scholarly journals Cognitive frailty in relation to adverse health outcomes independent of multimorbidity in Chinese older adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 908-909
Author(s):  
Zuyun Liu ◽  
Chen Chen ◽  
Juyoung Park ◽  
Chenkai Wu ◽  
Qian-Li Xue ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Health Outcomes ◽  
Healthy Aging ◽  
Physical Frailty ◽  
International Consensus ◽  
Cognitive Frailty ◽  
Chinese Older Adults ◽  
Adverse Health ◽  
Adverse Health Outcomes

Abstract Cognitive frailty was proposed in 2013 by an (I.A.N.A./I.A.G.G.) international consensus group; however, little is known about its status and associations with adverse health outcomes in China. The objectives of this study were to evaluate: 1) the associations of cognitive frailty with various health outcomes including disability, hospitalization, and death; 2) whether the associations differed by multimorbidity in Chinese older adults. We included 5113 Chinese older adults (aged 60+ years) who had baseline (2011 wave) cognition and physical frailty assessments and follow-up for 4 years from the China Health and Retirement Longitudinal Study. We found that about 16.0% had cognitive impairment; 6.7% had physical frailty; and 1.6% met criteria for cognitive frailty (having both cognitive impairment and physical frailty). Both cognitive impairment (odds ratios (ORs) range: 1.41 to 2.11) and physical frailty (ORs range: 1.51 to 2.43) were independently associated with basic activities of daily living (BADL), instrumental ADL (IADL), mobility disability, hospitalization, and death among participants without that corresponding outcome at baseline, even after accounting for covariates. Relative to participants who had normal cognition and were nonfrail, those with cognitive frailty had the highest risk for IADL disability (OR=3.40, 95% CI, 1.23–9.40) and death (OR=3.89, 95% CI, 2.25–6.47). We did not find significant interaction effects between cognitive frailty and multimorbidity (P for interactions>0.05). Overall, cognitive frailty was associated with disability and death, independent of multimorbidity. This highlights the importance of assessing cognitive frailty in the community to promote primary and secondary preventions for healthy aging.

scholarly journals Self-Reported Energy Trajectories Predict Adverse Health Outcomes in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 794-795
Author(s):  
Briana Sprague ◽  
Xiaonan Zhu ◽  
Rebecca Ehrenkranz ◽  
Qu Tian ◽  
Theresa Gmelin ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Mixed Models ◽  
Single Item ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Observational Cohort ◽  
Outcome Performance ◽  
Future Work ◽  
Mortality Hazard Ratio

Abstract Declining energy may indicate homeostatic dysregulation and predict adverse health outcomes. We hypothesized that declining energy would predict greater frailty (1-10), greater mortality, and faster mood (CES-D) and cognition (3MS) decline over time. This observational cohort studies included 2,443 older adults (mean age=74.6, 62.5% White, 47.8% men) from the Health ABC Study with up to eight years of data. Energy was assessed using a single-item question about prior month’s energy (baseline mean=6.7, SD=1.7, range=0–10, lower=less energy). We used linear mixed models to create energy change scores (mean=-.07 points/year, SD=.05, range=-0.32-0.21, negative=decreased energy). In regression models adjusting for baseline outcome performance and energy and demographics, declining energy predicted greater frailty (β=-2.72, 95%CI = -3.39,-2.06), greater mortality (hazard ratio=.07, p<.001), and faster CES-D (β=-.93, 95%CI=-1.10,-0.75) but not 3MS decline. Energy changes are easy to assess and predict clinically-relevant outcomes. Future work should consider mechanisms of declining energy on disability-related outcomes. Part of a symposium sponsored by Brain Interest Group.

scholarly journals Serious Fall Injury History and Adverse Health Outcomes After Initiating Hemodialysis Among Older U.S. Adults

2018 ◽  
Vol 73 (9) ◽  
pp. 1216-1221 ◽  
Author(s):  
C Barrett Bowling ◽  
Rasheeda K Hall ◽  
Anjali Khakharia ◽  
Harold A Franch ◽  
Laura C Plantinga
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Skilled Nursing Facility ◽  
Prognostic Significance ◽  
Dialysis Initiation ◽  
First Year ◽  
Prognostic Information ◽  
Fall Injury ◽  
Adverse Health ◽  
Adverse Health Outcomes

