scholarly journals Erratum to: The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review

2021 ◽  
pp. 1-1
Author(s):  
A.R.M.S. Ekram ◽  
R.L. Woods ◽  
C. Britt ◽  
S. Espinoza ◽  
M.E. Ernst ◽  
...  
Keyword(s):  
Online Publication ◽  
Community Dwelling ◽  
Original Version ◽  
Original Publication ◽  
Older Individuals ◽  
Umbrella Review ◽  
All Cause Mortality

The original version of this article unfortunately contained a mistake. Appendix II was published twice in the supporting information. The original publication has been updated. Appendix I and Appendix II are now both available in the online publication.

scholarly journals The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review

2020 ◽  
Author(s):  
A R M Saifuddin Ekram ◽  
Robyn Woods ◽  
Carlene Britt ◽  
Sara E Espinoza ◽  
Michael E Ernst ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Critical Appraisal ◽  
Frailty Index ◽  
Community Dwelling ◽  
Older Individuals ◽  
Umbrella Review ◽  
Frailty Phenotype ◽  
Essential Information ◽  
All Cause Mortality ◽  
Meta Analyses

Abstract Background Frailty is associated with multiple adverse health outcomes, including mortality. Several methods have been used to characterize frailty, each based on different frailty scales. These include scales based on a phenotype, multidomain, and deficit accumulations. Several systematic reviews have examined the association between frailty and mortality; however, it is unclear whether these different frailty scales similarly predict mortality. This umbrella review aims to examine the association between frailty assessed by different frailty scales and all-cause mortality among community-dwelling older adults. Methods The umbrella review protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched to identify systematic reviews and meta-analyses examining the association between frailty and all-cause mortality. Methodological quality was assessed using the JBI. Critical Appraisal Checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Results Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All the systematic reviews performed meta-analyses and assessed between-study heterogeneity. All of the systematic reviews found that frailty was significantly associated with all-cause mortality.Conclusion This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.

scholarly journals The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review

2021 ◽  
pp. 1-7
Author(s):  
A.R.M.S. Ekram ◽  
R.L. Woods ◽  
C. Britt ◽  
S. Espinoza ◽  
M.E. Ernst ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Critical Appraisal ◽  
Frailty Index ◽  
Community Dwelling ◽  
Older Individuals ◽  
Umbrella Review ◽  
Deficit Accumulation ◽  
Frailty Phenotype ◽  
Essential Information ◽  
All Cause Mortality

Frailty is associated with multiple adverse health outcomes, including mortality. Several methods have been used to characterize frailty, each based on different frailty scales. These include scales based on phenotype, multidomain, and deficit accumulations. Several systematic reviews have examined the association between frailty and mortality; however, it is unclear whether these different frailty scales similarly predict mortality. This umbrella review aims to examine the association between frailty assessed by different frailty scales and all-cause mortality among community-dwelling older adults. A protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched. Methodological quality was assessed using the JBI critical appraisal checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried’s physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All of the systematic reviews found that frailty was significantly associated with all-cause mortality. This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.

scholarly journals Frailty Status and All-Cause Mortality in the Community-Dwelling Older People: An Umbrella Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 488-489
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Carlene Britt ◽  
Sara Espinoza ◽  
Robyn Woods
Keyword(s):  
Older People ◽  
Systematic Reviews ◽  
Community Dwelling ◽  
Umbrella Review ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Community Dwelling Older People ◽  
Meta Analyses

Abstract Frailty is increasingly recognised for its association with adverse health outcomes including mortality. However, various measures are used to assess frailty, and the strength of association could vary depending on the specific definition used. This umbrella review aimed to map which frailty scale could best predict the relationship between frailty and all-cause mortality among community-dwelling older people. According to the PRISMA guidelines, Medline, Embase, EBSCOhost and Web of Science databases were searched to identify eligible systematic reviews and meta-analyses which examined the association between frailty and all-cause mortality in the community-dwelling older people. Relevant data were extracted and summarised qualitatively. Methodological quality was assessed by AMSTAR-2 checklist. Five moderate-quality systematic reviews with a total of 374,529 participants were identified. Of these, two examined the frailty phenotype and its derivatives, two examined the cumulative deficit models and the other predominantly included studies assessing frailty with the FRAIL scale. All of the reviews found a significant association between frailty status and all-cause mortality. The magnitude of association varied between individual studies, with no consistent pattern related to the frailty measures that were used. In conclusion, regardless of the measure used to assess frailty status, it is associated with an increased risk of all-cause mortality.

