A Frailty Index based on clinical data to quantify mortality risk in dogs

AbstractFrailty is defined as a decline in an organism’s physiological reserves resulting in increased vulnerability to stressors. In humans, a single continuous variable, the so-called Frailty Index (FI), can be obtained by multidimensionally assessing the biological complexity of an ageing organism. Here, we evaluate this variability in dogs and compare it to the data available for humans. In dogs, there was a moderate correlation between age and the FI, and the distribution of the FI increased with age. Deficit accumulation was strongly related to mortality. The effect of age, when combined with the FI, was negligible. No sex-related differences were evident. The FI could be considered in epidemiological studies and/or experimental trials to account for the potential confounding effects of the health status of individual dogs. The age-related deficit accumulation reported in dogs is similar to that demonstrated in humans. Therefore, dogs might represent an excellent model for human aging studies.

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Frailty in Preclinical Models: Impact of Healthspan on Disease Expression Over the Life Course

Innovation in Aging ◽

10.1093/geroni/igab046.120 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 33-33

Author(s):

Susan Howlett

Keyword(s):

Health Care Providers ◽

Frailty Index ◽

Scale Up ◽

Care Providers ◽

Deficit Accumulation ◽

Adverse Health Outcomes ◽

Frail Patients ◽

Age Related ◽

And Function ◽

The Life Course

Abstract People age at different rates. This heterogeneity in aging has led to the concept of “frailty”, a state of heightened vulnerability to adverse health outcomes at any age. Frailty challenges health care providers, as frail patients are more likely than non-frail patients to experience diseases, hospitalization, and death. We showed that frailty occurs not only in humans, but also in aging rodents. It can be measured with a “frailty index” (FI) based on age-related health deficit accumulation as originally established in humans. We found that maladaptive changes in heart structure and function in late life are correlated more so with frailty than age and are closely graded by FI score, especially in male mice. Adverse effects of frailty originate at cellular/subcellular levels and scale up to organ and system levels, predisposing towards cardiovascular disease. Poor overall health, quantified with an FI, may drive maladaptive cardiac remodeling, especially in older males.

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A-036 Deficit Accumulation Frailty Index as a Predictor of Cognitive Outcomes in HIV+ and HIV- Adults

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.036 ◽

2020 ◽

Vol 35 (6) ◽

pp. 826-826

Author(s):

Tureson K ◽

Gold A ◽

Mclntosh E ◽

Thames A

Keyword(s):

Los Angeles ◽

Cognitive Performance ◽

Memory Performance ◽

Frailty Index ◽

Cognitive Outcomes ◽

Hiv Status ◽

Deficit Accumulation ◽

Global Functioning ◽

Motor Processing ◽

Age Related

Abstract Objective Adults aging with HIV face elevated rates of frailty than the general aging population and are frail at younger ages, but associations between frailty and cognition in HIV are not well understood. The study aimed to examine: 1) relationships between frailty index and age, and whether relationships differed by HIV status; 2) relationships between frailty index and cognitive performance, and whether relationships differed by HIV-status. It was hypothesized that 1) the frailty index would significantly predict age in non-infected (HIV-) controls but not HIV-infected (HIV+) adults; 2) higher frailty index scores would significantly predict worse cognitive functioning regardless of HIV-status. Method Participants included 109 (39.4% HIV+) participants aged ≥45 from a community-based sample in Los Angeles. HIV-status groups did not differ by age, education, or race (p’s > .10). Frailty was assessed using a deficit accumulation frailty index (DAFI) composed of 32 age-related health variables. A comprehensive neurocognitive battery was used to examine motor, processing speed, executive functioning, verbal fluency, learning, memory, and global functioning. Multivariate linear regression was used to assess relationships between the DAFI and age and cognitive performance, and HIV-by-frailty interaction. Results DAFI scores were higher in HIV+ adults compared to HIV- controls. The DAFI significantly predicted global, motor, and memory performance (p’s < .05), but the effect was only observed in HIV- controls. The DAFI did not significantly predict age in either group. Conclusions Findings highlight that relationships between frailty and cognition may be complicated in patients with chronic health conditions. Frailty may not predict cognitive dysfunction in aging HIV+ adults.

