scholarly journals Is phenotypical prefrailty all the same? A longitudinal investigation of two prefrailty subtypes in TILDA

2019 ◽  
Vol 49 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Roman Romero-Ortuno ◽  
Siobhan Scarlett ◽  
Aisling M O’Halloran ◽  
Rose Anne Kenny
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Sex Education ◽  
Population Based ◽  
Frailty Phenotype ◽  
Unexplained Weight Loss ◽  
Iadl Disability ◽  
Baseline Characteristics ◽  
Adl Disability ◽  
Preventative Interventions

Abstract Background Fried’s frailty phenotype is defined by five criteria: exhaustion, unexplained weight loss, weakness, slowness and low physical activity. Prefrailty (PF) meets one or two criteria. PF is of interest as a target for preventative interventions, but it is not known if it is a homogenous syndrome. Objective to compare the longitudinal trajectories of two PF groups: one defined by exhaustion and/or unexplained weight loss (PF1) and one defined by one or two of the following: weakness, slowness, low physical activity (PF2). Design and setting population-based longitudinal study of ageing. Subjects One-thousand four-hundred seventy-six PF participants aged ≥50 years from wave 1 of the study (2010), followed 2-yearly over four longitudinal waves (2012, 2014, 2016, 2018). Methods generalised estimating equations (GEEs) were used to assess the effect of PF type across waves to predict cumulative mortality and disability in basic activities of daily living (ADL) and independent ADL (IADL), adjusting for baseline characteristics (age, sex, education, living alone, self-rated health, comorbidity, body mass index). Results in wave 1, there were 503 PF1 and 973 PF2 participants. By wave 5, 38 (7.6%) PF1 and 145 (14.9%) PF2 participants had died. In PF1 participants, mean numbers of ADL and IADL disabilities both increased from 0.1 to 0.2 from wave 1 to wave 5, whilst in PF2 increases were from 0.2 to 0.5. Adjusted GEE models suggested significantly divergent trajectories of IADL disability by wave 2, ADL disability by wave 3 and mortality by wave 3. Conclusion PF may not be a homogenous biological syndrome.

scholarly journals 17 Is Phenotypical Prefrailty all the Same? A Longitudinal Investigation of Two Prefrailty Subtypes in a Population-Based Longitudinal Study of Ageing

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Roman Romero-Ortuno ◽  
Siobhan Scarlett ◽  
Rose Anne Kenny
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Longitudinal Study ◽  
Sex Education ◽  
Population Based ◽  
Frailty Phenotype ◽  
Unexplained Weight Loss ◽  
Iadl Disability ◽  
Baseline Characteristics ◽  
Adl Disability

Abstract Background Fried’s frailty phenotype is defined by five criteria: exhaustion, unexplained weight loss, weakness, slowness and low physical activity. Pre-frailty (PF) meets one or two criteria. PF is of interest as a target for preventative strategies, but it is not known if it is a homogenous syndrome. The objective of this study was to compare the longitudinal trajectories of two PF groups: one defined by exhaustion and/or unexplained weight loss (PF1) and one defined by one or two of the following: weakness, slowness, low physical activity (PF2). Methods: Design and setting  population-based longitudinal study of ageing. Subjects  1,660 PF participants aged ≥50 years from wave 1 of the study (2010), followed 2-yearly over 4 longitudinal waves (2012, 2014, 2016, 2018). Methods  Generalised Estimating Equations (GEE) were used to assess the effect of PF type across waves to predict cumulative mortality and disability in basic (ADL) and independent (IADL) activities of daily living, adjusting for baseline characteristics (age, sex, education, living alone, self-rated health, comorbidity, body mass index). Results In wave 1, there were 687 PF1 and 973 PF2 participants. By wave 5, 64 (9.3%) PF1 and 145 (14.9%) PF2 participants had died. In PF1 participants, mean numbers of ADL and IADL disabilities both increased from 0.2 to 0.3 from wave 1 to wave 5, whilst in PF2 increases were from 0.2 to 0.5. Adjusted GEE models suggested significantly divergent trajectories of IADL disability by wave 2, ADL disability by wave 3, and mortality by wave 4. Conclusion Prefrailty may not be a homogenous biological syndrome. This may have relevance for the design of interventions to delay or reverse frailty in populations.