scholarly journals 444Frailty status and all-cause mortality in the community-dwelling individuals: An umbrella review

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Carlene Britt ◽  
Sara Espinoza ◽  
Robyn Woods
Keyword(s):  
Systematic Reviews ◽  
Critical Appraisal ◽  
Frailty Index ◽  
Community Dwelling ◽  
Umbrella Review ◽  
Deficit Accumulation ◽  
Frailty Phenotype ◽  
Essential Information ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Frailty is increasingly recognised for its association with adverse health outcomes, including mortality. However, various measures are used to assess frailty, and the strength of association could vary depending on the specific definition used. This umbrella review aims to map which frailty scale can best predict the relationship between frailty and all-cause mortality among community-dwelling older people. Methods A protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched. Methodological quality was assessed using the JBI critical appraisal checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Results Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried's physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All of the systematic reviews found that frailty was significantly associated with all-cause mortality. Conclusion This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale. Key messages Frailty is associated with an increased risk of all-cause mortality in community-dwelling individuals signifying the importance of assessment in the primary healthcare setting.

226Health-related quality of life and all-cause mortality among older people: a prospective cohort study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Aung Zaw Zaw Phyo ◽  
Joanne Ryan ◽  
David Gonzalez-Chica ◽  
John McNeil ◽  
Robyn Woods ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
The United States ◽  
Community Dwelling ◽  
Older Individuals ◽  
Patient Reported ◽  
All Cause Mortality ◽  
Related Quality ◽  
Health Related

Abstract Background Health-related quality of life (HRQoL) is a measure of an individual’s self-perceived health status. Few studies have examined HRQoL as a risk factor for mortality. This study examined whether HRQoL predicts all-cause mortality in older community-dwelling individuals from Australia and the United States enrolled in the Aspirin in Reducing Events in the Elderly (ASPREE) trial, and if this association varies across gender. Methods The 19,106 persons aged 65–98 years and free of known major life-limiting disease, who completed the 12-item short form (SF-12) HRQoL at ASPREE-baseline (2010–2014) were followed prospectively until 2017 for all-cause mortality. Cox proportional-hazard models were used to determine the association between the physical (PCS) and mental component scores (MCS) of HRQoL and all-cause mortality, adjusting for sociodemographic factors, health-related behaviours, and clinical measures. Results There were 1,052 deaths over a median 4.7-year of follow-up, with 11.9 events per 1,000 person-years. A 10-unit increase in PCS was associated with a 17% decrease in all-cause mortality (95%CI: 0.77, 0.89). MCS was not associated with all-cause mortality. There was no evidence these associations were different between males and females (P-values for interaction: PCS 0.13 and MCS 0.44). Conclusions PCS, but not MCS, was inversely associated with all-cause mortality in this large cohort of healthy older individuals. Key messages Our findings support the decision of the Australian Commission on Safety and Quality in Health Care to incorporate the SF-12 into the routine collection of Patient Reported Outcome Measures as a policy goal for the Australian health system.

scholarly journals Severe Hypoglycemia, Cardiac Structure and Function, and Risk of Cardiovascular Events among Older Adults with Diabetes

2020 ◽  
Author(s):  
Justin B. Echouffo-Tcheugui ◽  
Natalie Daya ◽  
Alexandra K Lee ◽  
Olive Tang ◽  
Chiadi E. Ndumele ◽  
...  
Keyword(s):  
Older Adults ◽  
Negative Binomial ◽  
Cox Regression ◽  
Severe Hypoglycemia ◽  
Left Ventricular ◽  
Community Dwelling ◽  
Emergency Department Visits ◽  
Cardiac Structure ◽  
Older Individuals ◽  
All Cause Mortality

