Association between 9p21-23 Locus and Frailty in a Community-Dwelling Greek Population: Results from the Hellenic Longitudinal Investigation of Ageing and Diet

2022 ◽  
pp. 1-9
Author(s):  
N. Mourtzi ◽  
A. Hatzimanolis ◽  
G. Xiromerisiou ◽  
E. Ntanasi ◽  
M.K. Georgakis ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Frailty Index ◽  
Positive Association ◽  
Community Dwelling ◽  
Greek Population ◽  
Geriatric Syndrome ◽  
Risk Alleles ◽  
Psychological Domain ◽  
Age Related ◽  
Increased Risk

Background: Frailty is a complex geriatric syndrome arising from a combination of genetic and environmental factors and is associated with adverse health outcomes and mortality. A recent study reported an association between variants of the 9p21-23 locus, associated with a number of age-related disorders, including Alzheimer’s disease (AD), and frailty. Frailty has been associated with increased risk of developing AD and it has been proposed that frailty burden may modify AD clinical presentation. In view of the overlapping genetic architecture between the two disorders, it is noteworthy to conduct studies to uncover risk variants that contribute to both AD and frailty. The purpose of this study is to test the reproducibility of the association of 9p21-23 locus with frailty in a population that is ethnically different from previous work and in the context of multidimensional definitions of frailty that will allow us to examine the potential impact to domains pertaining to AD pathology. Methods: We operationalized frailty according two definitions and the corresponding instruments, the Frailty Index (FI) and the Tilburg Frailty Indicator (TFI) and we determined genotypes of eight alleles previously identified as risk increasing for frailty in 1172 community-dwelling older participants (57% females) from the HELIAD study with a mean age of 74 years old. We cross-sectionally investigated the association between risk alleles and frailty, as well as with specific components of each definition using linear regression analyses adjusted for age, sex and years of education. Results: Compared to non-carriers, carriers of rs7038172 C risk allele, were associated with a higher FI Score (β=0.089, p=0.002). Similarly, we found a positive association between the presence of at least one rs7038172 C variant and TFI score (β=0.053, p=0.04). Moreover, the rs7038172 variant was associated, irrespectively of dementia status, with the memory and psychological domain of FI and TFI, respectively. Conclusion: Our study confirms the association of the rs7038172 C allele with the frailty syndrome in a Greek population and in the context of multidimensional definitions of frailty. Furthermore, we report novel associations between this allele and the memory domain of FI and the psychological domain of TFI, that includes memory problems on its components. Given that frailty burden has been shown to modify the AD clinical presentation, it is likely that rs7038172 C allele may accelerate the transition of AD or frailty to dementia Overall, our study corroborates the role of the 9p21-23 region in frailty development and draw potential links with AD pathology.

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.

HOW DO COMMUNITY PHYSICAL AND OCCUPATIONAL THERAPISTS CLASSIFY FRAILTY? A PILOT STUDY

2014 ◽  
pp. 1-4
Author(s):  
K.P. ROLAND ◽  
O. THEOU ◽  
J.M. JAKOBI ◽  
L. SWAN ◽  
G.R. JONES
Keyword(s):  
Cardiovascular Health ◽  
Healthcare Professionals ◽  
Frailty Index ◽  
Occupational Therapists ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Geriatric Syndrome ◽  
Dimensional Approach

Background: Frailty is a complex geriatric syndrome that is often difficult to diagnose, especially by healthcare professionals working in the community. Objectives, Measurements: This study examined how physical and occupational therapists classified community-dwelling clients using categories of ‘nonfrail’, ‘prefrail’ or ‘frail’ as compared to measurements of established frailty criteria from the Cardiovascular Health Study frailty index (CHSfi). Results: Results indicate that community therapists underestimate frailty in comparison to the CHSfi. Therapists’ classification of frailty suggested their perceptions of frailty may not only relate to client’s functional capacity, but the context in which the client receives care. Conclusion: A multi-dimensional approach is required to capture all aspects of frailty across the healthcare continuum that accounts for how the client thrives within their personal environment.

