Dynapaenic obesity and its association with health outcomes in older adult populations: protocol for a systematic review

IntroductionTwo major global health challenges are the rapidly ageing population and the high prevalence of obesity in all age groups. Older adults are also susceptible to age-related loss of muscle strength, termed dynapaenia. The co-occurrence of both obesity and dynapaenia, termed dynapaenic obesity (DO), has been associated with poorer health outcomes and increased healthcare usage compared with either state alone. The purpose of this systematic review is to quantify the prevalence and incidence of DO in older adult populations, and to explore the association between DO and health outcomes, specifically chronic disease and multimorbidity, functional disability and healthcare usage.Methods and analysisUsing the Meta-analyses Of Observational Studies in Epidemiology guidelines, we will conduct a systematic review of cross-sectional and longitudinal observational studies of older adults, which include measures of DO and specified outcomes. Detailed literature searches of will be conducted using six electronic databases: Excerpta Medica dataBASE (EMBASE), PubMed, MEDLINE, SCOPUS, ScienceDirect and Cumulative Index of Nursing and Allied Health Complete (CINAHL), including articles published from database inception until Febuary 2019. The reference lists of included articles will also be searched. Two independent reviewers will undertake a three-step screening and review process using the Population, Risk Factor, Outcome framework to define eligibility. The Newcastle Ottawa Scale for non-randomised studies will be used to assess risk of bias and to rate study quality. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval is not required for this systematic review. Findings from this research will be submitted for peer-reviewed publication in academic journals, and presented at relevant academic conferences.PROSPERO registration numberCRD42018112471.

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Using structural equation modeling in the understanding of functional disability in older adults

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.4555.3451 ◽

2021 ◽

Vol 29 ◽

Author(s):

Darlene Mara dos Santos Tavares ◽

Nayara Gomes Nunes Oliveira ◽

Flavia Aparecida Dias Marmo ◽

Joilson Meneguci

Keyword(s):

Older Adults ◽

Sedentary Behavior ◽

Structural Equation ◽

Functional Disability ◽

Depressive Symptomatology ◽

Age Groups ◽

Community Dwelling ◽

Likelihood Method ◽

Equation Modeling ◽

Cross Sectional

Objective: to analyze functional disability and its associated factors among community-dwelling older adults. Method: a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. Results: the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. Conclusion: the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.

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Potential associated factors of functional disability in Chinese older inpatients: A multicenter cross-sectional study

10.21203/rs.2.21887/v1 ◽

2020 ◽

Author(s):

Hongpeng Liu ◽

Jing Jiao ◽

Chen Zhu ◽

Minglei Zhu ◽

Xianxiu Wen ◽

...

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Functional Disability ◽

Age Groups ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Older Inpatients ◽

Hospital Wards

Abstract Background: Older adults are vulnerable to a decline in physical functioning, including basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL). The causes of functional disability in older adults are multifactorial. A comprehensive understanding of these factors will contribute toward future health service planning. However, studies of ADL and IADL in Chinese older adults are insufficient. The aim of this study is to describe the level of ADL and IADL in different age groups and explore the factors associated with functional disability in Chinese older inpatients. Methods: We conducted a cross-sectional study consisted of 9,996 Chinese older inpatients aged 65 years and older. Participants were recruited from six provinces or municipality city in southwest (Sichuan province), northeast (Heilongjiang), south central (Hubei province), northern (Beijing municipality city), northwest (Qinghai province), and eastern China (Zhejiang province) from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale in consecutive intervals from 65 years of age. After controlling for the cluster effect of hospital wards, a mixed-effect generalized linear model was used to examine the association between functional disability and covariates. Results: The average ADL score was 27.68±4.59 and the mean IADL score 6.76±2.01 for all participants. A negative correlation between scores and age was observed, and there was a significant difference in ADL and IADL scores among different age groups. The top negatively influential factor in ADL and IADL was stair climbing and shopping, respectively. After controlling for the cluster effect of hospital wards, aging, emaciation, frailty, depression, falling accidents in past 12 months, hearing dysfunction, cognitive dysfunction, urinary dysfunction, and defecation dysfunction were associated with ADL and IADL. Patients transitioned from the emergency department and other hospitals were also affected by ADL disability. Former smoking was associated with lower IADL scores. Higher level of education, living in a building without elevators, and current alcohol consumption were correlated with better IADL performance. Conclusion: Decreased functional ability was associated with the increasing age. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care.

