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Dlima SD, Hall A, Aminu AQ, Akpan A, Todd C, Vardy ERLC. Frailty: a global health challenge in need of local action. BMJ Glob Health 2024; 9:e015173. [PMID: 39122463 PMCID: PMC11331888 DOI: 10.1136/bmjgh-2024-015173] [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: 01/25/2024] [Accepted: 06/24/2024] [Indexed: 08/12/2024] Open
Abstract
Frailty is a complex, age-related clinical condition that involves multiple contributing factors and raises the risk of adverse outcomes in older people. Given global population ageing trends, the growing prevalence and incidence of frailty pose significant challenges to health and social care systems in both high-income and lower-income countries. In this review, we highlight the disproportionate representation of research on frailty screening and management from high-income countries, despite how lower-income countries are projected to have a larger share of older people aged ≥60. However, more frailty research has been emerging from lower-income countries in recent years, paving the way for more context-specific guidelines and studies that validate frailty assessment tools and evaluate frailty interventions in the population. We then present further considerations for contextualising frailty in research and practice in lower-income countries. First, the heterogeneous manifestations of frailty call for research that reflects different geographies, populations, health systems, community settings and policy priorities; this can be driven by supportive collaborative systems between high-income and lower-income countries. Second, the global narrative around frailty and ageing needs re-evaluation, given the negative connotations linked with frailty and the introduction of intrinsic capacity by the World Health Organization as a measure of functional reserves throughout the life course. Finally, the social determinants of health as possible risk factors for frailty in lower-income countries and global majority populations, and potential socioeconomic threats of frailty to national economies warrant proactive frailty screening in these populations.
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Affiliation(s)
- Schenelle Dayna Dlima
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration - Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alex Hall
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Abodunrin Quadri Aminu
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Asangaedem Akpan
- Bunbury Regional Hospital, Bunbury, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration - Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma R L C Vardy
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration - Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Oldham Care Organisation, Northern Care Alliance NHS Foundation Trust, Rochdale Road, Oldham, UK
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Yang C, Gao Y, An R, Lan Y, Yang Y, Wan Q. Oral frailty: A concept analysis. J Adv Nurs 2024; 80:3134-3145. [PMID: 38214108 DOI: 10.1111/jan.16042] [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: 04/05/2023] [Revised: 11/20/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024]
Abstract
AIM To clarify the concept of oral frailty to provide a clear and standardized conceptual basis for further research in older people. DESIGN Rodgers and Knafl's evolutionary concept analysis approach. METHODS The narrative analysis detailedly extracted and synthesized the attributes of oral frailty, as well as its antecedents, consequences and related terms under the guidance of Rodgers' evolutionary method. DATA SOURCES Multiple databases including Pubmed, CINAHL and Cochrane were searched using selected search terms 'oral frail*', 'oral health' and 'aged' respectively. Articles written between 2013 and 2023 were included, and grey literature was excluded. RESULTS A total of 32 articles were included for further analysis and synthesis. The attributes of oral frailty were hypofunction, predisposing in nature, non-specific and multidimensional. Antecedents of prefrailty were classified into four categories, namely, sociodemographic characteristics, comorbidity, physical function and psychosocial factors. Consequences of oral frailty include three themes: increased risk of adverse outcomes, poor nutritional status and possibility of social withdrawal. Related terms that had shared attributes with oral frailty were oral health, functional dentition, oral hypofunction and deterioration of oral function. CONCLUSIONS Oral frailty is an age-related phenomenon reflected in decreased oral function. The findings of this concept analysis are conducive to understanding and clarifying the oral frailty, which can help clinicians or other healthcare providers to consider how to distinguish oral frailty in older adults and further promote the development of this field. IMPACT Oral frailty is increasingly recognized as an age-related phenomenon reflected in decreased oral function. As it is newly proposed, no consensus has been reached regarding the theoretical and operational concept of it. Through clarifying the concept, this paper will guide future healthcare research on oral frailty regarding the influencing factors, mechanisms and interventions, thus raising the awareness with regard to oral health among older adults. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: In the context of older adults, oral frailty is a concept that requires further research to guide future theoretical development, and the influencing factors, mechanisms and interventions need to be further studied. Raise awareness with regard to oral health among older people and more attention will be paid to the early identification and intervention of oral frailty, so as to further improve the quality of life of older adults.
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Affiliation(s)
- Chengfengyi Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Yajing Gao
- School of Nursing, Peking University, Beijing, China
| | - Ran An
- School of Nursing, Peking University, Beijing, China
| | - Yue Lan
- School of Nursing, Peking University, Beijing, China
| | - Yue Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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Cao X, Tian Y, Chen H, Li S, Zhou J. The Global Research Trends on Intrinsic Capacity of Older Adults: A Bibliometric and Visual Analysis of Papers Published During 2015-2023. J Multidiscip Healthc 2024; 17:3323-3339. [PMID: 39010933 PMCID: PMC11249103 DOI: 10.2147/jmdh.s471324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 07/04/2024] [Indexed: 07/17/2024] Open
Abstract
Objective The concept of intrinsic capacity (IC) revolves around healthy aging and active aging. Since the Introduction of the concept by the World Health Organization in 2015, a series of studies have been conducted by scholars from multiple fields. However, no bibliometric analysis has systematically investigated this issue. We aim to identify the current landscape and frontier trends of scientific achievements on IC in older adults through bibliometric approaches. Methods Quantitative analysis of publications relating to IC in older adults from 2015 to 2023 was interpreted and graphed through the Web of Science Core Collection database on December 5, 2023. A variety of quantitative variables was analyzed, including publication and citation counts, H-index, and journal citation reports. Co-authorship, citation, co-citation, and co-occurrence analyses were performed for countries/regions, institutions, authors, and keywords using the VOSviewer and CiteSpace. Results A total of 952 original and review articles in English were identified. The European countries possessed an absolute advantage in this field. The most contributive institution was the University of São Paulo. The most productive author is Cesari Matteo from France, followed by Qaisar Rizwan from the United Arab Emirates. However, a relatively low level of research cooperation existed between institutions and authors. Important topics mainly include the connotations, theoretical framework models, evaluation, screening tools, and application scenarios of IC. Among the promising hotspots, "biological aging", "ICOPE", "Covid-19", "prevention", "inflammation", "caf22", "prevalence", and "randomized controlled trial" displayed relatively latest average appearing year. Conclusion Global trends indicate a growing scientific output on IC in older adults, and developed countries are leading the way. There is still room for improvement in research team collaboration. The focus gradually shifts from theoretical research to empirical research. It is recommended to pay attention to the latest hot spots, such as "biological aging", "ICOPE implementation", "post-COVID-19 syndrome", and "biomarkers".
