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Hu M, Si J, Wang J. Gender Disparities in Frailty and Its Decomposition Among Chinese Older Adults. J Adv Nurs 2024. [PMID: 39206926 DOI: 10.1111/jan.16422] [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: 03/18/2024] [Revised: 07/04/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024]
Abstract
AIMS To identify the evidence of gender disparities in frailty and explore the factors contributing to male-female differences. DESIGN A longitudinal study. METHODS A total of 24,429 older adults (60+) were enrolled. Frailty was assessed by frailty index and frailty risk based on Rockwood's cumulative deficit frailty index. OLS and logistic regression models were conducted, with Oaxaca-Blinder and Fairlie decomposition methods to further analyse the factors contributing to gender disparities in frailty. DATA SOURCES The paper used four waves of the China Health and Retirement Longitudinal Study from 2011 to 2018, a nationwide survey organised by the National Development Institute of Peking University. RESULTS Women had higher frailty status than men, with more pronounced increases. Among the factors, education has the most significant association with frailty gender disparities. The contribution of individual characteristics, particularly education, to gender disparities in frailty appeared to diminish over time, while the contribution of family and regional factors remained relatively stable, and the contribution of institutions was deemed inadequate. CONCLUSIONS The frailty in Chinese older adults is generally on the rise with continuously expanded gender disparities. It is crucial to consider the contributing factors to frailty in older adults for effective prevention and intervention strategies. Additional gender-specific geriatric care policies are needed in order to address gender inequality in health. IMPACT The findings of this study highlight the prevalence of increasing gender disparities in frailty and identify that the level of education, per capita annual household income as well as marital status are the most significant factors contributing to the gender gap. Those findings provide policy implications for healthcare nursing service from a gender-specific perspective in order to achieve health equity. REPORTING METHOD This study has adhered to the STROBE guideline. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY: This study provided implications on gender-specific geriatric care nursing services. The study highlighted the importance of focusing on frailty and its gender disparities in geriatric clinical nursing.
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Affiliation(s)
- Meili Hu
- Department of Gynecology, Baoding Maternal and Child Health Care Hospital, Baoding, China
| | - Jiacheng Si
- School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Jiayi Wang
- School of Public Administration, Renmin University of China, Beijing, China
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Ji D, Guo H, Qiu S, Dong L, Shen Y, Shen Z, Xu J. Screening for frailty and its association with activities of daily living, cognitive impairment, and falls among community-dwelling older adults in China. BMC Geriatr 2024; 24:576. [PMID: 38961352 PMCID: PMC11223382 DOI: 10.1186/s12877-024-05173-0] [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: 12/26/2023] [Accepted: 06/24/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVES Frailty is a prevalent geriatric condition that significantly impacts the health of older adults. This study aimed to examine the prevalence of frailty among older Chinese adults aged ≥ 65 years and to assess its association with adverse geriatric outcomes. METHOD This study included 20,724 older adults aged ≥ 65 years in Jiangsu Province, China, utilizing a random, stratified, multistage cluster sampling approach. Frailty was assessed using the 5-item FRAIL scale. Geriatric outcomes, such as independence in activities of daily living (ADL), cognitive impairment, and frequent fall events (occurring four or more times in the preceding year), were evaluated. Logistic regression models were employed to evaluate the association between frailty and geriatric outcomes, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The mean age of the participants was 73.4 ± 6.4 years. The standardized prevalence of prefrailty and frailty was 35.2% and 10.3%, respectively. Individuals identified as prefrail or frail tended to live in rural areas, have lower educational levels, be widowed, have lower incomes, and engage in less physical activity. Prefrailty and frailty were associated with an increased risk of limitations in BADL (OR: 9.62, 95% CI: 7.43-12.46; and OR: 29.25, 95% CI: 22.42-38.17, respectively) and IADL (OR: 2.54, 95% CI 2.35-2.74; and OR: 5.19, 95% CI 4.66-5.78, respectively), positive cognitive impairment screening (OR: 1.23, 95% CI: 1.16-1.31; and OR: 1.72, 95% CI: 1.56-1.91, respectively), and frequent falls (occurring four or more times in the preceding year) (OR: 3.38, 95% CI: 2.50-4.56; and OR: 8.37, 95% CI: 6.01-11.65). The association between frailty and both limitations in BADL and falls was notably more pronounced among the younger age groups (p for interaction < 0.001). CONCLUSIONS According to the 5-item FRAIL scale, frailty was associated with limitations in BADLs and IADLs, positive cognitive impairment screening, and recent falls among older adults living in the community. Screening for frailty in younger age groups has the potential to prevent declines in physical function and falls.
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Affiliation(s)
- Dakang Ji
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Haijian Guo
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
| | - Shanhu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Lirong Dong
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Ya Shen
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Zhengkai Shen
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Jinshui Xu
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
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Zhang Y, Xia H, Jiang X, Wang Q, Hou L. Prevalence and Outcomes of Cognitive Frailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Res Gerontol Nurs 2024; 17:202-212. [PMID: 39047228 DOI: 10.3928/19404921-20240621-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
PURPOSE To systematically review the available evidence regarding the prevalence and outcomes of cognitive frailty-a clinical syndrome characterized by the combination of physical frailty and cognitive impairment, without dementia-in community-dwelling older adults. METHOD The following databases were searched: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled Trials, ProQuest, CNKI, Wanfang, VIP, and CBMdisc (inception to October 2, 2023). RESULTS Twenty-four studies were included (N = 62,169) reporting a median prevalence of cognitive frailty among community-dwelling older adults of 12.2%. Frailty with cognitive impairment was independently associated with increased all-cause mortality (adjusted 8-year hazard ratio [HR] = 2.6, 95% confidence interval [CI] [2.05, 3.30]). There was evidence of increased risk of 3-year mortality for frailty (adjusted HR = 1.92, 95% CI [1.26, 2.93]) and prefrailty (adjusted HR = 1.79, 95% CI [1.33, 2.41]) with cognitive impairment. There was also evidence of increased risk of dementia for frailty (adjusted 24-month HR = 6.19, 95% CI [2.74, 13.99]; adjusted 4-year HR = 4.98, 95% CI [2.17, 11.41]) and prefrailty (adjusted 4-year HR = 5.21, 95% CI [2.95, 9.20]; adjusted 5-year HR = 14.5, 95% CI [1.68, 125.1]) with cognitive impairment. Activities of daily living (ADL) dependence was more frequent in individuals with cognitive impairment and frailty (adjusted 4-year odds ratio = 5.6, 95% CI [2.13, 14.72]). CONCLUSION Of community-dwelling older adults, 12.2% have cognitive frailty as well as increased risk of all-cause mortality, dementia, and ADL dependence. Further studies on prevention and treatment of cognitive frailty is warranted. Health care providers should formulate specific interventions to decrease the impact of cognitive frailty. [Research in Gerontological Nursing, 17(4), 202-212.].
