Impact of physical activity, protein intake and social network and their combination on the development of frailty

Abstract Background Frailty is a geriatric condition associated with adverse health outcomes. As physical inactivity, low protein intake and poor social network are known risk factors, we aimed to assess the influence of these parameters and their interaction in an 11-year follow-up study on a Europe-wide level. Methods Data from the Study on Health, Ageing and Retirement in Europe were used, including 22 226 community-dwelling robust and prefrail persons aged ≥50 years, from 11 countries. Frailty was assessed with the ‘Frailty Instrument for Primary care of the Survey of Health, Ageing and Retirement in Europe’. Additionally, self-reported physical activity (PA), protein intake and satisfaction with social network were assessed. The impact of these parameters on the development of frailty was calculated using multivariate cox regressions. Results Performing no regular PA, was associated with higher hazards ratio (HRs) for frailty compared with performing regular PA [men: 1.90 (95%CI: 1.50–2.42); women: 1.65 (95%CI: 1.25–2.18)]; HRs for low protein intake were 1.16 (95%CI: 0.93–1.46) for men and 1.05 (95%CI: 0.80–1.37) for women. And HR for poor social network were 0.92 (95%CI: 0.74–1.15) for men and 1.72 (95%CI: 1.31–2.27)] for women. In general, persons with a combination of two of the assessed risk factors had a higher risk for frailty compared with those with no or only one of the risk factors. However, no significant synergy index could be found. Conclusion The results illustrate the importance of PA, but also of nutritional and social network to prevent frailty.

Download Full-text

Influence of Physical Activity, Protein Intake and Social Network on the Frailty development

European Journal of Public Health ◽

10.1093/eurpub/ckz185.143 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

S Haider ◽

T E Dorner ◽

I Grabovac

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Social Network ◽

Protein Intake ◽

Community Dwelling ◽

Synergy Index ◽

Follow Up Study ◽

Low Protein ◽

The Impact

Abstract Background Frailty, a geriatric syndrome, is associated with many adverse health outcomes. Risk factors include physical inactivity, low protein intake and an inadequate social network. In this analysis we aimed to assess the influence of these factors and their combination in an 11-year-follow-up study on a Europe-wide level. Methods The analysed dataset included 22,226 community-dwelling robust and prefrail persons aged ≥50 years (11 countries) from the Study on Health, Ageing and Retirement in Europe (SHARE). Frailty was measured with the “Frailty Instrument for Primary care of the Survey of Health, Ageing and Retirement in Europe”. Additionally, self-reported level of vigorous physical activity (PA), protein intake and satisfaction with social network were assessed. The impact of these parameters on the development of frailty was calculated using Cox regressions, adjusted for age, education, smoking, alcohol BMI, depression, long-term illness and each other. Results People who do not engage in PA, had a higher HRs for frailty development compared to people performing PA regularly [women: 1.62 (95%CI: 1.22-2.13); men: 1.83 (95%CI: 1.44-2.33)]. People with low protein intake did not have significant higher HR [women: 1.05 (95%CI: 0.80-1.37); men: 1.16 (95%CI: 0.93-1.46)]. Women with poor social network showed HRs of 1.34 (95%CI: 1.24-2.15)], men with poor social network had a HR of 0.88 (95%CI: 0.70-1.10). In general, we found that persons with a combination of two risk factors had a higher risk for frailty compared to those with no or only one. However, no significant synergy index could be found. Conclusions Regular PA, but also adequate social networks seem to be important factors in frailty prevention. Key messages Sufficient PA and satisfaction with social network were shown as modifiable factors to prevent frailty in an 11-year-follow-up study. A combination of two risk factors was associated with a higher risk for frailty compared to one, however, with no significant synergy index.

Download Full-text

Effects of Reallocating Time Spent in Different Physical Activity Intensities on Sarcopenia Risk in Older Adults: An Isotemporal Substitution Analysis

Biology ◽

10.3390/biology11010111 ◽

2022 ◽

Vol 11 (1) ◽

pp. 111

Author(s):

Jort Veen ◽

Diego Montiel-Rojas ◽

Fawzi Kadi ◽

Andreas Nilsson

Keyword(s):

