“Age-Related Positivity Effect” in the Relationship Between Pain and Depression Among Chinese Community-Dwelling Older Adults: Sex Differences

Abstract Frailty is a clinical syndrome that becomes increasingly common as people age. Subjective age refers to how young or old individuals experience themselves to be. It is associated with many risk factors of frailty, such as increased depression, worse cognitive function, and poorer psychological wellbeing. In this study, we examined the relationship between subjective age and frailty using the 2011-2015 waves of the National Health and Aging Trends Study. Participants were community-dwelling older adults without frailty in the initial wave (N=1,165). Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the Fried five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust=0, pre-frail=1 or 2; frail=3 or more criteria met. Participants were, on average, 74.1±6.5 years old, female (52%), and non-Hispanic White (81%). Eighty-five percent of the participants felt younger, and 3% felt older than their chronological age, but 41% of them were pre-frail/frail. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95%CI= 1.01, 1.01-1.02). In contrast, frailty predicted an “older” subjective age (OR, 95%CI= 2.97, 1.65-5.35) adjusting for demographics and health conditions. These findings suggest a bidirectional relationship between subjective age and frailty. Older people who feel younger than their chronological age are at reduced risk of becoming pre-frail/frail. Intervention programs to delay frailty progression should include strategies that may help older adults perceive a younger subjective age.

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Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126666 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6666

Author(s):

Yoshihiro Kugimiya ◽

Masanori Iwasaki ◽

Yuki Ohara ◽

Keiko Motokawa ◽

Ayako Edahiro ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cross Sectional Study ◽

Albumin Level ◽

Community Dwelling ◽

Tongue Pressure ◽

Swallowing Function ◽

Cross Sectional ◽

Community Dwelling Older Adults ◽

The Relationship

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.

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Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

Physical Therapy ◽

10.1093/ptj/pzab059 ◽

2021 ◽

Author(s):

K Makino ◽

S Lee ◽

S Bae ◽

I Chiba ◽

K Harada ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Fear Of Falling ◽

Community Dwelling ◽

Cardiovascular Health Study ◽

Physical Frailty ◽

Frailty Status ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

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Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2020-041578 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041578

Author(s):

Linglin Kong ◽

Huimin Zhao ◽

Junyao Fan ◽

Quan Wang ◽

Jie Li ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Depressive Symptoms ◽

Community Health ◽

Community Dwelling ◽

Central China ◽

Chinese Community ◽

Cross Sectional ◽

Community Dwelling Older Adults

ObjectivesTo assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes.DesignA cross-sectional design.SettingTwo community health centres in central China.Participants291 community-dwelling older adults aged ≥65 years with type 2 diabetes.Main outcome measuresData were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty.ResultsThe prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884).ConclusionsA high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.

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