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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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Kishiki T, Hasegawa H, Yoshino H, Aso N, Iioka A, Wakamatsu T, Honda K, Kataoka I, Kim S, Ishii S, Isobe S, Shirota T, Ide M, Taniai S, Moriyama K, Yorozu T, Kondo H, Sakamoto Y, Abe N, Sunami E. Physical frailty recovery is slower than mental frailty recovery after non-cardiac surgery in older adult patients. Langenbecks Arch Surg 2023; 408:395. [PMID: 37821759 DOI: 10.1007/s00423-023-03123-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE Frailty is characterized by fragility and decline in physical, mental, and social activities; it is commonly observed in older adults. No studies have reported frailty status changes between the preoperative and postoperative periods, including mental and cognitive factors. Therefore, this study investigated frailty factors, including mental and cognitive functions, that change after non-cardiac surgery in older adults. METHODS Patients aged ≥ 75 years who underwent non-cardiac surgery were surveyed using five tools (Eastern Cooperative Oncology Group-Performance Status (PS); handgrip strengths; Japan-Cardiovascular Health Study index (J-CHS index); Mini-Mental State Examination (MMSE); and Geriatric Depression Scale) for comprehensive evaluation of perioperative functions. The results before surgery, at discharge, and during follow-up at the outpatient clinic were compared. RESULTS Fifty-three patients with a median age of 80 (IQR, 77-84) years were evaluated. MMSE scores did not change during the perioperative period. The PS and J-CHS index worsened significantly at discharge and did not improve at the outpatient clinic follow-up. The dominant handgrip strength decreased after surgery (p < 0.001) but improved during follow-up. Additionally, nondominant handgrip strength decreased after surgery (p < 0.001) but did not recover as much as the dominant handgrip strength during follow-up (p = 0.015). CONCLUSION Changes in physical frailty and mental and cognitive functions were not identical perioperatively in older adult patients undergoing non-cardiac surgery. Physical frailty did not improve 1 month after surgery, mental function recovered early, and cognitive function did not decline. This study may be important for frailty prevention in older adult patients.
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Affiliation(s)
- Tomokazu Kishiki
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan.
| | - Hiroshi Hasegawa
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Hideaki Yoshino
- Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan
| | - Nobuyoshi Aso
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Aiko Iioka
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Takashi Wakamatsu
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Kazuna Honda
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Isao Kataoka
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Sangchul Kim
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Shun Ishii
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Satoshi Isobe
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Toshiya Shirota
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Mayumi Ide
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Seiichi Taniai
- Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan
| | - Kumi Moriyama
- Department of Anesthesiology, St John's Sakuramachi Hospital, Tokyo, Japan
| | - Tomoko Yorozu
- Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan
| | - Haruhiko Kondo
- Department of Thoracic and Thyroid Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Yoshihiro Sakamoto
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Nobutsugu Abe
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Eiji Sunami
- Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
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Nerobkova N, Park YS, Park EC, Shin J. Frailty transition and depression among community-dwelling older adults: the Korean Longitudinal Study of Aging (2006-2020). BMC Geriatr 2023; 23:148. [PMID: 36932383 PMCID: PMC10024357 DOI: 10.1186/s12877-022-03570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/10/2022] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Frailty is recognized as a geriatric syndrome associated with depression. The consequences and mechanism of frailty transitions are still understudied. This study assessed the influence of frailty transitions on new-onset depressive symptomology using longitudinal, nationwide data of Korean community-dwelling older adults. METHODS Longitudinal population-based study conducted in every even-numbered year starting from 2006 to 2020 (eight waves) with a sample of older adults aged ≥ 60 years old. After the application of exclusion criteria, a total of 2,256 participants were included in the 2008 baseline year. Frailty transition was determined through the biennial assessment of change in frailty status using the frailty instrument (FI); depression was measured using the Center for Epidemiological Studies Depression 10 Scale. We employed the lagged general estimating equations to assess the temporal effect of frailty transition on obtaining depressive symptoms. RESULTS Compared to non-frail individuals, the risk of depression was higher in transitioned into frailty and constantly frail participants over a 2-year interval: men (odds ratio (OR) 1.26, 95% confidence interval (CI) 1.21-1.32; OR 1.29, 95% CI 1.21-1.38), women (OR 1.34, 95% CI 1.28-1.40; OR 1.51, 95% CI 1.41-1.62), respectively. CONCLUSIONS Frailty transition is found to be associated with new-onset depressive symptoms. Frail individuals and those who transitioned into frailty were associated with a higher risk of depression. Particular attention should be paid to these frailty transitioned groups. Early intervention and implementation of prevention strategies at physical, nutritional, and social levels are warranted to ameliorate frailty and depression in late life.