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Trombetta CM, Accardi G, Aiello A, Calabrò A, Caruso C, Ligotti ME, Marchi S, Montomoli E, Neto MM, Temperton N, Candore G. Centenarians, semi and supercentenarians, COVID-19 and Spanish flu: a serological assessment to gain insight into the resilience of older centenarians to COVID-19. Immun Ageing 2024; 21:44. [PMID: 38937774 PMCID: PMC11210044 DOI: 10.1186/s12979-024-00450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/21/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Although it is well known that the older people have been the most susceptible to COVID-19, there are conflicting data on the susceptibility of centenarians. Two epidemiological study have shown that older centenarians (> 101 years old at the time of the 2020 pandemic peak) are more resilient than the remaining centenarians, suggesting that this resilience might be linked to the 1918 Spanish Flu pandemic. To gain insight into this matter, specifically whether the resilience of older centenarians to SARS-CoV-2 infection is linked to the Spanish Flu they had been affected by, we conducted a retrospective serological study. This study examined serum samples from 33 centenarians, encompassing semi- (aged > 104 < 110 years, N = 7) and supercentenarians (aged > 109 years, N = 4), born between 1905 and 1922, against both SARS-CoV-2 and 1918 H1N1 pseudotype virus. RESULTS Anamnestic and laboratory data suggest that SARS-CoV-2 infection occurred in 8 centenarians. The infection appeared to have been asymptomatic or mild, and hospitalization was not required, despite 3 out of 8 being between 109 and 110 years old. The levels of anti-spike antibodies in centenarians infected and/or vaccinated were higher, although not significantly, than those produced by a random sample of seventy-year-old individuals used as controls. All centenarians had antibody levels against the 1918 H1N1 virus significantly higher (almost 50 times) than those observed in the quoted group of seventy-year-old subjects, confirming the key role in maintaining immunological memory from a priming that occurred over 100 years ago. Centenarians whose blood was collected prior to the pandemic outbreak demonstrated neutralising antibodies against the 1918 H1N1 virus, but all these subjects tested negative for SARS-CoV-2. CONCLUSION This retrospective study shows that older centenarians are quite resilient to COVID-19, as they are capable of producing good levels of neutralising antibodies and experiencing mild or asymptomatic disease. This could be attributed to the 1918 Spanish flu pandemic through mechanisms other than the presence of cross-reactive antibodies between the 1918 H1N1 virus and SARS-CoV-2. Another possibility is that the association is purely temporal, solely correlated with the advanced age of resilient centenarians compared to those born after 1918, since older centenarians are known to have better control of immune-inflammatory responses.
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Affiliation(s)
- Claudia Maria Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi Research srl, Siena, Italy
| | - Giulia Accardi
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Anna Aiello
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Anna Calabrò
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Calogero Caruso
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy.
| | - Mattia Emanuela Ligotti
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
- Department of Research, ISMETT-IRCCS Mediterranean Institute forTransplants and Highly Specialized Therapies, Palermo, Italy
| | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi Research srl, Siena, Italy
- VisMederi srl, Siena, Italy
| | - Martin Mayora Neto
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent, Kent, UK
| | - Nigel Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent, Kent, UK
| | - Giuseppina Candore
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
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Sliwinski S, Faqar-Uz-Zaman SF, Heil J, Mohr L, Detemble C, Dreilich J, Zmuc D, Bechstein WO, Becker S, Chun F, Derwich W, Schreiner W, Solbach C, Fleckenstein J, Filmann N, Schnitzbauer AA. Predictive value of a novel digital risk calculator to determine early patient outcomes after major surgery: a proof-of-concept pilot study. Patient Saf Surg 2024; 18:13. [PMID: 38610002 PMCID: PMC11010393 DOI: 10.1186/s13037-024-00395-y] [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: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND A structured risk assessment of patients with validated and evidence-based tools can help to identify modifiable factors before major surgeries. The Protego Maxima trial investigated the value of a new digitized risk assessment tool that combines tools which can be easily used and implemented in the clinical workflow by doctors and qualified medical staff. The hypothesis was that the structured assessment and risk-grouping is predictive of short-term surgical quality reflected by complications and overall survival. METHODS The Protego Maxima Trial was a prospective cohort analysis of patients undergoing major surgery (visceral, thoracic, urology, vascular and gynecologic surgeries) as key inclusion criterion and the absence of an acute or acute on chronically decompensated pulmo-cardiovascular decompensation. Patients were risk-scored with the software (The Prehab App) that includes a battery of evidence-based risk assessment tools that allow a structured risk assessment. The data were grouped to predefined high and low risk groups and aggregate and individual scores. The primary outcome was to validate the predictive value of the RAI score and the TUG for overall survival in the high and low risk groups. Secondary outcomes were surgical outcomes at 90-days after surgery (overall survival, Clavien-Dindo (CD) 1-5 (all complications), and CD 3-5 (major complications)). The study was carried out in accordance with the DIN ISO 14,155, and the medical device regulation (MDR) at Frankfurt University Hospital between March 2022 and January 2023. RESULTS In total 267 patients were included in the intention to treat analysis. The mean age was 62.1 ± 12.4 years. Patients with a RAI score > 25 and/or a timed up and go (TUG) > 8 s had a higher risk for mortality at 90 days after surgery. The low-risk group predicted beneficial outcome and the high-risk group predicted adverse outcome in the ROC analysis (Area Under the Curve Receiver Operator Characteristics: AUROC > 0.800; p = 0.01). Risk groups (high vs. low) showed significant differences for 90-day survival (99.4% vs. 95.5%; p = 0.04) and major complications (16.4% vs. 32.4%; p < 0.001). CONCLUSION The proof-of-concept trial showed that a risk assessment with 'The Prehab App' may be viable to estimate the preoperative risk for mortality and major complications before major surgeries. The overall performance in this initial set of data indicated a certain reliability of the scoring and risk grouping, especially of the RAI score and the TUG. A larger data set will be required to proof the generalizability of the risk scoring to every subgroup and may be fostered by artificial intelligence approaches. TRIAL REGISTRATION Ethics number: 2021-483-MDR/MPDG-zuständig monocentric; The Federal Institute for Pharmaceuticals and Medical Devices/BfArM, reference number: 94.1.04-5660-13655; Eudamed: CIV-21-07-0307311; German Clinical Trial Registry: DRKS 00026985.
