scholarly journals 17 Is Phenotypical Prefrailty all the Same? A Longitudinal Investigation of Two Prefrailty Subtypes in a Population-Based Longitudinal Study of Ageing

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Roman Romero-Ortuno ◽  
Siobhan Scarlett ◽  
Rose Anne Kenny
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Longitudinal Study ◽  
Sex Education ◽  
Population Based ◽  
Frailty Phenotype ◽  
Unexplained Weight Loss ◽  
Iadl Disability ◽  
Baseline Characteristics ◽  
Adl Disability

Abstract Background Fried’s frailty phenotype is defined by five criteria: exhaustion, unexplained weight loss, weakness, slowness and low physical activity. Pre-frailty (PF) meets one or two criteria. PF is of interest as a target for preventative strategies, but it is not known if it is a homogenous syndrome. The objective of this study was to compare the longitudinal trajectories of two PF groups: one defined by exhaustion and/or unexplained weight loss (PF1) and one defined by one or two of the following: weakness, slowness, low physical activity (PF2). Methods: Design and setting  population-based longitudinal study of ageing. Subjects  1,660 PF participants aged ≥50 years from wave 1 of the study (2010), followed 2-yearly over 4 longitudinal waves (2012, 2014, 2016, 2018). Methods  Generalised Estimating Equations (GEE) were used to assess the effect of PF type across waves to predict cumulative mortality and disability in basic (ADL) and independent (IADL) activities of daily living, adjusting for baseline characteristics (age, sex, education, living alone, self-rated health, comorbidity, body mass index). Results In wave 1, there were 687 PF1 and 973 PF2 participants. By wave 5, 64 (9.3%) PF1 and 145 (14.9%) PF2 participants had died. In PF1 participants, mean numbers of ADL and IADL disabilities both increased from 0.2 to 0.3 from wave 1 to wave 5, whilst in PF2 increases were from 0.2 to 0.5. Adjusted GEE models suggested significantly divergent trajectories of IADL disability by wave 2, ADL disability by wave 3, and mortality by wave 4. Conclusion Prefrailty may not be a homogenous biological syndrome. This may have relevance for the design of interventions to delay or reverse frailty in populations.

scholarly journals Is phenotypical prefrailty all the same? A longitudinal investigation of two prefrailty subtypes in TILDA

2019 ◽  
Vol 49 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Roman Romero-Ortuno ◽  
Siobhan Scarlett ◽  
Aisling M O’Halloran ◽  
Rose Anne Kenny
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Sex Education ◽  
Population Based ◽  
Frailty Phenotype ◽  
Unexplained Weight Loss ◽  
Iadl Disability ◽  
Baseline Characteristics ◽  
Adl Disability ◽  
Preventative Interventions

Abstract Background Fried’s frailty phenotype is defined by five criteria: exhaustion, unexplained weight loss, weakness, slowness and low physical activity. Prefrailty (PF) meets one or two criteria. PF is of interest as a target for preventative interventions, but it is not known if it is a homogenous syndrome. Objective to compare the longitudinal trajectories of two PF groups: one defined by exhaustion and/or unexplained weight loss (PF1) and one defined by one or two of the following: weakness, slowness, low physical activity (PF2). Design and setting population-based longitudinal study of ageing. Subjects One-thousand four-hundred seventy-six PF participants aged ≥50 years from wave 1 of the study (2010), followed 2-yearly over four longitudinal waves (2012, 2014, 2016, 2018). Methods generalised estimating equations (GEEs) were used to assess the effect of PF type across waves to predict cumulative mortality and disability in basic activities of daily living (ADL) and independent ADL (IADL), adjusting for baseline characteristics (age, sex, education, living alone, self-rated health, comorbidity, body mass index). Results in wave 1, there were 503 PF1 and 973 PF2 participants. By wave 5, 38 (7.6%) PF1 and 145 (14.9%) PF2 participants had died. In PF1 participants, mean numbers of ADL and IADL disabilities both increased from 0.1 to 0.2 from wave 1 to wave 5, whilst in PF2 increases were from 0.2 to 0.5. Adjusted GEE models suggested significantly divergent trajectories of IADL disability by wave 2, ADL disability by wave 3 and mortality by wave 3. Conclusion PF may not be a homogenous biological syndrome.

