Homocysteine, Folic Acid, Cyanocobalamin, and Frailty in Older People: Findings From the “Invece. Ab” Study

Frailty is an important age-related syndrome associated with several adverse health outcomes. Its biological basis is undefined. Raised plasma homocysteine (HOcy) is an established risk factor for cardiovascular disease, dementia, cognitive impairment, and mortality, but little is known about the possible role of plasma HOcy, cyanocobalamin (B12), and folate (FO levels in the development of frailty. Our first aim was to explore the possible association between frailty and plasma concentrations of HOcy, FO, and B12 in a cohort of community-dwelling older people. The second was to assess the influence of these metabolic factors on six-year incidence of frailty in the 875 individuals eligible for inclusion in this study (those with a full follow-up dataset). This research is based on data from three waves – 2012 (herein taken as baseline), 2014, and 2018 – of a longitudinal study (InveCe.Ab) in which non-frail men and women born between 1935 and 1939 underwent multidimensional assessments. Frailty was estimated using a deficit accumulation-based frailty index (FI). HOcy concentration was significantly positively correlated with FI at all timepoints, while B12 and FO levels were not. Plasma concentration of HOcy emerged as a predictor of six-year cumulative incidence of frailty, independent of age, sex, and education, while B12 and FO levels showed no relationship with frailty incidence. Individuals with plasma HOcy in the top quintile showed five months less frailty-free survival (HR 1.487; 95% CI: 1.063–2.078), regardless of age, sex, and education. These results demonstrate that higher HOcy is a risk factor for frailty onset in older adults.

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Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-032904 ◽

2019 ◽

Vol 9 (10) ◽

pp. e032904 ◽

Cited By ~ 3

Author(s):

Kirubakaran Kesavan Kendhapedi ◽

Niveditha Devasenapathy

Keyword(s):

Older People ◽

Fear Of Falling ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Cross Sectional ◽

Domain Definition ◽

Tilburg Frailty Indicator ◽

Community Dwelling Older People ◽

Frailty Indicator

ObjectiveThere is sparse data on the prevalence of frailty from rural parts of India. Our aim was to estimate prevalence of frailty among community-dwelling older people in rural South Indian population and explore socio-demographic factors associated with frailty. We further explored the associations between frailty with fear of falling and falls.DesignCommunity based cross-sectional study.SettingFour villages in Thanjavur district of Southern India.ParticipantsRandom sample of adults aged 60 years and above from four villages.MethodsWe sampled community-dwelling older adults from the electoral list of four villages using stratified random sampling. We report prevalence of frailty as defined by physical definition (Fried’s Phenotype), accumulation of deficits (Frailty Index) and multi-domain definition (Tilburg Frailty Indicator). We report proportion of agreement of frailty status between the frailty tools. We used logistic regressions with robust SEs to examine the associations between socio-demographic determinants with frailty and the association between frailty with fear of falling and falls.ResultsAmong the 408 participants, the weighted (non-response and poststratification for sex) prevalence and 95% CI of frailty was 28% (18.9 to 28.1) for physical definition, 59% (53.9 to 64.3) for accumulation of deficits and 63% (57.4 to 67.6) for multi-domain definition. Frailty Index and Tilburg Frailty Indicator had good agreement (80%). Age, female, lower education, lower socioeconomic status, minimum physical activity in routine work were independently associated with frailty irrespective of the frailty definitions. Frail elderly had higher odds of falls as well as fear of falling compared with non-frail, irrespective of the definitions.ConclusionPrevalence of frailty among older people in rural Thanjavur district of South India was high compared with low-income and middle-income countries. Understanding the modifiable determinants of frailty can provide a valuable reference for future prevention and intervention.

