scholarly journals Attitudes to Ageing and Change in Frailty Status: The English Longitudinal Study of Ageing

Gerontology ◽  
2017 ◽  
Vol 64 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Catharine R. Gale ◽  
Cyrus Cooper

Background: Older people with more negative attitudes to ageing are at increased risk of several adverse outcomes, including decline in physical function and increased difficulties with activities of daily living. Objective: We investigated whether negative attitudes to ageing increase the risk of the onset or progression of frailty. Method: Participants were 3,505 men and women aged 60 years and over from the English Longitudinal Study of Ageing. They completed a 12-item questionnaire on attitudes to ageing. Exploratory factor analysis was used to examine the structure of these items, and a single factor was derived which we labelled “physical and psychological loss.” Frailty was assessed by the Fried phenotype of physical frailty at waves 2 and 4, and by a frailty index at waves 2-5. Results: Having a more positive attitude to ageing as regards “physical and psychological loss” was associated with a decreased risk of becoming physically frail or pre-frail at follow-up. For a standard deviation increment in score, the relative risk ratios (95% confidence interval), adjusted for age, sex and baseline level of physical frailty, were 0.86 (0.79, 0.94) for pre-frailty and 0.72 (0.63, 0.83) for frailty. Further adjustment for other potential confounding variables had only slight attenuating effects on these associations: multivariable-adjusted relative risk ratios were 0.89 (0.81, 0.98) for pre-frailty and 0.78 (0.68, 0.91) for frailty. Attitude to ageing was not associated with change in the frailty index over time after adjustment for potential confounding variables. Conclusion: Older people who have a more positive attitude to ageing are at reduced risk of becoming physically frail or pre-frail. Future research needs to replicate this finding and discover the underlying mechanisms. Attitude to ageing was not a risk factor for change in the more broadly defined frailty index.

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i7-i11
Author(s):  
K Davies ◽  
A Maharani ◽  
T Chandola ◽  
C Todd ◽  
N Pendleton

Abstract Introduction Ten percent of over 65 s and between a quarter and half of over 85 s are frail. Loneliness and social isolation are associated with increased falls, rates of hospitalisation and mortality. Lonely and socially isolated older adults may also be at risk of frailty. We examined the relationship between loneliness, social isolation and incident frailty among older adults in England longitudinally over 12 years. Methods The study sample are 9,171 older adults aged ≥50 years participating in a population representative longitudinal panel survey, the English Longitudinal Study of Ageing Waves 2–8. To define frailty across the biannual waves, we used the Frailty Index (FI), analysed continuously and into categories (FI ≤0.08 non-frail, 0.08–0.25 pre-frail and ≥ 0.25–1 frail). We used baseline (Wave 2): loneliness measure using the UCLA 3-item loneliness scale; social isolation measure using previously reported method (Banks et al. The Institute for Fiscal Studies. 2006.). Both were categorised into low/medium/high. To examine relationships, we used linear mixed methods modelling (for the continuous FI), and Cox proportional hazard model (for the categorical FI). Results Loneliness (β = 0.023; 95% CI = 0.022, 0.025) and social isolation (β = 0.007; 95% CI = 0.003, 0.010) were significantly associated with increased FI, after adjusting for cofounders (gender, age, marital status, smoking status and wealth). There was a 60% greater relative risk of belonging to the frail class with a medium loneliness score compared to low (HR = 1.570; 95% CI 1.492, 1.652) and a 160% greater relative risk with high loneliness score compared to low (HR = 2.621; 95% CI 2.488, 2.761). Although less pronounced, there was a 1% greater relative risk of developing frailty with a medium social isolation score compared to low (HR = 1.010, 95% CI 1.010, 1.197) and a 30% greater relative risk with high social isolation score compared to low (HR = 1.267; 95% CI 1.154, 1.390). Conclusions Our research indicates both loneliness and social isolation increase risk of developing frailty, expanding on previous evidence. This provides further support to the importance of understanding approaches to promote social inclusion of older adults.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
P. Zaninotto ◽  
Y. T. Huang ◽  
G. Di Gessa ◽  
J. Abell ◽  
C. Lassale ◽  
...  

