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Lee WJ, Peng LN, Lin MH, Loh CH, Hsiao FY, Chen LK. Intrinsic capacity and multimorbidity predicting incident disability-Insights from the I-Lan Longitudinal Aging Study. Arch Gerontol Geriatr 2024; 121:105357. [PMID: 38340587 DOI: 10.1016/j.archger.2024.105357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES This longitudinal cohort study aimed to examine the effect of intrinsic capacity (IC) and multimorbidity on the development of new disabilities. METHODS The study utilized data from 1,009 participants without disabilities from the I-Lan Longitudinal Aging Study. Multivariable logistic regressions were employed to assess the predictive capability of IC (ranging from 0 to 100) and multimorbidity for incident disability over a 7-year follow-up period. RESULTS Both low IC (OR 4.9, 95 % CI 2.1-11.1, p < 0.001) and multimorbidity (OR 4.5, 95 % CI 2.2-9.2, p < 0.001) significantly predicted incident disability over the 7-year period. A one-point increase in IC reduced the risk of incident disability by 10 % (OR 0.9, 95 % CI 0.8-0.9, p < 0.001). Among IC subdomains, both better locomotion (OR 0.96, 95 % CI 0.94-0.99, p = 0.014) and psychology (OR 0.97, 95 %CI 0.94-1.00, p = 0.049) significantly reduced the risk of incident disability. Rapid declines in IC significantly predicted incident disability (OR 4.1, 95 % CI 1.8-9.3, p = 0.001), whereas the onset of new multimorbidity or changes in the number of chronic conditions did not demonstrate a significant association with incident disability. The interaction terms between IC and multimorbidity, both categorically (low IC * multimorbidity, p = 0.959) and numerically (IC (per point) * multimorbidity, p = 0.660) were all statistically insignificant. CONCLUSIONS IC exhibited better predictive capacity for 7-year incident disability compared to multimorbidity, so health care services targeting older adults should adopt an integrated care approach that combines both function- and disease-centric strategies.
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Affiliation(s)
- Wei-Ju Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan.
| | - Li-Ning Peng
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Hsien Lin
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Hui Loh
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan; Center of Health and Aging, Hualien Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
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Yang Y, Ma G, Wei S, Wei X, Yan B, Yuan Y, Chen Y, Qin J, Ma Y. Adverse outcomes of intrinsic capacity in older adults: A scoping review. Arch Gerontol Geriatr 2024; 120:105335. [PMID: 38422884 DOI: 10.1016/j.archger.2024.105335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 03/02/2024]
Abstract
Background and Purpose Intrinsic capacity (IC) has been shown to have the greatest impact on an individual's health status and health trajectory and can independently predict adverse outcomes such as mortality and care dependency in older adults. However, the current understanding of adverse outcomes associated with IC is incomplete. Methods A scoping review of the literature from PubMed, Web of Science (WOS), The Cochrane Library, CINAHL, and Embase databases was conducted from January 2015 to March 2023 to identify articles related to the adverse outcomes associated with IC in older adults. Results 711 studies met screening criteria, and 25 studies met inclusion criteria. These studies reported a total of 17 adverse outcomes related to IC across four domains. (1) Adverse outcomes in the physiological function domains included frailty, pneumonia onset, memory impairment, polypharmacy, incontinence, and poor/fair self-rated health. (2) Clinical outcomes domains included IADL disability, ADL disability, mortality, falls, autonomy decline, and incident dependence. (3) The resource utilization domains included hospitalization, nursing home stays, polypharmacy healthcare costs, and emergency department visits. (4) The other domains mainly included poor quality of life. Conclusion It is evident that IC decline in older adults is associated with a broad spectrum of adverse outcomes spanning cognitive function, activity ability, sensory perception, physical and mental health and living standards. Future studies should further deepen the exploration of IC.
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Affiliation(s)
- Yiyi Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.
| | - Guifen Ma
- Gannan Tibetan Autonomous Prefecture health school, Gannan Tibetan Autonomous Prefecture, China.
| | - Suhong Wei
- Department of Endocrinology, Gansu Provincial People's Hospital, Lanzhou, China.
| | - Xiaoqin Wei
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.
| | - Bailing Yan
- ICU, the First Hospital of Lanzhou University, Lanzhou, China.
| | - Yue Yuan
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.
| | - Yajing Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.
| | - Jiangxia Qin
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.
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Sun J, Zhou N, Zhang H, Wu H, Wang F, Luo Y. Longitudinal analysis of the mediating role of self-perception of aging in the relationship between frailty and intrinsic capacity: A cross-lagged mediation model. Arch Gerontol Geriatr 2024; 120:105336. [PMID: 38301318 DOI: 10.1016/j.archger.2024.105336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/06/2024] [Accepted: 01/18/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES The causal relationship between intrinsic capacity and frailty in older adults, as well as the underlying temporal mechanisms, remained poorly understood. The study aimed to investigate the causal association between intrinsic capacity and frailty while exploring the potential mediating role of self-perception of aging. MEASUREMENTS A survey was conducted with a sample of 429 participants who completed measures of intrinsic capacity, self-perception of aging, and frailty at baseline and were followed for one year. The relationships between these variables were assessed using an autoregressive cross-lagged model. RESULTS The study found reciprocal associations between intrinsic capacity and frailty (p < 0.01). Furthermore, the results indicated that self-perception of aging partially mediated the effect of frailty at baseline (T1) on intrinsic capacity at one-year follow-up (T2) (β = -0.02, confidence interval: [-0.055, -0.004]). However, the reverse causation was not observed. CONCLUSIONS AND IMPLICATIONS This study demonstrates a bidirectional causal relationship between intrinsic capacity and frailty in older adults. Self-perception of aging plays a significant mediating role in this relationship. Older adults with a worse level of frailty should be made aware of the potentially vicious cycle related to self-perception of aging, which can negatively affect their intrinsic capacity. Maintaining a positive self-perception of aging may help preserve physical and psychological reserves, maintain intrinsic capacity, and slow the decline of frailty.
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Affiliation(s)
- Junjun Sun
- School of Nursing, Xinxiang Medical University, Xinxiang, China
| | - Ning Zhou
- School of Nursing, Xinxiang Medical University, Xinxiang, China
| | - Huimin Zhang
- School of Nursing, Xinxiang Medical University, Xinxiang, China
| | - Huimin Wu
- School of Nursing, Xinxiang Medical University, Xinxiang, China
| | - Feifei Wang
- School of Nursing, Xinxiang Medical University, Xinxiang, China
| | - Yanyan Luo
- School of Nursing, Xinxiang Medical University, Xinxiang, China.
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Strand BH, Håberg AK, Eyjólfsdóttir HS, Kok A, Skirbekk V, Huxhold O, Løset GK, Lennartsson C, Schirmer H, Herlofson K, Veenstra M. Spousal bereavement and its effects on later life physical and cognitive capability: the Tromsø study. GeroScience 2024:10.1007/s11357-024-01150-y. [PMID: 38594472 DOI: 10.1007/s11357-024-01150-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/31/2024] [Indexed: 04/11/2024] Open
Abstract
Spousal bereavement is associated with health declines and increased mortality risk, but its specific impact on physical and cognitive capabilities is less studied. A historical cohort study design was applied including married Tromsø study participants (N=5739) aged 50-70 years with baseline self-reported overall health and health-related factors and measured capability (grip strength, finger tapping, digit symbol coding, and short-term recall) at follow-up. Participants had data from Tromsø4 (1994-1995) and Tromsø5 (2001), or Tromsø6 (2007-2008) and Tromsø7 (2015-2016). Propensity score matching, adjusted for baseline confounders (and baseline capability in a subset), was used to investigate whether spousal bereavement was associated with poorer subsequent capability. Spousal bereavement occurred for 6.2% on average 3.7 years (SD 2.0) before the capability assessment. There were no significant bereavement effects on subsequent grip strength, immediate recall, or finger-tapping speed. Without adjustment for baseline digit symbol coding test performance, there was a negative significant effect on the digit symbol coding test (ATT -1.33; 95% confidence interval -2.57, -0.10), but when baseline digit symbol coding test performance was taken into account in a smaller subsample, using the same set of matching confounders, there was no longer any association (in the subsample ATT changed from -1.29 (95% CI -3.38, 0.80) to -0.04 (95% CI -1.83, 1.75). The results in our study suggest that spousal bereavement does not have long-term effects on the intrinsic capacity components physical or cognition capability to a notable degree.
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Affiliation(s)
- Bjørn Heine Strand
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway.
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
| | - Asta K Håberg
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Harpa Sif Eyjólfsdóttir
- Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Stockholm University, Stockholm, Sweden
| | - Almar Kok
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life Programme, Amsterdam, The Netherlands
| | - Vegard Skirbekk
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Gøril Kvamme Løset
- NOVA - Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
| | - Carin Lennartsson
- Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden
- Swedish Institute for Social Research (SOFI), Stockholm University, Stockholm, Sweden
| | - Henrik Schirmer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Cardiology, Akershus, University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Katharina Herlofson
- NOVA - Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
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Chen LK. The grip on healthspan: Handgrip strength as a vital sign of aging. Arch Gerontol Geriatr 2024:105436. [PMID: 38584043 DOI: 10.1016/j.archger.2024.105436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Affiliation(s)
- Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
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Augusto da Costa Teixeira L, Rocha-Vieira E, Aparecida Soares L, Mota de Oliveira F, Aparecida Oliveira Leopoldino A, Netto Parentoni A, Amaral Mendonça V, Cristina Rodrigues Lacerda A. The strong inverse association between plasma concentrations of soluble tumor necrosis factor receptors type 1 with adiponectin/leptin ratio in older women. Cytokine 2024; 176:156512. [PMID: 38281360 DOI: 10.1016/j.cyto.2024.156512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/27/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
Complex inflammatory crosstalk between muscular and adipose organs during ageing is controlled by adipokines and myokines. The Adiponectin/Leptin ratio (A/L ratio) has proven to be a promising biomarker for identifying insulin sensitivity, cardiovascular risk and adipose tissue inflammation. Although the A/L ratio has been related to inflammatory conditions, its ability to associate with or indicate the behavior of other inflammatory mediators remains unknown. The present study aimed to verify the association between the A/L ratio and a panel of inflammatory biomarkers in community-dwelling older women. The plasmatic concentrations of adiponectin, leptin, resistin, brain-derived neurotrophic factor (BDNF), interferon-gamma (IFN-γ), interleukins 2, 4, 5, 6, 8 and 10, tumour necrosis factor (TNF) and its soluble receptors (sTNF-r) 1 and 2 were evaluated in 71 community-dwelling older women with 75 (±7) years. The A/L ratio was negative and inverse correlated with BNDF (r = -0.29; p = 0.01), IL-8 (r = -0.37; p = 0.001) and sTNFr- 1 (r = -0.98; p < 0.001) levels. A strong and inverse association, with proportional effect, between A/L ratio and sTNFr-1 concentrations was found (Adjusted R2 = 0.22; β = -0.48; p > 0.001). It suggests that the presence of sTNFr-1 causes an inflammatory effect that affect cross-talk between muscle and adipose tissue, contributing to pro-inflammatory imbalance, which may have molecular and functional consequences. In addition, we provide insights into diagnostic biomarkers for inflammation, especially related to muscle wasting and intrinsic capacity in older people.
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Affiliation(s)
- Leonardo Augusto da Costa Teixeira
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil
| | - Etel Rocha-Vieira
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil
| | - Luana Aparecida Soares
- Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil
| | | | | | | | - Vanessa Amaral Mendonça
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
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Bencivenga L, Strumia M, Rolland Y, Guyonnet S, Parini A, Cestac P, Andrieu S, Souto Barreto PD, Rouch L. Visit-to-visit blood pressure variability is associated with intrinsic capacity decline: Results from the MAPT Study. Eur J Intern Med 2024:S0953-6205(24)00097-9. [PMID: 38499456 DOI: 10.1016/j.ejim.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND The effectiveness of the body physiological regulatory mechanisms declines in late life, and increased Blood Pressure Variability (BPV) may represent an alteration in cardiovascular homeostatic patterns. Intrinsic Capacity (IC) has been proposed by the World Health Organization as a marker of healthy aging, based on individual's functional abilities and intended at preserving successful aging. We aimed to investigate the association of visit-to-visit BPV with IC decline in a population of community-dwelling older adults. METHODS The study population consisted of 1407 community-dwelling participants aged ≥70 years from the MAPT study evaluated during the 5-year follow-up. Systolic BPV (SBPV) and diastolic BPV (DBPV) were determined through six indicators. Cognition, psychology, locomotion and vitality constituted the four IC domains assessed. Total IC Z-score resulted from the sum of the four domains Z-scores divided by 4. The incidence of domain impairment over time was also assessed. RESULTS Higher SBPV was significantly associated with poorer IC Z-scores in all linear mixed models [1-SD increase of CV%: β(SE)=-0.010(0.001), p < 0.01]. Similar results were observed for DBPV [1-SD increase of CV%: β(SE)=-0.003(0.001), p = 0.02]. Incident IC impairment was significantly higher in participants with greater SBPV, [HR=1.16 (95 % CI, 1.01-1.33), p = 0.03], while greater DBPV did not show a higher risk of incident IC impairment. CONCLUSIONS Greater BPV is associated with IC decline over time. Our findings support BP instability as a presumable index of altered cardiovascular homeostatic mechanism, suggesting that BPV might be a clinical marker of aging and addressable risk factor for promoting healthy aging.
