COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

AbstractBackgroundFrailty and multimorbidity have been suggested as risk factors for severe COVID-19 disease.AimsWe investigated whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19 in the UK Biobank.Methods502,640 participants aged 40-69 years at baseline (54-79 years at COVID-19 testing) were recruited across UK 2006-10. A modified assessment of frailty using Fried’s classification was generated from baseline data. COVID-19 test results (England) were available 16/03/2020-01/06/2020, mostly taken in hospital settings. Logistic regression was used to discern associations between frailty, multimorbidity and COVID-19 diagnoses, adjusting for sex, age, BMI, ethnicity, education, smoking and number of comorbidity groupings, comparing COVID-19 positive, COVID-19 negative and non-tested groups.Results4,510 participants were tested for COVID-19 (positive=1,326, negative=3,184). 497,996 participants were not tested. Compared to the non-tested group, after adjustment, COVID-19 positive participants were more likely to be frail (OR=1.3 [95% CI=1.1, 1.7]), report slow walking speed (OR=1.3 [1.1, 1.6]), report two or more falls in the past year (OR=1.3 [1.0, 1.5]) and be multimorbid (≥4 comorbidity groupings vs 0-1: OR=1.9 [1.5, 2.3]). However, similar strength of associations were apparent when comparing COVID-19 negative and non-tested groups. Furthermore, frailty and multimorbidity were not associated with COVID-19 diagnoses, when comparing COIVD-19 positive and COVID-19 negative participants.Discussion and conclusionsFrailty and multimorbidity do not appear to aid risk stratification, in terms of a positive versus negative results of COVID-19 testing. Investigation of the prognostic value of these markers for adverse clinical sequelae following COVID-19 disease is urgently needed.

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COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01653-6 ◽

2020 ◽

Vol 32 (9) ◽

pp. 1897-1905 ◽

Cited By ~ 5

Author(s):

S. J. Woolford ◽

S. D’Angelo ◽

E. M. Curtis ◽

C. M. Parsons ◽

K. A. Ward ◽

...

Keyword(s):

Prognostic Value ◽

Walking Speed ◽

Prospective Analysis ◽

Test Results ◽

Uk Biobank ◽

The Past ◽

Negative Results ◽

Slow Walking ◽

The Uk ◽

Slow Walking Speed

Abstract Background Frailty and multimorbidity have been suggested as risk factors for severe COVID-19 disease. Aims We investigated, in the UK Biobank, whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19. Methods 502,640 participants aged 40–69 years at baseline (54–79 years at COVID-19 testing) were recruited across UK during 2006–10. A modified assessment of frailty using Fried’s classification was generated from baseline data. COVID-19 test results (England) were available for 16/03/2020–01/06/2020, mostly taken in hospital settings. Logistic regression was used to discern associations between frailty, multimorbidity and COVID-19 diagnoses, after adjusting for sex, age, BMI, ethnicity, education, smoking and number of comorbidity groupings, comparing COVID-19 positive, COVID-19 negative and non-tested groups. Results 4510 participants were tested for COVID-19 (positive = 1326, negative = 3184). 497,996 participants were not tested. Compared to the non-tested group, after adjustment, COVID-19 positive participants were more likely to be frail (OR = 1.4 [95%CI = 1.1, 1.8]), report slow walking speed (OR = 1.3 [1.1, 1.6]), report two or more falls in the past year (OR = 1.3 [1.0, 1.5]) and be multimorbid (≥ 4 comorbidity groupings vs 0–1: OR = 1.9 [1.5, 2.3]). However, similar strength of associations were apparent when comparing COVID-19 negative and non-tested groups. However, frailty and multimorbidity were not associated with COVID-19 diagnoses, when comparing COVID-19 positive and COVID-19 negative participants. Discussion and conclusions Frailty and multimorbidity do not appear to aid risk stratification, in terms of positive versus negative results of COVID-19 testing. Investigation of the prognostic value of these markers for adverse clinical sequelae following COVID-19 disease is urgently needed.

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84 COVID-19 and Associations with Frailty and Multimorbidity: A Prospective Analysis of UK Biobank Participants

Age and Ageing ◽

10.1093/ageing/afab030.45 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

S J Woolford ◽

S D’Angelo ◽

E M Curtis ◽

C M Parsons ◽

K A Ward ◽

...

