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Iriarte E, Cianelli R, De Santis JP, Alamian A, Castro JG, Matsuda Y, Araya AX. Multidimensional Frailty, Quality of Life and Self-Management in Aging Hispanics Living With HIV. J Appl Gerontol 2024; 43:899-909. [PMID: 38173356 DOI: 10.1177/07334648231211743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
An observational cross-sectional study was conducted to examine multidimensional frailty and its potential impact on quality of life (QOL) in aging Hispanic people living with HIV (PLWH) and assess the extent to which HIV self-management moderates this association. The sample included 120 Hispanic PLWH aged 50 years and older (M = 59.11; SD = 7.04). The structural equation modeling analyses demonstrated that multidimensional frailty was significantly related to QOL in its two dimensions, physical and mental (p < .001). The relationship between multidimensional frailty and mental and physical QOL remained significant even after controlling for confounders (age and gender). The moderator analyses indicated no statistically significant moderator effect of HIV self-management on multidimensional frailty and mental or physical QOL. These study results have practical implications that highlight the need for early screening for frailty with a multidimensional focus. Age-appropriate and culturally tailored interventions to prevent or mitigate multidimensional frailty may improve QOL.
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Affiliation(s)
- Evelyn Iriarte
- Pontificia Universidad Católica de Chile, School of Nursing, Santiago, Chile
- University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, CO, USA
- Millennium Institute for Care Research (MICARE) (ICS2019_024), Santiago, Chile
| | - Rosina Cianelli
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Joseph P De Santis
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Arsham Alamian
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Jose G Castro
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Yui Matsuda
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Alejandra-X Araya
- Millennium Institute for Care Research (MICARE) (ICS2019_024), Santiago, Chile
- Universidad Andres Bello, School of Nursing, Santiago, Chile
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Collette-Robert S, Guerville F, Novais T, Pongan E, Morelon E, Vernaudon J, Francq E, Couzi L, Bourdel-Marchasson I, Caillard S, Pszczolinski R, Heitz D, Gilbert T, Garnier-Crussard A. Intrinsic capacity and frailty in older adults with end-stage kidney disease undergoing pre-kidney transplant comprehensive geriatric assessment. J Nutr Health Aging 2024; 28:100236. [PMID: 38643611 DOI: 10.1016/j.jnha.2024.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVE Frailty has been extensively studied in end-stage kidney disease (ESKD) and kidney transplant (KT) patients. The identification of frailty is useful to predict adverse outcomes among ESKD and KT patients. The recent concept of intrinsic capacity (IC) appears as a good and easy-to-understand tool to screen for and monitor frailty in older adults with ESKD. This study aims to assess the relationships between frailty and IC in older adults with ESKD awaiting KT. DESIGN Cross-sectional study SETTING AND PARTICIPANTS: 236 patients from a day-care geriatric unit undergoing pre-KT geriatric assessment between 2017 and 2022 were included in the main sample, and 151 patients in an independent multicentric replication sample. MEASUREMENTS Frailty was evaluated using the physical frailty phenotype (PFP) and IC measures using the World Health Organization's screening (step 1) and diagnostic (step 2) tools for five IC domains (vitality, locomotion, audition, cognition, psychology). Multivariate regressions were run to assess relationships between PFP and IC domains, adjusted for age, sex, and comorbidities. Analyses were replicated using another independent multicenter cohort including 151 patients with ESKD to confirm the results. RESULTS Impairments in the locomotion, psychology, and vitality IC domains according to WHO screening tools were associated with frailty (odds ratio 9.62 [95% CI 4.09-24.99], 3.19 [95% CI 1.11-8.88], and 3.11 [95% CI 1.32-7.29], respectively). When IC were measured linearly with z-scores, all IC domains except hearing were inversely associated with frailty. In the replication cohort, results were overall similar, with a greater association between psychology domain and frailty. CONCLUSION This study highlights the relationship between frailty and IC in ESKD patients. We assume that IC may be assessed and monitored in ESKD patients, to predict and prevent future frailty, and post-KT adverse outcomes.
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Affiliation(s)
- Sarah Collette-Robert
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France
| | - Florent Guerville
- Clinical Gerontology Department, Bordeaux University Hospital, F-33000 Bordeaux, France; UMR 5536 CNRS/University of Bordeaux, Bordeaux, France; ImmunoConcEpT Lab UMR 5164 CNRS, INSERM ERL 1303, F-33000/University of Bordeaux, Bordeaux, France
| | - Teddy Novais
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France; Pharmaceutical Unit, Charpennes Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Elodie Pongan
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France; Memory Clinical and Research Center of Saint Etienne, Neurology Unit, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - Emmanuel Morelon
- Department of Transplantation, Nephrology and Immunology, Hospices Civils de Lyon, Lyon, France
| | - Julien Vernaudon
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France; Geriatric Medicine Department, Villefranche-Sur-Saône Hospital, 69400 Villefranche-Sur-Saône, France
| | - Eloïse Francq
- Clinical Gerontology Department, Bordeaux University Hospital, F-33000 Bordeaux, France
| | - Lionel Couzi
- Department of Nephrology, Transplantation, Dialysis and Apheresis, CHU Bordeaux, Bordeaux, France
| | - Isabelle Bourdel-Marchasson
- Clinical Gerontology Department, Bordeaux University Hospital, F-33000 Bordeaux, France; UMR 5536 CNRS/University of Bordeaux, Bordeaux, France
| | - Sophie Caillard
- Nephrology-Transplantation Department, University Hospital, 2 Rheumatology Department, University Hospital, Strasbourg, France
| | - Romain Pszczolinski
- Nephrology-Transplantation Department, University Hospital, 2 Rheumatology Department, University Hospital, Strasbourg, France
| | - Damien Heitz
- Unité d'OncoGériatrie, Institut de Cancérologie de Strasbourg Europe, 67033 Strasbourg France
| | - Thomas Gilbert
- Research on Healthcare Professionals and Performance RESHAPE, Inserm U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France; Geriatric Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Sud, CEDEX, 69495 Pierre-Bénite, France.
| | - Antoine Garnier-Crussard
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Neuropresage Team, Cyceron, 14000 Caen, France.
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Iriarte E, Cianelli R, De Santis JP, Villegas N, Irarrazabal L, Jankowski C, Provencio-Vasquez E. HIV-Related Stigma and Multidimensional Frailty Among Older Latinos With HIV. HISPANIC HEALTH CARE INTERNATIONAL 2024; 22:99-108. [PMID: 37853706 DOI: 10.1177/15404153231208130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Introduction: Frailty is a geriatric syndrome of increased vulnerability to stressors marked by a higher risk for poor health outcomes. HIV-related stigma is a stressor for Latino people with HIV (PWH) and an important barrier to HIV care. This study examines the association between HIV-related stigma and multidimensional frailty among older Latino PWH. Methods: A cross-sectional design with 120 Latino PWH aged 50 and older was used. Self-reported questionnaires were administered to assess multidimensional frailty (Tilburg Frailty Indicator) and HIV-related stigma (HIV stigma scale). Results: Participants were 59.1 ± 7.0 years old, primarily White-Hispanic (85.00%, n = 102), single (48.33%, n = 58), and male (73.30%, n = 88). Nearly half of the participants were frail (45.85%, n = 55). Compared to non-frail, frail individuals had significantly higher scores in the total HIV-related stigma (M = 98.5 ± 24.7 vs. M = 85.3 ± 25.6, p = .020) and all subscales. The odds of multidimensional frailty were 1.021 times higher for people with higher HIV-related stigma scores (p = .007). This association remained significant after adjustment for income and comorbidities (p = .049). Conclusions: HIV-related stigma among older Latino PWH was significantly associated with their odds of being frail. Efforts to prevent multidimensional frailty should consider addressing HIV-related stigma through age-appropriate and culturally tailored resources for this group.
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Affiliation(s)
- Evelyn Iriarte
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
- Millennium Institute for Care Research, MICARE (ICS2019_024), Santiago, Chile
| | - Rosina Cianelli
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Joseph P De Santis
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Natalia Villegas
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisette Irarrazabal
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
| | - Catherine Jankowski
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Qiu Y, Li G, Wang X, Liu W, Li X, Yang Y, Wang L, Chen L. Prevalence of multidimensional frailty among community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Stud 2024; 154:104755. [PMID: 38522186 DOI: 10.1016/j.ijnurstu.2024.104755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/02/2024] [Accepted: 03/08/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE The aims of this systematic review were to explore the pooled prevalence of multidimensional frailty assessed by the Tilburg Frailty Indicator among community-dwelling older adults. DESIGN A systematic review and meta-analysis. METHODS A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, Embase, the Cochrane Library, CINAHL and three Chinese databases. Two independent researchers selected the literatures, extracted the data and evaluated the quality. All statistical analyses were performed using STATA version 16.0. RESULTS There were 66 studies with a total of 40,597 individuals that were eligible for the meta-analysis. Data from the meta-analysis revealed the pooled prevalence of 42 % for multidimensional frailty (95 % CI: 38 %-45 %, I2 = 98.9 %, T2 = 0.024, p < 0.001). Among the six studies that provided data for different age groups, the results demonstrated an increasing trend in the prevalence of multidimensional frailty with advancing age. The results of gender-stratified analysis proved that the pooled prevalence of multidimensional frailty in women (45 %, 95 % CI: 39 %-51 %, p < 0.001) was higher than that in men (33 %, 95 % CI: 28 %-39 %, p < 0.001). Based on different education levels, the prevalence of multidimensional frailty is highest in the primary elementary or illiterate group (41 %, 95 % CI: 30 %-52 %, p < 0.001). According to different marital status types, the pooled prevalence of multidimensional frailty in the married group was significantly lower (36 %, 95 % CI: 28 %-43 %) than that in the unmarried, divorced or widowed group (51 %, 95 % CI: 37 %-65 %). CONCLUSIONS Through a comprehensive review, we identified that 42 % of elderly individuals living in communities exhibit multidimensional frailty, indicating that multidimensional frailty is relatively common in this population. Stratified analysis revealed that advanced age, female gender, lower education level and unmarried status were associated with higher rates of multidimensional frailty.
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Affiliation(s)
- Yiming Qiu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Guichen Li
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Xinxin Wang
- The First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, China.
| | - Wei Liu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Xin Li
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Yali Yang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Lisheng Wang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Li Chen
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin 130021, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China.
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Tanimura C, Oba K, Noguchi Y, Itamochi T. A Concept Analysis of Self-Management of Physical Frailty. Yonago Acta Med 2024; 67:80-92. [PMID: 38803587 PMCID: PMC11128080 DOI: 10.33160/yam.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/09/2024] [Indexed: 05/29/2024]
Abstract
This review aimed to clarify the concept of self-management in the context of physical frailty and to provide insights that support the development of interventions to prevent physical frailty. A concept analysis using thirty-three studies was performed, six attributes of the concept "self-management of physical frailty" were identified: {Cooperating with healthcare professionals or familiar persons}, {Investing and managing in resources}, {Acquisition and maintenance of individualized self-management strategies}, {Self-directed process}, {Goal setting and personalized action planning} and {Living with one's own health condition with a positive attitude}. Self-management of physical frailty can be defined as a process in which an individual independently sets goals and action plans, engages in strategies such as exercise and nutritional management, and lives with one's own health condition with a positive attitude by collaborating with healthcare professionals and others, in addition to utilizing resources. To support the process in which an individual independently sets goals and action plans, engages in strategies, self-management support based on learning theories that lead to cognitive, emotional, and behavioral changes is necessary.
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Affiliation(s)
- Chika Tanimura
- School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Keiko Oba
- School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Yoshimi Noguchi
- School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Tomoyuki Itamochi
- Department of Nursing Science, Faculty of Nursing and Nutrition, The University of Shimane, Izumo 693-8550, Japan
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Kasa AS, Traynor V, Drury P. Measuring the effects of nurse-led frailty intervention on community-dwelling older people in Ethiopia: a quasi-experimental study. BMC Geriatr 2024; 24:384. [PMID: 38689218 PMCID: PMC11061989 DOI: 10.1186/s12877-024-04909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Despite the critical need, interventions aimed at frailty in sub-Saharan Africa are scarce, attributed to factors such as insufficient healthcare infrastructure, the pressing need to address infectious diseases, maternal and child health issues, and a general lack of awareness. Hence, the aim of this research was to develop, implement, and evaluate the effect of a nurse-led program on frailty and associated health outcomes in community-dwelling older individuals in Ethiopia. METHODS This study utilised a pre-test, post-test, and follow-up single-group quasi-experimental design. The main outcome measure was to determine changes in the frailty levels of older individuals living in communities at three different intervals: initially (T0), immediately after the intervention (T1), and 12 weeks following the intervention (T2). Secondary outcomes were the observed changes in daily living activities, nutritional status, depression levels, and quality of life (QOL), evaluated at each of these data collection points. To analyse changes in frailty and response variables over these periods, Friedman's ANOVA and Cochran's Q test were employed, setting the threshold for statistical significance at P < 0.05. RESULTS Sixty-six older people with a high adherence rate of 97% completed the intervention and the follow-up measurements. Participants had an average age of 66.7 ± 7.9 years, with females comprising 79.4% of the group. Notably, 12 weeks post-intervention, there was a marked decrease in frailty (χ2(2) = 101.05, p < 0.001) and depression scores (χ2(2) = 9.55, p = 0.008) compared to the baseline. However, the changes in depression, physical, mental, and environmental domains of QOL were not sustained for 12 weeks post-intervention. Study participants showed an improvement in nutritional status (χ2(2) = 25.68, p < 0.001), activity of daily living (χ2(2) = 6.00, p = 0.05), and global quality of life (χ2(2) = 20.64, p < 0.001). CONCLUSIONS The nurse-led intervention notably, 12 weeks post-intervention reduced frailty and depression. The intervention improved the nutritional status and some components of the quality of life of the participants. There is a need for further studies, especially with larger participant groups and stronger research designs such as randomized controlled trials (RCTs). TRIAL REGISTRATION ClinicalTrials.gov: NCT05754398 (03/03/2023).
