scholarly journals Incidence of frailty among community-dwelling older adults: a nationally representative profile in China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weihao Xu ◽  
Ya-Xi Li ◽  
Chenkai Wu
Keyword(s):  
Older Adults ◽  
Incidence Rate ◽  
Rural Areas ◽  
Geographic Region ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Chinese Older Adults ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Abstract Background Frailty is a clinically recognizable state of reduced resilience to stressors and increased vulnerability to adverse outcomes. The majority of studies have focused on the prevalence and risk factors of frailty, while the incidence of frailty has not been well documented, especially in less developed regions including China—a country that has the largest aging population in the world. We investigated the incidence of frailty among non-frail Chinese older adults by sociodemographic characteristics, disease burden, and geographic region. Methods Participants were 4939 adults aged ≥60 years from the China Health and Retirement Longitudinal Study, a cohort study of a nationally representative sample of middle-aged and older community-dwelling adults from 28 provinces in China. Frailty was assessed by an adapted version of the well-validated Fried’s physical frailty phenotype, in which five criteria were included: weakness, slowness, exhaustion, physical inactivity, and shrinking. Results Over an average of 2.1 years of follow-up (10,514.2 person-years), the weighted incidence rate of frailty was 60.6 per 1000 person-years; the incidence rate was 28.8 and 86.6 per 1000 person-years for those who were initially robust and prefrail, respectively. Participants who were older and widowed, had lower education and household income, lived in rural areas, and had higher burden of chronic conditions had higher frailty incidence. Frailty incidence ranged from 44.8 per 1000 person-years in the Southeast to 93.0 per 1000 person-years in the Northwest. Conclusions Incidence rate of frailty was 60.6 per 1000 person-years among community-living Chinese adults aged ≥ 60 years. Substantial sociodemographic and geographical disparities exist in frailty incidence.

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

Nutrients ◽  
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.

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.

scholarly journals Impact of a Wearable Device-Based Walking Programs in Rural Older Adults on Physical Activity and Health Outcomes: Cohort Study (Preprint)

2018 ◽  
Author(s):  
Il-Young Jang ◽  
Hae Reong Kim ◽  
Eunju Lee ◽  
Hee-Won Jung ◽  
Hyelim Park ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Health Care ◽  
Health Outcomes ◽  
Rural Areas ◽  
Wearable Devices ◽  
Community Dwelling ◽  
Wearable Device ◽  
Self Management ◽  
Community Dwelling Older Adults

BACKGROUND Community-dwelling older adults living in rural areas are in a less favorable environment for health care compared with urban older adults. We believe that intermittent coaching through wearable devices can help optimize health care for older adults in medically limited environments. OBJECTIVE We aimed to evaluate whether a wearable device and mobile-based intermittent coaching or self-management could increase physical activity and health outcomes of small groups of older adults in rural areas. METHODS To address the above evaluation goal, we carried out the “Smart Walk” program, a health care model wherein a wearable device is used to promote self-exercise particularly among community-dwelling older adults managed by a community health center. We randomly selected older adults who had enrolled in a population-based, prospective cohort study of aging, the Aging Study of Pyeongchang Rural Area. The “Smart Walk” program was a 13-month program conducted from March 2017 to March 2018 and included 6 months of coaching, 1 month of rest, and 6 months of self-management. We evaluated differences in physical activity and health outcomes according to frailty status and conducted pre- and postanalyses of the Smart Walk program. We also performed intergroup analysis according to adherence of wearable devices. RESULTS We recruited 22 participants (11 robust and 11 prefrail older adults). The two groups were similar in most of the variables, except for age, frailty index, and Short Physical Performance Battery score associated with frailty criteria. After a 6-month coaching program, the prefrail group showed significant improvement in usual gait speed (mean 0.73 [SD 0.11] vs mean 0.96 [SD 0.27], P=.02), International Physical Activity Questionnaire scores in kcal (mean 2790.36 [SD 2224.62] vs mean 7589.72 [SD 4452.52], P=.01), and European Quality of Life-5 Dimensions score (mean 0.84 [SD 0.07] vs mean 0.90 [SD 0.07], P=.02), although no significant improvement was found in the robust group. The average total step count was significantly different and was approximately four times higher in the coaching period than in the self-management period (5,584,295.83 vs 1,289,084.66, P<.001). We found that participants in the “long-self” group who used the wearable device for the longest time showed increased body weight and body mass index by mean 0.65 (SD 1.317) and mean 0.097 (SD 0.513), respectively, compared with the other groups. CONCLUSIONS Our “Smart Walk” program improved physical fitness, anthropometric measurements, and geriatric assessment categories in a small group of older adults in rural areas with limited resources for monitoring. Further validation through various rural public health centers and in a large number of rural older adults is required.

