Car Accidents Associated with Physical Frailty and Cognitive Impairment

Gerontology ◽  
2020 ◽  
Vol 66 (6) ◽  
pp. 624-630
Author(s):  
Takehiko Doi ◽  
Hideaki Ishii ◽  
Kota Tsutsumimoto ◽  
Sho Nakakubo ◽  
Satoshi Kurita ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Assessment Tool ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Car Accidents ◽  
Age Related ◽  
Low Activity

<b><i>Introduction:</i></b> Age-related functional decline elevates the risk of car accidents. Whether specific cognitive impairments and physical frailty increase the risk of car accidents is still unclarified. <b><i>Objective:</i></b> This study examines the association between car accidents, frailty, and cognitive function, owing to an increase in car accidents related to older adults. <b><i>Methods:</i></b> Data were collected from 12,013 older adults (45.4% women, mean age: 71.7 years [min: 60, max: 96]) enrolled in the National Center for Geriatrics and Gerontology (NCGG) – Study of Geriatric Syndromes. A 2-year self-reported history of car accidents was assessed. The Japanese cardiovascular health study index was used as the criterion and included the following components of frailty: shrinking, weakness, exhaustion, low activity, and slowness. “Frailty” was assigned a value of 1 or more based on these components. Cognitive function was assessed using the NCGG Functional Assessment Tool, and cognitive impairment was assessed using a standardized value. <b><i>Results:</i></b> Of the participants, 1,117 (9.3%) had a car accident history. The proportions of the frailty components’ applicability were observed in the car accidents group compared to the non-car accidents group: shrinking (<i>p</i> = 0.006), exhaustion (<i>p</i> = 0.031), low activity (<i>p</i> = 0.034), and slowness (<i>p</i> = 0.030), but not weakness (<i>p</i> = 0.452). The proportion of cognitive impairment in executive function was also higher in the car accidents group (<i>p</i> = 0.011). A logistic regression analysis showed that both frailty (OR 1.26, 95% CI 1.11–1.43; <i>p</i> &#x3c; 0.001) and cognitive impairment (OR 1.26, 95% CI 1.11–1.43, <i>p</i> &#x3c; 0.001) are associated with car accidents. <b><i>Discussion:</i></b> This study’s findings contribute to enhancing the utility of risk assessments for older drivers. Further study is required to clarify the risk of car accidents.

scholarly journals Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults

2021 ◽  
Vol 18 (6) ◽  
pp. 2931
Author(s):  
Ryo Komatsu ◽  
Koutatsu Nagai ◽  
Yoko Hasegawa ◽  
Kazuki Okuda ◽  
Yuto Okinaka ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Cross Sectional ◽  
Important Indicator ◽  
Community Dwelling Older Adults ◽  
Oral Frailty

This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22–4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73–0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.

CONCURRENCE OF FRAILTY AND PARKINSON’S DISEASE

2012 ◽  
pp. 1-5
Author(s):  
K.P. ROLAND ◽  
K.M.D. CORNETT ◽  
O. THEOU ◽  
J.M. JAKOBI ◽  
G.R. JONES
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cardiovascular Health ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Levodopa Dose ◽  
Frailty Phenotype ◽  
Age Related

Background: Females with Parkinson’s disease (PD) are at greater risk of frailty than males. Little is known about how age and disease-related characteristics influence frailty in females with PD because frailty studies often exclude persons with underlying neurological pathologies. Objective: To determine age and diseaserelated characteristics that best explain physical frailty in community-dwelling females with and without PD. Design & Measurement: Correlation coefficients described relationships between PD-related characteristics and physical frailty phenotype criteria (Cardiovascular Health Study). Regression analysis identified associations between disease-related characteristics and frailty in non-PD and PD females. Setting: Community-dwelling. Participants: Females with mild to moderate PD (n = 17, mean age = 66 ± 8.5 years) and non-PD (n = 18, mean age = 72 ± 13.2 years) participated. Results: Daily carbidopa-levodopa dose best explained frailty in PD females (β = 0.5), whereas in non-PD females, age (β = 0.7) and comorbidity (β = 0.5) were most associated with frailty. Conclusions: Dopaminergic medication explained frailty in PD and not measures of disease progression (i.e. severity, duration). In females without PD age-related accumulation of comorbidities resulted in greater risk of frailty. This indicates dopaminergic management of PD symptoms may better reflect frailty in females with PD than disease severity or duration. These data suggest the influence of underlying frailty should be considered when managing neurological conditions. Understanding how frailty concurrently exists with PD and how these conditions progress within the aging female will facilitate future care management.