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Yusheng Tian
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Hui Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Sihong Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Jiansong Zhou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
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Bencivenga L, Strumia M, Rolland Y, Guyonnet S, Parini A, Cestac P, Andrieu S, Souto Barreto PD, Rouch L. Visit-to-visit blood pressure variability is associated with intrinsic capacity decline: Results from the MAPT Study. Eur J Intern Med 2024; 125:82-88. [PMID: 38499456 DOI: 10.1016/j.ejim.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND The effectiveness of the body physiological regulatory mechanisms declines in late life, and increased Blood Pressure Variability (BPV) may represent an alteration in cardiovascular homeostatic patterns. Intrinsic Capacity (IC) has been proposed by the World Health Organization as a marker of healthy aging, based on individual's functional abilities and intended at preserving successful aging. We aimed to investigate the association of visit-to-visit BPV with IC decline in a population of community-dwelling older adults. METHODS The study population consisted of 1407 community-dwelling participants aged ≥70 years from the MAPT study evaluated during the 5-year follow-up. Systolic BPV (SBPV) and diastolic BPV (DBPV) were determined through six indicators. Cognition, psychology, locomotion and vitality constituted the four IC domains assessed. Total IC Z-score resulted from the sum of the four domains Z-scores divided by 4. The incidence of domain impairment over time was also assessed. RESULTS Higher SBPV was significantly associated with poorer IC Z-scores in all linear mixed models [1-SD increase of CV%: β(SE)=-0.010(0.001), p < 0.01]. Similar results were observed for DBPV [1-SD increase of CV%: β(SE)=-0.003(0.001), p = 0.02]. Incident IC impairment was significantly higher in participants with greater SBPV, [HR=1.16 (95 % CI, 1.01-1.33), p = 0.03], while greater DBPV did not show a higher risk of incident IC impairment. CONCLUSIONS Greater BPV is associated with IC decline over time. Our findings support BP instability as a presumable index of altered cardiovascular homeostatic mechanism, suggesting that BPV might be a clinical marker of aging and addressable risk factor for promoting healthy aging.
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Affiliation(s)
- Leonardo Bencivenga
- Department of Translational Medical Sciences, University of Naples Federico II, Napoli, Italy; Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France.
| | - Mathilde Strumia
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France; Department of Pharmacy, Toulouse University, Toulouse, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France
| | - Sophie Guyonnet
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France
| | - Angelo Parini
- Institut Des Maladies Métaboliques Et Cardiovasculaires (I2MC), Toulouse, France
| | - Philippe Cestac
- Department of Pharmacy, Toulouse University, Toulouse, France
| | - Sandrine Andrieu
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France
| | - Philipe De Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France
| | - Laure Rouch
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France; Department of Pharmacy, Toulouse University, Toulouse, France
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Maheshwari S, Dai C, Giri S, Harmon C, Tucker A, Fowler ME, Outlaw D, Williams GR. Intrinsic capacity and survival among older adults with gastrointestinal malignancies: The Cancer and Aging Resilience Evaluation registry. Cancer 2024. [PMID: 38865419 DOI: 10.1002/cncr.35427] [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: 12/05/2023] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Intrinsic capacity (IC) was introduced by the World Health Organization (WHO) as a marker of healthy aging, and is defined as the combination of an individual's physical, mental, and psychological capacities. This study aimed to assess IC via a patient-reported geriatric assessment (GA) and evaluate its association with survival among older adults with gastrointestinal (GI) malignancies. METHODS Data were used from a single-institution prospective registry of older adults undergoing GA before cancer therapy. Key domains of IC (vitality, locomotion, and sensory [hearing and visual], psychological, and cognitive capacities) were captured via GA, and each was given a score of 0 or 1 (0, impaired) to compute the total IC score (range, 0-6, where 6 indicates no impairment and ≤5 indicates impairment in ≥1 domains). A frailty index (FI) was measured via the deficit accumulation method. Cox regression models and Kaplan-Meier curves were used to examine the impact of IC impairment on survival. RESULTS The study included 665 patients; the median age was 68 years, 57.4% were men, and 72.9% were White. The median IC score was 4, and 79.3% of participants showed impairment in ≥1 domains of IC. Most commonly impaired domains were locomotion (48.7%) and vitality (43.9%). IC was inversely associated with FI (Spearman coefficient, -0.75; p < .001). IC impairment was associated with inferior overall survival (score, 4-5: adjusted hazard ratio [aHR], 1.7; 95% CI, 1.11-2.48; score, 2-3: aHR, 1.9; 95% CI, 1.30-2.85; score, 0-1: aHR, 1.9; 95% CI, 1.11-2.48). CONCLUSIONS IC impairment is associated with frailty and reduced overall survival in older patients with GI malignancies. GA can be used to screen for IC impairment as recommended by the WHO. PLAIN LANGUAGE SUMMARY The World Health Organization introduced intrinsic capacity as a marker of healthy aging. Intrinsic capacity is the combination of an individual's physical, mental, and psychological capacities. It contains six key domains: vitality, locomotion, and sensory (hearing and visual), psychological, and cognitive capacities. Older adults with cancer are susceptible to a decrease in intrinsic capacity as a result of cancer and the aging process. In this study, we aimed to assess the intrinsic capacity for patients with gastrointestinal cancer and also identify whether there exists any association of intrinsic capacity with overall survival. We identified that approximately 80% of this population had one or more impaired domains, and more intrinsic capacity impairment was associated with reduced overall survival.