<b>Objective: </b>To assess the association of severe hypoglycemia measured at baseline with cardiovascular disease (CVD) among community-dwelling older individuals with diabetes, a group particularly susceptible to hypoglycemia. <p><b>Methods: </b>We included older adults with diabetes from the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 5 (2011–2013, baseline). Severe hypoglycemia at baseline was defined using first position ICD-9 codes, from hospitalizations, emergency department visits, and ambulance calls. We examined cross-sectional associations of severe hypoglycemia with echocardiographic indices of cardiac structure-function. We prospectively evaluated the risks of incident or recurrent CVD (coronary heart disease, stroke or heart failure) and all-cause mortality, from baseline to 31 December 2018, using negative binomial and Cox regression models. </p> <p><b>Results: </b>Among 2,193 participants (mean age: 76 years [SD: 5], 57% female, 32% blacks), 79 had a history of severe hypoglycemia at baseline. Severe hypoglycemia was associated with a lower left ventricular (LV) ejection fraction (adjusted beta coefficient: -3.7 % [95% CI: -5.5, -1.7]), higher LV end diastolic volume (14.8 ml [95% CI: 8.8, 20.8]), higher E/A ratio (0.11 [95% CI: 0.03, 0.18]), and higher septal E/e’ (2.48 [95%CI: 1.13, 3.82]). In adjusted models, severe hypoglycemia was associated with incident or recurrent CVD (incidence rate ratio [IRR]: 2.49 (95% CI 1.4, 4.39]) and all-cause mortality (HR 1.70 [95% CI 1.10, 2.67]) among those without prevalent CVD. </p> <p><b>Conclusions:</b> Our findings suggest that a history severe hypoglycemia is associated with alterations in cardiac function and is an important marker of future cardiovascular risk in older adults.<br> </p>

scholarly journals Severe Hypoglycemia, Cardiac Structure and Function, and Risk of Cardiovascular Events among Older Adults with Diabetes

2020 ◽  
Author(s):  
Justin B. Echouffo-Tcheugui ◽  
Natalie Daya ◽  
Alexandra K Lee ◽  
Olive Tang ◽  
Chiadi E. Ndumele ◽  
...  
Keyword(s):  
Older Adults ◽  
Negative Binomial ◽  
Cox Regression ◽  
Severe Hypoglycemia ◽  
Left Ventricular ◽  
Community Dwelling ◽  
Emergency Department Visits ◽  
Cardiac Structure ◽  
Older Individuals ◽  
All Cause Mortality

<b>Objective: </b>To assess the association of severe hypoglycemia measured at baseline with cardiovascular disease (CVD) among community-dwelling older individuals with diabetes, a group particularly susceptible to hypoglycemia. <p><b>Methods: </b>We included older adults with diabetes from the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 5 (2011–2013, baseline). Severe hypoglycemia at baseline was defined using first position ICD-9 codes, from hospitalizations, emergency department visits, and ambulance calls. We examined cross-sectional associations of severe hypoglycemia with echocardiographic indices of cardiac structure-function. We prospectively evaluated the risks of incident or recurrent CVD (coronary heart disease, stroke or heart failure) and all-cause mortality, from baseline to 31 December 2018, using negative binomial and Cox regression models. </p> <p><b>Results: </b>Among 2,193 participants (mean age: 76 years [SD: 5], 57% female, 32% blacks), 79 had a history of severe hypoglycemia at baseline. Severe hypoglycemia was associated with a lower left ventricular (LV) ejection fraction (adjusted beta coefficient: -3.7 % [95% CI: -5.5, -1.7]), higher LV end diastolic volume (14.8 ml [95% CI: 8.8, 20.8]), higher E/A ratio (0.11 [95% CI: 0.03, 0.18]), and higher septal E/e’ (2.48 [95%CI: 1.13, 3.82]). In adjusted models, severe hypoglycemia was associated with incident or recurrent CVD (incidence rate ratio [IRR]: 2.49 (95% CI 1.4, 4.39]) and all-cause mortality (HR 1.70 [95% CI 1.10, 2.67]) among those without prevalent CVD. </p> <p><b>Conclusions:</b> Our findings suggest that a history severe hypoglycemia is associated with alterations in cardiac function and is an important marker of future cardiovascular risk in older adults.<br> </p>

