scholarly journals Polypharmacy Is Significantly and Positively Associated with the Frailty Status Assessed Using the 5-Item FRAIL Scale, Cardiovascular Health Phenotypic Classification of Frailty Index, and Study of Osteoporotic Fractures Scale

2021 ◽  
Vol 10 (19) ◽  
pp. 4413
Author(s):  
Chi-Di Hung ◽  
Chen-Cheng Yang ◽  
Chun-Ying Lee ◽  
Stephen Chu-Sung Hu ◽  
Szu-Chia Chen ◽  
...  
Keyword(s):  
Cardiovascular Health ◽  
Frailty Index ◽  
Osteoporotic Fractures ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Future Research ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Phenotypic Classification

The aim of this study was to investigate the association between frailty and polypharmacy using three different frailty screening tools. This was a cross-sectional study of people aged ≥65 years. Participants were included and interviewed using questionnaires. Polypharmacy was defined as the daily use of eight or more pills. Frailty was assessed using a screening tool, including (1) the Fatigue, Resistance, Ambulation, Illness and Loss of Weight Index (5-item FRAIL scale), (2) the Cardiovascular Health Phenotypic Classification of Frailty (CHS_PCF) index (Fried’s Frailty Phenotype), and (3) the Study of Osteoporotic Fracture (SOF) scale. A total of 205 participants (mean age: 71.1 years; 53.7% female) fulfilled our inclusion criteria. The proportion of patients with polypharmacy was 14.1%. After adjustments were made for comorbidity or potential confounders, polypharmacy was associated with frailty on the 5-item FRAIL scale (adjusted odds ratio [aOR]: 9.12; 95% confidence interval [CI]: 3.6–23.16), CHS_PCF index (aOR: 8.98; 95% CI: 2.51–32.11), and SOF scale (aOR: 6.10; 95% CI: 1.47–25.3). Polypharmacy was associated with frailty using three frailty screening tools. Future research is required to further enhance our understanding of the risk of frailty among older adults.

scholarly journals Cardiovascular risk factors, anxiety symptoms and inflammation markers: Evidence of association from a cross-sectional study

2017 ◽  
Vol 41 (S1) ◽  
pp. s503-s503
Author(s):  
G. Rioli ◽  
S. Tassi ◽  
G. Mattei ◽  
S. Alboni ◽  
S. Mancini ◽  
...  
Keyword(s):  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Screening Tools ◽  
Western World ◽  
Future Research ◽  
Pathophysiological Mechanism ◽  
Sectional Study ◽  
High Concentration ◽  
Cross Sectional

IntroductionAnxiety disorders and Cardiovascular (CV) diseases, among the most common disorders in Western World, are often comorbid. A chronic systemic inflammatory state might be a shared underlining pathophysiological mechanism.AimsTo investigate the association between anxiety symptoms, CV risks factors and inflammatory markers in an outpatient sample.MethodsCross-sectional study. Inclusion criteria: outpatients aged ≥40 years, attending colonoscopy after positive faecal occult blood test, negative medical history for cancer. Collected data: blood pressure, glycaemia, lipid profile, waist circumference, BMI, PCR (C Reactive Protein), LPS (bacterial Lipopolysaccharide). Psychometric tests: HADS, TCI, IMSA, SF36. Statistical analysis performed with STATA13.ResultsFifty four patients enrolled (27 males, 27 females). Sixteen patients (30.19%) were positive for anxiety symptoms. Thirty-three patients (61.11%) had hypertension, 14 (25.93%) hyperglycaemia and 64.81% were overweight, with frank obesity (BMI≥ 30) in 11 subjects (20.37%). Anxiety symptoms were associated with low hematic HDL values (OR = 0.01; P = 0.01) and high concentration of triglycerides (OR = 0.023; P = 0.02) at the multiple regression model. At the univariate logistic analysis, anxiety was associated with LPS (OR = 1.06; P = 0.04).ConclusionsFurther evidence over the epidemiological link between common mental disorders and CV diseases was collected, with possible hints on pathophysiology and causative mechanisms related to inflammation. The importance of screening for anxiety and depression in medical populations is confirmed. Suggestions on future availability of screening tools based on inflammatory-related indicators should be the focus of future research.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Prevalence of frailty in older adults in outpatient physiotherapy in an urban region in the western part of Germany: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027768 ◽  
Author(s):  
Tobias Braun ◽  
Christian Thiel ◽  
Carina Ziller ◽  
Julia Rasche ◽  
Carolin Bahns ◽  
...  
Keyword(s):  
Older Adults ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Urban Region ◽  
Sectional Study ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Age Related