scholarly journals Relationship between Perceived Indoor Temperature and Self-Reported Risk for Frailty among Community-Dwelling Older People

2019 ◽  
Vol 16 (4) ◽  
pp. 613 ◽  
Author(s):  
Yukie Nakajima ◽  
Steven Schmidt ◽  
Agneta Malmgren Fänge ◽  
Mari Ono ◽  
Toshiharu Ikaga
Keyword(s):  
Older People ◽  
Economic Status ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Indoor Temperature ◽  
Cross Sectional ◽  
Economic Satisfaction ◽  
Increased Risk ◽  
Community Dwelling Older People

This study investigated the relationship between perceived indoor temperature in winter and frailty among community-dwelling older people. This cross-sectional study included 342 people 65 years and older in Japan. Participants answered questions about demographics, frailty, housing, and perceived indoor temperature in winter. Participants were grouped based on perceived indoor temperature (Cold or Warm) and economic satisfaction (Unsatisfied or Satisfied). Differences in the frailty index between perceived indoor temperature groups and economic satisfaction groups were tested by using ANCOVA and MANCOVA. An interaction effect showed that people in the Cold Group and unsatisfied with their economic status had significantly higher frailty index scores (F(1, 336) = 5.95, p = 0.015). Furthermore, the frailty index subscale of fall risk was the specific indicator of frailty that accounted for this significant relationship. While previous research has shown the risks related to cold indoor temperature in homes, interestingly among those who reported cold homes, only those who were not satisfied with their economic situation reported being at increased risk for frailty. This highlights the potential importance of preventing fuel poverty to prevent frailty.

scholarly journals Frailty and Mortality in a Community-Dwelling Relatively Healthy Older Population

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 573-573
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Sara Espinoza ◽  
Michael Ernst ◽  
Anne Murray ◽  
...  
Keyword(s):  
Older Adults ◽  
Cox Regression ◽  
Multinomial Logistic Regression ◽  
Frailty Index ◽  
Community Dwelling ◽  
Deficit Accumulation ◽  
Healthy Older Adults ◽  
Frailty Status ◽  
Increased Risk ◽  
Related Mortality

Abstract This study examined factors associated with frailty and studied the association between frailty status and mortality in healthy community-dwelling older persons. Participants included 19,114 individuals from the “ASPirin in Reducing Events in the Elderly” (ASPREE) trial. Frailty was defined using modified Fried phenotype comprising exhaustion, body mass index, grip strength, gait speed and physical activity. A deficit accumulation frailty index (FI) using 66 items was also developed. Correlates of frailty were examined using multinomial logistic regression. The association between frailty status at baseline and mortality was analyzed using Cox regression. At baseline, 39.0% (95% CI: 38.3, 39.7) of participants were prefrail, and 2.2% (95% CI: 2.0, 2.4) were frail according to Fried phenotype, while 40.6% (95% CI: 40.0, 41.3) of participants were pre-frail and 8.1% (95% CI: 7.7, 8.5) were frail according to FI. Older age, female sex, lower education, African-American and Hispanic ethno-racial status, smoking, alcohol use, comorbidities, and polypharmacy were associated with frailty status. Pre-frailty increased risk of all-cause mortality significantly (Fried HR: 1.48; 95% CI: 1.28, 1.71; FI HR: 1.54; 95% CI: 1.31, 1.81); and the risk was even higher for frailty (Fried HR: 2.24; 95% CI: 1.67, 3.00; FI HR: 2.34; 95% CI: 1.83, 2.99) after adjustment for covariates. Cardiovascular disease (CVD) and non-CVD-related mortality showed similar trends. These results highlight a considerable burden of pre-frailty among a large group of community-dwelling, initially healthy older adults. Both Fried phenotype and deficit accumulation FI similarly predicted all-cause, CVD and non-CVD-related mortality in relatively healthy older adults.

scholarly journals Hearing Care Disparities in Dementia: Access and Usability in the Coming Era of OTC Hearing Aids