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Affiliation(s)
- Supriya Maheshwari
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chen Dai
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Smith Giri
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christian Harmon
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Abigail Tucker
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mackenzie E Fowler
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Darryl Outlaw
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Grant R Williams
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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da Costa Teixeira LA, Soares LA, Lima LP, Avelar NCP, de Moura JA, Leopoldino AAO, Figueiredo PHS, Parentoni AN, Mendonça VA, Lacerda ACR. Cognitive function is associated with performance in time up and go test and with leptin blood levels in community-dwelling older women. Sci Rep 2024; 14:9841. [PMID: 38684691 PMCID: PMC11058236 DOI: 10.1038/s41598-024-60274-5] [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: 10/04/2023] [Accepted: 04/21/2024] [Indexed: 05/02/2024] Open
Abstract
Considering the challenge that cognitive dysfunction and dementia represent to health is imperative to prioritize early diagnosis strategies and explore the pathophysiological mechanisms. There is no consensus on specific markers and physical tests that indicate cognitive decline in older. The objective of this study was to evaluate a panel of inflammatory biomarkers and physical function and investigate their association with cognitive function in community-dwelling older women. Seventy-one participants were included in this study. Cognitive function was assessed by Mini Mental State Examination, muscle strength using dynamometer, body composition using Dual X-ray absorptiometry, respiratory muscle strength using manuvacuometer, and physical function using the Short Physical Performance Battery and Time Up and Go (TUG) tests. Blood samples were collected to analyze a panel of inflammatory biomarkers. The cognitive function was associated with TUG (β = - 0.48; 95%IC = - 0.54 to - 0.21; p < 0.001), inspiratory muscle strength (β = 0.30; 95%IC = 0.005-0.03; p = 0.009), and leptin concentrations (β = 0.32; 95% IC = 0.001-0.006; 0.007). Time spent on TUG test and leptin levels accounted for 27% of variability in cognitive function independent of age. Poorer physical function with leptin plasma levels is associated with decreased cognitive function in older women. These findings contribute to comprehension of pathophysiology underlying cognitive decline and informing the development of new approaches to prevent, diagnose, monitoring and treat cognitive decline in aging.
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Affiliation(s)
- Leonardo Augusto da Costa Teixeira
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Luana Aparecida Soares
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Liliana Pereira Lima
- Programa de Pós-Graduação em Ciências Fisiológicas (PPGCF), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | | | - Julia Araújo de Moura
- Programa de Pós-Graduação em Educação Física (PPGEF-UnB), Universidade de Brasília, Brasília, DF, Brazil
| | | | - Pedro Henrique Scheidt Figueiredo
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Adriana Netto Parentoni
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Vanessa Amaral Mendonça
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
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Augusto da Costa Teixeira L, Rocha-Vieira E, Aparecida Soares L, Mota de Oliveira F, Aparecida Oliveira Leopoldino A, Netto Parentoni A, Amaral Mendonça V, Cristina Rodrigues Lacerda A. The strong inverse association between plasma concentrations of soluble tumor necrosis factor receptors type 1 with adiponectin/leptin ratio in older women. Cytokine 2024; 176:156512. [PMID: 38281360 DOI: 10.1016/j.cyto.2024.156512] [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: 10/30/2023] [Revised: 12/27/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
Complex inflammatory crosstalk between muscular and adipose organs during ageing is controlled by adipokines and myokines. The Adiponectin/Leptin ratio (A/L ratio) has proven to be a promising biomarker for identifying insulin sensitivity, cardiovascular risk and adipose tissue inflammation. Although the A/L ratio has been related to inflammatory conditions, its ability to associate with or indicate the behavior of other inflammatory mediators remains unknown. The present study aimed to verify the association between the A/L ratio and a panel of inflammatory biomarkers in community-dwelling older women. The plasmatic concentrations of adiponectin, leptin, resistin, brain-derived neurotrophic factor (BDNF), interferon-gamma (IFN-γ), interleukins 2, 4, 5, 6, 8 and 10, tumour necrosis factor (TNF) and its soluble receptors (sTNF-r) 1 and 2 were evaluated in 71 community-dwelling older women with 75 (±7) years. The A/L ratio was negative and inverse correlated with BNDF (r = -0.29; p = 0.01), IL-8 (r = -0.37; p = 0.001) and sTNFr- 1 (r = -0.98; p < 0.001) levels. A strong and inverse association, with proportional effect, between A/L ratio and sTNFr-1 concentrations was found (Adjusted R2 = 0.22; β = -0.48; p > 0.001). It suggests that the presence of sTNFr-1 causes an inflammatory effect that affect cross-talk between muscle and adipose tissue, contributing to pro-inflammatory imbalance, which may have molecular and functional consequences. In addition, we provide insights into diagnostic biomarkers for inflammation, especially related to muscle wasting and intrinsic capacity in older people.
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Affiliation(s)
- Leonardo Augusto da Costa Teixeira
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil
| | - Etel Rocha-Vieira
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil
| | - Luana Aparecida Soares
- Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil
| | | | | | | | - Vanessa Amaral Mendonça
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
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Gavrila Laic RA, Firouzi M, Claeys R, Bautmans I, Swinnen E, Beckwée D. A State-of-the-Art of Exoskeletons in Line with the WHO's Vision on Healthy Aging: From Rehabilitation of Intrinsic Capacities to Augmentation of Functional Abilities. SENSORS (BASEL, SWITZERLAND) 2024; 24:2230. [PMID: 38610440 PMCID: PMC11014060 DOI: 10.3390/s24072230] [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: 03/05/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024]
Abstract
The global aging population faces significant health challenges, including an increasing vulnerability to disability due to natural aging processes. Wearable lower limb exoskeletons (LLEs) have emerged as a promising solution to enhance physical function in older individuals. This systematic review synthesizes the use of LLEs in alignment with the WHO's healthy aging vision, examining their impact on intrinsic capacities and functional abilities. We conducted a comprehensive literature search in six databases, yielding 36 relevant articles covering older adults (65+) with various health conditions, including sarcopenia, stroke, Parkinson's Disease, osteoarthritis, and more. The interventions, spanning one to forty sessions, utilized a range of LLE technologies such as Ekso®, HAL®, Stride Management Assist®, Honda Walking Assist®, Lokomat®, Walkbot®, Healbot®, Keeogo Rehab®, EX1®, overground wearable exoskeletons, Eksoband®, powered ankle-foot orthoses, HAL® lumbar type, Human Body Posturizer®, Gait Enhancing and Motivation System®, soft robotic suits, and active pelvis orthoses. The findings revealed substantial positive outcomes across diverse health conditions. LLE training led to improvements in key performance indicators, such as the 10 Meter Walk Test, Five Times Sit-to-Stand test, Timed Up and Go test, and more. Additionally, enhancements were observed in gait quality, joint mobility, muscle strength, and balance. These improvements were accompanied by reductions in sedentary behavior, pain perception, muscle exertion, and metabolic cost while walking. While longer intervention durations can aid in the rehabilitation of intrinsic capacities, even the instantaneous augmentation of functional abilities can be observed in a single session. In summary, this review demonstrates consistent and significant enhancements in critical parameters across a broad spectrum of health conditions following LLE interventions in older adults. These findings underscore the potential of LLE in promoting healthy aging and enhancing the well-being of older adults.