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Affiliation(s)
- Ayele Semachew Kasa
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), NSW, Australia.
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), NSW, Australia
| | - Peta Drury
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), NSW, Australia
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Tang J, Ma Y, Hoogendijk EO, Chen J, Yue J, Wu C. Associations between healthy lifestyle and mortality across different social environments: a study among adults with frailty from the UK Biobank. Eur J Public Health 2024; 34:218-224. [PMID: 38288504 PMCID: PMC10990525 DOI: 10.1093/eurpub/ckae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Among people living with frailty, adherence to a healthy lifestyle may be a low-cost and effective strategy to decrease frailty-induced health risks across different social environments. METHODS We included 15 594 frail participants at baseline from the UK Biobank study. We used four lifestyle factors to create a composite healthy lifestyle score and 17 social factors to construct a polysocial score. We classified the lifestyle score into two levels (unhealthy and healthy) and the polysocial score into three levels (low, intermediate and high). We used Cox regression to determine the association of each lifestyle factor and lifestyle score with all-cause mortality, respectively. We also examined the associations across polysocial score categories. We evaluated the joint association of the lifestyle score and the categorical polysocial score with all-cause mortality. RESULTS During up to 14.41 follow-up years, we documented 3098 all-cause deaths. After multivariable adjustment, we found a significant association between not smoking and adequate physical activity with all-cause mortality across polysocial score categories, respectively. We also found a significant association between a healthy diet and all-cause mortality among frail participants living in an intermediate social environment. A healthy lifestyle was associated with a lower all-cause mortality risk across polysocial score categories, especially among those with a low polysocial score. CONCLUSIONS Adherence to a healthy lifestyle, particularly not smoking, adequate physical activity and a healthy diet, may provide a feasible solution to decreasing mortality risk among frail adults across different social environments, especially for those in the socially disadvantaged group.
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Affiliation(s)
- Junhan Tang
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC—location VU University Medical Center, Amsterdam, The Netherlands
| | - Jie Chen
- Center for Global Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
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Inoue Y, Nakatani H, Ono I, Peng X. Factors related to a sense of economic insecurity among older adults who participate in social activities. PLoS One 2024; 19:e0301280. [PMID: 38547217 PMCID: PMC10977778 DOI: 10.1371/journal.pone.0301280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 03/12/2024] [Indexed: 04/02/2024] Open
Abstract
Japan has the highest life expectancy worldwide. Older adults who experience economic insecurity may refrain from seeking medical consultation or using long-term care insurance, and these behaviors may increase the incidence and progression of frailty. This study conducted a cross-sectional survey to identify factors related to a sense of economic insecurity among older adults who participate in social activities, and identified support measures. In total, 1,351 older adults aged ≥65 years who had participated in social activities voluntarily completed an anonymous self-administered questionnaire. The questionnaire encompassed their physical, cognitive, social, and psychological conditions, and economic insecurity. We performed univariate analysis considering a sense of economic insecurity as the dependent variable, and conducted multiple logistic regression analysis (forced entry method) considering the independent variables with p<0.1 as the covariates. Among the 872 filled questionnaires, 717 were analyzed as they had no missing data with respect to the responses to survey questions (valid response rate was 53.1%). Analysis results showed that 43.6% of the older adults had a sense of economic insecurity, which was most common among those aged 75-84 years, accounting for 47.3%, followed by those aged 65-74 years accounting for 44.1%, and those aged ≥85 years accounting for 31.5% (p<0.05). The sense of economic insecurity was not associated with physical conditions, subjective symptoms of dementia, or social conditions; however, it grew with increased loneliness (OR: 1.71, 1.002-2.92, p = 0.049) and decreased with an increased subjective sense of well-being (OR: 0.86, 0.81-0.92, <0.001). Economic insecurity among older adults was not associated with physical, cognitive, or social aspects, as reported in previous studies. The survey respondents constituted older adults who participate in social activities. Maintaining interactions within the community, even in old age, may prevent loneliness and improve subjective health.
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Affiliation(s)
- Yuriko Inoue
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
| | - Hisae Nakatani
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
| | - Ichie Ono
- Department of Nursing, Yasuda Women’s University, Hiroshima City, Hiroshima, Japan
| | - Xuxin Peng
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
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Li T, Shen Y, Leng Y, Zeng Y, Li L, Yang Z, Wang S, Jiang Y. The prevalence of oral frailty among older adults: a systematic review and meta‑analysis. Eur Geriatr Med 2024:10.1007/s41999-023-00930-7. [PMID: 38528284 DOI: 10.1007/s41999-023-00930-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/29/2023] [Indexed: 03/27/2024]
Abstract
BACKGROUND In recent years, oral frailty was proposed as a new concept regarding dental and oral health in older adults. Poor oral health is linked to preserving general health and has become a geriatric public health problem that deeply affects healthy aging. While in present, evidence on the prevalence associated with oral frailty in older adults remains unclear. OBJECTIVE To systematically evaluate the prevalence of oral frailty among older adults, stratified by relevant factors such as gender, source, study design, region, and the evaluation scales for oral frailty and provide an evidence-based foundation for healthcare professionals and policymakers to formulate relevant measures. METHODS Ten electronic databases were systematically searched from inception to September 2023, including PubMed, Web of Science, Embase, PsycINFO, The Cochrane Library, CINAHL, China National Knowledge Infrastructure Database (CNKI), Chinese Biomedical Database (Sinomed), Weipu Database, and Wanfang database. Based on the Stata 15.0 software package, a random effect model was used to calculate the pooled prevalence of oral frailty among older adults. In addition, sensitivity analysis, subgroup analysis, and meta-regression were conducted based on different study characteristics to detect heterogeneity sources. Funnel plots, Begg's and Egger's tests were used to evaluate the publication bias. RESULTS Eighteen studies with a total of 12,932 older adults were included for meta-analysis. The pooled prevalence of oral frailty and oral pre-frailty was 24% (95% CI: 20-28%) and 57% (95% CI: 52-61%) respectively. Based on different assessment tools of oral frailty, the pooled prevalence of oral frailty was higher when using the OFI-8 scale (44.1%; 95% CI: 35.4-52.8%) than the OFI-6 scale (18.3%; 95% CI: 15.8-20.8%) or OF checklist (22.1%; 95% CI: 17.4-26.7%). The prevalence of oral frailty was higher among older adults in females (23.8%; 95% CI: 18.4-29.2%), hospital settings (31%, 95% CI: 16.6-45.5%), cross-sectional design (26.7%, 95% CI: 19.2-34.2%), and China (45.9%, 95% CI: 34.4-57.3%). CONCLUSIONS Our study showed that oral frailty was common among older adults and various characteristics may affect its prevalence. Thus, healthcare professionals and policymakers should take oral frailty seriously in clinical practice and program planning and develop more preventive measures for oral frailty among older adults.
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Affiliation(s)
- Tao Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yinli Shen
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yingjie Leng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - You Zeng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Long Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Zijiang Yang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Siyu Wang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yunlan Jiang
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
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Chen M, Bolt G, Hooimeijer P. The impact of residential environment on older people's capabilities to live independently: a survey in Beijing. BMC Public Health 2024; 24:843. [PMID: 38500091 PMCID: PMC10949666 DOI: 10.1186/s12889-024-18262-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/03/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Studies have shown how environmental factors influence older people's health and functional limitations, which are crucial for achieving healthy aging. However, such a healthy aging model has been criticized for defining health as an absence of disease, because chronic conditions cannot be reversed through medical treatments. In response to such critiques, this study refers to Huber's positive health definition, arguing that health should not be defined as the absence of disease but as the ability to adapt and self-manage in the face of social, physical, and emotional challenges. There is a need to develop a community-based approach to healthy aging that considers how the residential environment enables older people to adapt and self-manage. Drawing on Sen's capability approach, this study proposes that such a community-based approach should provide a supportive environment to enable older people's capabilities to live independently. METHODS Using hierarchical multiple regression analysis of data from 650 older people (60 years and older) surveyed in Beijing, we unravel which features of the residential environment support older people' s capabilities to live independently and how these impacts differ depending on older people's frailty levels. RESULTS The results show that four environmental factors, namely perceived accessibility (B = 0.238, p < 0.001 for physical capability, B = 0.126, p < 0.001 for social capability, B = 0.195, p < 0.001 for psychological capability), pleasant surroundings (B = 0.079, p < 0.05 for physical capability, B = 0.065, p < 0.05 for social capability), meeting opportunities (B = 0.256, p < 0.001 for social capability, B = 0.188, p < 0,001 for psychological capability, and life convenience B = 0.089, p < 0.05 for physical capability, B = 0.153, p < 0.001 for psychological capability) positively affect older people's capabilities to live independently. These four environmental factors cause differences in older people's capabilities between different neighborhood types. Moderation analysis shows that meeting opportunities are more relevant for frail older people (B = 0.090, p < 0.001 for social capability, B = 0.086, p < 0.01 for psychological capability). CONCLUSIONS This study contributes to the literature by emphasizing the role of supportive residential environments in enabling older people to live independently. Furthermore, we identify four environmental factors that support older people's capabilities. Results can be used to develop effective community-based environmental support to enable older people to live independently.
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Affiliation(s)
- Mengyuan Chen
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands.
| | - Gideon Bolt
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands
| | - Pieter Hooimeijer
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands
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11
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Lameirinhas J, Gorostiaga A, Etxeberria I. Defining and assessing psychological frailty in older adults: a scoping review protocol. BMJ Open 2024; 14:e080179. [PMID: 38443084 PMCID: PMC11086467 DOI: 10.1136/bmjopen-2023-080179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Frailty is widely acknowledged as a multidimensional construct encompassing physical, psychological and social aspects. However, the lack of consensus in defining and operationalising psychological frailty challenges the holistic approach to frailty advocated by health professionals. Consequently, there is a need to develop a comprehensive definition of psychological frailty based on contributions made by experts in the field, primarily existing frailty assessment tools. This scoping review will aim to identify the key psychological variables that are considered in frailty assessment tools used with older adults as well as to analyse how these psychological variables have been operationalised. METHODS AND ANALYSIS The study will be conducted in accordance with recommendations from several methodological frameworks for scoping reviews and will be reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews statement guidelines. A systematic literature search will be performed in the CINAHL, MEDLINE, PsycInfo, Scopus and Web of Science databases, supplemented by a search in Google Scholar and reference lists. The focus will be on studies that describe the development of multicomponent frailty assessment tools including at least one psychological variable. Study selection and data extraction will be independently conducted by three reviewers working in pairs. Data will be presented in tabular form, and the data will be analysed using qualitative content analysis. ETHICS AND DISSEMINATION This study does not require ethical approval since it is based on secondary data analysis. The findings of the review will be disseminated through publication in a peer-reviewed scientific journal and will be presented at conferences and seminars. TRIAL REGISTRATION NUMBER The scoping review was registered in Open Science Framework on 29 March 2022 (https://osf.io/bn24y).