Physical Activity ◽

Older Adults ◽

Protein Intake ◽

Handgrip Strength ◽

Community Dwelling ◽

Self Report ◽

Linear Regression Models ◽

Age Related ◽

Muscle Health ◽

The Impact

The role of daily time spent sedentary and in different intensities of physical activity (PA) for the maintenance of muscle health currently remains unclear. Therefore, we investigated the impact of reallocating time spent in different PA intensities on sarcopenia risk in older adults, while considering PA type (muscle strengthening activities, MSA) and protein intake. In a sample of 235 community-dwelling older adults (65–70 years), a sarcopenia risk score (SRS) was created based on muscle mass assessed by bioimpedance, together with handgrip strength and performance on the five times sit-to-stand (5-STS) test assessed by standardized procedures. Time spent in light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and being sedentary was assessed by accelerometry, and PA type (MSA) by self-report. Linear regression models based on isotemporal substitution were employed. Reallocating sedentary time to at least LPA was significantly (p < 0.05) related to a lower SRS, which remained evident after adjustment by PA type (MSA) and protein intake. Similarly, reallocating time in LPA by MVPA was related to a significantly (p < 0.05) lower SRS. Our results emphasize the importance of displacing sedentary behaviours for more active pursuits, where PA of even light intensities may alleviate age-related deteriorations of muscle health in older adults.

Download Full-text

Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic

Journal of Primary Care & Community Health ◽

10.1177/21501327211047781 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110477

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera ◽

Denisse A. Rumbea ◽

Pedro Pérez ◽

Bettsy Y. Recalde ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Regression Models ◽

Community Dwelling ◽

The Body ◽

Study Results ◽

The Impact ◽

Community Dwelling Older Adults

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.

Download Full-text

Dietary Protein, Exercise, and Frailty Domains

Nutrients ◽

10.3390/nu11102399 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2399 ◽

Cited By ~ 2

Author(s):

Josje D. Schoufour ◽

Elvera Overdevest ◽

Peter J. M. Weijs ◽

Michael Tieland

Keyword(s):

Physical Activity ◽

Beneficial Effect ◽

Dietary Protein ◽

Protein Intake ◽

Social Health ◽

Physical Domain ◽

Physical Frailty ◽

Future Studies ◽

Low Protein ◽

The Impact

Increasing awareness of the impact of frailty on elderly people resulted in research focusing on factors that contribute to the development and persistence of frailty including nutrition and physical activity. Most effort so far has been spent on understanding the association between protein intake and the physical domain of frailty. Far less is known for other domains of frailty: cognition, mood, social health and comorbidity. Therefore, in the present narrative review, we elaborate on the evidence currently known on the association between protein and exercise as well as the broader concept of frailty. Most, but not all, identified studies concluded that low protein intake is associated with a higher prevalence and incidence of physical frailty. Far less is known on the broader concept of frailty. The few studies that do look into this association find a clear beneficial effect of physical activity but no conclusions regarding protein intake can be made yet. Similar, for other important aspects of frailty including mood, cognition, and comorbidity, the number of studies are limited and results are inconclusive. Future studies need to focus on the relation between dietary protein and the broader concept of frailty and should also consider the protein source, amount and timing.

Download Full-text

Gender-specific risk factors for incident sarcopenia: 8-year follow-up of the English longitudinal study of ageing

Journal of Epidemiology & Community Health ◽

10.1136/jech-2018-211258 ◽

2018 ◽

Vol 73 (1) ◽

pp. 86-88 ◽

Cited By ~ 8

Author(s):

Lin Yang ◽

Lee Smith ◽

Mark Hamer

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Longitudinal Study ◽

Large Population ◽

Community Dwelling ◽

Inverse Association ◽

Specific Risk ◽

Gender Specific ◽

English Longitudinal Study

BackgroundThe aetiology of age-related sarcopenia is not known.ObjectivesTo investigate if risk of developing sarcopenia differs by gender and to identify gender-specific risk factors of incident sarcopenia in a large population-based cohort of older English adults.MethodsThe sample (n=3404; age 63.4 (SD 7.7) years; 54.1% women) comprised older community-dwelling adults recruited from the English Longitudinal Study of Ageing. Sarcopenia was defined as handgrip <26 kg in men and <16 kg in women. Handgrip strength was assessed at baseline (2004/2005) and repeated at follow-up (2012/2013). Analysed risk factors included baseline anthropometric measures, smoking, vigorous and moderate physical activity, depressive symptoms, chronic illnesses and wealth. After excluding participants with sarcopenia at baseline, multivariable logistic regressions were used to explore baseline risk factors for incident sarcopenia.ResultsDuring 8-year follow-up, 208 and 287 cases of sarcopenia were identified in men (n=1564) and women (n=1840), respectively. Women were at 20% (age adjusted OR=1.20, 95% CI 0.98 to 1.47) higher risk of developing sarcopenia than men. The inverse association between physical activity and sarcopenia risk was observed at moderate (OR=0.44, 95% CI 0.27 to 0.67) and vigorous (0.53, 95% CI 0.31 to 0.82) intensities in men and only vigorous (OR=0.44, 95% CI 0.28 to 0.68) intensity in women. Social factors, such as wealth, and chronic health conditions appeared to be more strongly associated with sarcopenia in men.ConclusionWomen are at higher risk of developing incident sarcopenia than men, and this is likely explained by a range of gender-specific risk factors.