scholarly journals Severe Hypoglycemia, Cardiac Structure and Function, and Risk of Cardiovascular Events among Older Adults with Diabetes

2020 ◽  
Author(s):  
Justin B. Echouffo-Tcheugui ◽  
Natalie Daya ◽  
Alexandra K Lee ◽  
Olive Tang ◽  
Chiadi E. Ndumele ◽  
...  
Keyword(s):  
Older Adults ◽  
Negative Binomial ◽  
Cox Regression ◽  
Severe Hypoglycemia ◽  
Left Ventricular ◽  
Community Dwelling ◽  
Emergency Department Visits ◽  
Cardiac Structure ◽  
Older Individuals ◽  
All Cause Mortality

<b>Objective: </b>To assess the association of severe hypoglycemia measured at baseline with cardiovascular disease (CVD) among community-dwelling older individuals with diabetes, a group particularly susceptible to hypoglycemia. <p><b>Methods: </b>We included older adults with diabetes from the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 5 (2011–2013, baseline). Severe hypoglycemia at baseline was defined using first position ICD-9 codes, from hospitalizations, emergency department visits, and ambulance calls. We examined cross-sectional associations of severe hypoglycemia with echocardiographic indices of cardiac structure-function. We prospectively evaluated the risks of incident or recurrent CVD (coronary heart disease, stroke or heart failure) and all-cause mortality, from baseline to 31 December 2018, using negative binomial and Cox regression models. </p> <p><b>Results: </b>Among 2,193 participants (mean age: 76 years [SD: 5], 57% female, 32% blacks), 79 had a history of severe hypoglycemia at baseline. Severe hypoglycemia was associated with a lower left ventricular (LV) ejection fraction (adjusted beta coefficient: -3.7 % [95% CI: -5.5, -1.7]), higher LV end diastolic volume (14.8 ml [95% CI: 8.8, 20.8]), higher E/A ratio (0.11 [95% CI: 0.03, 0.18]), and higher septal E/e’ (2.48 [95%CI: 1.13, 3.82]). In adjusted models, severe hypoglycemia was associated with incident or recurrent CVD (incidence rate ratio [IRR]: 2.49 (95% CI 1.4, 4.39]) and all-cause mortality (HR 1.70 [95% CI 1.10, 2.67]) among those without prevalent CVD. </p> <p><b>Conclusions:</b> Our findings suggest that a history severe hypoglycemia is associated with alterations in cardiac function and is an important marker of future cardiovascular risk in older adults.<br> </p>

Perceived Voice Disorders in Older Adults and Impact on Social Interactions

2021 ◽  
pp. 1-8
Author(s):  
Connie K. Porcaro ◽  
Clare Singer ◽  
Boris Djokic ◽  
Ali A. Danesh ◽  
Ruth Tappen ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interactions ◽  
Social Engagement ◽  
Leisure Activities ◽  
Treatment Strategies ◽  
Voice Disorders ◽  
Community Dwelling ◽  
Vocal Performance ◽  
Older Individuals ◽  
Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

scholarly journals Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

2021 ◽  
Vol 18 (13) ◽  
pp. 7067
Author(s):  
Esther García-Esquinas ◽  
Rosario Ortolá ◽  
Iago Gine-Vázquez ◽  
José A. Carnicero ◽  
Asier Mañas ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
Social Isolation ◽  
Community Dwelling ◽  
Housing Conditions ◽  
Older Individuals ◽  
Lifestyle Risk Factors ◽  
Increased Risk ◽  
Lifestyle Risk

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

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