scholarly journals Definitions of Frailty in Qualitative Research: A Qualitative Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
Deborah A. Lekan ◽  
Susan K. Collins ◽  
Audai A. Hayajneh
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Qualitative Research ◽  
Objective Assessment ◽  
Subjective Assessment ◽  
Adverse Outcomes ◽  
Older Age ◽  
Future Research ◽  
Qualitative Systematic Review ◽  
Physical Limitations

The purpose of this qualitative systematic review was to examine how frailty was conceptually and operationally defined for participant inclusion in qualitative research focused on the lived experience of frailty in community-living frail older adults. Search of six electronic databases, 1994–2019, yielded 25 studies. Data collection involved extracting the definition of frailty from the study aim, background, literature review, methods, and sampling strategy in each research study. Quality appraisal indicated that 13 studies (52%) demonstrated potential researcher bias based on insufficient information about participant recruitment, sampling, and relationship between the researcher and participant. Content analysis and concept mapping were applied for data synthesis. Although frailty was generally defined as a multidimensional, biopsychosocial construct with loss of resilience and vulnerability to adverse outcomes, most studies defined the study population based on older age and physical impairments derived from subjective assessment by the researcher, a healthcare professional, or a family member. However, 13 studies (52%) used objective or performance-based quantitative measures to classify participant frailty. There was no consistency across studies in standardized measures or objective assessment of frailty. Synthesis of the findings yielded four themes: Time, Vulnerability, Loss, and Relationships. The predominance of older age and physical limitations as defining characteristics of frailty raises questions about whether participants were frail, since many older adults at advanced age and with physical limitations are not frail. Lack of clear criteria to classify frailty and reliance on subjective assessment introduces the risk for bias, threatens the validity and interpretation of findings, and hinders transferability of findings to other contexts. Clear frailty inclusion and exclusion criteria and a standardized approach in the reporting of how frailty is conceptually and operationally defined in study abstracts and the methodology used is necessary to facilitate dissemination and development of metasynthesis studies that aggregate qualitative research findings that can be used to inform future research and applications in clinical practice to improve healthcare.

scholarly journals How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Grainne Vavasour ◽  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Daniel Kelly
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Gait Speed ◽  
Outcome Measurement ◽  
Wearable Sensors ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Ageing Population ◽  
Application Development ◽  
Community Dwelling Older Adults

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

Perceptions of the Neighborhood Built Environment for Walking Behavior in Older Adults Living in Close Proximity

2020 ◽  
pp. 073346482097925
Author(s):  
Florian Herbolsheimer ◽  
Atiya Mahmood ◽  
Nadine Ungar ◽  
Yvonne L. Michael ◽  
Frank Oswald ◽  
...  
Keyword(s):  
Older Adults ◽  
Built Environment ◽  
Past Research ◽  
Subjective Assessment ◽  
Neighborhood Environment ◽  
Walking Behavior ◽  
Close Proximity ◽  
Physical Limitations ◽  
Pedestrian Infrastructure ◽  
Neighborhood Built Environment

Past research documents a discordance between perceived and objectively assessed neighborhood environmental features on walking behavior. Therefore, we examined differences in the perception of the same neighborhood built environment. Participants were grouped if they lived 400 m or closer to each other. The perception of the pedestrian infrastructure, neighborhood aesthetics, safety from crime, and safety from traffic was derived from a telephone survey from two North American metropolitan areas; 173 individuals were clustered into 42 groups. Older adults who walked for transport in their neighborhood experienced the same neighborhood as more walkable (β = .19; p = .011) with better pedestrian infrastructure (β = .16; p = .037). Older adults with physical limitations experienced the same neighborhood as less safe from crime (β = −.17; p = .030) and traffic (β = −.20; p = .009). The study supports the notion that individual behavior and physical restrictions alter the environment’s perception and explains part of the discordance between objective and subjective assessment of the neighborhood environment.

scholarly journals Towards a Gerontoludic Manifesto

2015 ◽  
Vol 36 (2) ◽  
pp. 112-120 ◽  
Author(s):  
Bob De Schutter ◽  
Vero Vanden Abeele
Keyword(s):  
Older Adults ◽  
Research And Development ◽  
Digital Games ◽  
Older Age ◽  
Age Related ◽  
Physical Limitations ◽  
Game Industry