scholarly journals Prevalence and Multidimensional Risk Factors of Physical Frailty in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study

2020 ◽  
Author(s):  
Heeeun Jung ◽  
Miji Kim ◽  
Yunhwan Lee ◽  
Chang Won Won
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cohort Study ◽  
Medical Condition ◽  
Glycosylated Hemoglobin ◽  
Community Dwelling ◽  
National Standard ◽  
Timed Up And Go ◽  
Frailty Phenotype ◽  
Community Dwelling Older Adults

Frailty is defined as a state of increased vulnerability to stressors, and it predicts the disability and mortality in the older population. This study aimed to investigate standardized prevalence and multidimensional risk factors associated with frailty among the Korean community-dwelling older adults. We analyzed the baseline data of 2,907 adults aged 70&ndash;84 years (mean age 75.8&plusmn;3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and pre-frailty was 7.9% (95% confidence interval [CI] 6.8&ndash;8.9%) and 57.2% (95% CI 45.1&ndash;48.8%), respectively. The following 14 risk factors had a significant association with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer timed up and go, and low short physical performance battery score (p&lt;0.05). Physico-nutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Older Adults: A Prospective Observational Study

2021 ◽  
pp. 089826432110552
Author(s):  
Qian Lian ◽  
Tazeen H. Jafar ◽  
John C. Allen ◽  
Stefan Ma ◽  
Rahul Malhotra
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Diastolic Blood Pressure ◽  
Mortality Risk ◽  
Cox Regression ◽  
Community Dwelling ◽  
Representative Study ◽  
Hazard Ratios ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Objectives To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. Methods Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60–97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. Results Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100–119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23–4.72); SBP 160–179 mmHg: 1.51 (1.02–2.22); and SBP ≥180 mmHg: 1.78 (1.12–2.81). With DBP of 70–79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28–4.54) and DBP ≥110 mmHg: 2.16 (1.09–4.31). Discussion Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.

Relationship Between Frailty and Depression Among Community-Dwelling Older Adults: The Mediating and Moderating Role of Social Support

2020 ◽  
Vol 60 (8) ◽  
pp. 1466-1475 ◽  
Author(s):  
Yaru Jin ◽  
Huaxin Si ◽  
Xiaoxia Qiao ◽  
Xiaoyu Tian ◽  
Xinyi Liu ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Rating Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Linear Regression Models ◽  
Frailty Phenotype ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Background and Objectives Frailty is associated with depression in older adults and reduces their social support. However, the mechanism underlying such relationship remains unclear. We aim to examine whether social support acts as a mediator or moderator in the relationship between frailty and depression. Research Design and Methods This cross-sectional study was conducted among 1,779 community-dwelling older adults aged 60 and older. Frailty, social support, and depressive symptoms were measured by the Physical Frailty Phenotype, Social Support Rating Scale, and five-item Geriatric Depression Scale, respectively. Data were also collected on age, gender, years of schooling, monthly income, cognitive function, number of chronic diseases, physical function, and pain. Results Linear regression models showed that subjective support and support utilization, but not objective support, mediated and moderated the relationship between frailty and depressive symptoms. The Johnson–Neyman technique determined a threshold of 30 for subjective support, but not for support utilization, beyond which the detrimental effect of frailty on depressive symptoms was offset. Discussion and Implications Social support underlies the association of frailty with depression, and its protective role varies by type. Interventions on depression should address improving perceptions and utilization of social support among frail older adults rather than simply providing them with objective support.

scholarly journals Prevalence of Physical Frailty and Its Multidimensional Risk Factors in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study

2020 ◽  
Vol 17 (21) ◽  
pp. 7883
Author(s):  
Heeeun Jung ◽  
Miji Kim ◽  
Yunhwan Lee ◽  
Chang Won Won
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cohort Study ◽  
Medical Condition ◽  
Glycosylated Hemoglobin ◽  
Community Dwelling ◽  
National Standard ◽  
Timed Up And Go ◽  
Frailty Phenotype ◽  
Community Dwelling Older Adults