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Affiliation(s)
- Rebeca Alejandra Gavrila Laic
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
| | - Mahyar Firouzi
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - Reinhard Claeys
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - Ivan Bautmans
- FRIA, Frailty in Ageing, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
| | - Eva Swinnen
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - David Beckwée
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- FRIA, Frailty in Ageing, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
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Salinas-Rodríguez A, Fernández-Niño JA, Rivera-Almaraz A, Manrique-Espinoza B. Intrinsic capacity trajectories and socioeconomic inequalities in health: the contributions of wealth, education, gender, and ethnicity. Int J Equity Health 2024; 23:48. [PMID: 38462637 PMCID: PMC10926672 DOI: 10.1186/s12939-024-02136-0] [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: 08/02/2023] [Accepted: 02/25/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Life-long health inequalities exert enduring impacts and are governed by social determinants crucial for achieving healthy aging. A fundamental aspect of healthy aging, intrinsic capacity, is the primary focus of this study. Our objective is to evaluate the social inequalities connected with the trajectories of intrinsic capacity, shedding light on the impacts of socioeconomic position, gender, and ethnicity. METHODS Our dynamic cohort study was rooted in three waves (2009, 2014, 2017) of the World Health Organization's Study on Global AGEing and Adult Health in Mexico. We incorporated a nationally representative sample comprising 2722 older Mexican adults aged 50 years and over. Baseline measurements of socioeconomic position, gender, and ethnicity acted as the exposure variables. We evaluated intrinsic capacity across five domains: cognition, psychological, sensory, vitality, and locomotion. The Relative Index of Inequality and Slope Index of Inequality were used to quantify socioeconomic disparities. RESULTS We discerned three distinct intrinsic capacity trajectories: steep decline, moderate decline, and slight increase. Significant disparities based on wealth, educational level, gender, and ethnicity were observed. Older adults with higher wealth and education typically exhibited a trajectory of moderate decrease or slight increase in intrinsic capacity. In stark contrast, women and indigenous individuals were more likely to experience a steeply declining trajectory. CONCLUSIONS These findings underscore the pressing need to address social determinants, minimize gender and ethnic discrimination to ensure equal access to resources and opportunities across the lifespan. It is imperative for policies and interventions to prioritize these social determinants in order to promote healthy aging and alleviate health disparities. This approach will ensure that specific demographic groups receive customized support to sustain their intrinsic capacity during their elder years.
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Affiliation(s)
- Aaron Salinas-Rodríguez
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Julián Alfredo Fernández-Niño
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E8532, Baltimore, MD, 21205, USA.
- Department of Public Health, Universidad del Norte, Barranquilla, Atlántico, Colombia.
| | - Ana Rivera-Almaraz
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Betty Manrique-Espinoza
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Yıldırım Ayaz E, Dincer B, Mete E, Kaygusuz Benli R, Cinbaz G, Karacan E, Cankül A, Mesci B. Evaluating the impact of aerobic and resistance green exercises on the fitness, aerobic and intrinsic capacity of older individuals. Arch Gerontol Geriatr 2024; 118:105281. [PMID: 38056100 DOI: 10.1016/j.archger.2023.105281] [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: 09/29/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Our study determined the impact of 12-week aerobic exercise (AE) and aerobic + resistance exercises (AE + RE) within the green exercise concept, on senior fitness, aerobic capacity, and intrinsic capacity (IC). METHODS The study was a multicenter, randomized controlled study conducted at two senior living facilities with individuals aged 65 and above whose cardiorespiratory and musculoskeletal conditions are suitable for moderate exercise and who have normal cognition levels. Block randomization was applied to 96 participants in a ratio of 1:1:1 to be assigned to AE, AE + RE, and control (C) groups. Intervention groups received exercise sessions led by physiotherapists within the senior living facilitiy gardens, with a frequency of once a week for 50 min, for 12 weeks. Also, they were prescribed additional exercise sessions on two additional days of the week. At the commencement of the study and 12th week, shuttle walking test, senior fitness test (SFT), intrinsic capacity assessment (with Timed Up and Go test, Mini Mental State Examination, Geriatric Depression Scale-15, Mini Nutritional Assessment, handgrip strength test) was conducted of all participants. The primary outcome was the Z score of IC, secondary outcomes were VO2max and SFT subparameters. The study was registered in the Protocol Registry and Results System (Clinicaltrials.gov PRS) with the registration number NCT05958745. RESULTS 90 participants successfully completed the study, with 30 individuals in each of the AE, AE + RE, and C groups. By the end of the 12th week, the arm curl score was significantly higher in the AE + RE compared to the C (mean difference: 3.96, 95 % CI= 2.47 to 5.46, p = 0.01). There were significant differences in chair stand, two-minute step, 8-foot up-and-go, chair sit and reach, and back scratch tests in both AE and AE + RE compared to C. AE and AE + RE exhibited significantly higher shuttle test distances and VO2max values compared to the C (p < 0.0001). AE + RE achieved a significantly higher total IC score than the C (mean difference: 0.59, %95 CI= -0.07 to 1.26, p = 0.025). CONCLUSION In this study within the green exercise concept, both AE and AE + RE led to similar improvements in strength, flexibility, mobility, endurance, and aerobic capacity. Notably, AE + RE demonstrated an additional benefit by increasing the total IC, while AE alone did not exhibit the same effect.
