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Cipolli GC, Ribeiro IC, Yasuda CL, Balthazar MLF, Fattori A, Yassuda MS. Frailty and brain changes in older adults without cognitive impairment: A scoping review. Arch Gerontol Geriatr 2024; 123:105395. [PMID: 38492289 DOI: 10.1016/j.archger.2024.105395] [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: 12/22/2023] [Revised: 02/11/2024] [Accepted: 03/02/2024] [Indexed: 03/18/2024]
Abstract
Little is known about changes in the brain associated with frailty, in particular, which brain areas could be related to frailty in older people without cognitive impairment. This scoping review mapped evidence on functional and/or structural brain changes in frail older adults without cognitive impairment. The methodology proposed by the JBI® was used in this study. The search in PubMed, PubMed PMC, BVS/BIREME, EBSCOHOST, Scopus, Web of Science, Embase, and PROQUEST was conducted up to January 2023. Studies included following the population, concepts, context and the screening and data extraction were performed by two independent reviewers. A total of 9,912 records were identified, 5,676 were duplicates and were excluded. The remaining articles were screened; 31 were read in full and 17 articles were included. The results showed that lesions in white matter hyperintensities, reduced volume of the hippocampus, cerebellum, middle frontal gyrus, low gray matter volume, cortical atrophy, decreased connectivity of the supplementary motor area, presence of amyloid-beta peptide (aβ) in the anterior and posterior putamen and precuneus regions were more frequently observed in frail older adults, compared with non-frail individuals. Studies have suggested that such findings may be of neurodegenerative or cerebrovascular origin. The identification of these brain alterations in frail older adults through neuroimaging studies contributes to our understanding of the underlying mechanisms of frailty. Such findings may have implications for the early detection of frailty and implementation of intervention strategies.
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Affiliation(s)
- Gabriela Cabett Cipolli
- Postgraduate Program in Gerontology, College of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Isadora Cristina Ribeiro
- Postgraduate Program in Medical Pathophysiology, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Clarissa Lin Yasuda
- Faculty of Medical Sciences, Department of Neurology, State University of Campinas, Campinas, Brazil
| | | | - André Fattori
- Postgraduate Program in Gerontology, College of Medical Sciences, State University of Campinas, Campinas, Brazil; Faculty of Medical Sciences, Department of Internal Medicine, State University of Campinas, Campinas, Brazil
| | - Mônica Sanches Yassuda
- Postgraduate Program in Gerontology, College of Medical Sciences, State University of Campinas, Campinas, Brazil; Postgraduate Program in Gerontology, University of São Paulo, São Paulo, Brazil.
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O' Dowd A, Hirst R, Setti A, Kenny R, Newell F. Longitudinal grip strength is associated with susceptibility to the Sound Induced Flash Illusion in older adults. AGING BRAIN 2023; 3:100076. [PMID: 37287584 PMCID: PMC10241972 DOI: 10.1016/j.nbas.2023.100076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/20/2023] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
The precision of temporal multisensory integration is associated with specific aspects of physical functioning in ageing, including gait speed and incidents of falling. However, it is unknown if such an association exists between multisensory integration and grip strength, an important index of frailty and brain health and predictor of disease and mortality in older adults. Here, we investigated whether temporal multisensory integration is associated with longitudinal (eight-year) grip strength trajectories in a large sample of 2,061 older adults (mean age = 64.42 years, SD = 7.20; 52% female) drawn from The Irish Longitudinal Study on Ageing (TILDA). Grip strength (kg) for the dominant hand was assessed with a hand-held dynamometer across four testing waves. Longitudinal k-means clustering was applied to these data separately for sex (male, female) and age group (50-64, 65-74, 75+ years). At wave 3, older adults participated in the Sound Induced Flash Illusion (SIFI), a measure of the precision of temporal audio-visual integration, which included three audio-visual stimulus onset asynchronies (SOAs): 70, 150 and 230 ms. Results showed that older adults with a relatively lower (i.e., weaker) grip strength were more susceptible to the SIFI at the longer SOAs compared to those with a relatively higher (i.e., stronger) grip strength (p <.001). These novel findings suggest that older adults with relatively weaker grip strength exhibit an expanded temporal binding window for audio-visual events, possibly reflecting a reduction in the integrity of the central nervous system.