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Affiliation(s)
- Leonardo Bencivenga
- Department of Translational Medical Sciences, University of Naples Federico II, Napoli, Italy; Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France.
| | - Mathilde Strumia
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France; Department of Pharmacy, Toulouse University, Toulouse, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France
| | - Sophie Guyonnet
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France
| | - Angelo Parini
- Institut Des Maladies Métaboliques Et Cardiovasculaires (I2MC), Toulouse, France
| | - Philippe Cestac
- Department of Pharmacy, Toulouse University, Toulouse, France
| | - Sandrine Andrieu
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France
| | - Philipe De Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France
| | - Laure Rouch
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France; Department of Pharmacy, Toulouse University, Toulouse, France
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Hernandes ECR, Aliberti MJR, Guerra RO, Ferriolli E, Perracini MR. Intrinsic capacity and hospitalization among older adults: a nationally representative cross-sectional study. Eur Geriatr Med 2024:10.1007/s41999-024-00933-y. [PMID: 38491314 DOI: 10.1007/s41999-024-00933-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/04/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Monitoring intrinsic capacity (IC) in community-dwelling older people can be potentially used to alert for adverse health outcomes. However, whether there is an association between IC and hospitalization has yet to be fully explored. This study aimed to investigate the association of the IC composite measure and its 5 domains with hospitalization in the previous year and length of hospital stay. METHODS We conducted cross-sectional analyses using data from a representative sample of community-dwelling adults (≥ 65 years). We assessed the IC domains (vitality, locomotor, cognitive, sensory, and psychological) using validated self-reported information and performance tests. We calculated standardized estimated scores (z scores) for IC composite measure and domains and conducted multivariate logistic and ordinal regressions. The primary outcomes were hospitalizations in the previous year and length of hospital stay. RESULTS In a sample of 5354 participants (mean age = 73 ± 6 years), we found that participants with high IC composite z scores were less likely to have experienced hospitalization in the previous year (OR = 0.51; 95% CI = 0.44-0.58). Among those who were hospitalized, high IC scores were associated with short stays (OR = 0.87; 95% CI = 0.80-0.95). Cognitive and psychological domains were associated with hospitalizations, and the locomotor domain was related to length of hospital stay. The vitality domain was associated with both outcomes. CONCLUSION IC as a composite measure was associated with previous hospitalizations and length of stay. IC can help clinicians identify older people prone to adverse outcomes, prompting preventive integrated care interventions.
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Affiliation(s)
- Elisângela Cristina Ramos Hernandes
- Masters' and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesáreo Galeno, 448, Tatuapé, São Paulo, 03071-000, Brazil
| | - Márlon Juliano Romero Aliberti
- Laboratorio de Investigaçao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas, Disciplina de Geriatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Research Institute, Hospital Sirio-Libanes, São Paulo, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Eduardo Ferriolli
- Laboratorio de Investigaçao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas, Disciplina de Geriatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Monica Rodrigues Perracini
- Masters' and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesáreo Galeno, 448, Tatuapé, São Paulo, 03071-000, Brazil.
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.
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Yang F, Su Q, Ran Q, Hu Y. Longitudinal change of intrinsic capacity and associated factors in older Chinese adults: China Health and Retirement Longitudinal Study. J Nutr Health Aging 2024; 28:100214. [PMID: 38489991 DOI: 10.1016/j.jnha.2024.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Although intrinsic capacity (IC) has been constructed in older populations, whether IC retains the same structure over time has not been formally examined, nor have the factors associated with the changes in IC over time been thoroughly investigated. This study aimed to establish that the structure of IC remains unchanged over time by testing its longitudinal measurement invariance and to investigate factors that influence the longitudinal change of IC over time. METHODS Data came from 7,271 participants aged 60 and older from the China Health and Retirement Longitudinal Study in 2011 (Wave 1) and 2015 (Wave 3). Bifactor confirmatory factor analysis (CFA) was used to construct IC with its domains, and the longitudinal measurement invariance of IC between Waves was tested. RESULTS Bifactor CFA fitted the data well at both Waves and showed good construct validity. Partial scalar invariance was supported with non-invariant intercepts for delayed word recall, math, and close vision. Decreases in IC were associated with increasing age, being female (-0.030, 95% CI: -0.045, -0.016), living in rural areas (-0.019, 95% CI: -0.030, -0.009), BMI < 18.5 (-0.019, 95% CI: -0.035, -0.003), and hypertension (-0.012, 95% CI: -0.022, -0.001). Increases in IC were associated with higher education (primary school: 0.012, 95% CI: 0.001, 0.024; lower secondary school: 0.023, 95% CI: 0.005, 0.041) and drinking ≥4/week (0.019, 95% CI: 0.003, 0.034). Stratifying the sample by gender, the protective effect of education was observed only in women. CONCLUSIONS The bifactor structure of the IC construct was valid and retained its meaning over time. Longitudinal changes in IC were associated with various sociodemographic factors, lifestyle, and health conditions, confirming the need to monitor IC for timely intervention, particularly in those with risk factors for IC decline.
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Affiliation(s)
- Fang Yang
- College of Public Health, Chongqing Medical University, Chongqing, P.R. China
| | - Qin Su
- College of Public Health, Chongqing Medical University, Chongqing, P.R. China
| | - Qin Ran
- College of Public Health, Chongqing Medical University, Chongqing, P.R. China
| | - Yaoyue Hu
- College of Public Health, Chongqing Medical University, Chongqing, P.R. China.
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Rico CLV, Quirarte NHG, Ortiz LGC, Hidalgo HC, Valderrama SMC, Rayas LF. Factors associated with the deterioration of intrinsic capacity in older people in Mexico and Colombia. Ann Geriatr Med Res 2024:agmr.23.0182. [PMID: 38475665 DOI: 10.4235/agmr.23.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/08/2024] [Indexed: 03/14/2024] Open
Abstract
Background Intrinsic capacity (IC) is defined as "all the physical and mental attributes possessed by the older person." This concept has gained momentum in recent years because it provides insights into the changes in the functional capacity of individuals during their life. This study examined common factors associated with IC decline among older adults in Mexico and Colombia. Methods This cross-sectional, correlational study included 348 community-dwelling older adults. Sociodemographic, clinical, and family conditions were assessed as possible associated factors, and IC was analyzed across five domains: cognitive, locomotor, psychological, vitality (malnutrition through deficiency and excess), and sensory (visual and auditory). Parametric and non-parametric statistical analyses were performed. Results The common factors associated with impairment according to domain were family dysfunctionality (cognitive domain); myocardial infarction, family dysfunctionality, age >80 years, home occupation, and not having a partner (locomotor domain); dysfunctional family and risk of falls (psychological domain); age >80 years and not having a partner (malnutrition by deficiency domain); age 60-79 years, walking <7,500 steps/day, and peripheral vascular disease (malnutrition by excess domain); risk of falling and being female (visual sensory domain); risk of falling (auditory sensory domain); and dysfunctional family and risk of falling (total intrinsic capacity). Conclusion Both populations had common sociodemographic, clinical, and familial factors that directly affected total IC stocks and their domains.
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Salinas-Rodríguez A, Fernández-Niño JA, Rivera-Almaraz A, Manrique-Espinoza B. Intrinsic capacity trajectories and socioeconomic inequalities in health: the contributions of wealth, education, gender, and ethnicity. Int J Equity Health 2024; 23:48. [PMID: 38462637 PMCID: PMC10926672 DOI: 10.1186/s12939-024-02136-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/25/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Life-long health inequalities exert enduring impacts and are governed by social determinants crucial for achieving healthy aging. A fundamental aspect of healthy aging, intrinsic capacity, is the primary focus of this study. Our objective is to evaluate the social inequalities connected with the trajectories of intrinsic capacity, shedding light on the impacts of socioeconomic position, gender, and ethnicity. METHODS Our dynamic cohort study was rooted in three waves (2009, 2014, 2017) of the World Health Organization's Study on Global AGEing and Adult Health in Mexico. We incorporated a nationally representative sample comprising 2722 older Mexican adults aged 50 years and over. Baseline measurements of socioeconomic position, gender, and ethnicity acted as the exposure variables. We evaluated intrinsic capacity across five domains: cognition, psychological, sensory, vitality, and locomotion. The Relative Index of Inequality and Slope Index of Inequality were used to quantify socioeconomic disparities. RESULTS We discerned three distinct intrinsic capacity trajectories: steep decline, moderate decline, and slight increase. Significant disparities based on wealth, educational level, gender, and ethnicity were observed. Older adults with higher wealth and education typically exhibited a trajectory of moderate decrease or slight increase in intrinsic capacity. In stark contrast, women and indigenous individuals were more likely to experience a steeply declining trajectory. CONCLUSIONS These findings underscore the pressing need to address social determinants, minimize gender and ethnic discrimination to ensure equal access to resources and opportunities across the lifespan. It is imperative for policies and interventions to prioritize these social determinants in order to promote healthy aging and alleviate health disparities. This approach will ensure that specific demographic groups receive customized support to sustain their intrinsic capacity during their elder years.
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Affiliation(s)
- Aaron Salinas-Rodríguez
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Julián Alfredo Fernández-Niño
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E8532, Baltimore, MD, 21205, USA.
- Department of Public Health, Universidad del Norte, Barranquilla, Atlántico, Colombia.
| | - Ana Rivera-Almaraz
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Betty Manrique-Espinoza
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Miyahara S, Maeda K, Kawamura K, Matsui Y, Satake S, Arai H, Umegaki H. Association between intrinsic capacity and oral health in older patients in a frailty clinic. Eur Geriatr Med 2024:10.1007/s41999-024-00956-5. [PMID: 38438830 DOI: 10.1007/s41999-024-00956-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/24/2024] [Indexed: 03/06/2024]
Abstract
PURPOSE This study aimed to investigate how intrinsic capacity (IC) deficit is associated with oral functional decline. METHODS This cross-sectional study enrolled older adults at a research hospital frailty clinic between July 2021 and May 2023. IC evaluation included the locomotion, cognition, vitality, psychology, and sensory domains. Criteria for deficits were established within each domain, and the number of IC deficit domains was calculated for each patient. Oral function assessment included oral hygiene, oral dryness, occlusal force, tongue-lip motor function, tongue pressure, masticatory function, and swallowing function. Patients who met three or more criteria were classified into the oral hypofunction (OHF) group. Univariate and multivariate logistic regression analyses were performed to investigate the relationship between IC deficit and OHF. RESULTS Of 222 included patients (mean age 78.3 ± 6.3 years; 39.6% men), 105 (47.3%) met the criteria for OHF. This OHF group showed a significantly higher prevalence of locomotion, cognition, psychology, and sensory domain deficits than the normal oral function group. Multivariate analysis adjusted for age and sex revealed a significant association between IC deficits and OHF (odds ratio [OR], 1.33; 95% confidence interval [CI] 1.04-1.70). A significant association was also observed between the locomotion domain and OHF (OR, 2.06; 95% CI 1.13-3.76). CONCLUSION This study highlights the potential relationship between the number of IC domain deficits and oral functional decline, with the most significant domain being locomotion. Furthermore, it suggests a possible link between sensory and oral function.
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Affiliation(s)
- Shuzo Miyahara
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan.
- Nutrition Therapy Support Center, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Koki Kawamura
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Shosuke Satake
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
- Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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Sanchez-Rodriguez D, Bruyère O, Surquin M, Reginster JY, Beaudart C. Towards a core outcome set (COS) for intrinsic capacity (IC) intervention studies in adults in midlife and beyond: a scoping review to identify frequently used outcomes and measurement tools. Aging Clin Exp Res 2024; 36:54. [PMID: 38441748 PMCID: PMC10914863 DOI: 10.1007/s40520-023-02681-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/27/2023] [Indexed: 03/07/2024]
Abstract
This scoping review was conducted to identify the outcomes and measurement tools used in IC intervention studies, as first step towards the development of a core outcome set (COS) for IC trials. PRISMA-ScR and COS-STAD were followed. The review considered randomized controlled trials targeting IC published in Medline, Scopus, Embase, Cochrane Central Register of Controlled Trials, and clinicaltrials.gov, until June 2023. Of 699 references, 534 studies were screened once duplicates were removed, 15 were assessed for eligibility, and 7 (4 articles and 3 protocols) met eligibility criteria. Twenty-eight outcomes were identified (19 related to IC and its domains and 9 unrelated). The most reported primary outcome was the change in IC levels postintervention (5 over 7 studies) and the most reported outcomes (either as primary and/or secondary) were the changes in physical performance and in depressive symptoms (6 over 7 studies). Fifty-five tools used to construct the domains' z-scores and/or assess the effect of interventions were identified (47 related to IC and its domains and 8 unrelated). The most reported tool was an IC Z-score, calculated by 4 domains' z-scores: locomotor, vitality, cognitive, and psychological (5 over 7 studies). The tools differed among studies (10 locomotor related, 6 vitality related, 16 cognitive related, 8 psychological related, 6 sensorial related, 8 unrelated tools). The vast heterogeneity (28 outcomes and 55 tools within 7 studies) highlighted the need of a COS. These outcomes and tools will be presented to experts in a future step, to select the ones that should be taken into consideration in IC trials.
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Affiliation(s)
- Dolores Sanchez-Rodriguez
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
- Geriatrics Department, Rehabilitation Research Group, Hospital Del Mar Research Institute, Barcelona, Spain.
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Murielle Surquin
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Clinical Pharmacology and Toxicology Research Unit, Faculty of Medicine, NAmur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium
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López-Ortiz S, Caruso G, Emanuele E, Menéndez H, Peñín-Grandes S, Guerrera CS, Caraci F, Nisticò R, Lucia A, Santos-Lozano A, Lista S. Digging into the intrinsic capacity concept: Can it be applied to Alzheimer's disease? Prog Neurobiol 2024; 234:102574. [PMID: 38266702 DOI: 10.1016/j.pneurobio.2024.102574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 01/26/2024]
Abstract
Historically, aging research has largely centered on disease pathology rather than promoting healthy aging. The World Health Organization's (WHO) policy framework (2015-2030) underscores the significance of fostering the contributions of older individuals to their families, communities, and economies. The WHO has introduced the concept of intrinsic capacity (IC) as a key metric for healthy aging, encompassing five primary domains: locomotion, vitality, sensory, cognitive, and psychological. Past AD research, constrained by methodological limitations, has focused on single outcome measures, sidelining the complexity of the disease. Our current scientific milieu, however, is primed to adopt the IC concept. This is due to three critical considerations: (I) the decline in IC is linked to neurocognitive disorders, including AD, (II) cognition, a key component of IC, is deeply affected in AD, and (III) the cognitive decline associated with AD involves multiple factors and pathophysiological pathways. Our study explores the application of the IC concept to AD patients, offering a comprehensive model that could revolutionize the disease's diagnosis and prognosis. There is a dearth of information on the biological characteristics of IC, which are a result of complex interactions within biological systems. Employing a systems biology approach, integrating omics technologies, could aid in unraveling these interactions and understanding IC from a holistic viewpoint. This comprehensive analysis of IC could be leveraged in clinical settings, equipping healthcare providers to assess AD patients' health status more effectively and devise personalized therapeutic interventions in accordance with the precision medicine paradigm. We aimed to determine whether the IC concept could be extended from older individuals to patients with AD, thereby presenting a model that could significantly enhance the diagnosis and prognosis of this disease.