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Affiliation(s)
- Elif Yıldırım Ayaz
- University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, Internal Medicine Clinic, Selimiye, Tıbbiye Cd, 34668 Üsküdar, İstanbul Turkey.
| | - Berna Dincer
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Internal Medicine Nursing, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Emel Mete
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Physiothetapy and Rehabilitation, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Reyhan Kaygusuz Benli
- Demiroglu Science University, Health Science Faculty, Department of Physiothetapy and Rehabilitation, Yazarlar St. No:17, 34394 Esentepe Şişli, İstanbul, Turkey
| | - Gülser Cinbaz
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Physiothetapy and Rehabilitation, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Esra Karacan
- Yeditepe University, Health Science Faculty, Department of Physiothetapy and Rehabilitation, Kayışdağı, İnönü Mahallesi, Kayışdağı Cd., 34755 Ataşehir, İstanbul, Turkey
| | - Ayşegül Cankül
- Medipol University Hospital, Internal Medicine and Onkology Clinic, TEM Avrupa Otoyolu Göztepe Çıkışı No:1, 34214, Bağcılar, İstanbul, Turkey
| | - Banu Mesci
- Istanbul Medeniyet University Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Internal Medicine Clinic, Eğitim Mah. Fahrettin Kerim Gökay, Caddesi Kadıköy, İstanbul, Turkey
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Zhao Y, Chen Y, Xiao LD, Liu Q, Nan J, Li X, Feng H. Intrinsic capacity trajectories, predictors and associations with care dependence in community-dwelling older adults: A social determinant of health perspective. Geriatr Nurs 2024; 56:46-54. [PMID: 38237340 DOI: 10.1016/j.gerinurse.2023.12.022] [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: 09/15/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 04/05/2024]
Abstract
AIMS To identify intrinsic capacity trajectories, predictors of intrinsic capacity trajectories and associations between intrinsic capacity trajectories and care dependence in community-dwelling older adults in China. METHODS A retrospective longitudinal study was conducted, and the data were obtained from a five-year national longitudinal cohort study of older adults in China between 2011 and 2015. The social determinants of health framework informed the data analysis and interpretation. RESULTS A total of 3893 older adults met the selection criteria and were included in the study. Three intrinsic capacity trajectories were identified: high trajectory (15.7 %), stable trajectory (52.7 %) and declining trajectory (31.6 %). Social determinants contribute to intrinsic capacity decline in older adults. Decreased cognitive function, psychological status, and locomotion at baseline were associated with care dependence. CONCLUSION Approximately thirty percent of the older adults in this cohort study experienced a decline in intrinsic capacity within a 5-year period. Social determinants contributed to this decline in older adults.
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Affiliation(s)
- Yinan Zhao
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Yifei Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Qingcai Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Jiahui Nan
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China; Xiangya-Oceanwide Health Management Research Institute, Central South University, China.
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12
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Shen J, Shi H, Zhang J, Meng X, Zhang C, Kang Y. Household polluting cooking fuels and intrinsic capacity among older population: A harmonized nationwide analysis in India and China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169031. [PMID: 38042204 DOI: 10.1016/j.scitotenv.2023.169031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUNDS Household polluting cooking fuels, as an important changeable behavior, are related to various detrimental health effects among the elderly. There is limited research on the association between polluting cooking fuel use and intrinsic capacity (IC) as an indicator of healthy aging. This study aimed to evaluate the above-mentioned association in India and China, where polluting cooking fuel use is common. METHODS We enrolled 33,803 participants aged ≥60 years from two nationally representative studies: the Longitudinal Aging Study in India and the China Health and Retirement Longitudinal Study. Polluting cooking fuel use was defined as a self-report of using wood, coal, kerosene, crop residue, or dung. IC was measured by five aspects, including locomotion, cognition, vitality, sensory, and psychological capacity. The random-effects mixed linear regression and logistic regression with population weighting were performed. Multivariable-adjusted model and propensity score were used to adjust for potential confounders. RESULTS A total of 47.54 % and 59.32 % of elderly adults reported primary cooking using polluting fuels in India and China, respectively. Using polluting cooking fuels was consistently associated with IC decline; particularly, cognitive capacity was the most susceptible domain. In India, participants using polluting fuels had a 1.062 (95 % confidence interval [CI]: 1.047-1.078) times risk for IC deficits, whereas more prominent results were observed in China (odds ratio [OR]: 2.040, 95 % CI: 1.642-2.533). Such harmful effects might be alleviated by transferring from polluting to clean fuels. Additionally, the duration of polluting fuel use was also positively associated with IC deficits. CONCLUSION This study provided substantial public implications on healthy aging for the elderly population at a global scale, strengthening the importance of health education and policy efforts to accelerate the transition from polluting to clean fuels.
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Affiliation(s)
- Ji Shen
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Hong Shi
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Jie Zhang
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Xue Meng
- Office of National Clinical Research for Geriatrics, Department of Scientific Research, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Yuting Kang
- Office of National Clinical Research for Geriatrics, Department of Scientific Research, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China.
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Gilchrist H, Oliveira JS, Kwok WS, Sherrington C, Pinheiro MB, Bauman A, Tiedemann A, Hassett L. Use of behavior change techniques in physical activity programs and services for older adults: findings from a rapid review. Ann Behav Med 2024; 58:216-226. [PMID: 38300788 PMCID: PMC10858305 DOI: 10.1093/abm/kaad074] [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: 02/03/2024] Open
Abstract
BACKGROUND Understanding behavior change techniques (BCTs) used in randomized controlled trials (RCTs) of physical activity programs/services for older adults can help us to guide their implementation in real-world settings. PURPOSE This study aims to: (a) identify the number and type of BCTs used in physical activity programs/services for older adults evaluated in large, good quality RCTs and (b) explore the impact of different BCTs on different outcome domains. METHODS This is a secondary data analysis of a WHO-commissioned rapid review of physical activity programs/services for older adults. Fifty-six trials testing 70 interventions were coded for the type and number of BCTs present using a published BCT taxonomy. The proportion of positive effects found from physical activity interventions using the most common BCTs was calculated for the outcomes of physical activity, intrinsic capacity, functional ability, social domain, cognitive and emotional functioning, and well-being and quality of life. RESULTS Thirty-nine of the 93 possible BCTs were identified in the included trials and 529 BCTs in total (mean 7.6, range 2-17). The most common BCTs were "action planning" (68/70 interventions), "instructions on how to perform a behavior" (60/70), "graded tasks" (53/70), "demonstration of behavior" (44/70), and "behavioral practice/rehearsal" (43/70). Interventions that used any of the most common BCTs showed overwhelmingly positive impacts on physical activity and social domain outcomes. CONCLUSION Consideration of which BCTs are included in interventions and their impact on outcomes can improve the effectiveness and implementation of future interventions. To enable this, providers can design, implement, and evaluate interventions using a BCT taxonomy.