scholarly journals GAIT SLOWING AMONG FRAIL OLDER ADULTS: IS HIGHER DOPAMINERGIC SIGNALING PROTECTIVE?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S89-S89
Author(s):  
Caterina Rosano ◽  
Stephanie Studenski ◽  
Nicolaas Bohnen ◽  
Andrea Rosso
Keyword(s):  
Older Adults ◽  
Racial Differences ◽  
Gait Speed ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Linear Regression Models ◽  
Full Cohort ◽  
Frail Older Adults ◽  
Age Related

Abstract Strategies to reduce gait slowing in frail older adults are urgently needed. Higher dopaminergic (DA) signaling is emerging as a protecting factor against age-related gait slowing, in the absence of Parkinson’s Disease (PD). DA signaling is potentially modifiable, thereby offering promising novel strategies to reduce gait slowing. In 3,752 PD-free participants of the Cardiovascular Health Study (72.3 years, 81% white, 39% male), we measured gait speed (usual pace, 15 feet), frailty (Fried definition), and genetic polymorphism of Catechol-O-methyltransferase (COMT, rs4680), an enzyme regulating tonic brain DA levels. Multivariable linear regression models of COMT predicting gait speed were adjusted for age, gender, BMI, ankle-arm index, vision, and arthritis. Strength, education, medications, pulmonary, cardio- and cerebro-vascular diseases, diabetes, mood, and cognition were considered as additional covariates. We examined the full cohort and the subgroup with frailty (n=222), without and with race-stratification to address racial differences in allele frequencies. Average (SE) gait speed was 0.88 (0.003) and 0.58 (0.01) m/sec in the full cohort and the frail subgroup, respectively. COMT was linearly associated with gait speed; gait was faster for met/met (higher DA signaling) and slower for val/val (lower DA signaling) participants. In adjusted models, differences between these two groups were: 0.02 (0.01) m/sec in the full cohort (p=0.4); 0.07(0.02) m/sec in the frail subgroup (p=0.02); 0.10 (0.02) m/sec in white with frailty (p=0.01). COMT genotyping may help identify frail adults who are less vulnerable to gait impairments. Studies of frailty should examine whether higher DA signaling offers resilience against age-related gait slowing.

scholarly journals Association between cognitive impairment and criteria for frailty syndrome among older adults

2020 ◽  
Vol 78 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Allan Gustavo BRIGOLA ◽  
Ana Carolina OTTAVIANI ◽  
Danilo Henrique Trevisan CARVALHO ◽  
Nathalia Alves OLIVEIRA ◽  
Érica Nestor SOUZA ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cardiovascular Health ◽  
Functional Dependence ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Multinomial Regression ◽  
Cognitive Frailty ◽  
Elderly Caregivers ◽  
State Examination

Abstract The association between cognitive impairment and physical frailty has been studied in older adults. The criteria degree of frailty may be keys to associated cognitive impairment. Objective: To analyze the association between cognitive impairment and the criteria for frailty. Methods: We cross-sectionally examined data from 667 older adults (≥60 years of age) from a study entitled ‘Variables associated to cognition in elderly caregivers’ involving patients in an urban and rural primary healthcare center. We defined cognitive impairment based on different groups of scores on the Mini Mental State Examination, and defined frailty and prefrailty using the criteria by the Cardiovascular Health Study. We performed multinomial regression models to analyze the association between levels of frailty and cognitive impairment. Results: Similar proportions of women (54.8%) and men (45.2%) participated in the study (mean age: 71 years old). We found cognitive impairment, prefrailty and frailty in 34, 54, and 24% of the participants, respectively. Concomitant cognitive impairment and frailty was found in 13% of them. The chances of cognitive impairment increased up to 330% (Odds Ratio [OR]: 4.3; 95% confidence interval [95%CI] 2.4‒7.7; p<0.001) among frail individuals, and 70% (OR: 1.7; 95%CI 1.0‒2.8; p=0.033) among prefrail individuals compared to robust/non-frail individuals. After controlling for age, education, place of residence and functional dependence, slowness and fatigue criteria were significantly associated with cognitive impairment. Conclusion: Older adults with frailty have a greater likelihood of concomitant cognitive impairment than prefrail and robust older adults. The prevalence of cognitive impairment and frailty is consistent with data reported in literature. The present findings contribute to the investigation of cognitive frailty.