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Affiliation(s)
- Susana López-Ortiz
- i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain
| | - Giuseppe Caruso
- Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy; Neuropharmacology and Translational Neurosciences Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | | | - Héctor Menéndez
- i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain
| | - Saúl Peñín-Grandes
- i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain
| | - Claudia Savia Guerrera
- Department of Educational Sciences, University of Catania, 95125 Catania, Italy; Department of Biomedical and Biotechnological Sciences, University of Catania, 95125 Catania, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy; Neuropharmacology and Translational Neurosciences Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Robert Nisticò
- School of Pharmacy, University of Rome "Tor Vergata", 00133 Rome, Italy; Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, 00143 Rome, Italy
| | - Alejandro Lucia
- Research Institute of the Hospital 12 de Octubre ('imas12'), 28041 Madrid, Spain; Faculty of Sport Sciences, European University of Madrid, 28670 Villaviciosa de Odón, Madrid, Spain; CIBER of Frailty and Healthy Ageing (CIBERFES), 28029 Madrid, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain; Research Institute of the Hospital 12 de Octubre ('imas12'), 28041 Madrid, Spain
| | - Simone Lista
- i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain.
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Yıldırım Ayaz E, Dincer B, Mete E, Kaygusuz Benli R, Cinbaz G, Karacan E, Cankül A, Mesci B. Evaluating the impact of aerobic and resistance green exercises on the fitness, aerobic and intrinsic capacity of older individuals. Arch Gerontol Geriatr 2024; 118:105281. [PMID: 38056100 DOI: 10.1016/j.archger.2023.105281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Our study determined the impact of 12-week aerobic exercise (AE) and aerobic + resistance exercises (AE + RE) within the green exercise concept, on senior fitness, aerobic capacity, and intrinsic capacity (IC). METHODS The study was a multicenter, randomized controlled study conducted at two senior living facilities with individuals aged 65 and above whose cardiorespiratory and musculoskeletal conditions are suitable for moderate exercise and who have normal cognition levels. Block randomization was applied to 96 participants in a ratio of 1:1:1 to be assigned to AE, AE + RE, and control (C) groups. Intervention groups received exercise sessions led by physiotherapists within the senior living facilitiy gardens, with a frequency of once a week for 50 min, for 12 weeks. Also, they were prescribed additional exercise sessions on two additional days of the week. At the commencement of the study and 12th week, shuttle walking test, senior fitness test (SFT), intrinsic capacity assessment (with Timed Up and Go test, Mini Mental State Examination, Geriatric Depression Scale-15, Mini Nutritional Assessment, handgrip strength test) was conducted of all participants. The primary outcome was the Z score of IC, secondary outcomes were VO2max and SFT subparameters. The study was registered in the Protocol Registry and Results System (Clinicaltrials.gov PRS) with the registration number NCT05958745. RESULTS 90 participants successfully completed the study, with 30 individuals in each of the AE, AE + RE, and C groups. By the end of the 12th week, the arm curl score was significantly higher in the AE + RE compared to the C (mean difference: 3.96, 95 % CI= 2.47 to 5.46, p = 0.01). There were significant differences in chair stand, two-minute step, 8-foot up-and-go, chair sit and reach, and back scratch tests in both AE and AE + RE compared to C. AE and AE + RE exhibited significantly higher shuttle test distances and VO2max values compared to the C (p < 0.0001). AE + RE achieved a significantly higher total IC score than the C (mean difference: 0.59, %95 CI= -0.07 to 1.26, p = 0.025). CONCLUSION In this study within the green exercise concept, both AE and AE + RE led to similar improvements in strength, flexibility, mobility, endurance, and aerobic capacity. Notably, AE + RE demonstrated an additional benefit by increasing the total IC, while AE alone did not exhibit the same effect.
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Affiliation(s)
- Elif Yıldırım Ayaz
- University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, Internal Medicine Clinic, Selimiye, Tıbbiye Cd, 34668 Üsküdar, İstanbul Turkey.
| | - Berna Dincer
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Internal Medicine Nursing, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Emel Mete
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Physiothetapy and Rehabilitation, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Reyhan Kaygusuz Benli
- Demiroglu Science University, Health Science Faculty, Department of Physiothetapy and Rehabilitation, Yazarlar St. No:17, 34394 Esentepe Şişli, İstanbul, Turkey
| | - Gülser Cinbaz
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Physiothetapy and Rehabilitation, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Esra Karacan
- Yeditepe University, Health Science Faculty, Department of Physiothetapy and Rehabilitation, Kayışdağı, İnönü Mahallesi, Kayışdağı Cd., 34755 Ataşehir, İstanbul, Turkey
| | - Ayşegül Cankül
- Medipol University Hospital, Internal Medicine and Onkology Clinic, TEM Avrupa Otoyolu Göztepe Çıkışı No:1, 34214, Bağcılar, İstanbul, Turkey
| | - Banu Mesci
- Istanbul Medeniyet University Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Internal Medicine Clinic, Eğitim Mah. Fahrettin Kerim Gökay, Caddesi Kadıköy, İstanbul, Turkey
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16
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Huang ZT, Lai ETC, Luo Y, Woo J. Social determinants of intrinsic capacity: A systematic review of observational studies. Ageing Res Rev 2024; 95:102239. [PMID: 38382677 DOI: 10.1016/j.arr.2024.102239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/07/2024] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND The World Health Organization defined healthy ageing as the maintenance of functional ability with ageing. Intrinsic capacity is a measurement of healthy ageing, and can be shaped by social determinants. However, an overall understanding of how multiple social determinants contribute to intrinsic capacity remains unclear. We aim to summarize observational studies investigating the relationships between social determinants and intrinsic capacity among community-dwelling adults. METHODS A systematic search was conducted through Medline, Embase, PsycInfo, Web of Science, and CINAHL until August 14, 2023. RESULTS After reviewing 813 articles, we included 21 studies from nine countries in Asia, Europe, and America. Seventeen studies used a cross-sectional design and the others were longitudinal studies. Social determinants related to intrinsic capacity can be classified into five domains, containing socioeconomic status (16, 76.2% of studies), lifestyles (14, 66.7%), psychosocial factors (9, 42.9%), material circumstances (4, 19.0%), and healthcare systems (1, 4.8%). Strong evidence supported that better intrinsic capacity was associated with higher education, higher wealth, more physical activities, no smoking, more social engagement, and being married or partnered. The relationships of intrinsic capacity with dietary patterns and alcohol drinking were contradictory across studies. Research on the associations of working status, housing environments, and healthcare accessibility with intrinsic capacity was insufficient to draw conclusions. CONCLUSION These findings highlight roles of socioeconomic status, lifestyles, and psychosocial factors in improving intrinsic capacity thus promoting healthy ageing. Future research is needed to investigate causal relationships between social determinants and intrinsic capacity, especially material circumstances and healthcare systems.
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Affiliation(s)
- Zi-Ting Huang
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Eric T C Lai
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Yan Luo
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Jean Woo
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China; Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
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Zhao Y, Chen Y, Xiao LD, Liu Q, Nan J, Li X, Feng H. Intrinsic capacity trajectories, predictors and associations with care dependence in community-dwelling older adults: A social determinant of health perspective. Geriatr Nurs 2024; 56:46-54. [PMID: 38237340 DOI: 10.1016/j.gerinurse.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 04/05/2024]
Abstract
AIMS To identify intrinsic capacity trajectories, predictors of intrinsic capacity trajectories and associations between intrinsic capacity trajectories and care dependence in community-dwelling older adults in China. METHODS A retrospective longitudinal study was conducted, and the data were obtained from a five-year national longitudinal cohort study of older adults in China between 2011 and 2015. The social determinants of health framework informed the data analysis and interpretation. RESULTS A total of 3893 older adults met the selection criteria and were included in the study. Three intrinsic capacity trajectories were identified: high trajectory (15.7 %), stable trajectory (52.7 %) and declining trajectory (31.6 %). Social determinants contribute to intrinsic capacity decline in older adults. Decreased cognitive function, psychological status, and locomotion at baseline were associated with care dependence. CONCLUSION Approximately thirty percent of the older adults in this cohort study experienced a decline in intrinsic capacity within a 5-year period. Social determinants contributed to this decline in older adults.
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Affiliation(s)
- Yinan Zhao
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Yifei Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Qingcai Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Jiahui Nan
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan province, China; Xiangya-Oceanwide Health Management Research Institute, Central South University, China.
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18
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Shen J, Shi H, Zhang J, Meng X, Zhang C, Kang Y. Household polluting cooking fuels and intrinsic capacity among older population: A harmonized nationwide analysis in India and China. Sci Total Environ 2024; 912:169031. [PMID: 38042204 DOI: 10.1016/j.scitotenv.2023.169031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUNDS Household polluting cooking fuels, as an important changeable behavior, are related to various detrimental health effects among the elderly. There is limited research on the association between polluting cooking fuel use and intrinsic capacity (IC) as an indicator of healthy aging. This study aimed to evaluate the above-mentioned association in India and China, where polluting cooking fuel use is common. METHODS We enrolled 33,803 participants aged ≥60 years from two nationally representative studies: the Longitudinal Aging Study in India and the China Health and Retirement Longitudinal Study. Polluting cooking fuel use was defined as a self-report of using wood, coal, kerosene, crop residue, or dung. IC was measured by five aspects, including locomotion, cognition, vitality, sensory, and psychological capacity. The random-effects mixed linear regression and logistic regression with population weighting were performed. Multivariable-adjusted model and propensity score were used to adjust for potential confounders. RESULTS A total of 47.54 % and 59.32 % of elderly adults reported primary cooking using polluting fuels in India and China, respectively. Using polluting cooking fuels was consistently associated with IC decline; particularly, cognitive capacity was the most susceptible domain. In India, participants using polluting fuels had a 1.062 (95 % confidence interval [CI]: 1.047-1.078) times risk for IC deficits, whereas more prominent results were observed in China (odds ratio [OR]: 2.040, 95 % CI: 1.642-2.533). Such harmful effects might be alleviated by transferring from polluting to clean fuels. Additionally, the duration of polluting fuel use was also positively associated with IC deficits. CONCLUSION This study provided substantial public implications on healthy aging for the elderly population at a global scale, strengthening the importance of health education and policy efforts to accelerate the transition from polluting to clean fuels.
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Affiliation(s)
- Ji Shen
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Hong Shi
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Jie Zhang
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Xue Meng
- Office of National Clinical Research for Geriatrics, Department of Scientific Research, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Yuting Kang
- Office of National Clinical Research for Geriatrics, Department of Scientific Research, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China.
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Pan Y, Li Y, Chhetri JK, Liu P, Li B, Liu Z, Shui G, Ma L. Dysregulation of acyl carnitines, pentose phosphate pathway and arginine and ornithine metabolism are associated with decline in intrinsic capacity in Chinese older adults. Aging Clin Exp Res 2024; 36:36. [PMID: 38345670 PMCID: PMC10861606 DOI: 10.1007/s40520-023-02654-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/03/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND Intrinsic capacity is the combination of individual physical and mental abilities, reflecting the aging degree of the older adults. However, the mechanisms and metabolic characteristics of the decline in intrinsic capacity are still unclear. AIMS To identify metabolic signatures and associated pathways of decline in intrinsic capacity based on the metabolite features. METHODS We recruited 70 participants aged 77.19 ± 8.31 years. The five domains of intrinsic capacity were assessed by Short Physical Performance Battery (for mobility), Montreal cognition assessment (for cognition), 30-Item Geriatric Depression Scale (for psychology), self-reported hearing/visual impairment (for sensory) and Nutritional risk screening (for vitality), respectively. The serum samples of participants were analyzed by liquid chromatography-mass spectrometry-based metabolomics, followed by metabolite set enrichment analysis and metabolic pathway analysis. RESULTS There were 50 participants with a decline in intrinsic capacity in at least one of the domains. A total of 349 metabolites were identified from their serum samples. Overall, 24 differential metabolites, 5 metabolite sets and 13 pathways were associated with the decline in intrinsic capacity. DISCUSSION Our results indicated that decline in intrinsic capacity had unique metabolomic profiles. CONCLUSION The specific change of acyl carnitines was observed to be a feature of decline in intrinsic capacity. Dysregulation of the pentose phosphate pathway and of arginine and ornithine metabolism was strongly associated with the decline in intrinsic capacity.
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Affiliation(s)
- Yiming Pan
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Research Center for Geriatric Medicine, 45 Changchun Street, Beijing, 100053, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Yun Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Research Center for Geriatric Medicine, 45 Changchun Street, Beijing, 100053, China.
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
| | - Jagadish K Chhetri
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Research Center for Geriatric Medicine, 45 Changchun Street, Beijing, 100053, China
- Department of Neurology and Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Pan Liu
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Research Center for Geriatric Medicine, 45 Changchun Street, Beijing, 100053, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Bowen Li
- LipidALL Technologies Company Limited, Changzhou, 213022, Jiangsu, China
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics, Second Affiliated Hospital and Department of Big Data in Health Science, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Guanghou Shui
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Research Center for Geriatric Medicine, 45 Changchun Street, Beijing, 100053, China.
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
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Angelsen A, Nakrem S, Zotcheva E, Strand BH, Strand LB. Health-promoting behaviors in older adulthood and intrinsic capacity 10 years later: the HUNT study. BMC Public Health 2024; 24:284. [PMID: 38267907 PMCID: PMC10809656 DOI: 10.1186/s12889-024-17840-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/22/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND With the global population growing older, there is a need for more knowledge of how to improve and/or maintain functional capacities to promote healthy ageing. In this study we aimed to assess the effect of several known health-promoting behaviors in old age with intrinsic capacity ten years later. METHODS This was a prospective cohort study looking at participants that were ≥ 65 years at the time of the third wave of the Trøndelag Health Study (HUNT3, 2006-2008) who also took part in the 70 + sub-study of the fourth wave (HUNT4 70+, 2017-2019). Self-reported behavior data from short questionnaires, including diet and physical activity, were collected in HUNT3, and data on the five domains of intrinsic capacity defined by the World Health Organization were collected in HUNT4 70+. A composite index was created for both healthy life and intrinsic capacity, awarding points for how well participants adhered to guidelines for healthy living and their level of functional impairment, respectively. Ordinal logistic regression was used to assess the relationship between health-promoting behaviors and intrinsic capacity. RESULTS Of 12,361 participants in HUNT3 ≥ 65 years, 4699 (56.5% women) also participated in HUNT4 70+. On the health-promoting behaviors, lowest adherence to healthy living guidelines were seen for fruit and vegetables intake (47.2%), milk intake (46.7%) and physical activity (31.1%). On intrinsic capacity domains, highest impairment was seen in the domains of locomotion (29.7%), hearing (11.1%) and vitality (8.3%). A higher adherence to guidelines for healthy living was associated with higher intrinsic capacity 10 years later. A one-point increase in the healthy life index was associated with a 1.15 (95% confidence interval 1.10-1.21) times increased odds of being in a higher intrinsic capacity category. CONCLUSION Health-promoting behaviors in old age are associated with better intrinsic capacity ten years later. In clinical settings assessment of health-promoting behaviors could potentially be done using short questionnaires.
