Association Between Activity Diversity and Frailty in Community-Dwelling Older Japanese: A Cross-Sectional Study

Abstract In addition to intensity and quality, diversity of activity will be an important factor to explain health outcomes among older adults. Few studies, though, examined an association between activity diversity and health outcomes. This study aimed to examine the association between activity diversity and frailty among community-dwelling older Japanese. Participants were community-dwelling older adults who participated in a cohort study, the “Otassya-Kenshin” in 2018 . The participants were asked frequency of 20 daily activities, inside/outside chores, leisure activities with/without physically, direct/indirect contact with friends and so on, in a week and activity diversity score were calculated using the formula of Shannon’s entropy. Frailty was defined by the Japanese version of the Cardiovascular Health Study criteria. The difference in diversity score between frail and non frail were examined by t-test. Logistic regression analysis with covariates, age, sex, economic status, living alone, BMI, Mini-Mental State Examination, and IADL was adopted to find association between activity diversity score and presence of frailty. Of 652 participants (age: 72.8±6.3, women: 60.6%) analyzed, 27 (4.1%) were defined as frail. Frailty group revealed significantly lower activity diversity score than non-frailty group (0.66±0.11 vs 0.75±0.08, P<0.01). 0.2 point of decrease in diversity score increase 5 times chance of frailty after controlling covariates. We found significant relationship between activity diversity and health outcome among older subjects. The activity diversity may provide additional information to number or intensity of activity.

Download Full-text

Higher frailty burden in older adults with chronic constipation

BMC Gastroenterology ◽

10.1186/s12876-021-01684-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jihye Lim ◽

Hyungchul Park ◽

Heayon Lee ◽

Eunju Lee ◽

Danbi Lee ◽

...

Keyword(s):

Older Adults ◽

Chronic Constipation ◽

Cardiovascular Health ◽

Functional Constipation ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Geriatric Syndrome ◽

Frailty Phenotype ◽

Cross Sectional

Abstract Background Despite constipation being a common clinical condition in older adults, the clinical relevance of constipation related to frailty is less studied. Hence, we aimed to investigate the association between chronic constipation (CC) and frailty in older adults. Methods This is a cross-sectional analysis of a population-based, prospective cohort study of 1278 community-dwelling older adults in South Korea. We used the Rome criteria to identify patients with irritable bowel syndrome with predominant constipation (IBS-C) and functional constipation (FC). We investigated whether participants consistent with the criteria for IBS-C and FC had CC. Frailty was assessed using the Cardiovascular Health Study (CHS) frailty phenotype. Results In the study population with a mean age of 75.3 ± 6.3 years, 136 (10.7%) had CC. The participants with CC were older, had higher medication burdens, and had worse physical performances compared to those without CC (All P < .05). By association analysis, the prevalence of CC was associated with frailty by the CHS criteria (P < .001). The CHS frailty score was associated with the presence of CC by the univariate logistic regression analysis and the multivariate analysis adjusted for age, sex, and multimorbidity. Conclusions Frailty was associated with CC in community-dwelling older people, suggesting that constipation should be considered as an important geriatric syndrome in clinical practice concerning frail older adults.

Download Full-text

Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062931 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2931

Author(s):

Ryo Komatsu ◽

Koutatsu Nagai ◽

Yoko Hasegawa ◽

Kazuki Okuda ◽

Yuto Okinaka ◽

...

Keyword(s):

Older Adults ◽

Gait Speed ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Physical Frailty ◽

Cross Sectional ◽

Important Indicator ◽

Community Dwelling Older Adults ◽

Oral Frailty

This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22–4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73–0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.

Download Full-text

Association Between Erythrocyte Levels of n-3 Polyunsaturated Fatty Acids and Risk of Frailty in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa042 ◽

2020 ◽

Author(s):

Doyeon Kim ◽

Chang Won Won ◽

Yongsoon Park

Keyword(s):

Fatty Acids ◽

Cohort Study ◽

Polyunsaturated Fatty Acids ◽

Cardiovascular Health ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Cross Sectional ◽

