scholarly journals Prognostic significance of blood pressure in frail older adults

2021 ◽  
Author(s):  
Yasuharu Tabara
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Prognostic Significance ◽  
Frail Older Adults

scholarly journals Systematic Review of Guidelines on Antihypertensive Treatment in Older Adults: SPRINTing to More Heterogeneity?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 212-213
Author(s):  
Jonathan Bogaerts ◽  
Leonie von Ballmoos ◽  
Wilco Achterberg ◽  
Jacobijn Gussekloo ◽  
Sven Streit ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Antihypertensive Treatment ◽  
Oldest Old ◽  
Middle Aged ◽  
Frail Older Adults ◽  
Blood Pressure Targets ◽  
All Cause Mortality ◽  
Guideline Quality

Abstract Clinical trials have demonstrated that antihypertensive treatment (AHT) in older adults is beneficial. Longitudinal studies, in contrast, have shown that low blood pressure is associated with higher all-cause mortality, especially in frail older adults. Despite the high quality of the available evidence, its translation into clinical guidance for the heterogeneous older population is challenging. To give a systematic overview of blood pressure targets for older adults recommended in clinical guidelines, we searched PubMed, Embase, Emcare, and five guideline databases. We selected guidelines with numerical thresholds for the initiation or the goal of non-disease-specific AHT (January 2008-October 2019). Guidelines with advices concerning AHT in older adults were analyzed. We appraised the guideline quality with the AGREEII-instrument. Of the 44 guidelines containing a numerical threshold for the initiation or the goal of AHT, 33 (75%) provided recommendations concerning AHT for older adults. Nineteen advised a higher target of systolic blood pressure (SBP) for older adults in comparison with the middle-aged population and 3 more recent advised a lower target. Over half (19/33) recommended to treat hypertension in the oldest old to a SBP <150 mmHg, while others advised intensive treatment to targets <120 mmHg. Although many guidelines mentioned frailty, only three gave specific thresholds and targets for frail older adults. The quality of the guidelines was not related with the recommended targets. Targets of AHT in older adults in international guidelines range from less strict to more intensive in comparison with the middle-aged and are set on chronological rather than biological age.

scholarly journals Systolic blood pressure and outcomes in frail older adults

2021 ◽  
pp. 1-4
Author(s):  
Jane AH Masoli ◽  
Oliver M Todd ◽  
Christopher E Clark
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Older People ◽  
Systolic Blood Pressure ◽  
Frail Older Adults

Hypertension is diagnosed in the majority of older people with frailty, in whom blood pressure prognosis is not well understood. This editorial describes recent evidence on blood pressure and outcomes in older people with frailty.

Promoting higher blood pressure targets for frail older adults: A consensus guideline from Canada

2014 ◽  
Vol 81 (7) ◽  
pp. 427-437 ◽  
Author(s):  
Laurie Herzig Mallery ◽  
Michael Allen ◽  
Isobel Fleming ◽  
Kim Kelly ◽  
Susan Bowles ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Consensus Guideline ◽  
Frail Older Adults ◽  
Blood Pressure Targets

Frailty Modifies the Association of Hypertension with Cognition in Older Adults: Evidence from the ELSI-BRAZIL

2020 ◽  
Author(s):  
Márlon J R Aliberti ◽  
Claudia Szlejf ◽  
Maria Fernanda Lima-Costa ◽  
Fabíola B de Andrade ◽  
Tiago S Alexandre ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Later Life ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Frail Older Adults ◽  
Frailty Status ◽  
Z Scores

