scholarly journals Trajectories of frailty with aging: Coordinated analysis of five longitudinal studies

2022 ◽  
Author(s):  
Natalie D Jenkins ◽  
Emiel O Hoogendijk ◽  
Joshua J Armstrong ◽  
Nathan A Lewis ◽  
Janice M Ranson ◽  
...  
Keyword(s):  
Frailty Index ◽  
Potential Effect ◽  
Quadratic Growth ◽  
Future Research ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Growth Curve Models ◽  
Or Groups ◽  
The Mean ◽  
Design And Methods

Abstract Background and Objectives There is an urgent need to better understand frailty and it’s predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in five independent cohorts to evaluate longitudinal trajectories of frailty and the effect of three previously identified critical risk factors: sex, age, and education. Research Design and Methods We derived a frailty index (FI) for five cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term. Results Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the InCHIANTI cohort to 0.009 in the LASA. Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the HRS cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves. Discussion and Implications Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions.

Menstrual disorders and medical counseling among schoolgirls in South Egypt: a cross-sectional study

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Ahmed Arafa ◽  
Shaimaa Senosy
Keyword(s):  
Cross Sectional Study ◽  
Future Research ◽  
Menstrual Disorders ◽  
Cross Sectional ◽  
Facial Hair ◽  
Multi Stage ◽  
Medical Counseling ◽  
The Mean ◽  
Age Of Menarche ◽  
Self Administered Questionnaire

Abstract Background Menstrual disorders are common gynecological problems among adolescents, however, medical counseling for these disorders is not well documented in developing countries. Objectives This study aimed to assess medical counseling for menstrual disorders among schoolgirls in Beni-Suef city in South Egypt. Methods Using a multi-stage random sampling, a total of 970 preparatory schoolgirls were included in this study. We used a self-administered questionnaire to detect the premenstrual and menstrual disorders as reported by the schoolgirls during the previous 6 months. Medical counseling for the menstrual disorders and other demographic characteristics were also surveyed. Results The mean age of the schoolgirls was 15.4 ± 0.8 years, age of menarche 13.2 ± 1.1 years and menstrual flow days 5.0 ± 1.3. During the past 6 months, 19.4% of the schoolgirls reported medical counseling for at least one menstrual symptom. Dysmenorrhea (89.2%), premenstrual fatigue (32.4%) and headache (31.1%) were the most often reported symptoms. After adjustment for personal and gynecological characters, abdominal bloating [odds ratio (OR) 3.66; 95% confidence interval (CI) 2.18–6.17], flow days >4 (OR 1.73; 95% CI 1.21–2.47), acne flare (OR 1.42; 95% CI 1.01–1.99), dysuria (OR 2.09; 95% CI 1.35–3.22) and facial hair (OR 6.89; 95% CI 3.47–13.69) were associated significantly with a higher likelihood of medical counseling. Conclusion Menstrual disorders are highly prevalent among preparatory schoolgirls in Beni-Suef, however, there is a noticeable lack of the medical counseling for these disorders. Future research should focus on the barriers to medical counseling for menstrual disorders among adolescents.

scholarly journals Polypharmacy Is Significantly and Positively Associated with the Frailty Status Assessed Using the 5-Item FRAIL Scale, Cardiovascular Health Phenotypic Classification of Frailty Index, and Study of Osteoporotic Fractures Scale

2021 ◽  
Vol 10 (19) ◽  
pp. 4413
Author(s):  
Chi-Di Hung ◽  
Chen-Cheng Yang ◽  
Chun-Ying Lee ◽  
Stephen Chu-Sung Hu ◽  
Szu-Chia Chen ◽  
...  
Keyword(s):  
Cardiovascular Health ◽  
Frailty Index ◽  
Osteoporotic Fractures ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Future Research ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Phenotypic Classification