Abstract Background Although older adults with predialysis chronic kidney disease are at higher risk for falls, the prognostic significance of a serious fall injury prior to dialysis initiation has not been well described in the end-stage renal disease population. Methods We examined the association between a serious fall injury in the year prior to starting hemodialysis and adverse health outcomes in the year following dialysis initiation using a retrospective cohort study of U.S. Medicare beneficiaries ≥ 67 years old who initiated dialysis in 2010–2012. Serious fall injuries were defined using diagnostic codes for falls plus an injury (fracture, joint dislocation, or head injury). Health outcomes, defined as time-to-event variables within the first year of dialysis, included four outcomes: a subsequent serious fall injury, hospital admission, post-acute skilled nursing facility (SNF) utilization, and mortality. Results Among this cohort of 81,653 initiating hemodialysis, 2,958 (3.6%) patients had a serious fall injury in the year prior to hemodialysis initiation. In the first year of dialysis, 7.6% had a subsequent serious fall injury, 67.6% a hospitalization, 30.7% a SNF claim, and 26.1% died. Those with versus without a serious fall injury in the year prior to hemodialysis initiation were at higher risk (hazard ratio, 95% confidence interval) for a subsequent serious fall injury (2.65, 2.41–2.91), hospitalization (1.11, 1.06–1.16), SNF claim (1.40, 1.30–1.50), and death (1.14, 1.06–1.22). Conclusions For older adults initiating dialysis, a history of a serious fall injury may provide prognostic information to support decision making and establish expectations for life after dialysis initiation.

scholarly journals Underlying Vulnerabilities to the Cytokine Storm and Adverse COVID-19 Outcomes in the Aging Immune System

2020 ◽  
Author(s):  
Lolita S Nidadavolu ◽  
Jeremy D Walston
Keyword(s):  
Older Adults ◽  
Immune System ◽  
Chronic Disease ◽  
Health Outcomes ◽  
Innate Immune System ◽  
Innate Immune ◽  
Cytokine Storm ◽  
Adverse Health ◽  
Disease States ◽  
Adverse Health Outcomes

Abstract Older adults are far more vulnerable to adverse health outcomes and mortality after contracting COVID-19. There are likely multiple age-related biological, clinical, and environmental reasons for this increased risk, all of which are exacerbated by underlying age-associated changes to the immune system as well as increased prevalence of chronic disease states in older adults. Innate immune system overactivity, termed the cytokine storm, appears to be critical in the development of the worst consequences of COVID-19 infection. Pathophysiology suggests that viral stimulation of the innate immune system, augmented by inflammatory signals sent from dying cells, ramps up into a poorly controlled outpouring of inflammatory mediators. Other aging-related changes in cells such as senescence as well as higher prevalence of chronic disease states also likely ramp up inflammatory signaling. This in turn drives downstream pathophysiological changes to pulmonary, cardiovascular, skeletal muscle, and brain tissues that drive many of the adverse health outcomes observed in older adults. This article provides an overview of the underlying etiologies of innate immune system activation and adaptive immune system dysregulation in older adults and how they potentiate the consequences of the COVID-19-related cytokine storm, and possible uses of this knowledge to develop better risk assessment and treatment monitoring strategies.

Poor Social Network, Not Living Alone, Is Associated With Incidence of Adverse Health Outcomes in Older Adults

2019 ◽  
Vol 20 (11) ◽  
pp. 1438-1443 ◽  
Author(s):  
Ryota Sakurai ◽  
Hisashi Kawai ◽  
Hiroyuki Suzuki ◽  
Hunkyung Kim ◽  
Yutaka Watanabe ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Network ◽  
Health Outcomes ◽  
Living Alone ◽  
Adverse Health ◽  
Adverse Health Outcomes

scholarly journals Emergency Department Discharge Diagnosis and Adverse Health Outcomes in Older Adults

2009 ◽  
Vol 57 (10) ◽  
pp. 1856-1861 ◽  
Author(s):  
S. Nicole Hastings ◽  
Heather E. Whitson ◽  
Jama L. Purser ◽  
Richard J. Sloane ◽  
Kimberly S. Johnson
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Outcomes ◽  
Discharge Diagnosis ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Emergency Department Discharge
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