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Affiliation(s)
- Nataliya Nerobkova
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
- Department of Policy Analysis and Management, College of Human Ecology, Cornell University, Ithaca, NY, USA.
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Cohen CI, Benyaminov R, Rahman M, Ngu D, Reinhardt M. Frailty: A Multidimensional Biopsychosocial Syndrome. Med Clin North Am 2023; 107:183-197. [PMID: 36402498 DOI: 10.1016/j.mcna.2022.04.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The original conceptual landscape of frailty has evolved into a complex, multidimensional biopsychosocial syndrome. This has broadened the field to now include social and behavioral scientists and clinicians from a wide range of specialties. This article aims to provide an updated overview of this conceptual change by examining the emerging definitions of physical, cognitive, social, and psychological frailty; the tools used for diagnosis and assessment of these domains; the epidemiology of the domains; their pathogenesis, risk factors, and course; frameworks for prevention and treatment; and unresolved issues affecting the field.
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Affiliation(s)
- Carl I Cohen
- SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
| | - Rivka Benyaminov
- SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Manumar Rahman
- SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Dilys Ngu
- SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Michael Reinhardt
- SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
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Prevalence of cognitive frailty among community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Stud 2021; 125:104112. [PMID: 34758429 DOI: 10.1016/j.ijnurstu.2021.104112] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis was to investigate the pooled prevalence of cognitive frailty among community-dwelling older adults and provide evidence-based support for policy-makers planning health and social care policies. DESIGN A systematic review and meta-analysis. METHODS PubMed, Web of Science, Embase and the Cochrane Library were systematically searched from their inception to December 10, 2020. Descriptive studies (cross-sectional studies or population-based longitudinal studies) and cohort studies were available. Participants were community-dwelling older adults aged 60 years and above. Two researchers independently screened the literature, extracted the data and evaluated the quality of the included studies. All statistical analyses were conducted using Stata 15.0. RESULTS We screened 2815 records, among which 24 studies met the inclusion criteria and were included in the review. The pooled prevalence of cognitive frailty was 9% (95% CI: 8%-11%, I2 = 99.3%). The results of the subgroup analysis showed that the pooled prevalence of cognitive frailty was 11% (95% CI: 9%-14%) in men and 15% (95% CI: 11%-19%) in women. The pooled prevalence of cognitive frailty based on the descriptive studies and cohort studies was 7% (95% CI: 5%-9%) and 17% (95% CI: 11%-22%), respectively. The pooled estimates of cognitive frailty prevalence were 6% (95% CI: 4%-8%) from 2012 to 2017 and 11% (95% CI: 9%-14%) from 2018 to 2020. CONCLUSIONS This systematic review analyzed the available literature and revealed that the pooled prevalence of cognitive frailty among community-dwelling older adults was 9%. The stratified analysis showed that the prevalence of cognitive frailty was higher in older women. In addition, the prevalence has increased in recent years, which has important implications for adapting health and social care systems.
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Frailty transitions and cognitive function among South Korean older adults. Sci Rep 2021; 11:10658. [PMID: 34017031 PMCID: PMC8138002 DOI: 10.1038/s41598-021-90125-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/04/2021] [Indexed: 01/23/2023] Open
Abstract
Frailty is considered a multidimensional geriatric syndrome, manifested by the accumulation of age-associated deficits. The consequences of frailty transitions are still understudied. This study evaluated the influence of frailty transitions on cognitive function in the older adult population. We used data derived from the Korean Longitudinal Study of Aging (KLoSA) (2008–2018) on older adults aged ≥ 65 years. Frailty was assessed using a validated Korean frailty measure known as the frailty instrument (FI), and cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE). Transitions in frailty and their relationship with cognitive function were investigated using lagged generalized estimating equations (GEE), t-tests, and ANOVA. Respondents who experienced frailty transitions (those with ameliorating frailty), those who developed frailty, and whose frailty remained constant, were more likely to have a lower cognitive function than those who were consistently non-frail. Older age, activities of daily living (ADL) disability, and instrumental ADL disability were more negatively associated with declining cognitive function, especially in the “frail → frail” group. Changes in all individual components of the frailty instrument were significantly associated with impaired cognitive function. The results suggest an association between frailty transitions and cognitive impairment. Over a 2-year span, the remaining frail individuals had the highest rate of cognitive decline in men, while the change from non-frail to frail state in women was significantly associated with the lowest cognitive function values. We recommend early interventions and prevention strategies in older adults to help ameliorate or slow down both frailty and cognitive function decline.