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Affiliation(s)
- Heidi Gilchrist
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney Musculoskeletal Health, University of Sydney, Gadigal Country, Sydney, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Juliana S Oliveira
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney Musculoskeletal Health, University of Sydney, Gadigal Country, Sydney, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Wing S Kwok
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney Musculoskeletal Health, University of Sydney, Gadigal Country, Sydney, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Catherine Sherrington
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney Musculoskeletal Health, University of Sydney, Gadigal Country, Sydney, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, Australia
- WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, University of Sydney, Gadigal Country, Sydney, Australia
| | - Marina B Pinheiro
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney Musculoskeletal Health, University of Sydney, Gadigal Country, Sydney, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Adrian Bauman
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney Musculoskeletal Health, University of Sydney, Gadigal Country, Sydney, Australia
- WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, University of Sydney, Gadigal Country, Sydney, Australia
| | - Anne Tiedemann
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney Musculoskeletal Health, University of Sydney, Gadigal Country, Sydney, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, Australia
- WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, University of Sydney, Gadigal Country, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, Sydney Musculoskeletal Health, University of Sydney, Gadigal Country, Sydney, Australia
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Sivakumar PT, Harbishettar V, Pandey NM, Tiwari SC. Clinical practice guidelines for promoting mental health and well-being of older adults: A special focus on strategies for coping with social isolation and loneliness. Indian J Psychiatry 2024; 66:S331-S337. [PMID: 38445288 PMCID: PMC10911326 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_757_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/04/2023] [Indexed: 03/07/2024] Open
Affiliation(s)
- Palanimuthu T Sivakumar
- Geriatric Psychiatry Unit, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vijaykumar Harbishettar
- Geriatric Psychiatry Unit, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Nisha M Pandey
- Department of Geriatric Mental Health, King George Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Sarvada C Tiwari
- Department of Geriatric Mental Health, King George Medical University, Lucknow, Uttar Pradesh, India E-mail:
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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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Poskotinova L, Kontsevaya A, Kudryavtsev AV. The Association between Kidney Function Biomarkers and Delayed Memory Impairments among Older Adults in the European North of Russia. Brain Sci 2023; 13:1664. [PMID: 38137112 PMCID: PMC10742109 DOI: 10.3390/brainsci13121664] [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: 09/28/2023] [Revised: 11/18/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
The prevention of memory decline requires better knowledge of biological markers. We studied the associations between kidney function biomarkers and memory decline (assessed with the Mini-Mental State Examination-MMSE) in elderly individuals without dementia (MMSE 24-30, age 60-74 years, n = 643, Arkhangelsk, Russia). Participants were divided by sex and into three groups according to the delayed memory performance: recall of 0-1, 2, and 3 out of 3 words. The median of serum creatinine was 82 μmol/L in men who recalled 2 words and both medians in those recalling 3 and 0-1 words were 87 μmol/L. The 90th percentile for creatinine in men recalling 0-1 words (115.0 μmol/L) exceeded the upper limit of the normal range (110.5 μmol/L), while those who recalled 3 and 2 words had 90th percentiles within the normal range (109 and 101 μmol/L, respectively). Glomerular filtration rates were normal (≥60 mL/min/1.73 m2) with a median of 92.0 mL/min/1.73 m2 in men who recalled 2 words, 84.4 and 84.9 mL/min/1.73 m2 in men who recalled 3 and 0-1 words, respectively. None of these associations were observed in women. A reduced serum creatinine in older non-demented men may indicate the initial stages of memory decline, while the increased creatinine may reflect further stages of memory impairment.
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Affiliation(s)
- Liliya Poskotinova
- Biorhythmology Laboratory of the Institute of Environmental Physiology, N. Laverov Federal Center for Integrated Arctic Research of the Ural Branch of the Russian Academy of Sciences, 163001 Arkhangelsk, Russia;
- Central Scientific Research Laboratory, Northern State Medical University, 163069 Arkhangelsk, Russia
| | - Anna Kontsevaya
- Department of Public Health, National Medical Research Centre for Therapy and Preventive Medicine, 101000 Moscow, Russia;
| | - Alexander V. Kudryavtsev
- Central Scientific Research Laboratory, Northern State Medical University, 163069 Arkhangelsk, Russia
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
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Wang Y, Xu J, Yang S, Jiang J, Gao J. Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China. Sci Rep 2023; 13:19971. [PMID: 37968334 PMCID: PMC10651855 DOI: 10.1038/s41598-023-46854-x] [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: 07/16/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023] Open
Abstract
It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI = 0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.
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Affiliation(s)
- Yujie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Shitong Yang
- School of Public Health, Fudan University, Shanghai, China
| | - Junjia Jiang
- School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China.
- Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases, Shanghai, China.
- Core Unit of Shanghai Clinical Research Center for Geriatric Diseases, Shanghai, China.