TRANSITION PATTERNS OF FRAILTY SYNDROME IN COMMUNITY-DWELLING ELDERLY INDIVIDUALS: A LONGITUDINAL STUDY

2015 ◽  
pp. 1-6
Author(s):  
S. LANZIOTTI AZEVEDO DA SILVA ◽  
Á. CAMPOS CAVALCANTI MACIEL ◽  
L. DE SOUSA MÁXIMO PEREIRA ◽  
J.M. DOMINGUES DIAS ◽  
M. GUIMARÃES DE ASSIS ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Longitudinal Study ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Activity Level ◽  
Frailty Syndrome ◽  
Frailty Phenotype ◽  
Elderly Individuals ◽  
Belo Horizonte

Background: Little information is available about transitional patterns related to frailty syndrome in elderly individuals living in the community. Objective: To assess transitional patterns and determine which frailty phenotype variables are more involved in this process. Design: Longitudinal study. Population: Community-dwelling elderly individuals in Belo Horizonte, Minas Gerais, Brazil. Participants: Two hundred individuals over 65 years old. Measurements: The frailty phenotype was assessed at two different times, with a mean interval of 13 months. Comparison of the frequency distributions between the baseline and second assessment was conducted through Pearson’s chi-squared test, and a binary logistic regression was conducted to assess the most important items in this transition. Results: Sixty-eight percent of the elderly were women, with an average age of 73.7 (± 6.1) years. The pre-frail group transitioned the most between evaluations. Eighty-five individuals transitioned among frailty levels: 46 showed improvement while 39 worsened. Individuals who did scored low on the handgrip strength test in the first evaluation were more likely to have their frailty level worsen. Among individuals who showed improvements, those who were positive for weight loss and poor physical activity level in the first evaluation were less likely to improve. In this study, a greater number of individuals showed improved frailty levels over 13 months than worsened levels. Conclusion: Poor handgrip strength, weight loss, and poor physical activity are the most influential variables in frailty transitioning, leading to worsening levels of frailty or difficulty in making improvements.

scholarly journals Prevalence of Frailty Indicators in Community-dwelling Older Adults From Northeastern Brazil, 2009-2015

2021 ◽  
Author(s):  
Adrianna Ribeiro Lacerda ◽  
Maria do Carmo Eulálio ◽  
Edivan Gonçalves Silva Júnior ◽  
Ricardo Alexandre Arcêncio ◽  
Ricardo Alves Olinda ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Weight Loss ◽  
Explanatory Models ◽  
Community Dwelling ◽  
Self Report ◽  
Northeastern Brazil ◽  
Frailty Phenotype ◽  
Frail Older Adults ◽  
Community Dwelling Older Adults

Abstract BACKGROUND: Frailty is a clinical syndrome, and its development is multifactorial and dynamic. The clinical indicators (physical measures and self-report) that characterize the syndrome tend to vary across studies. To determine the contributions of the indicators in the determination of frailty it is important to obtain data about the variations that occur among the levels of frailty. The aim of this study was to a) survey the prevalence of the frailty syndrome and of the indicators that compose the frailty phenotype in community-dwelling older adults, and b) to evaluate the contribution of each indicator in the determination frailty.METHODS: Prevalence study carried out with 163 older adults who participated in two assessments; the first one was performed in 2009 and after 70 months the second assessment was conducted. Assessment of physical measurements was performed to constitute the frailty phenotype (gait speed and handgrip strength) alongside self-report (fatigue, unintentional weight loss, and physical activity), as proposed by Fried. We used the McNemar’s test and Pearson’s chi-square to analyze the differences between means and Multinomial Logistic Regression values.RESULTS: There was an increase in the number of pre-frail older adults (from 47.85% to 65.03%) and frail ones (from 7.98% to 9.82%). The frailty indicators increased significantly (+ 8.6% for walking; + 6.8% for fatigue; + 6.8% for grip strength; + 1.2% for physical activity), except for the “weight loss” item (-3%). The indicators with the highest predictors of frailty in 2009 were fatigue (OR = 31.41; 95%CI 11.66-84-65, p<0.001) and weight loss (OR = 28.74; 95%CI 9.20-89.84, p<0.001). In the second assessment, the items that had the highest chance for developing frailty were slow gait (OR = 23.64; 95%CI 5.38-103.83, p<0.001) and muscle weakness (OR = 79.39; 95%CI 8.58-734.24, p<0.001). CONCLUSION: There was an increase in frail and pre-frail older adults during the two assessments and an increase in the indicators that mark the syndrome phenotype. The explanatory models of frailty changed in both assessments. The evolution of frailty signals the necessity for interventions to be carried out with older adults to delay the progress of declining faculties that threaten their health.