Abstract Background Falls amongst older people are common; however, around 40% of falls could be preventable. Medications are known to increase the risk of falls in older adults. The debate about reducing the number of prescribed medications remains controversial, and more evidence is needed to understand the relationship between polypharmacy and fall-related hospital admissions. We examined the effect of polypharmacy on hospitalization due to a fall, using a large nationally representative sample of older adults. Methods Data from the English Longitudinal Study of Ageing (ELSA) were used. We included 6220 participants aged 50+ with valid data collected between 2012 and 2018.The main outcome measure was hospital admission due to a fall. Polypharmacy -the number of long-term prescription drugs- was the main exposure coded as: no medications, 1–4 medications, 5–9 medications (polypharmacy) and 10+ medications (heightened polypharmacy). Competing-risk regression analysis was used (with death as a potential competing risk), adjusted for common confounders, including multi-morbidity and fall risk-increasing drugs. Results The prevalence of people admitted to hospital due to a fall increased according to the number of medications taken, from 1.5% of falls for people reporting no medications, to 4.7% of falls among those taking 1–4 medications, 7.9% of falls among those with polypharmacy and 14.8% among those reporting heightened polypharmacy. Fully adjusted SHRs for hospitalization due to a fall among people who reported taking 1–4 medications, polypharmacy and heightened polypharmacy were 1.79 (1.18; 2.71), 1.75 (1.04; 2.95), and 3.19 (1.61; 6.32) respectively, compared with people who were not taking medications. Conclusions The risk of hospitalization due to a fall increased with polypharmacy. It is suggested that prescriptions in older people should be revised on a regular basis, and that the number of medications prescribed be kept to a minimum, in order to reduce the risk of fall-related hospital admissions.


2015 ◽  
Vol 44 (6) ◽  
pp. 938-942 ◽  
Author(s):  
Krisztina Mekli ◽  
Alan Marshall ◽  
James Nazroo ◽  
Bram Vanhoutte ◽  
Neil Pendleton

2020 ◽  
Author(s):  
SHA SHA ◽  
Xu Yuebin ◽  
Chen Lin

Abstract Background: previous literature has reported that loneliness is a strong predictor of frailty risk, yet less is known about the role of loneliness in frailty transition types. In this study, we examined whether and how loneliness is related to frailty transition among Chinese old people. Methods: our study used participants (aged>=60) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely and grouped into three levels: never, seldom, and often. FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.Results: greater loneliness at baseline reduced the possibility of remaining robust or prefrail physical frailty state after adjusting for confounding variables (3-year period: OR=0.78, p<0.001;6-year period: OR=0.84, p<0.05). Greater loneliness was associated with an increased risk of worsening physical frailty after years: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (p<0.01) after 3 years and 1.34 (p<0.001) after 6 years, adjusted for confounding variables. The association between loneliness and change in the frailty index differed in survey periods: often loneliness at baselines was found to reduce the possibility of participants remaining nonfrail (OR= 0.83, p<0.05) and increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, p<0.001; often loneliness: OR= 1.74, p<0.001) after 6 years. Besides, loneliness at baselines was significantly associated with frailty transition at follow-up among males, even after adjusting for all potential confounding variables. However, a similar association was not observed among females.Conclusion: old people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to suffer from frailty transition than female elderly in China.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S60-S60
Author(s):  
Jessica G Abell ◽  
Camille Lassale ◽  
Andrew Steptoe ◽  
G David Batty ◽  
Paola Zaninotto

Abstract Falls are the most frequent type of accidents among older people, with one in three people aged over 65 falling each year. Falls serious enough to result in hospital admission are especially problematic, since they can lead to an increased likelihood of future disability, loss of independence, and premature mortality. Understanding the factors that may determine the risk of experiencing a fall, which requires admission to hospital, is therefore an important priority. This paper seeks to examine this issue using Hospital Episode Statistics (HES) data – administrative data from English hospitals in the National Health Service (NHS). These data have recently been linked with the English Longitudinal Study of Ageing (ELSA). We examine the association between a range of predictors (demographic, social environment, physical and mental functioning) drawn from wave 4 of ELSA with the first occurrence of hospitalisation due to an accidental fall, identified using ICD-10 codes. Analysis using Cox regression suggest a range of factors are negatively associated with admission to hospital with diagnosis of a fall, such as living alone (HR=1.42; 95% CI: 1.19, 1.68), urinary incontinence (HR=1.33; 95% CI: 1.09, 1.61) and depressive symptoms (HR=1.50; 95% CI: 1.23, 1.82). High walking speed (HR=0.30; 95% CI: 0.23, 0.39) and good hand-grip strength (HR=0.97; 95% CI: 0.96, 0.98) were found to be protective. The prevention of serious falls amongst older people will require determinants to be identified and managed effectively by health and social care services.


Sign in / Sign up

Export Citation Format

Share Document