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Stara V, Soraci L, Takano E, Kondo I, Möller J, Maranesi E, Luzi R, Riccardi GR, Browne R, Dacunha S, Palmier C, Wieching R, Ogawa T, Bevilacqua R. Intrinsic Capacity and Active and Healthy Aging Domains Supported by Personalized Digital Coaching: Survey Study Among Geriatricians in Europe and Japan on eHealth Opportunities for Older Adults. J Med Internet Res 2023; 25:e41035. [PMID: 37824183 PMCID: PMC10603559 DOI: 10.2196/41035] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/03/2022] [Accepted: 07/14/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND The worldwide aging trend requires conceptually new prevention, care, and innovative living solutions to support human-based care using smart technology, and this concerns the whole world. Enabling access to active and healthy aging through personalized digital coaching services like physical activity coaching, cognitive training, emotional well-being, and social connection for older adults in real life could offer valuable advantages to both individuals and societies. A starting point might be the analysis of the perspectives of different professionals (eg, geriatricians) on such technologies. The perspectives of experts in the sector may allow the individualization of areas of improvement of clinical interventions, supporting the positive perspective pointed out by the intrinsic capacity framework. OBJECTIVE The overall aim of this study was to explore the cross-national perspectives and experiences of different professionals in the field of intrinsic capacity, and how it can be supported by eHealth interventions. To our knowledge, this is the first study to explore geriatric care providers' perspectives about technology-based interventions to support intrinsic capacity. METHODS A survey involving 20 geriatricians or clinical experts in the fields of intrinsic capacity and active and healthy aging was conducted in Italy, France, Germany, and Japan between August and September 2021. RESULTS The qualitative findings pointed out relevant domains for eHealth interventions and provided examples for successful practices that support subjective well-being under the intrinsic capacity framework (the benefits offered by personalized interventions, especially by promoting health literacy but avoiding intrusiveness). Moreover, eHealth interventions could be used as a bridge that facilitates and enables social engagement; an instrument that facilitates communication between doctors and patients; and a tool to enrich the monitoring actions of medical staff. CONCLUSIONS There is an unexplored and significant role for such geriatric perspectives to help the development process and evaluate the evidence-based results on the effectiveness of technologies for older people. This is possible only when clinicians collaborate with data scientists, engineers, and developers in order to match the complex daily needs of older adults.
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Affiliation(s)
- Vera Stara
- Medical Direction, IRCCS, INRCA, Ancona, Italy
| | - Luca Soraci
- Unit of Geriatric Medicine, IRCCS, INRCA, Cosenza, Italy
| | - Eiko Takano
- National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Izumi Kondo
- National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Johanna Möller
- Diocesan Caritas Association for the Archdiocese of Cologne, Cologne, Germany
| | | | | | | | - Ryan Browne
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | | | - Cecilia Palmier
- Service de gériatrie 1&2, AP-HP, Hôpital Broca, Paris, France
| | - Rainer Wieching
- Institute for New Media & Information Systems, University of Siegen, Siegen, Germany
| | - Toshimi Ogawa
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
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Shen S, Xie Y, Zeng X, Chen L, Guan H, Yang Y, Wu X, Chen X. Associations of intrinsic capacity, fall risk and frailty in old inpatients. Front Public Health 2023; 11:1177812. [PMID: 37886051 PMCID: PMC10598390 DOI: 10.3389/fpubh.2023.1177812] [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: 03/02/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction This study explored the associations of intrinsic capacity (IC), fall risk, and frailty in geriatric inpatients. Methods A total of 703 hospitalized patients aged 75 years or older were recruited for this retrospective observational study from Zhejiang Hospital using a comprehensive geriatric assessment. The IC composite score was constructed from the scores of the Chinese version of the Mini-Mental State Examination, Short Physical Performance Battery, Short Form Mini Nutritional Assessment, 15-item Geriatric Depression Scale, and self-reported hearing and vision impairment. Adverse outcomes were recorded as the fall risk and frailty using the Morse Fall Scale and the Clinical Frailty Scale. Spearman's correlation coefficient analyses and multivariate logistic regression models were used to explore the associations between IC, high fall risk, and frailty. Results Declined IC composite scores were associated with increased risks of falls [odds ratio (OR) = 0.64, 95% confidence interval (CI): 0.57-0.72] and frailty (OR = 0.45, 95%CI: 0.37-0.54) among older hospitalized patients after adjusting for the related potential confounders. In addition, decreased cognitive, vitality, locomotion, and psychological scores were associated with increased adverse health conditions, with ORs ranging from 0.26 to 0.70. Vision impairment was observed to increase the risk of frailty (OR = 0.42, 95%CI: 0.23-0.76) after adjusting for the related potential confounders. Discussion This study indicated that declined IC was associated with fall risk and frailty in older inpatients. Further prospective studies are needed to explore the longitudinal associations between baseline IC and subsequent risk of falls and frailty.
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Affiliation(s)
- Shanshan Shen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Yanhong Xie
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Xingkun Zeng
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Lingyan Chen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Huilan Guan
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Yinghong Yang
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Xiushao Wu
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Xujiao Chen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
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Audisio R, Balducci L, Monfardini S, Peccatori FA, Rostoft S, van Leeuwen B. Should cancer treatment stop at the age of 75? J Am Geriatr Soc 2023; 71:3342-3344. [PMID: 37224400 DOI: 10.1111/jgs.18420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/26/2023]
Affiliation(s)
- Riccardo Audisio
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden
| | | | - Silvio Monfardini
- European School of Oncology Program on the History of European Oncology, Milan, Italy
| | - Fedro A Peccatori
- Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy
| | - Siri Rostoft
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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21
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Chang YH, Chen YC, Ku LJE, Chou YT, Chen HY, Su HC, Liu CH, Wu YL, Cheng HJ, Yang YC, Li CY. Association between sleep health and intrinsic capacity among older adults in Taiwan. Sleep Med 2023; 109:98-103. [PMID: 37423025 DOI: 10.1016/j.sleep.2023.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/11/2023] [Accepted: 06/17/2023] [Indexed: 07/11/2023]
Abstract
Although the association between poor sleep quality and frailty has been previously reported, the relationship between sleep health and intrinsic capacity (IC) remains largely unknown. We aimed to examine the association between sleep health and IC among older adults. This was a cross-sectional study, and 1268 eligible participants completed a questionnaire collecting information on demographic, socioeconomic, lifestyle, sleep health, and IC. Sleep health was measured by the RU-SATED V2.0 scale. High, moderate, and low levels of IC were defined using the Integrated Care for Older People Screening Tool for Taiwanese. The ordinal logistic regression model estimated the odds ratio and corresponding 95% confidence interval. Low IC was significantly associated with age of 80 years or above, female, currently unmarried, uneducated, currently not working, financially dependent, and having emotional disorders. A one-point increase in sleep health was significantly associated with a 9% reduction in the odds of poor IC. An increase in daytime alertness was related to the greatest reduction in poor IC (aOR, 0.64; 95% CI, 0.52-0.79). In addition, the subitems sleep regularity (aOR, 0.77; 95% CI, 0.60-0.99), sleep timing (aOR, 0.80; 95% CI, 0.65-0.99), and sleep duration (aOR, 0.77; 95% CI, 0.61-0.96) were associated with a reduced OR of poor IC but with marginal statistical significance. Our findings showed that sleep health across multiple dimensions is related to IC, particularly daytime alertness in older adults. We suggest developing interventions to improve sleep health and prevent IC decline, which is crucial in causing poor health outcomes.