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Affiliation(s)
- Svenja Sliwinski
- Department for General, Visceral, Transplant and Thoracic Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Sara Fatima Faqar-Uz-Zaman
- Department for General, Visceral, Transplant and Thoracic Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Jan Heil
- Department for General, Visceral, Transplant and Thoracic Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Lisa Mohr
- Institute of Sports Medicine, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
| | - Charlotte Detemble
- Department for General, Visceral, Transplant and Thoracic Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Julia Dreilich
- Institute of Sports Medicine, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
| | - Dora Zmuc
- Department for General, Visceral, Transplant and Thoracic Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Wolf O Bechstein
- Department for General, Visceral, Transplant and Thoracic Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Sven Becker
- Department for Gynecology, Frankfurt University Hospital, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
| | - Felix Chun
- Department for Urology, Frankfurt University Hospital, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
| | - Wojciech Derwich
- Department for Vascular Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
| | - Waldemar Schreiner
- Department for General, Visceral, Transplant and Thoracic Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Christine Solbach
- Department for Gynecology, Frankfurt University Hospital, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
| | - Johannes Fleckenstein
- Institute of Sports Medicine, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
- Pain Center, Hospital Landsberg am Lech, Landsberg am Lech, Germany
| | - Natalie Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University Frankfurt, Frankfurt/Main, Germany
| | - Andreas A Schnitzbauer
- Department for General, Visceral, Transplant and Thoracic Surgery, Frankfurt University Hospital, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
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Wang H, Huang Y, Zhou M, Jiang H, Zong Y, Zhu X, Sun X. Socioeconomic support, quality of life, and prognosis of frailty among the older adults. HEALTH CARE SCIENCE 2024; 3:101-113. [PMID: 38939613 PMCID: PMC11080858 DOI: 10.1002/hcs2.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/11/2024] [Accepted: 02/25/2024] [Indexed: 06/29/2024]
Abstract
Background Although socioeconomic support is recommended for frailty management, its association with the prognosis of frailty is unclear. Methods Using data from participants aged ≥65 years in the Chinese Longitudinal Healthy Longevity Survey (2008-2018), the associations between socioeconomic support (source of income, medical insurance, community support, living status), onset of prefrailty/frailty, and worsening of prefrailty, were analyzed using multinominal logistic regression models. The associations between self-reported low quality of life (QoL) and reversion of prefrailty/frailty were analyzed using multivariate logistic regression models. Associations with mortality risk were analyzed using Cox proportional hazard regression models. Results A total of 13,859 participants (mean age: 85.8 ± 11.1 years) containing 2056 centenarians were included. Financial dependence was a risk factor for low QoL among prefrail/frail individuals, but not among robust individuals. Having commercial or other insurance, and receiving social support from the community were protective factors for low QoL among prefrail/frail individuals and for the worsening of prefrailty. Continuing to work was a risk factor for low QoL, but a protective factor for worsening of prefrailty. A negative association between continuing to work and mortality existed in prefrail individuals aged <85 years and ≥85 years. Living alone was a risk factor for low QoL, but was not significantly associated with frailty prognosis. Conclusions Prefrail and frail individuals were vulnerable to changes in socioeconomic support and more sensitive to it compared with robust individuals. Preferential policies regarding financial support, social support, and medical insurance should be developed for individuals with frailty.
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Affiliation(s)
- Huai‐Yu Wang
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of DiseasesBeijing University of Chinese MedicineBeijingChina
- College of Chinese MedicineBeijing University of Chinese MedicineBeijingChina
| | - Yuming Huang
- Nephrology DepartmentFirst Affiliated Hospital of Youjiang Medical College for NationalitiesBaiseChina
| | - Meng‐Ru Zhou
- College of Chinese MedicineBeijing University of Chinese MedicineBeijingChina
| | - Hao‐Yue Jiang
- Institute of Basic Theory for Chinese MedicineChina Academy of Chinese Medical SciencesBeijingChina
| | - Yu‐Han Zong
- The Second School of Clinical MedicineGuangzhou University of Chinese MedicineGuangzhouChina
| | - Xi‐Huan Zhu
- Qi‐huang Chinese Medicine SchoolBeijing University of Chinese MedicineBeijingChina
| | - Xiaojing Sun
- Renal Division, Department of Medicine, Peking University First HospitalPeking University Institute of NephrologyBeijingChina
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Wang HY, Wang J, Wang Q, Yang C, Huang Y, Chen M. Blood pressure in the longevous population with different status of hypertension and frailty. Hypertens Res 2024; 47:959-969. [PMID: 37985739 DOI: 10.1038/s41440-023-01499-1] [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: 01/11/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023]
Abstract
Blood pressure(BP) of the longevous population with hypertension and/or frailty was under-investigated. To investigate the association between age, BP, variation of BP, and survival among the old adults with different status of hypertension and frailty, the present study included adults ≥65 years in the Chinese Longitudinal Healthy Longevity Survey (2008-2018), defined frailty using the Fried criteria, and identified hypertension by self-report or SBP/DBP ≥ 140/90 mm Hg. The association between age and BP were investigated using linear regression models. Variation of BP was defined if annual change of BP lower than quartile 1(sharp decrease) or higher than quartile 3(sharp increase). The association between age and BP variation were investigated using multinominal logistic regression models. The association between BP and survival was analyzed using Cox regression models. Among 13,447 adults (centenarian: 1965[14.6%]), age was positively associated with SBP in robust hypertensive elderly but negatively associated with it in frail hypertensive elderly. Annual change of BP was more likely to be increment among the normotensive elderly, but be decrement among the hypertensive elderly, especially among those with frailty. SBP < 120 mmHg was the risk factor of mortality among the frail oldest-old (≥85 years) while SBP ≥ 150 mmHg was that among the robust young-old (65-84 years). DBP ≥ 90 mmHg was the risk factor of mortality both in the robust young-old and the frail oldest old. In conclusion, age and frailty might be the criteria to predict the change of BP to guide the BP management of the longevous population.
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Affiliation(s)
- Huai-Yu Wang
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, China.
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Qin Wang
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Yuming Huang
- First Nephrology Department, Affiliated Hospital of Youjiang Medical College for Nationalities, Baise, Guangxi, China
| | - Min Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
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Huang J, Zeng X, Ning H, Peng R, Guo Y, Hu M, Feng H. Development and validation of prediction model for older adults with cognitive frailty. Aging Clin Exp Res 2024; 36:8. [PMID: 38281238 PMCID: PMC10822804 DOI: 10.1007/s40520-023-02647-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/01/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE This study sought to develop and validate a 6-year risk prediction model in older adults with cognitive frailty (CF). METHODS In the secondary analysis of Chinese Longitudinal Healthy Longevity Survey (CLHLS), participants from the 2011-2018 cohort were included to develop the prediction model. The CF was assessed by the Chinese version of Mini-Mental State Exam (CMMSE) and the modified Fried criteria. The stepwise regression was used to select predictors, and the logistic regression analysis was conducted to construct the model. The model was externally validated using the temporal validation method via the 2005-2011 cohort. The discrimination was measured by the area under the curve (AUC), and the calibration was measured by the calibration plot. A nomogram was conducted to vividly present the prediction model. RESULTS The development dataset included 2420 participants aged 60 years or above, and 243 participants suffered from CF during a median follow-up period of 6.91 years (interquartile range 5.47-7.10 years). Six predictors, namely, age, sex, residence, body mass index (BMI), exercise, and physical disability, were finally used to develop the model. The model performed well with the AUC of 0.830 and 0.840 in the development and external validation datasets, respectively. CONCLUSION The study could provide a practical tool to identify older adults with a high risk of CF early. Furthermore, targeting modifiable factors could prevent about half of the new-onset CF during a 6-year follow-up.
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Affiliation(s)
- Jundan Huang
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Xianmei Zeng
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Ruotong Peng
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Yongzhen Guo
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China.
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China.
