Abstract P411: Longitudinal Association Between Frailty and Arterial Stiffness in Community-dwelling Older Adults: The Atherosclerosis Risk in Communities Study

Introduction: Frailty is predictive of cardiovascular disease and is suggested to co-occur with arterial stiffening, the hallmark of vascular aging. However, the temporal relationship is uncertain. Using the ARIC study, we examine the association of baseline frailty with cross-sectional and 5-year change in carotid-femoral pulse wave velocity (cfPWV) in older adults. Methods: Participants at visit 5 (2011-2013) were classified as frail (≥3 criteria), prefrail (1-2 criteria), or robust using the Fried frailty phenotype criteria (unintentional weight loss, exhaustion, grip strength, slow walking speed, and low physical activity). We measured cfPWV at visits 5 and 6/7 (2016-2019). We used linear regression with inverse-probability of attrition weights to estimate the association between frailty and 5-year change in cfPWV while accounting for loss-to-follow-up among survivors. Models were adjusted for age, sex, race-center, mean arterial pressure, height, heart rate, smoking, and time between visits. Results: Of 5,096 participants at visit 5 (58% female, 21% black, mean age 75 [SD 5.1] years), 296 (6%) were frail and 2403 (47%) prefrail. In adjusted analyses at visit 5, frail participants had 30 cm/s (95% CI: -9, 69; p=0.1) higher cfPWV and prefrail participants had 12 cm/s (95% CI: -5, 30; p=0.2) higher cfPWV than those classified as robust (Table 1). In longitudinal analyses adjusted for attrition, we observed a 3 cm/s (95% CI: -11, 19; p=0.6) and 6 cm/s (95% CI: 0, 12; p=0.05) greater annualized increase in cfPWV over ~5 years among frail and prefrail participants, respectively, relative to the rate of arterial stiffening among robust participants (26 cm/s per year). Conclusions: Compared to robust older adults, greater aortic stiffness was observed among frail community-dwelling adults. Changes in aortic stiffening over the course of 5 years were not materially influenced by frailty status at baseline. Frail older adults may present with greater arterial aging and its associated hemodynamic effects on target organs.

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Dairy Product Intake and Long-Term Risk for Frailty among French Elderly Community Dwellers

Nutrients ◽

10.3390/nu13072151 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2151

Author(s):

Berna Rahi ◽

Hermine Pellay ◽

Virginie Chuy ◽

Catherine Helmer ◽

Cecilia Samieri ◽

...

Keyword(s):

Older Adults ◽

Dairy Product ◽

Food Group ◽

Community Dwelling ◽

Physical Frailty ◽

Frailty Phenotype ◽

Cross Sectional ◽

Sectional Analysis ◽

Community Dwelling Older Adults

Dairy products (DP) are part of a food group that may contribute to the prevention of physical frailty. We aimed to investigate DP exposure, including total DP, milk, fresh DP and cheese, and their cross-sectional and prospective associations with physical frailty in community-dwelling older adults. The cross-sectional analysis was carried out on 1490 participants from the Three-City Bordeaux cohort. The 10-year frailty risk was examined in 823 initially non-frail participants. A food frequency questionnaire was used to assess DP exposure. Physical frailty was defined as the presence of at least 3 out of 5 criteria of the frailty phenotype: weight loss, exhaustion, slowness, weakness, and low physical activity. Among others, diet quality and protein intake were considered as confounders. The baseline mean age of participants was 74.1 y and 61% were females. Frailty prevalence and incidence were 4.2% and 18.2%, respectively. No significant associations were observed between consumption of total DP or DP sub-types and frailty prevalence or incidence (OR = 1.40, 95%CI 0.65–3.01 and OR = 1.75, 95%CI 0.42–1.32, for a total DP consumption >4 times/d, respectively). Despite the absence of beneficial associations of higher DP consumption on frailty, older adults are encouraged to follow the national recommendations regarding DP.

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Is there an association between ageist attitudes and frailty?

