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Dzando G, Ward P, Gesesew HA, Tyndall J, Ambagtsheer RC. Prevalence, perceptions, and experiences of frailty among older migrants from Low- and Middle-Income Countries to High Income Countries: A mixed method systematic review. Arch Gerontol Geriatr 2024; 121:105360. [PMID: 38341959 DOI: 10.1016/j.archger.2024.105360] [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: 10/22/2023] [Revised: 01/18/2024] [Accepted: 01/29/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Frailty is increasingly becoming a public health concern, especially among vulnerable populations. Older migrants from Low- and Middle-Income Countries to High Income Countries present with poorer health and are at increased risk of becoming frail. This review aims to explore the prevalence, perceptions, and experiences of frailty among older migrants from Low- and Middle-Income Countries to High Income Countries. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Five electronic databases were comprehensively searched for relevant literature published from January 1, 2000, to April 30, 2023. Quality appraisal for the quantitative studies was done with the Joanna Brigg's critical appraisal tool for analytic cross-sectional studies, and the qualitative studies were assessed with the Critical Appraisal Skill Program tool for qualitative studies. RESULT Seven studies met the inclusion criteria. Frailty was assessed using modified versions of the Frailty Phenotype and Frailty Index. The prevalence of frailty using the Frailty Phenotype was 16.6 %, and 17 % to 61.9 % according to the Frailty Index. The perceptions and experiences of frailty were characterised by chronic ill-health and a review of healthy pre-migration and early migration lives. CONCLUSION Despite the variation in frailty assessment methods, the high prevalence of frailty among older migrants was highlighted across the included studies. The perceptions and experiences of frailty reflect a state of resignation which can complicate the state of frailty. There is the need for ongoing research among migrant groups to identify their predisposition to frailty for early intervention.
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Affiliation(s)
- Gideon Dzando
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia.
| | - Paul Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia; College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Jessica Tyndall
- Library, Torrens University Australia, Adelaide, SA, Australia
| | - Rachel C Ambagtsheer
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia
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Brandhorst S, Longo VD. Exploring juventology: unlocking the secrets of youthspan and longevity programs. FRONTIERS IN AGING 2024; 5:1379289. [PMID: 38638872 PMCID: PMC11024265 DOI: 10.3389/fragi.2024.1379289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/20/2024] [Indexed: 04/20/2024]
Abstract
In recent decades, the study of biological aging has evolved from simplistic theories like the free radical theory to more complex and nuanced perspectives. In particular, the identification of evolutionary conserved genes and signaling pathways that can modulate both lifespan but also healthspan has resulted in the expanding understanding of the link between nutrients, signal transduction proteins, and aging along with substantial support for the existence of multiple "longevity programs," which are activated based on the availability of nutrients. Periodic fasting and other dietary restrictions can promote entry into a longevity program characterized by cellular protection and optimized function, and the activation of regenerative processes that lead to rejuvenation. This review discusses the idea of juventology, a novel field proposing the existence of longevity programs that can maintain organisms in a highly functional state for extended periods of time. Drawing upon research on Saccharomyces cerevisiae and other model organisms, the review explores the distinctiveness of juventology from traditional aging-centered views. The focus on the "age of youth" challenges conventional thinking and opens new avenues for understanding and extending the period of peak functionality in organisms. Thus, a "juventology"-based strategy can complement the traditional gerontology approach by focusing not on aging but on the longevity program affecting the life history period in which mortality is very low and organisms remain youthful, healthy, and fully functional.
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Affiliation(s)
- Sebastian Brandhorst
- Leonard Davis School of Gerontology, Longevity Institute, University of Southern California, Los Angeles, CA, United States
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Sancho-Martínez SM, López-Hernández FJ. Pathophysiology of Acute Kidney Frailty. Physiology (Bethesda) 2023; 38:0. [PMID: 37738019 DOI: 10.1152/physiol.00011.2023] [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: 04/27/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 09/23/2023] Open
Abstract
Acute kidney frailty is a premorbid condition of diminished renal functional reserve that predisposes to acute kidney injury; this condition results from subclinical wear or distortion of renal homeostatic responses that protect the renal excretory function. Knowledge of its pathophysiological basis is critical for the development of diagnostic and therapeutic strategies that allow for prophylactic intervention and disease prevention.
