TRANSITION PATTERNS OF FRAILTY SYNDROME IN COMMUNITY-DWELLING ELDERLY INDIVIDUALS: A LONGITUDINAL STUDY

2015 ◽  
pp. 1-6
Author(s):  
S. LANZIOTTI AZEVEDO DA SILVA ◽  
Á. CAMPOS CAVALCANTI MACIEL ◽  
L. DE SOUSA MÁXIMO PEREIRA ◽  
J.M. DOMINGUES DIAS ◽  
M. GUIMARÃES DE ASSIS ◽  
...  

Background: Little information is available about transitional patterns related to frailty syndrome in elderly individuals living in the community. Objective: To assess transitional patterns and determine which frailty phenotype variables are more involved in this process. Design: Longitudinal study. Population: Community-dwelling elderly individuals in Belo Horizonte, Minas Gerais, Brazil. Participants: Two hundred individuals over 65 years old. Measurements: The frailty phenotype was assessed at two different times, with a mean interval of 13 months. Comparison of the frequency distributions between the baseline and second assessment was conducted through Pearson’s chi-squared test, and a binary logistic regression was conducted to assess the most important items in this transition. Results: Sixty-eight percent of the elderly were women, with an average age of 73.7 (± 6.1) years. The pre-frail group transitioned the most between evaluations. Eighty-five individuals transitioned among frailty levels: 46 showed improvement while 39 worsened. Individuals who did scored low on the handgrip strength test in the first evaluation were more likely to have their frailty level worsen. Among individuals who showed improvements, those who were positive for weight loss and poor physical activity level in the first evaluation were less likely to improve. In this study, a greater number of individuals showed improved frailty levels over 13 months than worsened levels. Conclusion: Poor handgrip strength, weight loss, and poor physical activity are the most influential variables in frailty transitioning, leading to worsening levels of frailty or difficulty in making improvements.

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Roman Romero-Ortuno ◽  
Siobhan Scarlett ◽  
Rose Anne Kenny

Abstract Background Fried’s frailty phenotype is defined by five criteria: exhaustion, unexplained weight loss, weakness, slowness and low physical activity. Pre-frailty (PF) meets one or two criteria. PF is of interest as a target for preventative strategies, but it is not known if it is a homogenous syndrome. The objective of this study was to compare the longitudinal trajectories of two PF groups: one defined by exhaustion and/or unexplained weight loss (PF1) and one defined by one or two of the following: weakness, slowness, low physical activity (PF2). Methods: Design and setting  population-based longitudinal study of ageing. Subjects  1,660 PF participants aged ≥50 years from wave 1 of the study (2010), followed 2-yearly over 4 longitudinal waves (2012, 2014, 2016, 2018). Methods  Generalised Estimating Equations (GEE) were used to assess the effect of PF type across waves to predict cumulative mortality and disability in basic (ADL) and independent (IADL) activities of daily living, adjusting for baseline characteristics (age, sex, education, living alone, self-rated health, comorbidity, body mass index). Results In wave 1, there were 687 PF1 and 973 PF2 participants. By wave 5, 64 (9.3%) PF1 and 145 (14.9%) PF2 participants had died. In PF1 participants, mean numbers of ADL and IADL disabilities both increased from 0.2 to 0.3 from wave 1 to wave 5, whilst in PF2 increases were from 0.2 to 0.5. Adjusted GEE models suggested significantly divergent trajectories of IADL disability by wave 2, ADL disability by wave 3, and mortality by wave 4. Conclusion Prefrailty may not be a homogenous biological syndrome. This may have relevance for the design of interventions to delay or reverse frailty in populations.


2021 ◽  
Author(s):  
Adrianna Ribeiro Lacerda ◽  
Maria do Carmo Eulálio ◽  
Edivan Gonçalves Silva Júnior ◽  
Ricardo Alexandre Arcêncio ◽  
Ricardo Alves Olinda ◽  
...  

