
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Affiliation(s)
- Monica M Nader
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | - Caglar Cosarderelioglu
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
- Ankara University School of Medicine, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey
| | - Emily Miao
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Geriatrics, New York, NY, USA
| | - Heather Whitson
- Duke University School of Medicine, Center for the Study of Aging, Durham, NC, USA
| | - Qian-Li Xue
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Esther Oh
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | | | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Jeremy D Walston
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | - Claudene George
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Geriatrics, New York, NY, USA
| | - Peter M Abadir
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA.
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Karanth S, Braithwaite D, Katsumata Y, Duara R, Norrod P, Aukhil I, Abner E. Association of Physical Frailty and Cognitive Function in a Population-Based Cross-Sectional Study of American Older Adults. Gerontology 2023; 70:48-58. [PMID: 37903474 PMCID: PMC10961850 DOI: 10.1159/000533919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/28/2023] [Indexed: 11/01/2023] Open
Abstract
INTRODUCTION Cognitive impairment and frailty are prevalent in older persons. Physical frailty is associated with cognitive decline; however, the role of effect modifiers such as age, sex, race/ethnicity, and cognitive reserve is not well understood. METHODS Cross-sectional data from the National Health and Nutrition Examination Survey (2011-2014) were obtained for participants aged ≥60 years. Complete availability of cognitive scores was an inclusion criterion. Physical frailty was defined by the presence of exhaustion, weakness, low body mass, and/or low physical activity, and categorized into three groups: robust (0 present), pre-frail (1-2 present), or frail (3-4 present). Four cognitive test scores were converted to z-scores, and global cognition (composite z-score) was calculated by averaging the four-individual z-scores. Multivariable linear regression models were fit to estimate the associations between frailty and cognitive function. Frailty was also evaluated as a risk factor for self-reported subjective memory complaint (SMC) using logistic regression. All models were adjusted for age, sex, race/ethnicity, education, alcohol use, income, marital status, diabetes, hypertension, and history of stroke. Effect measure modification analyses were conducted by age, sex, race/ethnicity, education, and occupational cognitive demand. RESULTS The study population comprised 2,863 participants aged ≥60 years. 50.6% of the participants were categorized into robust, 43.2% pre-frail, and 6.2% frail. After adjusting for covariates, compared to robust participants, frail and prefrail participants had lower adjusted mean global cognitive z-scores, β^ = -0.61, 95% CI: -0.83, -0.38 and β^ = -0.21, 95% CI: -0.30, -0.12, respectively. Both prefrail and frail participants had higher odds of SMC compared to the robust participants. We did not see strong evidence that the association between frailty and cognition was modified by the factors we studied. DISCUSSION/CONCLUSION Both pre-frailty and frailty were associated with lower cognitive performance and were more likely to report subjective memory complaints relative to persons without frailty. These findings provide additional evidence that physical frailty may serve as a prognostic factor for cognitive deterioration or dementia, and prevention of frailty may be an important public health strategy.
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Affiliation(s)
- Shama Karanth
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
- University of Florida Health Cancer Center, Gainesville, Florida, USA
| | - Dejana Braithwaite
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
- University of Florida Health Cancer Center, Gainesville, Florida, USA
- Department of Epidemiology, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Yuriko Katsumata
- Department of Biostatistics, University of Kentucky, Lexington, Kentucky, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
| | - Ranjan Duara
- Florida Alzheimer's Disease Research Center, University of Florida, Gainesville, Florida, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center¸, Miami Beach, Florida, USA
| | - Paul Norrod
- Department of Population Health, College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ikramuddin Aukhil
- Department of Surgical Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Erin Abner
- Department of Biostatistics, University of Kentucky, Lexington, Kentucky, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
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25
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Deng Y, Li N, Wang Y, Xiong C, Zou X. Risk Factors and Prediction Nomogram of Cognitive Frailty with Diabetes in the Elderly. Diabetes Metab Syndr Obes 2023; 16:3175-3185. [PMID: 37867632 PMCID: PMC10588717 DOI: 10.2147/dmso.s426315] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023] Open
Abstract
Purpose Diabetes is a well-recognized risk factor for cognitive frailty. This study aimed to investigate the influencing factors of cognitive frailty in elderly patients with diabetes and develop a nomogram for its assessment. Methods We collected the clinical data of diabetic patients aged 60 years or older and the patients were divided into training and validation cohorts at a ratio of 7:3. In the training cohort, logistic regression was used to screen out the influencing factors of cognitive frailty in elderly diabetic patients, and a risk prediction model and nomogram were constructed and verified in the validation cohort. The performance of the model was evaluated using various measures, including the area under the receiver operating characteristic curve, calibration curve, Hosmer-Lemeshow test and decision curve analysis. Results A total of 315 elderly diabetic patients were included, of which 87 (27.6%) patients had cognitive frailty. Age, albumin levels, calf circumference, duration of diabetes, intellectual activity, and depressive state were identified as independent risk factors for cognitive frailty in older patients with diabetes (P < 0.05). The training cohort and validation cohort demonstrated area under curve (AUC) values of 0.866 and 0.821, respectively. Conclusion Older patients with diabetes have a higher prevalence of cognitive frailty. The nomogram model exhibited satisfactory calibration and identification, providing a reliable tool for assessing the risk of cognitive frailty in individuals with diabetes.
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Affiliation(s)
- Yinhui Deng
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Na Li
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Yaru Wang
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Chen Xiong
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Xiaofang Zou
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
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Cui K, Meng W, Li Z, Zeng X, Li X, Ge X. Dynamics, association, and temporal sequence of cognitive function and frailty: a longitudinal study among Chinese community-dwelling older adults. BMC Geriatr 2023; 23:658. [PMID: 37833637 PMCID: PMC10571451 DOI: 10.1186/s12877-023-04328-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Little is known about the association of longitudinal dynamics between cognitive function and frailty in Chinese older adults. The temporal sequences between cognitive function and frailty remains unclear. Our study investigates this directionality association using longitudinal data. METHODS Latent growth and multivariate latent growth models were employed to examine dynamics of cognition and frailty and their association among 2824 older adults in China. Cross-lagged panel analyses were used to assess the temporal sequences between frailty and cognition. The relation between cognitive domains and frailty was also examined using aforementioned methods. RESULTS Cognitive function was negatively associated with frailty status. Higher initial level of cognition indicated lower baseline level (β=-0.175, P < 0.001) and change rate (β=-0.041, P = 0.002) of frailty. We observed a reciprocal association between frailty and cognitive function rather than a unidirectional causal relationship. The initial cognitive performance for all components were negatively associated with baseline (β ranged between - 0.098 to -0.023) and change rate (β ranged between - 0.007 to -0.024) of frail status. No consistent associations between change rate of cognitive components and either initial level or change rate of frailty were detected. CONCLUSIONS Our study detected a reciprocal association between cognition and frailty rather than a unidirectional causal relationship. Our results also revealed different connections between cognitive performance and frailty across diverse cognitive domains.