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Robinson TL, Gogniat MA, Miller LS. Frailty and Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis of Cross-Sectional Studies. Neuropsychol Rev 2021; 32:274-293. [PMID: 33886024 DOI: 10.1007/s11065-021-09497-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
The relationship between cognitive function and frailty among older adults is a growing area of research due to the implications of cognitive and physical decline for functional independence in late life. Multiple studies demonstrate a meaningful relationship between these two factors, which together may constitute increased risk of negative health outcomes for older adults. The current analysis was conducted to 1) systematically review current evidence for differences in cognitive performance based on frailty status among older adults and provide quantitative evidence for the magnitude of this effect, and 2) assess the influence of demographic and methodological variables on this effect. The preregistered protocol (CRD42018087138) included a search of EBSCOhost, Pubmed, and Embase online databases and reference lists to identify cross-sectional studies comparing frail and non-frail or robust older adults (60+) on cognitive performance. In total, 42 effects were retrieved from 38 studies, expressed as Hedges' g, and pooled based on a random-effects model. Results indicated an overall significant, negative effect of frailty status on cognitive function among tests of global cognitive function (g = 0.734: 95% CI = 0.601-0.867) and individual cognitive domains (g = 0.439: 95% CI = 0.342-0.535). Age, frailty assessment used, and cognitive status of the sample did not significantly moderate the overall effect. Post-hoc moderator analysis revealed that difference in mean age of frail and robust groups significantly moderated the overall effect (R2 = 0.38, β = .0974, 95% CI = 0.0537-0.141). Implications for future research are discussed.
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Effects of combining exercise with long-chain polyunsaturated fatty acid supplementation on cognitive function in the elderly: a randomised controlled trial. Sci Rep 2020; 10:12906. [PMID: 32737350 PMCID: PMC7395090 DOI: 10.1038/s41598-020-69560-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/14/2020] [Indexed: 01/24/2023] Open
Abstract
Multifactorial lifestyle intervention is known to be more effective for ameliorating cognitive decline than single factor intervention; however, the effects of combining exercise with long-chain polyunsaturated fatty acids (LCPUFA) on the elderlies' cognitive function remain unclear. We conducted a randomised, single-masked placebo-controlled trial in non-demented elderly Japanese individuals. Participants were randomly allocated to the exercise with LCPUFA, placebo, or no exercise with placebo (control) groups. Participants in the exercise groups performed 150 min of exercise per week, comprised resistance and aerobic training, for 24 weeks with supplements of either LCPUFA (docosahexaenoic acid, 300 mg/day; eicosapentaenoic acid, 100 mg/day; arachidonic acid, 120 mg/day) or placebo. Cognitive functions were evaluated by neuropsychological tests prior to and following the intervention. The per-protocol set analysis (n = 76) revealed no significant differences between the exercise and the control groups in changes of neuropsychological tests. Subgroup analysis for participants with low skeletal muscle mass index (SMI) corresponding to sarcopenia cut-off value showed changes in selective attention, while working memory in the exercise with LCPUFA group was better than in the control group. These findings suggest that exercise with LCPUFA supplementation potentially improves attention and working memory in the elderly with low SMI.