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Affiliation(s)
- Joanes Lameirinhas
- Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Gipuzkoa, Spain
| | - Arantxa Gorostiaga
- Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Gipuzkoa, Spain
| | - Igone Etxeberria
- Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Gipuzkoa, Spain
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12
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Mehrabi F, Béland F. The role of frailty in the relationships between social relationships and health outcomes: a longitudinal study. BMC Public Health 2024; 24:602. [PMID: 38402184 PMCID: PMC10894481 DOI: 10.1186/s12889-024-18111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Socially isolated older adults incur increased risks of adverse health outcomes, though the strength of this association is unclear. We examined whether changes in physical frailty moderated the associations between changes in social relationships and changes in health outcomes among older adults. METHODS This longitudinal study is based on three waves of the FRéLE study among 1643 Canadian community-dwelling older adults aged 65 years and older over 2 years. We performed latent growth curve modelling (LGMs) to assess changes with the assumption of missing not at random, adjusting for time-invariant covariates. We used the latent moderated structural equations (LMS) to test the interactions in LGMs. Social relationships were measured by social participation, social networks, and social support from different social ties. Frailty was assessed using the five components of the phenotype of frailty. RESULTS The results revealed that changes in frailty moderated changes in social participation (β = 3.229, 95% CI: 2.212, 4.245), social contact with friends (β = 4.980, 95% CI: 3.285, 6.675), and social support from friends (β = 2.406, 95% CI: 1.894, 2.917), children (β = 2.957, 95% CI: 1.932, 3.982), partner (β = 4.170, 95% CI: 3.036, 5.305) and extended family (β = 6.619, 95% CI: 2.309, 10.923) with changes in cognitive function and depressive symptoms, but not with chronic diseases. These results highlight the beneficial role of social relationships in declining depressive symptoms and improving cognitive health among older adults experiencing increases in frailty. CONCLUSIONS The findings suggest that changes in social support have a protective and compensatory role in decreasing depressive symptoms and enhancing cognitive health among older adults with increasing frailty. Public health policy and strategies should consider the impact of social support on multiple health outcomes among older adults with increasing frailty. Further experimental studies and interventions are warranted to extend findings on the relationships between social relationships and health outcomes, targeting frail older adults. Future studies may also consider other health-related risk factors that may impact the associations between social relationships and health outcomes among older adults.
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Affiliation(s)
- Fereshteh Mehrabi
- School of Public Health, Université de Montréal, Montréal, Québec, Canada.
- Department of Psychology, Concordia University, Montréal, Québec, Canada.
| | - François Béland
- School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
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13
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Ijaz N, Jamil Y, Brown CH, Krishnaswami A, Orkaby A, Stimmel MB, Gerstenblith G, Nanna MG, Damluji AA. Role of Cognitive Frailty in Older Adults With Cardiovascular Disease. J Am Heart Assoc 2024; 13:e033594. [PMID: 38353229 PMCID: PMC11010094 DOI: 10.1161/jaha.123.033594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 02/21/2024]
Abstract
As the older adult population expands, an increasing number of patients affected by geriatric syndromes are seen by cardiovascular clinicians. One such syndrome that has been associated with poor outcomes is cognitive frailty: the simultaneous presence of cognitive impairment, without evidence of dementia, and physical frailty, which results in decreased cognitive reserve. Driven by common pathophysiologic underpinnings (eg, inflammation and neurohormonal dysregulation), cardiovascular disease, cognitive impairment, and frailty also share the following risk factors: hypertension, diabetes, obesity, sedentary behavior, and tobacco use. Cardiovascular disease has been associated with the onset and progression of cognitive frailty, which may be reversible in early stages, making it essential for clinicians to diagnose the condition in a timely manner and prescribe appropriate interventions. Additional research is required to elucidate the mechanisms underlying the development of cognitive frailty, establish preventive and therapeutic strategies to address the needs of older patients with cardiovascular disease at risk for cognitive frailty, and ultimately facilitate targeted intervention studies.
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Affiliation(s)
- Naila Ijaz
- Thomas Jefferson University HospitalPhiladelphiaPAUSA
| | - Yasser Jamil
- Yale University School of MedicineNew HavenCTUSA
| | | | | | - Ariela Orkaby
- New England GRECC, VA Boston Healthcare SystemBostonMAUSA
- Division of AgingBrigham & Women’s Hospital, Harvard Medical SchoolBostonMAUSA
| | | | | | | | - Abdulla A. Damluji
- Johns Hopkins University School of MedicineBaltimoreMDUSA
- The Inova Center of Outcomes ResearchInova Heart and Vascular InstituteFalls ChurchVAUSA
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14
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Miao X, Guo Y, Chen Y, Xu X, Ding L, Hu J, Zhao K, Lu J, Zhu H, Chen L, Zhu S, Xu Q. Exploration of frailty trajectories and their associations with health outcomes in older gastric cancer survivors undergoing radical gastrectomy: A prospective longitudinal observation study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107934. [PMID: 38160495 DOI: 10.1016/j.ejso.2023.107934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/21/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Frailty is commom among gastric cancer survivors and increases the burden of care. AIMS Our aims were to identify the frailty trajectories and investigate their associations with health outcomes in older gastric cancer survivors. METHODS We finally recruited 381 patients aged ≧60 who underwent radical gastrectomy and recorded frailty at discharge from the hospital, 1, 3, 6, and 12 months after surgery. Growth mixture modeling was used to investigate the frailty trajectories and linear regression models were used to examine their associations with health outcomes. RESULTS Three classes of frailty trajectories were identified: the "improving frailty", "maintaining frailty" and "deteriorating frailty". Compared with class 1, patients who followed class 2 and class 3 frailty trajectories were more likely to have more severe disability (β = -14.22, 95 % CI: -17.92, -10.61, P < 0.001; β = -48.34, 95 % CI: -52.25, -44.42, P < 0.001), worse quality of life (β = 10.89, 95 % CI: 7.71,14.08, P < 0.001; β = 34.82, 95 % CI: 31.46, 38.19, P < 0.001), and more frequency readmission within 1 year (β = 1.02, 95 % CI: 0.98, 1.06, P < 0.001; β = 2.10, 95 % CI: 2.01, 2.14, P < 0.001) after controlling potential confounders. However, class 2 and class 3 have no significant difference from class 1 in the total hospitalization costs (β = 1672.12, 95 % CI: -7145.95, 10496.19, P = 0.709; β = 7651.60, 95 % CI: -1670.28, 16793.47, P = 0.107). CONCLUSIONS Our study suggested the significant prognostic heterogeneity in frailty trajectories, and what we need to do is to identify patients with heterogeneous trajectory and intervene in them to reduce adverse outcomes, promote rational use of resources, and reduce the burden of care.
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Affiliation(s)
- Xueyi Miao
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Yinning Guo
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Yimeng Chen
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Xinyi Xu
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Lingyu Ding
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Jieman Hu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Jinling Lu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Li Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China.
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15
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Dewhurst F, Hanratty B, Frew K, Paes P, Walker R, Barnes C, Maddock H, Elverson J, Byrne-Davis L. Palliative medicine trainees be should learn about frailty: meta-synthesis and Delphi study to establish curriculum content. BMJ Support Palliat Care 2024; 13:e1008-e1018. [PMID: 34815248 DOI: 10.1136/bmjspcare-2021-003013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 10/02/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Frailty is common and highly associated with morbidity and mortality, a fact that has been highlighted by COVID-19. Understanding how to provide palliative care for frail individuals is an international priority, despite receiving limited mention in Palliative Medicine curricula or examinations worldwide. This study aimed to synthesise evidence and establish expert consensus on what should be included in a Palliative-Medicine Specialist Training Curriculum for frailty. METHODS Literature Meta-synthesis conducted by palliative medicine, frailty and education experts produced a draft curriculum with Bologna based Learning-Outcomes. A Delphi study asked experts to rate the importance of Learning-Outcomes for specialist-training completion and propose additional Learning-Outcomes. This process was repeated until 70% consensus was achieved for over 90% of Learning-Outcomes. Experts divided Learning-Outcomes into specific (for inclusion in a frailty subsection) or generic (applicable to other palliative conditions). The Delphi panel was Subject Matter Experts: Palliative-Medicine Consultants (n=14) and Trainees (n=10), representing hospital, community, hospice and care home services and including committee members of key national training organisations. A final reviewing panel of Geriatric Medicine Specialists including experts in research methodology, national training requirements and frailty were selected. RESULTS The meta-synthesis produced 114 Learning-Outcomes. The Delphi Study and Review by Geriatric Medicine experts resulted in 46 essential and 33 desirable Learning-Outcomes. CONCLUSIONS This frailty curriculum is applicable internationally and highlights the complex and unique palliative needs of frail patients. Future research is required to inform implementation, educational delivery and service provision.
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Affiliation(s)
- Felicity Dewhurst
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
- St Oswalds Hospice, Newcastle upon Tyne, UK
| | - Barbara Hanratty
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Katherine Frew
- Palliative Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Paul Paes
- Palliative Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
- School of Medical Education, Newcastle University, Newcastle upon Tyne, UK
| | - Richard Walker
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
- Geriatric Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Catherine Barnes
- Geriatric Medicine, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Helena Maddock
- Geriatic Medicine, Gateshead Health NHS Foundation Trust, Gateshead, UK
| | | | - Lucie Byrne-Davis
- Division of Medical Education, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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16
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Khalil AH, Gobbens RJJ. What If the Clinical and Older Adults' Perspectives about Frailty Converge? A Call for a Mixed Conceptual Model of Frailty: A Traditional Literature Review. Healthcare (Basel) 2023; 11:3174. [PMID: 38132064 PMCID: PMC10742490 DOI: 10.3390/healthcare11243174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/01/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
Existing frailty models have enhanced research and practice; however, none of the models accounts for the perspective of older adults upon defining and operationalizing frailty. We aim to propose a mixed conceptual model that builds on the integral model while accounting for older adults' perceptions and lived experiences of frailty. We conducted a traditional literature review to address frailty attributes, risk factors, consequences, perceptions, and lived experiences of older adults with frailty. Frailty attributes are vulnerability/susceptibility, aging, dynamic, complex, physical, psychological, and social. Frailty perceptions and lived experience themes/subthemes are refusing frailty labeling, being labeled "by others" as compared to "self-labeling", from the perception of being frail towards acting as being frail, positive self-image, skepticism about frailty screening, communicating the term "frail", and negative and positive impacts and experiences of frailty. Frailty risk factors are classified into socio-demographic, biological, physical, psychological/cognitive, behavioral, and situational/environmental factors. The consequences of frailty affect the individual, the caregiver/family, the healthcare sector, and society. The mixed conceptual model of frailty consists of interacting risk factors, interacting attributes surrounded by the older adult's perception and lived experience, and interacting consequences at multiple levels. The mixed conceptual model provides a lens to qualify frailty in addition to quantifying it.
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Affiliation(s)
- Asya Hani Khalil
- Hariri School of Nursing, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Robbert J. J. Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands;
- Zonnehuisgroep Amstelland, 1186 AA Amstelveen, The Netherlands
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
- Tranzo, Tilburg University, 5037 DB Tilburg, The Netherlands
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17
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Saeki N, Mizutani M, Tanimura S, Nishide R. Types and frequency of social participation and comprehensive frailty among community-dwelling older people in Japan. Prev Med Rep 2023; 36:102443. [PMID: 38021414 PMCID: PMC10656264 DOI: 10.1016/j.pmedr.2023.102443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Although research has established social participation as important for preventing frailty in older people, the association between the type and frequency of social participation and comprehensive frailty remains unclear. This study aimed to reveal the associations between types and frequency of social participation and comprehensive frailty among community-dwelling older people. This was a cross-sectional study conducted in four cities and towns (Inabe City, Nabari City, Odai Town, and Kiho Town) of Mie Prefecture, Japan, among adults who were: (i) aged ≥65 years and (ii) not certified as needing long-term care. We measured comprehensive frailty using the participants' total scores on the Kihon Checklist, developed by Ministry of Health, Labour and Welfare of Japan, which divides frailty status into three categories: robust (0-3 points), prefrail (4-7), and frail (8-25). Types and frequency of social participation were explanatory variables, and ordered logistic regression analysis adjusted for potential confounding factors identified the associations. The frailty status of the 296 participants (age 65-74 years: 44.3 %; female: 74.0 %) was as follows: frail, 21.3 %; prefrail, 40.2 %; and robust, 38.5 %. Lower level of frailty was associated with interaction using smartphones 2-3 times per month, participating in sports ≥4 times per week, participating in local improvement activities several times per year, and engaging in activities for children 2-4 times per month. Social participation among older adults at appropriate frequencies were associated with the lower level of comprehensive frailty. However, future longitudinal studies are needed using populations from more diverse countries or regions and from different cultures.
