[Differences between men and women in the prevalence of frailty and associated factors among older adults: evidence from ELSI-Brazil]

Intrinsic capacity and loneliness, according to sex, in an upper-middle income country: insights from the ELSI-Brazil cohort

OBJECTIVES

To investigate the association between loneliness and intrinsic capacity, a multidimensional indicator of healthy ageing, in Brazilians aged ≥50 years.

METHOD

This cross-sectional study used baseline data from 7,123 participants of the nationally representative Brazilian Longitudinal Study of Aging (ELSI-Brazil) (2015-2016). Intrinsic capacity (IC) (sensory, mobility, psychological, cognitive, and vitality), was determined using a validated composite z-score (higher scores = better capacity). Loneliness comprised a single-item. Quantile regression models were stratified by sex after adjusting for sociodemographic, and health characteristics.

RESULTS

The median IC were lower in women than in men (-0.54 vs. 0.69, respectively). Loneliness was related to lower IC composite z-scores in both sexes, demonstrating stronger associations at lower quantiles. The IC composite z-score decreased in those experiencing severe loneliness, both in women (quantile 0.75: β = -0.39; 95% CI = -0.47 to -0.31) and men (β = -0.36; 95% CI = -0.54 to -0.17). However, mild loneliness was associated with worse IC among men only at quantile 0.25 (β = -0.12; 95% CI = -0.23 to -0.01), different from women.

CONCLUSION

Loneliness was associated with worse IC. Cross-sectional design limits causal inference, but supports that community engagement, social support, and accessible environments are crucial for promoting healthy ageing in both sexes.

Influence of frailty and cognitive decline on dual task performance in older adults: an analytical cross-sectional study

OBJECTIVE

to analyze the influence of frailty and cognitive decline on dual-task performance in older adults.

METHODS

cross-sectional study carried out with older adults at a geriatrics outpatient clinic, in São Paulo. Sociodemographic data, cognitive performance, frailty phenotype, gait speed and dual-task assessments were used. The analysis was descriptive, combined with a multiple linear regression model.

RESULTS

219 older adults participated, with a mean age of 72.55 years, aged between 60 and 79 years (82.65%) and predominantly female (70.32%). Among them, 86 (39.27%) were frail and 123 (57.48%) presented cognitive decline. The mean time for simple walking was 15.95 (7.02) seconds; for the motor dual-task, 17.64 (8.44) seconds; and for the cognitive dual-task, 23.88 (11.87) seconds. Women without a partner, living with family, and with low education (0-4 years) required more time to perform both the cognitive and motor dual-tasks compared to the time for simple walking. Frail older adults exhibited impared gait performance, both in simple and dual motor/cognitive tasks.

CONCLUSION

frail older adults experienced a significant decline in performance in simple gait and in dual motor/cognitive tasks, with no difference in performance between those with and without cognitive decline. Multidisciplinary interventions should focus on promoting the health of older adults.

BACKGROUND

(1) Frailty and sarcopenia are important syndromes that need to be assessed in older adults. (2) Older adults with T2DM have a higher vulnerability to developing frailty. (3) Nurses should implement preventive measures to address frailty and sarcopenia.

The interactive effect of extreme weather events and PM2.5 on respiratory health among the elderly: a case-crossover study in a high-altitude city

With climate change posing increasing threats and aging populations, understanding the complex relationship between extreme temperatures, PM2.5 pollution, and respiratory health among the elderly is crucial. While some research exists, there remains a significant gap in studying the combined effects of heat waves, cold spells, and PM2.5 on elderly respiratory health in high-altitude regions. We collected data from Xining (2016-2021), including respiratory disease outpatient visits, meteorological, and pollutant data. Employing a case-crossover design and conditional Poisson regression analysis, we investigated the individual and interactive impacts of heat wave, cold spell, and PM2.5 on outpatient visits for respiratory disease among the elderly. We used the relative excess odds due to interaction (REOI), proportion attributable to interaction (AP), and synergy index (S) as quantitative indicators of interaction. Our analysis revealed significant associations between heat wave, cold spell, PM2.5 exposure, and outpatient visits for respiratory disease among the elderly, with odds ratios of 1.10 (95%CI: 1.06, 1.15) and 1.16 (95%CI: 1.13, 1.20), respectively. Moreover, a synergistic effect between cold spell and PM2.5 was observed, particularly affecting vulnerable groups such as female and those aged ≥ 80. The combined exposure to cold spell and elevated PM2.5 levels was estimated to contribute to up to 0.18 (95%CI: 0.17, 0.27) of respiratory outpatient visits. This study underscores the need for urgent interventions, such as reducing PM2.5 exposure and enhancing extreme weather warning systems, to protect the respiratory health of the elderly, especially in high-altitude regions.