scholarly journals Frailty and mortality: an 18-year follow-up study among Finnish community-dwelling older people

2019 ◽  
Vol 32 (10) ◽  
pp. 2013-2019 ◽  
Author(s):  
Marika Salminen ◽  
Anna Viljanen ◽  
Sini Eloranta ◽  
Paula Viikari ◽  
Maarit Wuorela ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Older People ◽  
Cox Regression ◽  
Frailty Index ◽  
Community Dwelling ◽  
Clinical Settings ◽  
Follow Up Study ◽  
Community Dwelling Older People ◽  
A Prospective Study

Abstract Background There is a lack of agreement about applicable instrument to screen frailty in clinical settings. Aims To analyze the association between frailty and mortality in Finnish community-dwelling older people. Methods This was a prospective study with 10- and 18-year follow-ups. Frailty was assessed using FRAIL scale (FS) (n = 1152), Rockwood’s frailty index (FI) (n = 1126), and PRISMA-7 (n = 1124). To analyze the association between frailty and mortality, Cox regression model was used. Results Prevalence of frailty varied from 2 to 24% based on the index used. In unadjusted models, frailty was associated with higher mortality according to FS (hazard ratio 7.96 [95% confidence interval 5.10–12.41] in 10-year follow-up, and 6.32 [4.17–9.57] in 18-year follow-up) and FI (5.97 [4.13–8.64], and 3.95 [3.16–4.94], respectively) in both follow-ups. Also being pre-frail was associated with higher mortality according to both indexes in both follow-ups (FS 2.19 [1.78–2.69], and 1.69 [1.46–1.96]; FI 1.81[1.25–2.62], and 1.31 [1.07–1.61], respectively). Associations persisted even after adjustments. Also according to PRISMA-7, a binary index (robust or frail), frailty was associated with higher mortality in 10- (4.41 [3.55–5.34]) and 18-year follow-ups (3.78 [3.19–4.49]). Discussion Frailty was associated with higher mortality risk according to all three frailty screening instrument used. Simple and fast frailty indexes, FS and PRISMA-7, seemed to be comparable with a multidimensional time-consuming FI in predicting mortality among community-dwelling Finnish older people. Conclusions FS and PRISMA-7 are applicable frailty screening instruments in clinical setting among community-dwelling Finnish older people.

scholarly journals Psychosocial resources related to survival among non-robust community-dwelling older people: an 18-year follow-up study

2020 ◽  
Vol 11 (3) ◽  
pp. 475-481
Author(s):  
Sirkku Lavonius ◽  
Marika Salminen ◽  
Tero Vahlberg ◽  
Raimo Isoaho ◽  
Sirkka-Liisa Kivelä ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Psychosocial Resources ◽  
Follow Up Study ◽  
Community Dwelling Older People

scholarly journals Apathy is associated with incident dementia in community-dwelling older people

Neurology ◽  
2017 ◽  
Vol 90 (1) ◽  
pp. e82-e89 ◽  
Author(s):  
Jan Willem van Dalen ◽  
Lennard L. Van Wanrooij ◽  
Eric P. Moll van Charante ◽  
Edo Richard ◽  
Willem A. van Gool
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Cox Regression ◽  
Depression Scale ◽  
Community Dwelling ◽  
Memory Complaints ◽  
Incident Dementia ◽  
Increased Risk ◽  
Community Dwelling Older People

ObjectiveTo assess whether apathy and depressive symptoms are independently associated with incident dementia during 6-year follow-up in a prospective observational population-based cohort study.MethodsParticipants were community-dwelling older people in the Prevention of Dementia by Intensive Vascular Care trial, aged 70–78 years, without dementia at baseline. Apathy and depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15). Dementia during follow-up was established by clinical diagnosis confirmed by an independent outcome adjudication committee. Hazard ratios (HRs) were calculated using Cox regression analyses. Given its potentially strong relation with incipient dementia, the GDS item referring to memory complaints was assessed separately.ResultsDementia occurred in 232/3,427 (6.8%) participants. Apathy symptoms were associated with dementia (HR 1.28, 95% confidence interval [CI] 1.12–1.45; p < 0.001), also after adjustment for age, sex, Mini-Mental State Examination score, disability, and history of stroke or cardiovascular disease (HR 1.21, 95% CI 1.06–1.40; p = 0.007), and in participants without depressive symptoms (HR 1.26, 95% CI 1.06–1.49; p = 0.01). Depressive symptoms were associated with dementia (HR 1.12, 95% CI 1.05–1.19), also without apathy symptoms (HR 1.16, 95% CI 1.03–1.31; p = 0.015), but not after full adjustment or after removing the GDS item on memory complaints.ConclusionsApathy and depressive symptoms are independently associated with incident dementia in community-dwelling older people. Subjective memory complaints may play an important role in the association between depressive symptoms and dementia. Our findings suggest apathy symptoms may be prodromal to dementia and might be used in general practice to identify individuals without cognitive impairment at increased risk of dementia.

scholarly journals Associations between Perceived Outdoor Environment and Walking Modifications in Community-Dwelling Older People: A Two-Year Follow-Up Study