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Affiliation(s)
- Kai Cui
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Weihan Meng
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Zhiqiang Li
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Xinning Zeng
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Xiaozhe Li
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China
| | - Xiaoyan Ge
- School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121000, P. R. China.
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Lorenzo-López L, Gandoy-Crego M, Tolentino LC. Editorial: World Alzheimer's month: cognitive frailty, Alzheimer's disease and dementia: how do they relate? The role of cognitive reserve. Front Psychol 2023; 14:1267306. [PMID: 37868608 PMCID: PMC10588476 DOI: 10.3389/fpsyg.2023.1267306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Affiliation(s)
- Laura Lorenzo-López
- Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, A Coruña, Spain
| | - Manuel Gandoy-Crego
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Leida C. Tolentino
- Department of Psychology, Santa Barbara City College, Santa Barbara, CA, United States
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Wrightson R, Albertini M, Pirrone F, McPeake K, Piotti P. The Relationship between Signs of Medical Conditions and Cognitive Decline in Senior Dogs. Animals (Basel) 2023; 13:2203. [PMID: 37443999 DOI: 10.3390/ani13132203] [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: 05/15/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Canine cognitive dysfunction syndrome (CCDS) is a progressive age-related neurodegenerative disorder in dogs. Minimal research has been performed to investigate how clinical signs may be impacted by other medical conditions. A cross-sectional study was performed using the Canine Cognitive Assessment Scale (CCAS) to evaluate cognitive impairment as reported by owners. Owner-reported health-related measures included behaviour changes, the body condition score, and veterinary diagnoses of disease. The responses from 804 dogs in the last 25% of their expected lifespan were analysed. Factors were identified in the owner-reported behavioural signs of disease representing pathologies in four body systems: musculoskeletal-neurological, digestive, metabolic, and dermatological, with the items comprising these factors also compiled into a cumulative measure of health. The results showed a strong correlation between the CCAS score and both the musculoskeletal-neurological factor and the overall cumulative measure of health. Moderate correlations between the CCAS score and the digestive factor and metabolic factor were also observed. The correlation between the dermatological factor and the CCAS score was weak. This study highlights the need to screen dogs for concurrent diseases when using scales to assess cognitive impairment and to monitor dogs who have health conditions, particularly those that are painful, for the onset of cognitive impairment.
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Affiliation(s)
- Rosalind Wrightson
- The Royal (Dick) School of Veterinary Studies, Midlothian, Edinburgh EH25 9RG, UK
| | - Mariangela Albertini
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
| | - Federica Pirrone
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
| | - Kevin McPeake
- The Royal (Dick) School of Veterinary Studies, Midlothian, Edinburgh EH25 9RG, UK
| | - Patrizia Piotti
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
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Chuang SY, Liu WL, Chang HY, Hsu CC, Pan WH. Central obesity and elevated blood pressure in middle life are associated with physical and cognitive impairment in later life: A retrospective design with repeated measures. Exp Gerontol 2023; 173:112093. [PMID: 36669710 DOI: 10.1016/j.exger.2023.112093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Physical and cognitive function decline indicates the prestage of disability and is associated with mortality among older adults. We investigated the association of metabolic disorders in midlife with physical and cognitive function decline in later life in a retrospective cohort. MATERIAL AND METHODS A total of 618 older adults aged ≥60 years in wave-6 (2014-2017) were enrolled in the Cardiovascular Disease Risk Factor Two-Township Study to evaluate physical (hand grip strength and 4-m walking speed) and cognitive function (Mine-Mental State Examination [MMSE] score). Repeated metabolic disorder measures in wave-2, wave-3, and wave-5 were obtained to identify three trajectory pattern groups according to each metabolic disorder through group-based trajectory modeling. Linear and logistic regressions were conducted to investigate the association of metabolic disorders in middle life with physical and cognitive function decline in later life. RESULTS The prevalence rates of a weak hand grip (<28 kg for men and <18 kg for women), slow walking speed (<0.8 m/s), and poor cognitive function (MMSE <25) were 24.43 %, 16.83 % and 10.5 %, respectively, among the older adults. In the retrospective cohort with 15-year follow-up, those with a waist circumference of ≥95 cm for men and ≥85 cm for women in middle life exhibited a significantly weak hand grip (odds ratio: 2.78 [95 % confidence interval: 1.26, 6.11]) and slow walking speed (2.26 [1.15, 4.43]) in later life compared with those with a smaller waist circumference (<85 cm for men and <75 cm for women). Elevated blood pressure (systolic blood pressure [BP] ≥130 mmHg or diastolic BP ≥80 mmHg) was significantly associated with a higher risk of cognitive function decline in later life. Furthermore, the high-trajectory and middle-trajectory groups' body mass index (3.17 [1.25, 8.04] and 2.27 [1.28, 4.00], respectively) and waist circumference (4.39 [2.07, 9.31] and 2.54 [1.39, 4.67], respectively) were significantly associated with a weak hand grip and slow walking speed, respectively, compared with those of the low-trajectory group. The high-trajectory diastolic BP group was significantly associated with a higher risk of cognitive function decline compared with the low-trajectory diastolic BP group. CONCLUSION Waist circumference and BP in middle life were associated with physical function decline and poor cognitive function in later life. The management of central obesity and BP in midlife may slow the decline of physical and cognitive function in later life.