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 746-746
Author(s):  
Carrie Nieman ◽  
Jennifer Deal ◽  
Sara Czaja ◽  
Esther Oh
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Hearing Aid Use ◽  
Age Related ◽  
Care Partners ◽  
Increased Risk

Abstract Age-related hearing loss is highly prevalent among persons with dementia (PwDs) and is associated with an increased risk of neuropsychiatric symptoms. However, few use hearing aids and disparities exist. PwDs and, in particular, minority older adults, have some of the lowest rates of hearing aid use. Recent federal legislation created the designation of over-the-counter hearing aids, which will debut by 2020-2021, and represents an opportunity to advance accessibility. This presentation will share estimates of hearing aid use among community-dwelling PwDs from two cohorts, where hearing aid use ranges from 7-11% among African Americans versus 33-45% among whites. To explore this gap, the presentation will share findings from semi-structured interviews with care partners of PwDs and hearing loss around barriers and facilitators of hearing care, including device usability. With growing understanding of sensory health, a changing hearing care landscape represents a critical opening to increase access to hearing care for PwDs. Part of a symposium sponsored by the Alzheimer’s Disease Research Interest Group.

scholarly journals Hallmarks of frailty and osteosarcopenia in prematurely aged PolgAD257A/D257A mice

2019 ◽  
Author(s):  
Ariane C. Scheuren ◽  
Gommaar D’Hulst ◽  
Gisela A. Kuhn ◽  
Evi Masschelein ◽  
Esther Wehrle ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Musculoskeletal System ◽  
Volume Fraction ◽  
Frailty Index ◽  
Bone Adaptation ◽  
Geriatric Syndrome ◽  
Bone Volume Fraction ◽  
Age Related ◽  
Caudal Vertebrae

AbstractBackgroundFrailty is a geriatric syndrome characterized by increased susceptibility to adverse health outcomes. One major determinant thereof is the gradual weakening of the musculoskeletal system and the associated osteosarcopenia. To improve our understanding of the underlying pathophysiology and, more importantly, to test potential interventions aimed at counteracting frailty suitable animal models are needed.MethodsTo evaluate the relevance of prematurely aged PolgA(D257A/D257A) mice as a model for frailty and osteosarcopenia, we quantified the clinical mouse frailty index in PolgA(D257A/D257A) and wild type littermates (PolgA(+/+), WT) with age and concertedly assessed the quantity and quality of bone and muscle tissue. Lastly, the anabolic responsiveness of skeletal muscle, muscle progenitors and bone was assessed.ResultsPolgA(D257A/D257A) accumulated health deficits at a higher rate compared to WT, resulting in a higher frailty index at 40 and 46 weeks of age (+166%, +278%, p<0.0001), respectively, with no differences between genotypes at 34 weeks. Concomitantly, PolgA(D257A/D257A) displayed progressive musculoskeletal deterioration such as reduced bone and muscle mass as well as impaired functionality thereof. In addition to lower muscle weights (-14%, p<0.05, -23%, p<0.0001) and fiber area (-20%, p<0.05, -22%, p<0.0001) at 40 and 46 weeks, respectively, PolgA(D257A/D257A) showed impairments in grip-strength and concentric muscle forces (p<0.05). PolgA(D257A/D257A) mutation altered the acute response to various anabolic stimuli in skeletal muscle and muscle progenitors. While PolgA(D257A/D257A) muscles were hypersensitive to eccentric contractions as well as leucine administration, shown by larger downstream signaling response of the mechanistic target of rapamycin complex 1 (mTORC1), myogenic progenitors cultured in vitro showed severe anabolic resistance to leucine and robust impairments in cell proliferation. Longitudinal micro-CT analysis of the 6th caudal vertebrae showed that PolgA(D257A/D257A) had lower bone morphometric parameters (e.g. bone volume fraction, trabecular and cortical thickness, p<0.05) as well as reduced remodeling activities (e.g. bone formation and resorption rate, p<0.05) compared to WT. When subjected to 4 weeks of cyclic loading, young but not aged PolgA(D257A/D257A) caudal vertebrae showed load-induced bone adaptation suggesting reduced mechanosensitivity with age.ConclusionsPolgA(D257A/D257A) mutation leads to hallmarks of age-related frailty and osteosarcopenia and provides a powerful model to better understand the relationship between frailty and the aging musculoskeletal system.

