Screening for frailty in older adults using a self-reported instrument

OBJECTIVE To validate a screening instrument using self-reported assessment of frailty syndrome in older adults.METHODS This cross-sectional study used data from the Saúde, Bem-estar e Envelhecimento study conducted in Sao Paulo, SP, Southeastern Brazil. The sample consisted of 433 older adult individuals (≥ 75 years) assessed in 2009. The self-reported instrument can be applied to older adults or their proxy respondents and consists of dichotomous questions directly related to each component of the frailty phenotype, which is considered the gold standard model: unintentional weight loss, fatigue, low physical activity, decreased physical strength, and decreased walking speed. The same classification proposed in the phenotype was utilized: not frail (no component identified); pre-frail (presence of one or two components), and frail (presence of three or more components). Because this is a screening instrument, “process of frailty” was included as a category (pre-frail and frail). Cronbach’s α was used in psychometric analysis to evaluate the reliability and validity of the criterion, the sensitivity, the specificity, as well as positive and negative predictive values. Factor analysis was used to assess the suitability of the proposed number of components.RESULTS Decreased walking speed and decreased physical strength showed good internal consistency (α = 0.77 and 0.72, respectively); however, low physical activity was less satisfactory (α = 0.63). The sensitivity and specificity for identifying pre-frail individuals were 89.7% and 24.3%, respectively, while those for identifying frail individuals were 63.2% and 71.6%, respectively. In addition, 89.7% of the individuals from both the evaluations were identified in the “process of frailty” category.CONCLUSIONS The self-reported assessment of frailty can identify the syndrome among older adults and can be used as a screening tool. Its advantages include simplicity, rapidity, low cost, and ability to be used by different professionals.

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DEVELOPMENT OF THE NUTRITION AND FUNCTIONALITY ASSESSMENT (NFA) AMONG OLDER ADULTS IN JAPAN

Journal of Frailty & Aging ◽

10.14283/jfa.2017.38 ◽

2017 ◽

pp. 1-6

Author(s):

Y. OKUBO ◽

M. NEMOTO ◽

Y. OSUKA ◽

S. JUNG ◽

S. SEINO ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Gait Speed ◽

Short Form ◽

Cross Sectional Study ◽

Nutrition Status ◽

Frailty Phenotype ◽

Cross Sectional ◽

Physical Activity Monitoring ◽

Physical Functionality

Objective: Develop and evaluate the feasibility and validity of the Nutrition and Functionality Assessment (NFA) which identifies “target” older adults who could benefit from a personalized program following evaluation of their nutrition status and physical functionality. Design: Cross-sectional study. Setting: Community and geriatric day-care centers and university in Japan. Participants: 267 older adults aged 65-90. Measurements: The “target” individuals were screened based on gait speed (0.6-1.5 m/s). Nutrition (Mini Nutrition Assessment-short form and protein intake), strength (30s chair sit-to-stand and hand-grip strength) and endurance (6-minute walk) were assessed. Physical activity was monitored using a tri-axil accelerometer for a week. Fried frailty phenotype was also assessed. Results: Out of 267 individuals, 185 (69%) had gait speed between 0.6-1.5 m/s, corresponding to our “target” group from which, 184 (95%) completed the nutrition and physical functionality assessments with the physical activity monitoring. The NFA was completed in approximately 30 minutes. No adverse events directly due to the NFA were reported. NFA physical functionality and global scores were significantly related to frailty phenotype but nutrition score was not related to frailty phenotype. Conclusion: The study demonstrated that the NFA is a safe and feasible tool to screen target older adults and simultaneously evaluate their nutritional status and physical functionality. Validity of the NFA was partially confirmed by the significant association of the global and physical functionality scores with frailty phenotype. More studies are required to validate and maximize the applicability of the NFA in communities and institutions in Japan and elsewhere.

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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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Visual Acuity’s Association With Levels of Leisure-Time Physical Activity in Community-Dwelling Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.20.1.1 ◽

2012 ◽

Vol 20 (1) ◽

pp. 1-14 ◽

Cited By ~ 4

Author(s):

Mark W. Swanson ◽

Eric Bodner ◽

Patricia Sawyer ◽

Richard M. Allman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Visual Acuity ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Cross Sectional Study ◽

Community Dwelling ◽

University Of Alabama ◽

Cross Sectional ◽

The University

Little is known about the effect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision, and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross-sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations while controlling for potential confounders. In multivariate analyses, each lower step in visual acuity below 20/50 was significantly associated with reduced odds of having a higher level of physical activity, OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults.