Download Full-text

Seasonal Changes in Continuous Sedentary Behavior in Community—Dwelling Japanese Adults: A Pilot Study

Medicines ◽

10.3390/medicines7090048 ◽

2020 ◽

Vol 7 (9) ◽

pp. 48

Author(s):

Chiaki Uehara ◽

Nobuyuki Miyatake ◽

Shuhei Hishii ◽

Hiromi Suzuki ◽

Akihiko Katayama

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Body Weight ◽

Sedentary Behavior ◽

Seasonal Changes ◽

Secondary Analysis ◽

Community Dwelling ◽

Adverse Health Outcomes ◽

Japanese Adults

Background: Sedentary behavior (SB) is associated with adverse health outcomes. The aim of this study was to clarify seasonal changes in SB including continuous SB (CSB) in community-dwelling Japanese adults. Methods: In this secondary analysis, a total of 65 community-dwelling Japanese adults (7 men and 58 women, 69 (50–78) years) were enrolled. SB (%), including CSB (≥30 min) as well as physical activity, were evaluated using a tri-accelerometer. The differences in these parameters between baseline (summer) and follow-up (winter) were examined. Results: %CSB and %SB at baseline were 20.5 (4.0–60.9) and 54.0 ± 11.5, respectively. CSB was significantly increased (6.6%), and SB was also increased (5.1%) at follow-up compared with baseline. In addition, there were positive relationships between changes in CSB and SB, and body weight and body mass index. Conclusions: These results suggest that there were significant seasonal changes in CSB and SB in community-dwelling Japanese adults.

Download Full-text

Do Depressive Symptoms Shape Blacks’ Perceptions of Stress Over Time?

Innovation in Aging ◽

10.1093/geroni/igaa057.1901 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 573-573

Author(s):

DeAnnah Byrd ◽

Roland Thorpe ◽

Keith Whitfield

Keyword(s):

Mental Health ◽

Risk Factors ◽

Depressive Symptoms ◽

Cognitive Aging ◽

Community Dwelling ◽

Future Work ◽

The Impact ◽

Over Time ◽

Time Future

Abstract The established association between stress and depression is typically examined only in one direction and cross-sectionally. Data from the Baltimore Study of Black Aging-Patterns of Cognitive Aging was used to longitudinally examine the bi-directional relationships between (1) stress-depression and (2) depression-stress, and age as a modifier. The sample consisted of 602 community-dwelling Blacks, aged 48-92 years at baseline and 450 at follow-up 33 months later. While the stress-depression relationship was non-significant; the depression-stress was (b= 0.236, p< 0.000) and this association varied by age with the impact of baseline depression on changes in stress greatest among Blacks in their 60’s versus those in their 50’s (b= 0.257, p= 0.002), controlling for model covariates. Findings highlight the importance of depression in shaping Blacks’ perception of stress over time. Future work should continue to identify stress and mental health risk factors that contribute to poor health and health disparities in older Blacks.

Download Full-text

Prevalence of low protein intake in 80+-year-old community-dwelling adults and association with dietary patterns and modifiable risk factors: a cross-sectional study

British Journal Of Nutrition ◽

10.1017/s0007114521000799 ◽

2021 ◽

pp. 1-12

Author(s):

Sussi F. Buhl ◽

Anne M. Beck ◽

Britt Christensen ◽

Gry Kock ◽

Eleanor Boyle ◽

...

Keyword(s):