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Homocysteine, Folic Acid, Cyanocobalamin, and Frailty in Older People: Findings From the “Invece. Ab” Study

Frontiers in Physiology ◽

10.3389/fphys.2021.775803 ◽

2021 ◽

Vol 12 ◽

Author(s):

Antonio Guaita ◽

Laura Brunelli ◽

Annalisa Davin ◽

Tino Emanuele Poloni ◽

Roberta Vaccaro ◽

...

Keyword(s):

Risk Factor ◽

Older People ◽

Frailty Index ◽

Plasma Concentrations ◽

Community Dwelling ◽

Deficit Accumulation ◽

Adverse Health Outcomes ◽

Established Risk Factor ◽

Age Related ◽

Community Dwelling Older People

Frailty is an important age-related syndrome associated with several adverse health outcomes. Its biological basis is undefined. Raised plasma homocysteine (HOcy) is an established risk factor for cardiovascular disease, dementia, cognitive impairment, and mortality, but little is known about the possible role of plasma HOcy, cyanocobalamin (B12), and folate (FO levels in the development of frailty. Our first aim was to explore the possible association between frailty and plasma concentrations of HOcy, FO, and B12 in a cohort of community-dwelling older people. The second was to assess the influence of these metabolic factors on six-year incidence of frailty in the 875 individuals eligible for inclusion in this study (those with a full follow-up dataset). This research is based on data from three waves – 2012 (herein taken as baseline), 2014, and 2018 – of a longitudinal study (InveCe.Ab) in which non-frail men and women born between 1935 and 1939 underwent multidimensional assessments. Frailty was estimated using a deficit accumulation-based frailty index (FI). HOcy concentration was significantly positively correlated with FI at all timepoints, while B12 and FO levels were not. Plasma concentration of HOcy emerged as a predictor of six-year cumulative incidence of frailty, independent of age, sex, and education, while B12 and FO levels showed no relationship with frailty incidence. Individuals with plasma HOcy in the top quintile showed five months less frailty-free survival (HR 1.487; 95% CI: 1.063–2.078), regardless of age, sex, and education. These results demonstrate that higher HOcy is a risk factor for frailty onset in older adults.

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Healthy Ageing Is Associated with Preserved or Enhanced Nutrient and Mineral Apparent Digestibility in Dogs and Cats Fed Commercially Relevant Extruded Diets

Animals ◽

10.3390/ani11072127 ◽

2021 ◽

Vol 11 (7) ◽

pp. 2127

Author(s):

Sofia Schauf ◽

Jonathan Stockman ◽

Richard Haydock ◽

Ryan Eyre ◽

Lisa Fortener ◽

...

Keyword(s):

Crude Protein ◽

Companion Animals ◽

Continuous Variable ◽

Nutrient Digestibility ◽

Healthy Ageing ◽

Digestive Efficiency ◽

Age Related ◽

Healthy Dogs ◽

The Impact ◽

Effect Of Age

Age-related changes in gastrointestinal function have been reported in companion animals, but the impact on digestive efficiency remains uncertain. Healthy dogs (n = 37; 2.6–14.2 years) received four diets varying in total dietary fibre (TDF; 6–29%, as fed). Healthy cats (n = 28; 1–13 years) received four diets with two fat (10–12%; 17–18%) and TDF (9 and 12%) levels. In a crossover design, diets were provided over four consecutive 10-day cycles, including a 4-day faecal collection. Apparent crude protein (CP), ether extract (EE), TDF, calcium (Ca), and phosphorus (P) digestibilities were determined. The effect of age was analysed as a continuous variable in dogs and as differences between adult (1–5 years) and senior (7–13 years) cats. In dogs, EE digestibility was unaffected by age (p > 0.10). Dogs of 6–12 years had higher digestibility of CP (p = 0.032), TDF (p = 0.019), Ca (p = 0.019), and P (p = 0.024) when fed the 6% TDF diet. Senior cats had greater digestibility of TDF (p < 0.01) and Ca (p = 0.024) but had lower EE and CP digestibility with one diet (17% fat; 9%TDF) (age, p > 0.10; diet × age, p < 0.001). Healthy ageing was associated with preserved nutrient digestibility in dogs and cats within the age ranges studied. The effect of ingredient sources in senior cats warrants further investigation.