BMC Geriatrics ◽

10.1186/s12877-019-1357-y ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Douglas Salguero ◽

Juliana Ferri-Guerra ◽

Nadeem Y. Mohammed ◽

Dhanya Baskaran ◽

Raquel Aparicio-Ugarriza ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Multinomial Logistic Regression ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Outcome Variable ◽

Cross Sectional ◽

Logistic Regression Models ◽

Frailty Status

Abstract Background Frailty is defined as a state of vulnerability to stressors that is associated with higher morbidity, mortality and healthcare utilization in older adults. Ageism is “a process of systematic stereotyping and discrimination against people because they are old.” Explicit biases involve deliberate or conscious controls, while implicit bias involve unconscious processes. Multiple studies show that self-directed ageism is a risk factor for increased morbidity and mortality. The purpose of this study was to determine whether explicit ageist attitudes are associated with frailty in Veterans. Methods This is a cross-sectional study of Veterans 50 years and older who completed the Kogan’s Attitudes towards Older People Scale (KAOP) scale to assess explicit ageist attitudes and the Implicit Association Test (IAT) to evaluate implicit ageist attitudes from July 2014 through April 2015. We constructed a frailty index (FI) of 44 variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living) that was retrospectively applied to the time of completion of the KAOP and IAT. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multinomial logistic regression models with frailty status (robust, prefrail and frail) as the outcome variable, and with KAOP and IAT scores as the independent variables. Age, race, ethnicity, median household income and comorbidities were considered as covariates. Results Patients were 89.76% male, 48.03% White, 87.93% non-Hispanic and the mean age was 60.51 (SD = 7.16) years. The proportion of robust, pre-frail and frail patients was 11.02% (n = 42), 59.58% (n = 227) and 29.40% (n = 112) respectively. The KAOP was completed by 381 and the IAT by 339 participants. In multinomial logistic regression, neither explicit ageist attitudes (KAOP scale score) nor implicit ageist attitudes (IAT) were associated with frailty in community dwelling Veterans after adjusting for covariates: OR = .98 (95% CI = .95–1.01), p = .221, and OR:=.97 (95% CI = .37–2.53), p = .950 respectively. Conclusions This study shows that neither explicit nor implicit ageist attitudes were associated with frailty in community dwelling Veterans. Further longitudinal and larger studies with more diverse samples and measured with other ageism scales should evaluate the independent contribution of ageist attitudes to frailty in older adults.

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Pre-frailty, frailty and associated factors in older caregivers of older adults

Revista de Saúde Pública ◽

10.11606/s1518-8787.2020054001655 ◽

2020 ◽

Vol 54 ◽

pp. 17

Author(s):

Roberta De Oliveira Máximo ◽

Ingrid Cristina Lopes ◽

Allan Gustavo Brigola ◽

Bruna Moretti Luchesi ◽

Aline Cristina Martins Gratão ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Low Income ◽

Associated Factors ◽

Multinomial Logistic Regression ◽

Community Dwelling ◽

Clinical Aspects ◽

Frailty Phenotype ◽

Cross Sectional ◽

Older Caregivers

INTRODUCTION: Providing care to an older adult is an activity that requires considerable physical effort and can cause stress and psychological strain, which accentuate factors that trigger the cycle of frailty, especially when the caregiver is also an older adult. However, few studies have analyzed the frailty process in older caregivers. OBJECTIVES: To investigate the prevalence of pre-frailty, frailty and associated factors in older caregivers of older adults. METHODS: A cross-sectional study was conducted including 328 community-dwelling older caregivers. Frailty was identified using frailty phenotype. Socio-demographic, behavioral and clinical aspects, characteristics related to care and functioning were covariables in the multinomial logistic regression. RESULTS: The prevalence of pre-frailty and frailty were 58.8% and 21.1%, respectively. An increased age, female sex, not having a conjugal life, depressive symptoms and pain were commonly associated with pre-frailty and frailty. Sedentary lifestyle was exclusively associated with pre-frailty, whereas living in an urban area, low income and the cognitive decline were associated with frailty. A better performance on instrumental activities of daily living reduced the chance of frailty. CONCLUSION: Many factors associated with the frailty syndrome may be related to the act of providing care, which emphasizes the importance of the development of coping strategies for this population.

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The association between motor capacity and mobility performance: frailty as a moderator

European Review of Aging and Physical Activity ◽

10.1186/s11556-019-0223-4 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 4

Author(s):

Carl-Philipp Jansen ◽

Nima Toosizadeh ◽

M. Jane Mohler ◽

Bijan Najafi ◽

Christopher Wendel ◽

...

