Self-Reported Cognitive Frailty Predicts Adverse Health Outcomes for Community-Dwelling Older Adults Based on an Analysis of Sex and Age

2019 ◽  
Vol 23 (7) ◽  
pp. 654-664 ◽  
Author(s):  
Mika Okura ◽  
M. Ogita ◽  
H. Arai
2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 878-878
Author(s):  
Victoria Poole ◽  
Robert Dawe ◽  
Sue Luergans ◽  
David Bennett ◽  
Aron Buchman ◽  
...  

Abstract Age-related slowing of gait is exceedingly common and a robust predictor of various adverse health outcomes in older age. Prior neuroimaging studies have documented diverse non-specific structural brain abnormalities which are related to slow gait; however, the extent to which quantitative susceptibility mapping (QSM), which measures regional magnetic susceptibility in the brain, associates with gait speed remains unexplored. In the current study, 415 non-demented community-dwelling older adults (91 males; 81+/- 7 years) underwent an MRI (Siemens 3T TIM Trio) and in-home motor assessment. Gait speed was measured and averaged across 2 timed 8-ft walks. MR-acquired QSM data were pre-processed, registered to ICBM template, and spatially smoothed with a 5mm FWHM Gaussian kernel. When these maps entered group-level GLMs, voxel-wise associations with gait speed were of interest, after adjusting for demographics. We observed very strong negative associations between gait speed and magnetic susceptibility, such that those with slower gait had higher susceptibility in bilateral inferior frontal, superior temporal, and angular gyri (corrected p<.0005). Robust associations were also observed in the middle frontal, precentral, and postcentral gyri of the right hemisphere. These novel findings suggest that reduced myelination or increased iron accumulation in these brain regions may contribute to impaired gait. Future work will need to determine to what extent these cross-sectional QSM metrics are independent predictors of incident adverse health outcomes when controlling for other common brain imaging abnormalities observed in older adults.


Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Esther Williamson ◽  
Maria T. Sanchez-Santos ◽  
Alana Morris ◽  
Angela Garrett ◽  
Oliver Conway ◽  
...  

2021 ◽  
Author(s):  
Kai Wei ◽  
Yong Liu ◽  
Junjie Yang ◽  
Nannan Gu ◽  
Xinyi Cao ◽  
...  

Abstract Background: Although it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements.Methods: In the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 16255 community-dwelling older adults (≥65 years) were recruited. Living arrangements and feelings of loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The associations of loneliness with adverse health outcomes accroding to different living arrangements were estimated using logistic regression or Cox proportional hazards regression models. Interactions between living arrangement and loneliness on adverse health outcomes were also investigated.Results: Older adults who were lonely (47.8% of those living alone and 25% of those living with others) had higher prevalence of cognitive impairment, frailty and 3-year mortality than older adults without loneliness, especially among those who lived with others (OR=1.31, 95% CI=1.15-1.51; OR=1.42, 95% CI=1.26-1.60; HR=1.16, 95% CI=1.07-1.26, respecitvely). In contrast, among the living alone older adults, loneliness was only associated with higher prevalence of frailty (OR=1.41, 95% CI=1.06-1.88). Living arrangement modified the associations of loneliness with prevalent cognitive impairment and mortality (P values for interactions=0.006 and 0.015, respectively).Conclusions: Living arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population to reduce adverse health outcomes.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 908-909
Author(s):  
Zuyun Liu ◽  
Chen Chen ◽  
Juyoung Park ◽  
Chenkai Wu ◽  
Qian-Li Xue ◽  
...  

Abstract Cognitive frailty was proposed in 2013 by an (I.A.N.A./I.A.G.G.) international consensus group; however, little is known about its status and associations with adverse health outcomes in China. The objectives of this study were to evaluate: 1) the associations of cognitive frailty with various health outcomes including disability, hospitalization, and death; 2) whether the associations differed by multimorbidity in Chinese older adults. We included 5113 Chinese older adults (aged 60+ years) who had baseline (2011 wave) cognition and physical frailty assessments and follow-up for 4 years from the China Health and Retirement Longitudinal Study. We found that about 16.0% had cognitive impairment; 6.7% had physical frailty; and 1.6% met criteria for cognitive frailty (having both cognitive impairment and physical frailty). Both cognitive impairment (odds ratios (ORs) range: 1.41 to 2.11) and physical frailty (ORs range: 1.51 to 2.43) were independently associated with basic activities of daily living (BADL), instrumental ADL (IADL), mobility disability, hospitalization, and death among participants without that corresponding outcome at baseline, even after accounting for covariates. Relative to participants who had normal cognition and were nonfrail, those with cognitive frailty had the highest risk for IADL disability (OR=3.40, 95% CI, 1.23–9.40) and death (OR=3.89, 95% CI, 2.25–6.47). We did not find significant interaction effects between cognitive frailty and multimorbidity (P for interactions>0.05). Overall, cognitive frailty was associated with disability and death, independent of multimorbidity. This highlights the importance of assessing cognitive frailty in the community to promote primary and secondary preventions for healthy aging.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245680
Author(s):  
Aron S. Buchman ◽  
Sue E. Leurgans ◽  
Tianhao Wang ◽  
Michal Schnaider-Beeri ◽  
Puja Agarwal ◽  
...  