scholarly journals Discrimination and Risk of Incident Disability in Older African Americans

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 260-260
Author(s):  
Melissa Lamar ◽  
Sue Leurgans ◽  
Aron Buchman ◽  
Lisa Barnes ◽  
Brittney Lange-Maia
Keyword(s):  
African Americans ◽  
Activities Of Daily Living ◽  
Sex Education ◽  
Daily Living ◽  
Proportional Hazards ◽  
Vascular Diseases ◽  
Cox Proportional Hazards ◽  
Iadl Disability ◽  
Adl Disability ◽  
Everyday Discrimination

Abstract Discrimination is linked to poor health outcomes, but most studies examine young or midlife populations. We assessed associations between discrimination and disability in African Americans. The Detroit Areas Study Everyday Discrimination Scale quantified experiences of interpersonal mistreatment. Separate Cox-proportional hazards models tested the associations between baseline discrimination and incident mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) disability, adjusting for age, sex, education, BMI, smoking, depressive symptoms, and vascular diseases. At baseline, 441, 674, and 469, participants were initially free of mobility, ADL, and IADL disability, respectively, and 257, 185, and 269 new cases of mobility, ADL, and IADL disability were observed over approximately 8.5 years. Discrimination was associated with higher risk of ADL disability (hazard ratio: 1.03 per 1-point higher discrimination score, 95% confidence interval: 1.00-1.06) but no other disability type. Everyday discrimination is associated with risk of ADL disability.

Physical Activity as Protective Factor against Dementia: A Prospective Population-Based Study (NEDICES)

2015 ◽  
Vol 21 (10) ◽  
pp. 861-867 ◽  
Author(s):  
Sara Llamas-Velasco ◽  
Israel Contador ◽  
Alberto Villarejo-Galende ◽  
David Lora-Pablos ◽  
Félix Bermejo-Pareja
Keyword(s):  
Physical Activity ◽  
Sex Education ◽  
Protective Factor ◽  
Cox Regression ◽  
Statistical Significance ◽  
Population Based ◽  
Dose Effect ◽  
Incident Dementia ◽  
Health Related

AbstractThe aim of this study was to analyze whether physical activity (PA) is a protective factor for the incidence of dementia after 3 years of follow-up. The Neurological Disorders in Central Spain (NEDICES) is a prospective population-based survey of older adults (age 65 years and older) that comprised 5278 census-based participants at baseline (1994–1995). A broad questionnaire was used to assess participants’ sociodemographic characteristics, health status, and lifestyle. Subsequently, a modified version of Rosow-Breslau questionnaire was applied to classify individuals’ baseline PA into groups (i.e., sedentary, light, moderate, and high). Cox regression models adjusted for several covariates (age, sex, education, previous stroke, alcohol consumption, hypertension, health related variables) were carried out to estimate the association between the PA groups and risk of dementia at the 3-year follow-up (1997–1998). A total of 134 incident dementia cases were identified among 3105 individuals (56.6% female; mean age=73.15±6.26) after 3 years. Hazard ratios (HRs) of the light, moderate, and high PA groups (vs. sedentary group) were 0.40 (95% confidence interval {CI} [0.26, 0.62]; p<.001), 0.32 (95% CI [0.20, 0.54]; p<.001) and 0.23 (95% CI [0.13, 0.40]; p<.001), respectively. Even after controlling for covariates and the exclusion of doubtful dementia cases, HRs remained significant. However, a supplementary analysis showed that the dose-effect hypothesis did not reach statistical significance. PA is a protective factor of incident dementia in this population-based cohort. (JINS, 2015, 21, 861–867)

scholarly journals The association between dietary protein intake, energy intake and physical frailty: results from the Rotterdam Study

2019 ◽  
Vol 121 (4) ◽  
pp. 393-401 ◽  
Author(s):  
Josje D. Schoufour ◽  
Oscar H. Franco ◽  
Jessica C. Kiefte-de Jong ◽  
Katerina Trajanoska ◽  
Bruno Stricker ◽  
...  
Keyword(s):  
Physical Activity ◽  
Energy Intake ◽  
Protein Intake ◽  
Multinomial Logistic Regression ◽  
Large Population ◽  
Population Based ◽  
Rotterdam Study ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Logistic Regression Models

