scholarly journals Frailty among Mexican community-dwelling elderly: a story told 11 years later.The Mexican Health and Aging Study

2015 ◽  
Vol 57 ◽  
pp. 62 ◽  
Author(s):  
José Alberto Ávila Funes ◽  
Sara G Aguilar-Navarro ◽  
Hélène Amieva ◽  
Luis Miguel Gutiérrez-Robledo
Keyword(s):  
Community Dwelling ◽  
Multiple Covariates ◽  
Mexican Community ◽  
Aging Study ◽  
Health Related ◽  
Reported Health ◽  
Adl Disability ◽  
Self Reported Health Status ◽  
Slow Walking Speed

Objective. To describe the characteristics and prognosisof subjects classified as frail in a large sample of Mexican community-dwelling elderly. Materials and methods. An eleven-year longitudinal study of 5 644 old adults participating in the Mexican Health and Aging Study (MHAS). Frailty was defined by meeting at least three of the following criteria: weight loss, weakness, exhaustion, slow walking speed and low physical activity. The main outcomes were incident disability and death. Multiple covariates were used to test the prognostic value of frailty. Results. Thirty-seven percent of participants (n = 2 102) met the frailty criteria. Frail participants were significantly older, female, less educated, with more chronic disease, lower income, and poorer self-reported health status, in comparison with their non-frail counterparts. Frailty was a predictor both for disability activities of daily living and for mortality. Conclusion. After a follow-up of more than ten years, the phenotype of frailty was a predictor for adverse health-related outcomes, including ADL disability and death.

scholarly journals Predicting poorer health outcomes in older community-dwelling patients with multimorbidity: prospective cohort study assessing the accuracy of different multimorbidity definitions

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023919 ◽  
Author(s):  
Maxime Sasseville ◽  
Susan M Smith ◽  
Lisa Freyne ◽  
Ronald McDowell ◽  
Fiona Boland ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Outcomes ◽  
Community Dwelling ◽  
Health Related Quality ◽  
Predictive Values ◽  
Related Quality ◽  
Health Related ◽  
Reported Health

PurposeMultimorbidity is commonly defined and measured using condition counts. The UK National Institute for Health Care Excellence Guidelines for Multimorbidity suggest that a medication-orientated approach could be used to identify those in need of a multimorbidity approach to management.ObjectivesTo compare the accuracy of medication-based and diagnosis-based multimorbidity measures at higher cut-points to identify older community-dwelling patients who are at risk of poorer health outcomes.DesignA secondary analysis of a prospective cohort study with a 2-year follow-up (2010–2012).Setting15 general practices in Ireland.Participants904 older community-dwelling patients.ExposureBaseline multimorbidity measurements based on both medication classes count (MCC) and chronic disease count (CDC).OutcomesMortality, self-reported health related quality of life, mental health and physical functioning at follow-up.AnalysisSensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) adjusting for clustering by practice for each outcome using both definitions.ResultsOf the 904 baseline participants, 53 died during follow-up and 673 patients completed the follow-up questionnaire. At baseline, 223 patients had 3 or more chronic conditions and 89 patients were prescribed 10 or more medication classes. Sensitivity was low for both MCC and CDC measures for all outcomes. For specificity, MCC was better for all outcomes with estimates varying from 88.8% (95% CI 85.2% to 91.6%) for physical functioning to 90.9% (95% CI 86.2% to 94.1%) for self-reported health-related quality of life. There were no differences between MCC and CDC in terms of PPV and NPV for any outcomes.ConclusionsNeither measure demonstrated high sensitivity. However, MCC using a definition of 10 or more regular medication classes to define multimorbidity had higher specificity for predicting poorer health outcomes. While having limitations, this definition could be used for proactive identification of patients who may benefit from targeted clinical care.

FRAILTY IS ASSOCIATED WITH DISABILITY AND RECENT HOSPITALIZATION IN COMMUNITY-DWELLING ELDERLY: THE COYOACAN COHORT

2014 ◽  
pp. 1-5
Author(s):  
J.A. AVILA-FUNES ◽  
R.H. MEDINA-CAMPOS ◽  
O. TAMEZ-RIVERA ◽  
A.P. NAVARRETE-REYES ◽  
H. AMIEVA ◽  
...  
Keyword(s):  
Daily Living ◽  
Community Dwelling ◽  
Regression Analyses ◽  
Sectional Study ◽  
Multivariate Models ◽  
Mexican Community ◽  
Iadl Disability ◽  
Health Related ◽  
Cultural Traits ◽  
Adl Disability