Risk Factors ◽

Dietary Patterns ◽

Protein Intake ◽

Cross Sectional Study ◽

Community Dwelling ◽

Modifiable Risk Factors ◽

Sectional Study ◽

Cross Sectional ◽

Mouth Dryness ◽

Low Protein

Abstract Low protein intake may accelerate age-related loss of lean mass and physical function. We investigated the prevalence of low protein intake (<1·0 g/kg/day) and the associations between dietary patterns, modifiable risk factors and low protein intake in self-reliant community-dwelling adults ≥ 80 years. This cross-sectional study consisted of two home visits. Data collection consisted of physical measurements (e.g. physical function, physical activity) and self-report of nutritional intake (4-d food records), appetite, eating symptoms and medical conditions. Binary analyses were performed to compare participants with low and normal protein intake. Multiple logistic regression analyses were performed to investigate associations between low protein intake, dietary patterns and modifiable risk factors adjusted for age, sex, BMI categories and diseases. One hundred twenty-six were included in the study. Prevalence of low protein intake was 54 %. A greater day-to-day variation in protein intake was associated with low protein intake (adjusted OR 2·5; 95 % CI 1·14, 5·48). Participants with low protein intake had a higher prevalence of nausea, diarrhoea and mouth dryness. Reduced appetite, mouth dryness and pain increased odds of low protein intake (adjusted OR 3·06, 95 % CI 1·23, 7·63; OR 3·41, 95 % CI 1·51, 7·7; OR 1·54, 95 % CI 1·00, 2·36, respectively). There was a high prevalence of low protein intake in community-dwelling adults aged ≥ 80 years. Day-to-day variability, appetite, mouth dryness and pain may be potentially modifiable risk factors. Targeting dietary patterns and risk factors in primary prevention strategies may potentially improve intake of protein and minimise risk of physical frailty.

Download Full-text

281Physical activity and subsequent frailty incidence among the community-dwelling older adults: results from JAGES ATTACH

International Journal of Epidemiology ◽

10.1093/ije/dyab168.758 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Wenjing Zhao ◽

Bei Pan ◽

Sachiko Sasaki ◽

Shigekazu Ukawa ◽

Emiko Okada ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Evaluation Study ◽

Community Dwelling ◽

Daily Lives ◽

The Impact ◽

Community Dwelling Older Adults ◽

Walking Time ◽

Activity Questionnaire

Abstract Background Previous studies reported that physical activity (PA) could prevent frailty, but the longitudinal evidence between PA volume and frailty is scarce. Additionally, the impact of daily walking time on the risk of frailty is unclear. This study aimed to examination the association of incident frailty with PA volume and daily walking time among Japanese community-dwelling older adults. Methods About 485 participants aged 70–74 years from the Japan Gerontological Evaluation Study were included in this study. Frailty was assessed at baseline and 3 years later by using the Kaigo-Yobo Checklist. PA was assessed using the short-term International Physical Activity Questionnaire. Logistic regression was performed to calculate relative risk (RR) with 95% confidence intervals (CIs) after adjusting for potential confounders. Results After 3 years of follow-up, 46 new frailty cases were recorded. The association of frailty incidence with both PA volume and daily walking time presented a U-shaped curve, albeit not statistically significant. After adjusting for potential confounding factors, walking for 0.5–1 h per day displayed a greater association with decreased frailty risk (RR, 0.35; 95% CI, 0.12–0.98) than higher levels of daily walking time. We did not observe an association between PA volume and subsequent frailty. Conclusions Walking for 0.5–1 hour/day significantly decreases frailty risk. Incorporating a moderate level of regular walking into the daily lives of older adults may postpone the onset of frailty and improve the ageing process. Further studies are needed to investigate the impact of higher PA levels on frailty risk.

Download Full-text

Changes in stroke rehabilitation during the SARS-CoV-2 shutdown in Switzerland

Journal of Rehabilitation Medicine ◽

10.2340/jrm.v53.1118 ◽

2021 ◽

Author(s):

Jeremia P. O. Held ◽

Anne Schwarz ◽

Johannes Pohl ◽

Eva Thürlimann ◽

Silvan Porrtmann ◽

...

Keyword(s):

Physical Activity ◽

Community Dwelling ◽

Outpatient Rehabilitation ◽

Stroke Survivors ◽

Post Stroke ◽

Neurological Functioning ◽

Observational Cohort ◽

The Impact

Introduction: Many stroke survivors require continuous outpatient rehabilitation therapy to maintain or improve their neurological functioning, independence, and quality of life. In Switzerland and many other countries, the shutdown to contain SARS-CoV-2 infections led to mobility restrictions and a decrease in therapy delivery. This study investigated the impact of the COVID-19 shutdown on stroke survivors’ access to therapy, physical activity, functioning and mood. Methods: A prospective observational cohort study in stroke subjects. At 4 time-points (before, during, after the shutdown, and at 3-month follow-up), the amount of therapy, physical activities, motor function, anxiety, and depression were assessed. Results: Thirty-six community-dwelling stroke subjects (median 70 years of age, 10 months post-stroke) were enrolled. Therapy reductions related to the shutdown were reported in 72% of subjects. This decrease was associated with significantly extended sedentary time and minimal deterioration in physical activity during the shutdown. Both parameters improved between reopening and 3-month follow-up. Depressive symptoms increased slightly during the observation period. Patients more frequently reported on self-directed training during shutdown. Conclusion: The COVID-19 shutdown had measurable immediate, but no persistent, effects on post-stroke outcomes, except for depression. Importantly, a 2-month reduction in therapy may trigger improvements when therapy is fully re-initiated thereafter.

Download Full-text