TRANSITION PATTERNS OF FRAILTY SYNDROME IN COMMUNITY-DWELLING ELDERLY INDIVIDUALS: A LONGITUDINAL STUDY

2015 ◽  
pp. 1-6
Author(s):  
S. LANZIOTTI AZEVEDO DA SILVA ◽  
Á. CAMPOS CAVALCANTI MACIEL ◽  
L. DE SOUSA MÁXIMO PEREIRA ◽  
J.M. DOMINGUES DIAS ◽  
M. GUIMARÃES DE ASSIS ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Longitudinal Study ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Activity Level ◽  
Frailty Syndrome ◽  
Frailty Phenotype ◽  
Elderly Individuals ◽  
Belo Horizonte

Background: Little information is available about transitional patterns related to frailty syndrome in elderly individuals living in the community. Objective: To assess transitional patterns and determine which frailty phenotype variables are more involved in this process. Design: Longitudinal study. Population: Community-dwelling elderly individuals in Belo Horizonte, Minas Gerais, Brazil. Participants: Two hundred individuals over 65 years old. Measurements: The frailty phenotype was assessed at two different times, with a mean interval of 13 months. Comparison of the frequency distributions between the baseline and second assessment was conducted through Pearson’s chi-squared test, and a binary logistic regression was conducted to assess the most important items in this transition. Results: Sixty-eight percent of the elderly were women, with an average age of 73.7 (± 6.1) years. The pre-frail group transitioned the most between evaluations. Eighty-five individuals transitioned among frailty levels: 46 showed improvement while 39 worsened. Individuals who did scored low on the handgrip strength test in the first evaluation were more likely to have their frailty level worsen. Among individuals who showed improvements, those who were positive for weight loss and poor physical activity level in the first evaluation were less likely to improve. In this study, a greater number of individuals showed improved frailty levels over 13 months than worsened levels. Conclusion: Poor handgrip strength, weight loss, and poor physical activity are the most influential variables in frailty transitioning, leading to worsening levels of frailty or difficulty in making improvements.

A Qualitative, Longitudinal Study Exploring Obese Adolescents’ Attitudes Toward Physical Activity

2012 ◽  
Vol 10 (1) ◽  
pp. 115-123 ◽  
Author(s):  
Anders Lindelof ◽  
Claus Vinther Nielsen ◽  
Birthe D. Pedersen
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Longitudinal Study ◽  
Positive Attitude ◽  
Willingness To Participate ◽  
Obese Adolescents ◽  
Theory Of Practice ◽  
Active Life ◽  
Hermeneutic Approach ◽  
Study Participants

Background:Individuals’ attitude toward physical activity may contribute to their willingness to participate in such behavior. This study qualitatively and longitudinally explored obese adolescents’ attitudes to physical activity.Methods:Fifteen obese adolescents were recruited at a weight loss camp. Participants were followed for 2.5 years with 3 yearly rounds of participant observations and interviews. Data were analyzed using a phenomenological-hermeneutic approach.Results:Four categories were identified: 1) throughout the study participants became more sedentary as they de-selected activities like bike riding; 2) participants did not perceive their increasing inactive lifestyle as hindering weight loss as they consider such activities as futile compared with vigorously hard exercise; 3) participants frequently failed to participate in hard exercise, like going to the gym; and 4) participants had a genuine antipathy against being physical active.Conclusions:Among others, a reason why obese adolescents fail to live an active life is that they find limited pleasure in such behavior. It is argued that obese adolescents need a positive attitude toward physical activity if they are to be more active. With reference to Bourdieu’s theory of practice, it is hypothesized that such attitude needs to be learned through everyday life by experiencing joy and meaning by being physical active.

scholarly journals Factors associated with different patterns of weight change after bariatric surgery: A longitudinal study