Keyword(s):

Prognostic Value ◽

Walking Speed ◽

Prospective Analysis ◽

Test Results ◽

Uk Biobank ◽

The Past ◽

Negative Results ◽

Slow Walking ◽

The Uk ◽

Slow Walking Speed

Abstract Introduction Frailty and multimorbidity have been suggested as risk factors for severe COVID-19 disease. We therefore investigated whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19 in the UK Biobank. Method 502,640 participants aged 40–69 years at baseline (54–79 years at COVID-19 testing) were recruited across UK 2006–10. A modified assessment of frailty using Fried’s classification was generated from baseline data. COVID-19 test results (England) were available 16/03/2020–01/06/2020, mostly taken in hospital settings. Logistic regression was used to discern associations between frailty, multimorbidity and COVID-19 diagnoses, adjusting for sex, age, BMI, ethnicity, education, smoking and number of comorbidity groupings, comparing COVID-19 positive, COVID-19 negative and non-tested groups. Results 4,510 participants were tested for COVID-19 (positive = 1,326, negative = 3,184). 497,996 participants were not tested. Compared to the non-tested group, after adjustment, COVID-19 positive participants were more likely to be frail (OR = 1.4 [95%CI = 1.1, 1.8]), report slow walking speed (OR = 1.3 [1.1, 1.6]), report two or more falls in the past year (OR = 1.3 [1.0, 1.5]) and be multimorbid (≥4 comorbidity groupings vs 0–1: OR = 1.9 [1.5, 2.3]). However, similar strength of associations were apparent when comparing COVID-19 negative and non-tested groups. Furthermore, frailty and multimorbidity were not associated with COVID-19 diagnoses, when comparing COVID-19 positive and COVID-19 negative participants. Conclusions Frailty and multimorbidity do not appear to aid risk stratification, in terms of a positive versus negative results of COVID-19 testing. Investigation of the prognostic value of these markers for adverse clinical sequelae following COVID-19 disease is urgently needed.

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COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

Innovation in Aging ◽

10.1093/geroni/igaa057.3435 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 938-938

Author(s):

Stephen Woolford ◽

Stefania D’Angelo ◽

Elizabeth Curtis ◽

Camille Parsons ◽

Elaine Dennison ◽

...

Keyword(s):

Prognostic Value ◽

Walking Speed ◽

Prospective Analysis ◽

Test Results ◽

Uk Biobank ◽

The Past ◽

Negative Results ◽

Slow Walking ◽

The Uk ◽

Slow Walking Speed

Abstract Frailty and multimorbidity, which are more prevalent in older people, have been suggested as risk factors for severe COVID-19 disease. We investigated whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19 in the UK Biobank. 502,640 participants aged 40-69 years at baseline (54-79 years at COVID-19 testing) were recruited across UK 2006-10. A modified assessment of frailty using Fried’s classification was generated from baseline data. COVID-19 test results (England) were available 16/03/2020-01/06/2020, mostly taken in hospital settings. Logistic regression was used to discern associations between frailty, multimorbidity and COVID-19 diagnoses, adjusting for sex, age, BMI, ethnicity, education, smoking and number of comorbidity groupings, comparing COVID-19 positive, COVID-19 negative and non-tested groups. 4,510 participants were tested for COVID-19 (positive=1,326, negative=3,184). 497,996 participants were not tested. Compared to the non-tested group, after adjustment, COVID-19 positive participants were more likely to be frail (OR=1.4 [95%CI=1.1, 1.8]), report slow walking speed (OR=1.3 [1.1, 1.6]), report two or more falls in the past year (OR=1.3 [1.0, 1.5]) and be multimorbid (≥4 comorbidity groupings vs 0-1: OR=1.9 [1.5, 2.3]). However, similar strength of associations were apparent when comparing COVID-19 negative and non-tested groups. Furthermore, frailty and multimorbidity were not associated with COVID-19 diagnoses, when comparing COVID-19 positive and COVID-19 negative participants. In conclusion, frailty and multimorbidity do not appear to aid risk stratification, in terms of a positive versus negative results of COVID-19 testing. Investigation of the prognostic value of these markers for adverse clinical sequelae following COVID-19 disease is urgently needed.