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Affiliation(s)
- Sandra M Sancho-Martínez
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), Salamanca, Spain
- National Network for Kidney Research RICORS2040 RD21/0005/0004, Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco J López-Hernández
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), Salamanca, Spain
- National Network for Kidney Research RICORS2040 RD21/0005/0004, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Estudios de Ciencias de la Salud de Castilla y León (IECSCYL), Soria, Spain
- Group of Biomedical Research on Critical Care (BioCritic), Valladolid, Spain
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Fan RR, Rudnick SB, Minami HR, Chen AM, Zemela MS, Wittgen CM, Williams MS, Smeds MR. Depression screening in patients with vascular disease. Vascular 2023; 31:758-766. [PMID: 35404707 DOI: 10.1177/17085381221084817] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVES Major depression is associated with increased morbidity and mortality in vascular surgery patients. The US Preventive Services Task Force and American Heart Association recommend routine depression screening for adults, especially those with cardiovascular disease. Since routine depression screening has not been implemented in most vascular surgery clinics across the nation, we sought to determine the feasibility of depression screening and understand the prevalence and predictors of depression in patients presenting to a single institution's vascular surgery clinic over a 4 month period. METHODS From June to September 2020, vascular surgery clinic patients were administered a 26-item survey that included validated scales for depression (PHQ-9), pain, frailty, alcohol dependence, and nicotine dependence. Although not validated, the Rosenberg Self-Esteem Scale was also administered. Patient charts were reviewed for demographic information and medical history. 9-digit patient zip codes were used to determine Area Deprivation Index, a measure of socioeconomic status. Univariate and multivariate analyses were performed to understand the factors associated with increased depression prevalence in the study population. RESULTS A total of 140 (36.4%) of 385 patients met study inclusion criteria. 35.7% of them screened positive for mild to severe depression (PHQ-9 scores ≥5). On univariate analysis, major depression was significantly associated with lower socioeconomic status (p = 0.007), higher frailty (p < 0.001), lower self-esteem (p < 0.001), higher daily pain (p < 0.001), health problems that interfere with social activities (p < 0.001), fatigue (p < 0.001), unmarried status (p = 0.031), and lack of primary care provider (p = 0.048). Multivariate analyses significantly predicted higher frailty (B= 0.487, p = 0.007) and lower self-esteem (B= -0.413, p < 0.001) in patients with depression. Depression was not associated with gender, age, employment status, smoking status, alcohol use, or type of vascular disease. COCLUSIONS More than one-third of vascular surgery clinic patients have comorbid depression. Higher frailty and lower self-esteem are significant risk factors for depression. Prevention and early identification of frailty may improve outcomes. Depression screening in vascular surgery clinics is feasible and could be useful in determining which patients may benefit from more frequent follow-up and monitoring for associated comorbidities. Vascular surgeons may play an important role in screening for depression and referring patients for psychotherapy and/or pharmacotherapy.
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Affiliation(s)
- Rachel R Fan
- Saint Louis University School of Medicine, St Louis, MO, USA
| | | | - Hataka R Minami
- Saint Louis University School of Medicine, St Louis, MO, USA
| | - Amy M Chen
- Saint Louis University School of Medicine, St Louis, MO, USA
| | - Mark S Zemela
- Saint Louis University School of Medicine, St Louis, MO, USA
| | - Catherine M Wittgen
- Division of Vascular and Endovascular Surgery, Saint Louis University School of Medicine, St Louis, MO, USA
| | - Michael S Williams
- Division of Vascular and Endovascular Surgery, Saint Louis University School of Medicine, St Louis, MO, USA
| | - Matthew R Smeds
- Division of Vascular and Endovascular Surgery, Saint Louis University School of Medicine, St Louis, MO, USA
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Oliosi E, Guede-Fernández F, Londral A. Machine Learning Approaches for the Frailty Screening: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148825. [PMID: 35886674 PMCID: PMC9320589 DOI: 10.3390/ijerph19148825] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 12/16/2022]
Abstract
Frailty characterizes a state of impairments that increases the risk of adverse health outcomes such as physical limitation, lower quality of life, and premature death. Frailty prevention, early screening, and management of potential existing conditions are essential and impact the elderly population positively and on society. Advanced machine learning (ML) processing methods are one of healthcare’s fastest developing scientific and technical areas. Although research studies are being conducted in a controlled environment, their translation into the real world (clinical setting, which is often dynamic) is challenging. This paper presents a narrative review of the procedures for the frailty screening applied to the innovative tools, focusing on indicators and ML approaches. It results in six selected studies. Support vector machine was the most often used ML method. These methods apparently can identify several risk factors to predict pre-frail or frailty. Even so, there are some limitations (e.g., quality data), but they have enormous potential to detect frailty early.