Abstract BACKGROUND: Frailty is a clinical syndrome, and its development is multifactorial and dynamic. The clinical indicators (physical measures and self-report) that characterize the syndrome tend to vary across studies. To determine the contributions of the indicators in the determination of frailty it is important to obtain data about the variations that occur among the levels of frailty. The aim of this study was to a) survey the prevalence of the frailty syndrome and of the indicators that compose the frailty phenotype in community-dwelling older adults, and b) to evaluate the contribution of each indicator in the determination frailty.METHODS: Prevalence study carried out with 163 older adults who participated in two assessments; the first one was performed in 2009 and after 70 months the second assessment was conducted. Assessment of physical measurements was performed to constitute the frailty phenotype (gait speed and handgrip strength) alongside self-report (fatigue, unintentional weight loss, and physical activity), as proposed by Fried. We used the McNemar’s test and Pearson’s chi-square to analyze the differences between means and Multinomial Logistic Regression values.RESULTS: There was an increase in the number of pre-frail older adults (from 47.85% to 65.03%) and frail ones (from 7.98% to 9.82%). The frailty indicators increased significantly (+ 8.6% for walking; + 6.8% for fatigue; + 6.8% for grip strength; + 1.2% for physical activity), except for the “weight loss” item (-3%). The indicators with the highest predictors of frailty in 2009 were fatigue (OR = 31.41; 95%CI 11.66-84-65, p<0.001) and weight loss (OR = 28.74; 95%CI 9.20-89.84, p<0.001). In the second assessment, the items that had the highest chance for developing frailty were slow gait (OR = 23.64; 95%CI 5.38-103.83, p<0.001) and muscle weakness (OR = 79.39; 95%CI 8.58-734.24, p<0.001). CONCLUSION: There was an increase in frail and pre-frail older adults during the two assessments and an increase in the indicators that mark the syndrome phenotype. The explanatory models of frailty changed in both assessments. The evolution of frailty signals the necessity for interventions to be carried out with older adults to delay the progress of declining faculties that threaten their health.


2021 ◽  
pp. 089011712110555
Author(s):  
Chung-Shan Hung ◽  
Ching-Hui Loh ◽  
Jyh-Gang Hsieh ◽  
Jia-Ching Chen ◽  
Yan-Wei Lin ◽  
...  

Purpose To explore the physical activity level of community environmental volunteering (CEV) participants and the differences in physical functions and daily activity patterns between the older adults who engaged in intensive CEV (≥15 hours/week) and non-intensive CEV (<15 hours/week) groups. Design Cross-sectional study. Setting Three recycling stations in Taiwan. Sample In total, 113 community-dwelling older adults who regularly participated in CEV. The response rate was 53%. Measures The ActiGraph wGT3x-BT accelerometer for the percentage of sedentary, light, and moderate to vigorous physical activity (MVPA) of CEV time and awaken time; the Jamar hand dynamometer for grip strength; and the MicroFET3 muscle testing dynamometer for knee extension strength. Analysis Analysis of covariance with the baseline characteristics as covariates. Results Overall, MVPA, light, and sedentary activities accounted for 53.73%, 41.10%, and 5.23% of CEV time, respectively. The intensive group (n = 61) displayed greater dominant handgrip strength ( P = .004) and higher MVPA percentage in daily life ( P = .044) than the non-intensive group (n = 52). Conclusion CEV provides sufficient opportunities for older adults to perform physical activity. Intensive CEV is related to greater handgrip strength but not lower limb strength. Further study is needed to establish the causal relationship between CEV and health variates.


2016 ◽  
Vol 33 (S1) ◽  
pp. S84-S85
Author(s):  
M. Arts ◽  
R. Collard ◽  
H. Comijs ◽  
P. Naudé ◽  
R. Risselada ◽  
...  