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Wanaratna K, Muangpaisan W, Kuptniratsaikul V, Chalermsri C, Nuttamonwarakul A. Prevalence and Factors Associated with Frailty and Cognitive Frailty Among Community-Dwelling Elderly with Knee Osteoarthritis. J Community Health 2020; 44:587-595. [PMID: 30604223 DOI: 10.1007/s10900-018-00614-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Physical frailty and cognitive impairment are risk factors for adverse outcomes in older people with osteoarthritis of the knee (knee OA). This cross-sectional study was conducted to determine the prevalence and associated factors of frailty and cognitive frailty among community-dwelling older patients with knee OA in four representative cities of Thailand. Data composed of three parts, Part 1: Demographic data, Part 2: The assessment of frailty by Fried phenotype and cognitive function by MiniCog and Part 3: The assessment of factors associated with frailty. Of 780 elders (mean age, 69.4 ± 6.9 years) screened, 101 (12.9%) were classified to be frail, 511 (65.6%) pre-frail and 168 (21.5%) non-frail. The prevalence of cognitive frailty was 2.44%. The correlation between physical activity rated by the Global Physical Activity Questionnaire (GPAQ) and self-rated methods was high (kappa 0.721; p < 0.001). Self-rated physical activity yielded similar prevalence of frail (9.4%), pre-frail (69.1%) and non-frail (21.5%). In multivariate analysis, aging (OR 3.42; 95% CI 1.16-10.11), severe knee OA symptoms (OR 18.96; 95% CI 3.53-101.65), malnutrition (OR 2.50; 95% CI 1.23-5.09), and functional dependence (OR 3.94; 95% CI 1.19-13.03) were associated with frailty. The prevalence of frailty and pre-frailty was high in knee OA and associated with aging, severe knee OA symptoms, malnutrition, and functional dependence, whereas the prevalence of cognitive frailty was not uncommon in community-dwelling elderly. Physical activity rated by the GPAQ and self-rated methods were highly correlated. Self-rated physical activity may be used in community surveys of frailty.
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Affiliation(s)
- Kulthanit Wanaratna
- Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Mueang Nonthaburi District, Nonthaburi, Thailand
| | - Weerasak Muangpaisan
- Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
| | - Vilai Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chalobol Chalermsri
- Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Apiwan Nuttamonwarakul
- Department of Medical Services, Ministry of Public Health, Mueang Nonthaburi District, Thailand
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Rutter EC, Tyas SL, Maxwell CJ, Law J, O'Connell ME, Konnert CA, Oremus M. Association between functional social support and cognitive function in middle-aged and older adults: a protocol for a systematic review. BMJ Open 2020; 10:e037301. [PMID: 32265252 PMCID: PMC7245373 DOI: 10.1136/bmjopen-2020-037301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Maintenance of cognitive function into old age is important for ageing populations. Researchers seek to identify modifiable risk and protective factors for cognitive function. One such modifiable factor is functional social support, that is, one's perception of whether their social network can provide resources such as material help, companionship, information and emotional contact, if needed. While the literature generally reports positive associations between functional social support and cognitive function, results vary according to study methods such as the tool used to measure functional social support or the specific cognitive domain under investigation. Our review will summarise the association between functional social support and cognitive function in middle-aged and older-aged adults who reside in any setting (eg, community dwelling, long-term care facilities). We will also identify sources of discrepant findings between studies. METHODS AND ANALYSIS This protocol was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guideline. PubMed, PsycINFO, Sociological Abstracts, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Scopus will be searched from inception to the present using a search strategy developed with a medical librarian's help. We will supplement the database searches with a grey literature search. English-language or French-language studies with a comparison group will be subject to inclusion, regardless of the measures used to assess functional social support or cognitive function. We will assess risk of bias with the Cochrane Risk of Bias Tool-Version 2 or the Newcastle-Ottawa Scale, narratively synthesise the extracted data and conduct a meta-analysis of studies with similar characteristics (eg, sample age and sex, cognitive function outcomes). Two independent raters will screen articles and assess risk of bias. ETHICS AND DISSEMINATION This review is timely given the push toward early diagnosis and treatment of dementia/major neurocognitive disorder and other types of cognitive impairment. This protocol does not require a formal ethics review. We will publish our findings in a peer-reviewed journal.