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Affiliation(s)
- Eduarda Oliosi
- Value for Health CoLAB, 1150-190 Lisboa, Portugal; (E.O.); (F.G.-F.)
- LIBPhys (Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics), NOVA School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Federico Guede-Fernández
- Value for Health CoLAB, 1150-190 Lisboa, Portugal; (E.O.); (F.G.-F.)
- LIBPhys (Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics), NOVA School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Ana Londral
- Value for Health CoLAB, 1150-190 Lisboa, Portugal; (E.O.); (F.G.-F.)
- Comprehensive Health Research Center, NOVA Medical School, NOVA University of Lisbon, 1150-082 Lisboa, Portugal
- Correspondence:
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Somagutta MR, Uday U, Bathula NR, Pendyala S, Mahadevaiah A, Jain MS, Mahmutaj G, Gad M, Jean Baptiste J. Diagnosing Frailty in Primary Care Practice. Cureus 2022; 14:e23329. [PMID: 35464517 PMCID: PMC9015073 DOI: 10.7759/cureus.23329] [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: 02/17/2022] [Accepted: 03/19/2022] [Indexed: 11/11/2022] Open
Abstract
Frailty is a complex age-related clinical condition with increased vulnerability to negative health outcomes that manifest as a multidimensional syndrome and hence, a challenge to identify at-risk populations. We aim to summarize the implementation of strategies to diagnose fragility in family practice using current evidence. We searched the PubMed and Google Scholar databases for relevant articles, using the Medical Subject Headings (MeSH) terms "Frailty," "Frailty Scales," and "Primary Health Care." All original research articles on the elderly population (65 years of age or older) published in English and the last five years were included. Frailty diagnosis has resulted in positive outcomes in the overall literature. Recent hospital admission may indicate a health problem that can end up in a negative outcome and has been often described as associated with frailty. It was also shown to affect the intensive care units' mortality, in-hospital mortality, and long-term mortality. However, multiple screening instruments have been developed and validated to improve feasibility in clinical practice. The frequent lack of agreement between frailty instruments has slowed the broad implementation of these tools. The impacts of frailty warrant an upstream, proactive, holistic, interprofessional primary care approach to its identification, assessment, and management. It is a preventable disorder; identifying elderly patients at risk in primary care can help shape appropriate care processes tailored to their needs. This literature review aims to demonstrate the importance and strategies in identifying frailty in primary care settings and assess its impact on several outcomes.
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Lu Q, Mårtensson J, Zhao Y, Johansson L. Needs of family members caring for stroke survivors in china: A deductive qualitative content analysis study by using the caregiver task inventory-25. BMC Geriatr 2022; 22:96. [PMID: 35114940 PMCID: PMC8812361 DOI: 10.1186/s12877-022-02774-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background In China, family caregivers are usually the main carers of relatives after stroke due to traditional Chinese culture and the limited development of the primary healthcare system. This responsibility often results in burdens and negative health outcomes. However, family caregivers seldom receive support. To improve informal care, as well as the health and well-being of family caregivers, it is important to identify their needs. Objective This study aimed to deductively explore the needs of family members caring for stroke survivors in China. Methods Twenty-six semi-structured interviews were performed with family caregivers of stroke survivors who were selected from one city and three communities by purposive sampling. A deductive qualitative content analysis method was performed by using the Caregiver Task Inventory-25 (CTI-25), an instrument measuring the needs of family caregivers, as a framework. Results All subscales, as well as all belonging items in the CTI-25, were identified in the present study, meaning that the family caregivers had needs related to learning to cope with new role, providing care according to care-receiver’s needs, managing own emotional needs, appraising supportive resources, and balancing caregiving needs and one’s own needs. Moreover, needs related to financial support, both direct and indirect, were identified but not part of the CTI-25. Conclusion These findings identified that family caregivers of stroke survivors in China had various needs, which is important knowledge when assessing needs and improving health care for family caregivers. Cultural adjustments and modifications should be made if CTI-25 is used in mainland China. This study also indicated a comprehensive and holistic perspective (individual, community, and social level) when identifying, assessing needs or implementing interventions to support family caregivers.