ObjectiveTo investigate the prevalence of frailty in older people in outpatient physiotherapy services in an urban region in the western part of Germany.DesignCross-sectional study.SettingOutpatient physiotherapy clinics were recruited in the municipal area of the city of Bochum, Germany, and selected randomly.ParticipantsOlder adults aged 65 years and older seeking outpatient physiotherapy.Primary and secondary outcome measuresPrevalence of frailty was assessed based on the frailty phenotype model of physical frailty and the accumulation of deficit model, expressed as a Frailty Index. Prevalence was calculated for the whole sample and according to age-related, sex-related and diagnosis-related subgroups.ResultsA total of 258 participants (74±6 years, 62% female) from 11 out of 130 (8%) different physiotherapy clinics were included. Participants’ main indication for physiotherapy was an orthopaedic or surgical condition (75%). According to the model of a physical frailty phenotype, 17.8% (95% CI 13.2 to 22.5) participants were frail and 43.4% (95% CI 37.4 to 49.5) were prefrail. The Frailty Index identified 31.0% (95% CI 25.4 to 36.7) of individuals as frail. In both models, prevalence increased with age and was higher in women than in men. Slow gait speed (34%), reduced muscle strength (34%) and exhaustion (28%) were the most prevalent indicators of physical frailty.ConclusionsFrailty is comparatively common in older patients attending physiotherapy care in Germany, with one out of three individuals being frail and every second individual being physically frail or prefrail.Trial registration numberDRKS00009384; Results.

scholarly journals 317Neighbourhood built and social environmental attributes associated with frailty among mid-to-older aged Australian adults

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Takumi Abe ◽  
Takemi Sugiyama ◽  
Alison Carver ◽  
Gavin Turrell
Keyword(s):  
Economic Status ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Future Research ◽  
Land Area ◽  
Cross Sectional ◽  
Environmental Attributes ◽  
Social Environmental ◽  
Intersection Density

Abstract Background Little is known about to what extent neighbourhood built and social environmental factors are associated with frailty among community-dwelling mid-to-older aged adults. Methods Participants of our cross-sectional study were adults aged 50-74 years residing in Brisbane, Australia. Frailty was assessed by a frailty index (FI), consisting of 32 items. Five built environmental attributes (population density, density of 4-way intersections, area of retail land, area of park land, and area of land for recreational facilities) and three social environmental attributes (safety, cohesion, and socio-economic status [SES]) were included. We performed multilevel logistic regression analysis to examine the associations between those attributes and frailty. Results Of 4,176 eligible participants (56.8% women), we found that 437 (10.5%) were frail (FI ≥ 0.35). After adjusting for potential confounders, one standard deviation (SD) increment in intersection density and retail land area was associated 26% (95%CI: 1.12, 1.41) and 18% (95%CI: 1.07, 1.30) higher odds of being frail, respectively. One SD increment in safety and area-level SES was associated with 24% (95%CI: 0.69, 0.84) and 30% (95%CI: 0.62, 0.79) lower odds of being frail. Conclusions This study found that mid-to-older aged adults with frailty are more likely to live in areas with higher intersection density, greater area of retail land, poorer safety, and higher levels of deprivation. Key messages There is spatial heterogeneity in the distribution of frailty. Future research should investigate behavioural mechanism for the distribution.

STUDY OF HISTOPATHOLOGY IN PATIENTS WITH HODGKIN AND NON - HODGKIN LYMPHOMA

2016 ◽  
pp. 59-65 ◽  
Author(s):  
Van Mao Nguyen
Keyword(s):  
Lymph Node ◽  
Hodgkin Lymphoma ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Histopathological Classification ◽  
Non Hodgkin Lymphoma ◽  
Key Words Lymphoma ◽  
Malignant Grade