scholarly journals Heterogeneous Influence of Frailty Phenotypes in Age-Related Hearing Loss and Tinnitus in Chinese Older Adults: An Explorative Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Qingwei Ruan ◽  
Jie Chen ◽  
Ruxin Zhang ◽  
Weibin Zhang ◽  
Jian Ruan ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Community Dwelling ◽  
Lower Probability ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Cognitive Frailty ◽  
Age Related

BackgroundFried physical frailty, with mobility frailty and non-motor frailty phenotypes, is a heterogeneous syndrome. The coexistence of the two phenotypes and cognitive impairment is referred to as cognitive frailty (CF). It remains unknown whether frailty phenotype has a different association with hearing loss (HL) and tinnitus.MethodsOf the 5,328 community-dwelling older adults, 429 participants aged ≥58 years were enrolled in the study. The participants were divided into robust, mobility, and non-mobility frailty, mobility and non-mobility CF (subdivided into reversible and potentially reversible CF, RCF, and PRCF), and cognitive decline [subdivided into mild cognitive impairment (MCI) and pre-MCI] groups. The severity and presentations of HL and/or tinnitus were used as dependent variables in the multivariate logistic or nominal regression analyses with forward elimination adjusted for frailty phenotype stratifications and other covariates.ResultsPatients with physical frailty (mobility frailty) or who are robust were found to have lower probability of developing severe HL and tinnitus, and presented HL and/or tinnitus than those with only cognitive decline, or CF. Patients with RCF and non-mobility RCF had higher probability with less HL and tinnitus, and the presentation of HL and/or tinnitus than those with PRCF and mobility RCF. Other confounders, age, cognitive and social function, cardiovascular disease, depression, and body mass index, independently mediated the severity of HL and tinnitus, and presented HL and/or tinnitus.ConclusionFrailty phenotypes have divergent association with HL and tinnitus. Further research is required to understand the differential mechanisms and the personalized intervention of HL and tinnitus.Clinical Trial RegistrationClinicalTrials.gov identifier, NCT2017K020.

scholarly journals Accelerometer Physical Activity is Associated with Greater Gray Matter Volumes in Older Adults Without Dementia or Mild Cognitive Impairment

2018 ◽  
Vol 74 (7) ◽  
pp. 1142-1151 ◽  
Author(s):  
Shannon Halloway ◽  
Konstantinos Arfanakis ◽  
JoEllen Wilbur ◽  
Michael E Schoeny ◽  
Susan J Pressler
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Gray Matter ◽  
Cross Sectional ◽  
Gray Matter Atrophy ◽  
Age Related ◽  
Gray Matter Volumes

Abstract Objectives Physical activity (PA) is a modifiable health behavior that can protect against age-related gray matter atrophy and cognitive dysfunction. Current studies of PA and gray matter failed to utilize device measures of PA and do not focus on adults >80 years. Thus, the purpose of this secondary analysis was to examine cross-sectional associations between accelerometer lifestyle PA and (a) gray matter volumes and (b) cognitive function, controlling for demographics, and health status. Method Participants were 262 older adults without dementia or mild cognitive impairment from Rush Memory and Aging Project, an epidemiological cohort study. Participants wore an accelerometer to assess total daily lifestyle PA, and completed anatomical magnetic resonance imaging to assess gray matter volumes and a neurocognitive test battery to assess cognitive function. Results Multivariate linear regression indicated that higher levels of total daily lifestyle PA was significantly related to larger gray matter volumes, F(2, 215) = 3.61, p = .027, including subcortical gray matter (β = 0.17, p = .007) and total gray matter (β = 0.11, p = .049), with no significant associations between lifestyle PA and cognitive function. Discussion These findings may inform future lifestyle PA interventions in order to attenuate age-related gray matter atrophy.