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Social support and depression among community dwelling older adults in Asia: a systematic review

BMJ Open ◽

10.1136/bmjopen-2018-026667 ◽

2019 ◽

Vol 9 (7) ◽

pp. e026667 ◽

Cited By ~ 15

Author(s):

Tengku Amatullah Madeehah Tengku Mohd ◽

Raudah Mohd Yunus ◽

Farizah Hairi ◽

Noran N Hairi ◽

Wan Yuen Choo

Keyword(s):

Social Support ◽

Systematic Review ◽

Older Adults ◽

Observational Studies ◽

Community Dwelling ◽

Eligibility Criteria ◽

Cross Sectional ◽

Support Measures ◽

Received Social Support ◽

Community Dwelling Older Adults

ObjectivesThis review aims to: (1) explore the social support measures in studies examining the association between social support and depression among community-dwelling older adults in Asia and (2) the evidence of association.DesignA systematic review was conducted using electronic databases of CINAHL, PubMed, PsychINFO, Psychology and Behavioural Sciences Collection, SocINDEX and Web of Science for articles published until the 11th of January 2018.Eligibility criteriaAll observational studies investigating the association between social support and depression among community-dwelling older adults in Asia were included.ParticipantsOlder adults aged 60 years and more who are living in the community.Exposure measuresSocial support.Outcome measuresDepression.ResultsWe retrieved16 356 records and screened 66 full-text articles. Twenty-four observational studies were included in the review. They consisted of five cohort studies and 19 cross-sectional studies. Social support was found to be measured by multiple components, most commonly through a combination of structural and functional constructs. Perceived social support is more commonly measured compared with received social support. Good overall social support, having a spouse or partner, living with family, having a large social network, having more contact with family and friends, having emotional and instrumental support, good support from family and satisfaction with social support are associated with less depressive symptoms among community-dwelling older adults in Asia.ConclusionsThere were 20 different social support measures and we applied a framework to allow for better comparability. Our findings emphasised the association between good social support and decrease depression among older adults. Compared with western populations, family support has a greater influence on depression among community-dwelling older adults in Asia. This indicates that the family institution needs to be incorporated into designed programmes and interventions when addressing depression in the Asian context.Trialregistration numberCRD42017074897.

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Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B6 and B12, with advancing older age: a systematic review

British Journal Of Nutrition ◽

10.1017/s0007114520004249 ◽

2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

N. Gillies ◽

D. Cameron-Smith ◽

S. Pundir ◽

C. R. Wall ◽

A. M. Milan

Keyword(s):

Systematic Review ◽

Older Adults ◽

Community Dwelling ◽

B Vitamins ◽

Cross Sectional ◽

Longitudinal Changes ◽

Dietary Adequacy ◽

Metabolism Regulation ◽

Age Related

Abstract Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).

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A systematic review of the impacts of intergenerational engagement on older adults’ cognitive, social, and health outcomes.

10.31234/osf.io/g6qh8 ◽

2021 ◽

Author(s):

Anna Krzeczkowska ◽

David Spalding ◽

William J. McGeown ◽

Alan J. Gow ◽

Michelle Carlson ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Randomised Controlled Trials ◽