Background: The phenotype of frailty proposed by Fried et al has shown to predict several adverse health-related outcomes in elderly populations worldwide; however, the description of such associations in Latin America is still scarce. Objective: To describe the association between frailty and recent hospitalization, disability for basic (ADL) and instrumental activities of daily living (IADL). Design, Setting and Participants:Cross-sectional study of 1,124 community-dwelling adults aged 70 and older participating in the Coyoacán cohort. Measurements: Frailty was defined by the presence of at least three of the following criteria: weight loss, exhaustion, low physical activity, slowness, and weakness. Multiple regression analyses were used to test the association between frailty and the outcomes of interest, adjusting for potential confounders. Results: Mean age was 78.2 (SD ±6.1) years. Prevalence of frailty was 14.1%. Adjusted multivariate models showed that frail status was associated with ADL disability (OR 3.06, 95%CI 1.52-6.17), IADL disability (OR 17.02, 95%CI 6.16-47.01), and recent hospitalization (OR 3.21, 95%CI 1.31-7.8). Conclusion: Among Mexican community-dwelling elderly, frailty is associated with ADL and IADL disability as well as with recent hospitalizations. Moreover, frailty’s prevalence in this population appears to be greater compared to what has been reported elsewhere. Social and cultural traits should be further studied as correlates of frailty in diverse populations.

ASSOCIATION BETWEEN SELF–REPORTED HEALTH STATUS AND FRAILTY IN COMMUNITY–DWELLING ELDERLY

2014 ◽  
pp. 1-5
Author(s):  
A.M. GONZÁLEZ-PICHARDO ◽  
A.P. NAVARRETE-REYES ◽  
H. ADAME-ENCARNACIÓN ◽  
S. AGUILAR-NAVARRO ◽  
J.M.A. GARCÍA-LARA ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Health Status ◽  
Multinomial Logistic Regression ◽  
Community Dwelling ◽  
Frailty Syndrome ◽  
Cross Sectional ◽  
Adverse Health ◽  
Health Related ◽  
Reported Health ◽  
Self Reported Health Status

Background:The phenotype of frailty proposed by Fried et al. has been related with increasedvulnerability for the development of adverse health-related outcomes. However, this phenotype is not often usedin daily clinical practice. On the other hand, poor self-reported health status (SRHS) has been associated withsimilar adverse health-related outcomes. Objectives:To determine the association between poor SRHS andfrailty. Design, setting and participants: Cross-sectional study of 927 community-dwelling elderly aged 70 andolder, participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty. Measurements:SRHS was established by the question “How do you rate your health status in general?” Frailty was definedaccording to the phenotype proposed by Fried et al. The association between SRHS and frailty was determinedthrough the construction of multinomial logistic regression models. Final analyses were adjusted by socio-demographic and health covariates, including depressive symptoms. Also, agreement between SRHS and thephenotype of frailty was explored. Results:Prevalence of frailty was 14.1%, and 4.4% of participants rated theirhealth status as “poor”. The unadjusted regression analyses demonstrated that fair and poor SRHS weresignificantly associated with prefrail and frail status. After adjustment for multiple covariates, the associationremained statistically significant. However, in the final adjustment for depressive symptoms, only the associationbetween poor SRHS and frail status continued to be statistically significant. Fair agreement between poor SRHSand frail status was also found. Conclusion:Poor SRHS shares common correlates as well as health-relatedadverse outcomes with frailty syndrome, and remains associated with it even when possible confounders aretaken into account. Therefore, poor SRHS could be further explored as an option for frailty syndrome screening.

scholarly journals Self-reported health status, treatment decision and survival in asymptomatic and symptomatic patients with aortic stenosis in a Western Norway population undergoing conservative treatment: a cross-sectional study with 18 months follow-up

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016489 ◽  
Author(s):  
Kjersti Oterhals ◽  
Rune Haaverstad ◽  
Jan Erik Nordrehaug ◽  
Geir Egil Eide ◽  
Tone M Norekvål
Keyword(s):  
Mental Health ◽  
Aortic Valve ◽  
Treatment Decision ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Western Norway ◽  
Asymptomatic Patients ◽  
Reported Health ◽  
Self Reported Health Status

ObjectivesTo investigate symptoms and self-reported health of patients conservatively treated for aortic stenosis (AS) and to identify factors associated with treatment decision and patient outcomes.DesignA cross-sectional survey with an 18-month follow-up.SettingOne tertiary university hospital in Western Norway.ParticipantsIn all, 1436 patients were diagnosed with AS between 2000 and 2012, and those 245 still under conservative treatment in 2013 were included in this study.Primary and secondary outcome measuresPrimary outcome measures were symptoms and self-reported health status. Secondary outcomes were treatment decision and patient survival after 18 months.ResultsA total of 136 patients with mean (SD) age 79 (12) years, 52% men responded. Among conservatively treated patients 77% were symptomatic. The symptom most frequently experienced was dyspnoea. Symptomatic patients reported worse physical and mental health compared with asymptomatic patients (effect size 1.24 and 0.74, respectively). In addition, symptomatic patients reported significantly higher levels of anxiety and depression compared with asymptomatic patients. However, symptom status did not correlate with haemodynamic severity of AS. After 18 months, 117 (86%) were still alive, 20% had undergone surgical aortic valve replacement (AVR) and 7% transcatheter aortic valve implantation (TAVI). When adjusting for age, gender, symptomatic status, severity of AS and European system for cardiac operative risk evaluation (EuroSCORE), patients with severe AS had more than sixfold chance of being scheduled for AVR or TAVI compared with those with moderate AS (HR 6.3, 95% CI 1.9 to 21.2, p=0.003). Patients with EuroSCORE ≥11 had less chance for undergoing AVR or TAVI compared with those with EuroSCORE ≤5 (HR 0.06, 95% CI 0.01 to 0.46, p=0.007).ConclusionsSymptoms affected both physical and mental health in conservatively treated patients with AS. Many patients with symptomatic severe AS are not scheduled for surgery, despite the recommendations in current guidelines. The referral practice for AVR is a path for further investigation.