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Association between frailty and risk of fall among diabetic patients

Endocrine Connections ◽

10.1530/ec-20-0405 ◽

2020 ◽

Vol 9 (10) ◽

pp. 1057-1064

Author(s):

Xiaojie Wang ◽

Zhiyuan Chen ◽

Ziyi Li ◽

Bo Chen ◽

Yong Qi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Frailty Index ◽

Epidemiological Studies ◽

Vulnerable Groups ◽

Diabetic Patients ◽

Balance Performance ◽

Deficit Accumulation ◽

Increased Risk ◽

Risk Of Fall

Background Several epidemiological studies have demonstrated the risk factors for fall, while few studies investigated the association between frailty and risk of fall in diabetic patients aged ≥45 years. Methods In this multicity observational study, participants with type 2 diabetes aged ≥45 years were enrolled. Frailty status was measured by a frailty index (FI) of deficit accumulation. We used multivariable regression models to examine the relationship between frailty and fall in diabetic patients, and further investigated the associations between frailty and fall in varied subgroups. Results A total of 2049 participants with type 2 diabetes were identified in our study. Our results showed a per-s.d. and a per-0.01 increment of FI were associated with an increased risk of fall, with a fully adjusted OR of 1.89 (95% CI: 1.50, 2.38), 1.06 (95% CI: 1.04, 1.09), respectively. The effects were magnified when frailty was considered as dichotomous, with an OR of 3.08 (95% CI: 2.18, 4.34). In further subgroup analyses, we found that the females, the older, rural residents, individuals with no sitting toilet, people with poor balance performance and those in poor health status were susceptible to fall. Especially, for the risk of fall in the older, a per-s.d. increase of FI corresponded to an OR of 2.46 (95% CI: 1.68, 3.62). When frailty was regarded as a binary variable, the effect increased to 4.62 (95% CI: 2.54, 8.38) in the older subgroup. Conclusion Frailty was associated with a higher risk of fall in people with type 2 diabetes, and the effects were higher in vulnerable groups. This evidence suggested that more attention should be paid to vulnerable groups for fall prevention.

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Lack of association between circulating apelin level and frailty-related functional parameters in older adults: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-020-01837-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Il-Young Jang ◽

Seungjoo Lee ◽

Jeoung Hee Kim ◽

Eunju Lee ◽

Jin Young Lee ◽

...

Keyword(s):

Older Adults ◽

Large Scale ◽

Frailty Index ◽

Threshold Effect ◽

Community Dwelling ◽

Deficit Accumulation ◽

Cross Sectional ◽

Functional Parameters ◽

Age Related

Abstract Background Apelin, an active endogenous peptide, has been recently receiving great attention as a promising target for antiaging intervention, primarily based on results from genetically altered mice. To validate previous experimental data and investigate the possible role of apelin in humans, in this study, we examined serum apelin level in relation to frailty and its associated parameters in a cohort of ambulatory, community-dwelling older adults. Methods Blood samples were collected from 80 participants who underwent a comprehensive geriatric assessment, and apelin level was measured using an enzyme immunoassay kit. Phenotypic frailty and deficit-accumulation frailty index (FI) were assessed using widely validated approaches, proposed by Fried and Rockwood groups, respectively. Results After adjustment for sex, age, and body mass index, serum apelin level was found to be not significantly different according to phenotypic frailty status (P = 0.550) and not associated with FI, grip strength, gait speed, time to complete 5 chair stands, and muscle mass (P = 0.433 to 0.982). To determine whether the association between serum apelin level and frailty has a threshold effect, we divided the participants into quartiles according to serum apelin level. However, there were no differences in terms of frailty-related parameters and the risk for frailty among the quartile groups (P = 0.248 to 0.741). Conclusions The serum apelin level was not associated with both phenotypic frailty and functional parameters in older adults, despite its beneficial effects against age-related physiologic decline in animal models. Further large-scale longitudinal studies are necessary to understand the definite role of circulating apelin in frailty risk assessment.