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Affiliation(s)
- Aslaug Angelsen
- Norwegian University of Science and Technology, Trondheim, Norway.
| | - Sigrid Nakrem
- Norwegian University of Science and Technology, Trondheim, Norway
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Blanco-Rambo E, Bandeira-Guimarães M, Rambo ES, Formighieri C, Steffens T, Cadore EL, Pietta-Dias C. Effects of social distancing provoked by COVID-19 pandemic in the functional capacity and cognitive function in nonagenarians and centenarians. J Bodyw Mov Ther 2024; 37:46-50. [PMID: 38432840 DOI: 10.1016/j.jbmt.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/02/2023] [Accepted: 11/11/2023] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Due to the rapid advance of coronavírus SARS-CoV-2 (COVID-19) pandemic in 2020, social distancing was the main way to reduce the transmission of the virus. Although this measure was efficient and necessary, the social distancing had severe consequences for physical function, mainly in older individuals. Thus, the aim of this study was to investigate the effects of social distancing in the functional and cognitive capacity of community-dwelling oldest-old adults. METHODS The present study is part of a larger prospective cohort study. Fifteen participants aged 90 years old or older were assessed in the 8-foot-timed-up-and-go test (8-footTUG), sit-to-stand-up test (STS), handgrip strength test (HGS), Mini Mental State Examination (MMSE), Katz Index and Lawton Scale before and after one year of social distancing. RESULTS A significant worsening in the 8-footTUG and MMSE score was observed, while there were no significant changes in the other variables. When analyzing the decreases in relation to previous functional capacity, it was observed that individuals categorized as dependent by STS cut-off points had the worst decreases in functional capacity. CONCLUSION The social distancing provoked by COVID-19 pandemic negatively affected the 8-footTUG and cognition. Moreover, individuals dependents showed greater decline in their functional capacity.
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Affiliation(s)
- Eduarda Blanco-Rambo
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Marcelo Bandeira-Guimarães
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Elias Scholl Rambo
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Formighieri
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Tainara Steffens
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo Lusa Cadore
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Caroline Pietta-Dias
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Chen ZJ, Tang FP, Chang SY, Chung HL, Tsai WH, Chou SS, Yeh HC, Tung HH. Resilience-happiness nexus in community-dwelling middle-aged and older adults: Results from Gan-Dau Healthy Longevity Plan. Arch Gerontol Geriatr 2024; 116:105162. [PMID: 37598465 DOI: 10.1016/j.archger.2023.105162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023]
Abstract
The core of healthy aging is intrinsic capacity (IC) that consists of major elements, i.e., cognition, locomotion, vitality, sensory capacity, and psychological aspect. This cross-sectional study analyzes data of the Gan-Dau Healthy Longevity Plan, targeting community-dwelling adults aged 50 years or older. The participants completed the assessment, in addition to WHO IC, including the Mini-Mental Status Examination (MMSE) for cognitive performance, 6 m walking speed (m/s),timed up-and-go test (s) and hand grip strength (Kg) for locomotor assessment, Cardiovascular health study (CHS) for frailty assessment, Mini Nutrition assessment short form (MNA-SF) for nutrition. Psychological aspect including the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Geriatric Depression Scale-5 (GDS-5) for depressive symptoms, the Brief Resilience Scale (BRS) for resilience, and the Chinese Happiness Inventory (CHI) for happiness levels. The study enrolled 810 participants (mean age of 68.45 ± 8.05 years, 32% male) and revealed that 94.7% of participants exhibited impairments in IC, with visual capacity and cognition being the most common deficit items of IC. Resilience levels varied, with 37.4% of men and 33.5% of women exhibiting moderate to low resilience. Only 23.4% of male participants and 21.1% female participants reported a high level of happiness. Resilience was found to partially mediate the relationship between intrinsic capacity and happiness, with approximately 6.6% of the variance in happiness being mediated by resilience. In conclusion, the study provides valuable insights into the connections between psychological aspect, IC, and healthy aging.
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Affiliation(s)
- Zhi-Jun Chen
- Global Research & Industry Alliance, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; Center for Healthy Longevity and Aging Sciences, Tungs' Taichung MetroHarbor Hospital, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Beitou Dist., Taipei 112, Taiwan, ROC
| | - Fong-Ping Tang
- Department of Nursing, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan, ROC
| | - Su-Yu Chang
- Department of Nursing, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan, ROC
| | - Hsiu-Ling Chung
- Department of Nursing, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan, ROC
| | - Wen-Huey Tsai
- Center for Administration and Management, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan, ROC
| | - Shin-Shang Chou
- Vice Superintendent Office, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan, ROC
| | - Hsiao-Chien Yeh
- Department of Nursing, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan, ROC
| | - Heng-Hsin Tung
- Center for Healthy Longevity and Aging Sciences, Tungs' Taichung MetroHarbor Hospital, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Beitou Dist., Taipei 112, Taiwan, ROC; Department of Nursing, National Yang Ming Chiao Tung University, Taipei 112, Taiwan, ROC.
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23
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da Silva JA, Martinez LO, Rolland Y, Najib S, Croyal M, Perret B, Jabrane-Ferrat N, El Costa H, Guyonnet S, Vellas B, de Souto Barreto P. Plasma Level of ATPase Inhibitory Factor 1 and Intrinsic Capacity in Community-Dwelling Older Adults: Prospective Data From the MAPT Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad142. [PMID: 37280149 DOI: 10.1093/gerona/glad142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Intrinsic capacity (IC) is a concept related to functionality that reflects healthy aging. ATPase inhibitory factor 1 (IF1) is a multifaceted protein that regulates mitochondrial oxidative phosphorylation (OXPHOS), and may be involved in IC. The objective of this study is to investigate the association between plasma levels of IF1 and IC changes in community-dwelling older adults. METHODS Community-dwelling older adults from the Multidomain Alzheimer Preventive Trial (MAPT Study) were enrolled in this study. A composite IC score was calculated based on 4 IC domains: locomotion, psychological dimension, cognition, and vitality (with data available annually over 4 years of follow-up). Secondary analyses were conducted on the sensory domain (with data available only for 1 year of follow-up). Mixed-model linear regression adjusted for confounders was conducted. RESULTS A total of 1 090 participants with usable IF1 values were included in the study (75.3 ± 4.4 years; 64% females). Compared to the lowest quartile, both the low- and high-intermediate IF1 quartiles were found to be cross-sectionally associated with greater composite IC scores across 4 domains (βlow-intermediate, 1.33; 95% confidence interval [CI] 0.06-2.60 and βhigh-intermediate, 1.78; 95% CI 0.49-3.06). In the secondary analyses, the highest quartile was found to be associated with a slower decline in composite IC scores across 5 domains over 1 year (βhigh 1.60; 95% CI 0.06-3.15). The low- and high-intermediate IF1 quartiles were also found to be cross-sectionally associated with greater locomotion (βlow-intermediate, 2.72; 95% CI 0.36-5.08) and vitality scores (βhigh-intermediate, 1.59; 95% CI 0.06-3.12), respectively. CONCLUSIONS This study is the first to demonstrate that levels of circulating IF1, a mitochondrial-related biomarker, are associated with IC composite scores in both cross-sectional and prospective analyses among community-dwelling older adults. However, further research is needed to confirm these findings and elucidate the potential underlying mechanisms that may explain these associations.
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Affiliation(s)
- Jaqueline Aragoni da Silva
- Institut du Vieillissement, Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Laurent O Martinez
- LiMitAging, Institut des Maladies Métaboliques et Cardiovasculaires, I2MC, Université de Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Yves Rolland
- Institut du Vieillissement, Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Souad Najib
- LiMitAging, Institut des Maladies Métaboliques et Cardiovasculaires, I2MC, Université de Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Mikaël Croyal
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du Thorax, BioCore, US16, SFR Bonamy, F-44000 Nantes, France
- CRNH-Ouest Mass Spectrometry Core Facility, Nantes, France
| | - Bertrand Perret
- LiMitAging, Institut des Maladies Métaboliques et Cardiovasculaires, I2MC, Université de Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Nabila Jabrane-Ferrat
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), INSERM-CNRS-University Toulouse III, Toulouse, France
| | - Hicham El Costa
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), INSERM-CNRS-University Toulouse III, Toulouse, France
| | - Sophie Guyonnet
- Institut du Vieillissement, Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Bruno Vellas
- Institut du Vieillissement, Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Philipe de Souto Barreto
- Institut du Vieillissement, Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
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Yu J, Jin Y, Si H, Bian Y, Liu Q, Li Y, Wang C. Relationship between intrinsic capacity and health-related quality of life among community-dwelling older adults: the moderating role of social support. Qual Life Res 2024; 33:267-280. [PMID: 37845404 DOI: 10.1007/s11136-023-03520-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To examine how social support might moderate the relationship between intrinsic capacity and health-related quality of life (HRQoL) based on the buffering model of social support. METHODS This was a cross-sectional study with a sample of 1181 Chinese community-dwelling older adults aged ≥ 60 years in 2016. Social support was assessed using the Social Support Rating Scale. Intrinsic capacity was assessed using the revised integrated care for older people screening tool. HRQoL was measured by the 12-item Short Form Health Survey. Hierarchical linear regression analysis was implemented to test the moderating effect of social support. RESULTS Support utilization attenuated the relationship between lower intrinsic capacity and poor physical HRQoL while subjective support attenuated the relationship between lower intrinsic capacity and poor mental HRQoL. However, objective support had no significant moderating effect on the relationship between intrinsic capacity and specific domains of HRQoL. CONCLUSION The moderating effects of social support on the association between intrinsic capacity and HRQoL vary by support types. Effective interventions should target the perception and utilization of available support among older adults with lower intrinsic capacity to maintain their physical and mental HRQoL.
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Affiliation(s)
- Jiaqi Yu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaru Jin
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Huaxin Si
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yanhui Bian
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Qinqin Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yanyan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Cuili Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Li X, Ma L. From biological aging to functional decline: Insights into chronic inflammation and intrinsic capacity. Ageing Res Rev 2024; 93:102175. [PMID: 38145874 DOI: 10.1016/j.arr.2023.102175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 12/27/2023]
Abstract
Intrinsic capacity is the sum of an individual's physical and mental capacities, which helps determine functional ability. Intrinsic capacity decline is an important predictor of adverse health outcomes and can identify individuals at higher risk of functional decline. Aging is characterized by a decrease in physiological reserves and functional abilities. Chronic inflammation, a mechanism of aging, is associated with decreased intrinsic capacity, which may mirror the broader relationship between aging and functional ability. Therefore, it is crucial for maintaining functional ability and promoting healthy aging to study the mechanisms of intrinsic capacity decline, identify easily available markers, and make targets for intervention from the perspective of chronic inflammation. We reviewed the current research on chronic inflammation, inflammation-related markers, and intrinsic capacity. To date, there is still no inflammatory markers with high specificity and sensitivity to monitor intrinsic capacity decline. Interleukin-6, C-reactive protein, and tumor necrosis factor-alpha may potentially indicate changes in intrinsic capacity, but their results with intrinsic capacity or each intrinsic capacity domain are inconsistent. Considering the variations in individual responses to changes in inflammatory markers, it may be beneficial to explore the use of multiple analytes instead of relying on a single marker. This approach could be valuable in monitoring the decline of intrinsic capacity in the future.
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Affiliation(s)
- Xiaxia Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China.
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Hu FW, Yueh FR, Fang TJ, Chang CM, Lin CY. Testing a Conceptual Model of Physiologic Reserve, Intrinsic Capacity, and Physical Resilience in Hospitalized Older Patients: A Structural Equation Modelling. Gerontology 2023; 70:165-172. [PMID: 37995668 DOI: 10.1159/000535413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION The relationship among physiologic reserve, intrinsic capacity, and physical resilience has not been examined, and a conceptual model that includes these key determinants of healthy ageing is needed. This study aimed to test a conceptual model using real-world data to determine the relationships among physiologic reserve, intrinsic capacity, physical resilience, and clinical outcomes. METHODS This longitudinal study was conducted at a 1,343-bed tertiary-care medical centre. Patients were eligible for inclusion if they were 65 years of age or older and able to communicate independently. Demographic factors, cumulative illness rating scale for geriatrics [CIRS-G] (assessing physiologic reserve), intrinsic capacity, physical resilience instrument for older adults [PRIFOR] (assessing physical resilience), and clinical frailty scale [CFS] were collected at admission. The CFS and EuroQoL 5-dimension 3-level questionnaire [EQ5D] were administered at discharge. RESULTS The mean age of the 413 patients was 76.34 ± 6.72 (52.5% female). Two conceptual models were identified and supported. Specifically, the path coefficients in the two models showed that the CIRS-G had diverse associations with each intrinsic capacity domain, and that all intrinsic capacity domains (except vitality) were significantly associated with PRIFOR. Moreover, PRIFOR was significantly associated with follow-up CFS, baseline control, and EQ5D scores. CONCLUSION Physiologic reserve positively correlated with the cognitive and locomotive domains of intrinsic capacity. Moreover, older patients with better intrinsic capacity may have improved physical resilience, which may lead to better clinical outcomes. Efforts to improve the intrinsic capacity and physical resilience of older patients are necessary to promote healthy ageing.
