The development of multidimensional screening model of geriatric syndrome for community-dwelling older adults: results of the Taiwan Integration Health and Welfare (TIHW) Study

Abstract Background: Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic and treatment process that identifies geriatric syndrome in older adults. However, CGA program is not appropriate in community screening. To the best of our knowledge, there is no applicable multidimensional screening model to evaluate geriatric syndrome in community-dwelling older adults. This study aimed to identify the risk factors of geriatric syndrome among physical function tests, socioeconomic status, medical history, and healthy behaviours in community-dwelling older adults and develop a multidimensional prediction model for community screening. Methods: A total of 1313 community-dwelling older adults aged 60 years or above were recruited from 58 communities in four aging cities in Taiwan. Geriatric syndrome was defined by disability using Instrumental Activities of Daily Livings, cognitive impairment using Short Portable Mental Status Questionnaire, depression using Geriatric Depression Scale, or by receiving mild disability card. The cutoff values of the physical function tests were calculated using receiver operating characteristic analysis. Multivariate logistic regression was used to evaluate the risk factors of geriatric syndrome, and the risk model was developed using stepwise logistic regression. Results: We developed the new cutoff values in predicting geriatric syndrome for dominant handgrip strength test, 6-meter walk, and timed up-and-go tests, which were significantly associated with geriatric syndrome. Moreover, male sex, obesity, absence of labour activities, and participants who cannot report personal information, had depressive mood for the past 2 weeks, and a history of heart disease were associated with geriatric syndrome. Finally, we developed Taiwan Risk Scores for Geriatric Syndrome (TRSGS) with the cutoff value of 6 (sensitivity, 77.2%; specificity, 75.5%). Conclusions: Most of the screening tools focus on specific problems such as sarcopenia, dementia, or frailty. The TRSGS model demonstrated a multidimensional prediction model, which could be applied in community screening for geriatric syndrome. Management of risk factors to prevent geriatric syndrome in the community is important.

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10-Year Renal Function Trajectories in Community-Dwelling Older Adults: Exploring the Risk Factors for Different Patterns

Journal of Clinical Medicine ◽

10.3390/jcm7100373 ◽

2018 ◽

Vol 7 (10) ◽

pp. 373

Author(s):

Chia-Ter Chao ◽

Yung-Ming Chen ◽

Fu-Hui Ho ◽

Kun-Pei Lin ◽

Jen-Hau Chen ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Logistic Regression ◽

Renal Function ◽

Estimated Glomerular Filtration Rate ◽

Community Dwelling ◽

Multivariate Logistic Regression ◽

Improve Risk Stratification ◽

Leukocyte Counts ◽

Community Dwelling Older Adults

Longitudinal changes of renal function help inform patients’ clinical courses and improve risk stratification. Rare studies address risk factors predicting changes in estimated glomerular filtration rate (eGFR) over time in older adults, particularly of Chinese ethnicity. We identified prospectively enrolled community-dwelling older adults (≥65 years) receiving annual health examinations between 2005 and 2015 with serum creatinine available continuously in a single institute, and used linear regression to derive individual’s annual eGFR changes, followed by multivariate logistic regression analyses to identify features associated with different eGFR change patterns. Among 500 elderly (71.3 ± 4.2 years), their mean annual eGFR changes were 0.84 ± 1.67 mL/min/1.73 m2/year, with 136 (27.2%) and 238 (47.6%) classified as having downward (annual eGFR change <0 mL/min/1.73 m2/year) and upward eGFR (≥1 mL/min/1.73 m2/year) trajectories, respectively. Multivariate logistic regression showed that higher age (odds ratio (OR) 1.08), worse renal function (OR 13.2), and more severe proteinuria (OR 9.86) or hematuria (OR 3.39) were predictive of a declining eGFR while greater waist circumference (OR 1.06) and higher leukocyte counts (OR 1.21) were predictive of an uprising 10-year eGFR. These findings elucidate important features associated with geriatric renal function variations, which are expected to improve their renal care.

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Risk Factors of Falls in Community-Dwelling Older Adults: Logistic Regression Tree Analysis

The Gerontologist ◽

10.1093/geront/gns043 ◽

2012 ◽

Vol 52 (6) ◽

pp. 822-832 ◽

Cited By ~ 26

Author(s):

T. Yamashita ◽

D. A. Noe ◽

A. J. Bailer

Keyword(s):

Risk Factors ◽

Older Adults ◽

Logistic Regression ◽

Regression Tree ◽

Community Dwelling ◽

Tree Analysis ◽

Regression Tree Analysis ◽

Community Dwelling Older Adults

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Functional Constipation and Anorexia in Community-Dwelling Older Adults: Korean Frailty and Aging Cohort Study (KFACS)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115754 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5754

Author(s):