Keyword(s):

Older Adults ◽

Frailty Index ◽

Community Dwelling ◽

Daily Routine ◽

Cross Sectional ◽

Mobility Performance ◽

Frailty Status ◽

Walking Performance ◽

And Performance ◽

The Relationship

Abstract Background In older adults, the linkage between laboratory-assessed ‘motor capacity’ and ‘mobility performance’ during daily routine is controversial. Understanding factors moderating this relationship could help developing more valid assessment as well as intervention approaches. We investigated whether the association between capacity and performance becomes evident with transition into frailty, that is, whether frailty status moderates their association. Methods We conducted a cross-sectional analysis of the observational Arizona Frailty Cohort Study (ClinicalTrials.gov identifier: NCT01880229) in a community-dwelling cohort in Tucson, Arizona. Participants were N = 112 older adults aged 65 years or older who were categorized as non-frail (n = 40), pre-frail (n = 53) or frail (n = 19) based on the Fried frailty index. Motor capacity was quantified as normal (NWS) and fast walking speed (FWS). Mobility performance was quantified as 1) cumulated physical activity (PA) time and 2) everyday walking performance (average steps per walking bout; maximal number of steps in one walking bout), measured by a motion sensor over a 48 h period. Hierarchical linear regression analyses were performed to evaluate moderation effects. Results Unlike in non-frail persons, the relationship between motor capacity and mobility performance was evident in pre-frail and frail persons, confirming our hypothesis. A moderating effect of frailty status was found for 1) the relationship between both NWS and FWS and maximal number of steps in one bout and 2) NWS and the average steps per bout. No moderation was found for the association between NWS and FWS with cumulated PA. Conclusion In pre-frail and frail persons, motor capacity is associated with everyday walking performance, indicating that functional capacity seems to better represent mobility performance in this impaired population. The limited relationship found in non-frail persons suggests that other factors account for their mobility performance. Our findings may help to inform tailored assessment approaches and interventions taking into consideration a person’s frailty status.

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Association Between Brain β-Amyloid and Frailty in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glz009 ◽

2019 ◽

Vol 74 (11) ◽

pp. 1747-1752 ◽

Cited By ~ 5

Author(s):

Mathieu Maltais ◽

Philipe De Souto Barreto ◽

Claudie Hooper ◽

Pierre Payoux ◽

Yves Rolland ◽

...

Keyword(s):

Older Adults ◽

Frailty Index ◽

Standardized Uptake Value ◽

Community Dwelling ◽

Cross Sectional ◽

Frailty Status ◽

Positron Emission ◽

New Information ◽

Amyloid Aβ ◽

Β Amyloid

Abstract Background We sought to determine whether cortical and regional β-amyloid (Aβ) were cross-sectionally and prospectively associated with change in frailty status in older adults. Methods We used data from 269 community-dwelling participants from the Multidomain Alzheimer’s Preventive Trial (MAPT) who were assessed for brain Aβ using positron-emission tomography scan. Regional and cortical-to-cerebellar standardized uptake value ratios were obtained. Frailty was assessed by a frailty index composed of 19 items not directly linked to cognition and Alzheimer’s disease. Results A significant and positive cross-sectional and prospective relationship was found for Aβ in the anterior putamen (cross-sectional: β = 0.11 [0.02–0.20], p = .02; prospective: β = 0.11 [0.03–0.19], p = .007), posterior putamen (cross-sectional: β = 0.12 [0.009–0.23], p = .03; prospective: β = 0.11 [0.02–0.21], p = .02), and precuneus regions (cross-sectional: β = 0.07 [0.01–0.12], p = .01; prospective: β = 0.07 [0.01–0.12], p = .01) with increasing frailty. Conclusions This study has found new information regarding cross-sectional and prospective positive associations between region-specific brain Aβ deposits and worsening frailty. The potential mechanisms involved require further investigation.

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Self-Management Behaviours and Change in Frailty Status among Community-Dwelling Older Adults: A National Longitudinal Population-based Cohort Study

10.21203/rs.3.rs-1171960/v1 ◽

2022 ◽

Author(s):

Thi Lien To ◽

Ching-Pyng Kuo ◽

Chih-Jung Yeh ◽

Wen-Chun Liao ◽

Meng-Chih Lee

Keyword(s):