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Affiliation(s)
- A. O' Dowd
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - R.J. Hirst
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - A. Setti
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
- School of Applied Psychology, University College Cork, Ireland
| | - R.A. Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
- Mercer Institute for Successful Ageing, St James. Hospital, Dublin, Ireland
| | - F.N. Newell
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
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Lammers-Lietz F, Zacharias N, Mörgeli R, Spies CD, Winterer G. Functional Connectivity of the Supplementary and Presupplementary Motor Areas in Postoperative Transition Between Stages of Frailty. J Gerontol A Biol Sci Med Sci 2022; 77:2464-2473. [PMID: 35040961 DOI: 10.1093/gerona/glac012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Frailty is a multietiological geriatric syndrome of run-down physical reserves with high vulnerability to stressors. Transitions between physical robustness and frailty often occur in the context of medical interventions. Studies suggest that neurological disorders contribute to faster progression of frailty. In a previous cross-sectional study we found altered functional connectivity of supplementary motor area (SMA) in (pre)frail compared to robust patients. We analyzed functional connectivity of the SMA and presupplementary motor area (pre-SMA) in patients with postoperative transitions between physical robustness and stages of frailty. METHODS We investigated 120 cognitively healthy patients (49.2% robust, 47.5% prefrail, 3.3% frail, 37.5% female, median age 71 [65-87] years) undergoing elective surgery from the BioCog project, a multicentric prospective cohort study on postoperative delirium and cognitive dysfunction. Assessments took place 14 days before and 3 months after surgery, comprising assessments of a modified frailty phenotype according to Fried and resting-state functional magnetic resonance imaging at 3 T. The associations between functional connectivity of the SMA and pre-SMA networks, preoperative frailty stages, and postoperative transitions were examined using mixed linear effects models. RESULTS Nineteen patients showed physical improvement after surgery, 24 patients progressed to (pre)frailty and in 77 patients no transition was observed. At follow-up, 57 (47.5%) patients were robust, 52 (43.3%) prefrail, and 11 (9.2%) frail. Lower functional connectivity in the pre-SMA network was associated with more unfavorable postoperative transition types. An exploratory analysis suggested that the association was restricted to patients who were prefrail at baseline. There was no association of transition type with SMA functional connectivity in the primary analysis. In an exploratory analysis, transition from prefrailty to robustness was associated with higher functional connectivity and progression in robust patients was associated with higher SMA network segregation. CONCLUSIONS Our findings implicate that dysfunctions of cortical networks involved in higher cognitive control of motion are associated with postoperative transitions between frailty stages. The pre-SMA may be a target for neurofeedback or brain stimulation in approaches to prevent frailty. Clinical Trials Registration Number: NCT02265263.
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Affiliation(s)
- Florian Lammers-Lietz
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Norman Zacharias
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Pharmaimage Biomarker Solutions GmbH, Berlin, Germany
| | - Rudolf Mörgeli
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia D Spies
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Georg Winterer
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Pharmaimage Biomarker Solutions GmbH, Berlin, Germany
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Pérez-Rodríguez R, Villalba-Mora E, Valdés-Aragonés M, Ferre X, Moral C, Mas-Romero M, Abizanda-Soler P, Rodríguez-Mañas L. Usability, User Experience, and Acceptance Evaluation of CAPACITY: A Technological Ecosystem for Remote Follow-Up of Frailty. SENSORS (BASEL, SWITZERLAND) 2021; 21:6458. [PMID: 34640777 PMCID: PMC8512153 DOI: 10.3390/s21196458] [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] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/26/2021] [Accepted: 09/26/2021] [Indexed: 12/03/2022]
Abstract
Frailty predisposes older persons to adverse events, and information and communication technologies can play a crucial role to prevent them. CAPACITY provides a means to remotely monitor variables with high predictive power for adverse events, enabling preventative personalized early interventions. This study aims at evaluating the usability, user experience, and acceptance of a novel mobile system to prevent disability. Usability was assessed using the system usability scale (SUS); user experience using the user experience questionnaire (UEQ); and acceptance with the technology acceptance model (TAM) and a customized quantitative questionnaire. Data were collected at baseline (recruitment), and after three and six months of use. Forty-six participants used CAPACITY for six months; nine dropped out, leaving a final sample of 37 subjects. SUS reached a maximum averaged value of 83.68 after six months of use; no statistically significant values have been found to demonstrate that usability improves with use, probably because of a ceiling effect. UEQ, obtained averages scores higher or very close to 2 in all categories. TAM reached a maximum of 51.54 points, showing an improvement trend. Results indicate the success of the participatory methodology, and support user centered design as a key methodology to design technologies for frail older persons. Involving potential end users and giving them voice during the design stage maximizes usability and acceptance.
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Affiliation(s)
- Rodrigo Pérez-Rodríguez
- Biomedical Research Foundation, Getafe University Hospital, 28905 Getafe, Spain
- Centre for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Pozuelo de Alarcón, 28223 Madrid, Spain; (E.V.-M.); (M.V.-A.); (X.F.); (C.M.); (L.R.-M.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28001 Madrid, Spain;
| | - Elena Villalba-Mora
- Centre for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Pozuelo de Alarcón, 28223 Madrid, Spain; (E.V.-M.); (M.V.-A.); (X.F.); (C.M.); (L.R.-M.)
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Myriam Valdés-Aragonés
- Centre for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Pozuelo de Alarcón, 28223 Madrid, Spain; (E.V.-M.); (M.V.-A.); (X.F.); (C.M.); (L.R.-M.)
- Geriatrics Service, Getafe University Hospital, 28095 Getafe, Spain
| | - Xavier Ferre
- Centre for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Pozuelo de Alarcón, 28223 Madrid, Spain; (E.V.-M.); (M.V.-A.); (X.F.); (C.M.); (L.R.-M.)
| | - Cristian Moral
- Centre for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Pozuelo de Alarcón, 28223 Madrid, Spain; (E.V.-M.); (M.V.-A.); (X.F.); (C.M.); (L.R.-M.)
| | - Marta Mas-Romero
- Geriatrics Service, Albacete University Hospital, 02006 Albacete, Spain;
| | - Pedro Abizanda-Soler
- CIBER of Frailty and Healthy Aging (CIBERFES), 28001 Madrid, Spain;
- Geriatrics Service, Albacete University Hospital, 02006 Albacete, Spain;
- Faculty of Medicine, University of Castilla-La Mancha, 02008 Albacete, Spain
| | - Leocadio Rodríguez-Mañas
- Centre for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Pozuelo de Alarcón, 28223 Madrid, Spain; (E.V.-M.); (M.V.-A.); (X.F.); (C.M.); (L.R.-M.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28001 Madrid, Spain;
- Geriatrics Service, Getafe University Hospital, 28095 Getafe, Spain
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