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Affiliation(s)
- Emily C Rutter
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Suzanne L Tyas
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Colleen J Maxwell
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- School of Pharmacy, University of Waterloo, Waterlo, Ontario, Canada
| | - Jane Law
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Candace A Konnert
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Mark Oremus
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Sugimoto K, Rakugi H, Kojima T, Ishii S, Akishita M, Tamura Y, Araki A, Kozaki K, Senda K, Fukuoka H, Satake S, Arai H. Chapter 4 Frailty and specific diseases. Geriatr Gerontol Int 2020; 20 Suppl 1:25-37. [PMID: 32050299 DOI: 10.1111/ggi.13833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Ken Sugimoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Shinya Ishii
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yoshiaki Tamura
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Atsushi Araki
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Koichi Kozaki
- Department of Geriatric Medicine, Kyorin University, School of Medicine, Mitaka, Japan
| | - Kazuyoshi Senda
- Department of Clinical Research Promotion, Innovation Center for Clinical Research, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hideki Fukuoka
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shosuke Satake
- Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
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12
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Sleight C, Holtzer R. Differential associations of functional and cognitive health outcomes with pre-frailty and frailty states in community-dwelling older adults. J Health Psychol 2018; 25:1057-1063. [PMID: 29385836 DOI: 10.1177/1359105317745964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined associations of pre-frailty and frailty states with cognitive and functional health outcomes among community-residing older adults (N = 457) in the Bronx, New York. Results: older adults who met criteria for frailty demonstrated poorer performance in attention, verbal memory, and overall global cognitive functioning compared to healthy controls. Moreover, pre-frail and frail older adults had significantly worse health outcomes including greater perceived difficulty with lower and upper extremity functioning and perceived limitations in completing daily activities, suggesting the need for targeted interventions in the community that may ameliorate age-related health decline.
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Affiliation(s)
| | - Roee Holtzer
- Yeshiva University, USA.,Albert Einstein College of Medicine, USA
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Sousa-Santos AR, Amaral TF. Differences in handgrip strength protocols to identify sarcopenia and frailty - a systematic review. BMC Geriatr 2017; 17:238. [PMID: 29037155 PMCID: PMC5644254 DOI: 10.1186/s12877-017-0625-y] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 10/08/2017] [Indexed: 12/28/2022] Open
Abstract
Background Hand grip strength (HGS) is used for the diagnosis of sarcopenia and frailty. Several factors have been shown to influence HGS values during measurement. Therefore, variations in the protocols used to assess HGS, as part of the diagnosis of sarcopenia and frailty, may lead to the identification of different individuals with low HGS, introducing bias. The aim of this systematic review is to gather all the relevant studies that measured HGS to diagnose sarcopenia and frailty and to identify the differences between the protocols used. Methods A systematic review was carried out following the recommendations of The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. PubMed and Web of Science were systematically searched, until August 16, 2016. The evidence regarding HGS measurement protocols used to diagnose sarcopenia and frailty was summarised and the most recent protocols regarding the procedure were compared. Results From the described search 4393 articles were identified. Seventy-two studies were included in this systematic review, in which 37 referred to sarcopenia articles, 33 to frailty and two evaluated both conditions. Most studies presented limited information regarding the protocols used. Conclusions The majority of the studies included did not describe a complete procedure of HGS measurement. The high heterogeneity between the protocols used, in sarcopenia and frailty studies, create an enormous difficulty in drawing comparative conclusions among them.
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Affiliation(s)
- A R Sousa-Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.
| | - T F Amaral
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
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Perna S, Francis MD, Bologna C, Moncaglieri F, Riva A, Morazzoni P, Allegrini P, Isu A, Vigo B, Guerriero F, Rondanelli M. Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools. BMC Geriatr 2017; 17:2. [PMID: 28049443 PMCID: PMC5209899 DOI: 10.1186/s12877-016-0382-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 11/25/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the performance of Edmonton Frail Scale (EFS) on frailty assessment in association with multi-dimensional conditions assessed with specific screening tools and to explore the prevalence of frailty by gender. METHODS We enrolled 366 hospitalised patients (women\men: 251\115), mean age 81.5 years. The EFS was given to the patients to evaluate their frailty. Then we collected data concerning cognitive status through Mini-Mental State Examination (MMSE), health status (evaluated with the number of diseases), functional independence (Barthel Index and Activities Daily Living; BI, ADL, IADL), use of drugs (counting of drugs taken every day), Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), Skeletal Muscle Index of sarcopenia (SMI), osteoporosis and functionality (Handgrip strength). RESULTS According with the EFS, the 19.7% of subjects were classified as non frail, 66.4% as apparently vulnerable and 13.9% with severe frailty. The EFS scores were associated with cognition (MMSE: β = 0.980; p < 0.01), functional independence (ADL: β = -0.512; p < 0.00); (IADL: β = -0.338; p < 0.01); use of medications (β = 0.110; p < 0.01); nutrition (MNA: β = -0.413; p < 0.01); mood (GDS: β = -0.324; p < 0.01); functional performance (Handgrip: β = -0.114, p < 0.01) (BI: β = -0.037; p < 0.01), but not with number of comorbidities (β = 0.108; p = 0.052). In osteoporotic patients versus not-osteoporotic patients the mean EFS score did not differ between groups (women: p = 0.365; men: p = 0.088), whereas in Sarcopenic versus not-Sarcopenic patients, there was a significant differences in women: p < 0.05. CONCLUSIONS This study suggests that measuring frailty with EFS is helpful and performance tool for stratifying the state of fragility in a group of institutionalized elderly. As matter of facts the EFS has been shown to be associated with several geriatric conditions such independence, drugs assumption, mood, mental, functional and nutritional status.