Background: Lymphoma is one of the most ten common cancers in the world as well as in Vietnam which has been ever increasing. It was divided into 2 main groups Hodgkin and non – Hodgkin lymphoma in which non-Hodgkin lymphoma appeared more frequency, worse prognosis and different therapy. Objectives: - To describe some common characteristics in patients with non – Hodgkin lymphoma; - To determine the proportion between Hodgkin and non- Hodgkin lymphoma, histopathological classification of classical Hodgkin by modified Rye 1966 and non-Hodgkin lymphoma by Working Formulation (WF) of US national oncology institute 1982. Materials and Method: This cross-sectional study was conducted on 65 patients with Hodgkin and non- Hodgkin lymphoma diagnosed definitely by histopathology at Hue Central Hospital and Hue University Hospital. Results:. The ratio of male/female for the non-Hodgkin lymphoma was 1.14/1, the most frequent range of age was 51-60 accounting for 35%, not common under 40 years. Non - Hodgkin lymphoma appeared at lymph node was the most common (51.7%), at the extranodal site was rather high 48.3%. The non - Hodgkin lymphoma proportion was predominant 92.3% comparing to the Hodgkin lymphoma only 7.7%; The most WF type was WF7 (53.3%), following the WF6 18,3% and WF5 11,7%; The intermediate malignancy grade of non- Hodgkin lymphoma was the highest proportion accouting for 85%, then the low and the high one 8.3% and 6.7% respectively. Conclusion: The histopathological classification and the malignant grade of lymphoma for Hodgkin and non - Hodgkin lymphoma played a practical role for the prognosis and the treatment orientation, also a fundamental one for the modern classification of non - Hodgkin lymphoma nowadays. Key words: lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, classication, grade, histopathology, lymph node

scholarly journals Women’s perceptions of factors influencing their food shopping choices and how supermarkets can support them to make healthier choices

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Preeti Dhuria ◽  
Wendy Lawrence ◽  
Sarah Crozier ◽  
Cyrus Cooper ◽  
Janis Baird ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Personal Responsibility ◽  
Food Preferences ◽  
Food Choices ◽  
Cross Sectional Study ◽  
Future Research ◽  
Cross Sectional ◽  
Telephone Interviews ◽  
Food Shopping ◽  
Women’S Perceptions

Abstract Objectives To examine women’s perceptions of factors that influence their food shopping choices, particularly in relation to store layout, and their views on ways that supermarkets could support healthier choices. Design This qualitative cross-sectional study used semi-structured telephone interviews to ask participants the reasons for their choice of supermarket and factors in-store that prompted their food selections. The actions supermarkets, governments and customers could take to encourage healthier food choices were explored with women. Thematic analysis was conducted to identify key themes. Setting Six supermarkets across England. Participants Twenty women customers aged 18–45 years. Results Participants had a median age of 39.5 years (IQR: 35.1, 42.3), a median weekly grocery spend of £70 (IQR: 50, 88), and 44% had left school aged 16 years. Women reported that achieving value for money, feeling hungry, tired, or stressed, and meeting family members’ food preferences influenced their food shopping choices. The physical environment was important, including product quality and variety, plus ease of accessing the store or products in-store. Many participants described how they made unintended food selections as a result of prominent placement of unhealthy products in supermarkets, even if they adopted more conscious approaches to food shopping (i.e. written or mental lists). Participants described healthy eating as a personal responsibility, but some stated that governments and supermarkets could be more supportive. Conclusions This study highlighted that in-store environments can undermine intentions to purchase and consume healthy foods. Creating healthier supermarket environments could reduce the burden of personal responsibility for healthy eating, by making healthier choices easier. Future research could explore the interplay of personal, societal and commercial responsibility for food choices and health status.

scholarly journals Self-rated health among undocumented and newly regularized migrants in Geneva: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julien Fakhoury ◽  
Claudine Burton-Jeangros ◽  
Idris Guessous ◽  
Liala Consoli ◽  
Aline Duvoisin ◽  
...  
Keyword(s):  
Social Support ◽  
Social Networks ◽  
Cross Sectional Study ◽  
Future Research ◽  
Undocumented Migrants ◽  
Long Term Effects ◽  
Residence Permit ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Self Rated Health

