Factors associated with the social, individual and programmatic vulnerability of older adults living at home

ABSTRACT Objective: To verify the occurrence and factors associated to social, individual and programmatic vulnerability among older adults. Method: A household and cross-sectional survey conducted with 701 community-dwelling older adults. For evaluation of the individual component, we used the frailty phenotype; for the social component, the social vulnerability index was implemented; and for the programmatic component, the Index of access and use of health services. Descriptive and bivariate statistical analyzes and multinomial logistic regression were also carried out (p≤ 0.05). Results: It was verified that 15.7% of the older adults lived in areas of high social vulnerability, 31.8% were physically frail and had a moderate programmatic vulnerability score. Older people of a lower age, having lower education and income levels were more likely to live in areas of high or very high social vulnerability. The female gender and the high age groups increased the chances of the frailty condition. It was also observed that the older adults in the 70├ 80-year age group and having lower education were more likely to have medium programmatic vulnerability. Conclusion: The importance of primary care professionals to consider the multidimensional aspect of vulnerability in identifying older adults who need to be prioritized in health care is evidenced.

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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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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 Social Vulnerability Index, Mortality and Disability in Mexican Middle-Aged and Older Adults

Geriatrics ◽

10.3390/geriatrics6010024 ◽

2021 ◽

Vol 6 (1) ◽

pp. 24

Author(s):

Natalia Sánchez-Garrido ◽

Sara G. Aguilar-Navarro ◽

José Alberto Ávila-Funes ◽

Olga Theou ◽

Melissa Andrew ◽

...

Keyword(s):

Older Adults ◽

Social Vulnerability ◽

Vulnerability Index ◽

Adverse Outcomes ◽

Social Vulnerability Index ◽

Middle Aged ◽

Logistic Regression Models ◽

The Social ◽

Aging Study ◽

Different Populations

The social vulnerability index (SVI) independently predicts mortality and others adverse outcomes across different populations. There is no evidence that the SVI can predict adverse outcomes in individuals living in countries with high social vulnerability such as Latin America. The aim of this study was to analyze the association of the SVI with mortality and disability in Mexican middle-aged and older adults. This is a longitudinal study with a follow-up of 47 months, the Mexican Health and Aging Study, including people over the age of 40 years. A SVI was calculated using 42 items stratified in three categories low (<0.36), medium (0.36–0.47), and high (>0.47) vulnerability. We examined the association of SVI with three-year mortality and incident disability. Cox and logistic regression models were fitted to test these associations. We included 14,217 participants (58.4% women) with a mean age of 63.9 years (±SD 10.1). The mean SVI was of 0.42 (±SD 0.12). Mortality rate at three years was 6% (n = 809) and incident disability was 13.2% (n = 1367). SVI was independently associated with mortality, with a HR of 1.4 (95% CI 1.1–1.8, p < 0.001) for the highest category of the SVI compared to the lowest. Regarding disability, the OR was 1.3 (95% CI 1.1–1.5, p = 0.026) when comparing the highest and the lowest levels of the SVI. The SVI was independently associated with mortality and disability. Our findings support previous evidence on the SVI and builds on how this association persists even in those individuals with underlying contextual social vulnerability.

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Factors Associated with Health-Related Quality of Life in Community-Dwelling Older Adults: A Multinomial Logistic Analysis

Journal of Clinical Medicine ◽

10.3390/jcm8111810 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1810 ◽

Cited By ~ 2

Author(s):

Encarnación Blanco-Reina ◽

Jenifer Valdellós ◽

Ricardo Ocaña-Riola ◽

María Rosa García-Merino ◽

Lorena Aguilar-Cano ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Multinomial Logistic Regression ◽

Community Dwelling ◽

Health Related Quality ◽

Factors Associated ◽

Related Quality ◽

Health Related ◽

Community Dwelling Older Adults

The main aim of this study was to determine the association of various clinical, functional and pharmacological factors with the physical (PCS) and mental (MCS) summary components of the health-related quality of life (HRQoL) of community-dwelling older adults. Design: Cross-sectional study. Patients and setting: Sample of 573 persons aged over 65 years, recruited at 12 primary healthcare centres in Málaga, Spain. Sociodemographic, clinical, functional, and comprehensive drug therapy data were collected. The main outcome was HRQoL assessed on the basis of the SF-12 questionnaire. A multinomial logistic regression model was constructed to study the relationship between independent variables and the HRQoL variable, divided into intervals. The average self-perceived HRQoL score was 43.2 (± 11.02) for the PCS and 48.5 (± 11.04) for the MCS. The factors associated with a poorer PCS were dependence for the instrumental activities of daily living (IADL), higher body mass index (BMI), number of medications, and presence of osteoarticular pathology. Female gender and the presence of a psychopathological disorder were associated with worse scores for the MCS. The condition that was most strongly associated with a poorer HRQoL (in both components, PCS and MCS) was that of frailty (odds ratio (OR) = 37.42, 95% confidence interval (CI) = 8.96–156.22, and OR = 20.95, 95% CI = 7.55–58.17, respectively). It is important to identify the determinant factors of a diminished HRQoL, especially if they are preventable or modifiable.