AbstractSufficient protein intake has been suggested to be important for preventing physical frailty, but studies show conflicting results which may be explained because not all studies address protein source and intake of other macronutrients and total energy. Therefore, we studied 2504 subjects with data on diet and physical frailty, participating in a large population-based prospective cohort among subjects aged 45+ years (the Rotterdam Study). Dietary intake was assessed with a FFQ. Frailty was defined according to the frailty phenotype as the presence of at least three out of the following five symptoms: weight loss, low physical activity, weakness, slowness and fatigue. We used multinomial logistic regression models to evaluate the independent association between protein intake and frailty using two methods: nutrient residual models and energy decomposition models. With every increase in 10 g total, plant or animal protein per d, the odds to be frail were 1·06 (95 % CI 0·98, 1·15), 0·87 (95 % CI 0·71, 1·07) and 1·07 (95 % CI 0·99, 1·15), respectively, using the nutrient residual method. Using the energy partition model, we observed that the odds to be frail were lower with higher vegetable protein intake (OR per 418·4 kJ (100 kcal): 0·61, 95 % CI 0·39, 0·97), however, results disappeared when adjusting for physical activity. For energy intake from any source we observed that with every 418·4 kJ (100 kcal) increase, the odds to be frail were 5 % lower (OR: 0·95, 95 % CI 0·93, 0·97). Our results suggest that energy intake, but not protein specifically, is associated with less frailty. Considering other macronutrients, physical activity and diet quality seems to be essential for future studies on protein and frailty.

scholarly journals Playing a Musical Instrument as a Protective Factor against Dementia and Cognitive Impairment: A Population-Based Twin Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
M. Alison Balbag ◽  
Nancy L. Pedersen ◽  
Margaret Gatz
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Sex Education ◽  
Twin Study ◽  
Odds Ratio ◽  
Protective Factor ◽  
Leisure Activities ◽  
Musical Instrument ◽  
Population Based ◽  
Control Study

Increasing evidence supports that playing a musical instrument may benefit cognitive development and health at young ages. Whether playing an instrument provides protection against dementia has not been established. In a population-based cotwin control study, we examined the association between playing a musical instrument and whether or not the twins developed dementia or cognitive impairment. Participation in playing an instrument was taken from informant-based reports of twins’ leisure activities. Dementia diagnoses were based on a complete clinical workup using standard diagnostic criteria. Among 157 twin pairs discordant for dementia and cognitive impairment, 27 pairs were discordant for playing an instrument. Controlling for sex, education, and physical activity, playing a musical instrument was significantly associated with less likelihood of dementia and cognitive impairment (odds ratio [OR] = 0.36 [95% confidence interval 0.13–0.99]). These findings support further consideration of music as a modifiable protective factor against dementia and cognitive impairment.

scholarly journals The Association of Prior Intensive Lifestyle Intervention and Diabetes Support and Education with Frailty Prevalence at Long-Term Follow-up in the Action for Health in Diabetes Extension Study

2021 ◽  
Author(s):  
Sara E Espinoza
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Frailty Phenotype ◽  
Intensive Lifestyle Intervention ◽  
Look Ahead ◽  
Long Term Follow Up ◽  
Overweight Or Obesity

Abstract Background Frailty is common in older adults with obesity and diabetes. We compared prevalence of the frailty phenotype between intervention groups in long-term follow-up of Look AHEAD, a randomized trial comparing a multidomain intensive lifestyle intervention (ILI) that promoted weight loss and physical activity with a diabetes support and education (DSE) control group in adults with type 2 diabetes and overweight or obesity. Methods Participants included 2,979 individuals randomized to ILI or DSE in 2001-04 who completed frailty assessment in Look AHEAD - Extension Wave 1 (2016-2018) at average age of 72.1 ± 6.2 years. Frailty was assessed using a modified frailty phenotype (excluding weight loss) defined as the presence of 3 or more of: weakness, slow gait speed, low physical activity, and exhaustion. Frailty odds by intervention assignment (DSE vs. ILI) were estimated using multivariable logistic regression, adjusting for sex, clinic site, and time since randomization. Results At median follow-up of 14.0 years [IQR: 13.8-14.1], frailty prevalence was 10.9% in ILI compared with 11.6% in DSE (odds ratio for frailty in ILI vs. DSE =0.94, 95% confidence interval = 0.75-1.18, P =0.60). Frailty was more prevalent in participants who were older, female, non-white, of lower socioeconomic status, and at baseline had a higher BMI and waist circumference, longer duration of diabetes, history of CVD, and metabolic syndrome. Conclusions Prior randomization to ILI compared with DSE was not associated with a lower prevalence of frailty after a median follow-up of 14.0 years in adults with diabetes and overweight or obesity.

