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Thorsted AB, Thygesen LC, Jezek AH, Pedersen MM, Jorgensen MG, Vinding K, Kannegaard PN, Pedersen SGH. The De Morton Mobility Index (DEMMI) in hospitalized geriatric patients is associated with risk of readmission, mortality, and discharge to a post-acute care facility: A nationwide register-based cohort study. Arch Gerontol Geriatr 2024; 120:105325. [PMID: 38237375 DOI: 10.1016/j.archger.2024.105325] [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: 11/05/2023] [Revised: 12/15/2023] [Accepted: 01/01/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To examine the association between the de Morton Mobility Index (DEMMI) score on admission in geriatric patients and readmission and mortality within 30, 180, and 365 days after discharge, and discharge to a post-acute care facility. METHODS A nationwide register-based cohort study including 23,941 geriatric in-patients aged ≥65 years admitted to a geriatric ward between 2014 and 2017 and included in the Danish National Database for Geriatrics. The DEMMI score was categorized into four subcategories: very low mobility (DEMMI=0-24), low mobility (DEMMI=27-39), moderately reduced mobility (DEMMI=41-57), and independent mobility (DEMMI=62-100). Patients were followed 30, 180 and 365 days after discharge for readmission and mortality. Their risk of being discharged to a post-acute care facility was examined. Adjusted hazard ratios (HRs) and odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated. RESULTS HRs for readmission within 30-days were 1.36 (1.24-1.48) for very low mobility, 1.30 (1.20-1.42) for low mobility and 1.17 (1.08-1.28) for moderately reduced compared with independent mobility. Similar results were seen for readmission within 180- and 365-days. For mortality, HR for 30-day mortality ranged from1.93 and 5.66, 180-day mortality between 1.62 and 3.19, and 365-day mortality between 1.54 and 2.81 compared with patients with independent mobility. OR for discharge to a post-acute care facility was 8.76 (7.29-10.53) for lowest compared with the highest DEMMI mobility subcategory. CONCLUSION In geriatric in-patients, lower DEMMI scores on hospital admission are associated with increased rates of discharge to a post-acute care facility, and for readmission, and mortality within one year.
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Affiliation(s)
- Anne B Thorsted
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Andrea H Jezek
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
| | - Mette M Pedersen
- Department of Clinical Research and Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Copenhagen University Hospital at Amager and Hvidovre, Kettegaard alle 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Martin G Jorgensen
- Department of Geriatric Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kirsten Vinding
- Diagnostic Center, Department of Medicine, Odense University Hospital, Baagøes Alle 31, 5700 Svendborg, Denmark
| | - Pia N Kannegaard
- Department of Geriatric and Palliative Medicine, Bispebjerg-Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Solvejg G H Pedersen
- Department of Medicine 2, Geriatric section, Holbaek University Hospital, Smedelundsgade 60, 4300 Holbaek, Denmark.
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Wang TN, An BW, Wang TX, McNamara M, Sweigert PJ, Yuce TK, Heh V, Collins CE, Haisley KR, Perry KA. The effect of frailty and age on outcomes in elective paraesophageal hernia repair. Surg Endosc 2023; 37:9514-9522. [PMID: 37704792 DOI: 10.1007/s00464-023-10363-9] [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: 04/02/2023] [Accepted: 07/30/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION Paraesophageal hernia repair (PEHR) is a safe and effective operation. Previous studies have described risk factors for poor peri-operative outcomes such as emergent operations or advanced patient age, and pre-operative frailty is a known risk factor in other major surgery. The goal of this retrospective cohort study was to determine if markers of frailty were predictive of poor peri-operative outcomes in elective paraesophageal hernia repair. METHODS Patients who underwent elective PEHR between 1/2011 and 6/2022 at a single university-based institution were identified. Patient demographics, modified frailty index (mFI), and post-operative outcomes were recorded. A composite peri-operative morbidity outcome indicating the incidence of any of the following: prolonged length of stay (≥ 3 days), increased discharge level of care, and 30-day complications or readmissions was utilized for statistical analysis. Descriptive statistics and logistic regression were used to analyze the data. RESULTS Of 547 patients who underwent elective PEHR, the mean age was 66.0 ± 12.3, and 77.1% (n = 422) were female. Median length of stay was 1 [IQR 1, 2]. ASA was 3-4 in 65.8% (n = 360) of patients. The composite outcome occurred in 32.4% (n = 177) of patients. On multivariate analysis, increasing age (OR 1.021, p = 0.02), high frailty (OR 2.02, p < 0.01), ASA 3-4 (OR 1.544, p = 0.05), and redo-PEHR (OR 1.72, p = 0.02) were each independently associated with the incidence of the composite outcome. On a regression of age for the composite outcome, a cutoff point of increased risk is identified at age 72 years old (OR 2.25, p < 0.01). CONCLUSION High frailty and age over 72 years old each independently confer double the odds of a composite morbidity outcome that includes prolonged post-operative stay, peri-operative complications, the need for a higher level of care after elective paraesophageal hernia repair, and 30-day readmission. This provides additional information to counsel patients pre-operatively, as well as a potential opportunity for targeted pre-habilitation.
