scholarly journals Social Frailty Is Independently Associated with Mood, Nutrition, Physical Performance, and Physical Activity: Insights from a Theory-Guided Approach

Author(s):  
Kalene Pek ◽  
Justin Chew ◽  
Jun Pei Lim ◽  
Suzanne Yew ◽  
Cai Ning Tan ◽  
...  

Notwithstanding the increasing body of evidence that links social determinants to health outcomes, social frailty is arguably the least explored among the various dimensions of frailty. Using available items from previous studies to derive a social frailty scale as guided by the Bunt social frailty theoretical framework, we aimed to examine the association of social frailty, independently of physical frailty, with salient outcomes of mood, nutrition, physical performance, physical activity, and life–space mobility. We studied 229 community-dwelling older adults (mean age 67.22 years; 72.6% females) who were non-frail (defined by the FRAIL criteria). Using exploratory factor analysis, the resultant 8-item Social Frailty Scale (SFS-8) yielded a three-factor structure comprising social resources, social activities and financial resource, and social need fulfilment (score range: 0–8 points). Social non-frailty (SNF), social pre-frailty (SPF), and social frailty (SF) were defined based on optimal cutoffs, with corresponding prevalence of 63.8%, 28.8%, and 7.4%, respectively. In logistic regression adjusted for significant covariates and physical frailty (Modified Fried criteria), there is an association of SPF with poor physical performance and low physical activity (odds ratio, OR range: 3.10 to 6.22), and SF with depressive symptoms, malnutrition risk, poor physical performance, and low physical activity (OR range: 3.58 to 13.97) compared to SNF. There was no significant association of SPF or SF with life–space mobility. In summary, through a theory-guided approach, our study demonstrates the independent association of social frailty with a comprehensive range of intermediary health outcomes in more robust older adults. A holistic preventative approach to frailty should include upstream interventions that target social frailty to address social gradient and inequalities.

2018 ◽  
Author(s):  
Il-Young Jang ◽  
Hae Reong Kim ◽  
Eunju Lee ◽  
Hee-Won Jung ◽  
Hyelim Park ◽  
...  

BACKGROUND Community-dwelling older adults living in rural areas are in a less favorable environment for health care compared with urban older adults. We believe that intermittent coaching through wearable devices can help optimize health care for older adults in medically limited environments. OBJECTIVE We aimed to evaluate whether a wearable device and mobile-based intermittent coaching or self-management could increase physical activity and health outcomes of small groups of older adults in rural areas. METHODS To address the above evaluation goal, we carried out the “Smart Walk” program, a health care model wherein a wearable device is used to promote self-exercise particularly among community-dwelling older adults managed by a community health center. We randomly selected older adults who had enrolled in a population-based, prospective cohort study of aging, the Aging Study of Pyeongchang Rural Area. The “Smart Walk” program was a 13-month program conducted from March 2017 to March 2018 and included 6 months of coaching, 1 month of rest, and 6 months of self-management. We evaluated differences in physical activity and health outcomes according to frailty status and conducted pre- and postanalyses of the Smart Walk program. We also performed intergroup analysis according to adherence of wearable devices. RESULTS We recruited 22 participants (11 robust and 11 prefrail older adults). The two groups were similar in most of the variables, except for age, frailty index, and Short Physical Performance Battery score associated with frailty criteria. After a 6-month coaching program, the prefrail group showed significant improvement in usual gait speed (mean 0.73 [SD 0.11] vs mean 0.96 [SD 0.27], P=.02), International Physical Activity Questionnaire scores in kcal (mean 2790.36 [SD 2224.62] vs mean 7589.72 [SD 4452.52], P=.01), and European Quality of Life-5 Dimensions score (mean 0.84 [SD 0.07] vs mean 0.90 [SD 0.07], P=.02), although no significant improvement was found in the robust group. The average total step count was significantly different and was approximately four times higher in the coaching period than in the self-management period (5,584,295.83 vs 1,289,084.66, P<.001). We found that participants in the “long-self” group who used the wearable device for the longest time showed increased body weight and body mass index by mean 0.65 (SD 1.317) and mean 0.097 (SD 0.513), respectively, compared with the other groups. CONCLUSIONS Our “Smart Walk” program improved physical fitness, anthropometric measurements, and geriatric assessment categories in a small group of older adults in rural areas with limited resources for monitoring. Further validation through various rural public health centers and in a large number of rural older adults is required.


2010 ◽  
Vol 18 (1) ◽  
pp. 75-86 ◽  
Author(s):  
Simone Nicolai ◽  
Petra Benzinger ◽  
Dawn A. Skelton ◽  
Kamiar Aminian ◽  
Clemens Becker ◽  
...  