Pathogen Burden, Blood Biomarkers and Functional Ageing in Community-Dwelling Older Adults

2021 ◽  
Author(s):  
Yanxia Lu ◽  
Crystal Tze Ying Tan ◽  
Xinyi Gwee ◽  
Keng Bee Yap ◽  
Tamas Fulop ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Frailty Index ◽  
Community Dwelling ◽  
Functional Mobility ◽  
Blood Biomarkers ◽  
Pathogen Load ◽  
Inflammatory Protein ◽  
Age Related ◽  
Repeated Infections

Abstract Background Lifelong accumulation of latent or persistent or repeated infections may be a contributing factor to the deterioration of physical and cognitive function associated with functional ageing, but the evidence is limited and the biological underpinnings are unclear. Methods We profiled the seropositivity for common viral, bacterial and plasmodial pathogens of local importance in community-living older adults in two studies involving 745 older adults (mean age 67.0, SD: 7.7 years), and 142 older adults (mean age 72.7, SD: 8.3 years). Pathogen load was related to different sets of age-related physical and cognitive measures of functional ageing and the frailty index, and plasma levels of biomarkers of inflammation, innate and adaptive immunity, and other physiological functions. Results High pathogen load was associated with impaired gait speed (GS), (p&lt;0.015), functional mobility (POMA) (p&lt;0.029), cognitive function (MMSE) (p&lt;&lt;0.05), and increased frailty index (FI) (p&lt;&lt;0.05). High pathogen load was significantly associated with C3a complement activity (p&lt;0.001), matrix metalloproteinase-7, macrophage inflammatory protein-1α (p&lt;0.05), and monocyte chemoattractant protein 2 (p=0.028). Blood biomarkers did not fully explain the observed association between pathogen load and functional ageing measures. Conclusions The present study provides novel evidence linking lifelong cumulated numbers of latent, persistent or repeated infection to functional ageing, plausibly via inflammatory and immune and other biological factors.

scholarly journals Study of association between the serum lipid profile and age-related macular degeneration in a tertiary care centre of Central UP

2019 ◽  
Vol 7 (4) ◽  
pp. 1104 ◽  
Author(s):  
Ahmad Husain ◽  
Brijesh Singh ◽  
Ravi Ranjan ◽  
Kalbe Jawad ◽  
Ifsa Sami ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Lipid Profile ◽  
Serum Lipid ◽  
Tertiary Care ◽  
Positive Association ◽  
Age Related Macular Degeneration ◽  
Tertiary Care Centre ◽  
Age Related ◽  
Increased Risk ◽  
The Relationship

Background: Age-related macular degeneration (ARMD) is the major challenge in the new millennium in the developing countries as the size of elderly population continues to rise due to betterment of medical facilities and increased life expectancy. Lipids are implicated in the pathogenesis of ARMD. The relationship between systemic lipids and ARMD has not been well characterized, especially in rural population. The objective was to investigate the relationship between serum lipids and ARMD in older adults.Methods: In this case-control study, 300 adults, aged ≥50 years, 150 each among cases and controls were included in the study. Mean lipids values between cases and controls were compared.Results: Mean age of cases was 62.45±8.472 years and mean age of controls was 61.89±8.51 years. Among 150 cases, 124 (82.66%) cases were of dry ARMD while 26 (17.33%) cases were Wet ARMD. Author found that 38 cases among total cases (25.33%) and 15 individuals (10%) among controls had altered lipid profile. All mean lipid values were higher among cases compare to controls (p>0.05), while the mean of VLDL, TG and TG/HDL were significantly raised showing positive association (p<0.05).Conclusions: Present study showed that high levels of serum lipid values especially VLDL, TG and TG/HDL positive association with an increased risk for development of ARMD, implying that strategies reducing serum lipid levels may be useful to prevent the development of the disease.