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Affiliation(s)
- Nanako Saeki
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Mayumi Mizutani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Susumu Tanimura
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Ritsuko Nishide
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
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18
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Calciolari S, Luini C. Effects of the bio-psycho-social frailty dimensions on healthcare utilisation among elderly in Europe: A cross-country longitudinal analysis. Soc Sci Med 2023; 339:116352. [PMID: 37952266 DOI: 10.1016/j.socscimed.2023.116352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/27/2023] [Accepted: 10/22/2023] [Indexed: 11/14/2023]
Abstract
Frailty represents an emerging challenge and has major implications for clinical practice, public health, and the sustainability of health systems. It is a geriatric condition, related to but distinct from disability and multimorbidity and characterized by a diminished physiological reserve of multiple organs. Despite limited consensus and evidence, it has been argued that cognitive and social aspects influence the condition. Therefore, we aim to provide evidence on the importance of taking a broader approach in defining frailty, by investigating the role of its physical, social, and psychological subdomains to predict healthcare utilisation in elderly Europeans. The study is based on the Survey of Health, Ageing and Retirement in Europe (SHARE), and uses 185,169 total observations from 12 European countries included in wave 4, 5, 6, and 8. The analysis investigates the influence of the physical frailty index (a proxy of the Frailty Phenotype definition), psychological and social frailty indexes (built to proxy the Tilburg Frailty Index) on the likelihood of hospitalisation and the number of doctor visits. We addressed missing values due to item non-response with fully conditional specification multivariate imputation and exploited the longitudinal structure of the data to control for time-fixed unobserved characteristics. In addition, our two multivariate models included regressors to correct for demand side factors (health status, socio-economic status, and behavioral risk) as well as for country-specific characteristics. Physical and psychological frailty positively influence the likelihood of hospitalisation (OR = 1.90 and OR = 1.31, respectively) and the number of doctor visits (IRR = 1.30 and IRR = 1.07), while social frailty reduces the two types of health services utilisation (OR = 0.53 and IRR = 0.90). The three frailty dimensions are relevant risk stratification factors in elderly Europeans, and health policies should focus more on the psycho-social aspects of this condition, as a strategy to both contain expenditures and avoid potential healthcare inequalities.
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Affiliation(s)
- Stefano Calciolari
- Università degli Studi di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milano, Italy; Università della Svizzera Italiana, Via G. Buffi 13, 6900, Lugano, Switzerland.
| | - Cecilia Luini
- Università della Svizzera Italiana, Via G. Buffi 13, 6900, Lugano, Switzerland
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19
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Luo S, Zhao H, Gan X, He Y, Wu C, Ying Y. Nomogram model for predicting frailty of patients with hematologic malignancies - A cross-sectional survey. Asia Pac J Oncol Nurs 2023; 10:100307. [PMID: 37928413 PMCID: PMC10622625 DOI: 10.1016/j.apjon.2023.100307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/09/2023] [Indexed: 11/07/2023] Open
Abstract
Objective This study aimed to develop and validate an assessment tool for predicting and mitigating the risk of frailty in patients diagnosed with hematologic malignancies. Methods A total of 342 patients with hematologic malignancies participated in this study, providing data on various demographics, disease-related information, daily activities, nutritional status, psychological well-being, frailty assessments, and laboratory indicators. The participants were randomly divided into training and validation groups at a 7:3 ratio. We employed Lasso regression analysis and cross-validation techniques to identify predictive factors. Subsequently, a nomogram prediction model was developed using multivariable logistic regression analysis. Discrimination ability, accuracy, and clinical utility were assessed through receiver operating characteristic (ROC) curves, C-index, calibration curves, and decision curve analysis (DCA). Results Seven predictors, namely disease duration of 6-12 months, disease duration exceeding 12 months, Charlson Comorbidity Index (CCI), prealbumin levels, hemoglobin levels, Generalized Anxiety Disorder-7 (GAD-7) scores, and Patient Health Questionnaire-9 (PHQ-9) scores, were identified as influential factors for frailty through Lasso regression analysis. The area under the ROC curve was 0.893 for the training set and 0.891 for the validation set. The Hosmer-Lemeshow goodness-of-fit test confirmed a good model fit. The C-index values for the training and validation sets were 0.889 and 0.811, respectively. The DCA curve illustrated a higher net benefit when using the nomogram prediction model within patients threshold probabilities ranging from 10% to 98%. Conclusions This study has successfully developed and validated an effective nomogram model for predicting frailty in patients diagnosed with hematologic malignancies. The model incorporates disease duration (6-12 months and>12 months), CCI, prealbumin and hemoglobin levels, GAD-7, and PHQ-9 scores as predictive variables.
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Affiliation(s)
- Shuangli Luo
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Huihan Zhao
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao Gan
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yu He
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Nanning, China
| | - Caijiao Wu
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yanping Ying
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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20
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Imamura K, Yamamoto S, Suzuki Y, Yoshikoshi S, Harada M, Osada S, Kamiya K, Matsuzawa R, Matsunaga A. Prevalence, overlap, and prognostic impact of multiple frailty domains in older patients on hemodialysis. Arch Gerontol Geriatr 2023; 114:105082. [PMID: 37290228 DOI: 10.1016/j.archger.2023.105082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/19/2023] [Accepted: 05/29/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Frailty is a state of increased vulnerability owing to adverse health outcomes and is recognized as a multidimensional construct. There is limited evidence on the association between multiple domains of frailty and the risk of adverse events in patients undergoing hemodialysis. We aimed to report on the prevalence, degree of overlap, and prognostic impact of multiple frailty domains in older patients undergoing hemodialysis. METHODS We retrospectively enrolled outpatients (aged ≥60 years) undergoing hemodialysis at two dialysis centers in Japan. The physical domain of frailty was defined as slow gait speed and low handgrip strength. The psychological and social domains of frailty were defined using a questionnaire to assess depressive symptoms and define social frailty status. The outcomes were all-cause mortality, all-cause hospitalization, and cardiovascular hospitalization. Cox proportional hazard and negative binomial models were used to examine these associations. RESULTS Among the 344 older patients (mean age, 72 years; male, 61%), 15.4% had an overlap in all three domains. Patients with a higher number of frailty domains had a higher risk of all-cause mortality, all-cause hospitalization, and cardiovascular hospitalization (P for trend = 0.001, 0.001, and 0.08, respectively). CONCLUSIONS These results suggest that multiple-domain assessment of frailty is an important strategy to prevent adverse events in patients requiring hemodialysis.
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Affiliation(s)
- Keigo Imamura
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan; Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi, Tokyo, 173-0015, Japan.
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Yuta Suzuki
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197 Japan
| | - Shun Yoshikoshi
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Manae Harada
- Department of Rehabilitation, Sagami Circulatory Organ Clinic, 4-21-15 Sonan, Minami-ku, Sagamihara, Kanagawa, 252-0312, Japan
| | - Shiwori Osada
- Department of Nephrology, Tokyo Ayase Kidney Center, 4-8-2 Kosuge, Katsushika, Tokyo, 124-0001 Japan
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
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Lindh Mazya A, Axmon A, Sandberg M, Boström AM, W Ekdahl A. Discordance in Frailty Measures in Old Community Dwelling People with Multimorbidity - A Cross-Sectional Study. Clin Interv Aging 2023; 18:1607-1618. [PMID: 37790740 PMCID: PMC10543411 DOI: 10.2147/cia.s411470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/05/2023] [Indexed: 10/05/2023] Open
Abstract
Purpose Assessment of frailty is a key method to identify older people in need of holistic care. However, agreement between different frailty instrument varies. Thus, groups classified as frail by different instruments are not completely overlapping. This study evaluated differences in sociodemographic factors, cognition, functional status, and quality of life between older persons with multimorbidity who were discordantly classified by five different frailty instruments, with focus on the Clinical Frailty Scale (CFS) and Fried's Frailty Phenotype (FP). Participants and Methods This was a cross-sectional study in a community-dwelling setting. Inclusion criteria were as follows: ≥75 years old, ≥3 visits to the emergency department the past 18 months, and ≥3 diagnoses according to ICD-10. 450 participants were included. Frailty was assessed by CFS, FP, Short Physical Performance Battery (SPPB), Grip Strength and Walking Speed. Results 385 participants had data on all frailty instruments. Prevalence of frailty ranged from 34% (CFS) to 75% (SPPB). Nine percent of participants were non-frail by all instruments, 20% were frail by all instruments and 71% had discordant frailty classifications. Those who were frail according to CFS but not by the other instruments had lower cognition and functional status. Those who were frail according to FP but not CFS were, to a larger extent, women, lived alone, had higher cognitive ability and functional status. Conclusion The CFS might not identify physically frail women in older community-dwelling people with multimorbidity. They could thus be at risk of not be given the attention their frail condition need.
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Affiliation(s)
- Amelie Lindh Mazya
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Geriatric Medicine of Danderyd Hospital, Stockholm, Sweden
| | - Anna Axmon
- EPI@LUND (Epidemiology, Population Studies, and Infrastructures at Lund University), Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Magnus Sandberg
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Anne-Marie Boström
- Theme Inflammation and Aging, Nursing Unit Aging, Karolinska University Hospital, Huddinge, Sweden
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- R&D unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Anne W Ekdahl
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences Helsingborg, Lund University, Helsingborg, Sweden
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22
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Mehta SP, Indramohan P, Dobariya V, Seccurro D, Goebel LJ. Validity and Accuracy of the Tilburg Frailty Indicator Part B for Identification of Frailty in Older Adults Consulting a Rural Geriatric Medicine Clinic. Can J Aging 2023; 42:466-474. [PMID: 37226297 DOI: 10.1017/s0714980823000077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
The Tilburg Frailty Indicator (TFI) is a validated tool for determining frailty in older adults. This study examined the validity and accuracy of the TFI Part B (TFI-B) in a North American context. Seventy-two individuals ≥ 65 years of age recruited from a rural geriatric medicine clinic completed a set of self-reported and performance-based measures, including TFI-B. Frailty level was determined using modified Fried's Frailty Phenotype (FFP). Pearson correlation coefficients (r) assessed the concurrent relationships between the TFI-B and other measures. Accuracy of the TFI-B in classifying frailty level was assessed using assessing area under the curve (AUC). The TFI-B scores showed low correlations (r < 0.4) with gait speed and grip, suggesting that the TFI-B did not consider frailty as merely a physical problem. The AUC of 0.82 indicated that the TFI-B scores accurately classified frail versus non-frail individuals. The score of ≥ 5 on the TFI-B scores showed satisfactory sensitivity/specificity (73%/77%) and excellent negative predictive value (91.95%). This indicates that a TFI-B score of < 5 can be used to rule out frailty.
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Affiliation(s)
- Saurabh P Mehta
- Physical Therapy Program, East Tennessee State University, Johnson City, TN, USA
- School of Physical Therapy, Marshall University, Huntington, WV, USA
| | - Pavithramohan Indramohan
- Department of Internal Medicine, Geriatrics Section, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Varun Dobariya
- Department of Internal Medicine, Geriatrics Section, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Drake Seccurro
- Department of Internal Medicine, Geriatrics Section, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Lynne J Goebel
- Department of Internal Medicine, Geriatrics Section, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
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23
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Mazya AL, Boström AM, Bujacz A, Ekdahl AW, Kowalski L, Sandberg M, Gobbens RJJ. Translation and Validation of the Swedish Version of the Tilburg Frailty Indicator. Healthcare (Basel) 2023; 11:2309. [PMID: 37628509 PMCID: PMC10454910 DOI: 10.3390/healthcare11162309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
The Tilburg Frailty Indicator (TFI) is a questionnaire with 15 questions designed for screening for frailty in community-dwelling older people. TFI has a multidimensional approach to frailty, including physical, psychological, and social dimensions. The aim of this study was to translate TFI into Swedish and study its psychometric properties in community-dwelling older people with multimorbidity. A cross-sectional study of individuals 75 years and older, with ≥3 diagnoses of the ICD-10 and ≥3 visits to the Emergency Department in the past 18 months. International guidelines for back-translation were followed. Psychometric properties of the TFI were examined by determining the reliability (inter-item correlations, internal consistency, test-retest) and validity (concurrent, construct, structural). A total of 315 participants (57.8% women) were included, and the mean age was 83.3 years. The reliability coefficient KR-20 was 0.69 for the total sum. A total of 39 individuals were re-tested, and the weighted kappa was 0.7. TFI correlated moderately with other frailty measures. The individual items correlated with alternative measures mostly as expected. In the confirmatory factor analysis (CFA), a three-factor model fitted the data better than a one-factor model. We found evidence for adequate reliability and validity of the Swedish TFI and potential for improvements.
