scholarly journals 443Factors associated with frailty in a relatively healthy community-dwelling older adults

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Sara Espinoza ◽  
Anne Newman ◽  
Anne Murray ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
The United States ◽  
Community Dwelling ◽  
Study Cohort ◽  
Factors Associated ◽  
Frailty Status ◽  
Healthy Cohort ◽  
Trial Participants

Abstract Background Frailty is gaining importance as a predictor of disability and mortality in aged adults, and becoming frail poses a challenge for healthy aging. We investigated the prevalence and factors associated with pre-frail and frail status in a large study cohort of community-dwelling healthy older adults from Australia and the United States. Methods A total of 19,114 individuals (87% Australian and 56% women) aged 65 years or older enrolled in a primary prevention clinical trial were evaluated. Frailty status was classified using the modified Fried phenotype criteria comprising exhaustion, body mass index, grip strength, gait speed and physical activity. Prevalence and factors associated with frailty status (e.g., demographic characteristics and lifestyle factors) were reported using descriptive statistics along with a logistic regression model. Results At baseline, 39.0% (95% CI: 38.3, 39.7) of older trial participants were pre-frail and 2.2% (95% CI: 2.0, 2.4) were frail, respectively. Women were more likely to be frail (65.1% vs. 36.9%) and prefrail (58.0% vs. 42.0%) than men. Lower levels of education (<12 years), living alone, ethnic minorities, current smoking and past alcohol use were some of the factors which were common among frail or prefrail. Conclusions Despite being a relatively healthy cohort, more than one-third of the older trial participants were pre-frail, which was more prevalent among specific subgroups of individuals. This study emphasizes the high burden of the prefrailty status even among a healthy cohort of community-dwelling older people. Key messages The burden of prefrailty is high, even among a healthy cohort of older people in the communities.

scholarly journals Factors Associated with Frailty Status in Relatively Healthy Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 488-488
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Sara Espinoza ◽  
Anne Murray ◽  
Michael Ernst ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
The United States ◽  
Community Dwelling ◽  
Study Cohort ◽  
Factors Associated ◽  
Frailty Status ◽  
Healthy Cohort ◽  
Trial Participants

Abstract Frailty is gaining importance as a predictor of disability and mortality in older people, and becoming frail poses a challenge for healthy aging. We investigated the prevalence and factors associated with pre-frail and frail status in a large study cohort of community-dwelling healthy older adults from Australia and the United States. A total of 19,114 individuals (87% Australian and 56% women) aged 65 years or older enrolled in a primary prevention clinical trial were evaluated. Frailty status was classified using the modified Fried phenotype criteria comprising of exhaustion, body mass index, grip strength, gait speed and physical activity. Prevalence and factors associated with frailty status (e.g. demographic characteristics and lifestyle factors) were reported using descriptive statistics along with a logistic regression model. At baseline, 2.3 % (95% CI, 2.1-2.5) of older trial participants were frail and 39.2% (95% CI, 38.5-39.9) were pre-frail, respectively. Women were more likely to be frail (65.1% vs 36.9%) and prefrail (58.0% vs 42.0%) than men. Lower levels of education (<12 years), living alone, ethnic minorities, current smoking and past alcohol use were some of the factors which were common among frail or prefrail. Despite being a relatively healthy cohort, more than one-third of the older trial participants were pre-frail, which was more prevalent among specific subgroups of individuals. This study emphasizes the high burden of the prefrailty status even among an apparently healthy cohort of community-dwelling older people.

scholarly journals Digital Health Interventions for Healthy Aging: A Qualitative User Evaluation and Ethical Assessment

2020 ◽  
Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto Kressig ◽  
Tenzin Wangmo
Keyword(s):  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
Ethical Issues ◽  
Digital Health ◽  
Functional Independence ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Health Technologies ◽  
Community Dwelling Older Adults

Abstract BackgroundDigital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. AimThe aim of this study is to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. MethodFace-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. ResultsThree main themes and twelve sub-themes emerged. The three main themes revolved around the following thematic areas: favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. ConclusionsOur study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact also emerged as key considerations.

