Social participation and physical prefrailty in older Japanese adults: The Shimane CoHRE study

As older adults in an early stage (prefrailty) of frailty may return to a healthy state, it is necessary to examine the prevention of prefrailty. In this context, the number and types of social participation activities associated with physical prefrailty in community-dwelling older adults have remained relatively unexplored. This cross-sectional study investigates this issue by analyzing 616 participants living in Okinoshima, Shimane, a rural area of Japan, in 2019. Frailty was assessed using the 5-item frailty phenotype (unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity). Data on social participation were obtained using a questionnaire based on participants’ level of involvement with volunteer groups, sports clubs/groups, neighborhood associations, religious organizations/groups, and community elderly salons; their answers were categorized as “yes” if they answered “several times per year or more” and “no” if they answered “never.” Binominal logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) of prefrailty by the number or types of social participation activities, adjusted for gender, age, body mass index, smoking, medication-taking, educational attainment, working status, and living arrangement. Of the 616 participants, 273 (44.3%) and 28 (4.5%) had prefrailty and frailty, respectively. The analysis showed that the number of social participation activities was significantly associated with lower odds of prefrailty (OR = 0.83; 95% CI, 0.74–0.94). Regarding the types of social participation, sports clubs/groups were associated with lower odds of prefrailty (OR = 0.47; 95% CI, 0.31–0.73). Participation in neighborhood associations was associated with prefrailty/frailty (OR = 0.57; 95% CI, 0.37–0.86). These results suggest that increasing the number of social participation activities or involvement in sports clubs/groups and neighborhood associations may be important to prevent physical prefrailty in the older population.

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Multiple Physical Symptoms of Community-Dwelling Older People in Western China: Prevalence and Its Association with Frailty

Gerontology ◽

10.1159/000513246 ◽

2021 ◽

pp. 1-9

Author(s):

Shuli Jia ◽

Wanyu Zhao ◽

Yan Zhang ◽

Lisha Hou ◽

Xin Xia ◽

...

Keyword(s):

Older Adults ◽

Multinomial Logistic Regression ◽

Physical Symptoms ◽

Community Dwelling ◽

Western China ◽

Musculoskeletal Symptoms ◽

Frailty Phenotype ◽

The Past ◽

Organ Systems ◽

Multiple Symptoms

Introduction: Physical symptoms and frailty are common in older adults. A previous study has reported that multiple somatic symptoms are associated with frailty. In this study, we aimed to describe the picture of physical symptoms in older adults in western China and examine the relationship of multiple physical symptoms and frailty, as well as the sex difference of this relationship. Methods: Cross-sectional analyses were based on the West China Health and Aging Trend (WCHAT) study comprising 4,106 community-dwelling older adults (60–95 years). Frailty was assessed using the physical frailty phenotype (PFP). Participants’ experience of 28 different physical symptoms in the past 4 weeks was assessed. Physical symptoms were divided into several categories according to organ systems. Multinomial logistic regression analyses were performed to examine the association between frailty and multiple physical symptoms. Results: Nearly half of the subjects reported experiencing at least 1 physical symptom during the past 4 weeks. Musculoskeletal symptoms were the most prevalent symptoms. More than 5 physical symptoms were more likely to be frailty, even when all covariates were controlled. A significant association between multiple musculoskeletal symptoms and frailty also was found after adjusted for all covariates and multiple symptoms of other organ systems. Similar results were obtained for multiple cardiopulmonary symptoms. Furthermore, there were sex differences in these relationships. Conclusion: Multiple physical symptoms appear to have a detrimental impact on frailty in older adults. Compared with counting total symptoms, multiple symptoms of the same organ system may have a greater impact on frailty. Effective interventions and management of multiple physical symptoms are warranted to prevent frailty.

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Benefits and barriers: a qualitative study on online social participation among widowed older adults in Southwest China

BMC Geriatrics ◽

10.1186/s12877-021-02381-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yan Hong ◽

Jingjing Fu ◽

Dehui Kong ◽

Siqi Liu ◽

Zhu Zhong ◽

...

Keyword(s):

Older Adults ◽

Digital Media ◽

Social Participation ◽

Health Care Professionals ◽

Early Stage ◽

Economic Loss ◽

Original Data ◽

Southwestern China ◽

Digital World ◽

Barriers And Challenges

Abstract Background With the development of digital media, online activities are increasingly becoming part of the daily life of older adults. Widowed older adults generally would face changes in social interactions and activities due to widowhood; thus, the importance of online participation may be more prominent in this population. However, a detailed evidence on the experiences of online social participation among widowed older adults is relatively sparse. This study aimed to explore widowed older adults’ perceptions regarding online social participation in southwestern China. Methods This study adopted a qualitative approach. Semi-structured, in-depth individual interviews were conducted with 19 widowed older adults between September–December 2020. Thematic analysis was applied to analyse the data. Results Two major themes, “benefits” and “barriers” were identified from the original data analysis. Subcategories concerning the theme “benefits” were “benefit perception (convenience, flexible time, supplementation)”, “health promotion”, “emotional comfort”, and “social connection”. Subcategories of “barriers” were “worries: personal economic loss”, “concerns: security of digital device”, “troubles: the diversity of online social participation”, and “difficulties: using digital media”. Conclusions Social participation of widowed older adults in southwestern China has begun to be integrated into the digital world; however, it remains at an early stage with the simple purpose of engagement. The older adults may face many challenges for online social participation. Although there are barriers and challenges in online social participation, widowed older adults can reap its benefits, which can be used as an important measure to facilitate a fulfilling life and successful ageing. There is no doubt that online social participation will become a trend within the foreseeable future. Family, friends and health care professionals should pay more attention to the needs of online social participation in widowed older adults and provide adequate support for them to achieve a meaningful life.