scholarly journals Prevalence of Physical Frailty: Results from the DO-HEALTH Study

2021 ◽  
pp. 1-8
Author(s):  
M. Gagesch ◽  
P.O. Chocano-Bedoya ◽  
L.A. Abderhalden ◽  
G. Freystaetter ◽  
A. Sadlon ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Frailty Index ◽  
Female Gender ◽  
Community Dwelling ◽  
Health Study ◽  
Geriatric Syndrome ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Frailty Status

Background: Frailty is a geriatric syndrome associated with multiple negative health outcomes. However, its prevalence varies by population and instrument used. We investigated frailty and pre-frailty prevalence by 5 instruments in community-dwelling older adults enrolled to a randomized-controlled trial in 5 European countries. METHODS: Cross-sectional baseline analysis in 2,144 DO-HEALTH participants recruited from Switzerland, Austria, France, Germany, and Portugal with complete data for frailty. Frailty status was assessed by the Physical Frailty Phenotype [PFP], SOF-Frailty Index [SOF-FI], FRAIL-Scale, SHARE-Frailty Instrument [SHARE-FI], and a modified SHARE-FI, and compared by country, age, and gender. Logistic regression was used to determine relevant factors associated with frailty and pre-frailty. RESULTS: Mean age was 74.9 (±4.4) years, 61.6% were women. Based on the PFP, overall frailty and pre-frailty prevalence was 3.0% and 43.0%. By country, frailty prevalence was highest in Portugal (13.7%) and lowest in Austria (0%), and pre-frailty prevalence was highest in Portugal (57.3%) and lowest in Germany (37.1%). By instrument and overall, frailty and pre-frailty prevalence was highest based on SHARE-FI (7.0% / 43.7%) and lowest based on SOF-FI (1.0% / 25.9%). Frailty associated factors were residing in Coimbra (Portugal) [OR 12.0, CI 5.30-27.21], age above 75 years [OR 2.0, CI 1.17-3.45], and female gender [OR 2.8, CI 1.48-5.44]. The same three factors predicted pre-frailty. CONCLUSIONS: Among relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.

scholarly journals 10 Fear of Falling in Community Dwelling Ambulatory Older Patients: Associations with Physiological Falls Risk, Cognition and Mood Disorders

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
H Dolphin ◽  
A McFeely ◽  
S Kennelly ◽  
S Mello
Keyword(s):  
Mood Disorders ◽  
Fear Of Falling ◽  
Retrospective Chart Review ◽  
Community Dwelling ◽  
Rapid Decline ◽  
Day Hospital ◽  
Timed Up And Go ◽  
Targeted Interventions ◽  
Age Related ◽  
Increased Risk

Abstract Introduction Fear of falling (FOF) is associated with a range of adverse health outcomes including increased risk of falls1, and more rapid decline in physical and cognitive function2. We aim to determine the prevalence of FOF amongst ambulatory community dwelling older adults attending an Age-Related Day Hospital, and to describe it’s associations with cognition, mood disorders, frailty and mobility measures. Methods A retrospective chart review was conducted on 50 patients attending the Day Hospital. Baseline demographics collected include comorbidities, medications, and falls history. Objective mobility measurements include the Timed Up and Go (TUG) test and grip strength. Patients were divided into two groups based on their answer to the question, “Are you afraid of falling?” Differences between groups were compared using chi-squared test. Results The average age of Day Hospital attendees was 85 (SD X). 62% were male. Three quarters of patients experienced a recent fall, and half admitted to FOF. Those with FOF were more likely to be dependent in personal care (27% vs 16%, p = 0.15) and use a walking aid (69% vs 58%, p = 0.02). They were also more likely to be prescribed psychoactive medications (53% vs 45%, p = 0.42), and have a diagnosis of anxiety (4% vs 0%, p = 0.03). Conclusions Both having a falls history and FOF is prevalent in our Day Hospital population. FOF is associated with high physiological risk of falling, increased dependency, and anxiety. Standardization of mobility measures and potential screening for cognitive and mood disorders in patients with FOF will aid in further development of targeted interventions.

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