Factors associated with fear of falling in community-dwelling older adults with and without diabetes mellitus: Findings from the Frailty in Brazilian Older People Study (FIBRA-BR)

2017 ◽  
Vol 89 ◽  
pp. 103-111 ◽  
Author(s):  
Bruno de Souza Moreira ◽  
Rosana Ferreira Sampaio ◽  
Juliano Bergamaschine Mata Diz ◽  
Alessandra de Carvalho Bastone ◽  
Eduardo Ferriolli ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Older Adults ◽  
Older People ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Factors Associated ◽  
Community Dwelling Older Adults

scholarly journals Prospective GERiatric Observational (ProGERO) Study: Cohort Design and Preliminary Results

2020 ◽  
Author(s):  
Marcos Daniel Saraiva ◽  
Luís Fernando Rangel ◽  
Julia Lusis Lassance Cunha ◽  
Thereza Cristina Ariza Rotta ◽  
Christian Douradinho ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Hospital Admissions ◽  
Handgrip Strength ◽  
Academic Medical Center ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Charlson Comorbidity Index Score ◽  
Study Cohort ◽  
Demographic Changes

Abstract Background: The demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of older adults in Brazil, to collect data both on healthy aging and chronic diseases, and investigate characteristics associated with adverse outcomes in this population. Methods: The ProGERO study takes place in a geriatric outpatient clinic in the largest academic medical center in Latin America. We performed baseline health examinations in 2017 and will complete subsequent in-person visits every three years when new participants will also be recruited. We will use periodic telephone interviews to collect information on the outcomes of interest between in-person visits. The baseline evaluation included data on demographics, medical history, physical examination, and comprehensive geriatric assessment (CGA; including multimorbidity, medications, social support, functional status, cognition, depressive symptoms, nutritional status, pain assessment, frailty, gait speed, handgrip strength, and chair-stands test). We used a previously validated CGA-based model to rank participants according to mortality risk (low, medium, high). Our selected outcomes were falls, disability, health services utilization (emergency room visits and hospital admissions), institutionalization, and death. We will follow participants for at least ten years.Results: We included 1,336 participants with a mean age of 82±8 years old. Overall, 70% were women, 31% were frail, and 43% had a Charlson comorbidity index score ≥3. According to our CGA-based model, the incidence of death in one year varied significantly across categories (low-risk=0.6%; medium-risk=7.4%; high-risk=17.5%; P<0.001).Conclusion: The ProGERO study will provide detailed clinical data and explore the late-life trajectories of community-dwelling older patients during a follow-up period of at least 10 years. Moreover, the study will substantially contribute to new information on the predictors of healthy and pathological aging in older adults from LMICs.

scholarly journals A QUALITATIVE REVIEW OF OLDER ADULT PERSPECTIVES ON HEALTHY AGING IN THE CIRCUMPOLAR NORTH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S264-S265
Author(s):  
Britteny M Howell ◽  
Jennifer R Peterson
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Successful Aging ◽  
Healthy Aging ◽  
The United States ◽  
Community Dwelling ◽  
The Arctic ◽  
Cultural Research ◽  
Circumpolar North ◽  
Personal Resilience

Abstract Cross-cultural research has shown marked variation in health outcomes across the world’s older adult populations. Indeed, older adults in the Circumpolar North experience a variety of health disparities. Because aging is a biological process rooted in sociocultural context, there exists great variation in the ways older adults define and experience healthy, or “successful,” aging in their communities. The aim of this analysis was to synthesize qualitative research among older residents (aged 50+ years) in the Circumpolar North to identify a definition of healthy aging common in the region. The Circumpolar North is defined as the Arctic and subarctic regions of Canada, Finland, Denmark, Greenland & the Faroe Islands, Iceland, Norway, Russia, Sweden, and the United States. A thorough review was conducted across a variety of academic search databases for peer-reviewed, qualitative studies conducted among community-dwelling older adults. The search strategy initially identified 194 articles; 22 articles met the inclusion criteria. Included studies were coded and analyzed using Grounded Theory to examine underlying themes of healthy aging in the Circumpolar North. The findings reveal the importance older adults place on incorporating social, environmental, and personal resilience factors into multidimensional models of healthy aging. This research also highlights the need for increased translational research with populations in the Circumpolar North that are under-represented in the gerontological literature.

scholarly journals 90 The Effectiveness of Volunteer-Led Physical Activity Interventions in Improving Health Outcomes for Community-Dwelling Older People: A Systematic Review

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i30-i32
Author(s):  
S E R Lim ◽  
N J Cox ◽  
H C Roberts
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Older People ◽  
Health Outcomes ◽  
Grip Strength ◽  
Community Dwelling ◽  
Frailty Status ◽  
Community Dwelling Older People ◽  
Community Dwelling Older Adults

Abstract Introduction Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable. This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status.