The purpose of the study was to investigate whether a 24-hr recording period is sufficient to describe physical activity (PA) of 1 week for intraindividual comparison in older adults. Furthermore, the authors analyzed whether physical performance can be used as a surrogate marker of PA. PA was captured on 7 consecutive days by a body-fixed sensor in 44 community-dwelling older adults (80.75 ± 4.05 yr). Mean times of walking and of “time on feet” of the group were 10.2 hr (± 3.5) and 35.1 hr (± 9.43), respectively. Intraindividual variabilities of walking and of time on feet were 31.9% ± 10.79% and 19.4% ± 8.76%, respectively. Accumulated time of variables of PA showed no differences between weekdays, with variabilities of 3.8% and 1.8% for walking and time on feet, respectively. Association between Short Physical Performance Battery and PA was limited (walkingr= .397, time on feetr= .41).


Author(s):  
Eleftheria Giannouli ◽  
Michelle Pasquale Fillekes ◽  
Sabato Mellone ◽  
Robert Weibel ◽  
Otmar Bock ◽  
...  

Abstract Background Reduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains, this study explores predictors of different aspects of real-life mobility in community-dwelling older adults. Methods Data were obtained in two study waves with a total sample of n = 154. Real-life mobility (physical activity-based mobility and life-space mobility) was assessed over one week using smartphones. Active and gait time and number of steps were calculated from inertial sensor data, and life-space area, total distance, and action range were calculated from GPS data. Demographic measures included age, gender and education. Physical functioning was assessed based on measures of cardiovascular fitness, leg and handgrip strength, balance and gait function; cognitive functioning was assessed based on measures of attention and executive function. Psychological and social assessments included measures of self-efficacy, depression, rigidity, arousal, and loneliness, sociableness, perceived help availability, perceived ageism and social networks. Maximum temperature was used to assess weather conditions on monitoring days. Results Multiple regression analyses indicated just physical and psychological measures accounted for significant but rather low proportions of variance (5–30%) in real-life mobility. Strength measures were retained in most of the regression models. Cognitive and social measures did not remain as significant predictors in any of the models. Conclusions In older adults without mobility limitations, real-life mobility was associated primarily with measures of physical functioning. Psychological functioning also seemed to play a role for real-life mobility, though the associations were more pronounced for physical activity-based mobility than life-space mobility. Further factors should be assessed in order to achieve more conclusive results about predictors of real-life mobility in community-dwelling older adults.


2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i30-i32
Author(s):  
S E R Lim ◽  
N J Cox ◽  
H C Roberts

Abstract Introduction Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable. This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status.


2020 ◽  
Author(s):  
Ewelina Akehurst ◽  
David Scott ◽  
Juan Peña Rodriguez ◽  
Carol Alonso Gonzalez ◽  
Jasmaine Alyce Murphy ◽  
...  

Abstract Background: The risk of progressive declines in skeletal muscle mass and strength, termed sarcopenia, increases with age, physical inactivity and poor diet. The purpose of this study was to explore associations of sarcopenia components with self-reported physical activity and nutrition in older adults participating in resistance training at conventional or Helsinki University Research [HUR] gyms. Methods: Muscle strength (via handgrip strength and chair stands), appendicular lean mass [ALM] (via dual energy X-ray absorptiometry) and physical performance (via gait speed over a 4-metre distance, short physical performance battery, timed up and go and 400-metre walk tests) were evaluated in a cohort study of 80 community-dwelling older adults (mean±SD 76.5B6.5 years). Pearson correlations explored associations for sarcopenia components with self-reported physical activity (via Physical Activity Scale for Elderly [PASE]) and nutrition (via Australian Eating Survey), with higher scores indicative of greater physical activity levels and better nutrition, respectively. Results: No differences in PASE were observed between HUR and conventional gyms, however HUR gym participants had a significantly higher self-reported protein intake and a trend (p = 0.055) to have higher energy intake. In both gym groups, gait speed was positively associated with self-reported physical activity (r = 0.275; p = 0.039 and r = 0.423; p = 0.044 for HUR and conventional gyms, respectively). ALM was positively associated with protein (p = 0.047, r = 0.418) and energy (p = 0.038, r = 0.435) intake in the conventional gym group. Similar associations were observed for ALM/h2 in the HUR group. None of the sarcopenia components were associated with the Australian Recommended Food Score (derived from the Australian Eating Survey) in either gym group.


2012 ◽  
Vol 20 (3) ◽  
pp. 363-378 ◽  
Author(s):  
Pamela E. Toto ◽  
Ketki D. Raina ◽  
Margo B. Holm ◽  
Elizabeth A. Schlenk ◽  
Elaine N. Rubinstein ◽  
...  