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Affiliation(s)
- Simone Perna
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy
| | - Matthew D’Arcy Francis
- Deprtment of Internal Medicine and Medical Therapy, Section of Geriatrics University of Pavia, Azienda di Servizi alla Persona, Pavia, Italy
| | - Chiara Bologna
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy
| | - Francesca Moncaglieri
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy
| | | | | | | | - Antonio Isu
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy
| | - Beatrice Vigo
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy
| | - Fabio Guerriero
- Deprtment of Internal Medicine and Medical Therapy, Section of Geriatrics University of Pavia, Azienda di Servizi alla Persona, Pavia, Italy
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy
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Vieira AI, Nogueira D, de Azevedo Reis E, da Lapa Rosado M, Vânia Nunes M, Castro-Caldas A. Hand tactile discrimination, social touch and frailty criteria in elderly people: A cross sectional observational study. Arch Gerontol Geriatr 2016; 66:73-81. [DOI: 10.1016/j.archger.2016.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/07/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
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Cerebral microbleeds are associated with physical frailty: a community-based study. Neurobiol Aging 2016; 44:143-150. [DOI: 10.1016/j.neurobiolaging.2016.04.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 03/16/2016] [Accepted: 04/20/2016] [Indexed: 11/21/2022]
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17
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Prevalence and incidence of frailty in Aboriginal Australians, and associations with mortality and disability. Maturitas 2016; 87:89-94. [DOI: 10.1016/j.maturitas.2016.02.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 02/15/2016] [Accepted: 02/23/2016] [Indexed: 01/16/2023]
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Hajek A, Brettschneider C, Posselt T, Lange C, Mamone S, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Stein J, Luck T, Bickel H, Mösch E, Heser K, Jessen F, Maier W, Scherer M, Riedel-Heller SG, König HH. Predictors of Frailty in Old Age - Results of a Longitudinal Study. J Nutr Health Aging 2016; 20:952-957. [PMID: 27791226 DOI: 10.1007/s12603-015-0634-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To investigate time-dependent predictors of frailty in old age longitudinally. DESIGN Population-based prospective cohort study. SETTING Elderly individuals were recruited via GP offices at six study centers in Germany. The course of frailty was observed over 1.5 years (follow up wave 4 and follow up wave 5). PARTICIPANTS 1,602 individuals aged 80 years and older (mean age 85.4 years SD 3.2, with mean CSHA CFS 3.5 SD 1.6) at follow up wave 4. MEASUREMENTS Frailty was assessed by using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA CFS), ranging from 1 (very fit) to 7 (severely frail). RESULTS Fixed effects regressions revealed that frailty increased significantly with increasing age (β=.2) as well as the occurrence of depression (β=.5) and dementia (β=.8) in the total sample. Changes in marital status and comorbidity did not affect frailty. While the effects of depression and dementia were significant in women, these effects did not achieve statistical significance in men. CONCLUSION Our findings highlight the role of aging as well as the occurrence of dementia and depression for frailty. Specifically, in order to delay frailty in old age, developing interventional strategies to prevent depression might be a fruitful approach.
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Affiliation(s)
- A Hajek
- JDr. André Hajek, University Medical Center, Hamburg-Eppendorf, Hamburg Center for Health Economics, Department of Health Economics and Health Services Research, Telephone +49 40 7410 52877; Fax +49 40 7410 40261, E-mail:
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Affiliation(s)
- Yong Gyu Park
- Department of Biostatistics, The Catholic University of Korea College of Medicine, Seoul, Korea
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