Frailty is defined as a state of increased vulnerability to stressors, and it predicts disability and mortality in the older population. This study aimed to investigate the standardized prevalence and multidimensional risk factors associated with frailty among Korean community-dwelling older adults. We analyzed the baseline data of 2907 adults aged 70–84 years (mean age 75.8 ± 3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and prefrailty was 7.9% (95% confidence interval (CI) 6.8–8.9%) and 47.0% (95% CI, 45.1–48.8%), respectively. The following 14 risk factors were significantly associated with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive symptoms, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer Timed Up and Go, and low Short Physical Performance Battery score (p < 0.05). Physiconutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

scholarly journals Understanding of Resilience of Older Adults in Hong Kong: A Qualitative Investigation

2020 ◽  
Vol 6 ◽  
pp. 233372142096690
Author(s):  
Chun Hu ◽  
Pak-Kwong Chung ◽  
Chun-Qing Zhang ◽  
Yiqun Gan ◽  
Rui Hu
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Qualitative Content Analysis ◽  
Community Dwelling ◽  
Chinese Older Adults ◽  
Environmental Support ◽  
Positive Attitudes ◽  
Important Trait ◽  
Positive Experiences ◽  
Community Dwelling Older Adults

Purpose: Resilience is an important trait for older adults facing adversity. This qualitative study aimed to identify the characteristics that contribute to resilience in a group of community-dwelling older adults in Hong Kong. Methods: Twenty-five Chinese older adults were invited. Interviews were conducted to collect information about the adverse events in their lives, their attitudes towards adversity and the beliefs underlying their approaches to overcoming adversity. The transcripts were analyzed using qualitative content analysis. Results: Seven themes emerged from the interviews: equanimity, positive attitudes towards life; meaningfulness, self-reliance, social support, environmental support, and spirituality and faith. Conclusion: Our qualitative analysis found that resilience among older adults in Hong Kong is characterized by internal, external and existential factors. The results may be useful for the development of proactive interventions aimed at assisting older adults to enhance the positive experiences in their lives.

scholarly journals Evaluation of Clinically Meaningful Changes in Measures of Frailty

2020 ◽  
Vol 75 (6) ◽  
pp. 1143-1147 ◽  
Author(s):  
Il-Young Jang ◽  
Hee-Won Jung ◽  
Hea Yon Lee ◽  
Hyungchul Park ◽  
Eunju Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Clinical Care ◽  
Frailty Index ◽  
Large Change ◽  
Community Dwelling ◽  
Deficit Accumulation ◽  
Frailty Phenotype ◽  
Euroqol 5D ◽  
Community Dwelling Older Adults

Abstract Background To determine the clinically meaningful changes and responsiveness of widely used frailty measures. Methods We analyzed data from a prospective cohort study of 1,135 community-dwelling older adults who underwent assessments of frailty and health-related quality of life using the EuroQol-5D at baseline and 1 year later. Frailty measures included deficit-accumulation frailty index (FI); frailty phenotype; Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale; and the Study of Osteoporotic Fracture (SOF) index. We determined the clinically meaningful changes by the distribution-based method and the anchor-based method using the EuroQol-5D score and responsiveness indices. Results Frailty measures were available in 925 participants at 1 year (81.5%). Based on the distribution-based method, small and large clinically meaningful changes were 0.019 and 0.057 for FI, 0.249 and 0.623 for frailty phenotype, 0.235 and 0.587 for FRAIL scale, and 0.116 and 0.289 for SOF index, respectively. The anchor-based estimates of small and large changes were 0.028 and 0.076 for FI, 0.097 and 0.607 for frailty phenotype, 0.269 and 0.368 for FRAIL scale, and 0.023 and 0.287 for SOF index, respectively. Based on the responsiveness index, per-group sample sizes to achieve 80% power in clinical trials, ranged from 51 (FI) to 7,272 (SOF index) for a small change and 9 (FI) to 133 (FRAIL scale) for a large change. Conclusions The estimates of clinically meaningful change of frailty measures can inform the choice of frailty measures to track longitudinal changes of frailty in clinical trials and clinical care of community-dwelling older adults.

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