- Oceanwide Health Management Institute, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Li T, Zong G, Peng P, Wang S, Cheng B. Accelerometer-measured physical activity and sample-based frailty in older women: does pattern really matter? Front Public Health 2024; 11:1304279. [PMID: 38332942 PMCID: PMC10850322 DOI: 10.3389/fpubh.2023.1304279] [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: 09/29/2023] [Accepted: 12/29/2023] [Indexed: 02/10/2024] Open
Abstract
Background The relationship between the patterns of physical activity (PA) and frailty, including its various subdomains, remains poorly understood. Therefore, this study aims to investigate the correlations between the patterns of physical activity and frailty and its various subdomains in community-dwelling older women. Methods A cross-sectional study investigated the association between physical activity and frailty in 1,099 women aged between 60 to 70 years. Triaxial accelerometers were used to measure bouted PA (a minimum duration of 10 min) and sporadic PA (a duration of <10 min). Fried's frailty phenotype was utilized to evaluate the status of frailty. Data were analyzed using logistic regression and the receiver operating characteristic (ROC) curve. Results Bouted moderate-to-vigorous PA (MVPA) and sporadic MVPA were associated with decreased odds of being prefrail and frail, and the optimal cutoff values were 6 and 19.7 for the prefrail stage and 6.6 and 19.4 min/day for the frail stage, respectively. Bouted light PA (LPA) was associated with decreased odds of being prefrail, and the optimal cutoff value was 170.2 min/day. Additionally, bouted and sporadic MVPA were associated with decreased odds of being slow and their optimal cutoff values were 5 and 19.1 min/day, respectively. Sporadic MVPA was associated with decreased odds of exhaustion, and the cutoff was 19.7 min/day. Bouted MVPA and LPA were associated with decreased odds of having low PA, and the cutoff values were 4.4 and 163.2 min/day, respectively. Conclusion Any MVPA, regardless of bout duration, could be used as a suitable PA program to improve and prevent frailty in older women, such as bouted MVPA (4-5 times/week) or sporadic MVPA (20 min/day). The improvement effect of bouted and sporadic MVPA on the frailty of older people may not be affected by the subdomain. Additionally, bouted LPA was suitable for the management of prefrailty.
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Affiliation(s)
- Ting Li
- School of Physical Education, Shandong University, Jinan, China
| | | | - Pan Peng
- Ezhou High School, Ezhou, Hubei, China
| | - Shiqiang Wang
- College of Physical Education, Hunan University of Technology, Zhuzhou, China
- Hunan Key Laboratory of Physical Health and Sports Fitness, Zhuzhou, China
- Hunan Research Centre in Physical Fitness, Health, and Performance Excellence, Hunan University of Technology, Hunan, China
| | - Bin Cheng
- School of Physical Education, Shandong University, Jinan, China
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10
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Skubiszewska A, Broczek K, Maruniak-Chudek I, Oledzka G, Jonas MI, Puzianowska-Kuznicka M, Mossakowska M. Frailty and Survivability of Polish Caucasian Nonagenarians and Centenarians. Geriatrics (Basel) 2024; 9:14. [PMID: 38247989 PMCID: PMC10801576 DOI: 10.3390/geriatrics9010014] [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: 11/30/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Frailty is a major geriatric problem leading to an increased risk of disability and death. Prevention, identification, and treatment of frailty are important challenges in gerontology and public health. The study aimed to estimate the prevalence of the frailty phenotype (FP) among the oldest-old Polish Caucasians and investigate the relationship between the FP and mortality. Baseline data were collected from 289 long-lived individuals, including 87 centenarians and 202 subjects aged 94-99. Mortality was obtained from population registers over the following 5 years. Sixty percent of subjects were classified as frail, 33% as prefrail, and 7% as robust. Frailty was more common in women than men and among centenarians than nonagenarians. During the 5-year observation period, 92.6% of the frail women and all frail men died, while mortality rates were lower among prefrail, 78.8% and 66.7%, and robust individuals, 60% and 54.5%, respectively. In the survival analysis, frailty was the strongest negative risk factor: HR = 0.328 (95% CI: 0.200-0.539). The inability to perform handgrip strength measurement was an additional predictor of short survival. In conclusion, the FP is prevalent in nonagenarians and centenarians and correlates with lower survivability. Future studies should address differences between unavoidable age-associated frailty and reversible disability in long-lived individuals.
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Affiliation(s)
- Agnieszka Skubiszewska
- Department of Medical Biology, Medical University of Warsaw, 00-575 Warsaw, Poland
- Study on Ageing and Longevity, International Institute of Molecular and Cell Biology, 02-109 Warsaw, Poland
| | - Katarzyna Broczek
- Mazovia Branch, Polish Society of Gerontology, 01-826 Warsaw, Poland
| | | | - Gabriela Oledzka
- Department of Medical Biology, Medical University of Warsaw, 00-575 Warsaw, Poland
| | - Marta Izabela Jonas
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Monika Puzianowska-Kuznicka
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
- Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, 01-826 Warsaw, Poland
| | - Malgorzata Mossakowska
- Study on Ageing and Longevity, International Institute of Molecular and Cell Biology, 02-109 Warsaw, Poland
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11
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Yuan Y, Peng C, Burr JA, Lapane KL. Frailty, cognitive impairment, and depressive symptoms in Chinese older adults: an eight-year multi-trajectory analysis. BMC Geriatr 2023; 23:843. [PMID: 38087208 PMCID: PMC10717397 DOI: 10.1186/s12877-023-04554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Frailty, cognitive impairment, and depressive symptoms are closely interrelated conditions in the aging population. However, limited research has longitudinally analyzed the concurrent trajectories of these three prominent conditions in older adults in China. This study aimed to explore the eight-year trajectories of frailty, cognitive impairment, and depressive symptoms, and to identify individual-level and structural-level factors associated with the trajectories. METHODS Four waves of data from the China Health and Retirement Longitudinal Study (2011-2018) were used to identify 6,106 eligible older adults. The main measures included frailty by the frailty index constructed using 30 indicators, cognitive impairment by the summary score of immediate and delayed word recall, figure drawing, serial subtraction, and orientation, and depressive symptoms by the Center for Epidemiologic Studies Depression Scale. Multi-trajectory models identified the trajectories of frailty, cognitive impairment, and depressive symptoms over time. Multinomial logistic regression was employed to estimate the associations between individual-level capital factors and one structural factor (hukou and geographic residency) with the identified trajectories, adjusting for demographic characteristics. RESULTS Four trajectories emerged: (1) worsening frailty, worsening cognitive impairment, depression (14.0%); (2) declining pre-frailty, declining cognition, borderline depression (20.0%); (3) pre-frailty, worsening cognitive impairment, no depression (29.3%); and (4) physically robust, declining cognition, no depression (36.7%). Using the "physically robust, declining cognition, no depression" as the reference, not working, no social activity participant, worse childhood family financial situation, and poorer adult health were most strongly associated with the "worsening frailty, worsening cognitive impairment, depression" trajectory; worse health during childhood had the highest association with the "declining pre-frailty, declining cognition, borderline depression" trajectory; less education, lower household consumption, and rural hukou had the greatest association with the increased likelihood of the "pre-frailty, worsening cognitive impairment, no depression" trajectory. CONCLUSIONS Findings could inform the understanding of the interrelationship of frailty, cognitive impairment, and depressive symptoms in older adults in China and may help practitioners detect adults at risk for adverse trajectories to implement strategies for proper care.
