Physical Frailty Phenotype and the Development of Geriatric Syndromes in Older Adults with Coronary Heart Disease

Introduction: Frailty, a clinical state of vulnerability, is associated with subsequent adverse geriatric syndromes in the general population. Hypothesis: We hypothesized that frailty influence health outcomes among older patients with coronary heart disease (CHD). Methods: We used the National Health and Aging Trends Study, a prospective cohort study linked to a Medicare sample. CHD was identified by self-report and/or ICD codes one-year prior to the baseline visit. Frailty was measured using the Fried physical frailty phenotype (PFP). Geriatric outcomes were assessed during five-year follow-up. Results: Of the 4,656 study participants, 1,395 (28%) had a history of CHD one-year prior to their baseline visit. Compared to those without frailty, subjects with frailty were older (Age ≥75: 69.9% vs. 57.1%, p <0.001), more likely to be female, belong to an ethnic minority, and had lower BMI. The prevalence of hypertension, stroke, falls, disability, anxiety/depression, and multimorbidity were much higher in the frail, than non-frail, participants. In a multivariable Cox regression model, the incidences of geriatric syndromes including (1) dementia, (2) loss of independence, (3) impairment in activities of daily living, (4) impairment in instrumental activities of daily living (ADLs), (5) and mobility disability were significantly higher in the frail, than in the non-frail CHD Conclusion: Among patients with CHD, frailty is a risk factor for accelerated development of geriatric outcomes. Efforts to identify frailty in the context of CHD are needed, as well as interventions to limit or reverse frailty status in CHD patients.

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Frailty, with or without Cognitive Impairment, is a Strong Predictor of Recurrent Falls in a US Population-Representative Sample of Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glab083 ◽

2021 ◽

Author(s):

Mei-Ling Ge ◽

Eleanor M Simonsick ◽

Bi-Rong Dong ◽

Judith D Kasper ◽

Qian-Li Xue

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Strong Predictor ◽

Word Recall ◽

Physical Frailty ◽

Frailty Phenotype ◽

Clock Drawing Test ◽

Recurrent Falls ◽

Health Aging ◽

Marginal Means

Abstract Background Physical frailty and cognitive impairment have been separately associated with falls. The purpose of the study is to examine the associations of physical frailty and cognitive impairment separately and jointly with incident recurrent falls among older adults. Methods The analysis included 6000 older adults in community or non-nursing home residential care settings who were ≥65 years and participated in the National Health Aging Trends Study (NHATS). Frailty was assessed using the physical frailty phenotype; cognitive impairment was defined by bottom quintile of clock drawing test or immediate and delayed 10-word recall, or self/proxy-report of diagnosis of dementia, or AD8 score≥ 2. The marginal means/rates models were used to analyze the associations of frailty (by the physical frailty phenotype) and cognitive impairment with recurrent falls over 6 years follow-up (2012-2017). Results Of the 6000 older adults, 1,787 (29.8%) had cognitive impairment only, 334 (5.6%) had frailty only, 615 (10.3%) had both, and 3,264 (54.4%) had neither. After adjusting for age, sex, race, education, living alone, obesity, disease burden, and mobility disability, those with frailty (with or without cognitive impairment) at baseline had higher rates of recurrent falls than those without cognitive impairment and frailty (frailty only: Rate ratio (RR)=1.31, 95% confidence interval (CI)=1.18-1.44; both: RR=1.28, 95% CI=1.17-1.40). The association was marginally significant for those with cognitive impairment only (RR=1.07, 95% CI=1.00-1.13). Conclusions Frailty and cognitive impairment were independently associated with recurrent falls in non-institutionalized older adults. There was a lack of synergistic effect between frailty and cognitive impairment.

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Dairy Product Intake and Long-Term Risk for Frailty among French Elderly Community Dwellers

Nutrients ◽

10.3390/nu13072151 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2151

Author(s):

Berna Rahi ◽

Hermine Pellay ◽

Virginie Chuy ◽

Catherine Helmer ◽

Cecilia Samieri ◽

...

Keyword(s):

Older Adults ◽

Dairy Product ◽

Food Group ◽

Community Dwelling ◽

Physical Frailty ◽

Frailty Phenotype ◽

Cross Sectional ◽

Sectional Analysis ◽

Community Dwelling Older Adults

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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