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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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Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study

Innovation in Aging ◽

10.1093/geroni/igaa057.2380 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 683-683

Author(s):

Asa Inagaki ◽

Ayumi Igarashi ◽

Maiko Noguchi-Watanabe ◽

Mariko Sakka ◽

Chie Fukui ◽

...

Keyword(s):

Older Adults ◽

Online Survey ◽

Physical Restraint ◽

Community Dwelling ◽

Physical Restraints ◽

Care Nurse ◽

Factors Associated ◽

Home Care Nurse ◽

Community Dwelling Older Adults ◽

At Home

Abstract Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.

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Patterns and predictive factors of loss of the independence trajectory among community-dwelling older adults

BMC Geriatrics ◽

10.1186/s12877-021-02063-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Charlotte Bimou ◽

Michel Harel ◽

Cécile Laubarie-Mouret ◽

Noëlle Cardinaud ◽

Marion Charenton-Blavignac ◽

...

Keyword(s):

Older Adults ◽

Predictive Factors ◽

Multinomial Logistic Regression ◽

Cognitive Disorder ◽

Community Dwelling ◽

Functional Autonomy ◽

Process Loss ◽

Associated Risk Factors ◽

Study Participants ◽

Community Dwelling Older Adults

Abstract Background Independence is related to the aging process. Loss of independence is defined as the inability to make decisions and participate in activities of daily living (ADLs). Independence is related to physical, psychological, biological, and socioeconomic factors. An enhanced understanding of older people’s independence trajectories and associated risk factors would enable the develop early intervention strategies. Methods Independence trajectory analysis was performed on patients identified in the Unité de Prévention de Suivi et d’Analyse du Vieillissement (UPSAV) database. UPSAV cohort is a prospective observational study. Participants were 221 community-dwelling persons aged ≥75 years followed for 24 months between July 2011–November 2013 and benefits from a prevention strategy. Data were collected prospectively using a questionnaire. Independence was assessed using the “Functional Autonomy Measurement System (Système de Mesure de l’Autonomie Fonctionnelle (SMAF))”. Group-based trajectory modeling (GBTM) was performed to identify independence trajectories, and the results were compared with those of k-means and hierarchical ascending classifications. A multinomial logistic regression was performed to identify predictive factors of the independence trajectory. Results Three distinct trajectories of independence were identified including a “Stable functional autonomy (SFA) trajectory” (53% of patients), a “Stable then decline functional autonomy decline (SDFA) trajectory” (33% of patients) and a “Constantly functional autonomy decline (CFAD) trajectory” (14% of patients). Not being a member of an association, and previous fall were significantly associated of a SDFA trajectory (P < 0.01). Absence of financial and human assistance, no hobbies, and cognitive disorder were significantly associated with a CFAD trajectory (P < 0.01). Previous occupation and multiple pathologies were predictive factors of both declining trajectories SDFA and CFAD. Conclusions Community-living older persons exhibit distinct independence trajectories and the predictive factors. The evidence from this study suggests that the prevention and screening for the loss of independence of the older adults should be anticipated to maintaining autonomy.

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Exploratory Testing of an Artificial Neural Network Classification for Enhancement of the Social Vulnerability Index

ISPRS International Journal of Geo-Information ◽

10.3390/ijgi4041774 ◽

2015 ◽

Vol 4 (4) ◽

pp. 1774-1790 ◽

Cited By ~ 6

Author(s):

Ryan Hile ◽

Thomas Cova

Keyword(s):

Neural Network ◽

Artificial Neural Network ◽

Social Vulnerability ◽

Vulnerability Index ◽

Social Vulnerability Index ◽

Neural Network Classification ◽

Exploratory Testing ◽

The Social ◽

Artificial Neural

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Factors Associated with Frailty According to Gender of Older Adults Living Alone

Healthcare ◽

10.3390/healthcare9040475 ◽

2021 ◽

Vol 9 (4) ◽

pp. 475

Author(s):

Hye-Young Jang ◽

Ji-Hye Kim

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Nutritional Status ◽

Chronic Diseases ◽

Multinomial Logistic Regression ◽

Living Alone ◽

Factors Associated ◽

Chi Squared ◽

Korean Elderly

This study was conducted to identify the factors associated with frailty according to gender of older adults living alone in Korea. Data from the National Survey of the Living Conditions of Korean Elderly in 2017 were used. Participants were 2340 older adults who live alone. Frailty was determined based on the frailty criteria developed by van Kan et al. that consist of fatigue, resistance, ambulation, and illness. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, Jonckheere–Terpstra test and multinomial logistic regression. Among the older men living alone, 47.7% were in the pre-frail and 5.1% were in the frail. On the other hand, 51.8% were in the pre-frail and 12.2% were in the frail among the older women living alone. The factors associated with frailty according to gender are as follows. In males, depressive symptoms, limitation in IADL, and number of medications in pre-frail; BMI, limitation in IADL, and number of chronic diseases in frail. In females, depressive symptoms, number of chronic diseases, age, and nutritional status in pre-frail; limitation in IADL, depressive symptoms, age, number of chronic diseases, number of medications, nutritional status in frail. Based on the findings of this study, it is considered necessary to approach frailty management considering gender as well as the classification of frailty.

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