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Affiliation(s)
- Amelie Lindh Mazya
- Division of Clinical Geriatrics, Department NVS, Karolinska Institutet, 141 83 Huddinge, Sweden
- Department of Geriatric Medicine of Danderyd Hospital, 182 88 Danderyd, Sweden
| | - Anne-Marie Boström
- Theme Inflammation and Aging, Nursing Unit Aging, Karolinska University Hospital, 141 86 Huddinge, Sweden
- Division of Nursing, Department NVS, Karolinska Institutet, 141 83 Huddinge, Sweden
- R&D Unit, Stockholms Sjukhem, 112 19 Stockholm, Sweden
| | - Aleksandra Bujacz
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Anne W. Ekdahl
- Division of Clinical Geriatrics, Department NVS, Karolinska Institutet, 141 83 Huddinge, Sweden
- Department of Clinical Sciences Helsingborg, Lund University, 251 87 Helsingborg, Sweden
| | - Leo Kowalski
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Magnus Sandberg
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden
| | - Robbert J. J. Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands
- Zonnehuisgroep Amstelland, 1180 HV Amstelveen, The Netherlands
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
- Tranzo, Tilburg University, 5037 AB Tilburg, The Netherlands
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Kasa AS, Drury P, Chang HCR, Lee SC, Traynor V. Cross-Cultural Adaptation, Validity, and Reliability Testing of the Tilburg Frailty Indicator (TFI) Amharic Version for Screening Frailty in Community-Dwelling Ethiopian Older People. Clin Interv Aging 2023; 18:1115-1127. [PMID: 37522070 PMCID: PMC10377638 DOI: 10.2147/cia.s416942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Frailty is a global health problem, including in African countries. Despite this, no reliable or valid frailty instruments incorporate any African language, and no research exists to cross-culturally adapt and test the validity and reliability of instruments commonly used in other countries for use within African countries. The Tilburg Frailty Indicator (TFI) is a reliable and validated instrument with the potential to be relevant for older populations living in Africa. This study aimed to develop the TFI Amharic (TFI-AM) version for use within Ethiopia. METHODS This study employed psychometric testing and the evaluation of a translated and adapted instrument. The original English language version of the TFI was translated and culturally adapted into Amharic using the World Health Organization process of translation and adaptation of an instrument. A convenience sample of ninety-six community-dwelling older people 60 years and over was recruited. Cronbach's alpha was used for the analysis of the internal consistency of the TFI Amharic (TFI-AM) version using IBM SPSS 26.0 (IBM Corp., Armonk, NY, USA). Face and content validities of the TFI-AM were determined. RESULTS The TFI-AM total mean score was 5.76 (±2.89). The internal consistency of the TFI-AM was very good with an overall Cronbach alpha value of 0.82. The physical domain showed the highest reliability with a 0.75 Cronbach's alpha value while the social domain was the lowest with a 0.68 Cronbach's alpha value. The Cronbach's alpha reliability coefficients of the instrument ranged from 0.68 to 0.75. The item content validity index value ranged from 0.83 to 1.0 and the total content validity index average for the instrument was 0.91. CONCLUSION The TFI-AM is reliable, valid, and reproducible for the assessment of frailty among community-dwelling older populations in Ethiopia. TFI-AM proved an easy-to-administer, applicable and fast instrument for assessing frailty in community-dwelling older populations.
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Affiliation(s)
- Ayele Semachew Kasa
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Peta Drury
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
- School of Nursing and Midwifery, Western Sydney University, Parramatta South Campus, Parramatta, New South Wales, Australia
| | - Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
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25
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Zhao J, Liu YWJ, Tyrovolas S, Mutz J. Exploring the concept of psychological frailty in older adults: a systematic scoping review. J Clin Epidemiol 2023; 159:300-308. [PMID: 37156339 DOI: 10.1016/j.jclinepi.2023.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/18/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES We reviewed the existing definitions of psychological frailty and provided a comprehensive overview of the concept and associated measurements. STUDY DESIGN AND SETTING We followed the PRISMA guidelines for scoping reviews and the Joanna Briggs Institute Manual for Evidence Synthesis. The eligibility criteria for including studies were developed based on the participants-concept-context framework. We searched the Cumulative Index to Nursing and Allied Health Literature, Scopus, PubMed, Web of Science and PsycINFO databases, and other sources for relevant studies published between January 2003 and March 2022. RESULTS The final scoping review included 58 studies. Of these, 40 defined psychological frailty, seven provided a novel definition, and 11 focused on the components defining psychological frailty. We proposed four groups of components to better characterize psychological frailty: mood, cognitive, other mental health, and fatigue-related problems. We identified 28 measuring tools across studies, and the Tilburg Frailty Indicator was the most frequently used (46.6%). CONCLUSION Psychological frailty is a complex concept whose definition seems to lack consensus. It could include both psychological and physical features. Depression and anxiety are commonly used to define it. This scoping review outlined future research directions for refining the concept of psychological frailty.
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Affiliation(s)
- Jinlong Zhao
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yat Wa Justina Liu
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Stefanos Tyrovolas
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Julian Mutz
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Pasieczna AH, Szczepanowski R, Sobecki J, Katarzyniak R, Uchmanowicz I, Gobbens RJJ, Kahsin A, Dixit A. Importance analysis of psychosociological variables in frailty syndrome in heart failure patients using machine learning approach. Sci Rep 2023; 13:7782. [PMID: 37179399 PMCID: PMC10182994 DOI: 10.1038/s41598-023-35037-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/11/2023] [Indexed: 05/15/2023] Open
Abstract
The prevention and diagnosis of frailty syndrome (FS) in cardiac patients requires innovative systems to support medical personnel, patient adherence, and self-care behavior. To do so, modern medicine uses a supervised machine learning approach (ML) to study the psychosocial domains of frailty in cardiac patients with heart failure (HF). This study aimed to determine the absolute and relative diagnostic importance of the individual components of the Tilburg Frailty Indicator (TFI) questionnaire in patients with HF. An exploratory analysis was performed using machine learning algorithms and the permutation method to determine the absolute importance of frailty components in HF. Based on the TFI data, which contain physical and psychosocial components, machine learning models were built based on three algorithms: a decision tree, a random decision forest, and the AdaBoost Models classifier. The absolute weights were used to make pairwise comparisons between the variables and obtain relative diagnostic importance. The analysis of HF patients' responses showed that the psychological variable TFI20 diagnosing low mood was more diagnostically important than the variables from the physical domain: lack of strength in the hands and physical fatigue. The psychological variable TFI21 linked with agitation and irritability was diagnostically more important than all three physical variables considered: walking difficulties, lack of hand strength, and physical fatigue. In the case of the two remaining variables from the psychological domain (TFI19, TFI22), and for all variables from the social domain, the results do not allow for the rejection of the null hypothesis. From a long-term perspective, the ML based frailty approach can support healthcare professionals, including psychologists and social workers, in drawing their attention to the non-physical origins of HF.
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Affiliation(s)
| | - Remigiusz Szczepanowski
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland.
| | - Janusz Sobecki
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
| | - Radosław Katarzyniak
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
- Zonnehuisgroep Amstelland, Amstelveen, the Netherlands
| | | | - Anant Dixit
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
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Qin F, Guo Y, Ruan Y, Huang Z, Sun S, Gao S, Ye J, Wu F. Frailty and risk of adverse outcomes among community-dwelling older adults in China: a comparison of four different frailty scales. Front Public Health 2023; 11:1154809. [PMID: 37234757 PMCID: PMC10206323 DOI: 10.3389/fpubh.2023.1154809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
Background Data on which frailty scales are most suitable for estimating risk in Chinese community populations remain limited. Herein we examined and compared four commonly used frailty scales in predicting adverse outcomes in a large population-based cohort of Chinese older adults. Methods A total of 5402 subjects (mean age 66.3 ± 9.6 years, 46.6% male) from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Frailty was measured using a 35-item frailty index (FI), the frailty phenotype (FP), FRAIL, and Tilburg Frailty Indicator (TFI). Multivariate logistic regression models were performed to evaluate the independent association between frailty and outcomes including 4-year disability, hospitalization, and 4- and 7-year all-cause mortality. The accuracy for predicting these outcomes was determined by evaluating the area under the curve (AUC). The prevalence of frailty, sensitivity, and specificity were calculated using our proposed cut-off points and other different values. Results Prevalence of frailty ranged from 4.2% (FRAIL) to 16.9% (FI). FI, FRAIL and TFI were comparably associated with 4-year hospitalization, and 4- and 7-year mortality (adjusted odds ratios [aORs] 1.44-1.69, 1.91-2.22 and 1.85-2.88, respectively). FRAIL conferred the greatest risk of 4-year disability, followed by FI and TFI (aOR 5.55, 3.50, and 1.91, respectively). FP only independently predicted 4- and 7-year mortality (aOR 1.57 and 2.21, respectively). AUC comparisons showed that FI, followed by TFI and FRAIL, exhibited acceptable predictive accuracy for 4-year disability, 4- and 7-year mortality (AUCs 0.76-0.78, 0.71-0.71, 0.65-0.72, respectively), whereas all scales poorly predicted 4-year hospitalization (AUCs 0.53-0.57). For each scale, while specificity estimates (85.3-97.3%) were high and similar across all outcomes, their sensitivity estimates (6.3-56.8%) were not sufficient yet. Prevalence of frailty, sensitivity, and specificity varied considerably when different cut-off points were used. Conclusion Frailty defined using any of the four scales was associated with an increased risk of adverse outcomes. Although FI, FRAIL and TFI exhibited fair-to-moderate predictive accuracy and high specificity estimates, their sensitivity estimates were not sufficient yet. Overall, FI performed best in estimating risk, while TFI and FRAIL were additionally useful, the latter perhaps being more applicable to Chinese community-dwelling older adults.
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Affiliation(s)
- Fei Qin
- School of Public Health, Fudan University, Shanghai, China
| | - Yanfei Guo
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
- School of Public Health and Community Medicine, Institution of Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Ye Ruan
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Zhezhou Huang
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shuangyuan Sun
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shuna Gao
- Department of Chronic Non-communicable Disease, Shanghai Huangpu Center for Disease Control and Prevention, Shanghai, China
| | - Jinghong Ye
- Department of Chronic Non-communicable Disease, Shanghai Hongkou Center for Disease Control and Prevention, Shanghai, China
| | - Fan Wu
- School of Public Health, Fudan University, Shanghai, China
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Fan JY, Xie W, Zhang WY, Liu YT, Wang Q, Zhao HM, Kong LL, Li J. To validate the integral conceptual model of frailty among community-dwelling older adults in China: a cross-sectional study. BMC Geriatr 2023; 23:242. [PMID: 37085758 PMCID: PMC10120217 DOI: 10.1186/s12877-023-03960-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
PURPOSE The integral conceptual model of frailty (ICFM) integrates physical, psychological, social aspects of individuals and stresses that frailty is a dynamic state evolving over time. This study aimed to validate the ICMF among community-dwelling older adults in China. METHODS The study recruited 341 older community-dwelling adults by convenient sampling method between June 1 and August 30, 2019 in Hubei province, China. The data was collected by questionnaire-based survey. Frailty was assessed by the Chinese version of the Tilburg Frailty Index. Participants were assessed for life-course determinants, disease and adverse health outcomes. Hierarchical regression analyses, Bootstrap method and the structural equation model were conducted in data analysis. RESULTS Both linear and logistic hierarchical regression models were statistically significant. Life-course determinants, disease, and three domains of frailty together explained 35.6% to 50.6% of the variance of disability and all domains of quality of life. The mediation effect of frailty between disease and all adverse outcomes was significant, excluding hospitalization. The structural equation model guided by the ICMF fits the data well. CONCLUSIONS The ICMF is valid among community-dwelling older adults in China. Therefore, the multidimensional concept of frailty should be widely used in Chinese communities.
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Affiliation(s)
- Jun-Yao Fan
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen Xie
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Wen-Ya Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Yue-Ting Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Quan Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Hui-Min Zhao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Ling-Lin Kong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Jie Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China.
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Malnutrition risk and frailty in head and neck cancer patients: coexistent but distinct conditions. Eur Arch Otorhinolaryngol 2023; 280:1893-1902. [PMID: 36484854 PMCID: PMC9988738 DOI: 10.1007/s00405-022-07728-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/25/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Both malnutrition and frailty are associated with adverse treatment outcomes. Malnutrition (risk) and frailty are each commonly present in patients with head and neck cancer (HNC). However, their coexistence and association is unknown. Main goal of this study is to determine the coexistence of, and the association between malnutrition risk and frailty in patients with HNC. METHODS In this retrospective analysis on prospectively collected data, newly diagnosed patients with HNC, enrolled in the OncoLifeS databiobank were included. The Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) was used to assess malnutrition risk. The Groningen Frailty Indicator (GFI) was used to assess frailty status. Multivariate logistic regression analyses were performed, taking into account several patient- and tumor-related factors. RESULTS In total, 197 patients were included. Seventy-six patients (39%) had a medium or high malnutrition risk and 71 patients (36%) were frail. In 38 patients (19%), malnutrition risk coexisted with frailty. Patients with medium and high malnutrition risk were, respectively, 4.0 (95% CI 1.5-11.2) and 13.4 (95% CI 4.0-48.7) times more likely to be frail, compared to patients with low malnutrition risk. In turn, frail patients were 6.4 times (95% CI 2.6-14.9) more likely to have malnutrition risk compared to non-frail patients. CONCLUSIONS Malnutrition risk and frailty frequently coexist but not fully overlap in newly diagnosed patients with HNC. Therefore, screening for both conditions is recommended.
