community dwelling older people
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2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Marcel A. L. M. van Assen ◽  
Judith H. M. Helmink ◽  
Robbert J. J. Gobbens

Abstract Background Multidimensional frailty, including physical, psychological, and social components, is associated to disability, lower quality of life, increased healthcare utilization, and mortality. In order to prevent or delay frailty, more knowledge of its determinants is necessary; one of these determinants is lifestyle. The aim of this study is to determine the association between lifestyle factors smoking, alcohol use, nutrition, physical activity, and multidimensional frailty. Methods This cross-sectional study was conducted in two samples comprising in total 45,336 Dutch community-dwelling individuals aged 65 years or older. These samples completed a questionnaire including questions about smoking, alcohol use, physical activity, sociodemographic factors (both samples), and nutrition (one sample). Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI). Results Higher alcohol consumption, physical activity, healthy nutrition, and less smoking were associated with less total, physical, psychological and social frailty after controlling for effects of other lifestyle factors and sociodemographic characteristics of the participants (age, gender, marital status, education, income). Effects of physical activity on total and physical frailty were up to considerable, whereas the effects of other lifestyle factors on frailty were small. Conclusions The four lifestyle factors were not only associated with physical frailty but also with psychological and social frailty. The different associations of frailty domains with lifestyle factors emphasize the importance of assessing frailty broadly and thus to pay attention to the multidimensional nature of this concept. The findings offer healthcare professionals starting points for interventions with the purpose to prevent or delay the onset of frailty, so community-dwelling older people have the possibility to aging in place accompanied by a good quality of life.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Susan Calnan ◽  
Karen Lee ◽  
Sheena McHugh

Abstract Background There is growing acknowledgement of the need for a phased approach to scaling up health interventions, beginning with an assessment of ‘scalability’, that is, the capacity of an individual intervention to be scaled up. This study aims to assess the scalability of a multi-component integrated falls prevention service for community-dwelling older people and to examine the applicability of the Intervention Scalability Assessment Tool (ISAT). The ISAT consists of 10 domains for consideration when determining the scalability of an intervention, and each domain comprises a series of questions aimed at examining readiness for scale-up. Methods Multiple methods were used sequentially as recommended by the ISAT: a review of policy documents, results from a service evaluation and falls-related literature; one-to-one interviews (n = 11) with key stakeholders involved in management and oversight of the service; and a follow-up online questionnaire (n = 10) with stakeholders to rate scalability and provide further feedback on reasons for their scores. Results Three of the ISAT domains were rated highly by the participants. Analysis of the qualitative feedback and documents indicated that the issue of falls prevention among older people was of sufficient priority to warrant scale-up of the service and that the service aligned with national health policy priorities. Some participants also noted that benefits of the service could potentially outweigh costs through reduced hospital admissions and serious injuries such as hip fracture. The remaining domains received a moderate score from participants, however, indicating considerable barriers to scale-up. In the qualitative feedback, barriers identified included the perceived need for more healthcare staff to deliver components of the service, for additional infrastructure such as adequate room space, and for an integrated electronic patient management system linking primary and secondary care and to prevent duplication of services. Conclusions Plans to scale up the service are currently under review given the practical barriers that need to be addressed. The ISAT provides a systematic and structured framework for examining the scalability of this multi-component falls prevention intervention, although the iterative nature of the process and detailed and technical nature of its questions require considerable time and knowledge of the service to complete.


Author(s):  
Damayanthi H.D.W.T. ◽  
Abdullah K.L. ◽  
Moy F.M.

Introduction: Nutrition plays an important role in older people. Numerous factors are associated with malnutrition among community-dwelling older people. However, little is known about how malnourished older people experience their nutritional status. This study aimed to explore how malnourished community-dwelling older people perceive the factors associated with their nutritional status. Methods: An explorative qualitative design was performed in Kandy District, Sri Lanka. A group of 150 malnourished community-dwelling older people identified from a cross sectional survey were invited for Focus Group Discussions (FGDs). A purposive sampling method was used. Fifteen FGDs were conducted among 85 participants. A thematic analysis was done to identify relevant themes related to malnutrition status. Results: The mean age of the participants was 68.74 years (SD± 6.32). Their age range was 60 to 97 years. Four main themes were identified through FGDs: (1) factors affecting dietary patterns, (2) food choices, (3) health status, and (4) psychological challenges. Conclusions: Community-dwelling malnourished older people stated factors associated with their dietary patterns, such as age-related factors, food choices, health status and mental status, lead to their malnutrition status. Public health professionals must understand and recognize these realities to improve the nutritional status of community-dwelling older people. Keywords: Community-dwelling, Malnutrition, Older people, Sri Lanka


2021 ◽  
Vol 12 ◽  
Author(s):  
Antonio Guaita ◽  
Laura Brunelli ◽  
Annalisa Davin ◽  
Tino Emanuele Poloni ◽  
Roberta Vaccaro ◽  
...  

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.


2021 ◽  
Vol 46 ◽  
pp. S606
Author(s):  
S. Swagerman ◽  
D. van den Oort ◽  
M.J. Sealy ◽  
F. van der Lucht ◽  
H. Jager-Wittenaar

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052301
Author(s):  
Luiz Eduardo Lima Andrade ◽  
Beatriz Souza de Albuquerque Caciqu New York ◽  
Rafaella Silva dos Santos Aguiar Gonçalves ◽  
Sabrina Gabrielle Gomes Fernandes ◽  
Álvaro Campos Cavalcanti Maciel

ObjectiveTo map in the current literature instruments for the assessment and stratification of frailty in community-dwelling older people, as well as to analyse them from the perspective of the Brazilian context.DesignScoping review.Study selectionThe selection of studies took place between March and April 2020. Includes electronic databases: Medline, Latin American and Caribbean Literature in Health Sciences, Scopus, Web of Science and Cumulative Index of Nursing and Literature Health Alliance, in addition to searching grey literature.Data extractionA data extraction spreadsheet was created to collect the main information from the studies involved, from the title to the type of assessment and stratification of frailty.ResultsIn summary, 17 frailty assessment and stratification instruments applicable to community-dwelling older people were identified. Among these, the frailty phenotype of Fried et al was the instrument most present in the studies (45.5%). The physical domain was present in all the instruments analysed, while the social, psychological and environmental domains were present in only 10 instruments.ConclusionsThis review serves as a guideline for primary healthcare professionals, showing 17 instruments applicable to the context of the community-dwelling older people, pointing out advantages and disadvantages that influence the decision of the instrument to be used. Furthermore, this scoping review was a guide for further studies carried out by the same authors, which aim to compare instruments.


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