scholarly journals Frailty Phenotype and Healthcare Costs in Women in Late Life: The SOF study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 778-778
Author(s):  
Lisa Langsetmo ◽  
Allyson Kats ◽  
John Schousboe ◽  
Tien Vo ◽  
Brent Taylor ◽  
...  
Keyword(s):  
Healthcare Costs ◽  
Functional Limitations ◽  
Late Life ◽  
Cost Ratio ◽  
Deficit Accumulation ◽  
Frailty Phenotype ◽  
Medicare Claims ◽  
Accumulation Index ◽  
Direct Healthcare Costs ◽  
Frailty Indicator

Abstract We used data from 1324 women (mean age 83) at the 2002-2004 exam linked with their Medicare claims to determine the association of the frailty phenotype with healthcare costs. The frailty phenotype was categorized as robust, pre-frail or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims. Functional limitations were assessed by asking about difficulty performing IADL. Total direct healthcare costs were ascertained during 36 months following the exam. Compared with robust, pre-frailty and frailty were associated with higher costs after accounting for demographics, multimorbidity, functional limitations and the frailty indicator (cost ratio 1.37 [1.10-1.71] among pre-frail and 1.63 [1.28-2.08] among frail). Discrimination of high-cost (top decile) women was improved by adding the phenotype and functional limitations to a model containing demographics and the claims-based measures. Findings suggest that assessment of the phenotype may improve identification of individuals at higher risk of costly care.

scholarly journals Frailty Phenotype and Healthcare Costs in Older Community-Dwelling Men: The MrOS study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 778-778
Author(s):  
Kristine Ensrud ◽  
Allyson Kats ◽  
Lisa Lisa Langsetmo ◽  
Tien Vo ◽  
John Schousboe
Keyword(s):  
Healthcare Costs ◽  
Claims Data ◽  
Functional Limitations ◽  
Community Dwelling ◽  
Cost Ratio ◽  
Deficit Accumulation ◽  
Frailty Phenotype ◽  
Increased Risk ◽  
Accumulation Index ◽  
Frailty Indicator

Abstract To determine the association of the frailty phenotype with subsequent healthcare costs, we studied 1514 men (mean age 79.3 years) participating in the 2007-2009 exam linked with their Medicare claims data. The frailty phenotype (5 components) was categorized as robust, pre-frail or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims data. Functional limitations were assessed by asking about difficulty performing 5 IADL. Total direct healthcare costs were ascertained during 36 months following the exam. Mean annualized costs (2018 dollars) was $5707 among robust, $8964 among pre-frail and $20,027 among frail men. Compared with robust, pre-frailty and frailty were each associated with higher costs after accounting for demographics, multimorbidity, functional limitations and the frailty indicator (cost ratio 1.18 [1.02-1.36] among pre-frail and 1.87 [1.47-2.39] among frail). Findings suggest that assessment of the phenotype may improve identification of individuals at increased risk of costly care.

scholarly journals Vascular lesions and functional limitations among older adults: does depression make a difference?

2014 ◽  
Vol 26 (9) ◽  
pp. 1501-1509 ◽  
Author(s):  
Celia F. Hybels ◽  
Carl F. Pieper ◽  
Lawrence R. Landerman ◽  
Martha E. Payne ◽  
David C. Steffens
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
White Matter ◽  
Functional Impairment ◽  
Functional Limitations ◽  
Late Life ◽  
Cognitive Status ◽  
Cerebral White Matter ◽  
Late Life Depression ◽  
Increased Risk

ABSTRACTBackground:The association between disability and depression is complex, with disability well established as a correlate and consequence of late life depression. Studies in community samples report that greater volumes of cerebral white matter hyperintensities (WMHs) seen on brain imaging are linked with functional impairment. These vascular changes are also associated with late life depression, but it is not known if depression is a modifier in the relationship between cerebrovascular changes and functional impairment.Methods:The study sample was 237 older adults diagnosed with major depression and 140 never depressed comparison adults, with both groups assessed at study enrollment. The dependent variable was the number of limitations in basic activities of daily living (ADL), instrumental ADLs, and mobility tasks. The independent variable was the total volume of cerebral white matter lesions or hyperintensities assessed though magnetic resonance imaging.Results:In analyses controlling for age, sex, race, high blood pressure, and cognitive status, a greater volume of WMH was positively associated with the total number of functional limitations as well as the number of mobility limitations among those older adults with late life depression but not among those never depressed, suggesting the association between WMH volume and functional status differs in the presence of late life depression.Conclusions:These findings suggest older patients with both depression and vascular risk factors may be at an increased risk for functional decline, and may benefit from management of both cerebrovascular risk factors and depression.