Frailty Criterion ◽

Long Chain

Abstract Background Inflammation is a major risk factor for frailty, but n-3 polyunsaturated fatty acids (PUFA) has been suggested as an anti-inflammatory agent. The present study aimed to investigate the hypothesis that the higher erythrocyte levels of long-chain n-3 PUFA were associated with lower odds of frailty and frailty criterion. Methods Cross-sectional analysis from the Korean Frailty and Aging Cohort Study, a total of 1,435 people aged 70–84 years were included. Sex- and age-stratified community residents, drawn in urban and rural regions nationwide, were eligible for participation in the study. All participants were categorized as frail and nonfrail according to the Cardiovascular Health Study index. Results The likelihood of frailty was inversely associated with the erythrocyte levels of eicosapentaenoic acid (EPA; odds ratio [OR] per unit 0.33; 95% confidence interval [CI] 0.14–0.77; p for trend = .002) and docosahexaenoic acid (DHA; OR per unit 0.42; 95% CI 0.20–0.87; p for trend = .018). Among each frailty criterion, the likelihood of slow walking speed was associated with erythrocyte levels of EPA and DHA, and the likelihood of exhaustion was inversely associated with the erythrocyte levels of DHA. Conclusions The present study showed that the frailty and frailty criterion were significantly associated with lower erythrocyte levels of long-chain n-3 PUFA, suggesting that lower n-3 PUFA could be a marker for the risk of frailty.

Download Full-text

Association of Frailty With Recovery From Disability Among Community-Dwelling Older Adults: Results From Two Large U.S. Cohorts

The Journals of Gerontology Series A ◽

10.1093/gerona/gly080 ◽

2018 ◽

Vol 74 (4) ◽

pp. 575-581 ◽

Cited By ~ 8

Author(s):

Chenkai Wu ◽

Dae H Kim ◽

Qian-Li Xue ◽

David S H Lee ◽

Ravi Varadhan ◽

...

Keyword(s):

Older Adults ◽

Daily Living ◽

Cardiovascular Health ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Factors Affecting ◽

Frailty Assessment ◽

Community Dwelling Older Adults ◽

Retirement Study

Abstract Background Disability in activities of daily living (ADLs) is a dynamic process and transitions among different disability states are common. However, little is known about factors affecting recovery from disability. We examined the association between frailty and recovery from disability among nondisabled community-dwelling elders. Methods We studied 1,023 adults from the Cardiovascular Health Study (CHS) and 685 adults from the Health and Retirement Study (HRS), who were ≥65 years and had incident disability, defined as having difficulty in ≥1 ADL (dressing, eating, toileting, bathing, transferring, walking across a room). Disability recovery was defined as having no difficulty in any ADLs. Frailty was assessed by slowness, weakness, exhaustion, inactivity, and shrinking. Persons were classified as “nonfrail” (0 criteria), “prefrail” (1–2 criteria), or “frail” (3–5 criteria). Results In total, 539 (52.7%) CHS participants recovered from disability within 1 year. Almost two-thirds of nonfrail persons recovered, while less than two-fifths of the frail recovered. In the HRS, 234 (34.2%) participants recovered from disability within 2 years. Approximately half of the nonfrail recovered, while less than one-fifth of the frail recovered. After adjustment, prefrail and frail CHS participants were 16% and 36% less likely to recover than the nonfrail, respectively. In the HRS, frail persons had a 41% lower likelihood of recovery than the nonfrail. Conclusions Frailty is an independent predictor of poor recovery from disability among nondisabled older adults. These findings validate frailty as a marker of decreased resilience and may offer opportunities for individualized interventions and geriatric care based on frailty assessment.

Download Full-text

Eating patterns of community-dwelling older adults: The cardiovascular health study

Annals of Epidemiology ◽

10.1016/1047-2797(94)90076-0 ◽

1994 ◽

Vol 4 (5) ◽

pp. 404-415 ◽

Cited By ~ 23

Author(s):

Shiriki Kumanyika ◽

Grethe S Tell ◽

Lynn Shemanski ◽

Joseph Polak ◽

Peter J Savage

Keyword(s):

Older Adults ◽

Cardiovascular Health ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Eating Patterns ◽

Community Dwelling Older Adults

Download Full-text

Neighborhood Characteristics Are Associated with Racial and Gender Variation Among Walking in Older Adults: the Cardiovascular Health Study

Ethnicity & Disease ◽

10.18865/ed.26.1.17 ◽

2016 ◽

Vol 26 (1) ◽

pp. 17

Author(s):

Tingjian Yan ◽

Li-Jung Liang ◽

Stefanie Vassar ◽

Monica Cheung Katz ◽

Jose J. Escarce ◽

...