A bi-directional association between weight change and health-related quality of life: evidence from the 11-year follow-up of 9916 community-dwelling adults

2020 ◽  
Vol 29 (6) ◽  
pp. 1697-1706 ◽  
Author(s):  
Berhe W. Sahle ◽  
Shameran Slewa-Younan ◽  
Yohannes Adama Melaku ◽  
Li Ling ◽  
Andre M. N. Renzaho
Keyword(s):  
Quality Of Life ◽  
Weight Change ◽  
Community Dwelling ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Motoric cognitive risk syndrome and incident dementia in older adults from the Québec NuAge cohort

2020 ◽  
Author(s):  
Olivier Beauchet ◽  
Harmehr Sekhon ◽  
Liam Cooper-Brown ◽  
Cyrille P Launay ◽  
Pierrette Gaudreau ◽  
...  
Keyword(s):  
Older Adults ◽  
Successful Aging ◽  
Walking Speed ◽  
Community Dwelling ◽  
Slow Walking ◽  
Cognitive Risk ◽  
Incident Dementia ◽  
Cognitive Complaint ◽  
Slow Walking Speed

Abstract Background The co-occurrence of slow walking speed and subjective cognitive complaint (SCC) in non-demented individuals defines motoric cognitive risk syndrome (MCR), which is a pre-dementia stage. There is no information on the association between MCR and incident dementia in Québec’s older population. Objective The study aims to examine the association of MCR and its individual components (i.e. SCC and slow walking speed) with incident dementia in community-dwelling older adults living in the province of Québec (Canada). Design Québec older people population-based observational cohort study with 3 years of follow-up. Setting Community dwellings. Subjects A subset of participants (n = 1,098) in ‘Nutrition as a determinant of successful aging: The Québec longitudinal study’ (NuAge). Methods At baseline, participants with MCR were identified. Incident dementia was measured at annual follow-up visits using the Modified Mini-Mental State (≤79/100) test and Instrumental Activity Daily Living scale (≤6/8) score values. Results The prevalence of MCR was 4.2% at baseline and the overall incidence of dementia was 3.6%. MCR (Hazard Ratio (HR) = 5.18, with 95% confidence interval (CI) = [2.43–11.03] and P ≤ 0.001) and SCC alone (HR = 2.54, with 95% CI = [1.33–4.85] and P = 0.005) were associated with incident dementia, but slow walking speed was not (HR = 0.81, with 95%CI = [0.25–2.63] and P = 0.736). Conclusions MCR and SCC are associated with incident dementia in NuAge study participants.

scholarly journals Digestive Symptoms in Older Adults: Prevalence and Associations with Institutionalization and Mortality

2012 ◽  
Vol 26 (12) ◽  
pp. 881-884 ◽  
Author(s):  
Turki AlAmeel ◽  
Mohammed Basheikh ◽  
Melissa K Andrew
Keyword(s):  
Older Adults ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Increased Risk ◽  
Reported Health ◽  
And Function ◽  
Self Assessed Health ◽  
Cognition Impairment ◽  
Community Dwelling Older Adults

BACKGROUND: Digestive symptoms are common in adults. However, little is known about their prevalence in older adults and the association of digestive symptoms with institutionalization and mortality in community-dwelling older adults.OBJECTIVE: To determine the prevalence of digestive symptoms among older adults in Canada and whether they are associated with increased risk of institutionalization and mortality, independent of the effect of potential confounders.METHODS: The present study was a secondary analysis of data collected from community-dwelling participants 65 years of age and older in the Canadian Study of Health and Aging. Measures incuded age, sex, presence of digestive symptoms, cognition, impairment in activities of daily living (ADL) and self-reported health. Outcome measures included death or institutionalization over the 10 years of follow-up.RESULTS: Digestive symptoms were found in 2288 (25.6%) of the 8949 subjects. Those with digestive symptoms were older, with a mean difference in age of six months (P=0.007). Digestive symptoms were more common among women (28.4%) than men (20.3%), among individuals with poor self-reported health and those with an increased number of impairments in their ADLs (P<0.001). The presence of digestive symptoms was associated with higher mortality (HR 1.15 [95% CI 1.05 to 1.25] adjusted for age, sex, cognitive function and ADL impairment); however, this association was not statistically significant after adjusting for self-reported health.CONCLUSION: Although digestive symptoms were associated with increased mortality independent of age and sex, cognition and function, this association was largely explained by poor self-assessed health. Digestive symptoms were not associated with institutionalization

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