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Affiliation(s)
- Theresa N Wang
- Department of Surgery/Center for Minimally Invasive Surgery, The Ohio State University, 395 W 12th Ave Suite 670, Columbus, OH, 43210, USA.
| | - Bryan W An
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Tina X Wang
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Molly McNamara
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Patrick J Sweigert
- Department of Surgery/Center for Minimally Invasive Surgery, The Ohio State University, 395 W 12th Ave Suite 670, Columbus, OH, 43210, USA
| | - Tarik K Yuce
- Department of Surgery/Center for Minimally Invasive Surgery, The Ohio State University, 395 W 12th Ave Suite 670, Columbus, OH, 43210, USA
| | - Victor Heh
- Department of Surgery/Center for Minimally Invasive Surgery, The Ohio State University, 395 W 12th Ave Suite 670, Columbus, OH, 43210, USA
| | - Courtney E Collins
- Department of Surgery/Center for Minimally Invasive Surgery, The Ohio State University, 395 W 12th Ave Suite 670, Columbus, OH, 43210, USA
| | - Kelly R Haisley
- Department of Surgery/Center for Minimally Invasive Surgery, The Ohio State University, 395 W 12th Ave Suite 670, Columbus, OH, 43210, USA
| | - Kyle A Perry
- Department of Surgery/Center for Minimally Invasive Surgery, The Ohio State University, 395 W 12th Ave Suite 670, Columbus, OH, 43210, USA
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Wada Y, Shojima K, Tamaki K, Mori T, Kusunoki H, Onishi M, Tsuji S, Matsuzawa R, Nagai K, Sano K, Hashimoto K, Goto M, Nagasawa Y, Shinmura K. Association Between Timed Up-and-Go Test and Future Changes in the Frailty Status in a Longitudinal Study of Japanese Community-Dwelling Older Adults. Clin Interv Aging 2023; 18:1191-1200. [PMID: 37534233 PMCID: PMC10392805 DOI: 10.2147/cia.s413513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose This study aimed to evaluate the relationship between timed up-and-go (TUG) test time and changes in frailty status in a longitudinal cohort study of rural Japanese older adults. Patients and Methods This prospective cohort study included 545 community-dwelling older adults. Initial and 2-year follow-up surveys were conducted. We compared the number of the Japanese version of the Cardiovascular Health Study components during the follow-up period and classified the participants into three groups: the favorable change, unchanged as prefrail, and unfavorable change groups. Associations between changes in frailty status and TUG time in the first survey were examined. The predictive ability of the TUG test was determined using the receiver operating characteristic (ROC) curve. Results The favorable change group comprised 315 individuals (57.8%), the unchanged as prefrail group 105 (19.2%), and the unfavorable change group 125 (22.9%). TUG time was associated with the favorable and unfavorable changes after adjustment for covariates (OR 0.79, 95% CI 0.68-0.92, P=0.001 and OR 1.27, 95% CI 1.09-1.49, P=0.002). The ROC curve of TUG time as a predictor of unfavorable changes showed an area under the curve of 0.59. A cut-off point of TUG was calculated as 6.3 s with 49.6% sensitivity and 66.0% specificity. Conclusion TUG time in the first survey was significantly associated with changes in frailty status 2 years later. However, its predictive value as a stand-alone test is limited and has the potential to predict future changes in the frailty status in older adults in combination with other tests.