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Affiliation(s)
- Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC.
| | - Wen-Ling Liu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, Taiwan
| | - Wen-Harn Pan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC; Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, ROC; Department of Nutrition Food and Health Biotechnology, Asia University, Taichung, Taiwan
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30
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Li C, Ge S, Yin Y, Tian C, Mei Y, Han P. Frailty is associated with worse cognitive functioning in older adults. Front Psychiatry 2023; 14:1108902. [PMID: 36816402 PMCID: PMC9928943 DOI: 10.3389/fpsyt.2023.1108902] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Frailty and impaired cognitive functioning often co-occur in older adults and are associated with adverse health outcomes. However, their relationship is unclear. This study sought to examine the association of frailty status with cognitive functioning in older adults. Method The study population consisted of 2,296 older adults aged ≥60 from the National Health and Nutrition Examination Survey 2011-2014. Frailty status was measured based on the Fried Phenotype and the participants were categorized into three groups- robust, pre-frailty, and frailty. Cognitive functioning was measured using the Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL) immediate and delayed recall tests, the Animal Fluency test (AFT), and the Digit Symbol Substitution Test (DSST). Test-specific and global cognition z-scores were calculated. Multinomial linear regression models were constructed to examine the association between frailty status (reference: robust) and test-specific and global cognition z-scores. Multiple linear regression models were used to examine the relationship between the number of frailty dimensions and test-specific and global cognition z-scores. All models controlled for age, race/ethnicity, education, total cholesterol level, and systolic blood pressure. Results About half of the participants (median age 68 years) were female (49.9%) and non-Hispanic White (48.7%). A quarter (23.3%) of the participants completed some college and above. Multinominal linear regression showed that compared with participants who were robust, those with frailty had worse DSST [β = -0.234, 95% confidence interval (CI): -0.391, -0.078, P = 0.003] and global cognition z scores (β = -0.129, 95% CI -0.233, -0.025, P = 0.02). Multiple linear regression model showed that the number of frailty dimensions was significantly associated with decreased the DSST (β = -0.065, 95% CI -0.103, -0.026, P = 0.001) and global cognition z-scores (β= -0.034, 95% CI -0.06, -0.009, P = 0.009). Conclusion Frailty is associated with worse processing speed, sustained attention, working memory, and global cognition in older adults. Prevention and treatment of frailty in older adults may help protect their cognitive functioning. Further, clinicians should consider assessing cognitive functioning, especially processing speed, sustained attention, and working memory, among frail older patients, which may allow early identification and interventions of cognitive impairment.
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Affiliation(s)
- Chunmei Li
- Infection Clinic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston, TX, United States
| | - Yueheng Yin
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Peijin Han
- Department of Computational Medicine and Bioinformatics, Medical School, University of Michigan, Ann Arbor, MI, United States
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Frechman E, Dietrich MS, Buck HG, Rhoten BA, Maxwell CA. Readiness to Plan for Aging and Frailty: Examining Contextual Factors. J Gerontol Nurs 2023; 49:27-35. [PMID: 36719659 DOI: 10.3928/00989134-20230106-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
As older adults live longer, individual and societal efforts must be directed toward strategies to promote healthy and successful aging. Planning for aging and frailty offers an opportunity for older adults to optimize their well-being and proactively prepare across their aging trajectory. The current study evaluated the relationship between contextual factors (functional status, frailty, health status, social support) that influence older adults' readiness to engage in planning in five domains of aging (communication, environmental, financial, physical care, cognitive) through the transtheoretical stages of change. Results showed that factors influencing active planning include older age, vulnerability, living situation, and social support. These results add to the discourse on future care planning through a comprehensive approach to planning across a life course perspective, while highlighting the importance of future research at individual and societal levels. Gerontological nurses are well-positioned to lead planning efforts for older adults that promote well-being, patient-centered care, and healthy aging. [Journal of Gerontological Nursing, 49(2), 27-35.].
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Resciniti NV, Farina MP, Merchant AT, Lohman MC. Depressive Symptoms Partially Mediate the Association of Frailty Phenotype Symptoms and Cognition for Females but Not Males. J Aging Health 2023; 35:42-49. [PMID: 35527693 PMCID: PMC9640765 DOI: 10.1177/08982643221100688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We aimed to evaluate whether depressive symptoms mediated the relationship between frailty phenotype and cognitive function by sex. METHODS Data came from the Health and Retirement Study from 2012-2016. The outcome was measured by Fried's frailty criteria, our outcome was continuous global cognition, and mediator was depressive symptoms. We used mediation analysis, stratified by sex, to estimate the direct and indirect effects of frailty symptoms on cognition mediated by depressive symptoms. RESULTS Males had a larger total effect (β= -0.43; 95% CI: -0.66, -0.02) for lower cognitive score for each increase in frailty symptom compared to females (β= -0.28; 95% CI: -0.47, -0.08). A significant indirect effect from frailty phenotype to cognition was found through depressive symptoms for females but not males. CONCLUSION These results highlight the importance of identifying individuals with frailty and depressive symptoms to monitor and provide interventions to preserve cognitive function.
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Affiliation(s)
- Nicholas V. Resciniti
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Mateo P. Farina
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Anwar T. Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Matthew C. Lohman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Jiang Z, Liu X, Lü Y. Unhealthy oral status contributes to the older patients with cognitive frailty: an analysis based on a 5-year database. BMC Geriatr 2022; 22:980. [PMID: 36536305 PMCID: PMC9764571 DOI: 10.1186/s12877-022-03673-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Oral health is associated with the onset and deterioration of cognitive function and physical frailty, which can be improved with appropriate interventions. However, far too little attention has been paid to oral health status of elderly with cognitive frailty. The objective of this study was to investigate the oral health status and potential risk factors of elderly hospitalized patients aged 60 years or older with cognitive frailty. METHODS The participants' assessment data derived from the Comprehensive Geriatric Assessment Database of hospitalized patients from The First Affiliated Hospital of Chongqing Medical University. Data were collected from April 2016 to December 2021. All participants underwent a face-to-face assessment conducted by professional evaluators. Physical frailty was defined by Fried's criteria. Cognitive function was assessed by Mini Mental State Examination (MMSE). The cognitive frailty is characterized by the simultaneous presence of at least 1 Fried's criteria and mild cognitive impairment according to Diagnostic and Statistical Manual of Mental Disorders 5th edition. The oral health was assessed according to 10-item Brief Oral Health Status Examination (BOHSE). The general demographic characteristics, BOHSE scores were compared between the cognitive frailty and non-cognitive frailty (control group). The score of BOHSE and ten items were included in the binary logistic regression analysis. The covariate characteristics were adjusted for a final model with a multivariate analysis. RESULTS A total of 425 patients (245 females) with cognitive frailty and 491 patients (283 females) with non-cognitive frailty were enrolled in this retrospective study. Univariate analysis showed statistically significant differences in age, education level, living arrangement, diabetes, Body Mass Index (BMI), Pittsburgh Sleep Quality Index (PSQI), depression between the two groups. The total BOHSE score of cognitive frailty was higher than that of the control group (4.35 ± 2.68 vs. 3.64 ± 2.60, Z = 4.07, P < 0.001). The average scores and the proportions of health changes and unhealthy states of tongue, mucosa tissue, gums, natural teeth, dentures, masticatory teeth and oral hygiene in cognitive frailty were greater than those of the control group (all P < 0.05). The binary logistical regression analysis showed that four or more natural teeth decayed or broken was independently associated with cognitive frailty after adjusting the age, gender, education level, living arrangement and BMI, PSQI, diabetes and depression (OR = 1.91, 95%CI: 1.20-3.07, P = 0.007). Additionally, while in the chewing position, those cases with a normal-occlusal-relationship number of less than 11 pairs had a higher risk of cognitive frailty than those with 12 pairs or more. CONCLUSIONS The oral health status of older hospitalized patients over 60 years with cognitive frailty was worse than that of patients with non-cognitive frailty. But only four or more natural teeth decayed or broken and a reduction in chewing pairs were independent risk factors for cognitive frailty.