The aim of this study was to investigate the association between frailty and polypharmacy using three different frailty screening tools. This was a cross-sectional study of people aged ≥65 years. Participants were included and interviewed using questionnaires. Polypharmacy was defined as the daily use of eight or more pills. Frailty was assessed using a screening tool, including (1) the Fatigue, Resistance, Ambulation, Illness and Loss of Weight Index (5-item FRAIL scale), (2) the Cardiovascular Health Phenotypic Classification of Frailty (CHS_PCF) index (Fried’s Frailty Phenotype), and (3) the Study of Osteoporotic Fracture (SOF) scale. A total of 205 participants (mean age: 71.1 years; 53.7% female) fulfilled our inclusion criteria. The proportion of patients with polypharmacy was 14.1%. After adjustments were made for comorbidity or potential confounders, polypharmacy was associated with frailty on the 5-item FRAIL scale (adjusted odds ratio [aOR]: 9.12; 95% confidence interval [CI]: 3.6–23.16), CHS_PCF index (aOR: 8.98; 95% CI: 2.51–32.11), and SOF scale (aOR: 6.10; 95% CI: 1.47–25.3). Polypharmacy was associated with frailty using three frailty screening tools. Future research is required to further enhance our understanding of the risk of frailty among older adults.

scholarly journals A Frailty Index from Next-of-Kin Data: A Cross-Sectional Analysis from the Mexican Health and Aging Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Mario Ulises Pérez-Zepeda ◽  
Matteo Cesari ◽  
María Fernanda Carrillo-Vega ◽  
Guillermo Salinas-Escudero ◽  
Pamela Tella-Vega ◽  
...  
Keyword(s):  
Older Adults ◽  
Frailty Index ◽  
Community Dwelling ◽  
Next Of Kin ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Aging Study ◽  
The Mean ◽  
Number Of Visits ◽  
Sectional Analysis

Objectives. To construct a frailty index from next-of-kin information of the last year of life of community-dwelling 50 years old or older adults and test its association with health services utilization. Methods. Cross-sectional analysis from next-of-kin data available from the last wave of the Mexican Health and Aging Study (MHAS). Measurements. Along with descriptive statistics, the frailty index (FI) was tested in regression models to assess its association with adverse outcomes previous to death: number of hospitalized days in the previous year and number of visits to a physician in the previous year, in unadjusted and adjusted models. Results. From a total of 2,649 individuals the mean of age was 74.8 (±11.4) and 56.3% (n = 1,183) were women. The mean of the FI was of 0.279 (±SD 0.131, R = 0.0–0.738) and distribution was biased to the right. There was a significant association (p < 0.001) between the FI and number of hospitalized days (β = 45.7, 95% CI 36.1–55.4, p < 0.001) and for the number of visits to a physician (β = 25.93, 95% CI 19.27–32.6, p < 0.001) both models adjusted for age and sex. Conclusion. The FI constructed with next-of-kin data showed similar characteristics to similar indexes of older adults. It was independently associated with health care use.

scholarly journals Frailty and neuropathology in relation to dementia status: the Cambridge City over-75s Cohort study

2021 ◽  
pp. 1-9
Author(s):  
Lindsay Wallace ◽  
Sally Hunter ◽  
Olga Theou ◽  
Jane Fleming ◽  
Kenneth Rockwood ◽  
...  
Keyword(s):  
Cohort Study ◽  
Frailty Index ◽  
Population Attributable Fraction ◽  
Population Based ◽  
Attributable Fraction ◽  
Future Research ◽  
Time Of Death ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
People With Dementia

ABSTRACT Objective: To examine the relative contributions of frailty and neuropathology to dementia expression in a population-based cohort study. Design: Cross-sectional analysis of observational data. Setting: Population-representative clinicopathological cohort study. Participants: Adults aged 75+ recruited from general practice registries in Cambridge, UK, in 1985. Measurements: A 39-item frailty index and 15-item neuropathological index were used to operationalize frailty and neuropathology, respectively. Dementia status was ascertained by clinical consensus at time of death. Relationships were evaluated using logistic regression models in participants with autopsy records (n = 183). Model fit was assessed using change in deviance. Population attributable fraction for frailty was evaluated in relation to dementia incidence in a representative sample of the survey participants (n = 542). Results: Participants with autopsy were 92.3 ± 4.6 years at time of death, and mostly women (70%). Average frailty index value at last survey before death was 0.34 ± 0.16. People with dementia (63% of the sample) were frailer, had lower MMSE scores, and a higher burden of neuropathology. Frailty and neuropathological burden were significantly and independently associated with dementia status, without interaction; frailty explained an additional 3% of the variance in the model. Assuming a causal relationship and based on population-attributable fraction analyses, preventing severe frailty (Frailty Index ≥ 0.40) could have avoided 14.2% of dementia cases in this population-based cohort. Conclusions: In the very old, frailty contributes to the risk for dementia beyond its relationship with the burden of traditional dementia neuropathologies. Reducing frailty could have important implications for controlling the burden of dementia. Future research on frailty interventions should include dementia risk as a key outcome, public health interventions and policy decisions should consider frailty as a key risk factor for dementia, and biomedical research should focus on elucidating shared mechanisms of frailty and dementia development.