scholarly journals WHICH ASPECTS OF HEALTH PREDICT LATE-LIFE SOCIAL INTEGRATION OVER TIME?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S618-S619
Author(s):  
Masahiro Toyama ◽  
Masahiro Toyama ◽  
Heather R Fuller
Keyword(s):  
Social Integration ◽  
Functional Limitations ◽  
Late Life ◽  
Subjective Health ◽  
Subjective Perception ◽  
Objective Health ◽  
Self Rated Health ◽  
Multiple Dimensions ◽  
Path Analyses ◽  
Over Time

Abstract Associations between late-life social integration and health have been found to be reciprocal. The present study focuses on the direction of health predicting social integration as it is not yet fully understood how different aspects of health may affect social integration. Using two-wave data from a community-based sample (N = 413, mean age 80 at baseline), the present study investigates whether depressive symptoms, chronic health conditions, functional limitations, and self-rated health independently predicted multiple dimensions of social integration over two years. The results of multiple regression and path analyses indicated that self-rated health was the most consistent predictor for social integration over time as the other health measures predicted no or fewer dimensions of social integration. Subjective perception of health appeared to have greater implications for social integration over time than more objective health symptoms/conditions. These findings highlight the important role of subjective health for maintaining late-life social integration.

scholarly journals 444Frailty status and all-cause mortality in the community-dwelling individuals: An umbrella review

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Carlene Britt ◽  
Sara Espinoza ◽  
Robyn Woods
Keyword(s):  
Systematic Reviews ◽  
Critical Appraisal ◽  
Frailty Index ◽  
Community Dwelling ◽  
Umbrella Review ◽  
Deficit Accumulation ◽  
Frailty Phenotype ◽  
Essential Information ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Frailty is increasingly recognised for its association with adverse health outcomes, including mortality. However, various measures are used to assess frailty, and the strength of association could vary depending on the specific definition used. This umbrella review aims to map which frailty scale can best predict the relationship between frailty and all-cause mortality among community-dwelling older people. Methods A protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched. Methodological quality was assessed using the JBI critical appraisal checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Results Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried's physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All of the systematic reviews found that frailty was significantly associated with all-cause mortality. Conclusion This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale. Key messages Frailty is associated with an increased risk of all-cause mortality in community-dwelling individuals signifying the importance of assessment in the primary healthcare setting.

scholarly journals Translational Modeling of Psychomotor Function in Normal and AD-Pathological Aging With Special Concerns on the Effects of Social Isolation

2021 ◽  
Vol 2 ◽  
Author(s):  
Lidia Castillo-Mariqueo ◽  
Lydia Giménez-Llort
Keyword(s):  
Social Isolation ◽  
Social Life ◽  
Functional Limitations ◽  
Social Contact ◽  
Physical Work ◽  
Motor Deficits ◽  
Psychomotor Function ◽  
Frailty Phenotype ◽  
One Year ◽  
Physical Resistance

One year after the start of the COVID-19 pandemic, its secondary impacts can be globally observed. Some of them result from physical distancing and severe social contact restrictions by policies still imposed to stop the fast spread of new variants of this infectious disease. People with Alzheimer's disease (AD) and other dementias can also be significantly affected by the reduction of their activity programs, the loss of partners, and social isolation. Searching for the closest translational scenario, the increased mortality rates in male 3xTg-AD mice modeling advanced stages of the disease can provide a scenario of “naturalistic isolation.” Our most recent work has shown its impact worsening AD-cognitive and emotional profiles, AD-brain asymmetry, and eliciting hyperactivity and bizarre behaviors. Here, we further investigated the psychomotor function through six different psychomotor analysis in a set of 13-month-old 3xTg-AD mice and their non-transgenic counterparts with normal aging. The subgroup of male 3xTg-AD mice that lost their partners lived alone for the last 2–3 months after 10 months of social life. AD's functional limitations were shown as increased physical frailty phenotype, poor or deficient psychomotor performance, including bizarre behavior, in variables involving information processing and decision-making (exploratory activity and spontaneous gait), that worsened with isolation. Paradoxical muscular strength and better motor performance (endurance and learning) was shown in variables related to physical work and found enhanced by isolation, in agreement with the hyperactivity and the appearance of bizarre behaviors previously reported. Despite the isolation, a delayed appearance of motor deficits related to physical resistance and tolerance to exercise was found in the 3xTg-AD mice, probably because of the interplay of hyperactivity and mortality/survivor bias. The translation of these results to the clinical setting offers a guide to generate flexible and personalized rehabilitation strategies adaptable to the restrictions of the COVID-19 pandemic.

