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Goto T, Kishimoto T, Fujiwara S, Shirayama Y, Ichikawa T. Social frailty as a predictor of all-cause mortality and functional disability: a systematic review and meta-analysis. Sci Rep 2024; 14:3410. [PMID: 38341512 PMCID: PMC10858956 DOI: 10.1038/s41598-024-53984-3] [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: 10/20/2023] [Accepted: 02/07/2024] [Indexed: 02/12/2024] Open
Abstract
The association between social frailty and adverse health outcomes, especially mortality and functional disability, which are essential health outcomes, has not been systematically summarized or meta-analyzed. In this study, we conducted a systematic review and meta-analysis of the impact of social frailty on all-cause mortality and functional disability, while addressing the components of social frailty. In this study, social frailty was operationally defined in alignment with the previous literature, as follows: "a state of increased vulnerability to the interactive back-and-forth of the community, including general resources, social resources, social behaviors, and needs." Hazard ratios or odds ratios described in each selected literature were used as the meta-analytic results. Considering the impact of social frailty on all-cause mortality, the hazard ratio was 1.96 (95% CI 1.20-3.19), indicating a significant association between the two but high heterogeneity. The hazard and odds ratios for the impact of social frailty on functional disability were 1.43 (95% CI 1.20-1.69) and 2.06 (95% CI 1.55-2.74), respectively. A significant association was found between social frailty and functional disability; both hazard and odds ratios were found, and low heterogeneity between these articles was observed. These results highlight the importance of assessing social frailty using more standardized methods and examining its effects on various health outcomes.
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Affiliation(s)
- Takaharu Goto
- Department of Prosthodontics and Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takahiro Kishimoto
- Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | | | - Yasuhiko Shirayama
- Department of Oral Health Science and Social Welfare, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tetsuo Ichikawa
- Department of Prosthodontics and Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
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Huang X, Zhang M, Fang J, Zeng Q, Wang J, Li J. Classifying and characterizing the development of self-reported overall quality of life among the Chinese elderly: a twelve-year longitudinal study. BMC Public Health 2022; 22:1139. [PMID: 35672842 PMCID: PMC9175517 DOI: 10.1186/s12889-022-13314-6] [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: 09/05/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background To promote healthy aging, the information about the development of quality of life (QoL) is of great importance. However, the explorations of the heterogeneity in the change of QoL under the Chinese context were limited. This study aimed to identify potential different development patterns of QoL and the influential factors using a longitudinal, nationally representative sample of the Chinese elderly. Methods We adopted a five-wave longitudinal dataset from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and a total of 1645 elderly were obtained. The sample had a mean age of 72.7 years (SD = 6.64) and was 47.2% male. Overall QoL was measured through self-report during the longitudinal process. We utilized the conditional growth mixture model (GMM) with time-invariant covariates (TICs) to explore various development patterns and associated factors. Results Three distinct trajectories of self-reported overall QoL were identified: the High-level Steady Group (17.08%), the Mid-level Steady Group (63.10%), and the Low-level Growth Group (19.82%). Results also indicated that several factors predicted distinct trajectories of self-reported overall QoL. Those elderly who received enough financial resources, had adequate nutrition, did not exhibit any disability, engaged in leisure activities, and did less physical labor or housework at the baseline were more likely to report a higher level of overall QoL over time. Conclusions There existed three development patterns of self-reported overall QoL in elders, and the findings provided valuable implications for the maintenance and improvement of QoL among the Chinese elderly. Future studies could examine the influence of other confounding factors.
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Affiliation(s)
- Xitong Huang
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| | - Minqiang Zhang
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China. .,Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China. .,Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China. .,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China.