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Affiliation(s)
- Qi Lu
- School of Health and Welfare, Jönköping University, Jönköping, Sweden. .,School of Nursing, Tianjin Medical University, Tianjin, China.
| | - Jan Mårtensson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Linda Johansson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Huang EY, Lam SC. Review of frailty measurement of older people: Evaluation of the conceptualization, included domains, psychometric properties, and applicability. Aging Med (Milton) 2021; 4:272-291. [PMID: 34964008 PMCID: PMC8711219 DOI: 10.1002/agm2.12177] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/03/2021] [Accepted: 09/05/2021] [Indexed: 11/10/2022] Open
Abstract
The purposes of this review are to describe the existing research on frailty measurement of older people and to understand their characteristics, with a focus on conceptual definitions, psychometric properties, and diagnostic accuracies. We reviewed the published literature to explore if cross-cultural studies of different types of frailty measurements have been conducted and to determine their applicability in the community setting. Narrative review with limited electronic database search and cross reference searching of included studies was performed. Studies published after year 2001 were searched for using MEDLINE and CINAHL Plus databases with keywords. A total of 5144 search results were obtained, but only 42 frailty measurements were identified in 68 studies. For the type, three different measurements were indicated, namely, self-report instrument (n = 17), clinical observation assessment (n = 19), and mixed frailty assessment instrument (n = 6). Only 12 (29%) measurements examined reliability and validity. Nevertheless, over 35% did not perform any psychometric testing before applying. For diagnosis accuracies, 35 (83%) frailty measurements reported the cut-off value(s) for determining level of the frailty. However, the sensitivity (56%-89.5%) and specificity (52%-91.3%) varied. The applicability was also diverse and some frailty instruments should be only used in some specific population and mode of administration. This review provides an overview of three major types of frailty measurements used in different settings with different purposes. For estimating the prevalence of frailty of older people in a community, the self-report type may be appropriate. The psychometric properties of many reviewed instruments are reported insufficiently. The cut-off value(s) are usually suggested with diverse sensitivity and specificity. Self-report instruments, such as Groningen Frailty Indicator (GFI) and Tilburg Frailty Indicator (TFI), are the most extensively examined in terms of satisfactory psychometric properties. Thus, GFI and TFI, with the current evidence, are recommended to be used in the community setting for frailty screening tools.
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Affiliation(s)
- Emma Yun‐zhi Huang
- Department of Social WorkZhongshan PolytechnicZhongshan CityChina
- School of NursingThe Hong Kong Polytechnic UniversityKowloonHong Kong SAR
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Psychometric Characteristics of the Croatian and the Serbian Versions of the Oral Health Impact Profile for Edentulous Subjects, with a Pilot Study on the Dimensionality. Zdr Varst 2021; 60:55-64. [PMID: 33488823 PMCID: PMC7780771 DOI: 10.2478/sjph-2021-0009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 11/24/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction The aim was to adapt the Croatian and the Serbian versions of the Oral Health Impact Profile for the edentulous population (OHIP-EDENT-CRO and OHIP-EDENT-SRB). Methods The translation and cross-cultural adaptation were carried out in accordance with accepted international standards. A total of 95 and 177 removable denture wearers were recruited in Croatia and Serbia respectively. The reliability was evaluated by calculating Cronbach’s alpha coefficient and by test-retest (30 participants in each country). The concurrent validity was determined by calculating the Spearman’s rank coefficient between the OHIP-EDENT summary scores and one question related to removable denture satisfaction. Construct validity was determined by exploratory factor analysis (EFA). Responsiveness was determined by comparison of the OHIP-EDENT summary scores before and after dental implant placement to support mandibular overdentures (23 patients in Croatia, 21 in Serbia). Results Cronbach’s alpha coefficient was 0.92 in Croatia and 0.87 in Serbia. The intraclass correlation coefficient was 0.98 in Croatia and 0.94 in Serbia. In Croatia the Spearman’s correlation coefficient was -0.71 (p<0.001) and in Serbia -0.74 (p<0.001). Both confirmed concurrent validity. Construct validity was tested by EFA, which extracted four factors in each country, accounting for 66.59% of the variance in Croatia and 59.33% in Serbia. Responsiveness was confirmed in both countries by a significant OHIP-EDENT summary score reduction and a high standardised effect size (3.9 in Croatia, 1.53 in Serbia). Conclusion The results prove that both instruments, the OHIP-EDENT-CRO and the OHIP-EDENT-SRB, have very good psychometric properties for assessing OHRQoL in the edentulous population.