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Affiliation(s)
- Yosuke Wada
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Roppou Clinic, Toyooka, Hyogo, Japan
| | - Kensaku Shojima
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Kayoko Tamaki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Takara Mori
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Amagasaki Medical COOP Honden Clinic, Amagasaki, Hyogo, Japan
| | - Hiroshi Kusunoki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of Internal Medicine, Osaka Dental University, Hirakata, Japan
| | - Masaaki Onishi
- Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Shotaro Tsuji
- Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of Orthopedic Surgery, Tatsuno City Hospital, Tatsuno, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Kyoko Sano
- Takarazuka Rehabilitation Hospital, Takarazuka, Japan
| | - Kana Hashimoto
- School of Pharmacy, Hyogo Medical University, Kobe, Japan
| | - Masashi Goto
- Department of General Medicine and Community Health Science, Hyogo Medical University, Sasayama Medical Center, Tambasasayama, Japan
| | - Yasuyuki Nagasawa
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Ken Shinmura
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of General Medicine and Community Health Science, Hyogo Medical University, Sasayama Medical Center, Tambasasayama, Japan
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Liu M, Kang N, Wang D, Mei D, Wen E, Qian J, Chen G. Analysis of Lower Extremity Motor Capacity and Foot Plantar Pressure in Overweight and Obese Elderly Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3112. [PMID: 36833807 PMCID: PMC9965343 DOI: 10.3390/ijerph20043112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Overweight, obesity and falls are major public health problems and old people are the biggest group suffering falls. METHODS 92 females were divided into the overweight or obesity (O) group (68.85 ± 3.85) and regular-weight (R) group (67.90 ± 4.02). Lower extremity motor capacity and plantar pressure were compared between the two groups. The IRB approval number is 20190804. RESULTS (1) Functional Movement Screen and Fugl-Meyer Assessment scores in the O group were significantly lower than in the R group. The time to complete the Timed Up and Go test in the O group was significantly longer than in the R group. (2) Foot flat phase, double support distance, and left foot axis angle in the O group were significantly higher than in the R group. Distance and velocity, left-foot minimum subtalar joint angle and right-foot maximum subtalar joint angle in the O group were significantly shorter than in the R group. (3) Peak force, average force and pressure of metatarsal 1-4, mid-foot, heel medial and lateral, peak pressure of metatarsal l, midfoot, heel medial and lateral in the O group were significantly higher than in the R group. (p < 0.05). CONCLUSIONS Overweight and obese elderly women have a lower sensorimotor function, flexibility and stability in functional movements, but higher loads on the foot.