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Affiliation(s)
- Fang-Wen Hu
- School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan,
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,
| | - Fang-Ru Yueh
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu-Jung Fang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Geriatrics and Gerontology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Ming Chang
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Muñoz-Redondo E, Morgado-Pérez A, Pérez-Sáez MJ, Pascual J, Tejero-Sánchez M, Curbelo YG, Terradellas-Fernández M, Meza-Valderrama D, Vázquez-Ibar O, Annweiler C, Sánchez-Rodríguez D, Marco E. New perspectives on frailty in light of the Global Leadership Initiative on Malnutrition, the Global Leadership Initiative on Sarcopenia, and the WHO's concept of intrinsic capacity: A narrative review. Maturitas 2023; 177:107799. [PMID: 37499428 DOI: 10.1016/j.maturitas.2023.107799] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
This review gathered the evidence on the epidemiology of frailty, as well as on screening and diagnostic tools, and new perspectives, in light of the latest global frameworks in malnutrition, sarcopenia, and the World Health Organization's concept of intrinsic capacity. Frailty is a worldwide health challenge and highly prevalent in older adults and the population with chronic diseases independent of age. Regardless of the particular concept of frailty, many screening and diagnostic tools are able to identify frailty in older people, but none of them has shown superiority in every population and healthcare setting. Physical, cognitive, and social components are part of the larger context of frailty. The latest evidence-based initiatives on frailty recommend the use of validated tools to identify frailty's different components, tailored to the needs of specific populations and healthcare systems. Unintentional weight loss is a shared criterion between physical frailty and malnutrition according to the Global Leadership Initiative on Malnutrition criteria. A new definition of sarcopenia by the Global Leadership Initiative on Sarcopenia is awaited, but at present physical frailty shares with sarcopenia the criteria of low muscle function and physical performance (severity grading) according to the revised consensus of the European Working Group on Sarcopenia in Older People (EWGSOP2). The EWGSOP2 includes both muscle mass and function, with most scientific groups agreeing that function is a key hallmark of sarcopenia. The concept of intrinsic capacity features the reserves and positive aspects of aging, and responds to ageism by addressing the deficit model approach. Intrinsic capacity is an emerging, person-centered and public health indicator, aimed at preserving health at mid-life and beyond, to move towards a better aging process in the Decade of Healthy Aging 2020-2030.
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Affiliation(s)
- Elena Muñoz-Redondo
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Andrea Morgado-Pérez
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - María José Pérez-Sáez
- Nephrology Department, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08003 Barcelona, Spain
| | - Julio Pascual
- Nephrology Department, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08003 Barcelona, Spain; Nephrology Department, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain
| | - Marta Tejero-Sánchez
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Yulibeth G Curbelo
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Marc Terradellas-Fernández
- Tecnocampus, Universitat Pompeu Fabra, Research group in Attention to Chronicity and Innovation in Health (GRACIS), Carrer d'Ernest Lluch, 32, 08302 Mataró, Barcelona, Spain
| | - Delky Meza-Valderrama
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation (INMFRE), City 0819, Panama; Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019 Barcelona, Spain
| | - Olga Vázquez-Ibar
- Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019 Barcelona, Spain; Faculty of Medicine, Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Dolores Sánchez-Rodríguez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium; WHO Collaborating Center for Public Health aspects of musculoskeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Campus Sart Tilman, Avenue Hippocrate (Bât 23), 4000 Liège, Belgium.
| | - Ester Marco
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Faculty of Medicine, Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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Jiang X, Chen F, Yang X, Yang M, Zhang X, Ma X, Yan P. Effects of personal and health characteristics on the intrinsic capacity of older adults in the community: a cross-sectional study using the healthy aging framework. BMC Geriatr 2023; 23:643. [PMID: 37817083 PMCID: PMC10566030 DOI: 10.1186/s12877-023-04362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Intrinsic capacity (IC) can better reflect the physical functioning of older adults. However, few studies have been able to systematically and thoroughly examine its influencing factors and provide limited evidence for the improvement of intrinsic capacity. The objective of this study was to provide a comprehensive description of the overall decline in intrinsic capacity among older persons in the community. Additionally, the study aimed to analyze the composition of the five domains of reduction, compare the rate of decline among older adults and investigate the factors that influence this decline. METHODS This was a cross-sectional study conducted in the Chinese community. The self-designed general characteristics questionnaire was created based on the healthy aging framework and a systematic review. Intrinsic capacity was assessed with the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), Community Health Record Management System (CHRMS), Mini Nutritional Assessment Brief Form (MNA-SF), and Short Physical Performance Battery (SPPB). The influencing factors of intrinsic capacity were investigated using stepwise logistic regression. RESULTS A total of 968 older adults with a mean age of 71.00 (68.00, 76.75) were examined, and 704 older adults (72.7%) showed a decline in intrinsic capacity. There was a decline in at least one domain in 39.3% of older adults, with reductions in each domain ranging from 5.3% (psychological) to 52.4% (sensory). The study examined the composition of domains that experienced a decline in intrinsic capacity. It was found that a combination of sensory and locomotor domains showed the most significant decrease in 44.5% (n = 106) of individuals who experienced a decline in the two domains. Furthermore, a combination of sensory, cognitive, and locomotor domains exhibited a significant decrease in 51.3% (n = 44) of individuals who experienced a reduction in three domains. Lastly, a combination of sensory, vitality, cognitive, and locomotor domains showed the most significant decline in four domains, accounting for 60.0% (n = 15) of the population. Older adults had a higher risk of intrinsic capacity decline if they were older (95% CI:1.158-2.310), had lower education, lived alone (95% CI: 1.133-3.216), smoked (95% CI: 1.163-3.251), high Charlson Comorbidity Index (95% CI: 1.243-1.807) scores, did not regular exercise (95% CI:1.150-3.084), with lower handgrip strength (95% CI: 0.945-0.982). CONCLUSIONS We found a relatively high prevalence of intrinsic capacity; more attention should be paid to older adults who are older, less educated, live alone, and have more comorbidities. It is imperative to prioritize a healthy lifestyle among older persons who exhibit smoking habits, lack regular exercise, and possess inadequate handgrip strength.
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Affiliation(s)
- Xin Jiang
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China
| | - Fenghui Chen
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China
| | - Xuanxuan Yang
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China
| | - Mei Yang
- Xingfu Road Branch of Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University (Xingfu Road Community Center), No.226, Xingfu Road, Tianshan District, Urumqi, 830002, China
| | - Xuehong Zhang
- Xingfu Road Branch of Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University (Xingfu Road Community Center), No.226, Xingfu Road, Tianshan District, Urumqi, 830002, China
| | - Xuan Ma
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China
| | - Ping Yan
- Nursing College of Xinjiang Medical University, No.567, Shangde North Road, Shuimogou District, Urumqi, 830017, China.
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Zhang N, Zhang H, Sun MZ, Zhu YS, Shi GP, Wang ZD, Wang JC, Wang XF. Intrinsic capacity and 5-year late-life functional ability trajectories of Chinese older population using ICOPE tool: the Rugao Longevity and Ageing Study. Aging Clin Exp Res 2023; 35:2061-2068. [PMID: 37460764 DOI: 10.1007/s40520-023-02489-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/27/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND AND AIMS Knowledge of how intrinsic capacity (IC) shape functional ability (FA) trajectories in later life remains unclear. We investigated the changes in IC and their impact on 5-years FA trajectories in the Chinese older population. METHODS A total of 1640 older adults from the Rugao Longitudinal Ageing Study were included and analyzed. FA was assessed by The Lawton Instrumental Activities of Daily Living Scale (IADLs). We used cognition, psychology, locomotion, sensory capacity, and vitality to capture the multiple domains of IC according to the ICOPE method. The IC was derived retrospectively from variables collected before this was described by WHO. RESULTS At baseline, a higher IC was associated with higher IADLs (β = 0.98, 95% CI 0.90, 1.06, P < 0.001). Individuals with declines in IC between wave1 and wave2 experienced a faster decline in IADLs over time (β = - 0.28, 95% CI - 0.40, - 0.16, P < 0.001) after considering covariates. One or more impairment IC scores at baseline strongly predicted death (HR = 1.20, 95% CI 1.11, 1.30, P < 0.001). In addition, according to the IC scores at baseline, we stratify IC in low, middle, and high, compared with those in the high IC score, those in the low were associated with a 2.56-fold (95% CI 1.64, 4.01, P < 0.001) higher risk of mortality, after adjustment for variables. CONCLUSION Changes in IC shape FA trajectories. IC impairment is associated with an increased risk of death. Assessing intrinsic capacity would facilitate early identification of older adults at high risk of adverse outcomes and prompt targeted interventions.
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Affiliation(s)
- Na Zhang
- MOE Key Laboratory of Contemporary Anthropology and School of Life Science and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Hui Zhang
- Zhangjiang Fudan International Innovation Centre, Human Phenome Institute, Fudan University, Shanghai, China
| | - Meng-Zhen Sun
- Zhangjiang Fudan International Innovation Centre, Human Phenome Institute, Fudan University, Shanghai, China
| | | | | | | | - Jiu-Cun Wang
- MOE Key Laboratory of Contemporary Anthropology and School of Life Science and Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
- Zhangjiang Fudan International Innovation Centre, Human Phenome Institute, Fudan University, Shanghai, China.
| | - Xiao-Feng Wang
- MOE Key Laboratory of Contemporary Anthropology and School of Life Science and Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
- Zhangjiang Fudan International Innovation Centre, Human Phenome Institute, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 201203, China.
- Department of Epidemiology, Human Phenome Institute, Fudan University, Shanghai, China.
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Liu Y, Du Q, Jiang Y. Detection rate of decreased intrinsic capacity of older adults: a systematic review and meta-analysis. Aging Clin Exp Res 2023; 35:2009-2017. [PMID: 37543528 DOI: 10.1007/s40520-023-02515-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/20/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVES To systematically assess the prevalence of decreased intrinsic capacity in older adults, stratified by relevant factors such as country, sex, sample source, and region. METHODS We conducted a comprehensive search of PubMed, Web of Science, EMBASE, The Cochrane Library, PsychINFO, CINAHL, China Knowledge Resource Integrated Database, Wanfang Database, Weipu Database, and Chinese Biomedical Database to collect studies published on the decline of intrinsic capacity in older adults before February 24, 2023. The results of the study were analyzed using the Stata 15.0 software package, using a random-effects model to estimate the pooled detection rate of decreased intrinsic capacity in older adults. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of all included studies. RESULTS A total of 16 studies (67,881 older adults in 4 countries) were included. The results showed that the pooled detection rate of decreased intrinsic capacity in older adults was 76.1% (95% CI: 68.0%-84.2%). The 16 studies had obvious heterogeneity, and further subgroup analysis showed that the detection rate of decreased intrinsic capacity in older adults was higher in developed countries, females, and hospitals. Thirteen studies found that the pooled detection rate was 73.7% (95%: CI 64.5%-82.8%) for decreased intrinsic capacity in Chinese older adults, with higher rates in mainland China and Hong Kong than in Taiwan. CONCLUSIONS Our study suggests that intrinsic capacity declines more rapidly in older adults. Understanding the degree of decline in the intrinsic capacity of older adults will help to provide an important basis for the formulation and development of care policies for older adults. TRIAL REGISTRATION NUMBER PROSPERO (CRD42023402680).
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Affiliation(s)
- Yaxin Liu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Sichuan Province, 611137, Chengdu City, China
| | - Qiufeng Du
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Sichuan Province, 611137, Chengdu City, China
| | - Yunlan Jiang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Sichuan Province, 611137, Chengdu City, China.
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-Qiao Road, Chengdu City, 610072, Sichuan Province, China.
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Sanchez-Rodriguez D, Demonceau C, Bruyère O, Cavalier E, Reginster JY, Beaudart C. Intrinsic capacity and risk of death: Focus on the impact of using different diagnostic criteria for the nutritional domain. Maturitas 2023; 176:107817. [PMID: 37573805 DOI: 10.1016/j.maturitas.2023.107817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/04/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE We aimed to estimate the ability of intrinsic capacity (IC) to predict death in community-dwelling older people using different diagnostic criteria to define the nutritional domain. METHODS Participants from the Belgian SarcoPhAge cohort were followed from 2013 to the present. Four IC domains were assessed at baseline (data on the sensorial domain were not collected), and considered unsatisfactory below some specific thresholds. The nutritional domain was considered unsatisfactory if baseline malnutrition was present, defined by: 1) MNA-SF ≤11 points; 2) seven versions of the GLIM criteria, varying by the technique used to identify a reduced muscle mass; or 3) the combination of MNA-SF ≤11 points + GLIM criteria. The association between baseline unsatisfactory IC and 9-year mortality was calculated using the odds ratio (OR) adjusted for cofounders. RESULTS Among the 534 participants (73.5 ± 6.2 years old; 60.3 % women at baseline), 157 (29.4 %) were dead after 9.3 ± 0.3 years of follow-up. Patients with baseline unsatisfactory IC in the locomotor domain (adjusted OR = 2.31 [95%CI 1.38-3.86]) or psychological domain (adjusted OR = 1.78 [1.12-2.83]) were at higher mortality risk. Regarding malnutrition, unsatisfactory IC in the nutrition domain was strongly associated with a higher mortality risk, whatever the criteria used to identify a reduced muscle mass. The highest association with mortality was found in participants with a baseline unsatisfactory nutritional domain defined by the combination of MNA-SF + GLIM criteria (adjusted OR = 3.27 [95%CI 1.72-6.23]). CONCLUSIONS Presenting any unsatisfactory IC at baseline was associated with a higher 9-year mortality risk in community-dwelling older people. The sequential incorporation of MNA-SF and GLIM criteria as the IC nutritional domain would be helpful to guide public health actions towards healthy ageing.