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

African Americans ◽

Cardiovascular Health ◽

Statistical Significance ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Neighborhood Socioeconomic Status ◽

And Gender

Objective: To examine variation by race and gender in the association between neighborhood socioeconomic status and walking among community-dwelling older adults.Design: Cross-sectional.Setting: Cardiovascular Health Study, a longitudinal population-based cohort.Participants: 4,849 adults aged >65 years.Measurements: Participants reported number of city blocks walked in the prior week. Neighborhood socioeconomic status (NSES) measured at the level of the census tract. Negative binominal regression models were constructed to test the association between NSES and blocks walked. In the fully adjusted models, we included two-way and three-way interaction terms among race, gender, and NSES. Results: In adjusted analyses, among White residents in the lowest NSES quartile (most disadvantaged), men walked 64% more than women (P<.001), while in the highest NSES (most advantaged), men walked 43% more than women (P<.001). Among African American residents in the lowest NSES quartile, men walked 196% more blocks than women (P<.001), while in the highest NSES, men walked 43% more blocks than women, but this did not reach statistical significance (P=.06). Conclusions: Female gender is more strongly associated with walking for African Americans than for Whites in low SES neighborhoods but had a similar association with walking for both African Americans and Whites in high SES neighborhoods. Ethn Dis. 2016;26(1):17-26; doi:10.18665/ed.26.1.17

Download Full-text

SECONDHAND SMOKE IS LINKED TO HIGHER RISK OF NON-CARDIOVASCULAR MORTALITY BUT NOT OF CARDIOVASCULAR MORTALITY IN COMMUNITY-DWELLING OLDER ADULTS: FINDINGS FROM CARDIOVASCULAR HEALTH STUDY (CHS)

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)32335-0 ◽

2018 ◽

Vol 71 (11) ◽

pp. A1794

Author(s):

Amiya Ahmed ◽

Evangelos Kanonidis ◽

Apostolos Tsimploulis ◽

Poonam Bhyan ◽

Phillip Lam ◽

...

Keyword(s):

Older Adults ◽

Cardiovascular Mortality ◽

Secondhand Smoke ◽

Cardiovascular Health ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Community Dwelling Older Adults

Download Full-text

Fibroblast Growth Factor 23, Bone Mineral Density, and Risk of Hip Fracture Among Older Adults: The Cardiovascular Health Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-1152 ◽

2013 ◽

Vol 98 (8) ◽

pp. 3323-3331 ◽

Cited By ~ 29

Author(s):

Anna Jovanovich ◽

Petra Bùžková ◽

Michel Chonchol ◽

John Robbins ◽

Howard A. Fink ◽

...

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Lumbar Spine ◽

Cardiovascular Health ◽

Fibroblast Growth Factor 23 ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Mineral Density ◽

Total Hip

Context: Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone that also inhibits calcitriol synthesis. Objective: Our objective was to evaluate the relationships of plasma FGF23 concentrations with bone mineral density (BMD) and hip fracture in community-dwelling older adults. Design and Setting: Linear regression and Cox proportional hazard models were used to examine the associations of plasma FGF23 concentrations with BMD and incident hip fracture, respectively. Analyses were also stratified by chronic kidney disease. Participants: Participants included 2008 women and 1329 men ≥65 years from the 1996 to 1997 Cardiovascular Health Study visit. Main Outcome Measures: Dual x-ray absorptiometry measured total hip (TH) and lumbar spine (LS) BMD in 1291 participants. Hip fracture incidence was assessed prospectively through June 30, 2008 by hospitalization records in all participants. Results: Women had higher plasma FGF23 concentrations than men (75 [56–107] vs 66 [interquartile range = 52–92] relative units/mL; P < .001). After adjustment, higher FGF23 concentrations were associated with greater total hip and lumbar spine BMD in men only (β per doubling of FGF23 = 0.02, with 95% confidence interval [CI] = 0.001–0.04 g/cm2, and 0.03 with 95% CI = 0.01–0.06 g/cm2). During 9.6 ± 5.1–11.0 years of follow-up, 328 hip fractures occurred. Higher FGF23 concentrations were not associated with hip fracture risk in women or men (adjusted hazard ratio = 0.95, with 95% CI = 0.78–1.15, and 1.09 with 95% CI = 0.82–1.46 per doubling of FGF23). Results did not differ by chronic kidney disease status (P > .4 for interactions). Conclusions: In this large prospective cohort of community-dwelling older adults, higher FGF23 concentrations were weakly associated with greater lumbar spine and total hip BMD but not with hip fracture risk.

Download Full-text