| | - Junyan Fang
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| | - Qing Zeng
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| | - Jinqing Wang
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
| | - Jia Li
- School of Psychology, South China Normal University, West of Zhongshan Avenue, Tianhe District, Guangzhou City, 510631, Guangdong Province, China
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Costenoble A, Rossi G, Knoop V, Debain A, Smeys C, Bautmans I, Verté D, De Vriendt P, Gorus E. Does psychological resilience mediate the relation between daily functioning and prefrailty status? Int Psychogeriatr 2021; 34:1-10. [PMID: 34629136 DOI: 10.1017/s1041610221001058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Understanding of prefrailty's relationship with limitations in activities of daily living (ADLs) moderated by psychological resilience is needed, as resilience might support ADLs' maintenance and thus protect against frailty. Therefore, this study aims to analyze the influence of psychological resilience (using the Connor-Davidson Resilience Scale; CD-RISC) on the relation between ADLs and frailty status of older individuals (i.e. prefrail versus robust). DESIGN Cross-sectional design. SETTING UZ Brussels, Belgium. PARTICIPANTS Robust (Fried 0/4;n = 214; Age = 82.3 ± 2.1yrs) and prefrail (Fried 1-2/4; n = 191; Age = 83.8 ±3.2yrs) community-dwelling older individuals were included. MEASUREMENTS Frailty scores were obtained from weight loss, exhaustion, gait speed, and grip strength. A total Disability Index (DI) expressed dependency for basic (b-), instrumental (i-), and advanced (a-)ADLs. Mediation was investigated by estimating direct and indirect effects of all levels of ADLs and CD-RISC total score on prefrailty/robustness using a stepwise multiple regression approach. RESULTS Prefrailty/robustness significantly correlated with a-ADL-DI (point-biserial correlation (rpb) = 0.098; p<0.05). Adjusted for age and gender, the a-ADL-DI (p<0.05) had a significant protective direct effect against prefrailty. No effects were found with the CD-RISC total score. CONCLUSIONS Less limitation in a-ADLs is a directly correlated factor of prefrailty and might represent a higher likelihood of robustness.
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Affiliation(s)
- Axelle Costenoble
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
| | - Gina Rossi
- Personality and Psychopathology Research Group, Faculty of Psychology and Educational Sciences, VUB, Brussels, Belgium
| | - Veerle Knoop
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
| | - Aziz Debain
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Celeste Smeys
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Dominique Verté
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Belgian Ageing Studies Research Group, VUB, Brussels, Belgium
| | - Patricia De Vriendt
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Arteveldehogeschool, Ghent, Belgium
| | - Ellen Gorus
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
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Søvde BE, Sandvoll AM, Natvik E, Drageset J. In the borderland of the body: How home-dwelling older people experience frailty. Scand J Caring Sci 2021; 36:255-264. [PMID: 33939195 DOI: 10.1111/scs.12984] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/14/2021] [Indexed: 01/10/2023]
Abstract
RATIONALE The increasing number of frail home-dwelling older people has sharpened the focus on discovering and implementing suitable treatment and care in clinical practice, aiming to prevent loss of physical functioning and preserve their autonomy and well-being. People's embodied experiences may yield rich descriptions to help to understand frailty. Thoroughly understanding older people's individual perceptions is especially relevant because the numbers of home-dwelling older people are increasing, and people tend to develop more health problems and become frailer as they age. Their perspectives are important to develop knowledge and high-quality care. AIM To explore the lived experiences of frail home-dwelling older people. METHODS We conducted a phenomenological study to obtain in-depth descriptions of the phenomenon. We interviewed 10 home-dwelling older adults (seven women and three men, 72-90 years old) in depth about their lived experience of frailty. We analysed the data using a hermeneutic phenomenological approach described by van Manen. FINDINGS The lived experience of frailty is described in one essential theme: frailty as being in the borderland of the body, including three interrelated subthemes: (1) the body shuts down; (2) living on the edge; and (3) not giving up. CONCLUSIONS Our study gives insight into lived experiences with frailty among home-dwelling older people related to their own body. Older people's experience of meaningful activities strengthened their feeling of being themselves, despite their frail and deteriorating body. Healthcare providers must consider the strategies of frail older people to consider both their vulnerabilities and self-perceived strengths. The resources and deficits of frail older people present in the state of being frail need to be recognised.