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103 Periodontal Health and Sarcopenia: Cross-Sectional Evidence From A Cohort of 2040 Twin Volunteers

Age and Ageing ◽

10.1093/ageing/afab030.64 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

M B Zazzara ◽

P M Wells ◽

R C E Bowyer ◽

M N Lochlainn ◽

E J Thompson ◽

...

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Frailty Index ◽

Muscle Quality ◽

Low Grade ◽

Periodontal Health ◽

Cross Sectional ◽

Age Related ◽

European Working ◽

Generalised Linear Mixed Model

Abstract Introduction Periodontitis is a chronic inflammatory disease affecting the periodontium, ultimately leading to looseness and/or loss of teeth. Sarcopenia refers to age-related reduction in muscle mass and strength. Similar to periodontitis, chronic low-grade inflammation is thought to play a key role in its development. In addition, both increase in prevalence with advancing age. Despite known associations with other diseases involving a dysregulated inflammatory response, for example rheumatoid arthritis,, the relationship between periodontitis and sarcopenia, and whether they could be driven by similar processes, remains uncertain. The aim of this study was to explore the association between periodontitis and sarcopenia. Methods Observational study of 2040 adult volunteers [age 67.18 (12.17)] enrolled in the TwinsUK cohort study. Presence of tooth mobility and number of teeth lost were used to assess periodontal health. A binary variable was created to define periodontitis. Measurements of muscle strength, muscle quality/quantity and physical performance were used to assess sarcopenia. A categorical variable was created according to the European Working Group on Sarcopenia in Older People (EWGSOP2) consensus, to define sarcopenia (1: probable; 2: positive; 3: severe). Generalised linear mixed model analysis used on complete cases and age-matched (n = 1,288) samples to ascertain associations between periodontitis and sarcopenia. Results No significant association was found between periodontitis and sarcopenia in both the complete cases analysis and age-matched analysis. Results were consistent when analysis was adjusted for potential confounders including body mass index, frailty index, Mini Mental State Examination smoking, nutritional status and educational level. Conclusions This study found no significant association between periodontitis and sarcopenia in a cohort of 2040 adults. Although both periodontitis and sarcopenia have been linked to a dysregulated immune response and demonstrate an increase in prevalence with increasing age, our work is inconclusive due to the plethora of possible aetiopathogenetic pathways.

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Associations between life-course frailty and later-life heart size and function in the 1946 NSHD British birth cohort-an epidemiological study

European Heart Journal ◽

10.1093/ehjci/ehaa946.2835 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C.C Topriceanu ◽

J.C Moon ◽

R Hardy ◽

A.D Hughes ◽

N Chaturvedi ◽

...

Keyword(s):