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Affiliation(s)
- Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Yen-Chin Chen
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Tsung Chou
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Yu Chen
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Chen Su
- Department of Neurology, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chieh-Hsiu Liu
- Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiang-Ju Cheng
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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22
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Gutiérrez-Barreto SE, Sosa-Tinoco E, Rojas-Calixto O, Deniss-Navarro Z, Avila-Avila A, Gutierrez JP. Evaluating the design of the Integrated Care for Older People: a theory of change approach. Front Med (Lausanne) 2023; 10:1166196. [PMID: 37502365 PMCID: PMC10368864 DOI: 10.3389/fmed.2023.1166196] [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: 02/14/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
Introduction Given the progressive aging of the population, there is an urgent need at the health system level to implement effective models to care for older people (OP). Healthy aging is imperative to reach the Sustainable Development Goals. The World Health Organization (WHO) developed the Integrated Care for Older People (ICOPE) strategy to address this challenge. Implementing ICOPE requires its adaption to a specific context. We propose a pathway for such adaptation through an evaluation of the design of ICOPE; thus, we aim to describe the Theory of Change (ToC) of ICOPE and evaluate it for its implementation in Mexico City. Methods Based on the WHO and published literature documentation, we drafted an initial ToC for ICOPE. Then, we validated the ToC with experts in ICOPE, after which we evaluated and refined it by discussing the causal pathway, intervention required to activate it, rationale, and assumptions in consecutive workshops with 91 stakeholders and healthcare workers, using the nominal group technique to reach a consensus. Results The resulting ToC has the potential to contribute to healthy aging by three expected impacts: (1) prevention, reversal, or delaying of the decline of intrinsic capacity (IC) in OP; (2) improvement of the quality of life of OP; and (3) increase of disability-free life expectancy. The ICOPE causal pathway had ten preconditions, including the availability of resources, identifying at-risk individuals, available treatments, and evaluating results. Discussion We adapted ICOPE to a specific implementation context by evaluating its ToC in a participatory process that allows us to identify challenges and address them, at least in terms of the guidelines to operate the strategy. As ICOPE is an approach for a primary healthcare system, its adoption in a community healthcare program is promising and feasible. Evaluation as a tool could contribute to the design of effective interventions. The evaluation of the design of ICOPE for its implementation contributes to the strength of its potential to improve care for OP. This design for implementing ICOPE has the potential to be applied to similar contexts, for example, in other lower-middle-income countries.
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Affiliation(s)
- Samuel E. Gutiérrez-Barreto
- Master’s and Doctorate Programs in Medical, Dental, and Health Sciences, National Autonomous University of Mexico, Mexico City, Mexico
| | | | | | | | | | - Juan Pablo Gutierrez
- Center for Policy, Population and Health Research, National Autonomous University of Mexico, Mexico City, Mexico
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23
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Lin S, Wang F, Zheng J, Yuan Y, Huang F, Zhu P. Intrinsic Capacity Declines with Elevated Homocysteine in Community-Dwelling Chinese Older Adults. Clin Interv Aging 2022; 17:1057-1068. [PMID: 35832608 PMCID: PMC9272847 DOI: 10.2147/cia.s370930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/26/2022] [Indexed: 12/16/2022] Open
Abstract
Purpose Intrinsic capacity (IC) reflects the overall health status of older adults and has great public health significance. But few studies described the related biomarkers for IC. The aim of this study was to investigate the association between homocysteine (Hcy) and IC in older adults. Participants and Methods This cross-sectional study included 1927 community-dwelling Chinese older adults aged 60–98 years from May 2020 to December 2020. Data were collected through interviews, physical examinations, and laboratory tests. IC involved five domains of cognition, locomotion, sensory, vitality, and psychology evaluated by the Mini-cog scale, 4-m walk test, self-reported visual and hearing conditions, MNA-SF scale, and GDS-4 scale, respectively. The score of each domain dichotomized as 0 (normal) and 1 (impaired) was added together to an IC total score. Low IC was defined as a score of 3–5, and high IC as 0–2. Hcy was measured by a two-reagent enzymatic assay. A restricted cubic spline regression model was used to explore the non-linear relationship between Hcy and low IC. Results Hcy was higher in the low IC group than in the high IC group. Restricted cubic spline analysis revealed a J-shaped nonlinear association between Hcy and low IC. The risk of IC decline was slowly decreased until 8.53 µmol/L of Hcy (OR=0.753, 95% CI=0.520–1.091, P=0.132), and increased with elevations of per 5 µmol/L Hcy afterwards (OR=1.176, 95% CI=1.059–1.327, P=0.005). Among the five domains of IC, Hcy had ORs of 1.116 (1.009–1.247) for cognition impairment, 1.167 (1.055–1.305) for vitality, and 1.160 (1.034–1.303) for psychology per 5 µmol/L increase in Hcy above the change point. Additional sensitivity analysis also demonstrated the nonlinear association between Hcy and low IC. Conclusion Hcy had a J-shaped association with low IC. Higher Hcy (Hcy ≥8.53µmol/L) might provide clinical implications for early identifying the risk of low IC.
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Affiliation(s)
- Siyang Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
| | - Fang Wang
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Health College, Fuzhou, Fujian, People's Republic of China.,Nursing School of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Jiaxin Zheng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
| | - Yin Yuan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, People's Republic of China
| | - Feng Huang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, People's Republic of China
| | - Pengli Zhu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, People's Republic of China
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