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Physical Activity and its Influencing Factors in Community-Dwelling Older Adults With Dementia: A Path Analysis

Clinical Nursing Research ◽

10.1177/10547738211033928 ◽

2021 ◽

pp. 105477382110339

Author(s):

Bei Li ◽

Xiuxiu Huang ◽

Chenchen Meng ◽

Qiaoqin Wan ◽

Yongan Sun

Keyword(s):

Physical Activity ◽

Older Adults ◽

Path Analysis ◽

Neuropsychiatric Symptoms ◽

Community Dwelling ◽

Cross Sectional ◽

People With Dementia ◽

The Status ◽

Path Analysis Approach ◽

Community Dwelling Older Adults

Dementia is prevalent in worldwide, and increases the care burden and potential costs. Physical activity (PA) has been increasingly shown to be beneficial for them. This was a cross-sectional observational study aiming to investigate the status of PA among community-dwelling older adults with dementia in Beijing or Hangzhou, China, and verify the relationships between neuropsychiatric symptoms, activities of daily living (ADL), caregivers’ fear of patients’ falling and their PA using a path analysis approach. The level of PA among 216 included people with dementia was low. PA was related to the neuropsychiatric symptoms, with ADL and caregivers’ fear of patients’ falling have mediation roles. The findings indicated that person-centered strategies related to the management of these symptoms might be helpful to improve ADL, relieve caregivers’ concerns about them falling and consequently foster positive participation in PA.

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Greenspace and depression in Japanese Older Adults considering physical activities: JAGES study

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.098 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Nishigaki ◽

C Koga ◽

M Hanazato ◽

K Kondo

Keyword(s):

Physical Activity ◽

Older Adults ◽

Large Scale ◽

Depression Scale ◽

Public Health Problem ◽

Evaluation Study ◽

Physical Activities ◽

Residential Areas ◽

Cross Sectional ◽

Local Climate

Abstract Introduction Older adult's depression is a public health problem. In recent years, exposure to local greenspace is beneficial to mental health via increased physical activity in people. However, few studies approach the relationship between greenspace and depression while simultaneously considering the frequency, time, and the number of types of physical activity, and large-scale surveys targeting the older adults. Methods Cross-sectional data conducted in 2016 by the Japan Gerontological Evaluation Study was used. The analysis included older adults aged 65 and over who did not require care or assistance, and a total of 126,878 people in 881 School districts. The explanatory variable is the percentage of the greenspace of the area, and the greenspace data used is data created from satellite photographs acquired by observation satellites of the Japan Aerospace Exploration Agency. The objective variable was depression (Geriatric Depression Scale 5 points or more). The analysis method was a multi-level logistic regression analysis. Physical activity was the number of sports-related hobbies, the frequency of participation in sports meetings, and walking time in daily life. Other factors such as personal attributes, population density of residential areas, and local climate were also considered. Results Depression in the survey was 20.4%. The abundance of greenspace was still associated with depression, considering all physical activity. The odds ratio of depression in areas with more greenspace was 0.92 (95% CI 0.87 - 0.98) compared to areas with less greenspace. Conclusions It became clear that areas with many greenspace were still associated with low depression, even considering the frequency, time and number of physical activities. It is conceivable that the healing effect of seeing greenspace, the reduction of air pollution and noise, etc. are related to the lack of depression without going through physical activity. Key messages In Japan, older adults are less depressed when there are many local greenspace. It became clear that areas with many greenspace were still associated with low depression, even considering physical activities.

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Frailty is associated with susceptibility and severity of pneumonia in older adults (A JAGES multilevel cross-sectional study)

Scientific Reports ◽

10.1038/s41598-021-86854-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kousuke Iwai-Saito ◽

Yugo Shobugawa ◽

Jun Aida ◽

Katsunori Kondo

Keyword(s):

Older Adults ◽

Evaluation Study ◽

Cross Sectional Study ◽

Community Dwelling ◽

Nutrition Status ◽

Cross Sectional ◽

Physical Strength ◽

Depression Status ◽

Respiratory Infectious Diseases ◽

Community Dwelling Older Adults

AbstractPneumonia is a leading cause of mortality among older adults worldwide. Recently, several studies reported that frailty was associated with mortality among older adults hospitalized due to respiratory infectious diseases, including pneumonia. However, it is unknown whether frailty is associated with susceptibility to and severity of pneumonia in functionally-independent community-dwelling older adults. In this study, we examined whether frailty increased the susceptibility to pneumonia and hospitalization in older adults. We used cross-sectional data from the Japan Gerontological Evaluation Study; the data was collected by using mail-based, self-reported questionnaires from 177,991 functionally-independent community-dwelling older adults aged ≥ 65 years. Our results showed that frailty was significantly associated with both occurrence of and hospitalization due to pneumonia after adjustments with covariates; (Preference ratio {PR} 1.92, 95% confidence interval {95% CI} [1.66–2.22] and PR 1.80, 95% CI [1.42–2.28], respectively, p < 0.001 for the both). Pre-frailty was associated only with the occurrence of pneumonia. Besides, the instrumental activity of daily living, physical strength, nutrition status, oral function, homeboundness, and depression status in frail older adults were associated with either or both occurrence of and hospitalization due to pneumonia. Our results suggest that frailty influenced the susceptibility to and severity of pneumonia in older adults.

