Trajectory and Correlation of Intrinsic Capacity and Frailty in a Beijing Elderly Community

Objectives: The World Health Organization proposed intrinsic capacity (IC) model to guide the implementation of person-centered care plan aimed at preserving or reserving functional ability, especially in frail older adults. We aimed to show the trajectory of IC and the overlap between IC impairment and frailty and investigate the correlation between IC domains and frailty status transitions.Method: Longitudinal observational study covering 230 community-dwelling older adults (mean age 84.0 ± 4.5 years) at baseline, and transition information at 2-year follow-up (n = 196). IC was measured by five domains: locomotion, cognition, vitality, psychological, and sensory. Frailty was defined by FRAIL Scale. IC and frailty status transitions were assessed. Logistic regression, odds ratios (OR) and 95% confidence interval (CI) were used for the analysis.Results: The prevalence of frailty was 23.0% and increased up to 41.8% over two years. Regarding frailty transitions, 38.3% of older adults progressed to more frailty status, and 8.6% regressed to lesser frailty status. The prevalence of IC impairment was 67.9% and increased to 81.6% over two years. Regarding IC transitions, 49.2% of adults with no IC impairment at baseline kept stable, and 50.8% developed new IC impairment. Among individuals with IC impairment at baseline, 57.9% worsened, and 13.5% improved. Importantly, IC impairment at baseline existed in 42.4% robust adults, 83.3% pre-frail adults, and 93.3% frail adults. 47.1% individuals who kept non-frail status within two years experienced IC worsened transition. Univariable analysis illustrated that new impaired locomotion, vitality, cognition, and sensory domains increased the risk of non-frail progressed to frail status. After adjusting for covariables, new impaired locomotion (OR = 3.625, 95% CI: 1.348–9.747) and vitality domains (OR = 3.034, 95% CI: 1.229–7.487) were associated with a higher possibility of non-frail progressed to frail status.Conclusion: IC impairment and frailty overlap and co-exist in older adults. IC impairment, especially new impairment in locomotion and vitality are associated with the transitions from non-frail to frail status. It is important that geriatricians tightly monitor IC trajectory and find the new impaired domains to take early action to minimize the public health burden of frailty.

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Disability, Frailty and Depression in the community-dwelling older adults with Osteosarcopenia

BMC Geriatrics ◽

10.1186/s12877-021-02022-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ki-Soo Park ◽

Gyeong-Ye Lee ◽

Young-Mi Seo ◽

Sung-Hyo Seo ◽

Jun-Il Yoo

Keyword(s):

Older Adults ◽

Short Form ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

Normal Group ◽

World Health ◽

Common Disease ◽

Using Data ◽

Health Organization

Abstract Background The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. Methods This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values according to Osteosarcopenia were large, and GDSSF (0.096) was medium Conclusions Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.

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World Health Organization Disability Health Assessment 2.0 for Health Monitoring: Examining the potential use of the WHODAS 2.0 as a health screening tool among older adults in rural North Carolina

American Journal of Recreation Therapy ◽

10.5055/ajrt.2016.0099 ◽

2017 ◽

Vol 15 (1) ◽

pp. 47

Author(s):

Amanda Warren, MS, CTRS ◽

Richard Williams, EdD, LRT/CTRS/FDRT

Keyword(s):

Older Adults ◽

Health Monitoring ◽

Assessment Tool ◽

Health Assessment ◽

Community Dwelling ◽

World Health ◽

Term Care ◽

Whodas 2.0 ◽

Financial Burdens ◽

Health Organization

Unless measures are taken, escalating healthcare costs and an aging population will increasingly contribute to financial burdens on federal and state healthcare budgets. With the help of appropriate supports, many older adults can remain in their homes and communities and delay expensive long-term care placements. An important aspect of aging in place is health monitoring so that health issues can be addressed before they escalate. The WHODAS 2.0 is a standardized assessment tool that may be valuable for recreational therapists and others to use to monitor health and functional status of community-dwelling older adults.

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‘It makes your life worthwhile. It gives you a purpose in living’: mobility experiences among active older adults with low income

Ageing and Society ◽

10.1017/s0144686x18000181 ◽

2018 ◽

Vol 39 (8) ◽

pp. 1639-1666 ◽

Cited By ~ 4

Author(s):

THEA FRANKE ◽

JOANIE SIMS-GOULD ◽

HABIB CHAUDHURY ◽

MEGHAN WINTERS ◽

HEATHER MCKAY

Keyword(s):

Older Adults ◽

Low Income ◽

Sense Of Self ◽

Travel Behaviour ◽

Community Dwelling ◽

Constructivist Grounded Theory ◽

World Health ◽

Highly Active ◽

Temporal Dimensions ◽

Health Organization

ABSTRACTThe World Health Organization claims that mobility is vital to healthy ageing and is the best guarantee of older adults being able to cope and remain in their homes and communities. Mobility enables older adults to maintain their physical health, independence and participation in society. In general, mobility is examined objectively, from a quantitative perspective where mobility is measured as physical movement (e.g.physical activity) and/or travel behaviour (e.g.trips, modes and distances). The predominant focus on the functional aspects of mobility tends to overlook the subjective (e.g.perceptions, attitudes and motivations) and temporal dimensions of older adults’ mobility experiences. Using a constructivist grounded theory methodology, we conducted 24 in-depth interviews with six highly active community-dwelling older adults with low income, aged 65 or over, over a period of four years. Our analysis identified the following themes: maintaining a sense of self, being resourceful, openness to engagement, engaging in superficial contact, experiencing social capital, accessing transportation, leaving the immediate neighbourhood and facing affordability. Findings illustrate that intrapersonal factors, in addition to environmental (built, social and cultural) and temporal-level factors, play a crucial role in mobility. In the future, this gained knowledge can be incorporated into approaches to study the multiple interrelated factors and their interrelations that influence older adults’ mobility.