Frailty and Associated Factors among Centenarians in the 5-COOP Countries

Gerontology ◽  
2018 ◽  
Vol 64 (6) ◽  
pp. 521-531 ◽  
Author(s):  
Marie Herr ◽  
Bernard Jeune ◽  
Stefan Fors ◽  
Karen Andersen-Ranberg ◽  
Joël Ankri ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Associated Factors ◽  
Walking Speed ◽  
Frailty Phenotype ◽  
Factors Associated ◽  
Low Level ◽  
Healthcare Needs ◽  
Slow Walking ◽  
Slow Walking Speed

Background: The global number of centenarians is still strongly growing and information about the health and healthcare needs of this segment of the population is needed. This study aimed to estimate the prevalence of frailty among centenarians included in a multinational study and to investigate associated factors. Methods: The 5-COOP study is a cross-sectional survey including 1,253 centenarians in 5 countries (Japan, France, Switzerland, Denmark, and Sweden). Data were collected using a standardized questionnaire during a face-to-face interview (73.3%), telephone interview (14.5%), or by postal questionnaire (12.2%). The 5 dimensions of the frailty phenotype (weight loss, fatigue, weakness, slow walking speed, and low level of physical activity) were assessed by using self-reported data. Factors associated with frailty criteria were investigated by using multivariate regression models. Results: Almost 95% of the participants had at least 1 frailty criterion. The overall prevalence of frailty (3 criteria or more) was 64.7% (from 51.5% in Sweden to 77.6% in Switzerland), and 32.2% of the participants had 4 or 5 criteria. The most frequent criteria were weakness (84.2%), slow walking speed (77.6%), and low level of physical activity (72.5%), followed by fatigue (43.8%) and weight loss (23.8%). Factors associated with frailty included data collection modes, country of residence, gender, living in institution, depression, dementia, disability, falls, and sensory impairments. Conclusions: This study shows that reaching 100 years of age rarely goes without frailty and sheds light on factors associated with frailty at a very old age.

Association between physical frailty and inflammation in late-life depression

2016 ◽  
Vol 33 (S1) ◽  
pp. S84-S85
Author(s):  
M. Arts ◽  
R. Collard ◽  
H. Comijs ◽  
P. Naudé ◽  
R. Risselada ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Gait Speed ◽  
Inflammatory Markers ◽  
Handgrip Strength ◽  
Low Grade ◽  
Late Life Depression ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Low Grade Inflammation

IntroductionAlthough the criteria for physical frailty and depression partly overlap, both represent unique, but reciprocally related constructs. The association between inflammation and frailty has been reported consistently, in contrast to the association between inflammation and late-life depression (LLD).Aim and objectivesTo determine whether physical frailty is associated with low-grade inflammation in LLD.MethodsThe physical frailty phenotype, defined as three out of five criteria (weight loss, weakness, exhaustion, slowness, low physical activity level), and three inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6), and neutrophil gelatinase–associated lipocalin (NGAL)] were assessed in a sample of individuals aged 60 and older with depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria (n = 366).ResultsThe physical frailty phenotype was not associated with inflammatory markers in linear regression models adjusted for sociodemographic characteristics, lifestyle characteristics, and somatic morbidity. Of the individual criteria, handgrip strength was associated with CRP and IL-6, and gait speed was associated with NGAL. Principal component analysis identified two dimensions within the physical frailty phenotype: performance-based physical frailty (encompassing gait speed, handgrip strength, and low physical activity) and vitality-based physical frailty (encompassing weight loss and exhaustion). Only performance-based physical frailty was associated with higher levels of inflammatory markers.ConclusionThe physical frailty phenotype is not a unidimensional construct in individuals with depression. Only performance-based physical frailty is associated with low-grade inflammation in LLD, which might point to a specific depressive subtype.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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