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Relationship between Perceived Indoor Temperature and Self-Reported Risk for Frailty among Community-Dwelling Older People

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040613 ◽

2019 ◽

Vol 16 (4) ◽

pp. 613 ◽

Cited By ~ 3

Author(s):

Yukie Nakajima ◽

Steven Schmidt ◽

Agneta Malmgren Fänge ◽

Mari Ono ◽

Toshiharu Ikaga

Keyword(s):

Older People ◽

Economic Status ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Indoor Temperature ◽

Cross Sectional ◽

Economic Satisfaction ◽

Increased Risk ◽

Community Dwelling Older People

This study investigated the relationship between perceived indoor temperature in winter and frailty among community-dwelling older people. This cross-sectional study included 342 people 65 years and older in Japan. Participants answered questions about demographics, frailty, housing, and perceived indoor temperature in winter. Participants were grouped based on perceived indoor temperature (Cold or Warm) and economic satisfaction (Unsatisfied or Satisfied). Differences in the frailty index between perceived indoor temperature groups and economic satisfaction groups were tested by using ANCOVA and MANCOVA. An interaction effect showed that people in the Cold Group and unsatisfied with their economic status had significantly higher frailty index scores (F(1, 336) = 5.95, p = 0.015). Furthermore, the frailty index subscale of fall risk was the specific indicator of frailty that accounted for this significant relationship. While previous research has shown the risks related to cold indoor temperature in homes, interestingly among those who reported cold homes, only those who were not satisfied with their economic situation reported being at increased risk for frailty. This highlights the potential importance of preventing fuel poverty to prevent frailty.

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Sarcopenia Is a Possible Independent Risk Factor of Cognitive Decline in Community-Dwelling Older People

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2016.03.006 ◽

2016 ◽

Vol 17 (6) ◽

pp. 559-560 ◽

Cited By ~ 1

Author(s):

Reiko Mori ◽

Hiroshi Shamoto ◽

Keisuke Maeda ◽

Hidetaka Wakabayashi

Keyword(s):

Risk Factor ◽

Older People ◽

Cognitive Decline ◽

Independent Risk Factor ◽

Community Dwelling ◽

Community Dwelling Older People

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Effects of Probiotics and Prebiotics on Frailty and Ageing: A Narrative Review

Current Clinical Pharmacology ◽

10.2174/1574884714666191120124548 ◽

2020 ◽

Vol 15 (3) ◽

pp. 183-192 ◽

Cited By ~ 3

Author(s):

Kulapong Jayanama ◽

Olga Theou

Keyword(s):

Older People ◽

Health Outcomes ◽

Cost Effective ◽

Adverse Outcomes ◽

Narrative Review ◽

Deficit Accumulation ◽

Adverse Health Outcomes ◽

Age Related ◽

The Relationship ◽

Health Deficit

Globally, the population over the age of 60 is growing fast, but people age in different ways. Frailty, shown by the accumulation of age-related deficits, is a state of increased vulnerability to adverse outcomes among people of the same chronological age. Ageing results in a decline in diversity and homeostasis of microbiomes, and gut flora changes are related to health deficit accumulation and adverse health outcomes. In older people, health deficits including inappropriate intake, sarcopenia, physical inactivity, polypharmacy, and social vulnerability are factors associated with gut dysbiosis. The use of probiotics and prebiotics is a cost-effective and widely available intervention. Intake of probiotics and prebiotics may improve the homeostasis of gut microflora and prevent frailty and unhealthy aging. However, health effects vary among probiotics and prebiotics and among individual populations. This narrative review summarizes recent evidence about the relationship between prebiotic and probiotic consumption with health outcomes in older people.

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Impact of drug burden index on adverse health outcomes in Irish community-dwelling older people: a cohort study

BMC Geriatrics ◽

10.1186/s12877-019-1138-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 7

Author(s):

Catherine J. Byrne ◽

Caroline Walsh ◽

Caitriona Cahir ◽

Kathleen Bennett

Keyword(s):

Cohort Study ◽

Older People ◽

Health Outcomes ◽

Community Dwelling ◽

Drug Burden Index ◽

Adverse Health ◽

Adverse Health Outcomes ◽

Community Dwelling Older People

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O2.19: Are drugs with sedative properties a risk factor for oral health habits in community-dwelling older people?

European Geriatric Medicine ◽

10.1016/s1878-7649(14)70124-x ◽

2014 ◽

Vol 5 ◽

pp. S61

Author(s):

A.T. Tiisanoja ◽

A.M. Syrjälä ◽

K. Komulainen ◽

S. Hartikainen ◽

H. Taipale ◽

...