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Imaoka Y, Saba N, Vanhoestenberghe A, de Bruin ED. Triggering Postural Movements With Virtual Reality Technology in Healthy Young and Older Adults: A Cross-Sectional Validation Study for Early Dementia Screening. Front Med (Lausanne) 2020; 7:533675. [PMID: 33304909 PMCID: PMC7701173 DOI: 10.3389/fmed.2020.533675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
With the ultimate aim of early diagnosis of dementia, a new body balance assessment system with integrated head-mounted display-based virtual reality (VR) has been developed. We hypothesized that people would sway more in anterior-posterior (AP) direction when they were exposed to a VR environment where we intentionally provoked movements in forward and backward directions. A total of 14 healthy older adults (OA) (73.14±4.26 years) and 15 healthy young adults (YA) (24.93±1.49 years) were assessed for group differences in sway behavior. Body sway speed in 22 different conditions with and without VR environments was analyzed. Significant differences and large effect sizes were observed in AP sway under the VR environments (OA with P < 0.02; effect size> 0.61, YA with P < 0.003; effect size> 0.72) compared to the baseline condition without the VR environments. In addition, significant differences were found between the two groups in AP sway in all test conditions (P < 0.01). Our study shows that a VR environment can trigger body sway in an expected direction, which may indicate that it is possible to enhance the sensitivity of balance assessment by integrating immersive VR environments. The result of this study warrants a cross-sectional study in which OA diagnosed with and without dementia are compared on their sway behavior.
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Affiliation(s)
- Yu Imaoka
- Motor Control & Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Nadja Saba
- Motor Control & Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Anne Vanhoestenberghe
- Aspire Centre for Rehabilitation Engineering and Assistive Technologies, University College London, London, United Kingdom
| | - Eling D de Bruin
- Motor Control & Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Pavlović J, Račić M, Ivković N. Serum Biomarkers Associated with Malnutrition and Nutritional Risk in Elderly Primary Care Patients: A Cross-sectional Study from Bosnia and Herzegovina. Zdr Varst 2020; 60:30-37. [PMID: 33488820 PMCID: PMC7780770 DOI: 10.2478/sjph-2021-0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 11/19/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The aim of the study was to determine the ability of ferritin, haemoglobin, albumin and total cholesterol to identify nutritional risk and malnutrition among elderly primary care patients. METHODS The cross-sectional study included 446 elderly adults over 65 years of age from four areas of Bosnia and Herzegovina. In addition to anthropometric, functional, cognitive and biochemical indicators, nutritional status was evaluated using 24-hour recall of meals, the Mini Nutritional Assessment (MNA), and Seniors in the Community: Risk Evaluation for Eating and Nutrition, Version II (SCREEN II). RESULTS Malnourished/at-risk study respondents had lower mean levels of haemoglobin (P=0.001) and total cholesterol (P<0.001), compared to those with normal nutritional status. Albumin levels significantly differed regarding nutritional status (P=0.004), but not nutritional risk level (P=0.521). Significant differences in serum ferritin levels were not found between malnourished and normally nourished study respondents (P=0.779) Determinants of albumin level were eating more than three meals a day (P<0.001), fewer than two portions of fruit and vegetables a day (P=0.024), drinking one glass of wine (P<0.001) and reporting functional independence (P=0.011). The AUC curves for serum ferritin, albumin and total cholesterol levels in men and women, as well as for haemoglobin levels in women, were poor to fair (AUC<0.800). CONCLUSION Although ferritin, haemoglobin, albumin and total cholesterol may be useful biomarkers of nutritional status, their accuracy in diagnosing malnutrition and nutritional risk among elderly primary health care patients is limited.