This single-group repeated-measures pilot study evaluated the effects of a 10-wk, multicomponent, best-practice exercise program on physical activity, performance of activities of daily living (ADLs), physical performance, and depression in community-dwelling older adults from low-income households (N= 15). Comparison of pretest and posttest scores using a one-tailed paired-samplesttest showed improvement (p< .05) for 2 of 3 ADL domains on the Activity Measure–Post Acute Care and for 6 physical-performance measures of the Senior Fitness Test. Repeated-measures ANOVA revealed significant main effects for 3 of 8 physical activity measures using the Yale Physical Activity Scale. Retention rate was 78.9%, and the adherence rate for group sessions was 89.7%. Results suggest that participation in a multicomponent, best-practice physical activity program may positively affect sedentary, community-dwelling older adults’ physical activity, ADL performance, and physical performance.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Hirofumi Tanaka ◽  
Natalia Gouskova ◽  
Aaron R Folsom ◽  
Kelly Evenson ◽  
Gwen Windham ◽  
...  

Introduction: Arterial stiffness increases with advancing age and is associated positively with coronary artery disease, stroke, dementia, and death. Regular physical activity appears to attenuate or even reverse age-related arterial stiffening. Yet, it is not clear if the reduced stiffening associated with habitual physical activity is also observed in community-dwelling older adults. Methods: We analyzed pulse wave velocity (PWV) data from 4,294 participants (mean age: 75 years, 42% male, 19% African-American) in the 5th clinic examination of the ARIC cohort conducted in 2011-13. Out of 6538 participants who completed the examination, we included all who had proper consent, PWV data, BMI<40 kg/m2, and non-missing outcomes and covariates. Sports and leisure physical activity indices were calculated using the Baecke physical activity questionnaire modified for the ARIC Study. The Short Physical Performance Battery (SPPB) was calculated by summing scores on repeated chair stands, balance, and 4m walk tests. Arterial stiffness was measured using the average of two measurements of carotid-femoral then brachial-ankle pulse wave velocities (cfPWV and baPWV). Bivariate and multivariate regression analyses examined the relationships between arterial stiffness and physical activity. Results: Both sports and leisure physical activity scores were significantly and inversely associated with cfPWV (Pearson r = -0.126 and -0.091; both P<0.0001). The associations remained highly significant after adjustments for age, gender, race, BMI, diabetes, hypertension, and smoking status (Pearson partial r = -0.099 and -0.058; both P<0.0001). Similarly, the SPPB was inversely related to cfPWV (Pearson r = -0.155; P<0.0001). After adjusting for covariates, the relation remained highly significant (Pearson partial r = -0.082; P<0.0001). In contrast, the associations between baPWV and physical activity indices were only borderline significant (Pearson r = -0.03 for both; P=0.048 and 0.051). Association of baPWV with SPPB score was significant in univariate analysis (Pearson r = 0.04;, P =0.0082), but was attenuated after adjustment for covariates (Pearson partial r=-0.005, P=0.7348). Conclusions: Greater participation in sports and leisure physical activity and greater physical performance are associated with lower central arterial stiffness in a large population-based sample of community-dwelling older adults.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2151
Author(s):  
Berna Rahi ◽  
Hermine Pellay ◽  
Virginie Chuy ◽  
Catherine Helmer ◽  
Cecilia Samieri ◽  
...  

Dairy products (DP) are part of a food group that may contribute to the prevention of physical frailty. We aimed to investigate DP exposure, including total DP, milk, fresh DP and cheese, and their cross-sectional and prospective associations with physical frailty in community-dwelling older adults. The cross-sectional analysis was carried out on 1490 participants from the Three-City Bordeaux cohort. The 10-year frailty risk was examined in 823 initially non-frail participants. A food frequency questionnaire was used to assess DP exposure. Physical frailty was defined as the presence of at least 3 out of 5 criteria of the frailty phenotype: weight loss, exhaustion, slowness, weakness, and low physical activity. Among others, diet quality and protein intake were considered as confounders. The baseline mean age of participants was 74.1 y and 61% were females. Frailty prevalence and incidence were 4.2% and 18.2%, respectively. No significant associations were observed between consumption of total DP or DP sub-types and frailty prevalence or incidence (OR = 1.40, 95%CI 0.65–3.01 and OR = 1.75, 95%CI 0.42–1.32, for a total DP consumption >4 times/d, respectively). Despite the absence of beneficial associations of higher DP consumption on frailty, older adults are encouraged to follow the national recommendations regarding DP.


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