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Affiliation(s)
- Zhiqiong Jiang
- grid.452206.70000 0004 1758 417XDepartment of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China ,grid.413387.a0000 0004 1758 177XDepartment of Geriatrics, Affiliated Hospital of North Sichuan Medical College, 637000 Nanchong, China
| | - Xintong Liu
- grid.452206.70000 0004 1758 417XDepartment of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China
| | - Yang Lü
- grid.452206.70000 0004 1758 417XDepartment of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China
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Maxwell CA, Roberts C, Oesmann K, Muhimpundu S, Archer KR, Patel MR, Mulubrhan MF, Muchira J, Boon J, LaNoue M. Health and wellness for disadvantaged older adults: The AFRESH pilot study. PEC INNOVATION 2022; 1:100084. [PMID: 37213747 PMCID: PMC10194225 DOI: 10.1016/j.pecinn.2022.100084] [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] [Received: 04/28/2022] [Revised: 08/23/2022] [Accepted: 09/13/2022] [Indexed: 05/23/2023]
Abstract
Introduction Older adults are unaware of the biological mechanisms that contribute to the development of disabilities, chronic conditions, and frailty, yet, when made aware, desire to employ lifestyle changes to mitigate these conditions. We developed the AFRESH health and wellness program and report on pilot testing undertaken in a local older adults apartment community. Materials and methods After program development, pilot testing was conducted. Participants: Older adults (N = 20; age 62+) residing in an apartment community. Procedures: Collection of baseline objective and self-report measures with a focus on physical activity; administration of the 10-week AFRESH program via weekly sessions; collection of follow-up data 12 and 36 weeks after baseline data collection. Data analysis: Descriptive statistics, growth curve analyses. Results Significant increases were observed for grip strength (lbs) (T1:56.2; T2:65.0 [d = 0.77]; T3:69.4 [d = 0.62], p = .001), the 6-min walk test (meters) (T1:327m: T2:388.7 m [d = 0.99]; T3:363.3 m [d = 0.60], p = .001), the Rapid Assessment of Physical Activity (RAPA) strength and flexibility score, and the Pittsburg Sleep Quality Index (PSQI) global score. These effects showed some attenuation by the final time point. Conclusion By combining novel educational content (bioenergetics), facilitation of physical activity, and habit formation, AFRESH is a multicomponent intervention that shows promise for future research.
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Affiliation(s)
- Cathy A Maxwell
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - Corley Roberts
- Catholic Charities, 2806 McGavock Pike, Nashville, TN 37214, USA
| | - Kelsey Oesmann
- Urban Housing Solutions, 822 Woodland St., Nashville, TN 37206, USA
| | - Sylvie Muhimpundu
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - Kristin R Archer
- Vanderbilt University Medical Center, 1215 21 Ave. South, Nashville, TN 37232, USA
| | - Maulik R Patel
- Vanderbilt University Biological Sciences, Box 351634, Nashville, TN 37235, USA
| | - Mogos F Mulubrhan
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - James Muchira
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - Jeffrey Boon
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - Marianna LaNoue
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
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Allcock L, Mantzioris E, Villani A. Adherence to a Mediterranean Diet is associated with physical and cognitive health: A cross-sectional analysis of community-dwelling older Australians. Front Public Health 2022; 10:1017078. [PMID: 36466491 PMCID: PMC9709195 DOI: 10.3389/fpubh.2022.1017078] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022] Open
Abstract
Poor cognitive function is associated with reduced functional independence, risk of institutionalization and reduced health-related quality of life. The ability to independently perform instrumental activities of daily living (iADLs) is compromised in patients with mild cognitive impairment (MCI) or dementia. Emerging evidence suggests that adherence to a Mediterranean diet (MedDiet), may play an important protective role against cognitive decline and dementia risk, whilst preserving functional status. This cross-sectional study aimed to explore the independent associations between MedDiet adherence, cognitive risk, and functional status in community-dwelling older adults living in Australia. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS); a modified Lawton's iADL scale was used for the assessment of functional status and risk of cognitive impairment was assessed using the AD8 dementia screening intervention. A total of n = 294 participants were included in the final analyses (70.4 ± 6.2 years; Females, n = 201; Males, n = 91; n = 2 unspecified). Adherence to a MedDiet was positively associated with functional ability (β = 0.172; CI: 0.022, 0.132; P = 0.006) independent of age, gender, Body Mass Index (BMI), smoking status, sleep duration, physical activity duration, diabetes status, and level of education. Furthermore, MedDiet adherence was inversely associated with cognitive risk (β = -0.134; CI: -0.198, -0.007; P = 0.035) independent of all covariates. However, our sensitivity analyses further showed that adherence to a MedDiet was not associated with cognitive risk in older adults free from cognitive impairment. We showed that adherence to a MedDiet is associated with healthy physical and cognitive aging. Nevertheless, exploration of these findings in larger cohorts, using longitudinal analyses and controlling for important confounders to ascertain the direction of the relationship is warranted.