Life Course ◽

Birth Cohort ◽

Frailty Index ◽

Later Life ◽

Left Ventricular ◽

Step Change ◽

Deficit Accumulation ◽

Heart Size ◽

And Function ◽

The Life Course

Abstract Background Cardiovascular diseases are an important component of the multi-morbidity syndrome which is associated with negative health outcomes resulting in a major societal economic burden. An objective way to assess multi-morbidity is to calculate a frailty index based on medical deficit accumulation. Late-life frailty has been validated to predict mortality, but little is known about the association between life-course frailty and cardiovascular health in later-life. Purpose To study the association between life-course frailty and later-life heart size and function using data from the world's longest running birth cohort with continuous follow-up. Methods A 45-deficit frailty index (FI) was calculated at 4 age-intervals across the life-course (0 to 16 years old, 19 to 44 years old, 45 to 54 years old and 60 to 64 years old) in participants from the UK 1946 Medical Research Council (MRC) National Survey of Heath and Development (NSHD) birth cohort. The life-course frailty indices (FI0_16, FI19_44, FI45_54 and FI60_64) reflect the cumulative medical deficits at the corresponding age-intervals. They were used to derive FImean and FIsum reflecting overall-life frailty. The step change in deficit accumulation between age-intervals was also calculated (FI2-1, FI3-1, FI4-1, FI3-2, FI4-2, FI4-3). Echocardiographic data at 60–64 years provided: E/e' ratio, ejection fraction (EF), myocardial contraction fraction index (MCFi) and left ventricular mass index (LVmassi). Generalized linear mixed models with gamma distribution and log link assessed the association between FIs and echo parameters after adjustment for sex, socio-economic position and body mass index. Results 1.805 NSHD participants were included (834 male). Accumulation of a single deficit had a significant impact (p<0.0001 to p<0.049) on LVmassi and MCFi in all the life-course FIs and overall FIs. LVmassi increased by 0.89% to 1.42% for the life-course FIs and by 0.36%/1.82% for FIsum and FImean respectively. MCFi decreased by 0.62% to 1.02% for the life-course FIs and by 0.33%/ 1.04%. for FIsum and FImean respectively. One accumulated deficit translated into higher multiplicative odds (13.2 for FI60-64, 2.1 for FI4-1, 75.4 for FI4-2 and 78.5 for FI4-3) of elevated filling pressure (defined as E/e' ratio >13, p<0.0.005 to p<0.02).A unit increase in frailty decreased LV EF (%) by 11%/12% for FI45-54 and FI60-64 respectively, by 10% to 12% for FI2-1, FI3-1, FI4-1 and FI4-2, and 4%/15% for FIsum and FImean respectively (p<0.0014 to p<0.044). Conclusion Frailty during the life-course, overall life-frailty and the step change in deficit accumulation is associated with later-life cardiac dysfunction. Frailty strain appears to have its greatest impact on pathological myocardial hypertrophy (high LVmassi and low MCFi) potentially paving the way to later-life systolic or diastolic dysfunction in susceptible individuals. Funding Acknowledgement Type of funding source: None

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Scotopic thresholds on dark-adapted chromatic perimetry in healthy aging and age-related macular degeneration

Scientific Reports ◽

10.1038/s41598-021-89677-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Manjot Kaur Grewal ◽

Shruti Chandra ◽

Alan Bird ◽

Glen Jeffery ◽

Sobha Sivaprasad

Keyword(s):

Macular Degeneration ◽

Healthy Aging ◽

Intraclass Correlation ◽

Age Related Macular Degeneration ◽

Healthy Individuals ◽

Age Related ◽

Rod Function ◽

The Mean ◽

Highly Correlated ◽

Effect Of Age

AbstractTo evaluate the effect of aging, intra- and intersession repeatability and regional scotopic sensitivities in healthy and age-related macular degeneration (AMD) eyes. Intra- and intersession agreement and effect of age was measured in healthy individuals. The mean sensitivity (MS) and pointwise retinal sensitivities (PWS) within the central 24° with 505 nm (cyan) and 625 nm (red) stimuli were evaluated in 50 individuals (11 healthy and 39 AMD eyes). The overall intra- and intersession had excellent reliability (intraclass correlation coefficient, ICC > 0.90) and tests were highly correlated (Spearman rs = 0.75–0.86). Eyes with subretinal drusenoid deposit (SDD) had reduced PWS centrally, particularly at inferior and nasal retinal locations compared with controls and intermediate AMD (iAMD) without SDD. There was no difference in MS or PWS at any retinal location between iAMD without SDD and healthy individuals nor between iAMD with SDD and non-foveal atrophic AMD groups. Eyes with SDD have reduced rod function compared to iAMD without SDD and healthy eyes, but similar to eyes with non-foveal atrophy. Our results highlight rod dysfunction is not directly correlated with drusen load and SDD location.

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