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Affiliation(s)
- Jelena Pavlović
- University of East Sarajevo, Faculty of Production and Management, Faculty of Medicine, Studentska 5, 73300Foca, Bosnia and Herzegovina
| | - Maja Račić
- Thomas J. Stephens & Associates, Phoenix, USA, 3635 W Altadena Ave, Phoenix, AZ85029, USA
| | - Nedeljka Ivković
- University of East Sarajevo, Faculty of Medicine, Department of Oral Rehabilitation, Studentska 5, 73300Foca, Bosnia and Herzegovina
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Wiśniowska-Szurlej A, Ćwirlej-Sozańska A, Wołoszyn N, Sozański B, Wilmowska-Pietruszyńska A, Washburn R. Cultural adaptation and validation of the Polish version of the physical activity scale for older people living in a community: a cross-sectional study. Eur Rev Aging Phys Act 2020; 17:19. [PMID: 33292174 PMCID: PMC7679979 DOI: 10.1186/s11556-020-00252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Polish clinicians and researchers face challenges in selecting physical activity tools appropriate and validated for older people. The aim of this study is to provide cultural adaptation and validation of the Polish version of the Physical Activity Scale for Elderly (PASE-P). METHODS This cross-sectional study was carried out among 115 older adults living in south-eastern Poland. The original version of the scale has been translated into the Polish language following standardized translation procedures. Validation was evaluated by Pearson's rank correlation coefficients between PASE-P, the normal Timed Up and Go test and that with a cognitive task (TUG and TUG cog, respectively), grip strength, basic and instrumental activities of daily living (ADL and IADL, respectively), Five Times Sit to Stand (5x STS), 10-m Walk Test (10MWT), the Berg Balance Scale (BBS) and the International Physical Activity Questionnaire (IPAQ). RESULTS The mean PASE-P was 91.54 (SD 71.15). Sufficient reliability of the test-retest of the PASE-P questionnaire components was found between the trials. The ICC test was strong and ranged from 0.988 to 0.778 for both major domains and the total scale score. A significant correlation was found between the total PASE-P score and the shorter TUG, TUG cog (r = - 0.514, p < 0.001; r = - 0.481, p < 0.001) and 10MWT (r = 0.472, p < 0.001). The total PASE-P score was also positively correlated with ADL and IADL (r = 0.337, p < 0.001; r = 0.415 p < 0.001), BBS (r = 0.537, p < 0.001) and 5xSTS (r = 0.558, p < 0.001). CONCLUSIONS The results obtained in the study confirm that the Polish version of the PASE scale is a valid and reliable tool for assessing the level of physical activity in older adults living in a community.
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Affiliation(s)
| | - Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, Medical College of Rzeszow University, Warzywna 1a, Rzeszow, 35-310, Poland
| | - Natalia Wołoszyn
- Institute of Health Sciences, Medical College of Rzeszow University, Warzywna 1a, Rzeszow, 35-310, Poland
| | - Bernard Sozański
- Institute of Medicine, Medical College of Rzeszow University, Warzywna 1a, Rzeszow, 35-310, Poland
| | | | - Richard Washburn
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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Sinn CLJ, Heckman G, Poss JW, Onder G, Vetrano DL, Hirdes J. A comparison of 3 frailty measures and adverse outcomes in the intake home care population: a retrospective cohort study. CMAJ Open 2020; 8:E796-E809. [PMID: 33262118 PMCID: PMC7721251 DOI: 10.9778/cmajo.20200083] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In Ontario, Canada, nearly all home care patients are assessed with a brief clinical assessment (interRAI Contact Assessment [interRAI CA]) on admission. Our objective was to compare 3 frailty measures that can be operationalized using the interRAI CA. METHODS We conducted a retrospective cohort study using linked patient-level assessment and administrative data for all Ontario adult (≥ 18 yr) home care patients assessed with the interRAI CA in 2014. We employed multivariable logistic models to compare the Changes in Health, End-stage disease and Signs and Symptoms Scale for the Contact Assessment (CHESS-CA), Assessment Urgency Algorithm (AUA) and the Frailty Index for the Contact Assessment (FI-CA) that was created for this study. Our outcomes of interest were death, hospital admission and emergency department visits within 90 days, and assessor-rated need for comprehensive geriatric assessment (CGA). RESULTS In 2014, there were 228 679 unique adult home care patients in Ontario assessed with the interRAI CA. Controlling for age, sex and health region, being in a higher frailty level defined by any measure increased the likelihood of experiencing adverse outcomes. Among all assessments, CHESS-CA was best suited for predicting death and hospital admission, and either AUA or FI-CA for predicting perceived need for CGA. Previous emergency department visits were more predictive of future visits than frailty. Model fit was independent of whether the assessment was completed over the phone or in person. INTERPRETATION Frailty measures from the interRAI CA identified patients at higher risk for death, hospital admission and perceived need for CGA. In jurisdictions where the CHESS-CA and AUA are already built into the electronic home care platform, such as Ontario, patients identified as high risk should be prioritized for proactive referral and care planning, and may benefit from greater involvement of primary care and other health professionals in the circle of care.