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Does the 1-year Decline in Walking Speed Predict Mortality Risk Beyond Current Walking Speed in Adults With Knee Osteoarthritis?

The Journal of Rheumatology ◽

10.3899/jrheum.200259 ◽

2020 ◽

pp. jrheum.200259

Author(s):

Hiral Master ◽

Tuhina Neogi ◽

Michael LaValley ◽

Louise M. Thoma ◽

Yuqing Zhang ◽

...

Keyword(s):

At Risk ◽

Knee Osteoarthritis ◽

Mortality Risk ◽

Walking Speed ◽

Cox Regression ◽

Knee Oa ◽

The Past ◽

Slow Walking ◽

Osteoarthritis Initiative ◽

Slow Walking Speed

Objective To investigate whether walking speed at 1 timepoint, decline over the past 12 months, or both predict mortality risk over 11 years in adults with, or at risk of, knee osteoarthritis (OA). Methods Using the data from the Osteoarthritis Initiative, we defined slow versus adequate walking speed as walking < 1.22 versus ≥ 1.22 m/s on a 20m walk test during the 12-month follow-up visit. We defined meaningful decline (yes/no) as slowing ≥ 0.08 m/s over the past year. At the 12-month visit, we classified adequate sustainers as those with adequate walking speed and no meaningful decline, slow sustainers as slow walking speed and no meaningful decline, adequate decliners as adequate walking speed and meaningful decline, and slow decliners as slow walking speed and meaningful decline. Mortality was recorded over 11 years. To examine the association of walking speed with mortality, HR and 95% CI were calculated using Cox regression, adjusted for potential confounders. Results Of 4229 participants in the analytic sample (58% female, age 62 ± 9 yrs, BMI 29 ± 5 kg/m2), 6% (n = 270) died over 11 years. Slow sustainers and slow decliners had 2-times increased mortality risk compared to adequate sustainers (HR 1.96, 95% CI 1.44–2.66 for slow sustainers, and HR 2.08, 95% CI 1.46–2.96 for slow decliners). Adequate decliners had 0.43 times the mortality risk compared with adequate sustainers (HR 0.57, 95% CI 0.32–1.01). Conclusion In adults with, or at risk of, knee OA, walking slower than 1.22 m/s in the present increased mortality risk, regardless of decline over the previous year.

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The Association of Vision, Hearing, and Dual-Sensory Loss with Walking Speed and Incident Slow Walking: Longitudinal and Time to Event Analyses in the Health and Retirement Study

Seminars in Hearing ◽

10.1055/s-0041-1726017 ◽

2021 ◽

Vol 42 (01) ◽

pp. 075-084

Author(s):

Ahmed F. Shakarchi ◽

Lama Assi ◽

Abhishek Gami ◽

Christina Kohn ◽

Joshua R. Ehrlich ◽

...

Keyword(s):

Walking Speed ◽

Linear Models ◽

Sensory Loss ◽

Health And Retirement Study ◽

Time To Event ◽

Slow Walking ◽

Public Health Challenges ◽

Nationally Representative ◽

Retirement Study ◽

Slow Walking Speed

AbstractWith the aging of the population, vision (VL), hearing (HL), and dual-sensory (DSL, concurrent VL and HL) loss will likely constitute important public health challenges. Walking speed is an indicator of functional status and is associated with mortality. Using the Health and Retirement Study, a nationally representative U.S. cohort, we analyzed the longitudinal relationship between sensory loss and walking speed. In multivariable mixed effects linear models, baseline walking speed was slower by 0.05 m/s (95% confidence interval [CI] = 0.04–0.07) for VL, 0.02 (95% CI = 0.003–0.03) for HL, and 0.07 (95% CI = 0.05–0.08) for DSL compared with those without sensory loss. Similar annual declines in walking speeds occurred in all groups. In time-to-event analyses, the risk of incident slow walking speed (walking speed < 0.6 m/s) was 43% (95% CI = 25–65%), 29% (95% CI = 13–48%), and 35% (95% CI = 13–61%) higher among those with VL, HL, and DSL respectively, relative to those without sensory loss. The risk of incident very slow walking speed (walking speed < 0.4 m/s) was significantly higher among those with HL and DSL relative to those without sensory loss, and significantly higher among those with DSL relative to those with VL or HL alone. Addressing sensory loss and teaching compensatory strategies may help mitigate the effect of sensory loss on walking speed.