IntroductionAlthough the criteria for physical frailty and depression partly overlap, both represent unique, but reciprocally related constructs. The association between inflammation and frailty has been reported consistently, in contrast to the association between inflammation and late-life depression (LLD).Aim and objectivesTo determine whether physical frailty is associated with low-grade inflammation in LLD.MethodsThe physical frailty phenotype, defined as three out of five criteria (weight loss, weakness, exhaustion, slowness, low physical activity level), and three inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6), and neutrophil gelatinase–associated lipocalin (NGAL)] were assessed in a sample of individuals aged 60 and older with depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria (n = 366).ResultsThe physical frailty phenotype was not associated with inflammatory markers in linear regression models adjusted for sociodemographic characteristics, lifestyle characteristics, and somatic morbidity. Of the individual criteria, handgrip strength was associated with CRP and IL-6, and gait speed was associated with NGAL. Principal component analysis identified two dimensions within the physical frailty phenotype: performance-based physical frailty (encompassing gait speed, handgrip strength, and low physical activity) and vitality-based physical frailty (encompassing weight loss and exhaustion). Only performance-based physical frailty was associated with higher levels of inflammatory markers.ConclusionThe physical frailty phenotype is not a unidimensional construct in individuals with depression. Only performance-based physical frailty is associated with low-grade inflammation in LLD, which might point to a specific depressive subtype.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Hilde Bremseth Bårdstu ◽  
Vidar Andersen ◽  
Marius Steiro Fimland ◽  
Lene Aasdahl ◽  
Hilde Lohne-Seiler ◽  
...  

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.


2021 ◽  
Author(s):  
Takuya Ataka ◽  
Noriyuki Kimura ◽  
Atsuko Eguchi ◽  
Etsuro Matsubara

Abstract Background: In this manuscript, we aimed at investigating whether objectively measured lifestyle factors, including walking steps, sedentary time, amount of unforced physical activity, level of slight and energetic physical activity, conversation time, and sleep parameters altered before and during the COVID-19 pandemic among community-dwelling older adults.Methods: Data were obtained from a prospective cohort study conducted from 2015 to 2019 and a subsequent dementia prevention study undertaken in September 2020. Community-dwelling adults aged ≥65 years wore wearable sensors before and during the pandemic.Results: A total of 56 adults were enrolled in this study. The mean age was 74.2±3.9 years, and 58.9% (n=33) of the participants were female. The moderate and vigorous physical activity time significantly decreased and sedentary time significantly increased during the pandemic. Conclusions: This is the first study to demonstrate differences in objectively assessed lifestyle factors before and during the COVID-19 pandemic among community-dwelling older adults. The findings show that the pandemic has adversely affected physical activity among older adults living on their own in Japan.


2020 ◽  
Author(s):  
Caroline Dupré ◽  
Bienvenue Bongue ◽  
Catherine Helmer ◽  
Jean François Dartigues ◽  
David Hupin ◽  
...  

Abstract Background Physical activity may decrease the risk of dementia; however, previous cohort studies seldom investigated the different types of physical activity and household activities. Our objective was to analyze the links between two physical activity types and dementia in older people. Methods The study used data from the prospective observational Three-city cohort and included 1550 community-dwelling individuals aged 72 to 87 without dementia at baseline. Physical activity was assessed with the Voorrips questionnaire. Two sub-scores were calculated to assess household/transportation activities and leisure/sport activities. Restricted cubic spline and proportional hazard Cox models were used to estimate the non-linear exposure-response curve for the dementia risk and the appropriate activity level thresholds. Models were adjusted for possible confounders, including socio-demographic variables, comorbidities, depressive symptoms and APOE genotype. Results The median age was 80 years, and 63.6% of participants were women. After a median follow-up of 4.6 years, dementia was diagnosed in 117 participants (7.6%). An inverse J-shaped association was found between household/transportation physical activity sub-score and dementia risk, which means that the risk is lowest for the moderately high values and then re-increases slightly for the highest values. The results remained significant when this sub-score was categorized in three classes (low, moderate, and high), with hazard ratios (95% confidence interval) of 0.55 (0.35-0.87) and 0.62 (0.38-1.01) for moderate and high activity levels, respectively. No significant effect was found for leisure/sport activities. Conclusions The 5-year risk of dementia was significantly and negatively associated with the household/transportation activity level, but not with the leisure and sport activity sub-score. This highlights the importance of considering all physical activity types in 72 years or older people.


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