Abstract Background In Europe, knowledge about the social determinants of health among undocumented migrants is scarce. The canton of Geneva, Switzerland, implemented in 2017–2018 a pilot public policy aiming at regularizing undocumented migrants. We sought to test for associations between self-rated health, proven eligibility for residence status regularization and social and economic integration. Methods This paper reports data from the first wave of the Parchemins Study, a prospective study whose aim is to investigate the effect of residence status regularization on undocumented migrants’ living conditions and health. The convenience sample included undocumented migrants living in Geneva for at least 3 years. We categorized them into those who were in the process of receiving or had just been granted a residence permit (eligible or newly regularized) and those who had not applied or were ineligible for regularization (undocumented). We conducted multivariate regression analyses to determine factors associated with better self-rated health, i.e., with excellent/very good vs. good/fair/poor self-rated health. Among these factors, measures of integration, social support and economic resources were included. Results Of the 437 participants, 202 (46%) belonged to the eligible or newly regularized group. This group reported better health more frequently than the undocumented group (44.6% versus 28.9%, p-value < .001), but the association was no longer significant after adjustment for social support and economic factors (odds ratio (OR): 1.12; 95% confidence interval (CI): 0.67–1.87). Overall, better health was associated with larger social networks (OR: 1.66; 95% CI: 1.04–2.64). This association remained significant even after adjusting for health-related variables. Conclusion At the onset of the regularization program, access to regularization was not associated with better self-rated health. Policies aiming at favouring undocumented migrants’ inclusion and engagement in social networks may promote better health. Future research should investigate long-term effects of residence status regularization on self-rated health.

scholarly journals Convergent and discriminative validity of the Frail-VIG index with the EQ-5D-3L in people cared for in primary health care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juan-José Zamora-Sánchez ◽  
Edurne Zabaleta-del-Olmo ◽  
Vicente Gea-Caballero ◽  
Iván Julián-Rochina ◽  
Gemma Pérez-Tortajada ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Convergent Validity ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Programme ◽  
Discriminative Validity ◽  
Primary Health ◽  
Related Quality

Abstract Background The Frail-VIG frailty index has been developed recently. It is an instrument with a multidimensional approach and a pragmatic purpose that allows rapid and efficient assessment of the degree of frailty in the context of clinical practice. Our aim was to investigate the convergent and discriminative validity of the Frail-VIG frailty index with regard to EQ-5D-3L value. Methods We carried out a cross-sectional study in two Primary Health Care (PHC) centres of the Catalan Institute of Health (Institut Català de la Salut), Barcelona (Spain) from February 2017 to January 2019. Participants in the study were all people included under a home care programme during the study period. No exclusion criteria were applied. We used the EQ-5D-3L to measure Health-Related Quality of Life (HRQoL) and the Frail-VIG index to measure frailty. Trained PHC nurses administered both instruments during face-to-face assessments in a participant’s home during usual care. The relationships between both instruments were examined using Pearson’s correlation coefficient and multiple linear regression analyses. Results Four hundred and twelve participants were included in this study. Frail-VIG score and EQ-5D-3L value were negatively correlated (r = − 0.510; P < 0.001). Non-frail people reported a substantially better HRQoL than people with moderate and severe frailty. EQ-5D-3L value declined significantly as the Frail-VIG index score increased. Conclusions Frail-VIG index demonstrated a convergent validity with the EQ-5D-3L value. Its discriminative validity was optimal, as their scores showed an excellent capacity to differentiate between people with better and worse HRQoL. These findings provide additional pieces of evidence for construct validity of the Frail-VIG index.

scholarly journals Media consumption and mental health during COVID-19 lockdown: a UK cross-sectional study across England, Wales, Scotland and Northern Ireland

2021 ◽  
Author(s):  
Ruth D Neill ◽  
Carolyn Blair ◽  
Paul Best ◽  
Emily McGlinchey ◽  
Cherie Armour
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Media Exposure ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Future Research ◽  
Media Consumption ◽  
Sectional Study ◽  
Cross Sectional ◽  
Longitudinal Data Collection

Abstract Aim As individuals adjust to new ‘norms’ and ways of living during the COVID-19 lockdown, there is a continuing need for up-to-date information and guidance. Evidence suggests that frequent media exposure is related to a higher prevalence of mental health problems, especially anxiety and depression. The aim of this study was to determine whether COVID-19 related media consumption is associated with changes in mental health outcomes. Methods This paper presents baseline data from the COVID-19 Psychological Wellbeing Study. The cross-sectional study data was collected using an online survey following the Generalised Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), with some other basic information collected. Logistic regression analysis was used to examine the influence of socio-demographic and media specific factors on anxiety and depression. Results The study suggested that media usage is statistically significantly associated with anxiety and depression on the GAD-7 and PHQ-9 scales with excessive media exposure related to higher anxiety and depression scores. Conclusion This study indicated that higher media consumption was associated with higher levels of anxiety and depression. Worldwide it should be acknowledged that excessive media consumption, particularly social media relating to COVID-19, can have an effect on mental health. However, as this was a cross-sectional study we cannot infer any directionality as we cannot infer cause and effect; therefore, future research involving longitudinal data collection and analyses of variables over time is warranted.