Background This study tested the hypothesis that sarcopenia and its constituent components, reduced lean muscle mass and impaired motor function, are associated with reduced survival and increased risk of incident disabilities. Methods 1466 community-dwelling older adults underwent assessment of muscle mass with bioelectrical impedance analysis (BIA), grip strength, gait speed and other components of physical frailty and annual self-report assessments of disability. We used Cox proportional hazards models that controlled for age, sex, race, education and height to examine the associations of a continuous sarcopenia metric with the hazard of death and incident disabilities. Results Mean baseline age was about 80 years old and follow-up was 5.5 years. In a proportional hazards model controlling for age, sex, race, education and baseline sarcopenia, each 1-SD higher score on a continuous sarcopenia scale was associated with lower hazards of death (HR 0.70, 95%CI [0.62, 0.78]), incident IADL (HR 0.80,95%CI [0.70, 0.93]), incident ADL disability (HR 0.80 95%CI [71, 91]) and incident mobility disability (HR 0.81, 95%CI [0.70, 0.93]). Further analyses suggest that grip strength and gait speed rather than muscle mass drive the associations with all four adverse health outcomes. Similar findings were observed when controlling for additional measures used to assess physical frailty including BMI, fatigue and physical activity. Conclusions Motor function is the primary driver of the associations of sarcopenia and physical frailty with diverse adverse health outcomes. Further work is needed to identify other facets of muscle structure and motor function which together can identify adults at risk for specific adverse health outcomes.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S126-S126
Author(s):  
Loretta Anderson

Abstract Previous studies have shown that higher levels of economic hardship in older adults is associated with increased odds of adverse health outcomes such as insomnia, anxiety, and depressive symptoms. The objective of this study was to determine if there was a differential association between individual measures of economic hardship and aforementioned adverse health outcomes. Cross-sectional analysis was conducted using data from the 2012 National Health and Aging Trends Study (NHATS). Logistic models were developed to assess the association between each of the four measures of economic hardship and three previously reported adverse health outcomes. Participants were asked if in the last month they did not have enough money for food, utility bills, mortgage/rent, or medical bills/prescription drugs. Measures of adverse health outcomes were symptoms of depression, anxiety, and insomnia. There were 7,075 community dwelling older adults aged 65 and older in the 2012 NHATS data. Results indicated that those who skipped meals were more likely to have depression, anxiety, and insomnia symptoms than those who did not skip meals. After adjusting for race, age, gender, education, and comorbid health conditions, skipping meals was associated with depression (OR=4.11, p<.000), anxiety (OR=2.81, p<.01), and insomnia (OR=2.16, p<.05). These results were higher and more statistically significant than the other measures of economic hardship. These findings are relevant to population-based efforts of nutrition interventions to improve quality of life in aging populations.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 515-515
Author(s):  
Loretta Anderson

Abstract Previous studies have shown that higher levels of economic hardship in older adults is associated with increased odds of adverse health outcomes such as insomnia, anxiety, and depressive symptoms. The objective of this study was to determine if there was a differential association between individual measures of economic hardship and aforementioned adverse health outcomes. Cross-sectional analysis was conducted using data from the 2013 National Health and Aging Trends Study (NHATS). Logistic models were developed to assess the association between four measures of economic hardship which included not having enough money for food, utility bills, mortgage/rent, or medical bills/prescription drugs. Measures of adverse health outcomes were symptoms of depression, anxiety, and insomnia. There were 4467 community-dwelling older adults (65+) in the analyses. Results indicated those who skipped meals were more likely to have depression, anxiety, and insomnia symptoms than those who did not skip meals. After adjusting for race, age, gender, education, and total number of comorbid health conditions, skipping meals was associated with depression (OR=2.71, p<.05) and anxiety (OR=2.84, p<.01). Skipping meals did not have a statistically significant association with insomnia. The analysis for skipping meals showed a higher odds and more statistically significant results than the other measures of economic hardship listed above. These findings are relevant to population-based efforts to improve quality of life in aging populations and may be of interest to those researchers investigating the gut-brain axis. These findings may also inform future policy efforts to address health disparities and food insecurity in older adults.


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