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Affiliation(s)
- Bente Egge Søvde
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Anne Marie Sandvoll
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Eli Natvik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Jorunn Drageset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Duppen D, Lambotte D, Dury S, Smetcoren AS, Pan H, De Donder L. Social Participation in the Daily Lives of Frail Older Adults: Types of Participation and Influencing Factors. J Gerontol B Psychol Sci Soc Sci 2021; 75:2062-2071. [PMID: 31001620 DOI: 10.1093/geronb/gbz045] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The advantages of social participation for older adults are well established and have been adopted in aging policy frameworks. However, little is known about the social participation of frail older adults. This research examined the types of social interaction of very frail older adults and the factors influencing this participation. METHOD Interviews with 38 very frail older adults were analyzed using Levasseur and colleagues' (Levasseur, Richard, Gauvin, & Raymond (2010). Inventory and analysis of definitions of social participation found in the aging literature: Proposed taxonomy of social activities. Social Science and Medicine (1982), 71, 2141-2149) taxonomy activity levels of involvement with others. A qualitative hybrid approach with inductive and deductive thematic analyses was used. RESULTS Participants often disengaged from activities with high involvement with others, preferring activities with less involvement. Low-key participation emerged as an important type of social participation enabling frail older adults to remain engaged in society. Key factors that influenced social participation were functional decline, and the physical (e.g., traffic, the disappearance of local stores) and social environment (e.g., social networks and the presence of meeting places such as community centers). DISCUSSION Findings advance our knowledge and recognition of the different ways frail older adults participate in society. Despite their frailty, older adults wish to stay socially active. Focusing on the social environment in the frameworks and policies of Age-Friendly Cities and Communities will benefit these individuals.
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Affiliation(s)
- Daan Duppen
- Vrije Universiteit Brussel, Department of Educational Sciences
| | | | - Sarah Dury
- Vrije Universiteit Brussel, Department of Educational Sciences.,Belgium and Research Foundation Flanders (FWO), Brussels, Belgium
| | | | - Honghui Pan
- Vrije Universiteit Brussel, Department of Educational Sciences
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Hall RK. Prioritizing the quality of life of older adults with kidney disease. Nat Rev Nephrol 2021; 17:149-150. [PMID: 33473235 DOI: 10.1038/s41581-021-00397-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Rasheeda K Hall
- Durham Veterans Affairs Healthcare System, Renal Section, Durham, NC, USA. .,Department of Medicine, Division of Nephrology, Duke University School of Medicine, Durham, NC, USA.
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Wiles J, Miskelly P, Stewart O, Rolleston A, Gott M, Kerse N. Gardens as resources in advanced age in aotearoa NZ: More than therapeutic. Soc Sci Med 2020; 288:113232. [PMID: 32739097 DOI: 10.1016/j.socscimed.2020.113232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/23/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
For older people gardens may be paradoxical sites. Whilst gardening is associated in multiple ways with wellbeing and health, gardens may also become a source of frustration and worry as ageing bodies limit gardening activities. Yet determination remains. However, little of the well-established body of work on gardens and old age includes people in advanced age. In this paper, we draw on interviews with Māori and non-Māori 85-90-year olds in Aotearoa, New Zealand, focusing on how they talk about their wellbeing in relation to past, present, and future experiences of home gardening. Our research shows home gardens and gardening figure prominently and positively in the narratives of people in advanced age. Most of our participants described themselves as active gardeners; most also lived with multimorbidity, sometimes severe and complex. Applying positioning theory, we examine how our participants connect gardens and gardening to identity; connectedness; and adaptation and renegotiation of health and wellbeing in ageing bodies. Home gardens are 'more than therapeutic'; while they are protective of health and wellbeing, they are also enabling places for the expression and performance of agency in advanced age. These understandings have practical implications for supporting wellbeing amongst those in advanced age.
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Affiliation(s)
- Janine Wiles
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Street address: 22-30 Park Avenue, Grafton, Mailing address: Private Bag 92019, Auckland, 1142, New Zealand.