scholarly journals Frailty Phenotype and Healthcare Costs and Utilization in Older Women

2018 ◽  
Vol 66 (7) ◽  
pp. 1276-1283 ◽  
Author(s):  
Kristine E. Ensrud ◽  
Allyson M. Kats ◽  
John T. Schousboe ◽  
Brent C. Taylor ◽  
Peggy M. Cawthon ◽  
...  
Keyword(s):  
Older Women ◽  
Healthcare Costs ◽  
Frailty Phenotype

MO545INSIDE ANEMIA OF CKD: ESTIMATING THE IMPACT OF POLICY INTERVENTIONS ON ANAEMIA OF CKD IN THE USA BY MICROSIMULATION MODELLING

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Lise Retat ◽  
Laura Webber ◽  
Juan Jose Garcia Sanchez ◽  
Claudia Cabrera ◽  
Susan Grandy ◽  
...  
Keyword(s):  
Healthcare Costs ◽  
Severe Anaemia ◽  
Service Planning ◽  
Microsimulation Model ◽  
Model Framework ◽  
The Us ◽  
The Usa ◽  
Direct Healthcare Costs ◽  
The Impact ◽  
Intervention Scenario

Abstract Background and Aims Anaemia is a common complication in patients with chronic kidney disease (CKD) and is associated with increased mortality, cardiovascular complications, reduced quality of life and increased use of healthcare resources. Mathematical modelling based on robust epidemiological and clinical data is a useful approach for predicting the future burden of disease and the impact of different intervention scenarios; this is important for health service planning. This analysis uses a microsimulation model, Inside ANEMIA of CKD, to predict the effects of a hypothetical intervention scenario that reduces the prevalence of anaemia of CKD on related healthcare costs in the USA from 2020 to 2025. Method A virtual cohort representing the US population was created within the Inside ANEMIA of CKD microsimulation model framework using demographics and epidemiological data drawn from the US Census Bureau, the Centers for Disease Control and Prevention, and the National Health and Nutrition Examination Survey. In the cohort, virtual individuals were ascribed an age–sex-stratified CKD status (defined by estimated glomerular filtration rate and albuminuria levels, as per international guidelines) and anaemia status (defined by haemoglobin level as mild, moderate or severe, as per WHO criteria) based on US prevalence data. Key comorbidities (type 2 diabetes, heart failure and hypertension) were also assigned, reflecting US-specific population statistics. Healthcare costs related to CKD and anaemia of CKD were taken from the published literature. The study modelled the effects on healthcare costs of a hypothetical intervention scenario in which the prevalence of moderate and severe anaemia is reduced by 20% per year from 2020 to 2025 compared with no intervention (baseline). In each scenario (i.e. intervention or baseline), the modelling analysis estimated healthcare costs related to CKD and anaemia (including inpatient, outpatient, pharmacy costs) for patients with moderate or severe anaemia of CKD. The model did not adjust for the potential costs of the intervention. Results Preliminary results predict that, with the hypothetical intervention, there could be 1.40 million fewer patients with moderate or severe anaemia of CKD in the USA in 2025 compared with no intervention (1.45 million versus 2.85 million). This represents a 49% reduction in cases of moderate or severe anaemia of CKD in 2025 with the intervention versus no intervention. The intervention is projected to lead to a reduction of approximately US$18 billion in annual direct healthcare costs in 2025 for patients with moderate or severe anaemia of CKD compared with no intervention (US$26 billion versus US$44 billion). Conclusion The Inside ANEMIA of CKD microsimulation model predicts that a hypothetical intervention which reduces the prevalence of moderate and severe anaemia of CKD would reduce direct healthcare costs. This suggests that interventions effective at reducing the prevalence of anaemia of CKD would help to reduce the economic burden on healthcare services.

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