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Affiliation(s)
- Lisa Allcock
- School of Health and Behavioral Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Evangeline Mantzioris
- Clinical and Health Sciences and Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Anthony Villani
- School of Health and Behavioral Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
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Qipo O, Debain A, Bautmans I. The influence of hypertension management on frailty prevention among older persons aged 65 and over: a systematic review. Aging Clin Exp Res 2022; 34:2645-2657. [PMID: 36195809 DOI: 10.1007/s40520-022-02247-0] [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: 04/08/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Frailty and hypertension are interrelated, but it remains unclear whether this relationship is modified by antihypertensive drugs. METHODS AND RESULTS A systematic review of PubMed and Web of Science databases was performed to review the influence of hypertension management on preventing the occurrence or progression of frailty in older people aged 65 and over. Studies providing information on this association regardless of the study setting, or definition of hypertension and frailty were included. Among the initial 2298 articles identified, 7 were included in the review. Three observational studies assessed the association between frailty and hypertension. Two of them reported no relationship between Aldosterone Antagonists use and frailty prevention. No relationship between BP and incidence frailty after adjustment for hypertension treatment was observed in two other articles. An indirect relationship was reported in the RCTs included. Higher AT11RaAb levels (control group), can lead to a generalized weakness/frailty risk shown by a decrease in grip strength (r = -0.57, p < 0.005) and walking speed (r = - 0.47, p < 0.005). No significant differences between int-hypertensive intervention and control were observed in frailty status after a 12-weeks follow-up after applying three different frailty measurement tools in the other RCT. CONCLUSIONS Based on the results of this systematic review we conclude that BP and frailty occur together but whether the treatment with anti-hypertensive drugs modifies this relationship remains unclear and needs to be further investigated.
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Affiliation(s)
- Orgesa Qipo
- Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - Aziz Debain
- Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - Ivan Bautmans
- Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium.
- Department of Geriatrics, Universitair Ziekenhuis Brussels (UZBrussels), Laarbeeklaan 101, B-1090, Brussels, Belgium.
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Sousa-Fraguas MC, Rodríguez-Fuentes G, Conejo NM. Frailty and cognitive impairment in Parkinson’s disease: a systematic review. Neurol Sci 2022; 43:6693-6706. [PMID: 36056182 DOI: 10.1007/s10072-022-06347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/12/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Frailty can lead to increased vulnerability in older people and patients with Parkinson's disease (pwPD) and worsen their health conditions. These patients can also develop cognitive function impairment. The objective is to analyze whether there is a relationship between frailty and cognitive impairment in pwPD, and to find out which instruments to use for its evaluation. METHODS Publications were searched in PubMed, Medline, Web of Science, Cinalh, Cochrane Library, Embase, Phycinfo, and Scopus. The results were measured with the instruments that are used to assess frailty and cognitive impairment, and analyze their relationship. RESULTS Two hundred seventy-one articles were identified, of which 12 met the inclusion criteria. All studies assessed frailty and cognitive function in pwPD. Five studies analyzed the relationship between frailty and cognitive impairment. The most used instruments were the Fried scale followed by the Clinical Frailty Scale (CFS) for frailty. Cognitive impairment was mostly evaluated with the Mini-Mental State Examination and the Montreal Cognitive Assessment. The prevalence data ranged from 20.2 to 51.5% with the Fried scale and from 35.6 to 83.9% with the CFS. Cognitive impairment was present in 15 to 45.2% of the pwPD. CONCLUSION Analysis of the included studies shows a relationship between frailty and cognitive impairment in pwPD. There was significant variability in the application of the scales used, which influences the prevalence data. More observational and experimental studies are needed to provide more evidence on this association and to determine which is the optimal tool to identify frailty in pwPD using multidimensional scales.
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Han C, An J, Chan P. Effects of cognitive ageing trajectories on multiple adverse outcomes among Chinese community-dwelling elderly population. BMC Geriatr 2022; 22:692. [PMID: 35996087 PMCID: PMC9396872 DOI: 10.1186/s12877-022-03387-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether cognitive ageing trajectory is related to common functional deficits independent of initial cognitive function remains inconclusive. We aimed to explore the adverse health effect and potential predictive factors of distinct cognitive trajectories among Chinese older adults. METHODS Three thousand five hundred eighty-one community-dwelling older adults who completed three consecutive cognitive function examinations with the Mini-Mental State Examination (MMSE) over 5 years and were without cognitive impairment at enrollment were included. A group-based trajectory model was used to estimate cognitive ageing trajectories. Multivariable-adjusted odds ratio (OR) and 95% confidence intervals (CI) were computed with logistic regression models to identify potential baseline determinants and health effect of cognitive trajectories on various adverse outcomes. RESULTS Two distinct cognitive ageing trajectories were identified with about 5.3% of the study participants ascribed to the rapidly decreasing group. Subjects with rapidly decreasing cognition showed significantly higher odds (OR, 95%CI) of experiencing frailty (4.04, 2.77-5.86), falls (2.01, 1.05-3.70), balance impairment (4.20, 2.75-6.38), high fall risk (5.66, 2.67-11.77) based on the Tinetti total score, disability in activities of daily living (1.76, 1.19-2.56), disability in instrumental activities of daily living (1.52, 1.05-2.19), and motor cognitive risk syndrome (2.24, 1.23-3.98) compared with their steadily decreasing counterparts. Individuals with older age, low education level, no marriage, high score of rapid eye movement behavior disorders, poor physical and cognitive function at baseline were more predisposed to an accelerated cognitive decline. CONCLUSIONS Faster cognitive decline was independently associated with higher risk of multiple adverse events. Our findings put more emphasis on a routine and constant surveillance of cognitive function among community-dwelling older adults.
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Affiliation(s)
- Chao Han
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jing An
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Piu Chan
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China. .,Department of Neurobiology, Neurology and Geriatrics, Beijing Institute of Geriatrics, Clinical Center for Parkinson's Disease, Key Laboratories for Neurodegenerative Diseases of the Ministry of Education; Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Advanced Innovative Center for Human Brain Protection, Xuanwu Hospital of Capital Medical University, 45 Changchun Road, Beijing, 100053, China.