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Factors Related to Multidimensional Frailty Among Hispanic People Living With HIV Aged 50 Years and Above: A Cross-sectional Study. J Assoc Nurses AIDS Care 2023; 34:259-269. [PMID: 36917646 DOI: 10.1097/jnc.0000000000000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
ABSTRACT Among Hispanics, frailty has been extensively studied as a physical syndrome associated with an increased risk for adverse outcomes. Because of additional barriers to accessing care, the impact of frailty may be even more significant for people living with HIV (PLWH). Multidimensional frailty among Hispanic PLWH has not been studied. This study aimed to examine the factors related to multidimensional frailty among Hispanic PLWH aged 50 years and above. A cross-sectional design with 120 participants was used. Hypothesized factors related to multidimensional frailty were sociodemographic and psychosocial variables. Multidimensional frailty was measured with the Tilburg Frailty Indicator. We found that 45.83% of the participants were frail ( n = 55), and multidimensional frailty was significantly associated with higher depressive symptoms ( b = .26, p < .001) and a higher number of comorbidities ( b = .71, p < .001). This study identified factors that clinicians should be aware of when caring for Hispanic PLWH to prevent or manage frailty-related complications.
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Römer C, Wolfarth B. Prediction of Relevant Training Control Parameters at Individual Anaerobic Threshold without Blood Lactate Measurement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4641. [PMID: 36901647 PMCID: PMC10001845 DOI: 10.3390/ijerph20054641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Active exercise therapy plays an essential role in tackling the global burden of obesity. Optimizing recommendations in individual training therapy requires that the essential parameters heart rate HR(IAT) and work load (W/kg(IAT) at individual anaerobic threshold (IAT) are known. Performance diagnostics with blood lactate is one of the most established methods for these kinds of diagnostics, yet it is also time consuming and expensive. METHODS To establish a regression model which allows HR(IAT) and (W/kg(IAT) to be predicted without measuring blood lactate, a total of 1234 performance protocols with blood lactate in cycle ergometry were analyzed. Multiple linear regression analyses were performed to predict the essential parameters (HR(IAT)) (W/kg(IAT)) by using routine parameters for ergometry without blood lactate. RESULTS HR(IAT) can be predicted with an RMSE of 8.77 bpm (p < 0.001), R2 = 0.799 (|R| = 0.798) without performing blood lactate diagnostics during cycle ergometry. In addition, it is possible to predict W/kg(IAT) with an RMSE (root mean square error) of 0.241 W/kg (p < 0.001), R2 = 0.897 (|R| = 0.897). CONCLUSIONS It is possible to predict essential parameters for training management without measuring blood lactate. This model can easily be used in preventive medicine and results in an inexpensive yet better training management of the general population, which is essential for public health.
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Hou YG, Feng SM, Wang SM, Zhao YJ, Yan L. The construction and validation of a frailty risk prediction model for older adults with lung cancer: A cross-sectional study. Eur J Oncol Nurs 2023; 64:102316. [PMID: 37141666 DOI: 10.1016/j.ejon.2023.102316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/18/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE We aimed to construct and internally validate a frailty risk prediction model in older adults with lung cancer. METHOD In total, 538 patients were recruited in a grade A tertiary cancer hospital in Tianjin, and patients were randomly divided into the training group (n = 377) and the testing group (n = 166) at a ratio of 7:3. The Frailty Phenotype scale was used to identify frailty and logistic regression analysis was used to identify the risk factors and establish a frailty risk prediction model. RESULTS In the training group, logistic regression showed that age, fatigue-related symptom cluster, depression, nutritional status, D-dimer level, albumin level, presence of comorbidities, and disease course were independent risk factors for frailty. The areas under the curve (AUCs) of the training and testing groups were 0.921 and 0.872, respectively. A calibration curve of P = 0.447 validated model calibration. The decision curve analysis demonstrated greater clinical benefit when the threshold probability was >20%. CONCLUSION The prediction model had a favorable prediction power for determining the risk of frailty, contributing to the prevention and screening of frailty. Patients with a frailty risk score of more than 0.374 should be regularly monitored for frailty and receive personalized preventive interventions.
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Affiliation(s)
- Ying-Ge Hou
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China; Tianjin Medical University, 300070, China.
| | - Shu-Mei Feng
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China; Tianjin Medical University, 300070, China.
| | - Song-Mei Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
| | - Ya-Jie Zhao
- Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
| | - Ling Yan
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China.
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Zhang B, Zhao P, Wang H, Wang S, Wei C, Gao F, Liu H. Factors associated with frailty in kidney transplant recipients: A cross-sectional study. J Ren Care 2023; 49:35-44. [PMID: 34860469 DOI: 10.1111/jorc.12407] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Frailty is prevalent in kidney transplant recipients and associated with multiple health care challenges. The association between frailty and outcomes has been extensively studied in kidney transplant recipients, but the status of frailty and its associated factors are not well studied, hindering efforts to develop strategies to improve care and reduce frailty. OBJECTIVES To identify the factors that are associated with frailty in kidney transplant recipients comprehensively. DESIGN AND PARTICIPANTS The associated factors of frailty were explored by a cross-sectional study of 185 kidney transplant recipients. MEASUREMENTS Data were collected using the general information questionnaire, the Charlson comorbidity index, the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Connor-Davidson Resilience Scale, the Perceived Social Support Scale and the Tilburg Frailty Indicator. Data were analyzed using the multiple linear regression analysis. RESULTS A total of 75 (40.5%) kidney transplant recipients were assessed as frail by Chinese TFI. Age (β = 0.228), time post-transplant (β = 0.055), sleep quality (β = 0.224) and psychological resilience (β = -0.038) entered the final multiple regression equation and accounted for 41.8% of the total frailty variation (R2 = 0.418, F = 21.31, p < 0.05). CONCLUSIONS Frailty was common among kidney transplant recipients. Old age, long time after transplantation, poor sleep quality and low psychological resilience were main associated factors for frailty. Integrated care interventions are therefore needed for this vulnerable population to prevent or delay frailty.
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Affiliation(s)
- Bei Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Peiyu Zhao
- Nursing Department, China-Japan Friendship Hospital, Beijing, China
| | - Han Wang
- Department of Clinical Nursing, School of Nursing, Beijing University of Chinese Medicine, Beijing, China
| | - Shasha Wang
- Department of Clinical Nursing, School of Nursing, Beijing University of Chinese Medicine, Beijing, China
| | - Changyun Wei
- Department of Clinical Nursing, School of Nursing, Beijing University of Chinese Medicine, Beijing, China
| | - Fengli Gao
- Nursing Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hongxia Liu
- Department of Clinical Nursing, School of Nursing, Beijing University of Chinese Medicine, Beijing, China
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Zhang Q, Yu M, Tang R, Wang H, Xiao M, Geng G, Xie J, Yan H. A pathway model of chronic pain and frailty in older Chinese cancer patients: The mediating effect of sleep. Geriatr Nurs 2023; 50:215-221. [PMID: 36805952 DOI: 10.1016/j.gerinurse.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 02/19/2023]
Abstract
This study aimed to explore the association between chronic pain, sleep quality, and frailty, and whether sleep quality will mediate the relationship between chronic pain and frailty. A cross-sectional study was conducted between June 2020 and July 2021 among 308 patients in Nantong city. The relationship between chronic pain and frailty was tested using linear regression. The bootstrap method was used to examine mediating effect of sleep quality. Chronic pain was significantly correlated with frailty (r=0.271, P<.001). Sleep quality played a partially mediating role between chronic pain and frailty (β=0.160, R2=32%, P<.001). Interventions to scientifically manage chronic pain and improve sleep quality may be effective in reducing the incidence of frailty in elderly cancer patients.
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Affiliation(s)
- Qin Zhang
- Department of Oncology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Ming Yu
- Department of Oncology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Rongrong Tang
- Department of Oncology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Hui Wang
- Department of Oncology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Mingbing Xiao
- Department of Science and Technology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Guiling Geng
- Medical School of Nantong University, Nantong 226001, China
| | - Juan Xie
- Department of Information, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China
| | - Haiou Yan
- Department of Nursing, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China.
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Akner G. Critical Appraisal of the Concept Frailty: Rating of Frailty in Elderly People has Weak Scientific Basis and should not be Used for Managing Individual Patients. Aging Dis 2023; 14:21-24. [PMID: 36818552 PMCID: PMC9937708 DOI: 10.14336/ad.2022.0506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
The concept frail elderly has been used to highlight the biological, rather than chronological, age. International and national bodies recommend that individuals over age 70 who visit healthcare facilities should be screened for frailty. There are important objections to the concept. Diagnostics: 'Frailty' is used for several completely different types of health problems. There are no useful biomarkers, but more than 60 different published rating methods for frailty, where different methods provide very different prevalence of frailty and also do not identify the same groups of elderly people. There is significant overlap between Clinical Frailty Scale- scores and activity of daily living (ADL)-scores. There is no gold standard method against which published frailty rating scales can be validated. It is unclear when, where and how often screening for frailty should occur in healthcare. Treatment: The evidence for treatment of frailty is very weak. A recent systematic overview found that the 21 included randomised, controlled studies (RCTs) were very heterogeneous as regards inclusion/exclusion criteria, how the condition of frailty was defined, what treatment was given and what health outcomes were assessed. In addition, there are often problems with the quality of the studies. The lack of a clear definition and evidence-based treatment of frailty means that it is inappropriate to introduce assessments of frailty in individual elderly patients in health care.
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Affiliation(s)
- Gunnar Akner
- Correspondence should be addressed to: Dr. Gunnar Akner, Geriatric Medicine at Karolinska Institutet, Stockholm, Sweden. .
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A nationwide analysis on the interaction between frailty and beta-blocker therapy in hip fracture patients. Eur J Trauma Emerg Surg 2023; 49:1485-1497. [PMID: 36633610 DOI: 10.1007/s00068-023-02219-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/31/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Hip fracture patients, who are often frail, continue to be a challenge for healthcare systems with a high postoperative mortality rate. While beta-blocker therapy (BBt) has shown a strong association with reduced postoperative mortality, its effect in frail patients has yet to be determined. This study's aim is to investigate how frailty, measured using the Orthopedic Hip Frailty Score (OFS), modifies the effect of preadmission beta-blocker therapy on mortality in hip fracture patients. METHODS This retrospective register-based study included all adult patients in Sweden who suffered a traumatic hip fracture and subsequently underwent surgery between 2008 and 2017. Treatment effect was evaluated using the absolute risk reduction (ARR) in 30-day postoperative mortality when comparing patients with (BBt+) and without (BBt-) ongoing BBt. Inverse probability of treatment weighting (IPTW) was used to reduce potential confounding when examining the treatment effect. Patients were stratified based on their OFS (0, 1, 2, 3, 4 and 5) and the treatment effect was also assessed within each stratum. RESULTS A total of 127,305 patients were included, of whom 39% had BBt. When IPTW was performed, there were no residual differences in observed baseline characteristics between the BBt+ and BBt- groups, across all strata. This analysis found that there was a stepwise increase in the ARRs for each additional point on the OFS. Non-frail BBt+ patients (OFS 0) exhibited an ARR of 2.2% [95% confidence interval (CI) 2.0-2.4%, p < 0.001], while the most frail BBt+ patients (OFS 5) had an ARR of 24% [95% CI 18-30%, p < 0.001], compared to BBt- patients within the same stratum. CONCLUSION Beta-blocker therapy is associated with a reduced risk of 30-day postoperative mortality in frail hip fracture patients, with a greater effect being observed with higher Orthopedic Hip Frailty Scores.
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Lachonius M, Wallström S, Odell A, Pétursson P, Jeppsson A, Skoglund K, Nielsen SJ. Patients' motivation to undergo transcatheter aortic valve replacement. A phenomenological hermeneutic study. Int J Older People Nurs 2023; 18:e12521. [PMID: 36464490 PMCID: PMC10078399 DOI: 10.1111/opn.12521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/08/2022] [Accepted: 11/17/2022] [Indexed: 12/08/2022]
Abstract
BACKGROUND Aortic stenosis is the most common valvular disease, and its prevalence is increasing due to the ageing population. Transcatheter aortic valve replacement (TAVR) is the recommended method when treating frail, older patients. Knowledge of what motivates older patients to undergo TAVR is important, in order to meet patients' expectations. OBJECTIVE The study aimed to explore the meaning of older patients' motivation to undergo TAVR. DESIGN AND METHODS The design was a qualitative study, analysed using a phenomenological hermeneutic approach. In-depth, semi-structured interviews with open-ended questions were conducted. Participants were selected from a specialist cardiology clinic in Sweden. Eighteen patients, six women and twelve men, aged 66-92, were recruited. RESULTS The analysis showed that patients who had agreed to undergo TAVR were deeply affected by their body's failure. Before the TAVR procedure, the participants were limited in their daily activities and experienced that their life was on hold. They experienced that they were barely existing. They were aware of their life-threatening condition and were forced to confront death. Yet despite an advanced age, they still had considerable zest for life. It was very important to them to remain independent in everyday life, and fear of becoming dependent had a strong impact on their motivations for undergoing TAVR. CONCLUSION Older patients' motivations to undergo TAVR are strongly influenced by their fear of being dependent on others and their zest for life. Health care professionals need to support these patients in setting realistic and personalised goals. IMPLICATION FOR PRACTICE Person-centered care actions could facilitate patients' involvement in the decision about TAVR and strenghten patients' beliefs in their own capabilities, before and after TAVR.