scholarly journals SOCIAL COHESION AFFECTS THE ASSOCIATION BETWEEN FRAILTY AND DISABILITY IN COMMUNITY-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S782-S782
Author(s):  
Boqin Xie
Keyword(s):  
Older Adults ◽  
Social Cohesion ◽  
Functional Disability ◽  
Community Dwelling ◽  
Analysis Of Covariance ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
The Impact ◽  
Community Dwelling Older Adults

Abstract The relationships between physical frailty and perceived neighborhood social cohesion (PNSC) and functional disability among community-dwelling older adults are poorly understood. This study aims to (1) examine the associations of frailty and PNSC with disability; and (2) evaluate low PNSC as a risk factor in the association between frailty and disability. A sample of 1645 older adults using multi-stage sampling method in Shanghai were randomly selected in this cross-sectional study. Frailty operationalized as Cardiovascular Health Study criteria (OR=2.4, 95%CI 1.16-4.96 for pre-frailty; OR=7.28, 95%CI 3.37-15.73 for frailty) and PNSC measured as Neighborhood Cohesion Scale (OR=1.81, 95%CI 1.23-2.67) were independently associated with basic and instrumental activities of daily living disability. A significant interaction of frailty and PNSC on disability (F (2, 66)=4.31, P=.014) was found, using a two-way analysis of covariance (ANCOVA). Compared to robust individuals with high PNSC, pre-frailty with high PNSC was not significantly associated with disability while pre-frailty with low PNSC was associated with approximate 4-fold increased prevalence of disability (OR=3.87, 95%CI 1.46-10.24, p=.006). Frailty with high PNSC was associated with higher likelihood of disability (OR=6.47, 95%CI 2.35-17.87) and frail individuals with low PNSC stood out with 10-fold increased prevalence of disability (OR=9.94, 95%CI 3.50-28.26). All analyses were controlled for demographical and clinical covariates. Our results suggest high level of social cohesion serves as a buffer against the impact of physical frailty on functional disability. These findings notably imply to the development of interventions for older frail adults from the neighborhood perspective.

scholarly journals Cognitive Frailty And Risk Of Functional Disability In Older Japanese Adults: A 4-Year Prospective Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 820-821
Author(s):  
Sanmei Chen ◽  
Takanori Honda ◽  
Tao Chen ◽  
Hiro Kishimoto ◽  
Shuzo Kumagai ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Functional Disability ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Minor Trauma ◽  
Physical Frailty ◽  
Term Care ◽  
Cognitive Frailty ◽  
Increased Risk

Abstract Background Cognitive frailty is a newly proposed clinical entity, referring to concurrent cognitive impairment and physical frailty in the absence of dementia. The clinical significance of cognitive frailty remains poorly understood. We aimed to investigate the association between cognitive frailty and functional disability in older adults. Methods A total of 1,644 non-demented older adults aged ≥65 years (mean age: 73 ± 6 years; men: 41.8%) and without functional disability at baseline were followed-up for 4 years. Cognitive frailty was defined as the presence of both physical frailty (based on the modified Cardiovascular Health Study criteria) and cognitive impairment (Mini-Mental State Examination score of &lt;24 points). Functional disability was identified using the database of Japan’s Long-term Care Insurance System. Association between cognitive frailty and functional disability was assessed by using the Cox proportional hazard models. Results During the follow-up, 152 participants were identified as being functionally disabled. There was a significant interaction between physical frailty and cognitive impairment on the development of functional disability (P &lt;0.1). Compared with being robust both physically and cognitively, the hazard ratio (95% confidence interval) of functional disability was 8.40 (4.05-17.42) for cognitively frailty, after adjustment for age, sex, education, living alone, smoking, drinking, number of comorbidities (hypertension, stroke, chronic heart disease, diabetes, chronic kidney disease, poor hearing, poor vision, osteoarthritis or rheumatism, minor trauma fracture, or cancer). Conclusion Cognitive frailty was associated with an increased risk of functional disability in community-dwelling older adults. Cognitive frailty could be an underrecognized risk factor for functional disability.

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