scholarly journals COVID-19 vaccine hesitancy in people with migratory backgrounds: a cross-sectional study among Turkish- and German-speaking citizens in Munich

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zekeriya Aktürk ◽  
Klaus Linde ◽  
Alexander Hapfelmeier ◽  
Raphael Kunisch ◽  
Antonius Schneider
Keyword(s):  
Cross Sectional Study ◽  
Vaccine Hesitancy ◽  
Chi Square ◽  
Cross Sectional ◽  
Or Groups ◽  
Migratory Background ◽  
German Speaking ◽  
The Mean ◽  
High Attitude ◽  
And Behavior

Abstract Background This study aimed to investigate the knowledge, attitudes, behaviors, and COVID-19 vaccine hesitancy of people with migratory backgrounds among Turkish- and German-speaking patients in Munich. Methods Primary outcomes were the intention to get vaccinated for COVID-19 and COVID-19 knowledge levels (25 true/false items). Other variables included demographics, attitudes to COVID-19 and vaccination (7 items), and behaviors regarding COVID-19 (7 items). The attitude and behavior questions had 5-point Likert scales. Of the 10 Turkish-speaking family physicians in Munich, six agreed to administer Turkish or German questionnaires to consecutive patients in February 2021. Furthermore, participants with either citizenship, country of origin, native language, or place of birth being non-German were categorized as “Having a migratory background.” Data from 420 respondents were analyzed. Results Women constituted 41.4% (n = 174), the mean age was 42.2 ± 15.5 years, 245 (58.3%) preferred the Turkish questionnaire, 348 (82.9%) had a migratory background, and 197 (47.9%) intended to be vaccinated. The mean knowledge, attitude, and behavioral scores were 21.5 ± 3.2 (max = 25), 3.7 ± 0.8 (max = 5), and 4.0 ± 0.5 (max = 5). While 42.3% (n = 145) of the participants with a migratory background considered getting vaccinated, this proportion was 76.5% (n = 52) for non-immigrant Germans (Chi-square = 26.818, p < 0.001). Non-migratory background (odds ratio (OR): 3.082), high attitude scores (OR: 2.877), male sex (OR: 2.185), years of schooling (OR: 1.064), and age (OR: 1.022) were positively associated with vaccination intention. Conclusions We suggest initiating or supporting projects run by persons or groups with immigrant backgrounds to attempt to elaborate and change their vaccination attitudes.

scholarly journals Psychological well-being among college students: A study from Central India

2022 ◽  
Vol 13 (1) ◽  
pp. 46-51
Author(s):  
Arvind Sharma ◽  
Tej Pratap Singh ◽  
Richa Sharma ◽  
Jagmohan Singh Dhakar ◽  
Aditi Bharti
Keyword(s):  
College Students ◽  
Internal Consistency ◽  
Central India ◽  
Well Being ◽  
Social Determinant ◽  
Future Research ◽  
Cross Sectional ◽  
Psychological Well Being ◽  
The Mean ◽  
The Impact

Background: Psychological well-being (PWB) is affected by age, physical health, personality, life experiences, socioeconomic status, and culture. Age is an important social determinant of health and age-based analysis is necessary to rectify one’s health and health care. Aims and Objectives: This study aims to assess the PWB of college students and to determine the correlation between age and PWB aspects. Materials and Methods: This cross-sectional study was conducted among 210 college students selected by simple random sampling. Ryff’s PWB scale, a 42-item version used for the assessment of PWB, and data were collected by self-administering questionnaires. Statistical Analysis: Internal consistency of the scale was estimated and descriptive statistics, independent samples t-test, and regression analysis were applied. Results: The mean age of the participants was 19.41±1.69 years and 61% were male. Cronbach’s alpha coefficient for internal consistency of Ryff’s PWB scale was 0.814 in this study. The mean of PWB was 205.42±11.04 and ≥20 years scored higher in all the parameters of PWB than <20 years, differences were (t=3.62, P=0.001) significant. Simple linear regression showed that age was a highly significant (P=0.002) predictor of PWB. Conclusion: The study illustrated that students of 20 years or more had better PWB in terms of all dimensions than <20 years-, and also suggested the need for future research, like, to deepen on the conceptual and relations between age and PWB, and to analyze the impact that social changes have toward age group on PWB.

