Associations Between Intellectual and Social Activities With Frailty Among Community-Dwelling Older Adults in China: A Prospective Cohort Study

Background: Frailty is one of the most important global health challenges. We aimed to examine the associations between frequency of intellectual and social activities and frailty among community-dwelling older adults in China.Methods: This is a prospective analysis of older adults (aged ≥60 years) who had intellectual and social activity data and were free of frailty from the national representative China Health and Retirement Longitudinal Study (CHARLS). The exposure was frequency of intellectual and social activities. Frailty was measured by the frailty index (FI) and defined as FI ≥ 0.25. Frailty incidents were followed up for 2 years. We estimated the relative risks (RRs) with 95% confidence intervals (CIs) using log-linear binominal regression adjusting for potential confounders.Results: We documented 655 frailty cases over the past 2 years. Participants who had frequent intellectual activities had a lower frailty risk compared with participants who did not have intellectual activity (adjusted RR = 0.65, 95%CI = 0.47–0.90). The adjusted RRs were 0.51 (95%CI = 0.33–0.77) for participants who did not have a slip or a fall accident and 1.06 (95%CI = 0.65–1.75) for participants who had experienced slip and fall accidents (P = 0.01 for interaction). Having frequent social activities was not associated with a significant decrease in frailty risk compared with participants who did not have social activity (adjusted RR = 0.93, 95%CI = 0.78–1.12).Conclusions: This observational study showed that having frequent intellectual activities was associated with a decreased frailty risk. The association was likely to be stronger in participants without a slip or a fall accident. Randomized controlled trials are needed to confirm this observational finding.

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Participation in Social Activities and Relationship between Walking Habits and Disability Incidence

Journal of Clinical Medicine ◽

10.3390/jcm10091895 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1895

Author(s):

Osamu Katayama ◽

Sangyoon Lee ◽

Seongryu Bae ◽

Keitaro Makino ◽

Ippei Chiba ◽

...

Keyword(s):

Older Adults ◽

Social Activity ◽

Community Dwelling ◽

Social Activities ◽

Term Care ◽

Long Term Care Insurance ◽

Community Dwelling Older Adults ◽

The Relationship

Identifying the relationship between physical and social activity and disability among community-dwelling older adults may provide important information for implementing tailored interventions to prevent disability progression. The aim of this study was to determine the effect of the number of social activities on the relationship between walking habits and disability incidence in older adults. We included 2873 older adults (mean age, 73.1 years; SD, ±5.9 years) from the National Center for Geriatrics and Gerontology—Study of Geriatric Syndromes. Baseline measurements, including frequencies of physical and social activities, health conditions, physical function, cognitive function, metabolic parameters, and other potential disability risk factors (for example, the number of years of education); monthly assessment for disability was monitored through long-term care insurance certification for at least 2 years from baseline. During a mean follow-up of 35.1 months (SD, 6.4 months), 133 participants developed disability. The disability incidence was 19.0 and 27.9 per 1000 person-years for participants who walked more (≥3 times per week) and less (≤3 times per week) frequently, respectively. The potential confounding factor-adjusted disability hazard ratio was 0.67 (95% confidence interval, 0.46 to 0.96; p = 0.030). The relationship between habitual walking and the number of social activities was statistically significant (p = 0.004). The reduction of disability risk by walking was greater among participants with fewer social activities. Habitual walking was associated with disability incidence, with a more pronounced effect among older adults who were less likely to engage in social activities.

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Bedside Ultrasound Measures of Muscle Mass and Frailty Measures in Community-Dwelling Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.861 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 269-269

Author(s):

Kenneth Madden ◽

Boris Feldman ◽

Shane Arishenkoff ◽

Graydon Meneilly

Keyword(s):

