scholarly journals Five-year longitudinal study of frailty prevalence and course assessed using the Kihon Checklist among community-dwelling older adults in Japan

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masayuki Ohashi ◽  
Takuya Yoda ◽  
Norio Imai ◽  
Toshihide Fujii ◽  
Kei Watanabe ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Municipal Government ◽  
Independent Predictor ◽  
Community Dwelling ◽  
Natural Course ◽  
Frailty Status ◽  
Body Mass Indexes ◽  
Community Dwelling Older Adults ◽  
Lower Physical Activity

AbstractThe aim of this study was to analyze the 5-year natural course of frailty status assessed with the Kihon Checklist (KCL) and the risk factors of transition towards frailty in community-dwelling older adults. We used the data from the postal KCL survey conducted by the municipal government between 2011 and 2016. The sample of the current study consisted of 551 older adults (265 men and 286 women) aged 65–70 years in 2011. The median KCL score increased from 2 (interquartile range 1–3) in 2011 to 3 (1–5) in 2016 (p < 0.001). Hence, the prevalence of frailty increased from 8.0 to 12.3% (p < 0.001). Regarding the 5-year transitions in frailty status, 68.3% of participants remained unchanged, while 21.4% transitioned towards a worse frailty status, and 10.3% towards an improved status. Of the 507 respondents who were robust or prefrail at the baseline, 44 experienced a transition towards frailty, indicating that the 5-year incidence of frailty was 8.7%. These 44 individuals had higher body mass indexes (BMI) and lower physical activity scores on the KCL than others (p < 0.05), the latter of which was an independent predictor of transition toward frailty in the multivariate analysis. This study was the first to evaluate the 5-year natural course of frailty status assessed using the KCL in community-dwelling elderly adults, in which the prevalence of frailty increased by 4.3%. To prevent transition towards frailty, maintaining optimal physical activity is recommended.

Five-year longitudinal study of frailty prevalence and course assessed using the Kihon Checklist among community-dwelling older adults in Japan

2020 ◽  
Author(s):  
Masayuki Ohashi ◽  
Takuya Yoda ◽  
Norio Imai ◽  
Toshihide Fujii ◽  
Kei Watanabe ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Municipal Government ◽  
Community Dwelling ◽  
Natural Course ◽  
Frailty Status ◽  
Checklist Score ◽  
Body Mass Indexes ◽  
Community Dwelling Older Adults ◽  
Group Comparisons

Abstract Background: The natural course of scores of the Kihon Checklist, one of the promising tools used for frailty screening, is unknown. We aimed to analyze the 5-year natural course of frailty as assessed using the Kihon Checklist in community-dwelling older adults. Methods: We used the data from the postal Kihon Checklist survey conducted by the municipal government between 2011 and 2016. The sample of the current study consisted of 551 older adults (265 men and 286 women) aged 65-70 years in 2011, who responded to the postal Kihon Checklist both in 2011 and in 2016. A Kihon Checklist score of 0 to 3 was considered an indicator of robustness, 4 to 7 of prefrailty, and 8 or higher of frailty. Group comparisons were performed with significance set at p<0.05. To identify independent risk factors for a transition towards frailty, a logistic regression analysis was performed using factors of p <0.20 in the group comparisons. Results: The median Kihon Checklist score significantly increased from 2 (interquartile range, 1-3) in 2011 to 3 (1-5) in 2016 (p<0.001). Hence, the prevalence of frailty significantly increased from 8.0% to 12.3% (p<0.001) during the same period. Regarding the 5-year transitions in frailty status, the majority (68.3%) of older adults remained unchanged, while 21.4% transitioned towards a worse frailty status, and 10.3% towards an improved status. Of the 507 respondents who were robust or prefrail at the baseline, 44 experienced a transition towards frailty, indicating that the 5-year incidence of frailty was 8.7%. These 44 individuals had higher body mass indexes and lower physical activity scores on the Kihon Checklist than the others (p<0.05). Multivariate analyses demonstrated that the physical activity score of the Kihon Checklist independently predicted a transition towards frailty in 5 years (odds ratio, 1.55; 95% confidence interval, 1.12–2.15; p=0.009). Conclusions: This study was the first to evaluate the course of frailty status, assessed using the Kihon Checklist in community-dwelling elderly adults, and should provide reference data to evaluate the effects of frailty interventions. Additionally, our results suggest that maintaining optimal physical activity should be recommended to prevent transition towards frailty.

scholarly journals 90 The Effectiveness of Volunteer-Led Physical Activity Interventions in Improving Health Outcomes for Community-Dwelling Older People: A Systematic Review