Abstract Background The relationship between hypertension and cognition in later life is controversial. We investigated whether the association of hypertension with cognition differs in older adults according to the frailty status using cross-sectional data from the Brazilian Longitudinal Study of Aging, a nationally representative sample of adults aged ≥50 years. Methods Hypertension was defined by a medical diagnosis or measured blood pressure ≥140/90 mmHg. Frailty status was assessed using the Cardiovascular Health Study criteria. We estimated the association of hypertension and systolic and diastolic blood pressure with global cognition, orientation, memory, and verbal fluency z-scores, using multiple linear regression models. We also investigated interactions between hypertension and frailty on cognitive performance and impairment. Results We evaluated 8,609 participants (mean age=61.9±9.6 years, 53% women). Participants with hypertension (59% of adults aged 50 to 64 and 77% of those aged ≥65 years) had poorer scores for global cognitive performance than those without hypertension, especially among adults aged 50 to 64 years (β=−0.09, 95% confidence interval=−0.15; −0.04, P=0.001). However, frailty modified the associations of hypertension with cognitive performance and impairment in those aged ≥65 years (P-values for interaction=0.01 and 0.02, respectively). Among non-frail older adults, hypertension was associated with cognitive impairment. In contrast, among frail older adults, hypertension was related to better global and memory cognitive z-scores. Conclusions Hypertension was associated with worse cognitive performance. Among older adults, hypertension was related to cognitive impairment only in non-frail participants. Frailty evaluation may help clinicians offer personalized hypertension management in older adults.

scholarly journals Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults

2021 ◽  
Vol 8 ◽  
Author(s):  
Hélio José Coelho-Júnior ◽  
Marco Carlos Uchida
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Heart Rate ◽  
Resistance Training ◽  
Muscle Strength ◽  
Physical Performance ◽  
Dual Task ◽  
High Speed ◽  
Frail Older Adults ◽  
Frailty Status

Aim: The current study investigated the effects of low-speed resistance training (LSRT) and high-speed resistance training (HSRT) on frailty status, physical performance, cognitive function and blood pressure in pre-frail and frail older people.Material and Methods: Sixty older adults, 32 prefrail and 28 frail, were randomly allocated into LSRT, HSRT, and control group (CG). Before and after intervention periods frailty status, blood pressure, heart rate, and a set of physical performance capabilities and cognitive domains were assessed. Exercise interventions occurred over 16 weeks and included four resistance exercises with 4–8 sets of 4–10 repetitions at moderate intensity.Results: The prevalence of frailty criteria in prefrail and frail older adults were reduced after both LSRT and HSRT. In prefrail, LSRT significantly improved lower-limb muscle strength, while mobility was only improved after HSRT. Muscle power and dual-task performance were significantly increased in both LSRT and HSRT. In frail, LSRT and HSRT similarly improved lower-limb muscle strength and power. However, exclusive improvements in dual-task were observed after LSRT. Memory was significantly increased in prefrail and frail, regardless of the type of resistance training. No significant changes were observed in blood pressure and heart rate.Conclusion: Findings of the present study indicated that both LSRT and HSRT reversed frailty status and improved physical performance in prefrail and frail older adults. Notably, different patterns of improvement were observed among RT protocols. Regarding frailty status, LSRT seemed to be more effective in reverse prefrailty and frailty when compared to HSRT. Greater improvements in muscle strength and power were also observed after LSRT, while HSRT produced superior increases in mobility and dual-task performance. One-leg stand performance was significantly reduced in LSRT, but not HSRT and CG, after 16 weeks. In contrast, RT programs similarly improved verbal memory in prefrail. Finally, no changes in blood pressure and heart rate were observed, regardless of the type of RT.Trial Registration: The protocol was approved by the University of Campinas Human Research Ethics Committee (Protocol No. 20021919.7.0000.5404) and retrospectively registered at ClinicalTrials.gov Protocol Registration and Results System: NCT04868071.

scholarly journals Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study

2021 ◽  
Author(s):  
Nien Xiang Tou ◽  
Shiou-Liang Wee ◽  
Wei Ting Seah ◽  
Daniella Hui Min Ng ◽  
Benedict Wei Jun Pang ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Controlled Study ◽  
Power Training ◽  
Frail Older Adults ◽  
Frailty Status ◽  
Randomized Controlled ◽  
Community Dwelling Older Adults

AbstractTranslation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods. Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020–retrospectively registered.

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