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Affiliation(s)
- Min Liu
- Institute of Population Research, Peking University, Beijing 100871, China
| | - Ning Kang
- Institute of Population Research, Peking University, Beijing 100871, China
| | - Dongmin Wang
- Department of Physical Education, Peking University, Beijing 100871, China
| | - Donghui Mei
- College of Psychology, Capital Normal University, Beijing 100048, China
| | - Erya Wen
- Department of Physical Education, Peking University, Beijing 100871, China
| | - Junwei Qian
- Department of Physical Education, Peking University, Beijing 100871, China
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing 100871, China
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Liang J, Wang Y, Zhang W, Ding H, Gao Y, Wang R, Sun X, Peng Y, Gan L, Zuo L. Incidence and risk factors of falls in patients undergoing hemodialysis: A multicenter survey in northern China. Hemodial Int 2023; 27:155-164. [PMID: 36744400 DOI: 10.1111/hdi.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/30/2022] [Accepted: 01/10/2023] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Patients undergoing hemodialysis (HD) are at a higher risk of falls than healthy individuals. Further knowledge regarding the risk of falls could lead to better risk prevention strategies. We designed a multicenter, prospective cohort study according to the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines to investigate the incidence and risk factors of falls in patients undergoing hemodialysis in Northern China. METHODS Patients undergoing hemodialysis in six hemodialysis units were recruited from January 2019 to January 2020. Data on demographics and disease conditions were collected at baseline. Data on other variables, the incidence of falls, and related conditions were collected every 3 months during a 1-year follow-up. The Generalized Estimating Equation model was used to evaluate factors associated with falls. FINDINGS This study included 472 patients. The incidence of falls was 0.31 per patient year. In patients aged 45-64 years (p = 0.01; odds ratio [OR]: 14.801; 95% confidence interval [CI]: 1.897-115.453) and ≥ 65 years (p = 0.007; OR: 16.562; 95% CI: 2.118-129.521), anemia (p = 0.015; OR: 2.122; 95% CI: 1.154-3.902) and moderately (p = 0.003; OR: 5.439; 95% CI: 1.791-16.516) and severely abnormal timed up and go test (TUGT) levels (p = 0.001; OR: 7.032; 95% CI: 2.226-22.216) were identified as independent risk factors of falls. DISCUSSION Falls are prevalent among patients undergoing in-center hemodialysis. Advanced age, anemia, and moderately and severely abnormal TUGT levels may be risk factors of falls.
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Affiliation(s)
- Junqing Liang
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
| | - Ying Wang
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
| | - Weilin Zhang
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
| | - Hong Ding
- Beijing Miyun Hospital, Department of Nephrology, Beijing, Miyun, People's Republic of China
| | - Yanjun Gao
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, Xicheng, People's Republic of China
| | - Rui Wang
- Beijing Fengtai Hospital, Department of Nephrology, Beijing, Fengtai, People's Republic of China
| | - Xiaofei Sun
- Beijing Renhe Hospital, Department of Nephrology, Beijing, Daxing, People's Republic of China
| | - Ying Peng
- Department of Nephrology, Beijing Zhanlanlu Hospital, Beijing, Xicheng, People's Republic of China
| | - Liangying Gan
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
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Kostka J, Sosowska N, Guligowska A, Kostka T. A Proposed Method of Converting Gait Speed and TUG Test in Older Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12145. [PMID: 36231451 PMCID: PMC9564782 DOI: 10.3390/ijerph191912145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/18/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Sarcopenia is one of the most important health problems in advanced age. In 2019, the European Working Group of Sarcopenia in Older People (EWGSOP) updated the operational diagnostic criteria for identification of people with sarcopenia (EWGSOP2). Among the two proposed low performance measures of sarcopenia are gait speed and the Timed Up and Go (TUG) test. Usage of any of those tools requires recalculation for the second one for eventual comparisons. The simple linear regression has been used for such comparisons in several previous studies, but the appropriateness of such an approach has not been verified. The aim of this study is to find the most appropriate model describing the relationship between these two popular measures of physical function. The study was performed in 450 consecutive outpatients of the Geriatric Clinic of the Medical University of Lodz, Poland, aged 70 to 92 years who volunteered to participate in the study. The TUG test and gait speed at 4 m to assess physical function were used. Different alternative models were compared to obtain the highest R-squared values. A Reciprocal-Y model (R-squared = 71.9%) showed the highest performance, followed by a Logarithmic-Y square root-X model (R-squared = 69.3%) and a Reciprocal-Y square root-X model (R-squared = 69.1%). The R-squared for the linear model was 49.5%. For the selected reciprocal model, the correlation coefficient was 0.85 and the equation of the fitted model was: Gait speed (m/s) = 1/(-0.0160767 + 0.101386 × TUG). In conclusion, in independent community-dwelling older adults, the relationship between gait speed and the TUG test in older subjects is nonlinear. The proposed reciprocal model may be useful for recalculations of gait speed or TUG in future studies.
