Trends in Frailty and its Association with Mortality: Results From the Longitudinal Aging Study Amsterdam (1995-2016)

Abstract The aim of the current study was to investigate trends in frailty and its relationship with mortality among older adults aged 64-84 years across a period of 21 years. Data from 1995 to 2016 were used from the Longitudinal Aging Study Amsterdam. A total of 7,742 observations of 2,874 respondents in the same age range (64-84 years) across six measurement waves were included. Frailty was measured with a 32-item frailty index, with a cut-point of ≥0.25 to indicate frailty. The outcome measure was 4-year mortality. Generalized Estimating Equation analyses showed that among older adults aged 64-84 years the 4-year mortality rate declined between 1995 and 2016, while the prevalence of frailty increased. Across all measurement waves, frailty was associated with 4-year mortality (Odds Ratio: 2.79, 95% Confidence Interval: 2.39, 3.26). There was no statistically significant interaction effect between frailty and time on 4-year mortality, indicating a stable association between frailty and mortality. In more recent generations of older adults, frailty prevalence rates were higher, while excess mortality rates of frailty remained the same. This is important information for health policy makers and clinical practice, as it shows that continued efforts are needed to reduce frailty and its negative health consequences.

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Awareness of risk factors for loneliness among third agers

Ageing and Society ◽

10.1017/s0144686x12001419 ◽

2013 ◽

Vol 34 (6) ◽

pp. 1035-1051 ◽

Cited By ~ 3

Author(s):

ERIC C. SCHOENMAKERS ◽

THEO G. VAN TILBURG ◽

TINEKE FOKKEMA

Keyword(s):

Risk Factors ◽

Older Adults ◽

Poor Health ◽

Preventive Action ◽

Policy Makers ◽

Early Action ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study ◽

Evidence For Policy

ABSTRACTAwareness of risk factors for loneliness is a prerequisite for preventive action. Many risk factors for loneliness have been identified. This paper focuses on two: poor health and widowhood. Preventive action by developing a satisfying social network requires time and effort and thus seems appropriate for people unexposed to risk factors, i.e. third agers and non-lonely persons. The third age is the period in old age after retirement, before people's social relationships deteriorate. This paper addresses three questions: Are older adults aware of poor health and widowhood as risk factors for loneliness? Are there differences in awareness between third and fourth agers? Are there differences in awareness between lonely and non-lonely older adults? After being introduced to four vignette persons, 920 respondents from the Longitudinal Aging Study Amsterdam were asked whether they expected these persons to be lonely. Older adults, especially third agers, expected peers exposed to the risk factors to be lonely more often than peers who were unexposed. The results indicate that awareness of loneliness-provoking factors is high among third agers, which is a first step towards taking actions to avoid loneliness. Compared to lonely older adults, non-lonely ones expected peers to be lonely less often, suggesting the latter's lower awareness of the risk factors. The results provide evidence for policy makers and practitioners that combating loneliness might require early action.

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Older adults report cancellation or avoidance of medical care during the COVID-19 pandemic: results from the Longitudinal Aging Study Amsterdam

European Geriatric Medicine ◽

10.1007/s41999-021-00514-3 ◽

2021 ◽

Author(s):

Noah A. Schuster ◽

Sascha de Breij ◽

Laura A. Schaap ◽

Natasja M. van Schoor ◽

Mike J. L. Peters ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Medical Care ◽

Help Seeking ◽

Community Dwelling ◽

Multiple Chronic Conditions ◽

Hospital Outpatient ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

Abstract Purpose Delay of routine medical care during the COVID-19 pandemic may have serious consequences for the health and functioning of older adults. The aim of this study was to investigate whether older adults reported cancellation or avoidance of medical care during the first months of the COVID-19 pandemic, and to explore associations with health and socio-demographic characteristics. Methods Cross-sectional data of 880 older adults aged ≥ 62 years (mean age 73.4 years, 50.3% female) were used from the COVID-19 questionnaire of the Longitudinal Aging Study Amsterdam, a cohort study among community-dwelling older adults in the Netherlands. Cancellation and avoidance of care were assessed by self-report, and covered questions on cancellation of primary care (general practitioner), cancellation of hospital outpatient care, and postponed help-seeking. Respondent characteristics included age, sex, educational level, loneliness, depression, anxiety, frailty, multimorbidity and information on quarantine. Results 35% of the sample reported cancellations due to the COVID-19 situation, either initiated by the respondent (12%) or by healthcare professionals (29%). Postponed help-seeking was reported by 8% of the sample. Multimorbidity was associated with healthcare-initiated cancellations (primary care OR = 1.92, 95% CI = 1.09–3.50; hospital OR = 1.86, 95% CI = 1.28–2.74) and respondent-initiated hospital outpatient cancellations (OR = 2.02, 95% CI = 1.04–4.12). Depressive symptoms were associated with postponed help-seeking (OR = 1.15, 95% CI = 1.06–1.24). Conclusion About one third of the study sample reported cancellation or avoidance of medical care during the first months of the pandemic, and this was more common among those with multiple chronic conditions. How this impacts outcomes in the long term should be investigated in future research.

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Social network size, loneliness, physical functioning and depressive symptoms among older adults: examining reciprocal associations in four waves of the Longitudinal Aging Study Amsterdam (LASA)

International Journal of Geriatric Psychiatry ◽

10.1002/gps.5560 ◽

2021 ◽

Author(s):

Joan Domènech‐Abella ◽

Jordi Mundó ◽

Lise Switsers ◽

Theo van Tilburg ◽

Daniel Fernández ◽

...