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Xie D, Huang H, Zhao Q, Ning P, Shen Q, Lu H, Xu F, Fu X, Xu Y. Prevalence and associated factors of frailty and sarcopenia in multiple system atrophy and progressive supranuclear palsy: a cross-sectional study. Neurol Sci 2022; 43:6329-6337. [DOI: 10.1007/s10072-022-06296-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/22/2022] [Indexed: 12/11/2022]
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Xiong J, Xue WX. The role of vitamin D in the link between physical frailty and cognitive function: A mediation analysis in community-dwelling Chinese older adults. Front Nutr 2022; 9:922673. [PMID: 35958260 PMCID: PMC9359101 DOI: 10.3389/fnut.2022.922673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Physical frailty and cognitive aging have important influences on poor clinical outcomes in older adults. Many studies have investigated the association between frailty and cognitive function, but whether vitamin D mediates the association between frailty and cognitive function is unclear. We explored the mediating role of vitamin D on the cross-sectional association between physical frailty and cognitive function using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Methods We analyzed data from 1944 subjects aged 60 years and older from the 2011 CLHLS cohort. Frailty status was identified by the Osteoporotic Fracture Study (SOF) index. The Chinese version of the Mini-Mental State Examination (MMSE) was used to assess cognitive function. Linear regression models were used to examine the association between frailty, vitamin D, and cognition, adjusted for a range of covariates. Mediation analyses tested the indirect effects of vitamin D on physical frailty and cognitive function. Result Physical frailty was negatively associated with vitamin D levels and scores on the MMSE, and vitamin D levels were positively associated with scores on the MMSE. Linear regression analysis showed that physical frailty and serum vitamin D concentration were significant predictors of cognitive function. Importantly, mediation analysis showed that serum vitamin D concentration significantly mediated the relationship between physical frailty and cognitive function. Conclusion The association between physical frailty and cognitive function appears to be mediated by vitamin D. Future studies should explore whether serum vitamin D concentrations may mediate the association between physical frailty and cognitive decline and whether this mediating role is moderated by other factors.
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Affiliation(s)
- Jian Xiong
- Department of Rehabilitation, Affiliated Zhangjiagang Hospital of Soochow University, Suzhou, China
| | - Wen-Xiong Xue
- Department of Rehabilitation, Affiliated Zhangjiagang Hospital of Soochow University, Suzhou, China
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Hui Z, Wang X, Zhou Y, Li Y, Ren X, Wang M. Global Research on Cognitive Frailty: A Bibliometric and Visual Analysis of Papers Published during 2013–2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138170. [PMID: 35805829 PMCID: PMC9265998 DOI: 10.3390/ijerph19138170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022]
Abstract
This study analyzed the current status, hotspots, and emerging trends of global research on cognitive frailty, in order to provide new research ideas for researchers. Articles and reviews related to cognitive frailty, published from 2013 to 2021, were retrieved from the Web of Science Core Collection (WoSCC) database on 26 November 2021. CiteSpace 5.8.R3 was employed for data analyses. A total of 2077 publications were included. There has been a rapid growth of publications on cognitive frailty research since 2016. The United States, Italy, England, and Australia have been the leading research centers of cognitive frailty; however, China has also recently focused on this topic. The National Center for Geriatrics and Gerontology, and Shimada H. were found to be the most prolific institution and author, respectively. Co-citation analysis identified 16 clusters, of which the largest was cognitive frailty. The keywords which occurred most frequently were “older adult”, followed by “cognitive impairment”, “frailty”, “risk”, “dementia”, “prevalence”, “mortality”, “health”, and “Alzheimer’s disease”. Burst keyword detection revealed a rising interest in cognitive frailty models. By analyzing these publications from recent years, this study provides a comprehensive analysis of cognitive frailty research.
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Affiliation(s)
- Zhaozhao Hui
- School of Public Health, Health Science Center, Xi’an Jiaotong University, 76 Yanta West Road, Xi’an 710061, China; (Z.H.); (Y.L.)
| | - Xiaoqin Wang
- School of Nursing, Health Science Center, Xi’an Jiaotong University, 76 Yanta West Road, Xi’an 710061, China; (X.W.); (X.R.)
| | - Ying Zhou
- Office of Cadre Health Care, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an 710061, China;
| | - Yajing Li
- School of Public Health, Health Science Center, Xi’an Jiaotong University, 76 Yanta West Road, Xi’an 710061, China; (Z.H.); (Y.L.)
| | - Xiaohan Ren
- School of Nursing, Health Science Center, Xi’an Jiaotong University, 76 Yanta West Road, Xi’an 710061, China; (X.W.); (X.R.)
| | - Mingxu Wang
- School of Public Health, Health Science Center, Xi’an Jiaotong University, 76 Yanta West Road, Xi’an 710061, China; (Z.H.); (Y.L.)
- Correspondence:
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Pedroli E, Mancuso V, Stramba-Badiale C, Cipresso P, Tuena C, Greci L, Goulene K, Stramba-Badiale M, Riva G, Gaggioli A. Brain M-App’s Structure and Usability: A New Application for Cognitive Rehabilitation at Home. Front Hum Neurosci 2022; 16:898633. [PMID: 35782042 PMCID: PMC9248351 DOI: 10.3389/fnhum.2022.898633] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
Cognitive frailty is defined as a clinical condition characterized by both physical frailty and cognitive impairment, without reaching the criteria for dementia. The major goal of rehabilitation intervention is to assist patients in performing ordinary personal duties without the assistance of another person, or at the very least to remove the need for additional support, using adaptive approaches and facilities. In this regard, home-based rehabilitation allows patients to continue an intervention begun in a hospital setting while also ensuring support and assistance when access to healthcare systems is limited, such as during the present pandemic situation. We thus present Brain m-App, a tablet-based application designed for home-based cognitive rehabilitation of frail subjects, addressing spatial memory, attention, and executive functions. This app exploits the potential of 360° videos which are well-suited to home-based rehabilitation. The Brain m-app is made up of 10 days of activities that include a variety of exercises. The activities were chosen based on those patients used to do during their clinical practice in the hospital with the aim to improve their independence and autonomy in daily tasks. The preliminary usability test, which was conducted on five older people, revealed a sufficient level of usability, however, the sample size was modest. Results from the clinical study with 10 patients, revealed that Brain m-App improved especially executive functions and memory performances.
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Affiliation(s)
- Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Valentina Mancuso
- Faculty of Psychology, eCampus University, Novedrate, Italy
- *Correspondence: Valentina Mancuso,
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy
| | - Luca Greci
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing – National Research Council, Milan, Italy
| | - Karine Goulene
- Department of Geriatrics and Cardiovascular Medicine, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Universitá Cattolica del Sacro Cuore, Milan, Italy
| | - Andrea Gaggioli
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy
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Balietti M, Conti F. Environmental enrichment and the aging brain: is it time for standardization? Neurosci Biobehav Rev 2022; 139:104728. [PMID: 35691473 DOI: 10.1016/j.neubiorev.2022.104728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/01/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Abstract
Aging entails a progressive decline of cognitive abilities. However, since the brain is endowed with considerable plasticity, adequate stimulation can delay or partially compensate for age-related structural and functional impairment. Environmental enrichment (EE) has been reported to determine a wide range of cerebral changes. Although most findings have been obtained in young and adult animals, research has recently turned to aged individuals. Notably, EE can contribute identifying key lifestyle factors whose change can help extend the "mind-span", i.e., the time an individual lives in a healthy cognitive condition. Here we discuss specific methodological issues that can affect the outcomes of EE interventions applied to aged rodents, summarize the main variables that would need standardization (e.g., timing and duration, enrichment items, control animals and setting), and offer some suggestions on how this goal may be achieved. Reaching a consensus on EE experiment design would significantly reduce differences between and within laboratories, enable constructive discussions among researchers, and improve data interpretation.