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Affiliation(s)
- Joanna Kostka
- Department of Gerontology, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland
| | - Natalia Sosowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Hallera 1, 90-647 Lodz, Poland
| | - Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Hallera 1, 90-647 Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Hallera 1, 90-647 Lodz, Poland
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Batko-Szwaczka A, Francuz T, Kosowska A, Cogiel A, Dudzińska-Griszek J, Wilczyński K, Hornik B, Janusz-Jenczeń M, Włodarczyk I, Wnuk B, Szołtysek J, Durmała J, Dulawa J, Szewieczek J. Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels. Clin Interv Aging 2022; 17:1173-1185. [PMID: 35957925 PMCID: PMC9362850 DOI: 10.2147/cia.s363881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/02/2022] [Indexed: 11/29/2022] Open
Abstract
Background Societal aging – as a global demographic phenomenon – shows no indication of abating. As a result, the problem of age-associated disability and related long-term care is emerging as a major public health challenge. It is important that methods for identifying older adults at risk of adverse outcomes are implemented early. Methods The study group consisted of 145 individuals, 44.1% women, who were randomized from community-dwelling 60–74-year-old adults. A comprehensive geriatric assessment was supplemented with Fried frailty phenotype evaluation and blood tests (including adhesion molecules, matrix metalloproteinases and neurotrophic factors). A follow-up by phone call was made for at least 3 years after the initial examination. Composite endpoint (CE) included falls, hospitalization, institutionalization and death. Results Mean study group age was 66.5 ± 4.1 years (\documentclass[12pt]{minimal}
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\end{document}) and mean number of diseases was 3.7 ± 2.2. Functional status of the subjects was good, as indicated by high Barthel Index scores of 99.1 ± 2.4, MMSE scores of 29.0 ±1.5 and no frailty case. During a three-year follow-up, 71 participants (49.0%) experienced any CE-events. The Wilcoxon-Gehan test indicates that a higher probability of three-year CE completion was associated with an age >65 years (P = 0.006), coronary artery disease (CAD) (P = 0.008), 6-Minute Walk Test <432 m (P = 0.034), serum glucose >120 mg/dL (P = 0.047), serum cortisol >10 μg/dL (P = 0.011), leptin ≥15 ng/mL (P = 0.018), P-selectin ≥23 ng/mL (P = 0.006) and GDNF ≥20 pg/mL (P = 0.004). CAD (OR = 3.64, 95% CI = 1.53−8.69, P = 0.004), educational status (OR = 0.87, 95% CI = 0.77−0.98, P = 0.022) and P-selectin levels (OR = 1.07, 95% CI = 1.02−1.13, P = 0.013) were independent measures predicting three-year CE occurrence in multivariate logistic regression analysis adjusted for clinical and functional measures, and blood tests. Conclusion Coronary artery disease, poorer lower educational status and higher P-selectin levels were predictive of adverse outcomes in the community-dwelling healthy-aging early-old adults during three-year follow-up.
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Affiliation(s)
- Agnieszka Batko-Szwaczka
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Correspondence: Agnieszka Batko-Szwaczka, Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Poniatowskiego 15, Katowice, 40-055, Poland, Tel +48323598239, Fax +48322059483, Email
| | - Tomasz Francuz
- Department of Biochemistry, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Kosowska
- Department of Biochemistry, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Anna Cogiel
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Dudzińska-Griszek
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Wilczyński
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Hornik
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Janusz-Jenczeń
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Iwona Włodarczyk
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bartosz Wnuk
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Szołtysek
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jacek Durmała
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Dulawa
- Department of Internal Medicine and Metabolic Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Szewieczek
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Imamura K, Kamide N, Ando M, Sato H, Sakamoto M, Shiba Y. Social isolation is associated with future decline of physical performance in community-dwelling older adults: a 1-year longitudinal study. Aging Clin Exp Res 2022; 34:1391-1398. [PMID: 35060108 DOI: 10.1007/s40520-021-02050-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Social isolation and decline of physical function, such as muscle strength and physical performance, are known to be associated with deterioration of functional capacity. However, the relationship between social isolation and physical function has not been sufficiently clarified by a longitudinal observational study. AIMS The aim of this study was to examine whether social isolation is associated with a future decline in physical function in older people. METHODS The participants were 166 community-dwelling older people (aged ≥ 65 years). Social isolation and physical function were assessed using the 6-item Lubben Social Network Scale and handgrip strength, knee extensor strength, usual walking time, and the Timed Up and Go (TUG) test in both the baseline and follow-up surveys. To define the presence or absence of physical function decline over time, we used the minimal detectable change. The associations between social isolation and physical function were analyzed using logistic regression analysis adjusted for confounding factors. Further, to examine the possibility of drop-out bias, inverse probability weighting (IPW) was performed. RESULTS The results of the logistic regression analysis adjusted for confounding factors showed social isolation at baseline was significantly associated with future TUG decline (OR 2.88, 95% CI 1.15-7.22). Social isolation was not associated with a decline in other physical functions. Similar results were found in an analysis using IPW. CONCLUSIONS Social isolation was an independent risk factor for future TUG decline in community-dwelling older people. Our results indicated that assessment of social isolation may be necessary to assess the risk of physical performance decline.