Cognitive Outcomes ◽

Controlled Trials ◽

Ageing Population ◽

High Quality Research ◽

Age Attitudes ◽

Randomised Controlled

Background: Promoting older adults’ health and wellbeing via intergenerational engagement can help with the needs of an ageing population. This systematic review evaluated the impacts of intergenerational engagement on cognitive, social, and health outcomes in healthy older adults and older adults with mild cognitive impairment. Research Design and Methods: Comprehensive literature searches were undertaken, with records screened and filtered according to pre-registered criteria. Study quality was formally assessed, and a narrative synthesis produced from the extracted findings.Results: Forty-four studies were included in the review. Two out of five studies found significant intergenerational engagement effects on cognitive outcomes; 16 of 24 on social outcomes; and 21 of 30 on health-related outcomes. Only 11 studies fully met the criteria for high quality research, of which the majority (eight) focused on social outcomes.Discussion and Implications: This review has identified potential benefits of intergenerational engagement, most notably regarding anxiety, generativity, cross-age attitudes, and physical activity. However, only five included studies were randomised, controlled trials, therefore strong conclusions cannot yet be drawn. More research is required involving gold standard and comparable models, enabling wider implementation and generalisability, and randomised, controlled trials to provide the highest quality evidence.

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Epidemiology of Frequent/Urgent Urination in Older Adults in China: A Multicenter, Cross-Sectional Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.669070 ◽

2021 ◽

Vol 9 ◽

Author(s):

Yiwen Zhang ◽

Xiao-Dan Wang ◽

Yehua Song ◽

Ruiqiang Peng ◽

Ting Tang ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Well Being ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Chinese Older Adults ◽

Adult Men ◽

Age Related

Background: Frequent/urgent urination is an event of multifactorial origin where involuntary leakage of urine occurs. Epidemiological study of this condition is of high importance due to its negative impact on the psychological, physical, and social well-being of the victims.Objective: This cross-sectional study aimed to investigate the prevalence of frequent/urgent urination in older adults in China.Method: In this study, a face-to-face questionnaire survey was conducted between April 2019 and August 2019 among 4,796 older adult populations in the communities of Tianjin jizhou and Xiamen jimei of China. Descriptive analysis, univariate regression, and all statistics were conducted in IBM SPSS v22. The count data were analyzed by chi-square test. P < 0.05 was considered statistically significant.Results: In the total investigated population, the prevalence of frequent or urgent urination was found in 1,164 patients (24.3%) where 31.7% (664/2,097) were male patients and 18.7% (500/2,699) were female patients, having a male-to-female ratio of 1.7:1. The prevalence was higher in the 70- to 84-year-old group (men: 33.3–34.8%, women 19.5–20.8%), whereas it was relatively low in the 65- to 69-year-old group and in older adults over 85 years of age (men 28.8, 30.3%, women 16.7, 18.5%, respectively). In terms of the course of the disease, among the population aged 65 years and above, 17.3% men and 9.9% women had frequent urination/urgency lasting for 1–4 years; 5–9 years in about 4.5% population (7.4% men and 4.2% women); 10–19 years in 4.9% men and 2.3% women; and more than 20 years duration in 1.6% men and 1.9% women. On the severity scale, mild frequent/urgent urination was observed in 24.6% of men and 15.4% women of Chinese older adults. Moderate cases were observed in 6.3% of men and 2.9% of women, whereas severe cases were found in 0.8% men and 0.2% women. Benign prostatic hyperplasia (BPH)/hypertrophy was the main risk factor for frequent/urgent urination in Chinese older adult men (P < 0.001). Obesity, hypertension, diabetes, heart disease, anxiety, depression, constipation, and brain injury were the other risk factors for frequent/urgent urination in Chinese older adult men and women. The results of this survey showed that smoking or drinking habits did not increase the prevalence of frequent/urgent urination in Chinese older adults.Conclusions: According to the results of this survey, the prevalence rate of frequent/urgent urination is high, and the course of the disease is long in Chinese older adults. BPH and depression, anxiety, and age-related chronic diseases increase the risk of frequent/urgent urination in Chinese older adults.