Keyword(s):

Risk Factor ◽

Oral Health ◽

Older People ◽

Community Dwelling ◽

Health Habits ◽

Community Dwelling Older People

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Letter to the Editor: Exploring Associations Between Oral Health and Frailty in Community-Dwelling Older People

Journal of Frailty & Aging ◽

10.14283/jfa.2021.10 ◽

2021 ◽

pp. 1-1

Author(s):

R.C. Castrejón-Pérez

Keyword(s):

Oral Health ◽

Older People ◽

Medical Record ◽

Frailty Index ◽

Community Dwelling ◽

Frailty Phenotype ◽

Cross Sectional ◽

Frailty Status ◽

Community Dwelling Older People ◽

Oral Conditions

The studies exploring the association between oral conditions and Frailty status are increasing in number, and many manuscripts have been published during the last couple of years. Even when Everaars et al. (1) manuscript is cross-sectional, it contributes to the knowledge by confirming the association between oral conditions and Frailty despite the selected strategy for measuring Frailty since authors added the interview Groningen Frailty Index and the Frailty Index (computed with data extracted from the Electronic Medical Record) to the most frequently used Frailty Phenotype and Kihon checklist (2).

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Frailty in Preclinical Models: Impact of Healthspan on Disease Expression Over the Life Course

Innovation in Aging ◽

10.1093/geroni/igab046.120 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 33-33

Author(s):

Susan Howlett

Keyword(s):

Health Care Providers ◽

Frailty Index ◽

Scale Up ◽

Care Providers ◽

Deficit Accumulation ◽

Adverse Health Outcomes ◽

Frail Patients ◽

Age Related ◽

And Function ◽

The Life Course

Abstract People age at different rates. This heterogeneity in aging has led to the concept of “frailty”, a state of heightened vulnerability to adverse health outcomes at any age. Frailty challenges health care providers, as frail patients are more likely than non-frail patients to experience diseases, hospitalization, and death. We showed that frailty occurs not only in humans, but also in aging rodents. It can be measured with a “frailty index” (FI) based on age-related health deficit accumulation as originally established in humans. We found that maladaptive changes in heart structure and function in late life are correlated more so with frailty than age and are closely graded by FI score, especially in male mice. Adverse effects of frailty originate at cellular/subcellular levels and scale up to organ and system levels, predisposing towards cardiovascular disease. Poor overall health, quantified with an FI, may drive maladaptive cardiac remodeling, especially in older males.

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Validation of a deficit-accumulation Frailty Index in the ASPREE study and its predictive capacity for disability-free survival

The Journals of Gerontology Series A ◽

10.1093/gerona/glab225 ◽

2021 ◽

Author(s):

Joanne Ryan ◽

Sara Espinoza ◽

Michael E Ernst ◽

A R M Saifuddin Ekram ◽

Rory Wolfe ◽

...

Keyword(s):

Physical Disability ◽

Frailty Index ◽

Community Dwelling ◽

Older Individuals ◽

Deficit Accumulation ◽

Predictive Capacity ◽

Frailty Phenotype ◽

Adverse Health Outcomes ◽

Risk Of Disease ◽

Independent Life

Abstract Frailty is a state of heightened vulnerability and susceptibility to physiologic stressors that increases with age. It has shown increasing utility in predicting a range of adverse health outcomes. Here, we characterise a 67-item deficit-accumulation frailty index (FI) in 19,110 community-dwelling individuals in the ASPREE clinical trial. Participants aged 65 to 98 years were recruited from the U.S. and Australia, and were without diagnosed dementia and cardiovascular disease, and without major physical disability. The median FI score was 0.10 (IQR: 0.07; 0.14) at baseline, and the prevalence of frailty (FI> 0.21) increased from 8.1% to 17.4% after six years. FI was positively associated with age, and women had significantly higher scores than men at all ages. The FI was negatively correlated with gait speed (r =-0.31) and grip strength (r = -0.46), and strongly associated with a modified Fried frailty phenotype (p<0.0001, for all comparisons). Frailty was associated with the primary composite outcome capturing independent life lived free of major disability and dementia, and increased the rate of persistent physical disability (HR:21.3, 95% CI:15.6-28.9). It added significantly to the predictive capacity of these outcomes above age, sex and ethnicity alone. The FI is thus a useful biomarker of aging even among relatively healthy older individuals, and provides important information about an individual’s vulnerability to and risk of disease.

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