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Affiliation(s)
- Yiyang Yuan
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, 01605, Worcester, MA, USA.
| | - Changmin Peng
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Jeffrey A Burr
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Kate L Lapane
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, 01605, Worcester, MA, USA
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12
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Zhong WF, Song WQ, Wang XM, Li ZH, Shen D, Liu D, Zhang PD, Shen QQ, Liang F, Nan Y, Xiang JX, Chen ZT, Li C, Li ST, Lv XG, Lin XR, Lv YB, Gao X, Kraus VB, Shi XM, Mao C. Dietary Diversity Changes and Cognitive Frailty in Chinese Older Adults: A Prospective Community-Based Cohort Study. Nutrients 2023; 15:3784. [PMID: 37686817 PMCID: PMC10490160 DOI: 10.3390/nu15173784] [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: 08/03/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
Evidence for the effects of dietary diversity changes and cognitive frailty (CF) in the older adults is not clear. This study aimed to investigate the relationship between dietary diversity changes and CF in older adults Chinese. A total of 14,382 participants (mean age: 82.3 years) were enrolled. Dietary diversity scores (DDSs) were collected and calculated using a food frequency questionnaire. DDS changes between baseline and first follow-up were categorized into nine patterns. The associations between DDS changes and the incidence of CF were estimated using Cox proportional hazards models. During an 80,860 person-year follow-up, 3023 CF cases were identified. Groups with a decrease in DDS had increased CF risk compared with the high-to-high DDS group, with adjusted hazard ratios (HRs; 95% confidence intervals (Cis)) of 1.30 (1.06, 1.59), 2.04 (1.51, 2.74), and 1.81 (1.47, 2.22) for high-to-medium, high-to-low, and medium-to-low groups, respectively. Lower overall DDS groups were associated with greater CF risks, with HRs (95% CIs) of 1.49 (1.19, 1.86) for the low-to-medium group and 1.96 (1.53, 2.52) for the low-to-low group. Compared with the high-to-high group, significant associations with CF were found in other DDS change groups; HRs ranged from 1.38 to 3.12 for the plant-based DDS group and from 1.24 to 1.32 for the animal-based DDS group. Additionally, extreme and moderate declines in overall DDS increased CF risk compared with stable DDS, with HRs (95% CIs) of 1.67 (1.50, 1.86) and 1.13 (1.03, 1.24), respectively. In conclusion, among older adults, a declining or persistently low DDS and a moderately or extremely declining DDS were linked to higher incident CF. Plant-based DDS changes correlated more strongly with CF than animal-based DDS changes.
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Affiliation(s)
- Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Dan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Pei-Dong Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Qiao-Qiao Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
- School of Nursing, Southern Medical University, Guangzhou 510515, China
| | - Fen Liang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Ying Nan
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
- School of Nursing, Southern Medical University, Guangzhou 510515, China
| | - Jia-Xuan Xiang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Zi-Ting Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Chuan Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Shi-Tian Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Xiao-Gang Lv
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Xiu-Rong Lin
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China;
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai 200433, China;
| | - Virginia Byers Kraus
- Division of Rheumatology, Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27701, USA;
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China;
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (W.-F.Z.); (W.-Q.S.); (X.-M.W.); (Z.-H.L.); (D.S.); (D.L.); (P.-D.Z.); (Q.-Q.S.); (F.L.); (Y.N.); (Z.-T.C.); (C.L.); (S.-T.L.); (X.-G.L.); (X.-R.L.)
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13
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Perls T. Successful aging and its subtypes in centenarians: The Chinese experience. J Am Geriatr Soc 2023; 71:1362-1364. [PMID: 36810715 PMCID: PMC10175185 DOI: 10.1111/jgs.18282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 01/17/2023] [Indexed: 02/24/2023]
Abstract
This editorial comments on the article by Lu et al
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Affiliation(s)
- Thomas Perls
- Affiliation Geriatrics Section, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
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Zhang J, Xu X, Zhang X, Yin Y, Wang J. Self-perceived care needs and quality of life in people with cognitive impairment during routine care at home: cross-sectional results of the interventional study. BMC Geriatr 2023; 23:185. [PMID: 36991348 PMCID: PMC10061730 DOI: 10.1186/s12877-023-03846-w] [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: 07/30/2022] [Accepted: 02/24/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Cognitive impairment (CI) is one of the most common disabling symptoms in the elderly, and people with CI face a variety of unmet care needs. There is limited evidence on the relationship between unmet needs and quality of life (QoL) of people with CI. The aim of this study is to analyse the current situation of unmet needs and QoL among people with CI, and to explore the correlation between QoL and unmet needs. METHODS The analyses use baseline data of the intervention trial, which recruited 378 participants to complete the questionnaire including the Camberwell Assessment of Need for the Elderly (CANE), and the Medical Outcomes Study 36-item Short-Form (SF-36). The SF-36 was further gathered into physical component summary (PCS) and mental component summary (MCS). Multiple linear regression analysis was conducted to explore the correlations between unmet care needs and PCS and MCS of SF-36. RESULTS The mean score of each of the eight domains of SF-36 was significantly lower than the Chinese population norm. The incidence of unmet needs ranged from 0 to 65.1%. Multiple linear regression results showed that living in rural areas (Beta=-0.16, P < 0.001), having unmet physical needs (Beta=-0.35, P < 0.001), and unmet psychological needs (Beta=-0.24, P < 0.001) were associated with lower PCS scores, whereas duration of CI > 2 years (Beta=-0.21, P < 0.001), unmet environmental needs (Beta=-0.20, P < 0.001), and unmet psychological needs (Beta=-0.15, P < 0.001) were associated with lower MCS scores. CONCLUSION The main results support the important view that lower QoL scores are associated with unmet needs in people with CI, depending on the domain. Given that the more unmet needs can further worsen QoL, it is recommended that more strategies should be taken, especially for those with unmet care needs, so as to improve their QoL.
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Affiliation(s)
- Juxia Zhang
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, China
| | - Xiaoqin Xu
- Neurology Department, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, China
| | - Xiaoli Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730000, China
| | - Yuhuan Yin
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730000, China
| | - Jiancheng Wang
- Geriatrics Department, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, China.
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15
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The national burden of frailty and disproportionate distribution of its components-the predominance of slow gait speed: a 2018-19 face-to-face epidemiologic assessment representative of population of older Poles. Aging Clin Exp Res 2023; 35:571-579. [PMID: 36633779 PMCID: PMC9835732 DOI: 10.1007/s40520-022-02331-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/16/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND The prevalence of frailty and its components may be affected by age, diseases and geriatric deficits. However, the current operational definition of frailty assigns equal weight to the five components of frailty. AIMS To perform a population-based assessment of physical frailty, its prevalence, and distribution of its components across different age, disease and deficit spectrum. METHODS From 2018 to 2019, we conducted a face-to-face cross-sectional assessment of a representative sample of older Poles. We obtained data on frailty components, chronic disease burden, and prevalence of particular diseases and geriatric deficits. We calculated weighted population estimates, representative of 8.5 million older Poles, of prevalence of frailty and its components across the disease burden, associated with the particular diseases and the geriatric deficits present. RESULTS Of 10,635 screened persons ≥ 60 years, 5987 entered the face-to-face assessment. Data of 5410 have been used for the present analysis. Seventy-two percent of the population are burdened with at least one frailty component. The estimated weighted population prevalence (95% CI) of frailty was 15.9% (14.6-17.1%), and of pre-frailty 55.8% (53.3-58.2%). Slow gait speed predominated across disease burden, specific diseases, geriatric deficits and the age spectrum. Overall, the prevalence of slow gait speed was 56.3% (52.7-60.0%), followed by weakness 26.9% (25.4-28.4%), exhaustion 19.2% (17.6-20.8%), low physical activity 16.5% (14.8-18.3%), and weight loss 9.4% (8.4-10.3%). CONCLUSIONS Slow gait speed predominates among the components of frailty in older Poles. This may affect the component-tailored preventive and therapeutic actions to tackle frailty.