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Affiliation(s)
- D Sanchez-Rodriguez
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium; Geriatrics Department, Parc Salut Mar, Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.
| | - C Demonceau
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - O Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - E Cavalier
- Department of Clinical Chemistry, University of Liège, CHU - Sart Tilman, Liège, Belgium
| | - J-Y Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - C Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Department of Health Services Research, University of Maastricht, Maastricht, the Netherlands
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Chang YH, Chen YC, Ku LJE, Chou YT, Chen HY, Su HC, Liu CH, Wu YL, Cheng HJ, Yang YC, Li CY. Association between sleep health and intrinsic capacity among older adults in Taiwan. Sleep Med 2023; 109:98-103. [PMID: 37423025 DOI: 10.1016/j.sleep.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/11/2023] [Accepted: 06/17/2023] [Indexed: 07/11/2023]
Abstract
Although the association between poor sleep quality and frailty has been previously reported, the relationship between sleep health and intrinsic capacity (IC) remains largely unknown. We aimed to examine the association between sleep health and IC among older adults. This was a cross-sectional study, and 1268 eligible participants completed a questionnaire collecting information on demographic, socioeconomic, lifestyle, sleep health, and IC. Sleep health was measured by the RU-SATED V2.0 scale. High, moderate, and low levels of IC were defined using the Integrated Care for Older People Screening Tool for Taiwanese. The ordinal logistic regression model estimated the odds ratio and corresponding 95% confidence interval. Low IC was significantly associated with age of 80 years or above, female, currently unmarried, uneducated, currently not working, financially dependent, and having emotional disorders. A one-point increase in sleep health was significantly associated with a 9% reduction in the odds of poor IC. An increase in daytime alertness was related to the greatest reduction in poor IC (aOR, 0.64; 95% CI, 0.52-0.79). In addition, the subitems sleep regularity (aOR, 0.77; 95% CI, 0.60-0.99), sleep timing (aOR, 0.80; 95% CI, 0.65-0.99), and sleep duration (aOR, 0.77; 95% CI, 0.61-0.96) were associated with a reduced OR of poor IC but with marginal statistical significance. Our findings showed that sleep health across multiple dimensions is related to IC, particularly daytime alertness in older adults. We suggest developing interventions to improve sleep health and prevent IC decline, which is crucial in causing poor health outcomes.
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Affiliation(s)
- Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Yen-Chin Chen
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Tsung Chou
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Yu Chen
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Chen Su
- Department of Neurology, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chieh-Hsiu Liu
- Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiang-Ju Cheng
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Ng TP, Gwee X, Chua DQL, Wee SL, Cheong CY, Yap PLK, Yap KB. The Healthy Ageing Questionnaire Index: Validation in the Singapore Longitudinal Ageing Study. Gerontology 2023; 69:1358-1367. [PMID: 37640015 DOI: 10.1159/000533635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Healthy ageing (HA) indices typically use full questionnaire, performance- or blood-based assessment of functional ability which are time-consuming and resource-intensive. We developed and validated a simple and brief Healthy Ageing Questionnaire (HAQ) index with comparable measurement accuracy. METHODS The 15-item HAQ (scored 0-100) was developed using data of 500 participants in the Singapore Study of Successful Ageing (SSOSA), a sub-cohort of the Singapore Longitudinal Ageing Study (SLAS-2). Its construct, concurrent, and predictive validity were evaluated in 2,161 participants in the SLAS-2 who were non-participants of the SSOSA. RESULTS The HAQ index (mean = 64.0, SD = 11.8) showed a coherent 3-factor structure (Cronbach's alpha = 0.735). HAQ scores were higher among participants who were female, highly educated, not living alone, non-smoking, non-alcohol drinkers, not at risk of malnutrition, were robust or pre-frail, not disabled, had no or <5 medical conditions, and no recent fall or hospitalization. It was positively correlated with Mini-Mental State Examination and life satisfaction, and negatively correlated with age, logMAR vision, 5 times sit-and-stand, and timed-up-and-go. The HAQ index was significantly correlated but showed modest concordance with the Rowe-Kahn SA index. Increasing HAQ index quintiles were associated with decreased mortality risks from 40.6 to 9.7 deaths per 1,000 person-years; covariate-adjusted hazard ratio for the highest Q5 levels (HAQ score >70) was 0.44 (95% CI = 0.28-0.67). Using receiver operating characteristics analysis of predictive accuracy for survival, the area under the curve of HAQ was 0.675, and Rowe-Kahn SA index was 0.660 (p = 0.361). CONCLUSION The HAQ is a brief and accurate HA index that is potentially useful across diverse settings and purposes in research, healthcare, and policy-making.
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Affiliation(s)
- Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Denise Q L Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shiou Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Chin Yee Cheong
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Philip Lin Kiat Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Keng Bee Yap
- Department of Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
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Lu F, Li J, Liu X, Liu S, Sun X, Wang X. Diagnostic performance analysis of the Integrated Care for Older People (ICOPE) screening tool for identifying decline in intrinsic capacity. BMC Geriatr 2023; 23:509. [PMID: 37612657 PMCID: PMC10463906 DOI: 10.1186/s12877-023-04180-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Intrinsic capacity (IC) is a comprehensive indicator of an individual's positive attributes. The World Health Organization (WHO) recommends a two-step approach to assess IC decline among older people. The first step involves the used of the integrated care for older people (ICOPE) screening tool to identify potential issues, and the second step involves using detailed assessments for confirmation. This study aimed to assess the diagnostic performance of the ICOPE screening tool as a simple preliminary screening to identify IC decline among community-dwelling older people, which has been rarely reported in China. METHODS This cross-sectional study included 228 community-dwelling older individuals aged ≥ 75 (mean age, 84.0 ± 4.4 years; 131 [57.5%] females) who completed the IC evaluation according to the WHO IC assessment pathway. The diagnostic performance of the ICOPE screening tool was calculated using a 2 × 2 table and a receiver operating characteristic curve. RESULTS The proportion of possible IC decline identified by the ICOPE screening tool was 79.4%, whereas the actual IC decline assessed by the detailed assessment was 73.2%, mainly in locomotion. The ICOPE screening tool showed sensitivity and specificity of 94.6% and 62.3%, respectively, with an overall diagnostic accuracy of 86.0%. The diagnostic effectiveness of the ICOPE screening tool was 0.91 (95% confidence interval: 0.87-0.95, p = 0.020). Except for the sensory dimension, the sensitivity of the ICOPE screening tool for diagnosing impairments in each dimension of the IC was the highest in the cognition domain (100%) and the lowest in the vitality domain (51.3%), whereas the specificity was the highest in vitality (94.7%) and the lowest in cognition (55.6%). CONCLUSIONS The ICOPE screening tool exhibits high sensitivity and can be used as an IC screening tool in community-dwelling older people. However, further improvements are needed in the vitality dimension of the ICOPE screening tool to enhance its sensitivity in identifying individuals at risk of malnutrition.
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Affiliation(s)
- Fei Lu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China
| | - Jiaojiao Li
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China
| | - Xiaohong Liu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China.
| | - Shuo Liu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China
| | - Xiaohong Sun
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China
| | - Xueying Wang
- Yanyuan Rehabilitation Hospital, No.2, Jingrong Street, Nanshao Town, Changping District, Beijing, China
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Nagae M, Umegaki H, Komiya H, Nakashima H, Fujisawa C, Watanabe K, Yamada Y, Miyahara S. Intrinsic capacity in acutely hospitalized older adults. Exp Gerontol 2023; 179:112247. [PMID: 37380006 DOI: 10.1016/j.exger.2023.112247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES We aimed to examine the association between intrinsic capacity (IC) and adverse outcomes of hospitalization. DESIGN A prospective observational cohort study. SETTING AND PARTICIPANTS We recruited patients aged 65 years or older who were admitted to the geriatric ward of an acute hospital between Oct 2019 and Sep 2022. MEASUREMENTS Each of the five IC domains (locomotion, cognition, vitality, sensory, and psychological capacity) was graded into three levels, and the composite IC score was calculated (0, lowest; 10, highest). Hospital-related outcomes were defined as in-hospital death, hospital-associated complications (HACs), length of hospital stay, and frequency of discharge to home. RESULTS In total, 296 individuals (mean age 84.7 ± 5.4 years, 42.7 % males) were analyzed. Mean composite IC score was 6.5 ± 1.8, and 95.6 % of participants had impairment in at least one IC domain. A higher composite IC score was independently associated with lower frequency of in-hospital death (odds ratio [OR] 0.59) and HACs (OR 0.71), higher frequency of discharge to home (OR 1.50), and shorter length of hospital stay (β = -0.24, p < 0.01). The locomotion, cognition, and psychological domains were independently associated with the occurrence of HACs, discharge destination, and length of hospital stay. CONCLUSION Evaluating IC was feasible in the hospital setting and was associated with outcomes of hospitalization. For older inpatients with decreased IC, integrated management may be required to achieve functional independence.
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Affiliation(s)
- Masaaki Nagae
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan; Department of Emergency Room and General Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan.
| | - Hitoshi Komiya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hirotaka Nakashima
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Chisato Fujisawa
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yosuke Yamada
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Shuzo Miyahara
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
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Jiang YS, Shi H, Kang YT, Shen J, Li J, Cui J, Pang J, Zhang C, Zhang J. Impact of age-friendly living environment and intrinsic capacity on functional ability in older adults: a cross-sectional study. BMC Geriatr 2023; 23:374. [PMID: 37328844 PMCID: PMC10276510 DOI: 10.1186/s12877-023-04089-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 06/02/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) has proposed healthy aging framework, supposing that intrinsic capacity (IC), environment and their interaction may have influence on functional ability (FA). It was still unclear how the IC level and age-friendly living environment impact on FA. This study aims to confirm the relationship between the IC level and age-friendly living environment with FA, especially in older adults with low IC. METHODS Four hundred eighty-five community-dwelling residents aged ≥ 60 years were enrolled. IC constructed by locomotion, cognition, psychological, vitality, and sensory domains was assessed using full assessment tools recommended by WHO. Age-friendly living environment was measured with 12 questions adapted from the spatial indicators framework of age-friendly cities. FA was assessed using activities of daily living (ADL) and one question about mobile payment ability. Multivariate logistic regression was used to explore the association between IC, environment and FA. The influence of the environment on electronic payment and ADL under the IC layer was assessed. RESULTS Of 485 respondents, 89 (18.4%) had ADL impairment, and 166 (34.2%) had mobile payment function impairment. Limited IC (odds ratio [OR] = 0.783, 95% confidence interval [CI] = 0.621-0.988) and poor environment (OR = 0.839, 95% CI = 0.733-0.960) were associated with mobile payment ability impairment. Our results suggested that a supportive age-friendly living environment influenced FA was more prominent in older adults with poor IC (OR = 0.650, 95% CI = 0.491-0.861). CONCLUSIONS Our results confirmed IC and the environment had an impact on mobile payment ability. The relationship between environment and FA showed differences according to IC level. These findings suggest that an age-friendly living environment is important to maintain and enhance elders' FA, especially in those with poor IC.
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Affiliation(s)
- Yi-Shan Jiang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong Shi
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO.1 Da HuaRoad, DongDan, Beijing, 100730, P. R. China
| | - Yu-Ting Kang
- Office of the National Clinical Research Center for Geriatric Diseases, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Ji Shen
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO.1 Da HuaRoad, DongDan, Beijing, 100730, P. R. China
| | - Jing Li
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO.1 Da HuaRoad, DongDan, Beijing, 100730, P. R. China
| | - Ju Cui
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, P. R. China
| | - Jing Pang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, P. R. China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, P. R. China
| | - Jie Zhang
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO.1 Da HuaRoad, DongDan, Beijing, 100730, P. R. China.
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Lin S, Huang M, Yang L, Chen S, Huang X, Zheng J, Yuan Y, Li N, Huang F, Zhu P. Dietary diversity and overweight are associated with high intrinsic capacity among Chinese urban older adults (2020-2021). Exp Gerontol 2023; 177:112194. [PMID: 37121333 DOI: 10.1016/j.exger.2023.112194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 04/09/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND AND OBJECTIVES The associations of intrinsic capacity (IC) with dietary diversity and body mass index (BMI) remain unclear in older adults. This study aimed to examine the respective association and combined effect of dietary diversity and BMI on high IC. METHODS The cross-sectional study used data from the Fujian Prospective Aging Cohort, which included 1972 individuals aged 60-98 from 2020 to 2021. The dietary diversity score (DDS) was constructed with eight food varieties, and consuming ≥five varieties of food daily was considered a high DDS. BMI was grouped into underweight, normal weight, overweight, and obesity according to the Chinese guidelines. High IC was defined as ≥three unimpaired domains of cognition, locomotion, sensory, vitality, and psychology. RESULTS Multivariate logistic regression analysis was used to assess the separate association of high DDS and BMI groups with high IC. Compared with low DDS, high DDS had a positive association with high IC (OR = 1.42, 95 % CI = 1.16-1.74). Compared with normal weight, underweight was inversely related to high IC (OR = 0.18, 95 % CI = 0.09-0.36), overweight was positively related to high IC (OR = 1.65, 95 % CI = 1.33-2.06), while no significant association was observed between obesity and high IC. The restricted cubic spline model exhibited an inverted U-shaped nonlinear curve of BMI and high IC and identified an optimal BMI of 25.7 kg/m2 for high IC. CONCLUSIONS High DDS is a protective factor of high IC in older adults. Overweight had the most protective association with high IC among the four BMI subgroups. Individuals with overweight and higher dietary diversity had higher IC.
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Affiliation(s)
- Siyang Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, China; Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, China
| | - Min Huang
- Department of Geriatric Medicine, 900TH Hospital of Joint Logistics Support Force, Fuzhou, Fujian, China
| | - Linxin Yang
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, China; Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, China
| | - Simiao Chen
- Xiamen Medical College, Xiamen, Fujian, China
| | - Xiaoming Huang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, China; Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, China
| | - Jiaxin Zheng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, China; Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, China
| | - Yin Yuan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, China; Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, China
| | - Na Li
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, China; Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, China
| | - Feng Huang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, China; Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, China.
| | - Pengli Zhu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, China; Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, China.
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Liao X, Shen J, Li M. Effects of multi-domain intervention on intrinsic capacity in older adults: A systematic review of randomized controlled trials (RCTs). Exp Gerontol 2023; 174:112112. [PMID: 36736466 DOI: 10.1016/j.exger.2023.112112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Intrinsic capacity is central to the maintenance of function in older adults, and maintaining optimal intrinsic capacity is of great importance to promote healthy aging. The purpose of this systematic review and meta-analysis was to analyze the impact of multi-domain interventions on intrinsic capacity in older adults, intervention components, and potential interactions between components. A total of 6740 published articles were screened until August 2022, and the review included 25 randomized controlled trials that analyzed populations, interventions, control groups, and outcomes. The meta-analysis showed improvements in the primary outcome indicators in the intervention group compared to the control group. These included increased scores on the Mini-Mental State Examination as an indicator of cognitive function, decreased scores on the Geriatric Depression Scale (GDS-15) as an indicator of psychological ability and increased scores on the Short Physical Performance Battery (SPPB) as an indicator of physical performance, with only the SPPB indicator analyzed showing greater heterogeneity. Significant improvements were also seen in the secondary indicators Time-to-Walk Test (TUG), gait speed, Chair Stand Test (CST), grip strength values and BMI. There was insufficient data for the Mini Nutritional Assessment (MNA) as an indicator of vitality to conduct a meta-analysis. Studies were of moderate to high quality. The results of this review indicate that multi-domain interventions can maintain the level of intrinsic capacity in older adults and are equally effective in older adults with declining self-care abilities.