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Enablers and barriers to the implementation of socially assistive humanoid robots in health and social care: a systematic review

BMJ Open ◽

10.1136/bmjopen-2019-033096 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033096 ◽

Cited By ~ 6

Author(s):

Irena Papadopoulos ◽

Christina Koulouglioti ◽

Runa Lazzarino ◽

Sheila Ali

Keyword(s):

Systematic Review ◽

Older Adults ◽

Social Care ◽

Assessment Tool ◽

Humanoid Robots ◽

Current Evidence ◽

Ageing Population ◽

Technical Problems ◽

Age Related ◽

Health And Social Care

ObjectivesSocially assistive humanoid robots are considered a promising technology to tackle the challenges in health and social care posed by the growth of the ageing population. The purpose of our study was to explore the current evidence on barriers and enablers for the implementation of humanoid robots in health and social care.DesignSystematic review of studies entailing hands-on interactions with a humanoid robot.SettingFrom April 2018 to June 2018, databases were searched using a combination of the same search terms for articles published during the last decade. Data collection was conducted by using theRayyansoftware, a standardised predefined grid, and a risk of bias and a quality assessment tool.ParticipantsPost-experimental data were collected and analysed for a total of 420 participants. Participants comprised: older adults (n=307) aged ≥60 years, with no or some degree of age-related cognitive impairment, residing either in residential care facilities or at their home; care home staff (n=106); and informal caregivers (n=7).Primary outcomesIdentification of enablers and barriers to the implementation of socially assistive humanoid robots in health and social care, and consequent insights and impact. Future developments to inform further research.ResultsTwelve studies met the eligibility criteria and were included. None of the selected studies had an experimental design; hence overall quality was low, with high risks of biases. Several studies had no comparator, no baseline, small samples, and self-reported measures only. Within this limited evidence base, the enablers found were enjoyment, usability, personalisation and familiarisation. Barriers were related to technical problems, to the robots’ limited capabilities and the negative preconceptions towards the use of robots in healthcare. Factors which produced mixed results were the robot’s human-like attributes, previous experience with technology and views of formal and informal carers.ConclusionsThe available evidence related to implementation factors of socially assistive humanoid robots for older adults is limited, mainly focusing on aspects at individual level, and exploring acceptance of this technology. Investigation of elements linked to the environment, organisation, societal and cultural milieu, policy and legal framework is necessary.PROSPERO registration numberCRD42018092866.

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Rhinoplasty in the Older Adult

Aesthetic Surgery Journal ◽

10.1093/asj/sjab140 ◽

2021 ◽

Author(s):

Sumun Khetpal ◽

Arvind U Gowda ◽

Yassmin Parsaei ◽

Mohammad Ali Mozaffari ◽

Jacob Dinis ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Soft Tissue ◽

Older Adult ◽

Retrospective Review ◽

Surgical Indications ◽

Institutional Review ◽

Age Related ◽

Primary Indication ◽

Post Traumatic

Abstract Background Rhinoplasty in older adults requires unique consideration of the ageing nose. The purpose of this study was to systematically review the literature pertaining to rhinoplasty in this population, review the senior author’s experience, and describe techniques aimed at addressing such features. Objectives We hypothesized consistent age-related nasal dysmorphology is described in the literature and standard rhinoplasty techniques may effectively address these changes. Furthermore, we hypothesized rhinoplasty is more commonly performed for post traumatic and functional indications than for aesthetic reasons. Methods A literature review including publications describing rhinoplasty in patients over 55 years old was conducted. Additionally, a retrospective review of the senior author’s cases was performed. Pre- and postoperative photographs were used to compare anthropometric changes. Demographic factors, surgical indications and operative details were collected. Results Nine articles met study criteria. Manifestations of the ageing nose included soft tissue atrophy, bony fragility and resorption, tip ptosis, internal and external valve collapse, and worsening dorsal hump. 27 patients were included in our institutional review. Primary indication for rhinoplasty was post-traumatic deformity in 17 (63%) patients and nasal obstructive symptoms in 10 (37%) patients. Tip refinement and ptosis were addressed through tip grafts (70%), columellar struts (26%), and caudal septal extension grafts (67%). Nasal obstruction was relieved through septoplasty (96%), turbinate ablation (85%), and spreader grafts (70%). Conclusions This study presents a systematic review of rhinoplasty in the older adult as well as a retrospective review of the senior author’s patients. Unique considerations specific to this population should be integrated into treatment planning.