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Caruso C, Marcon G, Accardi G, Aiello A, Calabrò A, Ligotti ME, Tettamanti M, Franceschi C, Candore G. Role of Sex and Age in Fatal Outcomes of COVID-19: Women and Older Centenarians Are More Resilient. Int J Mol Sci 2023; 24:2638. [PMID: 36768959 PMCID: PMC9916733 DOI: 10.3390/ijms24032638] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 02/03/2023] Open
Abstract
In the present paper, we have analysed the role of age and sex in the fatal outcome of COVID-19, as there are conflicting results in the literature. As such, we have answered three controversial questions regarding this aspect of the COVID-19 pandemic: (1) Have women been more resilient than men? (2) Did centenarians die less than the remaining older people? (3) Were older centenarians more resistant to SARS-CoV-2 than younger centenarians? The literature review demonstrated that: (1) it is women who are more resilient, in agreement with data showing that women live longer than men even during severe famines and epidemics; however, there are conflicting data regarding centenarian men; (2) centenarians overall did not die less than remaining older people, likely linked to their frailty; (3) in the first pandemic wave of 2020, centenarians > 101 years old (i.e., born before 1919), but not "younger centenarians", have been more resilient to COVID-19 and this may be related to the 1918 Spanish flu epidemic, although it is unclear what the mechanisms might be involved.
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Affiliation(s)
- Calogero Caruso
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90134 Palermo, Italy
| | - Gabriella Marcon
- Dipartimento di Scienze Medico Chirurgiche e della Salute, Università di Trieste, 34149 Trieste, Italy
- Dipartinento di Area Medica, Università di Udine, 33100 Udine, Italy
| | - Giulia Accardi
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90134 Palermo, Italy
| | - Anna Aiello
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90134 Palermo, Italy
| | - Anna Calabrò
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90134 Palermo, Italy
| | - Mattia Emanuela Ligotti
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90134 Palermo, Italy
| | - Mauro Tettamanti
- Laboratorio di Epidemiologia Geriatrica, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milano, Italy
| | - Claudio Franceschi
- Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum, Università di Bologna, 40126 Bologna, Italy
| | - Giuseppina Candore
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90134 Palermo, Italy
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Caruso C, Accardi G, Aiello A, Calabrò A, Ligotti ME, Candore G. Centenarians born before 1919 are resistant to COVID-19. Aging Clin Exp Res 2023; 35:217-220. [PMID: 36319938 PMCID: PMC9628492 DOI: 10.1007/s40520-022-02287-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
Although mortality from COVID-19 progressively increases with age, there are controversial data in the literature on the probability of centenarians dying from COVID-19. Moreover, it has been claimed that men in their 90s and 100s are more resilient than women. To gain insight into this matter, we analysed, according to gender, mortality data during the first year of pandemic of Sicilian nonagenarians and centenarians. We used mortality data from the 2019 as a control. The crude excess mortality between the two years was calculated. Data on deaths of Sicilian 90 + years show that, in line with what is known about the different response to infections between the two genders, oldest females are more resilient to COVID-19 than males. Moreover, centenarians born before 1919, but not "younger centenarians", are resilient to COVID-19. This latter datum should be related to the 1918 Spanish flu epidemic, although the mechanisms involved are not clear.
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Affiliation(s)
- Calogero Caruso
- grid.10776.370000 0004 1762 5517Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Giulia Accardi
- grid.10776.370000 0004 1762 5517Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Anna Aiello
- grid.10776.370000 0004 1762 5517Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Anna Calabrò
- grid.10776.370000 0004 1762 5517Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Mattia Emanuela Ligotti
- grid.10776.370000 0004 1762 5517Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Giuseppina Candore
- grid.10776.370000 0004 1762 5517Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
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Duan Y, Qi Q, Gao T, Du J, Zhang M, Liu H. Plant-Based Diet and Risk of Frailty in Older Chinese Adults. J Nutr Health Aging 2023; 27:371-377. [PMID: 37248761 DOI: 10.1007/s12603-023-1918-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/14/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES This study examined the relationship between the consumption of plant-based diet and frailty in older Chinese adults. DESIGN Prospective cohort study. SETTING Community-based setting in 22 provinces of China. PARTICIPANTS The final sample included data from 3990 older adults from 2011-2014 from the Chinese Longitudinal Healthy Longevity Survey. MEASUREMENTS A plant-based diet index (PDI) was calculated based on a qualitative food frequency questionnaire. Frailty was defined using modified Fried criteria. A Generalized Estimating Equation was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for frailty. We further performed subgroup analyses stratified by sex and lifestyle factors. RESULTS 557 cases of frailty were observed. After adjustment for covariates, the RR for frailty of a high PDI was 0.792 (95% CI: 0.644-0.973), relative to a low PDI. During follow-up, compared with respondents with a continually low PDI, the respondents with a continually high PDI had a significantly reduced risk of frailty (RR = 0.683, 95% CI: 0.514-0.908). In further subgroup analysis, a consistently high PDI over time resulted in a significantly reduced risk of frailty for male (RR = 0.591, 95% CI: 0.391-0.893); for never smokers (RR = 0.670, 95% CI: 0.458-0.979); for people who did never consume alcohol (RR = 0.654, 95% CI: 0.454-0.941); and for people with current or former exercise habits (RR = 0.488, 95% CI: 0.313-0.762). CONCLUSION Plant-based diet was associated with low risk of frailty in men and in older adults with healthy lifestyle. These findings stress that plant-based diet should be recommended as a dietary strategy to prevent and reduce frailty in older adults; in addition, more dietary interventions along with lifestyle modification should be adopted to promote successful ageing, especially for women.
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Affiliation(s)
- Y Duan
- Huaqing Liu, School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu 233030, China, Phone: 86-552-3175226, E-mail:
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Xu KY, Wang JJ, Chen J, Zhao X, Yuan LF, Zhang Q. Calf circumference predicts frailty in older adults: the Chinese longitudinal healthy longevity survey. BMC Geriatr 2022; 22:936. [PMID: 36471251 PMCID: PMC9720947 DOI: 10.1186/s12877-022-03644-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/22/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Although frailty is a common geriatric syndrome in old adults, a simple method to assess the degree of frailty in a person has not yet been established. In this study we have tried to establish the association between calf circumference (CC) and frailty among older Chinese people. METHODS We used the data obtained from the 2014 edition of the Chinese Longitudinal Healthy Longevity Survey; 1216 participants aged ≥60 years were included for the study. Body mass index, CC and waist circumference measurement data, and laboratory test results were collected. Frailty status was measured using the frailty index (FI). Participants were then classified into non-frail (FI < 0.25) and frail (FI ≥ 0.25) groups. RESULTS There were 874 participants (71.9%) in the non-frail group and 342 (28.1%) in the frail group. The CC was significantly different between the two groups (31.54 ± 4.16 versus 28.04 ± 4.53, P < 0.001). Logistic regression analysis revealed that CC (odds ratio = 0.947, 95% confidence interval: 0.904-0.993, P = 0.023) was an independent impact factor associated with frailty. The CC value of 28.5 cm was considered the best cut-off value in women with area under the curve (AUC) was 0.732 (P < 0.001) and 29.5 cm in men with AUC was 0.592 (P = 0.004);We created a simple prediction model for frailty that included age,sex and CC:[Formula: see text]P = elogit(P) /1 + elogit(P), and AUC is 0.849 (P < 0.001). CONCLUSIONS CC is a convenient and predictable marker of frailty in older adults.