2021 ◽  
Author(s):  
Diana Cristina Henao Carrillo ◽  
Ana María Gómez ◽  
Oscar Muñoz ◽  
Claudia Rubio ◽  
Natalia Rodríguez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Longitudinal Study ◽  
Estimating Equation ◽  
First Year ◽  
Factors Associated ◽  
Modifiable Factors ◽  
Over Time

Abstract Background Bariatric surgery is the most effective treatment for obesity. During long-term follow-up, weight loss (WL) is variable between subjects. The aim of this study is to assess the change in percentage of total weight loss (%TWL) and excess weight loss (%EWL) and to describe the factors associated with greater or lesser WL over time. Methods Longitudinal study including patients treated with laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (LSG) and followed at Hospital Universitario San Ignacio, Bogotá (Colombia). Baseline data was recorded before surgery. Follow-up was performed at 3 (n=192), 6 (n=190), 9 (n=188), 12 (n=186), 24 (n=99) and 36 (n=30) months. Generalized Estimating Equation (GEE) analysis was used to assess the change in %TWL and %EWL over time. Results 196 patients were included (82.4% female, BMI 41.3±5.2 kg/m2). The tendency to increase on %TWL (31.6±6.6) and %EWL (80.2 RIQ 70.7-97.3) was evident in the first year, stabilizing after that. Nutritionist follow-up, baseline BMI>40 kg/m2 and WL≥10kg before surgery were associated with an average higher increase of %TWL (2.39% p=0.014, 0.41% p<0.001 and 0.37% p=0.003, respectively). Subjects who performed physical activity >30 minutes/day after surgery reduced %TWL in 0.74% (p=0.009). Similar findings were described on %EWL. Conclusion Follow-up during the first year after bariatric surgery is critical to achieving %TWL and %EWL goals. This study suggests that modifiable factors such as nutritional follow-up, WL before surgery and time of physical activity are associated with a significant change in %TWL and %EWL during follow-up by a multidisciplinary team.

scholarly journals Prevalence of Frailty Indicators in Community-dwelling Older Adults From Northeastern Brazil, 2009-2015

2021 ◽  
Author(s):  
Adrianna Ribeiro Lacerda ◽  
Maria do Carmo Eulálio ◽  
Edivan Gonçalves Silva Júnior ◽  
Ricardo Alexandre Arcêncio ◽  
Ricardo Alves Olinda ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Weight Loss ◽  
Explanatory Models ◽  
Community Dwelling ◽  
Self Report ◽  
Northeastern Brazil ◽  
Frailty Phenotype ◽  
Frail Older Adults ◽  
Community Dwelling Older Adults

Abstract BACKGROUND: Frailty is a clinical syndrome, and its development is multifactorial and dynamic. The clinical indicators (physical measures and self-report) that characterize the syndrome tend to vary across studies. To determine the contributions of the indicators in the determination of frailty it is important to obtain data about the variations that occur among the levels of frailty. The aim of this study was to a) survey the prevalence of the frailty syndrome and of the indicators that compose the frailty phenotype in community-dwelling older adults, and b) to evaluate the contribution of each indicator in the determination frailty.METHODS: Prevalence study carried out with 163 older adults who participated in two assessments; the first one was performed in 2009 and after 70 months the second assessment was conducted. Assessment of physical measurements was performed to constitute the frailty phenotype (gait speed and handgrip strength) alongside self-report (fatigue, unintentional weight loss, and physical activity), as proposed by Fried. We used the McNemar’s test and Pearson’s chi-square to analyze the differences between means and Multinomial Logistic Regression values.RESULTS: There was an increase in the number of pre-frail older adults (from 47.85% to 65.03%) and frail ones (from 7.98% to 9.82%). The frailty indicators increased significantly (+ 8.6% for walking; + 6.8% for fatigue; + 6.8% for grip strength; + 1.2% for physical activity), except for the “weight loss” item (-3%). The indicators with the highest predictors of frailty in 2009 were fatigue (OR = 31.41; 95%CI 11.66-84-65, p<0.001) and weight loss (OR = 28.74; 95%CI 9.20-89.84, p<0.001). In the second assessment, the items that had the highest chance for developing frailty were slow gait (OR = 23.64; 95%CI 5.38-103.83, p<0.001) and muscle weakness (OR = 79.39; 95%CI 8.58-734.24, p<0.001). CONCLUSION: There was an increase in frail and pre-frail older adults during the two assessments and an increase in the indicators that mark the syndrome phenotype. The explanatory models of frailty changed in both assessments. The evolution of frailty signals the necessity for interventions to be carried out with older adults to delay the progress of declining faculties that threaten their health.