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Association of socioeconomic and clinical variables with the state of frailty among older inpatients

Revista Latino-Americana de Enfermagem ◽

10.1590/0104-1169.0660.2657 ◽

2015 ◽

Vol 23 (6) ◽

pp. 1121-1129 ◽

Cited By ~ 1

Author(s):

Darlene Mara dos Santos Tavares ◽

Isabella Danielle Nader ◽

Mariana Mapelli de Paiva ◽

Flavia Aparecida Dias ◽

Maycon Sousa Pegorari

Keyword(s):

Older Adults ◽

Average Length ◽

The State ◽

Chi Square ◽

Frailty Phenotype ◽

Cross Sectional ◽

Average Length Of Stay ◽

Hospitalization Period ◽

Older Inpatients ◽

Materials Used

Objectives: to identify the prevalence of frailty among inpatient older adults in a clinical hospital and check the association of the socioeconomic and clinical characteristics with the state of frailty. Method: observational, cross-sectional and analytical study, conducted with 255 hospitalized patients. Materials used: structured instrument for the economical and clinical data and frailty phenotype of Fried. Descriptive and bivariate statistical analysis was carried out and, by means of chi-square tests and ANOVA One-way (p<0.05). Results: the prevalence of frailty corresponded to 26.3%, while pre-frailty represented 53.3%. The highest proportion of frail seniors was identified for 80 years or older (p = 0.004), widowed (p = 0.035) and with the highest average length of stay (p = 0.006). Conclusion: inpatient older adults presented high percentages of frail states associated with socioeconomic variables and hospitalization period. The identification of the health conditions related to pre-frailty and frailty can foster the planning and implementation of the assistance to older adults in this context.

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Prevalence and factors associated with chronic wounds in older adults in primary care

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2017051303415 ◽

2018 ◽

Vol 52 (0) ◽

Cited By ~ 3

Author(s):

Chrystiany Plácido de Brito Vieira ◽

Telma Maria Evangelista de Araújo

Keyword(s):

Physical Activity ◽

Older Adults ◽

Primary Care ◽

Chronic Wounds ◽

Family Income ◽

Family Health ◽

Multivariate Logistic Regression Model ◽

Cross Sectional ◽

Diabetic Ulcer ◽

Dietary Restrictions

ABSTRACT Objective: To analyze the prevalence of pressure injuries, diabetic and vasculogenic ulcers and associated factors in older adults attended in primary care. Method: A cross-sectional, analytical study with older adults attended in the Family Health Strategy in a Brazilian municipality. Data collection was performed from January to March 2016 using interviews and evaluations of injuries. The variables were submitted to the multivariate logistic regression model using the odds ratio, with their respective 95% confidence intervals and significance set at <0.05. Results: 339 older adults participated in the study. The mean age was 71.1 years, 67.3% were female, 44% were illiterate, 85% had low family income, 91.7% had underlying diseases, 37.2% had dietary restrictions, and 76.1% did not practice physical activity. The prevalence of pressure injury was 5.0%, diabetic ulcer 3.2%, and vasculogenic ulcer 2.9%. Not working and not regularly practicing physical activity increased the chances of presenting these injuries by 1.5 and 2.3 times, respectively. Being actively mobility and not having dietary restrictions were protective factors for not developing chronic wounds. Conclusion: The prevalence of injuries among older adults was high, and its occurrence is associated with socioeconomic and clinical characteristics.

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Effects of Attitude, Motivation, and Eagerness for Physical Activity among Middle-Aged and Older Adults

Journal of Healthcare Engineering ◽

10.1155/2020/1014891 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Md Mizanur Rahman ◽

Dongxiao Gu ◽

Changyong Liang ◽

Rao Muhammad Rashid ◽

Monira Akter

Keyword(s):

Physical Activity ◽

Older Adults ◽

Positive Attitude ◽

Sports Participation ◽

Cost Effective ◽

Cross Sectional Study ◽

Middle Aged ◽

Cross Sectional ◽

Cost Effective Method ◽

Global Statistics

Background. Although physical activity (PA) is a noninvasive and cost-effective method of improving the quality of health, global statistics show that only a few middle-aged and older adults engage in the recommended PAs. This is due to a lack of motivation and companionship. Objective. This study analyses the attitudes and self-determined motivation of Chinese middle-aged and older adults for PAs and their eagerness to participate in PAs such as sports, exercise, and recreational and cultural activities (RCAs), from attitudinal, eagerness, and motivational objectives of PAs perspective. Methods. A cross-sectional study was carried out on 840 middle-aged (35–54 years) and older adults (55+ years). To determine their attitude, eagerness, and self-determined motivation for PA, we used attitudinal, Eagerness for Physical Activity Scale (EPAS), and Situational Motivational Scale (SIMS). The data were analyzed with SPSS 23.0. Results. The results show that 39.1% of the participants were not satisfied with PAs. Compared with females, males reported a less positive attitude towards PAs. Moreover, a positive attitude decreases with age. Participants’ motivation and eagerness in activities such as RCAs, exercise, and sports are decreasing. Regarding self-determined motivation, there are gender differences in RCAs, but there is none for exercise and sports participation. Conclusion. The findings show the importance of RCAs and the support of family and friends enhancing the eagerness, attitude, and motivation to participate in PAs. Furthermore, the findings can help to create more effective PA programs for middle-aged and older adults. By engaging in RCAs, participants can reap the benefits of PAs. Participating in RCAs can lead to social equity in health.

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