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Affiliation(s)
- Ke Ying Xu
- grid.13402.340000 0004 1759 700XDepartment of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China ,grid.13402.340000 0004 1759 700XKey Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China
| | - Jun Jie Wang
- grid.469604.90000 0004 1765 5222Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, Zhejiang, China
| | - Jing Chen
- grid.13402.340000 0004 1759 700XDepartment of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China ,grid.13402.340000 0004 1759 700XKey Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China
| | - Xinxiu Zhao
- grid.13402.340000 0004 1759 700XDepartment of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China ,grid.13402.340000 0004 1759 700XKey Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China
| | - Ling Fang Yuan
- grid.13402.340000 0004 1759 700XDepartment of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China ,grid.13402.340000 0004 1759 700XKey Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China
| | - Qin Zhang
- grid.13402.340000 0004 1759 700XDepartment of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China ,grid.13402.340000 0004 1759 700XKey Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou China
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Cao W, Cao C, Zheng X, Ji K, Liang Q, Wu Y, Hu Z, Bai Z. Factors Associated with Medication Adherence among Community-Dwelling Older People with Frailty and Pre-Frailty in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316001. [PMID: 36498074 PMCID: PMC9740801 DOI: 10.3390/ijerph192316001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Frail and pre-frail older people often need to take medications. However, factors related to medication adherence among this population remain unclear, warranting further research. This study aims to identify correlates of medication adherence among frail and pre-frail older adults. METHODS From November 2020 to December 2020; a total of 4218 community-dwelling residents aged ≥ 60 years were interviewed by a cross-sectional survey in China. Data on subjects' general information; medication adherence; and frailty status was obtained via the face-to-face structured questionnaire. Logistic regression models were fitted; separately; to examine these factors linked to medication adherence. RESULTS We found that 36.2% (n = 1527) and 18.8% (n = 792) of respondents were classified as pre-frail and frail. According to the Morisky scale scores, 66.74% (n = 2815) were found to have adequate medication adherence, and 33.26% (n = 1403) were found to have inadequate medication adherence. Among the pre-frail respondents, age (adjusted odds ratio (AOR) = 1.64; 95% confidence interval (CI): 1.18-2.29, P = 0.003), marital status (AOR = 1.52; 95% CI: 1.04-2.21, P = 0.030), smoking status (AOR = 0.61; 95% CI: 0.37-0.99, P = 0.044), and functional ability (AOR = 0.72; 95% CI: 0.58-0.91, P = 0.006) were significantly related to medication adherence. Among them, advanced age and single were risk factors, which were positively related to the medication adherence of subjects in pre-frailty, while quitting smoking and limited functional ability contributed to improving their medication adherence. In contrast, only age (AOR = 1.77; 95% CI: 1.16-2.69, P = 0.008) was significantly associated with medication adherence among frail subjects. CONCLUSION Influencing factors to medication adherence of old people in pre-frailty and frailty have been enriched, which provides a certain reference for promoting medication adherence in this population. Future adherence intervention methods should be designed based on these factors.
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Affiliation(s)
| | | | | | | | | | | | - Zhi Hu
- Correspondence: (Z.H.); (Z.B.); Tel.: +86-152-5658-4720 (Z.B.)
| | - Zhongliang Bai
- Correspondence: (Z.H.); (Z.B.); Tel.: +86-152-5658-4720 (Z.B.)
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21
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Peng Y, Zhong GC, Zhou X, Guan L, Zhou L. Frailty and risks of all-cause and cause-specific death in community-dwelling adults: a systematic review and meta-analysis. BMC Geriatr 2022; 22:725. [PMID: 36056319 PMCID: PMC9437382 DOI: 10.1186/s12877-022-03404-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 08/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The associations of frailty with all-cause and cause-specific mortality remain unclear. Therefore, we performed this meta-analysis to fill this gap. METHODS We searched the PubMed and Embase databases through June 2022. Prospective cohort studies or clinical trials examining frailty were evaluated, and the multiple adjusted risk estimates of all-cause and cause-specific mortality, such as death from cardiovascular disease (CVD), cancer, respiratory illness, dementia, infection, and coronavirus disease 2019 (COVID-19), were included. A random effects model was used to calculate the summary hazard ratio (HR). RESULTS Fifty-eight studies were included for the qualitative systematic review, of which fifty-six studies were eligible for the quantitative meta-analysis, and the studies included a total of 1,852,951 individuals and more than 145,276 deaths. Compared with healthy adults, frail adults had a significantly higher risk of mortality from all causes (HR 2.40; 95% CI 2.17-2.65), CVD (HR 2.64; 95% CI 2.20-3.17), respiratory illness (HR 4.91; 95% CI 2.97-8.12), and cancer (HR 1.97; 95% CI 1.50-2.57). Similar results were found for the association between prefrail adults and mortality risk. In addition, based on the studies that have reported the HRs of the mortality risk per 0.1 and per 0.01 increase in the frailty index, we obtained consistent results. CONCLUSIONS The present study demonstrated that frailty was not only significantly related to an increased risk of all-cause mortality but was also a strong predictor of cause-specific mortality from CVD, cancer, and respiratory illness in community-dwelling adults. More studies are warranted to clarify the relationship between frailty and cause-specific mortality from dementia, infection, and COVID-19. TRIAL REGISTRATION PROSPERO (CRD42021276021).
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Affiliation(s)
- Yang Peng
- Geriatric Diseases Institute of Chengdu, Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, 611137, China.
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
| | - Guo-Chao Zhong
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoli Zhou
- Department of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Lijuan Guan
- Geriatric Diseases Institute of Chengdu, Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, 611137, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Lihua Zhou
- Geriatric Diseases Institute of Chengdu, Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, 611137, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
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22
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Li S, Fan W, Zhu B, Ma C, Tan X, Gu Y. Effects of age, period, and cohort on the prevalence of frailty in Chinese older adults from 2002 to 2014. Front Public Health 2022; 10:935163. [PMID: 36033734 PMCID: PMC9412743 DOI: 10.3389/fpubh.2022.935163] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/18/2022] [Indexed: 01/25/2023] Open
Abstract
Background Currently, longitudinal studies on frailty are in an early stage, particularly in low- and middle-income countries. Only one study was conducted in Hong Kong to examine age-period-cohort effects on the prevalence of frailty among Chinese older adults. Objectives This study aims to shed light on the prevalence trajectory of frailty among older adults in mainland China through the APC model and to analyze the effects of age, period, and cohort on the prevalence trajectory. Methods The sample for this study was older adults aged 65-109 years old from the 2002 to 2014 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Frailty status was measured by Rockwood FI. An age-period-cohort model was used to describe the effects of age, period, and cohort on the prevalence trajectory of frailty. Results The prevalence of frailty among Chinese older adults changed significantly with age, period, and cohort. Furthermore, the effect of age was much stronger than the effect of period and cohort. The prevalence of frailty in the 101-103 and 104-106 age groups was 8.998 (95% CI 13.667-5.924) and 8.699 (95% CI 13.037-5.805) times higher than the in the 65-67 age group, respectively. The sensitivity analysis based on Fried's frailty phenotype showed similar results, confirming the robustness of our findings. Conclusion All of the age effect reflecting the individual aging process, period effect reflecting change in the social environment, and birth cohort effect reflecting different generations could influence the prevalence of frailty at the population level. In contrast, the age effect was the main effect.