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Affiliation(s)
- Keigo Imamura
- Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Naoto Kamide
- Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
| | - Masataka Ando
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Haruhiko Sato
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Miki Sakamoto
- Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Yoshitaka Shiba
- School of Health Sciences, Fukushima Medical University, Fukushima, Japan
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Sundarakumar JS, Raviteja KV, Muniz‐Terrera G, Ravindranath V. Normative data for three physical frailty parameters in an aging, rural Indian population. Health Sci Rep 2022; 5:e567. [PMID: 35356805 PMCID: PMC8938919 DOI: 10.1002/hsr2.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Physical frailty is associated with multiple adverse health outcomes. Since physical characteristics markedly vary with different populations, population‐specific norms for physical frailty parameters are necessary. Such norms are lacking for the Indian population, especially for older, rural Indians. We aimed to develop normative values for three quantitative, frailty parameters—handgrip strength, “Timed Up‐and‐Go” (TUG) test time, and physical activity in an aging, rural Indian population. Methods The study sample is from an ongoing, prospective, cohort (Srinivaspura NeuoSenescence and COGnition, SANSCOG) comprised of rural, community‐dwelling, cognitively healthy, aging Indians. Subjects are recruited through area sampling strategy, from villages of Srinivaspura, Kolar district, Karnataka state, India. Three physical frailty parameters of Fried's phenotype—handgrip strength (n = 1787), TUG time (n = 1863), and physical activity (n = 1640) were assessed using digital hand dynamometry, TUG test, and General Physical Activity Questionnaire (GPAQ), respectively. Results The 10th, 25th, 50th, 75th, 90th percentiles for the three frailty parameters were: right‐hand grip strength (kg): males—13.9, 18.6, 23.8, 28.7, 33.7 and females—7.8, 10.6, 14.2, 17.9, 21.3; left‐hand grip strength (kg): males—13.3, 18.3, 23.6, 28.9, 32.9 and females—7.9, 10.5, 14.3, 17.8, 21.2; TUG time (s): males—9.1, 10.1, 11.4, 13.4, 15.5 and females—9.5, 10.7, 12.4, 14.5, 16.6; physical activity (MET‐minutes/week): males—1680; 4320; 8880; 15,840; 23,352 and females—1680; 4320; 9240; 15,120; 20,160. Discussion Our findings show that from 45 years onwards, overall grip strength decreases and TUG time increases, with women performing significantly poorer than men across all age groups, except >75 years, where no differences were seen. Physical activity did not show any consistent trend according to age or gender. Reference values for this aging, rural Indian population were substantially lower for grip strength and higher for TUG time than aging populations in several Western and other Asian countries.