2020 ◽  
Vol 32 (10) ◽  
pp. 1538-1551 ◽  
Author(s):  
Heidi Skantz ◽  
Taina Rantanen ◽  
Timo Rantalainen ◽  
Kirsi E. Keskinen ◽  
Lotta Palmberg ◽  
...  
Keyword(s):  
Older People ◽  
Physical Capacity ◽  
Community Dwelling ◽  
Outdoor Environment ◽  
Follow Up Study ◽  
Mobility Barriers ◽  
Community Dwelling Older People ◽  
Facilitators And Barriers

Objectives: To examine associations of perceived outdoor environment with the prevalence and development of adaptive (e.g., slower pace) and maladaptive (e.g., avoiding walking) modifications in walking 2 km among older people. Methods: Community-dwelling 75–90 -year-old persons ( N = 848) reported environmental outdoor mobility facilitators and barriers at baseline. Modifications in walking 2 km (adaptive, maladaptive, or no) were assessed at baseline and one and two years later. Results: Outdoor mobility facilitators were more often reported by those not using modifications or using adaptive versus maladaptive walking modifications. Differences in health and physical capacity explained most of the associations between outdoor mobility barriers and walking modifications. Perceived outdoor environment did not systematically predict future adaptive or maladaptive walking modifications. Discussion: Facilitators may compensate the declined physical capacity and alleviate the strain of walking longer distances by enabling the use of adaptive walking modifications, while lack of such facilitators fuels avoidance of walking longer distances.

scholarly journals Task Modifications in Walking Postpone Decline in Life-Space Mobility Among Community-Dwelling Older People: A 2-year Follow-up Study

2017 ◽  
Vol 72 (9) ◽  
pp. 1252-1256 ◽  
Author(s):  
Merja Rantakokko ◽  
Erja Portegijs ◽  
Anne Viljanen ◽  
Susanne Iwarsson ◽  
Taina Rantanen
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Life Space ◽  
Follow Up Study ◽  
Community Dwelling Older People

scholarly journals Changes in life-space mobility and quality of life among community-dwelling older people: a 2-year follow-up study

2015 ◽  
Vol 25 (5) ◽  
pp. 1189-1197 ◽  
Author(s):  
Merja Rantakokko ◽  
Erja Portegijs ◽  
Anne Viljanen ◽  
Susanne Iwarsson ◽  
Markku Kauppinen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Community Dwelling ◽  
Life Space ◽  
Follow Up Study ◽  
Community Dwelling Older People

scholarly journals Does the Meeting Centres Support Programme reduce unmet care needs of community-dwelling older people with dementia? A controlled, 6-month follow-up Polish study

2019 ◽  
Vol Volume 14 ◽  
pp. 113-122 ◽  
Author(s):  
Justyna Mazurek ◽  
Dorota Szcześniak ◽  
Katrzyna Urbańska ◽  
Rose-Marie Dröes ◽  
Maciej Karczewski ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Care Needs ◽  
Support Programme ◽  
People With Dementia ◽  
Polish Study ◽  
Community Dwelling Older People

scholarly journals Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032904 ◽  
Author(s):  
Kirubakaran Kesavan Kendhapedi ◽  
Niveditha Devasenapathy
Keyword(s):  
Older People ◽  
Fear Of Falling ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Domain Definition ◽  
Tilburg Frailty Indicator ◽  
Community Dwelling Older People ◽  
Frailty Indicator

ObjectiveThere is sparse data on the prevalence of frailty from rural parts of India. Our aim was to estimate prevalence of frailty among community-dwelling older people in rural South Indian population and explore socio-demographic factors associated with frailty. We further explored the associations between frailty with fear of falling and falls.DesignCommunity based cross-sectional study.SettingFour villages in Thanjavur district of Southern India.ParticipantsRandom sample of adults aged 60 years and above from four villages.MethodsWe sampled community-dwelling older adults from the electoral list of four villages using stratified random sampling. We report prevalence of frailty as defined by physical definition (Fried’s Phenotype), accumulation of deficits (Frailty Index) and multi-domain definition (Tilburg Frailty Indicator). We report proportion of agreement of frailty status between the frailty tools. We used logistic regressions with robust SEs to examine the associations between socio-demographic determinants with frailty and the association between frailty with fear of falling and falls.ResultsAmong the 408 participants, the weighted (non-response and poststratification for sex) prevalence and 95% CI of frailty was 28% (18.9 to 28.1) for physical definition, 59% (53.9 to 64.3) for accumulation of deficits and 63% (57.4 to 67.6) for multi-domain definition. Frailty Index and Tilburg Frailty Indicator had good agreement (80%). Age, female, lower education, lower socioeconomic status, minimum physical activity in routine work were independently associated with frailty irrespective of the frailty definitions. Frail elderly had higher odds of falls as well as fear of falling compared with non-frail, irrespective of the definitions.ConclusionPrevalence of frailty among older people in rural Thanjavur district of South India was high compared with low-income and middle-income countries. Understanding the modifiable determinants of frailty can provide a valuable reference for future prevention and intervention.

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