Keyword(s):

Older Adults ◽

Social Network ◽

Depressive Symptoms ◽

Physical Functioning ◽

Network Size ◽

Social Network Size ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study ◽

Reciprocal Associations

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Frailty Changes Predict Mortality in 4 Longitudinal Studies of Aging

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa266 ◽

2020 ◽

Author(s):

Erwin Stolz ◽

Emiel O Hoogendijk ◽

Hannes Mayerl ◽

Wolfgang Freidl

Keyword(s):

Mortality Risk ◽

Clinical Decision Making ◽

Frailty Index ◽

Credible Interval ◽

Clinical Decision ◽

Population Based ◽

Time To Event Data ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

Abstract Background Baseline frailty index (FI) values have been shown to predict mortality among older adults, but little is known about the effects of changes in FI on mortality. Methods In a coordinated approach, we analyzed data from 4 population-based cohorts: the Health and Retirement Study (HRS), the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Survey of Ageing (ELSA), and the Longitudinal Aging Study Amsterdam (LASA), comprising a total of 24 961 respondents (65+), 95 897 observations, up to 9 repeated FI assessments, and up to 23 years of mortality follow-up. The effect of time-varying FI on mortality was modeled with joint regression models for longitudinal and time-to-event data. Results Differences (of 0.01) in current FI levels (hazard ratio [HR] = 1.04, 95% credible interval [CI] = 1.03–1.05) and baseline FI levels (HR = 1.03, 95% CI = 1.03–1.05) were consistently associated with mortality across studies. Importantly, individuals with steeper FI growth also had a higher mortality risk: An increase in annual FI growth by 0.01 was associated with an increased mortality risk of HR = 1.56 (95% CI = 1.49–1.63) in HRS, HR = 1.24 (95% CI = 1.13–1.35) in SHARE, HR = 1.40 (95% CI = 1.25–1.52) in ELSA, and HR = 1.71 (95% CI = 1.46–2.01) in LASA. Conclusions FI changes predicted mortality independently of baseline FI differences. Repeated assessment of frailty and individual’s frailty trajectory could provide a means to anticipate further health deterioration and mortality and could thus support clinical decision making.

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Predictors in starting and stopping Internet use between 2002 and 2012 by Dutch adults 65 years and older

Health Informatics Journal ◽

10.1177/1460458217720398 ◽

2017 ◽

Vol 25 (3) ◽

pp. 715-730 ◽

Cited By ~ 2

Author(s):

Jessica Berner ◽

Marja Aartsen ◽

Dorly Deeg

Keyword(s):

Older Adults ◽

Psychological Health ◽

Internet Use ◽

Cox Regression ◽

Demographic Predictors ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study ◽

Normal Cognition ◽

High Sense

Research has indicated the need to consider the ageing process with technology adoption by older adults. This study examined psychological, health, social and demographic predictors with starting and stopping Internet use by older adults (2002–2012). Data were used from the Longitudinal Aging Study Amsterdam, and Cox regression analyses were done to test predictors over time with starting or stopping Internet use. The results indicated that older adults starting to use the Internet (11.6%) outnumbered those who stopped (3.1%). Psychological, health, social and demographic predictors separately predicted starting and stopping Internet use. Starting use was predicted by lower age, higher education, normal cognition and living alone. The predictors in stopping use were being younger, having a high sense of mastery and being higher educated. The results need to be interpreted as indicative due to the small number of stoppers. Suggestions are made on how to improve usability.

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TRENDS IN LIFESTYLE AMONG 3 GENERATIONS OF OLDER ADULTS; THE LONGITUDINAL AGING STUDY AMSTERDAM

The Gerontologist ◽

10.1093/geront/gnw162.1818 ◽

2016 ◽

Vol 56 (Suppl_3) ◽

pp. 455-455

Keyword(s):

Older Adults ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

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Adverse effects of frailty on social functioning in older adults: Results from the Longitudinal Aging Study Amsterdam

Maturitas ◽

10.1016/j.maturitas.2015.09.002 ◽

2016 ◽

Vol 83 ◽

pp. 45-50 ◽

Cited By ~ 36

Author(s):

Emiel O. Hoogendijk ◽

Bianca Suanet ◽

Elsa Dent ◽

Dorly J.H. Deeg ◽

Marja J. Aartsen

Keyword(s):

Older Adults ◽

Adverse Effects ◽

Social Functioning ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

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Prevalence of attention-deficit hyperactivity disorder in older adults in the Netherlands

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.101196 ◽

2012 ◽

Vol 201 (4) ◽

pp. 298-305 ◽

Cited By ~ 103

Author(s):

Marieke Michielsen ◽

Evert Semeijn ◽

Hannie C. Comijs ◽

Peter van de Ven ◽

Aartjan T. F. Beekman ◽

...

Keyword(s):

Older Adults ◽

Attention Deficit Hyperactivity Disorder ◽

The Netherlands ◽

Attention Deficit ◽

Diagnostic Interview ◽

Elderly Adults ◽

Hyperactivity Disorder ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

BackgroundLittle is known about the prevalence of attention-deficit hyperactivity disorder (ADHD) among older adults.AimsTo estimate the prevalence of the syndromatic and symptomatic DSM-IV ADHD diagnosis in older adults in The Netherlands.MethodData were used from the Longitudinal Aging Study Amsterdam (LASA). At baseline, 1494 participants were screened with an ADHD questionnaire and in 231 respondents a structured diagnostic interview was administered. The weighted prevalence of ADHD was calculated.ResultsThe estimated prevalence rate of syndromatic ADHD in older adults was 2.8%; for symptomatic ADHD the rate was 4.2%. Younger elderly adults (60–70 years) reported significantly more ADHD symptoms than older elderly adults (71–94 years).ConclusionsThis is the first epidemiological study on ADHD in older persons. With a prevalence of 2.8% the study demonstrates that ADHD does not fade or disappear in adulthood and that it is a topic very much worthy of further study.

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