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Affiliation(s)
| | - Karru V. Raviteja
- Centre for Brain Research Indian Institute of Science Bangalore India
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Baker N, Grimmer K, Gordon S. Balance provocation tests identify near falls in healthy community adults aged 40-75 years; an observational study. Physiother Theory Pract 2021; 38:3072-3081. [PMID: 34637669 DOI: 10.1080/09593985.2021.1983909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Near falls, such as stumbles or slips without falling to the ground, are more common than falls and often lead to a fall. PURPOSE The objective of this study was to investigate which balance tests differentiate near fallers from fallers and non-fallers. METHODS This cross-sectional, observational study assessed balance in healthy community dwelling adults aged 40-75 years. Participants reported falls and near falls in the previous 6 months. Balance testing was completed in the local community for static (i.e. feet together and single-leg stance) and dynamic balance (i.e. tandem walk, Functional Movement Screen hurdle step and lunge). Between-group comparative analysis of pass-fail for each balance test was undertaken. RESULTS Of 627 participants, there were 99 fallers (15.8%), 121 near fallers (19.3%) and 407 non-fallers (64.9%). Near fallers were twice as likely as non-fallers to fail single-leg stance eyes (OR 2.7, 95% CI 1.5-4.9), five tandem steps (OR 2.5, 95% CI 1.5-5.7), hurdle step (OR 2.9, 95% CI 1.4-5.8), and lunge (OR 2.5. 95% CI 1.5-4.1). The predictive capacity differentiates near fallers with a sensitivity of 73.3%. DISCUSSION A new battery of tests assessing static and dynamic balance identifies near fallers in seemingly healthy, community dwelling middle- and young-older-aged adults.
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Affiliation(s)
- Nicky Baker
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Karen Grimmer
- Division of Physiotherapy, Faculty of Medicine and Health Science, Stellenbosch University, Stellenbosch, South Africa
| | - Sue Gordon
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
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Ninomiya K, Takahira N, Ikeda T, Suzuki K, Sato R, Kazuo H. Prevalence of frailty and associated factors among community-dwelling older adults after total hip arthroplasty. Hip Int 2021; 33:397-403. [PMID: 34569345 DOI: 10.1177/11207000211048180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate the prevalence of frailty and associated factors among community-dwelling older adults who have undergone total hip arthroplasty (THA). MATERIALS AND METHODS This study, which employed a cross-sectional, observational design, was conducted between April and November 2020. The participants were older adults (⩾65 years) who had undergone primary THA at the study hospital. Based on Fried's modified phenotype, frailty was stratified into 3 degrees according to the presence of 3 or more of the following components: weight loss, weakness, exhaustion, low activity level, and slow walking speed. Multinomial logistic regression was used to analyse the associations of frailty with its potential risk factors. RESULTS The data of 518 participants were analysed. The overall prevalence of frailty and prefrailty was 11.4% and 51.0%, respectively. The multinomial logistic regression analysis showed that calf circumference (odds ratio [OR] 0.716, 95% confidence interval [CI], 0.611-0.839; p < 0.001), fall history (OR 2.435, 95% CI, 1.114-5.322; p = 0.026), hip abductor muscle strength (OR 0.962, 95% CI, 0.938-0.987; p = 0.003), knee extensor muscle strength (OR 0.980, 95% CI, 0.964-0.996; p = 0.013), and Timed Up and Go test (TUG) performance (OR 1.802, 95% CI, 1.458-2.228; p < 0.001) were associated with frailty. CONCLUSIONS Frailty was highly prevalent in community-dwelling older adults after THA. Further, its potential associations with calf circumference, hip abductor and knee extensor muscle strength, TUG performance, and fall history highlight the significance of these factors for interventions.
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Affiliation(s)
- Kazunari Ninomiya
- Department of Rehabilitation, Shonan Kamakura Joint Reconstruction Centre, Kanagawa, Japan.,Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Naonobu Takahira
- Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.,Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
| | - Takashi Ikeda
- Department of Rehabilitation, Shonan Kamakura Joint Reconstruction Centre, Kanagawa, Japan.,School of Nursing and Rehabilitation Sciences, Showa University, Kanagawa, Japan
| | - Koji Suzuki
- Department of Rehabilitation, Shonan Kamakura Joint Reconstruction Centre, Kanagawa, Japan
| | - Ryoji Sato
- Department of Rehabilitation, Shonan Kamakura Joint Reconstruction Centre, Kanagawa, Japan
| | - Hirakawa Kazuo
- Department of Orthopaedic Surgery, Shonan Kamakura Joint Reconstruction Center, Kamakura, Kanagawa
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