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Affiliation(s)
- Chi-Ling Joanna Sinn
- School of Public Health and Health Systems (Sinn, Heckman, Poss, Hirdes), University of Waterloo; Research Institute for Aging (Heckman), Waterloo, Ont.; Department of Cardiovascular, Metabolic and Aging Diseases (Onder), Istituto Superiore di Sanità, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Vetrano), Università Cattolica del Sacro Cuore, Rome, Italy; Aging Research Center (Vetrano), Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - George Heckman
- School of Public Health and Health Systems (Sinn, Heckman, Poss, Hirdes), University of Waterloo; Research Institute for Aging (Heckman), Waterloo, Ont.; Department of Cardiovascular, Metabolic and Aging Diseases (Onder), Istituto Superiore di Sanità, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Vetrano), Università Cattolica del Sacro Cuore, Rome, Italy; Aging Research Center (Vetrano), Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jeffrey W Poss
- School of Public Health and Health Systems (Sinn, Heckman, Poss, Hirdes), University of Waterloo; Research Institute for Aging (Heckman), Waterloo, Ont.; Department of Cardiovascular, Metabolic and Aging Diseases (Onder), Istituto Superiore di Sanità, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Vetrano), Università Cattolica del Sacro Cuore, Rome, Italy; Aging Research Center (Vetrano), Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Graziano Onder
- School of Public Health and Health Systems (Sinn, Heckman, Poss, Hirdes), University of Waterloo; Research Institute for Aging (Heckman), Waterloo, Ont.; Department of Cardiovascular, Metabolic and Aging Diseases (Onder), Istituto Superiore di Sanità, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Vetrano), Università Cattolica del Sacro Cuore, Rome, Italy; Aging Research Center (Vetrano), Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Davide Liborio Vetrano
- School of Public Health and Health Systems (Sinn, Heckman, Poss, Hirdes), University of Waterloo; Research Institute for Aging (Heckman), Waterloo, Ont.; Department of Cardiovascular, Metabolic and Aging Diseases (Onder), Istituto Superiore di Sanità, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Vetrano), Università Cattolica del Sacro Cuore, Rome, Italy; Aging Research Center (Vetrano), Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - John Hirdes
- School of Public Health and Health Systems (Sinn, Heckman, Poss, Hirdes), University of Waterloo; Research Institute for Aging (Heckman), Waterloo, Ont.; Department of Cardiovascular, Metabolic and Aging Diseases (Onder), Istituto Superiore di Sanità, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Vetrano), Università Cattolica del Sacro Cuore, Rome, Italy; Aging Research Center (Vetrano), Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Kyriakou E, Tzefronis D, Dagianta G, K Triantafyllopoulos I. Implementing frailty assessment into a healthcare system: a clinical opinion paper. J Frailty Sarcopenia Falls 2020; 4:111-115. [PMID: 32300725 PMCID: PMC7155305 DOI: 10.22540/jfsf-04-111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2019] [Indexed: 11/21/2022] Open
Abstract
Frailty is a multifactorial medical syndrome characterized by reduced endurance and decreased physiological ability. The aim of this narrative literature review is to present the frailty diagnostic instruments that are already used in most Western countries and provide recommendations for use in clinical practice. Among the numerous available frailty instruments identified in current literature, the Frailty Index and the Physical Frailty Phenotype are most commonly used. There are large differences in each instrument design, ease of use by healthcare teams and also significant heterogeneity in the design of the studies based on these instruments. Therefore, future studies should be designed to properly address the discrepancy in the comparison of the existent instruments and consider their validity and feasibility of implementation in different healthcare settings with different healthcare providers.
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Affiliation(s)
- Eftychia Kyriakou
- 4 Department of Orthopedic Surgery, General Hospital of Athens KAT, Greece
| | | | - Georgia Dagianta
- 4 Department of Orthopedic Surgery, General Hospital of Athens KAT, Greece
| | - Ioannis K Triantafyllopoulos
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, National and Kapodistrian University of Athens, General Hospital of Athens KAT, Greece
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