Older Adults ◽

Muscle Mass ◽

Frailty Index ◽

Geriatric Medicine ◽

Muscle Thickness ◽

Vancouver General Hospital ◽

Community Dwelling ◽

Point Of Care Ultrasound ◽

Clinical Frailty Scale ◽

Community Dwelling Older Adults

Abstract The age-associated loss of muscle mass and strength in older adults is called sarcopenia, and it is associated with increased rates of falls, fractures, hospitalizations and death. Sarcopenia is one of the most common physical etiologies for increased frailty in older adults, and some recent work has suggested the use of Point-of care ultrasound (PoCUS) measures as a potential measure of muscle mass. The objective of this study was to examine the association of PoCUS measures of muscle thickness (MT) with measures of frailty in community-dwelling older adults. We recruited 150 older adults (age >= 65; mean age 80.0±0.5 years, 66 women, 84 men) sequentially from 5 geriatric medicine clinics (Vancouver General Hospital). We measured lean muscle mass (LMM, by bioimpedance assay) and an ultrasonic measure of muscle quantity (MT, vastus medialis muscle thickness) in all subjects, as well as two outcome measures of frailty (FFI, Fried Frailty Index; RCFS, Rockwood Clinical Frailty Scale). In our models, MT showed an inverse correlation with the FFI (Standardized β=-0.2320±0.107, p=0.032) but no significant correlation with the RCFS (Standardized β = -0.025±0.086, p=0.776). LMM showed no significant association with either FFI (Standardized β=-0.232±0.120, p=0.055) or RCFS (Standardized β = -0.043±0.119, p=0.719). Our findings indicate that PoCUS measures show potential as a way to screen for physical manifestations of frailty and might be superior to other bedside methods such as bioimpedance assay. However, PoCUS measures of muscle thickness will likely miss patients showing frailty in the much broader context captured by the RCFS.

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Corrigendum to “Oral Frailty Index-8 in the risk assessment of new-onset oral frailty and functional disability among community-dwelling older adults” Archives of Gerontology and Geriatrics, Volume 94 (2021) 104340

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2021.104466 ◽

2021 ◽

Vol 96 ◽

pp. 104466

Author(s):

Tomoki Tanaka ◽

Hirohiko Hirano ◽

Yuki Ohara ◽

Misa Nishimoto ◽

Katsuya Iijima

Keyword(s):

Older Adults ◽

Risk Assessment ◽

Functional Disability ◽

Frailty Index ◽

Community Dwelling ◽

Community Dwelling Older Adults ◽

Oral Frailty ◽

New Onset

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Oral Frailty Index-8 in the risk assessment of new-onset oral frailty and functional disability among community-dwelling older adults

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2021.104340 ◽

2021 ◽

Vol 94 ◽

pp. 104340

Author(s):

Tomoki Tanaka ◽

Hirohiko Hirano ◽

Yuki Ohara ◽

Misa Nishimoto ◽

Katsuya Iijima

Keyword(s):

Older Adults ◽

Risk Assessment ◽

Functional Disability ◽

Frailty Index ◽

Community Dwelling ◽

Community Dwelling Older Adults ◽

Oral Frailty ◽

New Onset

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44 Association between Falls and Cognitive Frailty among Community Dwelling Older Adults: A Cross Sectional Study

Age and Ageing ◽

10.1093/ageing/afz164.44 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv9-iv12

Author(s):

Resshaya Roobini Murukesu ◽

Devinder Kaur Ajit Singh ◽

Noor Izyani Mokhtar ◽

Janet Bong May Ing ◽

Ponnusamy Subramaniam ◽

...

Keyword(s):

Older Adults ◽

Rating Scale ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

Cognitive Frailty ◽

Prospective Longitudinal ◽

Community Dwelling Older Adults

Abstract Introduction The presence of either frailty or cognitive impairment have been determined as precursors of falls among older adults. However, the association between falls and cognitive frailty has yet to be established. Objective To investigate the association between falls and cognitive frailty among community dwelling older adults. Methods A total of 246 Malaysian community dwelling older adults aged 60 years and above residing in the state of Selangor participated in this cross-sectional study. Sociodemographic details and clinical characteristics including the history of falls were obtained via interview. The presence of cognitive frailty was identified using the Clinical Dementia Rating Scale and Fried Frailty Index. Data analysis was carried out via binary logistic regression. Results The prevalence of falls and cognitive frailty in this study were 21.2% and 21.9% respectively among community dwelling older adults (mean age 72.39±5.40). No significant relationship between falls and cognitive frailty [OR:1.187, 95% C.I: 0.493-2.856, p=0.702] was demonstrated. However, older women [OR:2.663, 95% C.I, 1.136-6.239, p=0.024] and the presence of multi-morbidities [OR: 1.431, 95% C.I, 1.026-1.997, p=0.035] were significantly associated with falls which corroborates with existing literature. Conclusion Cognitive frailty was not a significant risk factor of falls among community dwelling older adults in this study. Further research is required in prospective, longitudinal, population-based studies to confirm this result.

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LO13: Characteristics of emergency department visits by community-dwelling older adults who screened positive for elder abuse during home care assessments

CJEM ◽

10.1017/cem.2019.56 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S11 ◽

Cited By ~ 1

Author(s):

E. Mercier ◽

A. Jones ◽

A. Brousseau ◽

J. Hirdes ◽

F. Mowbray ◽

...