| | - Philippa Miskelly
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Street address: 22-30 Park Avenue, Grafton, Mailing address: Private Bag 92019, Auckland, 1142, New Zealand
| | - Oneroa Stewart
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Street address: 22-30 Park Avenue, Grafton, Mailing address: Private Bag 92019, Auckland, 1142, New Zealand
| | - Anna Rolleston
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Street address: 22-30 Park Avenue, Grafton, Mailing address: Private Bag 92019, Auckland, 1142, New Zealand
| | - Merryn Gott
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Street address: 22-30 Park Avenue, Grafton, Mailing address: Private Bag 92019, Auckland, 1142, New Zealand
| | - Ngaire Kerse
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Street address: 22-30 Park Avenue, Grafton, Mailing address: Private Bag 92019, Auckland, 1142, New Zealand
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Lambotte D, Smetcoren AS, Zijlstra GAR, De Lepeleire J, De Donder L, Kardol MJM. Meanings of Care Convoys: The Structure, Function, and Adequacy of Care Networks Among Frail, Community-Dwelling Older Adults. QUALITATIVE HEALTH RESEARCH 2020; 30:583-597. [PMID: 31303115 DOI: 10.1177/1049732319861934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Researchers propose that the convoy of care model should be used to study care networks of frail, older individuals. Care convoys are defined as the evolving collection of individuals who may or may not have close personal connections to the recipient or to one another, but who provide care, including help with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), socio-emotional care, skilled health care, monitoring, and advocacy. This study reports on community-dwelling older adults' experiences of their care convoy, how care convoys change over time, and perceived (positive) outcomes. A qualitative analysis among 65 semi-structured interviews with frail, community-dwelling older adults demonstrates a great variety in the composition of care convoys. Participants were often actively involved in their care convoy and valued the social/relational aspect of care. Care and support covered a wide range of activities, with some activities being provided by specific types of caregivers. Participants expressed the adequacy of their care convoy in terms of satisfaction and sufficiency. Noteworthy, participants who were satisfied with their care convoy did not necessarily receive sufficient help. Policies and practice should recognize the relational aspect of care, the complex interplay between all actors, and the dynamic character of care convoys.
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Hall RK, Cary MP, Washington TR, Colón-Emeric CS. Quality of life in older adults receiving hemodialysis: a qualitative study. Qual Life Res 2020; 29:655-663. [PMID: 31691203 PMCID: PMC7028790 DOI: 10.1007/s11136-019-02349-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2019] [Indexed: 01/01/2023]
Abstract
PURPOSE Patient priorities for quality of life change with age. We conducted a qualitative study to identify quality of life themes of importance to older adults receiving dialysis and the extent to which these are represented in existing quality of life instruments. METHODS We conducted semi-structured interviews with 12 adults aged ≥ 75 years receiving hemodialysis to elicit participant perspectives on what matters most to them in life. We used framework analysis methodology to process interview transcripts (coding, charting, and mapping), identify major themes, and compare these themes by participant frailty status. We examined for representation of our study's subthemes in the Kidney Disease Quality of Life (KDQOL-36) and the World Health Organization Quality of Life for Older Adults (WHOQOL-OLD) instruments. RESULTS Among the 12 participants, average age was 81 (4.2) years, 7 African-American, 6 women, and 6 met frailty criteria. We identified two major quality of life themes: (1) having physical well-being (subthemes: being able to do things independently, having symptom control, maintaining physical health, and being alive) and (2) having social support (subthemes: having practical social support, emotional social support, and socialization). Perspectives on the subthemes often varied by frailty status. For example, being alive meant surviving from day-to-day for frail participants, but included a desire for new life experiences for non-frail participants. The majority of the subthemes did not correspond with domains in the KDQOL-36 and WHOQOL-OLD instruments. CONCLUSION Novel instruments are likely needed to elicit the dominant themes of having physical well-being and having social support identified by older adults receiving dialysis.
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Affiliation(s)
- Rasheeda K Hall
- Renal Section, Durham Veterans Affairs Medical Center Healthcare System, Durham, NC, USA.
- Durham Veterans Affairs Healthcare System, Geriatric Research Education and Clinical Center, Durham VAMC, Durham, NC, USA.