Community-dwelling older adults' perceptions of dignity: core meanings, challenges, supports and opportunities

2013 ◽  
Vol 34 (8) ◽  
pp. 1292-1313 ◽  
Author(s):  
KATHY BLACK ◽  
DEBRA DOBBS
Keyword(s):  
Older Adults ◽  
Older People ◽  
The United States ◽  
Community Dwelling ◽  
Health Issues ◽  
Policy And Practice ◽  
Community Based ◽  
Self Identity ◽  
Community Dwelling Older Adults

ABSTRACTDignity is a universally important issue for all people, and particularly vital for older adults who face multiple losses associated with ageing. In the United States of America and beyond, the maintenance of dignity is a key aim of policy and service provision for older people. Yet surprisingly little research has been conducted into the meaning of dignity to community-based older adults in the context of everyday life. As life expectancy continues to increase worldwide, unprecedented numbers of people are living longer than ever before. The majority of older adults will face declining health and other factors that may impact dignity in the course of ageing in their communities. This paper reports on a study that explored older people's understandings and experiences of dignity through focus groups and a survey. Three key components of dignity are identified: autonomy, relational and self-identity. In addition, the paper discusses a range of factors that can facilitate or inhibit a sense of dignity for older people, including long-term health issues, sensory deficits and resilience to life events. Finally, the implications of these findings for policy and practice are considered in the context of American social structures and values.

scholarly journals Learning Together During a Pandemic Lockdown: Connecting Older Mentors with Nursing Students

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 951-951
Author(s):  
Alison Phinney ◽  
Frances Affleck
Keyword(s):  
Older Adults ◽  
Nursing Education ◽  
Nursing Students ◽  
Older People ◽  
Healthy Aging ◽  
Community Dwelling ◽  
Term Care ◽  
Undergraduate Nursing ◽  
Survey Results ◽  
The Impact

Abstract Nursing education tends to focus on complex clinical issues affecting older adults who are acutely ill or in long-term care. This creates challenges for educators wanting to expose students to a greater range of experience, including realities of healthy aging. Opportunities to do things differently were presented when an established undergraduate nursing course on complex aging care underwent significant adjustment in the early months of the COVID-19 pandemic. As the course was condensed and moved online and clinical sites closed, invitations were extended to community-dwelling older people who wanted to “help teach nursing students about aging”. The response was overwhelming; over nine days, 118 people (ages 65-94) volunteered to be mentors. Through weekly online/ phone conversations, each person guided their assigned student to learn about diverse experiences of aging. Post-survey results showed the impact of these conversations. Over 90% of mentors felt they had contributed in a meaningful way to student learning and would do it again and recommend it to others. 85% of students felt it was a meaningful experience, offering comments like: “I am more mindful of my assumptions now” and “I learned to approach interactions with older adults as a collaboration; we have so much to give each other”. These results provide a needed counterpoint to the predominant COVID discourse of older people as “isolated, helpless, and needy”. Students came to understand that older people were also “engaged, active, and contributing” and identified how this had changed their view of aging. Implications for nursing education are explored.

scholarly journals Examining Older Adults’ Perspectives on the Built Environment and Correlates of Healthy Aging in an American Age-Friendly Community

2020 ◽  
Vol 17 (19) ◽  
pp. 7056
Author(s):  
Kathy Black ◽  
Dylan J. Jester
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Population Aging ◽  
The United States ◽  
Community Dwelling ◽  
Public Health Action ◽  
Environmental Features ◽  
Outdoor Spaces ◽  
Health Related ◽  
Health Action

Population aging has led to an increased focus on the environmental context in which we age. While researchers have identified significant health benefits associated with built community features such as housing, transportation and outdoor spaces and buildings, less attention has focused on the correlates of healthy aging and other characteristics via the perspective of community-dwelling older adults. This study utilized cluster analysis to examine health-related subgroups of older adults (n = 598) in an age-friendly community located in the United States, of which nearly half of its residents are age 60 and older. Linear regression was used to associate the health clusters with perceptions of built environmental features and socio-demographics. Four distinct profiles were identified, with the greatest preference for housing and transportation found among those reporting poorer health compared to those reporting excellent health across multi-dimensional healthy aging measures. Perceptions on the importance of built environmental features were also found to vary by age, income and home accessibility status. Findings suggest that older adults’ perceptions about built environmental features differ across health and home status as well as age and income, underscoring opportunities for public health action to better reach and engage older adults by life-course trajectories in age-friendly communities.

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