scholarly journals 20 Comparison of Six Frailty Screening Tools in Patients Aged 65+ with An Arm Fragility Fracture

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
K Ibrahim ◽  
T Lim ◽  
M A Mullee ◽  
G L Yao ◽  
S Zhu ◽  
...  
Keyword(s):  
Fragility Fracture ◽  
Frailty Index ◽  
Screening Tools ◽  
Frailty Phenotype ◽  
Fracture Clinic ◽  
Increased Risk ◽  
Sensitivity Range ◽  
Practical Tool ◽  
Acute Trust ◽  
Medication Changes

Abstract Introduction Frailty is associated with an increased risk of falling and fracture, but not routinely assessed in fracture clinic. Early identification and management of frailty among older people with arm fragility fracture could help avoid further falls and fractures, especially of the hip. We evaluated the feasibility of assessing frailty in a busy fracture clinic. Methods People aged 65+ years with an arm fracture in one acute trust were recruited. Frailty was assessed in fracture clinics using six tools: Fried Frailty Phenotype (FFP), FRAIL scale, PRISMA-7, electronic Frailty Index (e-FI), Clinical Frailty Score (CFS), and Study of Osteoporotic Fracture (SOF). The sensitivity and specificity of each tool was compared against FFP as a reference. Participants identified as frail by 2+ tools were referred for Comprehensive Geriatric Assessment (CGA). Results 100 patients (mean age 75 years±7.2; 20 men) were recruited. Frailty prevalence was 9% (FRAIL scale), 13% (SOF), 14% (CFS &gt; 6), 15% (FFP; e-FI &gt; 0.25), and 25% (PRISMA-7). Men were more likely to be frail than women. Data were complete for all assessments and completion time ranged from one minute (PRISMA-7; CFS) to six minutes for the FFP which required most equipment. Comparing with FFP, the most accurate instrument for stratifying frail from non-frail was the PRISMA-7 (sensitivity = 93%, specificity = 87%) while the remaining tools had good specificity (range 93%–100%) but average sensitivity (range 40%–60%). Twenty patients were eligible for CGA. Five had recently had CGA and 11/15 referred were assessed. CGA led to 3–6 interventions per participant including medication changes, life-style advice, investigations, and onward referrals. Conclusion It was feasible to assess frailty in fracture clinic and to identify patients who benefitted from CGA. Frailty prevalence was 9%—25% depending on the tool used and was higher among men. PRISMA-7 could be a practical tool for routine use in fracture clinics.

scholarly journals Outdoor Air Pollution and Depression in Canada: A Population-Based Cross-Sectional Study from 2011 to 2016

2021 ◽  
Vol 18 (5) ◽  
pp. 2450
Author(s):  
Ashley K. Dores ◽  
Gordon H. Fick ◽  
Frank P. MacMaster ◽  
Jeanne V. A. Williams ◽  
Andrew G. M. Bulloch ◽  
...  
Keyword(s):  
Air Pollution ◽  
Fine Particulate Matter ◽  
Canadian Community Health Survey ◽  
Population Based ◽  
Cross Sectional Study ◽  
Future Research ◽  
Outdoor Air ◽  
Cross Sectional ◽  
Outdoor Air Pollution ◽  
Environmental Health Research

To assess whether exposure to increased levels of outdoor air pollution is associated with psychological depression, six annual iterations of the Canadian Community Health Survey (n ≈ 127,050) were used to estimate the prevalence of a major depressive episode (2011–2014) or severity of depressive symptoms (2015–2016). Survey data were linked with outdoor air pollution data obtained from the Canadian Urban Environmental Health Research Consortium, with outdoor air pollution represented by fine particulate matter ≤2.5 micrometers (μm) in diameter (PM2.5), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2). Log-binomial models were used to estimate the association between outdoor air pollution and depression, and included adjustment for age, sex, marital status, income, education, employment status, urban versus rural households, cigarette smoking, and chronic illness. No evidence of associations for either depression outcomes were found. Given the generally low levels of outdoor air pollution in Canada, these findings should be generalized with caution. It is possible that a meaningful association with major depression may be observed in regions of the world where the levels of outdoor air pollution are greater, or during high pollution events over brief time intervals. Future research is needed to replicate these findings and to further investigate these associations in other regions and populations.

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