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i30-i32
Author(s):  
S E R Lim ◽  
N J Cox ◽  
H C Roberts
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Older People ◽  
Health Outcomes ◽  
Grip Strength ◽  
Community Dwelling ◽  
Frailty Status ◽  
Community Dwelling Older People ◽  
Community Dwelling Older Adults

Abstract Introduction Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable. This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status.

scholarly journals Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology

Gerontology ◽  
2016 ◽  
Vol 62 (6) ◽  
pp. 654-664 ◽  
Author(s):  
M. Jane Mohler ◽  
Christopher S. Wendel ◽  
Ruth E. Taylor-Piliae ◽  
Nima Toosizadeh ◽  
Bijan Najafi
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Motor Performance ◽  
Area Under The Curve ◽  
Community Dwelling ◽  
Bout Duration ◽  
Frailty Status ◽  
Eyes Closed ◽  
Community Dwelling Older Adults ◽  
Balance Deficit

Background: Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity (PA) have evaluated subgroups of frailty status separately. Objective: To evaluate wearable sensor-based measures of gait, balance, and PA that are predictive of future falls in community-dwelling older adults. Methods: The Arizona Frailty Cohort Study in Tucson, Arizona, followed community-dwelling adults aged 65 years and over (without baseline cognitive deficit, severe movement disorders, or recent stroke) for falls over 6 months. Baseline measures included Fried frailty criteria: in-home and sensor-based gait (normal and fast walk), balance (bipedal eyes open and eyes closed), and spontaneous daily PA over 48 h, measured using validated wearable technologies. Results: Of the 119 participants (36% non-frail, 48% pre-frail, and 16% frail), 48 reported one or more fall (47% of non-frail, 33% of pre-frail, and 47% of frail). Although balance deficit and PA were independent fall predictors in pre-frail and frail groups, they were not sensitive to predict prospective falls in the non-frail group. Even though gait performance deteriorated as frailty increased, gait was not a predictor of prospective falls when participants were stratified based on frailty status. In pre-frail and frail participants combined, center of mass sway [odds ratio (OR) = 5.9, 95% confidence interval (CI) 2.6-13.7], PA mean walking bout duration (OR = 1.1, 95% CI 1.0-1.2), PA mean standing bout duration (OR = 0.94, 95% CI 0.91-0.99), and a fall in previous 6 months (OR = 7.3, 95% CI 1.5-36.4) were independent predictors of prospective falls (area under the curve: 0.882). Conclusion: This study suggests that independent predictors of falls are dependent on frailty status. Among sensor-derived parameters, balance deficit, longer typical walking episodes, and shorter typical standing episodes were the most sensitive predictors of prospective falls in the combined pre-frail and frail sample. Gait deficit was not a sensitive fall predictor in the context of frailty status.

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.

Physical Activity and its Influencing Factors in Community-Dwelling Older Adults With Dementia: A Path Analysis

2021 ◽  
pp. 105477382110339
Author(s):  
Bei Li ◽  
Xiuxiu Huang ◽  
Chenchen Meng ◽  
Qiaoqin Wan ◽  
Yongan Sun
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Path Analysis ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Cross Sectional ◽  
People With Dementia ◽  
The Status ◽  
Path Analysis Approach ◽  
Community Dwelling Older Adults

Dementia is prevalent in worldwide, and increases the care burden and potential costs. Physical activity (PA) has been increasingly shown to be beneficial for them. This was a cross-sectional observational study aiming to investigate the status of PA among community-dwelling older adults with dementia in Beijing or Hangzhou, China, and verify the relationships between neuropsychiatric symptoms, activities of daily living (ADL), caregivers’ fear of patients’ falling and their PA using a path analysis approach. The level of PA among 216 included people with dementia was low. PA was related to the neuropsychiatric symptoms, with ADL and caregivers’ fear of patients’ falling have mediation roles. The findings indicated that person-centered strategies related to the management of these symptoms might be helpful to improve ADL, relieve caregivers’ concerns about them falling and consequently foster positive participation in PA.

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

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.

scholarly journals Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial

2021 ◽  
Vol 18 (13) ◽  
pp. 6682
Author(s):  
Hilde Bremseth Bårdstu ◽  
Vidar Andersen ◽  
Marius Steiro Fimland ◽  
Lene Aasdahl ◽  
Hilde Lohne-Seiler ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Resistance Training ◽  
Home Care ◽  
Community Dwelling ◽  
Activity Level ◽  
Group Differences ◽  
Control Group ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

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