- Division of Nephrology, Department of Medicine, Duke University, Box DUMC 2747, 2424 Erwin Road Suite 605, Durham, NC, 27710, USA.
| | | | | | - Cathleen S Colón-Emeric
- Durham Veterans Affairs Healthcare System, Geriatric Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Division of Geriatric Medicine, Department of Medicine, Duke University, Durham, NC, USA
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Factors Associated with Health-Related Quality of Life in Community-Dwelling Older Adults: A Multinomial Logistic Analysis. J Clin Med 2019; 8:jcm8111810. [PMID: 31683766 PMCID: PMC6912260 DOI: 10.3390/jcm8111810] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/23/2019] [Accepted: 10/25/2019] [Indexed: 02/06/2023] Open
Abstract
The main aim of this study was to determine the association of various clinical, functional and pharmacological factors with the physical (PCS) and mental (MCS) summary components of the health-related quality of life (HRQoL) of community-dwelling older adults. Design: Cross-sectional study. Patients and setting: Sample of 573 persons aged over 65 years, recruited at 12 primary healthcare centres in Málaga, Spain. Sociodemographic, clinical, functional, and comprehensive drug therapy data were collected. The main outcome was HRQoL assessed on the basis of the SF-12 questionnaire. A multinomial logistic regression model was constructed to study the relationship between independent variables and the HRQoL variable, divided into intervals. The average self-perceived HRQoL score was 43.2 (± 11.02) for the PCS and 48.5 (± 11.04) for the MCS. The factors associated with a poorer PCS were dependence for the instrumental activities of daily living (IADL), higher body mass index (BMI), number of medications, and presence of osteoarticular pathology. Female gender and the presence of a psychopathological disorder were associated with worse scores for the MCS. The condition that was most strongly associated with a poorer HRQoL (in both components, PCS and MCS) was that of frailty (odds ratio (OR) = 37.42, 95% confidence interval (CI) = 8.96–156.22, and OR = 20.95, 95% CI = 7.55–58.17, respectively). It is important to identify the determinant factors of a diminished HRQoL, especially if they are preventable or modifiable.
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Critical reflections on the blind sides of frailty in later life. J Aging Stud 2019; 49:66-73. [PMID: 31229220 DOI: 10.1016/j.jaging.2019.100787] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/21/2019] [Accepted: 05/28/2019] [Indexed: 12/25/2022]
Abstract
Since the 1970's, frailty emerged as a major theme and has become one of the most researched topics in aging studies. However, throughout the years, the concept 'frailty' became susceptible to different interpretations and has been approached by different synonyms, which resulted in a confusing picture. Based on a narrative literature review, this theoretical paper not only attempts to describe these different views on frailty, but by criticizing the dominance of some of these views, it also aspires to move the research and policy agenda on frailty forward. This paper is part of the D-SCOPE project in Belgium, and critically reflects on the blind sides of the biomedical domination of frailty and discusses three main themes: 1) frailty as a multidimensional and multilevel concept; 2) positive perspectives on frailty in later life; and 3) the suggestion of moving from a merely deficit-based frailty approach towards the concept of frailty-balance. At the theoretical level, conceptualizing frailty is not simply an exercise in semantics, but altering the theoretical definition of frailty can have wide-ranging implications, not only for the way frailty prevalence is measured and handled, but also for public or personal opinions on frailty in older people, for care and support practices, and for the scope of legislation. Therefore, the final section of the paper presents three building blocks for future research and policy-making: 1) adopting a multidimensional, multilevel, dynamic and positive view on frailty; 2) moving from dependency to interdependency; and 3) giving voice to (the resilience of) frail older people.