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Disability, Frailty and Depression in the Community-dwelling Older adults with Osteosarcopenia

10.21203/rs.3.rs-27449/v4 ◽

2021 ◽

Author(s):

Ki-Soo Park ◽

Gyeong-Ye Lee ◽

Young-Mi Seo ◽

Sung-Hyo Seo ◽

Jun-Il Yoo

Keyword(s):

Older Adults ◽

Short Form ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

Normal Group ◽

World Health ◽

Common Disease ◽

Using Data ◽

Health Organization

Abstract Background: The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression.Methods: This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than -1.0.The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results: Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values according to Osteosarcopenia were large, and GDSSF (0.096) was medium.Conclusions: Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.

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Predictors of Social Isolation Among Community-dwelling Older Adults in Iran

Salmand ◽

10.32598/sija.16.2.1294.2 ◽

2021 ◽

Vol 16 (2) ◽

pp. 188-201

Author(s):

Elaheh Taghvaei ◽

◽

Seyedeh Ameneh Motalebi ◽

Maryam Mafi ◽

Mohammad Ali Soleimani ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Regression Analysis ◽

World Health Organization ◽

Social Isolation ◽

Well Being ◽

Community Dwelling ◽

World Health ◽

Health Organization ◽

Community Dwelling Older Adults

Objectives: Social isolation can lead to depression, reduced life expectancy, and increased death anxiety among older adults. The present study aims to determine the predictors of social isolation in community-dwelling older adults residing in Qazvin, Iran. Methods & Materials: This descriptive cross sectional study was conducted on 301 older adults in 2019 who were selected using a cluster sampling method. Data were collected using a demographic/clinical checklist, Lubben Social Network Scale, Multidimensional Scale of Perceived Social Support, World Health Organization Disability Assessment Schedule, 5-item World Health Organization Well-Being Index, and Pargament’s Religious Coping Questionnaire, which were completed through face to face interview. The collected data were analyzed using multivariable regression analysis. Results: The Mean±SD age of participants was 68.63±7.31 years. Multivariate regression analysis showed that the significant predictors of social isolation were social support (β=0.333, P<0.001), disability (β=-0.137, P=0.018), and living with spouse (β=0.154, P=0.010). The social isolation was reduced by increasing social support, decreasing disability, and living with spouse. Conclusion: Given the role of social support and disability in predicting social isolation in the elderly, it seems that one of the effective factors in reducing social isolation especially in the disable older adults is establishing or strengthening supportive social networks.

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Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study

Prevention Science ◽

10.1007/s11121-021-01221-y ◽

2021 ◽

Author(s):

Nien Xiang Tou ◽

Shiou-Liang Wee ◽

Wei Ting Seah ◽

Daniella Hui Min Ng ◽

Benedict Wei Jun Pang ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Controlled Trial ◽

Community Dwelling ◽

Controlled Study ◽

Power Training ◽

Frail Older Adults ◽

Frailty Status ◽

Randomized Controlled ◽

Community Dwelling Older Adults

AbstractTranslation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods. Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020–retrospectively registered.

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Functional difficulties and toileting among older adults in Ghana: evidence from the World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 1

Ageing and Society ◽

10.1017/s0144686x21000453 ◽

2021 ◽

pp. 1-23

Author(s):

Kofi Awuviry-Newton ◽

Kylie Wales ◽

Meredith Tavener ◽

Paul Kowal ◽

Julie Byles

Keyword(s):

Older Adults ◽

Marital Status ◽

Conceptual Framework ◽

World Health ◽

Adult Health ◽

Care Needs ◽

Functional Difficulties ◽

The World ◽

Health Organization ◽

Global Ageing

Abstract Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.

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World Health Report on Vision: Aging Implications for Global Vision and Eye Health

Innovation in Aging ◽

10.1093/geroni/igaa057.2933 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 807-808

Author(s):

Bonnielin Swenor ◽

Varshini Varadaraj ◽

Moon Jeong Lee ◽

Heather Whitson ◽

Pradeep Ramulu

Keyword(s):

Older Adults ◽

Visual Impairment ◽

Vision Loss ◽

World Health ◽

World Health Report ◽

Global Public Health ◽

Eye Care ◽

Health Report ◽

Public Health Challenges ◽

Health Organization

Abstract In 2019, the World Health Organization World Report on Vision estimated that that 2.2 billion people have a vision impairment, of which almost half could have been prevented or is yet to be addressed. As the global population ages and the prevalence of visual impairment increases, inequities in eye care and the downstream health and aging consequences of vision loss will become magnified. This session will: (1) provide key information regarding the burden of eye disease and visual impairment among older adults worldwide; (2) outline a framework created to conceptualize the aging and long-term health implications of vision loss, and (3) discuss the global public health challenges to eye care and to maximizing health for older adults with visual impairments.

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Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

Physical Therapy ◽

10.1093/ptj/pzab059 ◽

2021 ◽

Author(s):

K Makino ◽

S Lee ◽

S Bae ◽

I Chiba ◽

K Harada ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Fear Of Falling ◽

Community Dwelling ◽

Cardiovascular Health Study ◽

Physical Frailty ◽

Frailty Status ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

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