Older Adults ◽

Cohort Study ◽

Chronic Diseases ◽

Community Dwelling ◽

Self Management ◽

Geriatric Syndrome ◽

Frailty Phenotype ◽

Frailty Status ◽

Community Dwelling Older Adults

Abstract Background: Frailty in older adults is a common geriatric syndrome that can be reversed, thus coping strategies for the aging population are essential. Self-management behaviours may represent cost-effective strategies to reverse physical frailty in community-dwelling older adults. This study aimed to describe the changes in frailty status among community-dwelling older adults in Taiwan and investigate the association of self-management behaviours with changes in frailty status over a four-year follow-up period (2007 to 2011).Methods: This data was retrieved from the Taiwan Longitudinal Study of Aging (TLSA), which is a prospective cohort study of 1,283 community-dwelling older adults aged 65 years and older without cognitive impairment. Frailty was assessed based on Fried's frailty phenotype, in which ≥ three criteria indicate frail. Self-management behaviours (maintaining body weight, quitting smoking, drinking less, exercising, diet control, and maintaining a regular lifestyle) were assessed using a questionnaire. Multivariate logistic regression analyses were used to investigate the associations between self-management behaviours and changes in frailty status.Results: The prevalence of frailty was 8.7% at baseline and 8.1% after four years of follow-up, with 196 (15.3%) deaths. Overall, 74.6% of participants remained in the same state (non-frail or frail), 23.5% worsened (non-frail to frail, including missing data, and frail to death), and only 1.95% improved (frail to non-frail). Being aged ≥ 75-years-old, chronic diseases, and an absence of self-management behaviours were associated with higher risks of frailty at baseline and after follow-up. Exercise was significantly associated with a reversal of frailty in community-dwelling older adults (RR, 3.11; 95% CI, 1.95, 4.95) after adjusting for personal and disease covariates, regardless of whether death was coded as frail or not.Conclusions: Self-management behaviours beneficially reverse frailty status; maintaining regular exercise was especially associated with a reversal of frailty in community-dwelling older adults, even among individuals over 75-years-old and with chronic diseases. Older adults should be encouraged to perform adequate physical exercise to prevent the progression of frailty and ameliorate frailty status.

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The Association between Dietary Variety and Physical Frailty in Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare9010032 ◽

2021 ◽

Vol 9 (1) ◽

pp. 32

Author(s):

Yuto Kiuchi ◽

Hyuma Makizako ◽

Yuki Nakai ◽

Kazutoshi Tomioka ◽

Yoshiaki Taniguchi ◽

...

Keyword(s):

Older Adults ◽

Cross Sectional Study ◽

Community Dwelling ◽

Cutoff Point ◽

Physical Frailty ◽

Cross Sectional ◽

Frailty Status ◽

Diet Variety ◽

The One ◽

Community Dwelling Older Adults

The aim of this cross-sectional study was to examine the association between diet variety and physical frailty in community-dwelling older adults. Data of 577 older adults (mean age: 74.0 ± 6.3 years, women: 62.5%) were analyzed. Diet variety was assessed using the Food Frequency Score (FFS) (maximum, 30 points). The FFS assessed the one-week consumption frequency of ten foods (meat, fish/shellfish, eggs, milk & dairy products, soybean products, green & yellow vegetables, potatoes, fruits, seafood, and fats & oil). Physical frailty was assessed using Fried’s component (slowness, weakness, exhaustion, low physical activity, and weight loss). The participants were classified into frail, pre-frail, and non-frail groups. The prevalence of physical frailty was 6.6%. This study found significant associations between physical frailty and low FFS after adjusting for covariates (odds ratio (OR) 0.90, 95% confidence interval (CI) 0.84–0.97, p < 0.01). The optimal cutoff point of the FFS for physical frailty was ≤16 points. FFS lower than the cutoff point were significantly associated with physical frailty after adjusting for covariates (OR 3.46, 95% CI 1.60–7.50, p < 0.01). Diet variety assessed using the FFS cutoff value of ≤16 points was related to the physical frailty status in community-dwelling older adults.

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Actual Frailty Conditions and Lifestyle Changes in Community-Dwelling Older Adults Affected by Coronavirus Disease 2019 Countermeasures in Japan: A Cross-Sectional Study

SAGE Open Nursing ◽

10.1177/23779608211025117 ◽

2021 ◽

Vol 7 ◽

pp. 237796082110251

Author(s):

Tomoyuki Shinohara ◽

Kosuke Saida ◽

Shigeya Tanaka ◽

Akihiko Murayama

Keyword(s):