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Affiliation(s)
- Maria Lachonius
- Department of Molecular and Clinical Medicine, Sahlgrenska AcademyGothenburg UniversityGothenburgSweden
- Department of CardiologySahlgrenska University HospitalGothenburgSweden
| | - Sara Wallström
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
- Center for Person‐Centered Care (GPCC)University of GothenburgGothenburgSweden
- Department of Forensic PsychiatrySahlgrenska University HospitalGothenburgSweden
| | - Annika Odell
- Department of CardiologySahlgrenska University HospitalGothenburgSweden
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
| | - Pétur Pétursson
- Department of Molecular and Clinical Medicine, Sahlgrenska AcademyGothenburg UniversityGothenburgSweden
- Department of CardiologySahlgrenska University HospitalGothenburgSweden
| | - Anders Jeppsson
- Department of Molecular and Clinical Medicine, Sahlgrenska AcademyGothenburg UniversityGothenburgSweden
- Department of Cardiothoracic SurgerySahlgrenska University HospitalGothenburgSweden
| | - Kristofer Skoglund
- Department of Molecular and Clinical Medicine, Sahlgrenska AcademyGothenburg UniversityGothenburgSweden
- Department of CardiologySahlgrenska University HospitalGothenburgSweden
| | - Susanne J. Nielsen
- Department of Molecular and Clinical Medicine, Sahlgrenska AcademyGothenburg UniversityGothenburgSweden
- Department of Cardiothoracic SurgerySahlgrenska University HospitalGothenburgSweden
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Kim S, Won CW. Optimistic orientation and frailty in community-dwelling older adults: Results from KFACS study. Exp Gerontol 2022; 170:111963. [PMID: 36191834 DOI: 10.1016/j.exger.2022.111963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/30/2022] [Accepted: 09/21/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Optimistic orientation is linked to several benefits, including better-coping skills, lower stress levels, and better physical health. This study aimed to identify whether optimistic orientation is associated with physical frailty and whether it is related to each component of physical frailty. METHODS We conducted a cross-sectional analysis of 2019 survey data from the Korean Frailty and Aging Cohort Study, which included 1203 participants aged 70-84 years. Frailty was defined using the Fried frailty phenotype and optimistic orientation was assessed using the Life Orientation Test-Revised. RESULTS Optimistic orientation and frailty were negatively correlated (r = -0.214, p < 0.001). After adjusting for several variables, the relationship between optimistic orientation and physical frailty was only significant in women (odds ratio [OR] = 2.960, 95 % confidence interval [CI]:2 1.375-6.371). Regarding the relationship with the five components of the physical frailty phenotype, the least optimistic women were more exhausted (OR = 1.829, 95 % CI: 1.224-2.732) and weaker (OR = 1.955, 95 % CI: 1.197-3.192) after adjusting for age, body mass index, alcohol consumption, smoking, education, marital status, social activity, living alone, family income, cognitive state, nutritional status, comorbidity, and depression. DISCUSSION Optimistic orientation was negatively associated with physical frailty only in women. Among the components of physical frailty, exhaustion and weakness are associated with optimistic orientation in women.
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Affiliation(s)
- Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Fujiwara Y, Kondo K, Koyano W, Murayama H, Shinkai S, Fujita K, Arai H, Horiuchi F. Social frailty as social aspects of frailty: Research, practical activities, and prospects. Geriatr Gerontol Int 2022; 22:991-996. [DOI: 10.1111/ggi.14492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/08/2022] [Accepted: 09/17/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Yoshinori Fujiwara
- Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences Chiba University Chiba Japan
| | - Wataru Koyano
- Faculty of Psychology and Social Welfare Seigakuin University Ageo Japan
| | - Hiroshi Murayama
- Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | | | - Koji Fujita
- Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology Obu Japan
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Iriarte E, Cianelli R, De Santis JP, Baeza MJ, Alamian A, Castro JG, Matsuda Y, Araya AX. Frailty among older Hispanics living in the United States: A scoping review. Geriatr Nurs 2022; 48:287-295. [PMID: 36335855 DOI: 10.1016/j.gerinurse.2022.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
A scoping review was conducted to identify the available evidence about frailty among older Hispanics living in the U.S. using the Integral Model of Frailty. A not time-limited search was conducted in five peer-reviewed databases. Identified factors associated with frailty among older Hispanics are presented in four categories: (1) Characteristics and prevalence of frailty, (2) Life course determinants of frailty, (3) Comorbidities associated with frailty, and (4) Adverse outcomes of frailty. A total of 1030 articles were identified, and 37 articles were included in the scoping review. Most studies measured frailty based on the Fried Frailty Phenotype (59.5%, n= 22) and had a longitudinal design (64.9%, n= 24). The overall prevalence of frailty among Hispanics ranged from 4.3% to 37.1% (n= 20 studies). Further research is needed that targets Hispanics from different backgrounds in the U.S., particularly those that are high in number (i.e., Mexicans, Puerto Ricans, and Central Americans).
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Affiliation(s)
- E Iriarte
- CU College of Nursing, University of Colorado, 13120 E 19th Ave, Aurora, CO 80045, USA; Pontificia Universidad Católica de Chile, School of Nursing. Vicuña Mackenna 4680, Macul, Santiago, Chile; Millennium Institute for Care Research, MICARE. Chile.
| | - R Cianelli
- Pontificia Universidad Católica de Chile, School of Nursing. Vicuña Mackenna 4680, Macul, Santiago, Chile; School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA
| | - J P De Santis
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA
| | - M J Baeza
- Pontificia Universidad Católica de Chile, School of Nursing. Vicuña Mackenna 4680, Macul, Santiago, Chile; School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA
| | - A Alamian
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA
| | - J G Castro
- Leonard M. Miller School of Medicine, University of Miami, 1600 NW 10th Ave #1140, Miami, FL 33136, USA
| | - Y Matsuda
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA
| | - A X Araya
- Millennium Institute for Care Research, MICARE. Chile; School of Nursing, Universidad Andrés Bello, República 498, Santiago, Chile
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Marconcin P, Barak S, Ferrari G, Gouveia ÉR, de Maio Nascimento M, Willig R, Varela M, Marques A. Prevalence of Frailty and Its Association with Depressive Symptoms among European Older Adults from 17 Countries: A 5-Year Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114055. [PMID: 36360934 PMCID: PMC9655131 DOI: 10.3390/ijerph192114055] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND This study aimed to examine the association between frailty and depressive symptoms. METHODS Cross-sectional and five-year longitudinal study. Data were from the population-based Survey of Health, Aging, and Retirement in Europe (SHARE) waves six (2015) and eight (2020). Frailty was assessed using the SHARE-Frailty Instrument. Fatigue, appetite, walking difficulties, and physical activity were self-reported, and grip strength was measured using a handgrip dynamometer. The EURO-D 12-item scale was used to measure depressive symptoms. RESULTS The sample comprised 25,771 older adults (56.2% female) with a mean age of 66.5 (95% CI 66.4, 66.6) years. The prevalence of frailty was 4.2% (95% CI 3.9, 4.4) in 2015 and 6.7% (95% CI 13.5, 14.3) in 2020. Among frail participants, 72.5% and 69.6% had depression in 2015 and 2020, respectively. Frailty was associated with depression over the 5 years. Those with pre-frailty and those with frailty in 2015 had 1.86 (95% CI 1.71, 2.01) and 2.46 (95% CI 2.14, 2.83) greater odds of having depressive symptoms in 2020. CONCLUSIONS Frailty is a predictor of depression in older adults, and frail participants had greater odds of presenting depressive symptoms.
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Affiliation(s)
- Priscila Marconcin
- CIPER-Interdisciplinary Centre for the Study of Human Performance Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
- KinesioLab, Research Unit in Human Movement Analysis, Piaget Institute, 2805-059 Almada, Portugal
| | - Sharon Barak
- Department of Nursing, School of Health Sciences, Ariel University, Ariel 4076414, Israel
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat-Gan 5290002, Israel
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 9170022, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia 7500912, Chile
| | - Élvio R. Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- LARSYS-Laboratory for Robotics and Engineering System, Interactive Technologies Institute, 9020-105 Funchal, Portugal
| | - Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, Brazil
| | - Renata Willig
- KinesioLab, Research Unit in Human Movement Analysis, Piaget Institute, 2805-059 Almada, Portugal
| | - Margarida Varela
- RECI—Research Unit in Education and Community Intervention, Piaget Institute, 2805-059 Almada, Portugal
| | - Adilson Marques
- CIPER-Interdisciplinary Centre for the Study of Human Performance Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
- ISAMB-Environmental Health Institute, Faculty of Medicine, University of Lisbon, 1649-020 Lisbon, Portugal
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Tsukakoshi D, Yamamoto S, Takeda S, Furuhashi K, Sato M. Clinical Perspectives on Cardiac Rehabilitation After Heart Failure in Elderly Patients with Frailty: A Narrative Review. Ther Clin Risk Manag 2022; 18:1009-1028. [PMID: 36324527 PMCID: PMC9620837 DOI: 10.2147/tcrm.s350748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/11/2022] [Indexed: 01/25/2023] Open
Abstract
The purpose of this narrative review is to examine rehabilitation modalities for patients with heart failure and Frailty who require comprehensive intervention. Ischemic heart disease is the leading cause of death worldwide, accounting for 16% of global mortality. Due to population growing and aging, the total number of heart failure patients continues to rise, a condition known as the heart failure pandemic. Furthermore, frailty has been associated with an increased risk for heart failure and increased morbidity and mortality. The 2021 update of the 2017 ACC expert consensus decision pathway for optimization of HF treatment has become more concerning, citing frailty as one of the 10 most important issues associated with heart failure with reduced ejection fraction (HFrEF). Frailty and heart failure share common pathological mechanisms and are associated with poor clinical outcomes. Most studies of frailty in patients with heart failure primarily focus on physical frailty, and associations between psycho-psychological and social factors such as cognitive dysfunction and social isolation have also been reported. These results suggest that a more comprehensive assessment of frailty is important to determine the risk in patients with heart failure. Therefore, mechanisms of the three domains, including not only physical frailty but also cognitive, psychological, spiritual, and social aspects, should be understood. In addition to interventions in these three domains, nutritional and pharmacological interventions are also important and require tailor-made interventions for the widely varied conditions associated with heart failure and frailty. Although several studies have shown a relationship between frailty and prognosis in patients with heart failure, interventions to improve the prognosis have not yet been established. Further information is needed on frailty intervention by a multidisciplinary team to improve the prognosis.
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Affiliation(s)
- Daichi Tsukakoshi
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan,Correspondence: Shuhei Yamamoto, Department of Rehabilitation, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan, Tel +81-263-37-2836, Fax +81-263-37-2835, Email
| | - Shuhei Takeda
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Keisuke Furuhashi
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Masaaki Sato
- Division of Occupational Therapy, School of Health Sciences, Shinshu University, Matsumoto, Nagano, Japan
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Itokazu M, Ishizaka M, Uchikawa Y, Takahashi Y, Niida T, Hirose T, Ito A, Yakabi A, Endo Y, Sawaya Y, Igawa T, Kobayashi K, Hara T, Watanabe M, Kubo A, Urano T. Relationship between Eye Frailty and Physical, Social, and Psychological/Cognitive Weaknesses among Community-Dwelling Older Adults in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13011. [PMID: 36293591 PMCID: PMC9602133 DOI: 10.3390/ijerph192013011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the relationship between eye frailty and physical, social, and psychological/cognitive weaknesses among older adults in Japan. The participants were 192 community-dwelling older adult women. We measured handgrip strength, walking speed, and skeletal muscle mass; additionally, their physical, social, and psychological/cognitive frailties were surveyed using questionnaires. Eye frailty self-checks were used to assess eye frailty. Exploratory and confirmatory factor analyses were employed to verify the validity of the eye frailty self-checks. Eye frailty prevalence and related factors were investigated by conducting a binomial logistic regression analysis, with eye frailty as the dependent variable. The factor analysis results showed that a model could be constructed with the two factors of visual acuity or contrast and visual field. The model's goodness of fit was acceptable, supporting the validity of the self-checking construct. The Kihon checklist was the only variable with a significant relationship to eye frailty. Regarding the relationship between eye frailty and subordinate items of the Kihon checklist, social withdrawal [odds ratio (OR) 2.437, 95% confidence interval 1.145-5.188], cognitive function (OR 2.047, 95%CI 1.051-3.984), and depressed mood (OR 1.820, 95%CI 1.163-2.848) were significant. Eye frailty can be considered a factor reflecting the existence of social and psychological/cognitive frailties.