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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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The Effects of Technological Interventions on Social Participation of Community-Dwelling Older Adults with and without Dementia: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10112308 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2308

Author(s):

Pascale Heins ◽

Lizzy M. M. Boots ◽

Wei Qi Koh ◽

An Neven ◽

Frans R. J. Verhey ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Social Isolation ◽

Social Participation ◽

Methodological Quality ◽

Well Being ◽

Community Dwelling ◽

Cochrane Library ◽

Technological Interventions ◽

Community Dwelling Older Adults

Social isolation in community-dwelling older adults with dementia is a growing health issue that can negatively affect health and well-being. To date, little attention has been paid to the role of technology in improving their social participation. This systematic review aims to provide a systematic overview of the effects of technological interventions that target social participation in community-dwelling older adults with and without dementia. The scientific databases Medline (PubMed), PsycINFO, CINAHL, Web of Science, and the Cochrane Library were systematically searched and independently screened by two reviewers. Results were synthesized narratively. The methodological quality of included studies was independently assessed by two reviewers. In total, 36 studies of varying methodological quality were identified. Most studies evaluated social networking technology and ICT training programs. Three studies focused on people with dementia. Quantitative findings showed limited effects on loneliness, social isolation, and social support. Nevertheless, several benefits related to social participation were reported qualitatively. Social interaction, face-to-face contact, and intergenerational engagement were suggested to be successful elements of technological interventions in improving the social participation of community-dwelling older adults. Rigorous studies with larger sample sizes are highly needed to evaluate the long-term effects of technology on the multidimensional concept of social participation.

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

10.20944/preprints202009.0423.v1 ◽

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 70–84 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 pre-frailty was 7.9% (95% confidence interval [CI] 6.8–8.9%) and 57.2% (95% CI 45.1–48.8%), 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<0.05). Physico-nutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

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

Circulation ◽

10.1161/circ.141.suppl_1.p411 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Alvin G Thomas ◽

Anna Kucharska-Newton ◽

Jingkai Wei ◽

Priya Palta ◽

Sheila Burgard ◽

...

Keyword(s):

Older Adults ◽

Community Dwelling ◽

Frailty Phenotype ◽

Cross Sectional ◽

Arterial Stiffening ◽

Atherosclerosis Risk In Communities ◽

Loss To Follow Up ◽

Frailty Status ◽

Longitudinal Association ◽

Aortic Stiffening

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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The Influence of Social Isolation on the Preventive Behaviors for Non-Communicable Diseases in Community-Dwelling Older Adults in Japan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238985 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8985

Author(s):

Yuko Yamaguchi ◽

Masako Yamada ◽

Elsi Dwi Hapsari ◽

Hiroya Matsuo

Keyword(s):

Older Adults ◽

Social Isolation ◽

Social Participation ◽

Communicable Diseases ◽

Community Dwelling ◽

Moderate Intensity ◽

Lifestyle Behaviors ◽

Cross Sectional ◽

Non Communicable Diseases ◽

Community Dwelling Older Adults

This study aimed to examine the relationship between one’s physical status related to non-communicable diseases (NCDs) and social isolation, and to identify lifestyle behaviors for the prevention of NCDs associated with social isolation among community-dwelling older adults in Japan. A cross-sectional study was conducted to investigate lifestyle behaviors for NCD prevention associated with social isolation in Japanese adults aged 60 years and above in a community setting. Out of 57 participants, 17.5% were not socially participative, 66.7% hardly ever, 29.8% sometimes, and 3.5% often felt loneliness. Non-social participation and loneliness were negatively related to the frequency of vegetable and fruit intake. Additionally, loneliness was positively associated with one’s duration of smoking and current smoking habits, and negatively associated with the frequency of moderate-intensity activities, with marginal significance. Those with non-social participation or loneliness were less likely to eat a healthy diet and live a smoke-free lifestyle. The findings of this study suggest that a mutual health support system in the community and the development of community-based approaches for the prevention of NCDs among Japanese older adults are needed.

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Factors Associated with Successful Aging among Community-Dwelling Older Adults Based on Ecological System Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093220 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3220 ◽

Cited By ~ 2

Author(s):

Hye-Young Jang

Keyword(s):

Older Adults ◽

Successful Aging ◽

Living Arrangement ◽

Individual Characteristics ◽

Community Dwelling ◽

Ecological System ◽

System Model ◽

Healthcare Intervention ◽

Factors Associated ◽

Study Results

This study was conducted to identify the factors associated with successful aging in older adults based on the ecological system model. Data from the 2017 National Survey of the Living Conditions of Korean Elderly were used. Participants comprised 10,074 older adults. The three principal components in the successful aging model developed by Rowe and Kahn, “absence of disease and disease-related disability,” “maintenance of high mental and physical function,” and “continued engagement with life,” were used to determine successful aging. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, and logistic regression. The study results showed that the correlation factors were age, sex, educational level, economic status, heavy drinking, subjective health status, and health screening in the individual system; living arrangement, satisfaction with spouse, and frequency of contacting family, siblings, and relatives in the family system; and the frequency of contacting neighbors and friends, number of close neighbors and friends, and accessibility of neighborhood facilities in the community system. This study is significant because it confirms that individual characteristics and the environmental systems surrounding older adults should be considered for successful aging; it is necessary to develop and apply healthcare intervention programs that consider both of these aspects.

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

The Gerontologist ◽

10.1093/geront/gnaa072 ◽

2020 ◽

Vol 60 (8) ◽

pp. 1466-1475 ◽

Cited By ~ 1

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.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217883 ◽

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.

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