Older Adults ◽

Cross Sectional Study ◽

Lifestyle Changes ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

Daily Movement ◽

Frailty Status ◽

Leg Muscle ◽

Community Dwelling Older Adults

Introduction Because of the countermeasures to prevent the spread of coronavirus disease 2019 (COVID-19) in Japan, it is easy to predict that the suspension of local activities and changes in lifestyle that lead to decreased activity will result in increased frailty and prefrailty rates in older adults. Objective To clarify the actual frailty conditions and lifestyle changes among community-dwelling older adults affected by COVID-19 countermeasures in Japan. Methods This cross-sectional study was conducted between May 8 and June 12, 2020. Self-reported questionnaires were distributed to 1,078 older adults aged ≥65 years. We used the frailty screening index to assess frailty status and developed the Questionnaire for Change of Life (QCL) to assess lifestyle changes, the amount of daily movement, leg muscle strength, meal size, worry or anxiety, and opportunities to talk to people. The differences in prevalence rates of frailty, prefrailty, and robustness between this study and the reference based on the Japanese meta-analysis were verified using the chi-square goodness of fit test. We compared each of the QCL results among the frailty, prefrailty, and robust groups using Fisher’s exact test. Results Of 680 older adults (63.1%) analyzed, 60 (8.8%) had frailty and 354 (52.1%) had prefrailty. There was a significant difference between the observed and expected prevalence based on the reference (p = 0.018). The frailty status was significantly associated with lifestyle changes. In participants with frailty, the amount of daily movement, leg muscle strength, and meal size significantly decreased (p < 0.001), whereas worry or anxiety significantly increased (p = 0.040). In contrast, regardless of the frailty status, opportunities to talk to people decreased. Conclusion The prevalence of frailty and prefrailty might have increased due to the effects of COVID-19 countermeasures. Moreover, the lifestyle of community-dwelling older adults affected by COVID-19 countermeasures has changed. Lifestyle changes were more pronounced among older adults with frailty.

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Multimorbidity Patterns, Frailty, and Survival in Community-Dwelling Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/gly205 ◽

2018 ◽

Vol 74 (8) ◽

pp. 1265-1270 ◽

Cited By ~ 15

Author(s):

Quoc Dinh Nguyen ◽

Chenkai Wu ◽

Michelle C Odden ◽

Dae Hyun Kim

Keyword(s):

Older Adults ◽

Latent Class ◽

Community Dwelling ◽

Frailty Phenotype ◽

Frailty Status ◽

Hazard Ratios ◽

Risk Of Mortality ◽

Minimal Disease ◽

Excess Number ◽

Community Dwelling Older Adults

Abstract Background Frailty and multimorbidity are independent prognostic factors for mortality, but their interaction has not been fully explored. We investigated the importance of multimorbidity patterns in older adults with the same level of frailty phenotype. Methods In a cohort of 7,197 community-dwelling adults aged 65 years and older, physical frailty status (robust, pre-frail, frail) was defined using shrinking, exhaustion, inactivity, slowness, and weakness. Latent class analysis was used to identify individuals with multimorbidity patterns based on 10 self-reported chronic conditions. We estimated hazard ratios (HR) and incidence rate differences (IRDs) for mortality comparing multimorbidity patterns within each frailty state. Results Five multimorbidity classes were identified: minimal disease (24.7%), cardiovascular disease (29.0%), osteoarticular disease (27.3%), neuropsychiatric disease (8.9%), and high multisystem morbidity (10.0%). Within each frailty state, the mortality rate per 1,000 person-years over 4 years was greatest in the neuropsychiatric class and lowest in the minimal disease class: robust (56.3 vs 15.7; HR, 2.11 [95% CI: 1.05, 4.21]; IRD, 24.1 [95% CI: −11.2, 59.3]), pre-frail (85.3 vs 40.4; HR, 1.74 [95% CI: 1.28, 2.37]; IRD, 27.1 [95% CI: 7.6, 46.7]), and frail (218.1 vs 96.4; HR, 2.05 [95% CI: 1.36, 3.10]; IRD, 108.4 [95% CI: 65.0, 151.9]). Although HRs did not vary widely by frailty, the excess number of deaths, as reflected by IRDs, increased with greater frailty level. Conclusions Considering both multimorbidity patterns and frailty is important for identifying older adults at greater risk of mortality. Of the five patterns identified, the neuropsychiatric class was associated with lower survival across all frailty levels.

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Letter to the Editor: Exploring Associations Between Oral Health and Frailty in Community-Dwelling Older People

Journal of Frailty & Aging ◽

10.14283/jfa.2021.10 ◽

2021 ◽

pp. 1-1

Author(s):

R.C. Castrejón-Pérez

Keyword(s):

Oral Health ◽

Older People ◽

Medical Record ◽

Frailty Index ◽

Community Dwelling ◽

Frailty Phenotype ◽

Cross Sectional ◽

Frailty Status ◽

Community Dwelling Older People ◽

Oral Conditions

The studies exploring the association between oral conditions and Frailty status are increasing in number, and many manuscripts have been published during the last couple of years. Even when Everaars et al. (1) manuscript is cross-sectional, it contributes to the knowledge by confirming the association between oral conditions and Frailty despite the selected strategy for measuring Frailty since authors added the interview Groningen Frailty Index and the Frailty Index (computed with data extracted from the Electronic Medical Record) to the most frequently used Frailty Phenotype and Kihon checklist (2).

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