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Affiliation(s)
- Marta Balietti
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy.
| | - Fiorenzo Conti
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy; Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy.
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44
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Cerebral small vessel disease alters neurovascular unit regulation of microcirculation integrity involved in vascular cognitive impairment. Neurobiol Dis 2022; 170:105750. [DOI: 10.1016/j.nbd.2022.105750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/09/2022] [Accepted: 05/08/2022] [Indexed: 12/25/2022] Open
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Ebina J, Ebihara S, Kano O. Similarities, differences and overlaps between frailty and Parkinson's disease. Geriatr Gerontol Int 2022; 22:259-270. [PMID: 35243739 DOI: 10.1111/ggi.14362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/07/2021] [Accepted: 01/27/2022] [Indexed: 12/12/2022]
Abstract
Parkinson's disease is a neurodegenerative disorder clinically characterized by bradykinesia, rest tremor, rigidity, and postural and gait disturbances, which are frequently observed in older people. It also shows non-motor symptoms, such as depression, anxiety, cognitive impairment and dementia. The number of patients is gradually increasing worldwide. Aging is a risk factor for the onset of Parkinson's disease, and various physiological effects of aging influence its progression. Frailty is a geriatric syndrome in which the reversible and vulnerable status between robustness and disability is affected by various physiological stressors with aging. Frailty consists of physical, psychological and social aspects. Furthermore, sarcopenia, a syndrome characterized by the loss of muscle mass, strength and function, is also significantly associated with frailty. To maintain the quality of life of older people, frailty, including sarcopenia, should be quickly and appropriately managed. Polypharmacy is an important factor causing the progression of frailty in geriatric syndrome. Although Parkinson's disease and frailty have similar symptoms, and are considered to affect each other, the clinical features and mechanisms of both largely remain unclear. Nevertheless, little literature on the relationship between frailty and Parkinson's disease is currently available. This narrative review aims to clarify the relationships between Parkinson's disease and frailty, not only on the physical, but also on the mental, cognitive, and social aspects and issues regarding polypharmacy in Parkinson's disease explored by previous studies. Geriatr Gerontol Int 2022; 22: 259-270.
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Affiliation(s)
- Junya Ebina
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Satoru Ebihara
- Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Osamu Kano
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
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Govoni S, Fagiani F, Lanni C, Allegri N. The Frailty Puzzle: Searching for Immortality or for Knowledge Survival? Front Cell Neurosci 2022; 16:838447. [PMID: 35250489 PMCID: PMC8891148 DOI: 10.3389/fncel.2022.838447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/25/2022] [Indexed: 12/18/2022] Open
Abstract
What is the value of assessing the biological age and frailty and predicting residual lifespan and health status? The benefit is obvious if we have means to alter the pace of aging and the development of frailty. So far, limited but increasing examples of interventions altering the predicted status indicate that, at least in some cases, this is possible through interventions spanning from the economic-social through drug treatments. Thus, why searching for biological markers, when some clinical and socio-economic indicators do already provide sufficiently accurate predictions? Indeed, the search of frailty biomarkers and of their biological clocks helps to build up a mechanistic frame that may orientate the design of interventions and the time window of their efficacy. Among the candidate biomarkers identified, several studies converge to indicate epigenetic clocks as a promising sensitive biomarker of the aging process. Moreover, it will help to establish the relationship between personal aging and health trajectories and to individuate the check points beyond which biological changes are irreversible.
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Affiliation(s)
- Stefano Govoni
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
| | - Francesca Fagiani
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
| | - Cristina Lanni
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
| | - Nicola Allegri
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
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Ramírez-Vélez R, Martínez-Velilla N, Correa-Rodríguez M, Sáez de Asteasu ML, Zambom-Ferraresi F, Palomino-Echeverria S, García-Hermoso A, Izquierdo M. Lipidomic signatures from physically frail and robust older adults at hospital admission. GeroScience 2022; 44:1677-1688. [PMID: 35119615 PMCID: PMC9213630 DOI: 10.1007/s11357-021-00511-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
Identifying serum biomarkers that can predict physical frailty in older adults would have tremendous clinical value for primary care, as this condition is inherently related to poor quality of life and premature mortality. We compared the serum lipid profile of physically frail and robust older adults to identify specific lipid biomarkers that could be used to assess physical frailty in older patients at hospital admission. Forty-three older adults (58.1% male), mean (range) age 86.4 (78–100 years) years, were classified as physically frail (n = 18) or robust (n = 25) based on scores from the Short Physical Performance Battery (≤ 6 points). Non-targeted metabolomic study by ultra-high performance liquid chromatography coupled to mass spectrometry (UHPLC-MS) analysis with later bioinformatics data analysis. Once the significantly different metabolites were identified, the KEGG database was used on them to establish which were the metabolic pathways mainly involved. Area under receiver-operating curve (AUROC) analysis was used to test the discriminatory ability of lipid biomarkers for frailty based on the Short Physical Performance Battery. We identified a panel of five metabolites including ceramides Cer (40:2), Cer (d18:1/20:0), Cer (d18:1/23:0), cholesterol, and phosphatidylcholine (PC) (14:0/20:4) that were significantly increased in physically frail older adults compared with robust older adults at hospital admission. The most interesting in the physically frail metabolome study found with the KEGG database were the metabolic pathways, vitamin digestion and absorption, AGE-RAGE signaling pathway in diabetic complications, and insulin resistance. In addition, Cer (40:2) (AUROC 0.747), Cer (d18:1/23:0) (AUROC 0.720), and cholesterol (AUROC 0.784) were identified as higher values of physically frail at hospital admission. The non-targeted metabolomic study can open a wide view of the physically frail features changes at the plasma level, which would be linked to the physical frailty phenotype at hospital admission. Also, we propose that metabolome analysis will have a suitable niche in personalized medicine for physically frail older adults.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Health Sciences Faculty, University of Granada, Avda. De la Ilustración 60, 18016, Granada, Spain
| | - Mikel L Sáez de Asteasu