scholarly journals COVID-19 Vaccine Hesitancy in People With Migratory Backgrounds: A Cross-Sectional Study Among Turkish- and German-Speaking Citizens in Munich

2021 ◽  
Author(s):  
Zekeriya Aktürk ◽  
Klaus Linde ◽  
Alexander Hapfelmeier ◽  
Raphael Kunisch ◽  
Antonius Schneider
Keyword(s):  
Cross Sectional Study ◽  
Vaccine Hesitancy ◽  
Chi Square ◽  
Cross Sectional ◽  
Or Groups ◽  
Migratory Background ◽  
German Speaking ◽  
The Mean ◽  
High Attitude ◽  
And Behavior

Abstract BackgroundThis study aimed to investigate the knowledge, attitudes, behaviors, and vaccine hesitancy of people with migratory backgrounds among Turkish- and German-speaking patients in Munich regarding the COVID-19 pandemic.MethodsPrimary outcomes were the intention to get vaccinated for COVID-19 and COVID-19 knowledge levels (25 true/false items). Other variables included demographics, attitudes to COVID-19 and vaccination (7 items), and behaviors regarding COVID-19 (7 items). The attitude and behavior questions had 5-point Likert scales. Of the 10 Turkish-speaking family physicians in Munich, 6 agreed to administer Turkish or German questionnaires to consecutive patients during February 2021. Participants with either citizenship, country of origin, native language, or place of birth being non-German were categorized as “Having a migratory background.” Data from 420 respondents were analyzed.ResultsWomen constituted 41.4% (n=174), the mean age was 42.2±15.5 years, 245 (58.3%) preferred the Turkish questionnaire, 348 (82.9%) had a migratory background, and 197 (47.9%) intended to be vaccinated. The mean knowledge, attitude, and behavior scores were 21.5±3.2 (max=25), 3.7±0.8 (max=5), and 4.0±0.5 (max=5). While 42.3% (n=145) of the participants with a migratory background considered getting vaccinated, this proportion was 76.5% (n=52) for non-immigrant Germans (Chi-square=26.818, p<0.001). Non-migratory background (Odds Ratio (OR): 3.082), high attitude scores (OR: 2.877), male sex (OR: 2.185), years of schooling (OR: 1.064), and age (OR: 1.022) were positively associated with vaccination intention.ConclusionsWe suggest initiating or supporting projects run by persons or groups from inside the immigrants targeting to elaborate and change their vaccination attitudes.

scholarly journals Canadian Home Total Parenteral Nutrition Registry: Preliminary Data on the Patient Population

2007 ◽  
Vol 21 (10) ◽  
pp. 643-648 ◽  
Author(s):  
Maitreyi Raman ◽  
Leah Gramlich ◽  
Scott Whittaker ◽  
Johane P Allard
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Population Sample ◽  
Intestinal Failure ◽  
Care Utilization ◽  
Future Research ◽  
Karnofsky Score ◽  
Cross Sectional ◽  
Primary Indication ◽  
The Mean

BACKGROUND: Long-term administration of home total parenteral nutrition (HTPN) has permitted patients with chronic intestinal failure to survive for prolonged periods of time. However, HTPN is associated with numerous complications, all of which increase morbidity and mortality. In Canada, a comprehensive review of the HTPN population has never been performed.OBJECTIVES: To report on the demographics, current HTPN practice and related complications in the Canadian HTPN population.METHODS: This was a cross-sectional study. Five HTPN programs in Canada participated. Patients’ data were entered by the programs’ TPN team into a Web site-based registry. A unique confidential record was created for each patient. Data were then downloaded into a Microsoft Excel (Microsoft Corp, USA) spreadsheet and imported into SPSS (SPSS Inc, USA) for statistical analysis.RESULTS: One hundred fifty patients were entered into the registry (37.9% men and 62.1% women). The mean (± SD) age was 53.0±14 years and the duration requiring HTPN was 70.1±78.1 months. The mean body mass index before the onset of HTPN was 19.8±5.0 kg/m2. The primary indication for HTPN was short bowel syndrome (60%) secondary to Crohn’s disease (51.1%), followed by mesenteric ischemia (23.9%). Complications: over one year, 62.7% of patients were hospitalized at least once, with 44% of hospitalizations related to TPN. In addition, 28.6% of patients had at least one catheter sepsis (double-lumen more than single-lumen; P=0.025) and 50% had at least one catheter change. Abnormal liver enzymes were documented in 27.4% of patients and metabolic bone disease in 60% of patients, and the mean Karnofsky score was 63.CONCLUSIONS: In the present population sample, the data suggest that HTPN is associated with significant complications and health care utilization. These results support the use of a Canadian HTPN registry to better define the HTPN population, and to monitor complications for quality assurance and future research.