Keyword(s):

Older Adults ◽

Home Care ◽

Reporting System ◽

Elder Abuse ◽

Frailty Index ◽

Population Based ◽

Community Dwelling ◽

Care Assessment ◽

Ed Visits ◽

Community Dwelling Older Adults

Introduction: Elder abuse is infrequently detected in the emergency department (ED) and less than 2% are reported to proper law authorities by ED physicians. This study aims to examine the characteristics of community-dwelling older adults who screened positive for elder abuse during home care assessments and the epidemiology of ED visits by these patients relative to other home care patients. Methods: This study utilized a population-based retrospective cohort study of home care patients in Canada between April 1, 2007 and March 31, 2015. Standardized, comprehensive home care assessments were extracted from the Home Care Reporting System. A positive screen for elder abuse was defined as at least one these criteria: fearful of a caregiver; unusually poor hygiene; unexplained injuries; or neglected, abused, or mistreated. Home care assessments were linked to the National Ambulatory Care Reporting System in the regions and time periods in which population-based estimates could be obtained to identify all ED visits within 6 months of the home care assessment. Results: A total of 30,413 from the 2,401,492 patients (1.3%) screened positive for elder abuse during a home care assessment. They were more likely to be male (40.5% versus 35.3%, p < 0.001), to have a cognitive impairment (82.9% versus 65.3%, p < 0.001), a higher frailty index (0.27 versus 0.22, p < 0.001) and to exhibit more depressive symptoms (depression rating scale 1 or more: 68.7% versus 42.7%, p < 0.001). Patient who screened positive for elder abuse were less likely to be independent in activities of daily living (41.9% versus 52.7%, p < 0.001) and reported having fallen more frequently (44.2% versus 35.5%, p < 0.001). Caregiver expressing distress was associated with elder abuse (35.3% versus 18.3%, p < 0.001) but not a higher number of hours caring for the patient. Victims of elder abuse were more likely to attend the ED for low acuity conditions (Canadian triage and acuity scale (CTAS) 4 or 5). Diagnosis at discharge from ED were similar with the exception of acute intoxication that was more frequent in patients who are victims of abuse. Conclusion: Elder abuse is infrequently detected during home care assessments in community-dwelling older adults. Higher frailty index, cognitive impairment, depressive symptoms were associated with elder abuse during homecare assessments. Patients who are victims of elder abuse are attending EDs more frequently for low acuity conditions but ED diagnosis at discharge, except for acute intoxication, are similar.

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Evaluation of Clinically Meaningful Changes in Measures of Frailty

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa003 ◽

2020 ◽

Vol 75 (6) ◽

pp. 1143-1147 ◽

Cited By ~ 2

Author(s):

Il-Young Jang ◽

Hee-Won Jung ◽

Hea Yon Lee ◽

Hyungchul Park ◽

Eunju Lee ◽

...

Keyword(s):

Older Adults ◽

Clinical Trials ◽

Clinical Care ◽

Frailty Index ◽

Large Change ◽

Community Dwelling ◽

Deficit Accumulation ◽

Frailty Phenotype ◽

Euroqol 5D ◽

Community Dwelling Older Adults

Abstract Background To determine the clinically meaningful changes and responsiveness of widely used frailty measures. Methods We analyzed data from a prospective cohort study of 1,135 community-dwelling older adults who underwent assessments of frailty and health-related quality of life using the EuroQol-5D at baseline and 1 year later. Frailty measures included deficit-accumulation frailty index (FI); frailty phenotype; Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale; and the Study of Osteoporotic Fracture (SOF) index. We determined the clinically meaningful changes by the distribution-based method and the anchor-based method using the EuroQol-5D score and responsiveness indices. Results Frailty measures were available in 925 participants at 1 year (81.5%). Based on the distribution-based method, small and large clinically meaningful changes were 0.019 and 0.057 for FI, 0.249 and 0.623 for frailty phenotype, 0.235 and 0.587 for FRAIL scale, and 0.116 and 0.289 for SOF index, respectively. The anchor-based estimates of small and large changes were 0.028 and 0.076 for FI, 0.097 and 0.607 for frailty phenotype, 0.269 and 0.368 for FRAIL scale, and 0.023 and 0.287 for SOF index, respectively. Based on the responsiveness index, per-group sample sizes to achieve 80% power in clinical trials, ranged from 51 (FI) to 7,272 (SOF index) for a small change and 9 (FI) to 133 (FRAIL scale) for a large change. Conclusions The estimates of clinically meaningful change of frailty measures can inform the choice of frailty measures to track longitudinal changes of frailty in clinical trials and clinical care of community-dwelling older adults.

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