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Light-intensity physical activity and mental ill health: a systematic review of observational studies in the general population

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01196-7 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Mireia Felez-Nobrega ◽

Judit Bort-Roig ◽

Ruimin Ma ◽

Eugenia Romano ◽

Matthew Faires ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Systematic Review ◽

General Population ◽

Observational Studies ◽

Age Groups ◽

Cross Sectional ◽

Intensity Physical Activity ◽

The Relationship

Abstract Background Most of theevidence has focused on examining the influence of moderate-to-vigorous intensity physical activity on mental health, but he role of light intensity physical activity (LIPA) is less understood. The purpose of this systematic review was to assess the relationship between time spent in LIPA and mental ill health across the lifespan. Methods Data were obtained from online databases (Medline, Embase, Scopus, PsychInfo and CINAHL). The search and collection of eligible studies was conducted up to May 28, 2020. Observational studies conducted in the general population and reporting on the association between LIPA (1.6–2.9 metabolic equivalents; either self-reported or device-based measured) and mental ill health were included. Results Twenty-two studies were included in the review (16 cross-sectional and 6 longitudinal). In older adults (≥ 65 years) and adults (18–64 years), the evidence examining the relationship between LIPA and depressive symptoms is mixed. Data on anxiety, psychological distress and overall mental health are scarce, and results are inconclusive. There is no evidence suggesting favorable associations between LIPA and anxiety in college students. Finally, very limited data was found in adolescents (11–17 years) (n = 2 studies) and children (6–10 years) (n = 2 studies), but the evidence suggests that LIPA does not influence mental health outcomes in these age groups. Conclusions This review provided mostly cross-sectional evidence indicating that LIPA may not be associated with mental health outcomes across age groups. Future research efforts employing prospective research designs are warranted to better understand the role of LIPA on mental ill health across age groups.

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Frailty in people with rheumatoid arthritis: a systematic review of observational studies

Wellcome Open Research ◽

10.12688/wellcomeopenres.17208.1 ◽

2021 ◽

Vol 6 ◽

pp. 244

Author(s):

Peter Hanlon ◽

Holly Morrison ◽

Fraser Morton ◽

Bhautesh D Jani ◽

Stefan Siebert ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Clinical Outcomes ◽

Observational Studies ◽

Osteoporotic Fractures ◽

Frailty Phenotype ◽

Cross Sectional ◽

Age Related ◽

The Impact ◽

The Relationship

Background: Frailty, an age-related decline in physiological reserve, is an increasingly important concept in the management of chronic diseases. The implications of frailty in people with rheumatoid arthritis are not well understood. We undertook a systematic review to assess the prevalence of frailty in people with rheumatoid arthritis, and the relationship between frailty and clinical outcomes. Methods: We searched three electronic databases (January 2001 to April 2021) for observational studies assessing the prevalence of frailty in adults (≥18 years) with rheumatoid arthritis, or analysing the relationship between frailty and clinical outcomes in the context of rheumatoid arthritis. Titles, abstracts and full texts were assessed independently by two reviewers. Study quality was assessed using an adapted Newcastle-Ottawa Scale. Results: We identified 17 analyses, from 14 different sample populations. 15/17 were cross-sectional. These studies used 11 different measures of frailty. Frailty prevalence ranged from 10% (frailty phenotype) to 36% (comprehensive rheumatologic assessment of frailty) in general adult populations with rheumatoid arthritis. In younger populations (<60 or <65 years) prevalence ranged from 2.4% (frailty phenotype) to 19.9% (Kihon checklist) while in older populations (>60 or >65) prevalence ranged from 31.2% (Kihon checklist) to 55% (Geriatric 8 tool). Frailty was associated with higher disease activity (10/10 studies), lower physical function (7/7 studies), longer disease duration (2/5 studies), hospitalization (1/1 study) and osteoporotic fractures (1/1 study). Conclusion: Our review found that frailty is common in adults with rheumatoid arthritis, including those aged <65 years, and is associated with a range of adverse features. However, these is substantial heterogeneity in how frailty is measured in rheumatoid arthritis. We found a lack of longitudinal studies making the impact of frailty on clinical outcomes over time and the extent to which frailty is caused by rheumatoid arthritis unclear.

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