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Affiliation(s)
- Xiaoyan Liao
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China
| | - Jun Shen
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China.
| | - Miao Li
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China
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De Dobbeleer L, Swart MM, Geerds MAJ, Baggen RJ, Jansen AS, Tielemans R, Silva H, Lieten S, Barbé K, Peeters G, Vollenbroek-Hutten MMR, Melis RJF, Bautmans I. Validity and reliability of Eforto®, a system to (self-)monitor grip strength and muscle fatigability in older persons. Aging Clin Exp Res 2023. [PMID: 36897558 DOI: 10.1007/s40520-023-02365-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/05/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION We developed Eforto®, an innovative system for (self-)monitoring of grip strength (GS) and muscle fatigability (Fatigue Resistance (FR = time until GS decreased to 50% of maximum during sustained contraction) and grip work (GW = area under the strength-time curve)). The Eforto® system consists of a rubber bulb that is wirelessly connected to a smartphone-based application, and a telemonitoring platform. The aim was to evaluate the validity and reliability of Eforto® to measure muscle fatigability. METHODS Community-dwelling older persons (n = 61), geriatric inpatients (n = 26) and hip fracture patients (n = 25) were evaluated for GS and muscle fatigability. In community dwellers fatigability was tested twice in the clinic (once with Eforto®, once with Martin Vigorimeter (MV), standard analog handgrip system) and for six consecutive days as a self-assessment at home with Eforto®. In hospitalized participants, fatigability was tested twice using Eforto®, once by a researcher and once by a health professional. RESULTS Criterion validity was supported by good to excellent correlations between Eforto® and MV for GS (r = 0.95) and muscle fatigability (FR r = 0.81 and GW r = 0.73), and no significant differences in measurements between both systems. Inter-rater and intra-rater reliability for GW were moderate to excellent (intra-class correlation: 0.59-0.94). The standard error of measurement for GW was small for geriatric inpatients and hip fracture patients (224.5 and 386.5 kPa*s) and higher for community-dwellers (661.5 kPa*s). DISCUSSION/CONCLUSION We established the criterion validity and reliability of Eforto® in older community-dwelling persons and hospitalized patients, supporting the implementation of Eforto® for (self-)monitoring of muscle fatigability.
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Hamaker M, Gijzel S, Rostoft S, van den Bos F. Intrinsic capacity and resilience: Taking frailty to the next level. J Geriatr Oncol 2023; 14:101421. [PMID: 36657249 DOI: 10.1016/j.jgo.2022.101421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/21/2022] [Indexed: 01/19/2023]
Abstract
In addition to frailty, two novel concepts have been introduced in the field of geriatrics to capture the heterogeneous ageing process: the first is intrinsic capacity, which uses a community-based, holistic approach and is propagated by the World Health Organization (WHO); and the second is resilience, which provides a more dynamic perspective on the individual's reserves, injury and recovery. While both concepts are linked to frailty, with all three focusing on reserves in relation to ageing, each approaches this issue from a different point of view. In this paper, we will compare and contrast these three concepts - frailty, intrinsic capacity and resilience - and assess their relevance to future geriatric oncology research as well as daily clinical practice.
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Affiliation(s)
- Marije Hamaker
- Department of Geriatric Medicine, Diakonessenhuis Utrecht, the Netherlands.
| | - Sanne Gijzel
- Vivum Naaderheem Geriatric Rehabilitation Center, Naarden, the Netherlands
| | - Siri Rostoft
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Frederiek van den Bos
- Department of Geriatric Medicine, University Medical Centre Utrecht, the Netherlands
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Liang Y, Shang S, Gao Y, Zhai J, Cheng X, Yang C, Zhang R. Measurements of Intrinsic Capacity in Older Adults: A Scoping Review and Quality Assessment. J Am Med Dir Assoc 2023; 24:267-276.e2. [PMID: 36332688 DOI: 10.1016/j.jamda.2022.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This review summarizes the measurements of intrinsic capacity in 5 domains across different studies and evaluates the quality of research papers. DESIGN Scoping review of papers written in English and Chinese published in peer-reviewed journals. SETTING AND PARTICIPANTS The intrinsic capacity of older adults was assessed using the multidomain structure (Cognition, Locomotion, Psychological, Sensory and Vitality) proposed by the World Health Organization. METHODS We searched PubMed, MEDLINE, and Web of Science for papers in English, and CNKI, CBM for papers written in Chinese published until September 13, 2022. Both cross-sectional and cohort studies of multidomain measurements of intrinsic capacity were included. Three independent reviewers appraised the quality of studies, and Cohen's kappa was calculated to determine interrater reliability. Data were listed by author, year, setting, country, age range and number of participants, measurement and calculation of intrinsic capacity, and data acquisition method. RESULTS We included 53 studies. Twenty-one studies were of high quality, 31 studies were of moderate quality, and 1 study was of low quality. Measurements of intrinsic capacity and derivation of the summative index score were heterogeneous. Intrinsic capacity was usually assessed in 4 or 5 domains. Sensory was the most frequently overlooked domain or subdivided into vision and hearing in some studies. Indicators of vitality were the most heterogeneous. We also found consistency in heterogeneous measurements. The most common measurements of cognition, locomotion, and psychological capacity were the Mini-Mental State Examination, Short Physical Performance Battery, and Geriatric Depression Scale respectively. Self-reported questionnaires were commonly adopted in sensory domain. The Mini-Nutritional Assessment and grip strength were the most measured indicators of vitality. CONCLUSIONS AND IMPLICATIONS The focus on capacity and disease should be balanced to better promote healthy aging in older adults. Heterogeneity of intrinsic capacity measurements underscores the need for consensus about standardized measurements and calculation procedures.
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Affiliation(s)
- Yetian Liang
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China
| | | | - Yaxuan Gao
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China; Hebei Puai Aged Care Ltd. Co., Shijiazhuang, Hebei Province, PR China
| | - Jiahui Zhai
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China
| | - Xiaohan Cheng
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China
| | - Chen Yang
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China
| | - Ruili Zhang
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China.
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Torres JL, Vaz CT, Pinheiro LC, Braga LS, Moreira BS, Oliveira C, Lima-Costa MF. The relationship between loneliness and healthy aging indicators in Brazil (ELSI-Brazil) and England (ELSA): sex differences. Public Health 2023; 216:33-38. [PMID: 36791648 PMCID: PMC9992154 DOI: 10.1016/j.puhe.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES This study aimed to estimate five harmonized healthy aging indicators covering functional ability and intrinsic capacity among older women and men from Brazil and England and evaluate their association with loneliness. STUDY DESIGN This was a cross-sectional study. METHODS We used two nationally representative samples of men and women aged ≥60 years from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) wave 2 (2019-2021; n = 6929) and the English Longitudinal Study of Aging wave 9 (2018-2019; n = 5902). Healthy aging included five separate indicators (getting dressed, taking medication, managing money, cognitive function, and handgrip strength). Loneliness was measured by the 3-item University of California Loneliness Scale. Logistic regression models stratified by sex and country were performed. RESULTS Overall, age-adjusted healthy aging indicators were worse in Brazil compared with England for both men and women. Considering functional ability, loneliness was negatively associated with all indicators (ranging from odds ratio [OR] = 0.26, [95% confidence interval (CI) 0.13-0.52] in English men regarding the ability to take medication to OR = 0.49 [95% CI 0.27-0.89] in Brazilian women regarding the ability to manage money). Considering intrinsic capacity, loneliness was negatively associated with a higher cognitive function (OR = 0.72; 95% CI 0.55-0.95 in English women) and a higher handgrip strength (OR = 0.61; 95% CI 0.45-0.83 in Brazilian women). Lonely women demonstrated lower odds of a higher number of healthy aging indicators than men in both countries. CONCLUSIONS Country-specific social environments should be targeted by public policies to decrease loneliness and promote healthy aging later in life.
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Affiliation(s)
- J L Torres
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - C T Vaz
- Campos Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, Minas Gerais, Brazil
| | - L C Pinheiro
- Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - L S Braga
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - B S Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Universidade Federal de Minas Gerais e Fundação Oswaldo Cruz - MG, Belo Horizonte, Minas Gerais, Brazil
| | - C Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - M F Lima-Costa
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil; Núcleo de Estudos em Saúde Pública e Envelhecimento, Universidade Federal de Minas Gerais e Fundação Oswaldo Cruz - MG, Belo Horizonte, Minas Gerais, Brazil
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Langballe EM, Skirbekk V, Strand BH. Subjective age and the association with intrinsic capacity, functional ability, and health among older adults in Norway. Eur J Ageing 2023; 20:4. [PMID: 36853397 PMCID: PMC9975130 DOI: 10.1007/s10433-023-00753-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 03/01/2023] Open
Abstract
This study investigates the relationships between subjective age, intrinsic capacity, functional ability and health among Norwegians aged 60 years and older. The Norwegian Survey of Health and Ageing (NORSE) is a population-based, cross-sectional study of home-dwelling individuals aged 60-96 years in the former county of Oppland. Age- and sex-adjusted regression models were used to investigate the gap between subjective and chronological age and this gap's association with self-reported and objectively measured intrinsic capacity (covering all six sub domains defined by WHO), health, and functional ability among 817 NORSE participants. The results show most participants felt younger than their chronological age (86.5%), while relatively few felt the same as their chronological age (8.3%) or older (5.2%). The mean subjective age was 13.8 years lower than mean chronological age. Participants with urinal incontinence, poor vision, or poor hearing felt 3.1 [95% confidence interval (CI) (0.6, 5.5)], 2.9 [95% CI (0.2, 5.6)], and 2.9 [95% CI (0.3, 5.5)] years older, respectively, than participants without those conditions, whereas none of the following factors-anxiety, depression, chronic disease, Short Physical Performance Battery score, grip strength, cognition, or frailty-significantly had an impact on the gap. In line with prior research, this study finds that feeling considerably younger than one's chronological age is common at older ages. However, those with poor hearing, poor vision, and urinal incontinence felt less young compared to those not having these conditions. These relationships may exert undesirable effects on vitality and autonomy, which are considered key factors of intrinsic capacity and healthy ageing.
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Affiliation(s)
- Ellen Melbye Langballe
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. .,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
| | - Vegard Skirbekk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway ,Norwegian Institute of Public Health, Oslo, Norway
| | - Bjørn Heine Strand
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway ,Norwegian Institute of Public Health, Oslo, Norway
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Rojano i Luque X, Blancafort-Alias S, Prat Casanovas S, Forné S, Martín Vergara N, Fabregat Povill P, Vila Royo M, Serrano R, Sanchez-Rodriguez D, Vílchez Saldaña M, Martínez I, Domínguez López M, Riba Porquet F, Intxaurrondo González A, Salvà Casanovas A. Identification of decreased intrinsic capacity: Performance of diagnostic measures of the ICOPE Screening tool in community dwelling older people in the VIMCI study. BMC Geriatr 2023; 23:106. [PMID: 36809987 PMCID: PMC9945724 DOI: 10.1186/s12877-023-03799-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) has developed the Integrated Care for Older People (ICOPE) strategy to face the challenges of ageing societies. This strategy is focused on person centered care and the assessment intrinsic capacity (IC). Early identification of five domains of IC (cognition, locomotion, vitality, sensory (hearing and vision), and psychological) has been shown to be related with adverse outcomes and can guide actions towards primary prevention and healthy ageing. IC assessment proposed by the WHO ICOPE guidelines is composed by two steps: First, Screening for decreased IC by the ICOPE Screening tool; second, by the reference standard methods. The aim was to assess the performance of diagnostic measures (sensibility, specificity, diagnostic accuracy, and agreement of the ICOPE Screening tool) compared to the reference standard methods in European community-dwelling older adults. METHODS Cross-sectional analysis of the baseline of the ongoing VIMCI (Validity of an Instrument to Measure Intrinsic Capacity) cohort study, which was carried out in Primary Care centers and outpatient clinics from 5 rural and urban territories in Catalonia (Spain). Participants were 207community dwelling persons ≥ 70-year-old with Barthel ≥ 90, without dementia or advanced chronic conditions who provided their consent to participate. The 5 IC domains were assessed by the ICOPE Screening tool and the reference methods (SPPB, gait speed, MNA, Snellen chart, audiometry, MMSE, GDS5) during patients' visit. Agreement was assessed with the Gwet AC1 index. RESULTS ICOPE Screening tool sensitivity was higher for cognition (0.889) and ranged between 0.438 and 0.569 for most domains. Specificity ranged from 0.682 to 0.96, diagnostic accuracy from 0.627 to 0.879, Youden index from 0.12 to 0.619, and Gwet AC1 from 0.275 to 0.842. CONCLUSION The ICOPE screening tool showed fair performance of diagnostic measures; it was helpful to identify those participants with satisfactory IC and showed a modest ability to identify decreased IC in older people with high degree of autonomy. Since low sensitivities were found, a process of external validation would be recommended to reach better discrimination. Further studies about the ICOPE Screening tool and its performance of diagnostic measures in different populations are urgently required.