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Palomino-Echeverria
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,Laboratorio de Ciencias de La Actividad Física, El Deporte Y La Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain. .,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
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Umehara T, Kaneguchi A, Yamasaki T, Matsuura A, Kito N, Tanaka H, Yamaoka K. Interactive effects of exercise and sleep on frailty severity in community-dwelling older adults: a cross-sectional study. J Rural Med 2022; 17:21-28. [PMID: 35047098 PMCID: PMC8753256 DOI: 10.2185/jrm.2021-041] [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: 08/10/2021] [Accepted: 10/02/2021] [Indexed: 01/07/2023] Open
Abstract
Objectives: This study examined the effects of the interaction between
exercise and sleep on frailty severity in community-dwelling older adults. Materials and Methods: This was a cross-sectional study. Data were collected
in July 2019. In total, 2021 adults participated who responded to a questionnaire. Among
them, 672 participants (317 men and 355 women) with valid responses were included in the
analysis. Ordinal logistic regression analysis was performed to examine the association
between frailty severity and the interaction between exercise and sleep. The dependent
variable represents three different levels of frailty. The independent variables included
basic information and interaction between exercise and sleep. Results: The results of ordinal logistic regression analysis (odds ratio
[OR]) showed that the period from the start of exercise (OR=0.96), age (OR=1.00 for
participants in their 60 s, OR=1.65 for those in their 70s, and OR=3.13 for those aged
>80 years), poor subjective health perception (OR=2.12), poor quality of sleep
(OR=1.88), stress (OR=1.62), and exercise–sleep interaction (OR=1.00 based on
good-exercise–good-sleep interaction, OR=3.09 poor-exercise–good-sleep interaction, and
OR=3.50 poor-exercise–poor-sleep interaction) significantly contributed to the model. The
Nagelkerke coefficient of determination adjusted for degrees-of-freedom (R2),
which represents the contribution rate of the regression equation, was 0.334. Conclusions: Our results suggest that a combination of good exercise and
good sleep is needed to prevent frailty progression in community-dwelling older
adults.
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Affiliation(s)
- Takuya Umehara
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Akinori Kaneguchi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Takahiro Yamasaki
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
| | - Akihiro Matsuura
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Nobuhiro Kito
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
| | - Hideki Tanaka
- Well-being and Wellness Center, Hiroshima International University, Japan.,Department of Psychology, Faculty of Health Science, Hiroshima International University, Japan
| | - Kaoru Yamaoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
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Hoffman JM, Hernandez CM, Hernandez AR, Bizon JL, Burke SN, Carter CS, Buford TW. Bridging the Gap: A Geroscience Primer for Neuroscientists With Potential Collaborative Applications. J Gerontol A Biol Sci Med Sci 2022; 77:e10-e18. [PMID: 34653247 PMCID: PMC8751800 DOI: 10.1093/gerona/glab314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Indexed: 11/13/2022] Open
Abstract
While neurodegenerative diseases can strike at any age, the majority of afflicted individuals are diagnosed at older ages. Due to the important impact of age in disease diagnosis, the field of neuroscience could greatly benefit from the many of the theories and ideas from the biology of aging-now commonly referred as geroscience. As discussed in our complementary perspective on the topic, there is often a "silo-ing" between geroscientists who work on understanding the mechanisms underlying aging and neuroscientists who are studying neurodegenerative diseases. While there have been some strong collaborations between the biology of aging and neuroscientists, there is still great potential for enhanced collaborative effort between the 2 fields. To this end, here, we review the state of the geroscience field, discuss how neuroscience could benefit from thinking from a geroscience perspective, and close with a brief discussion on some of the "missing links" between geroscience and neuroscience and how to remedy them. Notably, we have a corresponding, concurrent review from the neuroscience perspective. Our overall goal is to "bridge the gap" between geroscience and neuroscience such that more efficient, reproducible research with translational potential can be conducted.
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Affiliation(s)
- Jessica M Hoffman
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Caesar M Hernandez
- Department of Cellular, Development, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Abbi R Hernandez
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer L Bizon
- Department of Neuroscience and Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Sara N Burke
- Department of Neuroscience and Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Christy S Carter
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Nathan Shock Center for Excellence in the Basic Biology of Aging, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas W Buford
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Geriatric Research Education and Clinical Center, Birmingham Veteran's Affairs Medical Center, Birmingham, Alabama, USA
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Cintra MTG, Bento BMA, Branco BVC, Sousa ADDM, Moraes END, Bicalho MAC. Clinical predictors of frailty in users of Secondary Care in Geriatrics and Gerontology. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.220150.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Abstract Objective To analyze the health predictors associated with frailty in the older population treated at a Secondary Care Service in Geriatrics and Gerontology, Belo Horizonte, Minas Gerais state, Brazil. Methods A cross-sectional observational study involving a sample of 4,323 individuals aged 60 years or older that underwent a clinical-functional evaluation was conducted. Sociodemographic and clinical-functional variables were analyzed and compared against the dependent variable of the study: clinical-functional stratum, as measured by the Visual Frailty Scale, dichotomized into frail and non-frail. Univariate logistic regressions were performed and the variables with p-value <0.2 were submitted to multivariate regression by stepwise and forward methods of selecting variables in the equation. Results The potential explanatory value of the model was 70.4%. Seven variables were associated with frailty: age (OR 1.016; 95%CI: 1.001–1.028; p<0.001), dementia (OR 5.179; 95%CI: 3.839–5.961; p<0.001), depressive symptoms (OR 1.268; 95%CI: 1.090–1.475; p=0.002), urinary incontinence (OR 1.330; 95%CI: 1.153–1.535; p<0.001), changes in gait speed (OR 1.483; 95%CI: 1.287–1.709; p<0.001), calf circumference (OR 0.956; 95%CI: 0.932–0.982; p=0.001), and BMI (OR 1.026; 95%CI: 1.008–1.044; p=0.005). Conclusion Advanced age, dementia, depressive symptoms, and continence and gait changes were associated with frailty. The study results reveal an association of reduced calf circumference and increased BMI values with frailty in older adults and that dementia diagnosis had the strongest association with the frailty syndrome.
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