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Relationship of an advanced glycation end product, plasma carboxymethyl-lysine, with slow walking speed in older adults: the InCHIANTI study

European Journal of Applied Physiology ◽

10.1007/s00421-009-1192-5 ◽

2009 ◽

Vol 108 (1) ◽

pp. 191-195 ◽

Cited By ~ 51

Author(s):

Richard D. Semba ◽

Stefania Bandinelli ◽

Kai Sun ◽

Jack M. Guralnik ◽

Luigi Ferrucci

Keyword(s):

Older Adults ◽

Walking Speed ◽

Advanced Glycation ◽

Advanced Glycation End Product ◽

Slow Walking ◽

Carboxymethyl Lysine ◽

Relationship Of ◽

Slow Walking Speed

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The effect of socioeconomic deprivation on the association between an extended measurement of unhealthy lifestyle factors and health outcomes: a prospective analysis of the UK Biobank cohort

The Lancet Public Health ◽

10.1016/s2468-2667(18)30200-7 ◽

2018 ◽

Vol 3 (12) ◽

pp. e576-e585 ◽

Cited By ~ 35

Author(s):

Hamish M E Foster ◽

Carlos A Celis-Morales ◽

Barbara I Nicholl ◽

Fanny Petermann-Rocha ◽

Jill P Pell ◽

...

Keyword(s):

Health Outcomes ◽

Lifestyle Factors ◽

Socioeconomic Deprivation ◽

Prospective Analysis ◽

Uk Biobank ◽

Unhealthy Lifestyle ◽

The Uk

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Associations between locomotive and non-locomotive physical activity and physical performance in older community-dwelling females with and without locomotive syndrome: a cross-sectional study

Journal of PHYSIOLOGICAL ANTHROPOLOGY ◽

10.1186/s40101-021-00268-8 ◽

2021 ◽

Vol 40 (1) ◽

Author(s):

Tomohiro Nishimura ◽

Atsushi Hagio ◽

Kanako Hamaguchi ◽

Toshiyuki Kurihara ◽

Motoyuki Iemitsu ◽

...

Keyword(s):

Physical Activity ◽

Walking Speed ◽

Cross Sectional Study ◽

Community Dwelling ◽

Step Test ◽

Locomotive Syndrome ◽

Sectional Study ◽

Cross Sectional ◽

Slow Walking ◽

Slow Walking Speed

Abstract Background Locomotive syndrome (LS) is a condition of reduced mobility due to a disorder of the locomotive system. Increasing moderate to vigorous physical activity (MVPA) has been recommended to prevent LS. However, to increase daily MVPA is difficult for older people with LS. The MVPA consists of not only locomotive activities such as walking but also non-locomotive activities such as household activities. The aim of this study was to examine the associations between locomotive/non-locomotive MVPA and physical performance in older females with and without LS. Methods Participants of this cross-sectional study were 143 older community-dwelling Japanese females. The participants were divided into two groups based on the results of the stand-up test: the normal group (NL) (n = 86) and the LS group (n = 57). Both the locomotive and non-locomotive PA seperately measured with its intensity. The intensity of physical activity (PA) was calculated as METs and classified as sedentary behavior (SB 1–1.5 metabolic equivalent tasks (METs)), low-intensity physical activity (LPA 1.6–2.9 METs), and MVPA (≥ 3 METs). For example, locomotive LPA is slow walking speed of 54 m/min, and locomotive MVPA is walking speed of 67 m/min. While non-locomotive LPA is office work and cooking, non-locomotive MVPA is housecleaning. Physical function was evaluated by handgrip strength, walking speed, and 2-step test. Results Walking speed, hand-grip strength, 2-step test, daily step counts, and all PA measurements were not significantly different between two groups. In the LS, locomotive MVPA (r = 0.293, p < 0.05) and total MVPA (r = 0.299, p < 0.05) was significantly correlated with walking speed, but not in the NL. Conclusions Walking speed was positively correlated with locomotive MVPA and total MVPA in the LS group, but not in NL group. This result suggests that slow walking speed in older people with LS occur in connection with lower locomotive MVPA and total MVPA.

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