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Affiliation(s)
- Xavier Rojano i Luque
- grid.477257.40000 0004 4904 4581Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain ,grid.413396.a0000 0004 1768 8905Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Sergi Blancafort-Alias
- Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain. .,Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain.
| | - Susanna Prat Casanovas
- grid.22061.370000 0000 9127 6969ABS Ripoll-Sant Joan de les Abadesses, Institut Català de la Salut (ICS), Ripoll, Spain
| | - Susanna Forné
- Fundació Sant Hospital, La Seu d’Urgell, Lleida, Spain
| | - Nuria Martín Vergara
- grid.22061.370000 0000 9127 6969EAP Horts de Miró, Institut Català de la Salut (ICS), Reus, Spain
| | | | - Maria Vila Royo
- grid.432291.f0000 0004 1755 8959Badalona Serveis Assistencials (BSA), Badalona, Spain
| | | | - Dolores Sanchez-Rodriguez
- grid.411371.10000 0004 0469 8354Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium ,grid.4861.b0000 0001 0805 7253 Health Organization Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium ,grid.20522.370000 0004 1767 9005Geriatrics Department, Rehabilitation Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | | | - Iris Martínez
- Fundació Sant Hospital, La Seu d’Urgell, Lleida, Spain
| | | | | | - Aimar Intxaurrondo González
- grid.477257.40000 0004 4904 4581Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain ,grid.413396.a0000 0004 1768 8905Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Antoni Salvà Casanovas
- grid.477257.40000 0004 4904 4581Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain ,grid.413396.a0000 0004 1768 8905Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain
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Lu F, Liu S, Liu X, Li J, Jiang S, Sun X, Huang X, Wang X. Comparison of the predictive value of intrinsic capacity and comorbidity on adverse health outcome in community-dwelling older adults. Geriatr Nurs 2023; 50:222-226. [PMID: 36805953 DOI: 10.1016/j.gerinurse.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES To compare the predictive value of intrinsic capacity (IC) and comorbidity on all-cause mortality and falls. METHODS This prospective cohort study included 220 older adults (84.0±4.4 years) followed for 3 years in a community in Beijing. The methodology recommended by the World Health Organization was used to assess IC, and comorbidity was assessed by the Cumulative Illness Rating Scale for Geriatrics. RESULTS The areas under the characteristic curve of IC and comorbidity were 0.78 vs. 0.67 (p=0.033), respectively, in predicting all-cause mortality, and 0.69 vs. 0.61 in predicting falls (p=0.032). The vitality domain impairment (odds ratio [OR]=3.28, p=0.013), and cognition domain impairment (OR=3.97, p=0.004) were significantly associated with all-cause mortality. Locomotion domain impairment (OR=2.35, p=0.010) was associated with higher fall risk. CONCLUSION IC might be a better predictor than comorbidity in community-dwelling older adults, in which the vitality, locomotion and cognition domains should be given more attention.
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Affiliation(s)
- Fei Lu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China
| | - Shuo Liu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China
| | - Xiaohong Liu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China.
| | - Jiaojiao Li
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China
| | - Shan Jiang
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China
| | - Xiaohong Sun
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China.
| | - Xia Huang
- The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, 301 Dashi Road, Nanan District, Chongqing, 400060, China
| | - Xueying Wang
- Yanyuan Rehabilitation Hospital, No. 2, Jingrong street, Nanshao Town, Changping District, Beijing, 102200, China
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Jia S, Zhao W, Ge M, Xia X, Hu F, Hao Q, Zhang Y, Yang M, Yue J, Dong B. Associations between transitions of intrinsic capacity and frailty status, and 3-year disability. BMC Geriatr 2023; 23:96. [PMID: 36788484 PMCID: PMC9930336 DOI: 10.1186/s12877-023-03795-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The trajectory of frailty and intrinsic capacity (IC) often overlap in older adults. Longitudinal analyses of transitions of frailty and IC, and their associations with incident functional decline are limited. The present study aimed to identify transitions of frailty status and IC, and explore associations between transitions of frailty and IC, and future disability among community-dwelling older adults. METHODS In the West China and Aging Trend Study, 808 participants aged ≥ 60 years completed baseline and three years follow-up (frailty, IC and disability assessments). Physical frailty was measured based on Fried phenotype. IC was evaluated by five domains (cognition, locomotion, sensory, psychological, and vitality). Disability was defined as a need for assistance in any items in activity of daily living (ADL) or the instrumental activity of daily living (IADL). Logistic regressions were performed to examine their relationships. RESULTS Four transitions of IC status (kept well: 27.4%, improved: 8.4%, worsened: 35.4%, and kept poor: 28.8%), and two transitions of frailty status (kept not-frail/improved: 93.2%, kept frail/worsened: 6.8%) were identified. Impaired locomotion and vitality at baseline were significantly associated with kept frail or worsened frail. However, impaired sensory and vitality at baseline not frailty status was significantly associated with transitions of IC. Adjusted for covariates and transitions of frailty, kept poor IC was associated with ADL (OR = 2.26, 95%CI = 1.17,4.34) and IADL disability (OR = 3.74, 95%CI = 1.79, 7.82). CONCLUSIONS Transitions of IC, but not frailty were associated with higher risk of incident disability. Baseline locomotion and vitality impairment were associated with worsened or kept frail. Our findings support the WHO's notion of monitoring and optimizing IC to delay deterioration of IC and preventing frailty and disability. CLINICAL TRIAL NUMBER ChiCTR1800018895.
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Affiliation(s)
- Shuli Jia
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Wanyu Zhao
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Meiling Ge
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Xin Xia
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Fengjuan Hu
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Qiukui Hao
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.25073.330000 0004 1936 8227School of Rehabilitation Science, McMaster University, Hamilton, ON Canada
| | - Yan Zhang
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Mei Yang
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Jirong Yue
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Birong Dong
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041, Sichuan, China. .,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041, Sichuan, China.
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Pilotto A, Custodero C, Palmer K, Sanchez-Garcia EM, Topinkova E, Polidori MC. A multidimensional approach to older patients during COVID-19 pandemic: a position paper of the Special Interest Group on Comprehensive Geriatric Assessment of the European Geriatric Medicine Society (EuGMS). Eur Geriatr Med 2023; 14:33-41. [PMID: 36656486 PMCID: PMC9851592 DOI: 10.1007/s41999-022-00740-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/24/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE The COVID-19 pandemic has been a dramatic trigger that has challenged the intrinsic capacity of older adults and of society. Due to the consequences for the older population worldwide, the Special Interest Group on Comprehensive Geriatric Assessment (CGA) of the European Geriatric Medicine Society (EuGMS) took the initiative of collecting evidence on the usefulness of the CGA-based multidimensional approach to older people during the COVID-19 pandemic. METHODS A narrative review of the most relevant articles published between January 2020 and November 2022 that focused on the multidimensional assessment of older adults during the COVID-19 pandemic. RESULTS Current evidence supports the critical role of the multidimensional approach to identify older adults hospitalized with COVID-19 at higher risk of longer hospitalization, functional decline, and short-term mortality. This approach appears to also be pivotal for the adequate stratification and management of the post-COVID condition as well as for the adoption of preventive measures (e.g., vaccinations, healthy lifestyle) among non-infected individuals. CONCLUSION Collecting information on multiple health domains (e.g., functional, cognitive, nutritional, social status, mobility, comorbidities, and polypharmacy) provides a better understanding of the intrinsic capacities and resilience of older adults affected by SARS-CoV-2 infection. The EuGMS SIG on CGA endorses the adoption of the multidimensional approach to guide the clinical management of older adults during the COVID-19 pandemic.
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Affiliation(s)
- Alberto Pilotto
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy.,Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, P.zza Giulio Cesare, 11, 70124, Bari, Italy
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, P.zza Giulio Cesare, 11, 70124, Bari, Italy.
| | - Katie Palmer
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Maria Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine, University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
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Gonzalez-Bautista E, de Souto Barreto P, Salinas-Rodriguez A, Manrique-Espinoza B, Sourdet S, Rolland Y, Rodríguez-Mañas L, Andrieu S, Vellas B. Development and Validation of a Cutoff for the Chair Stand Test as a Screening for Mobility Impairment in the Context of the Integrated Care for Older People Program. J Gerontol A Biol Sci Med Sci 2023; 78:104-110. [PMID: 35226732 DOI: 10.1093/gerona/glac055] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The 5-repetition chair stand test (CST) is increasingly being used to assess locomotion capacity in older adults. However, there is a lack of age-stratified cutoffs for adults aged ≥70 validated against a higher risk of functional loss. METHODS We used 2 population-based studies (Study on global AGEing and adult health in Mexico [SAGE Mexico] and Toledo Study for Healthy Aging [TSHA]) and receiver operating characteristic (ROC) analyses to develop and cross-validate age-stratified chair stand cutoffs with activities of daily living (ADL) disability as the outcome. Then, we used data from an randomized controlled trial (RCT) (Multidomain Alzheimer Preventive Trial [MAPT]) and a frailty day-hospital for external validation with cross-sectional and longitudinal measures of ADL disability. The merged sample of SAGE Mexico and TSHA was n = 1 595; sample sizes for external validation were: MAPT n = 1 573 and Frailty day-hospital n = 2 434. The Cox models for incident disability in MAPT had a mean follow-up of 58.6 months. RESULTS Cutoffs obtained were 14 second (ages 70-79) and 16 second (ages 80+). Those cutoffs identified older adults at higher odds of incident ADL disability odds ratio (OR) = 1.72 (95% confidence interval [CI] 1.06; 2.78) for ages 70-79 and odds ratio (OR) = 2.27 (95% CI 1.07; 4.80) in those aged 80+. Being a slow chair stander according to the cut points was associated with ADL disability in cross-sectional and longitudinal measures. CONCLUSIONS Fourteen- and 16-second cut points for the CST are suitable to identify people at higher risk of functional decline among older adults in Mexico and Toledo, Spain. Adjusting the cut point from 14 to 16 second generally improved the psychometric properties of the test. The validation of these cutoffs can facilitate the screening for limited mobility and the implementation of the Integrated Care for Older People program.
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Affiliation(s)
- Emmanuel Gonzalez-Bautista
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Philipe de Souto Barreto
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Aaron Salinas-Rodriguez
- Center for Surveys and Evaluation Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Betty Manrique-Espinoza
- Center for Surveys and Evaluation Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Sandrine Sourdet
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Yves Rolland
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | | | - Sandrine Andrieu
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Bruno Vellas
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
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Tang WH, Yu TH, Lee HL, Lee YJ. Interactive effects of intrinsic capacity and obesity on the KDIGO chronic kidney disease risk classification in older patients with type 2 diabetes mellitus. Diabetol Metab Syndr 2023; 15:1. [PMID: 36588165 PMCID: PMC9806894 DOI: 10.1186/s13098-022-00975-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Intrinsic capacity (IC) is a novel concept focusing on normal and healthy aging. The effect of IC on the risk of chronic kidney disease (CKD) according to KDIGO category in older type 2 diabetes mellitus (T2DM) patients has rarely been studied. We investigated whether a decline in IC is associated with the risk of CKD according to KDIGO 2012 categories. METHODS This is a cross-sectional study. The exposure variables (IC score and body mass index) and outcome variable (KDIGO categories of the risk of CKD) were collected at the same timepoint. A total of 2482 older subjects with T2DM managed through a disease care program were enrolled. The five domains of IC, namely locomotion, cognition, vitality, sensory, and psychological capacity were assessed. Based on these domains, the IC composite score was calculated. CKD risk was classified according to the KDIGO 2012 CKD definition. Univariate and multivariate analyses were used to assess the association between IC score and KDIGO categories of risk of CKD. RESULTS The KDIGO CKD risk category increased in parallel with IC score (p for trend < 0.0001). In multivariate analysis, compared to those with an IC score 0, the odds ratio of having a KDIGO moderately increased to very high risk category of CKD was 1.76 (1.31-2.37) times higher for those with an IC score of 2-5. Furthermore, an increased IC score was associated with a higher prevalence of moderate and severe obesity. Moreover, there was a synergistic interaction between IC score and obesity on the KDIGO moderately increased to very high risk category of CKD (synergy index = 1.683; 95% CI 0.630-3.628), and the proportion of the KDIGO moderately increased to very high risk category of CKD caused by this interaction was 25.6% (attributable proportion of interaction = 0.256). CONCLUSIONS Our findings indicate that IC score may be closely related to the KDIGO moderately increased to very high risk category of CKD. In addition, there may be a synergistic interaction between IC score and obesity, and this synergistic interaction may increase the KDIGO CKD risk stage.
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Affiliation(s)
- Wei-Hua Tang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien, 98142 Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304 Taiwan
| | - Teng-Hung Yu
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, 82445 Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Hui-Lan Lee
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, 10320 Taiwan
| | - Yau-Jiunn Lee
- Lee’s Endocrinologic Clinic, No. 130 Min-Tzu Rd, Pingtung, 90000 Taiwan
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Zhu L, Zong X, Shi X, Ouyang X. Association between Intrinsic Capacity and Sarcopenia in Hospitalized Older Patients. J Nutr Health Aging 2023; 27:542-549. [PMID: 37498101 DOI: 10.1007/s12603-023-1946-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/11/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES This study aimed to clarify the association between intrinsic capacity (IC) and sarcopenia in hospitalized older patients. DESIGN A cross-sectional study. SETTING Hospital-based. PARTICIPANTS This study included 381 inpatients aged ≥ 60 years (225 men and 156 women). MEASUREMENTS IC was evaluated in five domains defined by the World Health Organization: cognition (Mini-Mental State Examination), locomotion (Short Physical Performance Battery test), vitality (Short-Form Mini Nutritional Assessment), sensory (self-reported hearing and vision) and psychological (5-item Geriatric Depression Scale) capacities. IC composite score (0-5) was calculated based on five domains, with lower scores representing greater IC. Sarcopenia was defined in accordance with the criteria recommended by the Asian Working Group for Sarcopenia (AWGS) 2019. Multiple linear and logistic regressions were performed to explore the associations between IC composite score and IC domains with sarcopenia and its defining components. RESULTS The mean age of 381 patients included was 81.95±8.42 years. Of them, 128 (33.6%) patients had sarcopenia. The median IC composite score was 1 (1, 2). Cognition, locomotion, vitality, sensory and psychological capacities were impaired in 22.6%, 63.5%, 18.9%, 27.3% and 11.3% of patients. Multiple linear regression analyses showed that favorable IC domain scores in cognition, locomotion and vitality were associated with a stronger handgrip strength. A higher vitality score was associated with a greater appendicular skeletal muscle mass index (ASMI), and a higher locomotion score was associated with a greater gait speed. The multiple logistic regression analysis showed that only vitality impairment was associated with sarcopenia. A higher IC composite score was associated with higher risks of sarcopenia, as well as low ASMI, handgrip strength and gait speed. CONCLUSION This study indicated that a more serious impairment of IC was associated with a greater risk of sarcopenia. Vitality was the domain most strongly associated with sarcopenia. IC may be employed to detect and manage sarcopenia.
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Affiliation(s)
- L Zhu
- Xiaojun Ouyang, Department of Geriatrics, Geriatric Hospital of Nanjing Medical University, Nanjing, China, E-mail:
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