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Affiliation(s)
- Siying Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Wenye Fan
- School of Public Health, Wuhan University, Wuhan, China
| | - Boya Zhu
- School of Public Health, Wuhan University, Wuhan, China
| | - Chao Ma
- School of Public Health, Wuhan University, Wuhan, China
| | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Xiaodong Tan
| | - Yaohua Gu
- School of Nursing, Wuhan University, Wuhan, China,Yaohua Gu
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Liu X, Dai G, He Q, Ma H, Hu H. Frailty Index and Cardiovascular Disease among Middle-Aged and Older Chinese Adults: A Nationally Representative Cross-Sectional and Follow-Up Study. J Cardiovasc Dev Dis 2022; 9:jcdd9070228. [PMID: 35877590 PMCID: PMC9319589 DOI: 10.3390/jcdd9070228] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 12/30/2022] Open
Abstract
Evidence for the association between the frailty index and cardiovascular disease (CVD) is inconclusive, and this association has not been evaluated in Chinese adults. We aim to examine the association between the frailty index and CVD among middle-aged and older Chinese adults. We conducted cross-sectional and cohort analyses using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS). From 2011 to 2018, 17,708 participants aged 45 years and older were included in the CHARLS. The primary outcome was CVD events (composite of heart disease and stroke). Multivariable adjusted logistic regression and Cox proportional hazards models were used to estimate the association between the frailty index and CVD in cross-sectional and follow-up studies, respectively. A restricted cubic spline model was used to characterize dose−response relationships. A total of 16,293 and 13,580 participants aged 45 years and older were included in the cross-sectional and cohort analyses, respectively. In the cross-sectional study, the prevalence of CVD in robust, pre-frailty and frailty was 7.83%, 18.70% and 32.39%, respectively. After multivariable adjustment, pre-frailty and frailty were associated with CVD; ORs were 2.54 (95% confidence interval [CI], 2.28−2.84) and 4.76 (95% CI, 4.10−5.52), respectively. During the 7 years of follow-up, 2122 participants without previous CVD developed incident CVD; pre-frailty and frailty were associated with increased risk of CVD events; HRs were 1.53 (95% CI, 1.39−1.68) and 2.17 (95% CI, 1.88−2.50), respectively. Furthermore, a stronger association of the frailty index with CVD was observed in participants aged <55, men, rural community-dwellers, BMI ≥ 25, without hypertension, diabetes or dyslipidemia. A clear nonlinear dose−response pattern between the frailty index and CVD was widely observed (p < 0.001 for nonlinearity), the frailty index was above 0.08, and the hazard ratio per standard deviation was 1.18 (95% CI 1.13−1.25). We observed the association between the frailty index and CVD among middle-aged and elderly adults in China, independent of chronological age and other CVD risk factors. Our findings are important for prevention strategies aimed at reducing the growing burden of CVD in older adults.
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Li X, Cao X, Ying Z, Zhang J, Sun X, Hoogendijk EO, Liu Z. Associations of Serum Albumin With Disability in Activities of Daily Living, Mobility and Objective Physical Functioning Regardless of Vitamin D: Cross-Sectional Findings From the Chinese Longitudinal Healthy Longevity Survey. Front Nutr 2022; 9:809499. [PMID: 35284431 PMCID: PMC8908380 DOI: 10.3389/fnut.2022.809499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/19/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To examine the associations of serum albumin, a nutrition indicator, with disability in activities of daily living (ADL), mobility, and objective physical functioning among Chinese older adults. Materials and Methods Cross-sectional data of 2233 older adults (≥65 years) who participated in the 2011/2012 main survey of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the 2012 biomarker sub-study was used. Serum albumin was measured by immunoturbidimetric assay. Physical functioning included subjectively (ADL and mobility) and objectively measured disability (standing up from a chair, picking up a book from the floor, and turning around 360°). Multivariable logistic regression models were performed. Results After adjusting for age and sex, compared with participants in the lowest quartile group of serum albumin, those in the highest quartile group had 45% lower odds of disability in ADL (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.38, 0.80); 48% lower odds of disability in mobility (OR: 0.52; 95% CI: 0.38, 0.71); 46% lower odds of disability in standing up from a chair (OR: 0.54; 95% CI: 0.34, 0.85); and 37% lower odds of disability in picking up a book from the floor (OR: 0.63; 95% CI: 0.40, 0.97). We did not observe a statistically significant interaction effect between serum albumin and vitamin D on disability in physical functioning. Conclusion Serum albumin level was associated with physical functioning among Chinese older adults, regardless of vitamin D level. The findings indicate that appropriate management of poor nutritional status, in particular low serum albumin levels, may contribute to maintaining physical functioning in older adults.
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Affiliation(s)
- Xueqin Li
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xingqi Cao
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhimin Ying
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingyun Zhang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyi Sun
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Emiel O. Hoogendijk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-location VU University Medical Center, Amsterdam, Netherlands
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Alibaba-Zhejiang University Joint Research Center of Future Digital Healthcare, Hangzhou, China
- *Correspondence: Zuyun Liu ;
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Wang HY, Zhang M, Sun X. Sex-Specific Association Between Socioeconomic Status, Lifestyle, and the Risk of Frailty Among the Elderly in China. Front Med (Lausanne) 2021; 8:775518. [PMID: 34869494 PMCID: PMC8639189 DOI: 10.3389/fmed.2021.775518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Lifestyle contributors to frailty among the elderly were previously reported in the developed Western countries, while evidence from the less developed East Asian regions was still lacking. Due to the well-acknowledged sex-based disparity of frailty and sex-difference of socioeconomic status and lifestyle, it is worth investigating the sex-specific association between the social and behavioral contributors and the risk of frailty among the East Asian longevous population. Methods: The present study was an observational study based on the four waves of interviews of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. The participants aged ≥65 years and without frailty at baseline were included. Fried criteria (exhaustion, shrink, weakness, low mobility, and inactivity) were adopted to identify the incidence of frailty (≥3 domains) and pre-frailty (1-2 domains) during the follow-up. The sex-specific association between lifestyle (smoke status, drinking status, food intake, sleep, exercise, and physical activity) and the risk of incident pre-frailty and frailty was analyzed using the multinomial logistic regression models. Results: Altogether, 3,327 participants aged 81.2 ± 10.3 (range 65-116) years were included. In total, 964 (29.0%) and 1,249 (37.5%) participants were recognized as having incident pre-frailty and frailty, respectively. Older women were disproportionately uneducated, frequently did housework and labor work, but seldom did exercise. Men had diverse dietary and recreational activities but were frequently exposed to tobacco and alcohol. The protective effects of higher income, exercise, doing housework, and daily intake of fresh fruits/vegetables were found in both the sexes (P < 0.05). Sleep disorders (odds ratio [OR] = 2.16, 95% CI: 1.28-3.62) and labor work (OR = 2.18, 95% CI: 1.42-3.33) were associated with the increased risk of frailty among women. For men, diverse dietary (four types of food added: OR = 0.21, 95% CI: 0.09-0.50) showed a protective effect on the risk of frailty, but daily intake of pickled vegetables showed the opposite effect (OR = 1.86, 95% CI: 1.12-3.07). Conclusion: Socioeconomic status, lifestyle, and the association with the risk of frailty showed substantial difference between the sexes among the longevous population in China. To establish the individualized strategy of behavioral improvement for the frailty prevention should consider the sex disparity.
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Affiliation(s)
- Huai-Yu Wang
- National Institute of Health Data Science, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Mufan Zhang
- Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaojing Sun
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
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