Digital games have become an important part of the technoscape, not only for youngsters, but for players of all ages. Older adults are a large, currently still largely untapped market for innovative game research and development. However, the current discourse on games and ageing can largely be categorized into two themes. The first theme refers to digital games framed as a way for older adults to improve certain skills. The useful, pragmatic qualities, rather than the fun, hedonic aspects of games are emphasized. The second theme identifies the various age-related constraints that prevent older adults from playing. It focuses on the cognitive and physical limitations of older adults. Underlying both themes is a reductionist perspective on ageing as merely a process of decline and debilitation. In this article, we present a “gerontoludic” manifesto. Firstly, games should not be marketed solely as having the purpose of dealing with or mitigating age-related decline and focus on positive aspects of older age (adagio 1: growth over decline). Secondly, age-related adjustments should never interfere with the actual gameplay of the game (adagio 2: playfulness over usefulness). Finally, game researchers and game industry should put more efforts in understanding what differentiates elderly players, rather than seeing them as united in their age-related impairments (adagio 3: heterogeneity over unification). As this manifesto is a first step that needs further abutment by a wider community, we welcome debate and additions from game designers and researchers to further this manifesto and to move beyond ageism in games.  

A Meta-Study of Qualitative Research on Social Support Related to Physical Activity Among Older Adults

2020 ◽  
pp. 1-15
Author(s):  
L. Jayne Beselt ◽  
Michelle C. Patterson ◽  
Meghan H. McDonough ◽  
Jennifer Hewson ◽  
Scott MacKay
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
Qualitative Research ◽  
Well Being ◽  
Future Research ◽  
Physically Active ◽  
Supportive Behaviors ◽  
Study Methodology ◽  
Barriers And Challenges

Physical activity (PA) and social support have known benefits for the well-being and health of older adults, and social support is associated with PA behavior and positive affective experiences in PA contexts. The aim of this study was to synthesize qualitative research conducted on the experiences of social support related to PA among older adults (age ≥55 years). Following meta-study methodology, the authors searched nine databases and extracted information from 31 studies. Results were synthesized in terms of common themes and in light of theoretical and methodological perspectives used. The qualitative literature identifies supportive behaviors and social network outcomes which may be useful for informing how best to support older adults to be physically active. This literature rarely reflected the experiences of vulnerable populations, and future research should aim to further understand supportive behaviors which enable older adults to overcome barriers and challenges to being physically active.

scholarly journals Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport

2020 ◽  
Vol 54 (18) ◽  
pp. 1081-1088 ◽  
Author(s):  
Brady Green ◽  
Matthew N Bourne ◽  
Nicol van Dyk ◽  
Tania Pizzari
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Significant Risk ◽  
Older Age ◽  
Future Research ◽  
Hamstring Strain ◽  
Best Evidence Synthesis ◽  
History Of

ObjectiveTo systematically review risk factors for hamstring strain injury (HSI).DesignSystematic review update.Data sourcesDatabase searches: (1) inception to 2011 (original), and (2) 2011 to December 2018 (update). Citation tracking, manual reference and ahead of press searches.Eligibility criteria for selecting studiesStudies presenting prospective data evaluating factors associated with the risk of index and/or recurrent HSI.MethodSearch result screening and risk of bias assessment. A best evidence synthesis for each factor and meta-analysis, where possible, to determine the association with risk of HSI.ResultsThe 78 studies captured 8,319 total HSIs, including 967 recurrences, in 71,324 athletes. Older age (standardised mean difference=1.6, p=0.002), any history of HSI (risk ratio (RR)=2.7, p<0.001), a recent HSI (RR=4.8, p<0.001), previous anterior cruciate ligament (ACL) injury (RR=1.7, p=0.002) and previous calf strain injury (RR=1.5, p<0.001) were significant risk factors for HSI. From the best evidence synthesis, factors relating to sports performance and match play, running and hamstring strength were most consistently associated with HSI risk. The risk of recurrent HSI is best evaluated using clinical data and not the MRI characteristics of the index injury.Summary/conclusionOlder age and a history of HSI are the strongest risk factors for HSI. Future research may be directed towards exploring the interaction of risk factors and how these relationships fluctuate over time given the occurrence of index and recurrent HSI in sport is multifactorial.

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