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Affiliation(s)
- Masafumi Itokazu
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshikazu Uchikawa
- Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Takahashi
- Department of Ophthalmology, Dokkyo Medical University Nikko Medical Center, Nikko 321-2593, Tochigi, Japan
| | - Takahiro Niida
- Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Ito
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Endo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tatsuya Igawa
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Kaoru Kobayashi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita 286-8686, Chiba, Japan
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Lee M, Lee H, Song K, Lee YM. Benefits of sustained physical activity from middle age to early old age on quality of life in early old age. Sci Rep 2022; 12:16455. [PMID: 36180509 PMCID: PMC9524733 DOI: 10.1038/s41598-022-20431-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
This study aimed to examine changes in physical activity (PA) over time (2009-2017) in the same participants and to determine an association between changes in PA and health-related quality of life (HRQoL) in early older adults (n = 994) using data from the Korea Health Panel Survey. HRQoL was measured using the EuroQol system, and the amount of PA was grouped into four activity levels: remained inactive, became inactive, became active, and remained active. The association of changes in PA over 8 years with HRQoL was examined using logistic regression analysis while controlling for socioeconomic and behavioral factors. Total PA decreased from 1859.72 ± 1760.01 MET-minutes in 2009 to 1264.80 ± 1251.14 MET-minutes in 2017 (P < 0.001). In 2017, 142 (14.3%) remained inactive, whereas 419 (42.2%) remained active. Participants who remained inactive in early old age were more likely to be in the lowest 10% HRQoL of the sample (odds ratio = 1.95, 95% confidence interval = 1.09-3.48). These findings indicate that health education and promotion must be prioritized for middle-aged adults, who are relatively inactive, so that they increase their current PA and improve their HRQoL to maximize the benefits of PA in old age.
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Affiliation(s)
- Mikyung Lee
- College of Nursing, Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Hyeonkyeong Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
| | - Kijun Song
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Young-Me Lee
- School of Nursing, DePaul University, Chicago, IL, USA
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Ye B, Wang Y, Chen H, Chen Y, Yan H, Fu H, Bao Z, Gao J. Development and Validation of the Chinese Frailty Screening Scale: A Study among Community-Dwelling Older Adults in Shanghai. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811811. [PMID: 36142085 PMCID: PMC9517433 DOI: 10.3390/ijerph191811811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/07/2023]
Abstract
BACKGROUND Based on intrinsic capacity (IC) as defined by the World Health Organization, an accelerated decline may be an important precursor of frailty among older adults; however, there is a lack of validated instruments that both screen for frailty and monitor IC. This study aims to develop a comprehensive and acculturative frailty screening scale to determine healthy aging among older Chinese adults. SETTING AND PARTICIPANTS A cross-sectional and a cohort study both based on community-dwelling older adults aged 65 and older. METHODS This study mainly consisted of two parts. First, the selection and revision of 20 items related to frailty based on a literature review, expert consultation, and stakeholder analysis; second, a cross-sectional study was conducted to simplify the scale and test the reliability and validity of the new frailty screening tool. The fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale, the Tilburg frailty indictor (TFI), and a 49-item Frailty Index (FI) were investigated as criteria. Additionally, a cohort study in Shanghai was conducted to verify the predictive validity of the new screening scale. The disability measured by the activity of daily living (ADL), instrumental activity of daily living (IADL) and all-cause mortality were documented as outcomes. RESULTS A 10-item Chinese frailty screening scale (CFSS-10) was successfully developed and validated. It presented a Cronbach's α of 0.63 and an intraclass correlation coefficient of 0.73, which indicated good reliability. Taking the other frailty tools as criteria, Kappa values of 0.54-0.58 and an area under the curve of 0.87-0.91 showed good validity. The results of the log-binomial and Poisson models showed a high score, which predicted a higher risk of disability and all-cause mortality. An optimal cut-off point of 5 gave an excellent prediction of one-year disability. CONCLUSIONS The CFSS-10 has good validity and reliability as a quick and acculturative frailty screening scale for community-dwelling older adults in Shanghai. It may also supplement existing frailty screening tools.
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Affiliation(s)
- Bo Ye
- Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Yi Wang
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Hao Chen
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Yingwei Chen
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Huihui Yan
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Hua Fu
- School of Public Health, Fudan University, Shanghai 200032, China
- Health Communication Institute, Fudan University, Shanghai 200032, China
| | - Zhijun Bao
- Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai 200040, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai 200032, China
- Collaborative Innovation Cooperative Unit, National Clinical Research Center for Geriatric Diseases, Shanghai 200032, China
- Core Unit, Shanghai Clinical Research Center for Geriatric Diseases, Shanghai 200032, China
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Canbolat Seyman C, Sara Y. What do orthopaedic nurses think about frailty? A qualitative analysis. Collegian 2022. [DOI: 10.1016/j.colegn.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gaspar PM, Campos-Magdaleno M, Pereiro AX, Facal D, Juncos-Rabadán O. Cognitive reserve and mental health in cognitive frailty phenotypes: Insights from a study with a Portuguese sample. Front Psychol 2022; 13:968343. [PMID: 36110284 PMCID: PMC9470123 DOI: 10.3389/fpsyg.2022.968343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/08/2022] [Indexed: 12/04/2022] Open
Abstract
Background Research on prevalence of cognitive frailty phenotypes in community-dwelling older adults in different countries is important to estimate their prevalence and to determine the influence of cognitive reserve and mental health in order to prevent frailty. The aims of this study were to estimate the prevalence of reversible and potentially reversible cognitive frailty (R-CF, PR-CF) in a Portuguese sample of old adults and explore the associations between these phenotypes and demographic, comorbidity, social support, cognitive reserve and mental health factors. Methods We assessed frailty (Fried criteria) in 250 community-dwelling older adults (179 women) aged 60 years or over (mean 71.04 years) without dementia, neurological or psychiatric disorders. Subjective cognitive decline and Mild cognitive impairment were diagnosed according to standard criteria. The questionnaires Charlson Index, Medical Outcomes Study Social Support, Cognitive Reserve Index and General Health were used for assessing comorbidity, social support, cognitive reserve and mental health, respectively. Results Prevalence of R-CF was 14%, and that of PR-CF, 15.2%. Cognitive frailty profiles differed significantly in relation to education, comorbidity, mental health, and cognitive reserve, but not in age or sex. Multivariate logistic regression showed that age, sex, comorbidity, social support, mental health, and cognitive reserve together predicted R-CF and PR-CF (90% specificity 75% sensitivity) with significant OR for mental health and cognitive reserve. Discussion Cognitive reserve and mental health are important factors predicting R-CF and PR-CF. We recommend assessing these factors for early detection of cognitive frailty and promoting psychological well-being and lifestyles that increase cognitive reserve in adults.
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Affiliation(s)
- Pedro Miguel Gaspar
- UNICES, Universidade da Maia, Maia, Portugal
- *Correspondence: Pedro Miguel Gaspar,
| | - María Campos-Magdaleno
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Arturo X. Pereiro
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - David Facal
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Onésimo Juncos-Rabadán
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Nurses’ Opinions on Frailty. Healthcare (Basel) 2022; 10:healthcare10091632. [PMID: 36141244 PMCID: PMC9498801 DOI: 10.3390/healthcare10091632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/26/2022] Open
Abstract
Nurses come into frequent contact with frail older people in all healthcare settings. However, few studies have specifically asked nurses about their views on frailty. The main aim of this study was to explore the opinions of nurses working with older people on the concept of frailty, regardless of the care setting. In addition, the associations between the background characteristics of nurses and their opinions about frailty were examined. In 2021, members of professional association of nurses and nursing assistants in the Netherlands (V&VN) received a digital questionnaire asking their opinions on frailty, and 251 individuals completed the questionnaire (response rate of 32.1%). The questionnaire contained seven topics: keywords of frailty, frailty domains, causes of frailty, consequences of frailty, reversing frailty, the prevention of frailty, and addressing frailty. Regarding frailty, nurses especially thought of physical deterioration and dementia. However, other domains of human functioning, such as the social and psychological domains, were often mentioned, pointing to a holistic approach to frailty. It also appears that nurses can identify many causes and consequences of frailty. They see opportunities to reverse frailty and an important role for themselves in this process.
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Thakkar S, T. M, Srivastava S. Cross-sectional associations of physical frailty with fall, multiple falls and fall-injury among older Indian adults: Findings from LASI, 2018. PLoS One 2022; 17:e0272669. [PMID: 35960705 PMCID: PMC9374260 DOI: 10.1371/journal.pone.0272669] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although there has been a range of studies that focused on physical frailty and associated fall outcomes within developed countries, similar studies from developing countries have been limited. This study aimed to examine the relationship between physical frailty and the prevalence of falls, multiple falls and fall-related injuries among the ageing population within the Indian context. METHODS Individual-level data from the first wave of the Longitudinal Aging Study in India (LASI) with 28,285 older adults aged 60 years and above (male 48.9%) was used for this study. Physical frailty was assessed through the physical frailty phenotype adapted from Fried's criteria. Multivariable logistic regression was employed to examine the association of frailty status with falls, multiple falls, and fall-related injuries among Indian older adults. RESULTS The prevalence of frailty was found to be 29.94% within the sample and frail older adults had a higher prevalence of falls (15.43% vs 11.85%), multiple falls (7.73% vs 5.25%), and fall related injuries (6.68% vs 5.29%). The odds of falling among frail older adults were significantly higher in reference to the odds of falling among non-frail older adults [aOR: 1.24; CI: 1.09-1.41]. Similarly, the odds of multiple falls among frail older adults were significantly higher in reference to the odds of multiple falls among non-frail older adults [aOR: 1.24; CI: 1.05-1.48]. Moreover, the odds of fall-related injury among frail older adults were significantly higher in reference to the odds of fall-related injury among non-frail older adults [aOR: 1.21; CI: 1.01-1.45]. Falls, multiple falls and fall-related injuries were found to be significantly associated with employment and poor self-rated health, whereas, females and lone living older adults had a significantly higher likelihood of suffering from falls and multiple falls. CONCLUSION Older individuals with physical frailty were found to be at increased risk of falls, multiple falls and fall-related injuries in India. The findings of our study also have important clinical implications in the measures undertaken to reduce falls and enable future healthcare practitioners and policymakers to factor in the key determinant of physical frailty.
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Affiliation(s)
- Shriya Thakkar
- Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Muhammad T.
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, India
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Oba K, Kagiwada Y, Kamada M, Miki R, Kondo Y, Kamakura T, Yamagami T, Fujita T, Tsuchida Y. Evaluating the feasibility of a remote-based training program supported by information and communications technology in the older adults living at home. BMC Geriatr 2022; 22:574. [PMID: 35831789 PMCID: PMC9277784 DOI: 10.1186/s12877-022-03273-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Exercise has been one of the key strategies for preventing frailty. While training programs for preventing frailty have been mainly developed in person, which have now become difficult to perform due to the coronavirus disease pandemic. It would be worthwhile to explore a feasibility of methods for a remote-based training with information and communications technology (ICT) in the pre-frail/robust older adults living at home. Methods We assessed the feasibility of a remote-based training with ICT device in terms of 1) a measurement accuracy and 2) whether it could be used for remote-based training of different intensities. To evaluate a measurement accuracy of the ICT device, we evaluated an inter-rater reliability between a true score and scores obtaining from the ICT device in 20 participants aged 65 years and older. Intraclass correlation was calculated. To evaluate a feasibility of remote-based training interventions of different intensities, we did a parallel, randomized, active controlled trial. Participants aged 65 years or older were randomly allocated to the two 3-month intervention programs with different intensity of exercise with the ICT (i.e., an Exercise-Intensive program and a Light-load exercise program). The primary outcome was 3-month scores of the 30-s chair-stand test (CS-30), which was compared between two groups using mixed models for repeated measures to account for within-person correlations. Results The ICT device showed a high intraclass correlation of over 0.99 for all outcomes including CS-30. Between Aug and Oct 2020, 70 participants (36 and 34 in the Exercise-Intensive and Light-load exercise programs, respectively) were randomized. After 3 months of intervention, CS-30 scores and other physical function improved in both groups. Difference in the 3-month CS-30 scores between two programs was found to be 0.08 (95% confidence interval: − 2.64, 2.79; p = 0.955), which was not statistically significant. No harmful incidents, such as falls, occurred in either group. Conclusion We showed a remote-based training with ICT device in the older adults living at home was feasible. Further studies are warranted to determine what kind of remote exercise intervention programs is more effective for maintaining a physical performance and, beyond that, preventing frailty. Trial registration number UMIN000041616 (05/09/2020) https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000047504&type=summary&language=E
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Affiliation(s)
- Koji Oba
- Department of Biostatistics, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan. .,Interfaculty Initiative in Information Studies, the University of Tokyo, Tokyo, Japan.
| | - Yusuke Kagiwada
- Department of Biostatistics, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Masamitsu Kamada
- Department of Health Education and Health Sociology, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryusuke Miki
- Health Planning Division, Public Health Bureau, Kobe City Government, Kobe, Japan
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