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Duppen Rn D, Machielse A, Verté Rn D, Dury S, De Donder L, Consortium DS. Meaning in Life for Socially Frail Older Adults. J Community Health Nurs 2019; 36:65-77. [DOI: 10.1080/07370016.2019.1582160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Daan Duppen Rn
- Department Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anja Machielse
- Department Humanism & Philosophy, University for Humanistic Studies, Utrecht, The Netherlands
| | - Dominique Verté Rn
- Department Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sarah Dury
- Department Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Liesbeth De Donder
- Department Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - D-Scope Consortium
- Interdisciplinary Research Group (Vrije Universiteit Brussel, Hogent University College, Maastricht University, Universiteit Antwerpen, KU Leuven), Belgium & the Netherlands
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13
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Health, illness and frailty in old age: a phenomenological exploration. J Aging Stud 2018; 47:24-31. [DOI: 10.1016/j.jaging.2018.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/07/2018] [Accepted: 10/09/2018] [Indexed: 10/28/2022]
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Lambotte D, De Donder L, De Roeck EE, Hoeyberghs LJ, van der Vorst A, Duppen D, Van der Elst M, Fret B, Dury S, Smetcoren AS, Kardol MJM, Engelborghs S, De Deyn PP, De Witte N, Schols JMGA, Kempen GIJM, Zijlstra GAR, De Lepeleire J, Schoenmakers B, Verté D, Dierckx E. Randomized controlled trial to evaluate a prevention program for frail community-dwelling older adults: a D-SCOPE protocol. BMC Geriatr 2018; 18:194. [PMID: 30149798 PMCID: PMC6109979 DOI: 10.1186/s12877-018-0875-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 08/06/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Frail community-dwelling older adults, whom might experience problems regarding physical, cognitive, psychological, social and environmental factors, are at risk for adverse outcomes such as disability, institutionalization and mortality. People in need of help do not always find their way to care and support services and are left undetected. The aim of the D-SCOPE project is to detect frail community-dwelling older adults who previously went unnoticed and to improve their access to care and support. Goal is to increase their frailty-balance, quality of life, meaning in life, life satisfaction, mastery, community inclusion and ageing well in place. METHODS/DESIGN The study is a prospective, longitudinal randomized four-armed controlled trial with follow-up at 6 months. The study group aims to include 900 community-dwelling older adults aged 60 years and over from 3 municipalities in Flanders (Belgium). While selecting the study group, risk profiles for frailty will be taken into account. Participants will be randomly selected from the census records in each municipality. Data will be collected prospectively at baseline (T0) and at follow-up, 6 months after baseline (T1). At baseline, participants who are at least mild frail on one of the 5 domains of frailty (CFAI-plus) or feel frail based on the subjective assessment of frailty will be randomly assigned to (1) the study group or (2) the control group. A mixed method design with the inclusion of quantitative and qualitative data analyses will be used to evaluate the efficacy and experiences of the detection and prevention program on frailty. DISCUSSION The study will contribute to an innovative vision concerning the organization of care and support, and a timely and accurate detection and support of community-dwelling older adults at risk for frailty. TRIAL REGISTRATION This trial was registered at ClinicalTrials.gov, on May 26, 2017, identifier: NCT03168204 .
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Affiliation(s)
- Deborah Lambotte
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Liesbeth De Donder
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Ellen E. De Roeck
- Laboratory of Neurochemistry and Behavior, University of Antwerp, 1, Universiteitsplein, Wilrijk, 2610 Belgium
- Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Lieve J. Hoeyberghs
- Faculty of Education, Health and Social Work, University College Ghent, 80, Keramiekstraat, Ghent, 9000 Belgium
| | - Anne van der Vorst
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
| | - Daan Duppen
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Michaël Van der Elst
- Department of Public Health and Primary Care, University of Leuven, 33, Kapucijnenvoer, Leuven, 3000 Belgium
| | - Bram Fret
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Sarah Dury
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
- Research Foundation Flanders (FWO), 5, Egmontstraat, Brussels, 100 Belgium
| | - An-Sofie Smetcoren
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Martinus J. M. Kardol
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Sebastiaan Engelborghs
- Laboratory of Neurochemistry and Behavior, University of Antwerp, 1, Universiteitsplein, Wilrijk, 2610 Belgium
| | - Peter Paul De Deyn
- Laboratory of Neurochemistry and Behavior, University of Antwerp, 1, Universiteitsplein, Wilrijk, 2610 Belgium
| | - Nico De Witte
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
- Faculty of Education, Health and Social Work, University College Ghent, 80, Keramiekstraat, Ghent, 9000 Belgium
| | - Jos M. G. A. Schols
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
| | - Gertrudis I. J. M. Kempen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
| | - G. A. Rixt Zijlstra
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
| | - Jan De Lepeleire
- Department of Public Health and Primary Care, University of Leuven, 33, Kapucijnenvoer, Leuven, 3000 Belgium
| | - Birgitte Schoenmakers
- Department of Public Health and Primary Care, University of Leuven, 33, Kapucijnenvoer, Leuven, 3000 Belgium
| | - Dominique Verté
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Eva Dierckx
- Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
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