Eunjin Jeong ◽

Jung A Kim ◽

Byung Sung Kim ◽

Chang Kyun Lee ◽

Miji Kim ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Depressed Mood ◽

Mmse Score ◽

Univariate Analysis ◽

Functional Constipation ◽

Community Dwelling ◽

Geriatric Syndrome ◽

Female Sex ◽

Community Dwelling Older Adults

Anorexia is a relevant geriatric syndrome because it accounts for most malnutrition in older adults. Constipation has been suggested as a risk factor for anorexia. This study aimed to examine the association between anorexia and functional constipation in community-dwelling older adults. Data on 899 subjects aged 72–86 years were obtained from a follow-up survey of the Korean Frailty and Aging Cohort Study in 2018. Anorexia was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ), while functional constipation was diagnosed based on Rome IV criteria. Anorexia and functional constipation were present in 30.9% and 19.6% of the participants, respectively. Age, female sex, chewing problems, malnutrition, polypharmacy, low Mini-Mental Status Examination (MMSE) score, depressed mood, low serum albumin, and functional constipation were associated with anorexia in the univariate analysis. In the multivariate logistic regression, functional constipation was associated with anorexia (OR 1.478, 95% CI 1.038–2.104) after adjusting for age, female sex, and MMSE score. However, after further adjusting for depressed mood (OR 2.568) and chewing problems (OR 2.196), the relationship was no longer significant. This study showed that functional constipation is associated with anorexia in community-dwelling older adults, but this association is confounded by depressed mood and chewing problems.

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Prediction of 11-year incidence of psychophysically dependent status or death among community-dwelling younger elderlies: from an age-specified community-based cohort study (the NISSIN project)

Environmental Health and Preventive Medicine ◽

10.1186/s12199-021-00968-8 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Satoe Okabayashi ◽

Takashi Kawamura ◽

Hisashi Noma ◽

Kenji Wakai ◽

Masahiko Ando ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cohort Study ◽

Prediction Model ◽

Nursing Care ◽

Family Members ◽

Limited Resource ◽

Community Dwelling ◽

Older Individuals ◽

Regression Analyses

Abstract Background Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. Methods We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2005 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. Results Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714–0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699–0.771). Conclusions We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.

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Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126666 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6666

Author(s):

Yoshihiro Kugimiya ◽

Masanori Iwasaki ◽

Yuki Ohara ◽

Keiko Motokawa ◽

Ayako Edahiro ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cross Sectional Study ◽

Albumin Level ◽

Community Dwelling ◽

Tongue Pressure ◽

Swallowing Function ◽

Cross Sectional ◽

Community Dwelling Older Adults ◽

The Relationship

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.

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Diagnostic Power of Circulatory Metabolic Biomarkers as Metabolic Syndrome Risk Predictors in Community-Dwelling Older Adults in Northwest of England (A Feasibility Study)

Nutrients ◽

10.3390/nu13072275 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2275

Author(s):

Razieh Hassannejad ◽

Hamsa Sharrouf ◽

Fahimeh Haghighatdoost ◽

Ben Kirk ◽

Farzad Amirabdollahian

Keyword(s):

Risk Factors ◽

Older Adults ◽

Metabolic Syndrome ◽

Roc Analysis ◽

Cross Validation ◽

Community Dwelling ◽

Tnf Α ◽

Diagnostic Power ◽

Metabolic Biomarkers ◽

Community Dwelling Older Adults

Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.

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Polish Translation and Validation of the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire to Assess Nutritional and Non-Nutritional Risk Factors of Sarcopenia in Older Adults

Nutrients ◽

10.3390/nu13041061 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1061

Author(s):

Roma Krzymińska-Siemaszko ◽

Ewa Deskur-Śmielecka ◽

Arkadiusz Styszyński ◽

Katarzyna Wieczorowska-Tobis

Keyword(s):

Risk Factors ◽

Older Adults ◽

Risk Assessment ◽

Predictive Value ◽

High Sensitivity ◽

Community Dwelling ◽

Nutritional Risk ◽

Polish Language ◽

Community Dwelling Older Adults ◽

Translation And Validation

A simple, short, cheap, and reasonably sensitive and specific screening tool assessing both nutritional and non-nutritional risk factors for sarcopenia is needed. Potentially, such a tool may be the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire, which is available in a seven-item (MSRA-7) and five-item (MSRA-5) version. The study’s aim was Polish translation and validation of both MSRA versions in 160 volunteers aged ≥60 years. MSRA was validated against the six sets of international diagnostic criteria for sarcopenia used as the reference standards. PL-MSRA-7 and PL-MSRA-5 both had high sensitivity (≥84.9%), regardless of the reference standard. The PL-MSRA-5 had better specificity (44.7–47.2%) than the PL-MSRA-7 (33.1–34.7%). Both questionnaires had similarly low positive predictive value (PL-MSRA-5: 17.9–29.5%; PL-MSRA-7: 14.4–25.2%). The negative predictive value was generally high for both questionnaires (PL-MSRA-7: 89.8–95.9%; PL-MSRA-5: 92.3–98.5%). PL-MSRA-5 had higher accuracy than the PL-MSRA-7 (50.0–55% vs. 39.4–45%, respectively). Based on the results, the Mini Sarcopenia Risk Assessment questionnaire was successfully adopted to the Polish language and validated in community-dwelling older adults from Poland. When compared with PL-MSRA-7, PL-MSRA-5 is a better tool for sarcopenia risk assessment.

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Risk Factors for Mobility Limitation in Community-Dwelling Older Adults: A Social Ecological Perspective

Geriatric Nursing ◽

10.1016/j.gerinurse.2007.07.002 ◽

2008 ◽

Vol 29 (2) ◽

pp. 133-140 ◽

Cited By ~ 72

Author(s):

Hye A. Yeom ◽

Julie Fleury ◽

Colleen Keller

Keyword(s):

Risk Factors ◽

Older Adults ◽

Community Dwelling ◽

Mobility Limitation ◽

Ecological Perspective ◽

Social Ecological ◽

Community Dwelling Older Adults

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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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