scholarly journals Discrimination and Risk of Incident Disability in Older African Americans

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 260-260
Author(s):  
Melissa Lamar ◽  
Sue Leurgans ◽  
Aron Buchman ◽  
Lisa Barnes ◽  
Brittney Lange-Maia
Keyword(s):  
African Americans ◽  
Activities Of Daily Living ◽  
Sex Education ◽  
Daily Living ◽  
Proportional Hazards ◽  
Vascular Diseases ◽  
Cox Proportional Hazards ◽  
Iadl Disability ◽  
Adl Disability ◽  
Everyday Discrimination

Abstract Discrimination is linked to poor health outcomes, but most studies examine young or midlife populations. We assessed associations between discrimination and disability in African Americans. The Detroit Areas Study Everyday Discrimination Scale quantified experiences of interpersonal mistreatment. Separate Cox-proportional hazards models tested the associations between baseline discrimination and incident mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) disability, adjusting for age, sex, education, BMI, smoking, depressive symptoms, and vascular diseases. At baseline, 441, 674, and 469, participants were initially free of mobility, ADL, and IADL disability, respectively, and 257, 185, and 269 new cases of mobility, ADL, and IADL disability were observed over approximately 8.5 years. Discrimination was associated with higher risk of ADL disability (hazard ratio: 1.03 per 1-point higher discrimination score, 95% confidence interval: 1.00-1.06) but no other disability type. Everyday discrimination is associated with risk of ADL disability.

Physical Activity as Protective Factor against Dementia: A Prospective Population-Based Study (NEDICES)

2015 ◽  
Vol 21 (10) ◽  
pp. 861-867 ◽  
Author(s):  
Sara Llamas-Velasco ◽  
Israel Contador ◽  
Alberto Villarejo-Galende ◽  
David Lora-Pablos ◽  
Félix Bermejo-Pareja
Keyword(s):  
Physical Activity ◽  
Sex Education ◽  
Protective Factor ◽  
Cox Regression ◽  
Statistical Significance ◽  
Population Based ◽  
Dose Effect ◽  
Incident Dementia ◽  
Health Related

AbstractThe aim of this study was to analyze whether physical activity (PA) is a protective factor for the incidence of dementia after 3 years of follow-up. The Neurological Disorders in Central Spain (NEDICES) is a prospective population-based survey of older adults (age 65 years and older) that comprised 5278 census-based participants at baseline (1994–1995). A broad questionnaire was used to assess participants’ sociodemographic characteristics, health status, and lifestyle. Subsequently, a modified version of Rosow-Breslau questionnaire was applied to classify individuals’ baseline PA into groups (i.e., sedentary, light, moderate, and high). Cox regression models adjusted for several covariates (age, sex, education, previous stroke, alcohol consumption, hypertension, health related variables) were carried out to estimate the association between the PA groups and risk of dementia at the 3-year follow-up (1997–1998). A total of 134 incident dementia cases were identified among 3105 individuals (56.6% female; mean age=73.15±6.26) after 3 years. Hazard ratios (HRs) of the light, moderate, and high PA groups (vs. sedentary group) were 0.40 (95% confidence interval {CI} [0.26, 0.62]; p<.001), 0.32 (95% CI [0.20, 0.54]; p<.001) and 0.23 (95% CI [0.13, 0.40]; p<.001), respectively. Even after controlling for covariates and the exclusion of doubtful dementia cases, HRs remained significant. However, a supplementary analysis showed that the dose-effect hypothesis did not reach statistical significance. PA is a protective factor of incident dementia in this population-based cohort. (JINS, 2015, 21, 861–867)

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