scholarly journals 317Neighbourhood built and social environmental attributes associated with frailty among mid-to-older aged Australian adults

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Takumi Abe ◽  
Takemi Sugiyama ◽  
Alison Carver ◽  
Gavin Turrell
Keyword(s):  
Economic Status ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Future Research ◽  
Land Area ◽  
Cross Sectional ◽  
Environmental Attributes ◽  
Social Environmental ◽  
Intersection Density

Abstract Background Little is known about to what extent neighbourhood built and social environmental factors are associated with frailty among community-dwelling mid-to-older aged adults. Methods Participants of our cross-sectional study were adults aged 50-74 years residing in Brisbane, Australia. Frailty was assessed by a frailty index (FI), consisting of 32 items. Five built environmental attributes (population density, density of 4-way intersections, area of retail land, area of park land, and area of land for recreational facilities) and three social environmental attributes (safety, cohesion, and socio-economic status [SES]) were included. We performed multilevel logistic regression analysis to examine the associations between those attributes and frailty. Results Of 4,176 eligible participants (56.8% women), we found that 437 (10.5%) were frail (FI ≥ 0.35). After adjusting for potential confounders, one standard deviation (SD) increment in intersection density and retail land area was associated 26% (95%CI: 1.12, 1.41) and 18% (95%CI: 1.07, 1.30) higher odds of being frail, respectively. One SD increment in safety and area-level SES was associated with 24% (95%CI: 0.69, 0.84) and 30% (95%CI: 0.62, 0.79) lower odds of being frail. Conclusions This study found that mid-to-older aged adults with frailty are more likely to live in areas with higher intersection density, greater area of retail land, poorer safety, and higher levels of deprivation. Key messages There is spatial heterogeneity in the distribution of frailty. Future research should investigate behavioural mechanism for the distribution.

scholarly journals Alliance Between Therapist and Multi-stressed Families During the COVID-19 Pandemic: The Effect of Family-Based Videoconferencing

2021 ◽  
Author(s):  
Aurelie. M. C. Lange ◽  
Marc J. M. H. Delsing ◽  
Marieke van Geffen ◽  
Ron. H. J. Scholte
Keyword(s):  
Child Abuse ◽  
Multiple Testing ◽  
Future Research ◽  
Cross Sectional ◽  
Growth Curve Models ◽  
Face To Face ◽  
Family Based ◽  
And Gender ◽  
Analytical Approaches ◽  
Family Based Therapy

Abstract Background A strong therapeutic alliance or working relationship is essential for effective face-to-face family-based psychotherapy. However, little is known about the use of VC on alliance in family-based therapy. The recent COVID-19 pandemic led to a national lockdown during which most family-based therapy transferred to VC. Objective The current study analyzed the development and strength of alliance prior and during lockdown for multi-stressed families participating in Multisystemic Therapy (MST). Method Alliance with the therapist was reported monthly by 846 caregivers (81% female). Using latent growth curve models (longitudinal approach), the development of alliance was estimated for families participating in MST prior to the lockdown, transferring to VC early in treatment or late in treatment. Using regression analyses (cross-sectional approach), lockdown (yes/no) was included as predictor of alliance. In these analyses, type of family (regular; intellectual disability; concerns regarding child abuse or neglect) and gender of caregiver were included as moderators. Results Both analytical approaches showed that alliance was not affected by VC, except for families with concerns of child abuse, who reported lower alliances during lockdown. However, these results where no longer significant when controlling for multiple testing. Conclusions Strong alliances can be developed and maintained during family-based VC sessions with multi-stressed families. However, for some subgroups, such as families with concerns of child abuse, VC might not be suitable or sufficient. Future research needs to investigate the potential and limitations of using VC with families.

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