Prevalence of Physical Frailty and Its Multidimensional Risk Factors in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study.
Jung Heeeun,Kim Miji,Lee Yunhwan,Won Chang Won
International journal of environmental research and public health
Frailty is defined as a state of increased vulnerability to stressors, and it predicts disability and mortality in the older population. This study aimed to investigate the standardized prevalence and multidimensional risk factors associated with frailty among Korean community-dwelling older adults. We analyzed the baseline data of 2907 adults aged 70-84 years (mean age 75.8 ± 3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and prefrailty was 7.9% (95% confidence interval (CI) 6.8-8.9%) and 47.0% (95% CI, 45.1-48.8%), respectively. The following 14 risk factors were significantly associated with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive symptoms, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer Timed Up and Go, and low Short Physical Performance Battery score ( < 0.05). Physiconutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.
10.3390/ijerph17217883
Self-Rated Frailty and Mortality in Old Men: The Manitoba Follow-up Study.
Sachs E,St John P,Swift A,Tate R
The Journal of frailty & aging
BACKGROUND:While a multitude of definitions and operationalizations of frailty have been developed, rarely have these considered the perspective of the older adult themselves. This knowledge gap was addressed by examining older adults' self-rating of frailty. OBJECTIVES:To assess the validity of self-rated frailty and to determine whether self-rated frailty relates to mortality. DESIGN:The Manitoba Follow-up Study was initiated in 1948 as a prospective cohort study of 3,983 men. SETTING:Community dwelling older adult men. PARTICIPANTS:Survivors of the original cohort (231 men) were sent a quality of life survey in 2015. A response was received from 186 men, including 146 surveys completed by the participant himself and thus were eligible to include (completion rate of 78.4%). MEASUREMENTS:The quality of life survey is sent out annually to the study participants to ascertain information about mental, physical, and social functioning. In 2015, the Clinical Frailty Scale was adapted and added to the survey as a simple self-rating of frailty. RESULTS:The mean age of the 146 respondents in 2015 was 93.7 years (SD 2.7) Self-ratings of "moderate-severe" frailty, received from 132 men, were associated with worse measures of physical health and functional impairment, thus supporting the significance of self-rated frailty. Adjusted for age, the Hazard Ratio for mortality over the next 3 years was 3.3 (95% CI: 1.5, 7.1) for those who rated themselves as "mildly to severely frail" vs. "very fit or well, with no disease". CONCLUSION:The present study has illustrated that self-rated frailty is associated with other measures of health and that self-rated frailty predicts mortality over a three-year period. These findings support the utilization of older adult's self-ratings of frailty for new avenues of operationalizing frailty.
10.14283/jfa.2020.14
Telomere length and frailty in older adults-A systematic review and meta-analysis.
Araújo Carvalho Aline Carla,Tavares Mendes Mário Luis,da Silva Reis Monique Carla,Santos Victor Santana,Tanajura Diego Moura,Martins-Filho Paulo Ricardo Saquete
Ageing research reviews
Telomere shortening has been proposed as a potentially useful biomarker of human ageing and age-related morbidity and mortality. We performed a systematic review and meta-analysis to summarize results from individual studies on the telomere length according to the frailty status and frailty index in older adults. We searched the PubMed, SCOPUS and Web of Science databases to identify studies that evaluated the telomere length in frail and non-frail older adults and the relationship between telomere length and frailty index score. We used the base pairs (bp) as a measure of the telomere length. Summary estimates were calculated using random-effects models. Nine studies were included in the present systematic review and a total of 10,079 older adults were analyzed. We found that the frail older adults (n = 355) had shorter telomeres than the non-frail (n = 1894) (Standardized Mean Difference [SMD] -0.41; 95% CI -0.73 to -0.09; P = 0.01; I = 82%). Significant differences in telomere length between frail and non-frail older adults were identified in Hispanic (SMD -1.31; 95% CI -1.71 to -0.92; P < 0.0001; I = 0%) but not in Non-Hispanic countries (SMD -0.13; 95% CI -0.26 to 0.00; P = 0.06; I = 0%). Similar results were found in the adjusted meta-analysis (SMD -0.56; 95% -1.12 to 0.00; P = 0.05; I = 85%). A significant but weak relationship was found between telomere length and frailty index analyzing 8244 individuals (SMD -0.06; 95% IC -0.10 to 0.01; P = 0.01; I = 0%). The current available evidence suggests that telomere length may be not a meaningful biomarker for frailty. Because the potential influence of ethnicity in shortening of telomeres and decline in physiologic reserves associated with aging, additional multiethnic studies are needed.
10.1016/j.arr.2019.100914
Frailty as a Predictor of Mortality in Patients With Interstitial Lung Disease Referred for Lung Transplantation.
Montgomery Elyn,Macdonald Peter S,Newton Phillip J,Chang Sungwon,Jha Sunita R,Hannu Malin K,Thomson Claire,Havryk Adrian,Malouf Monique
Transplantation
BACKGROUND:Frailty is a clinically recognized syndrome of decreased physiological reserve and a key contributor to suboptimal clinical outcomes in various lung disease groups. Interstitial lung disease (ILD) is fast approaching chronic obstructive pulmonary disease as the number one indication for lung transplantation worldwide. Our aim was to assess whether frailty is a predictor of mortality in patients with ILD referred for lung transplantation in an Australian cohort. METHODS:Consecutive patients with ILD referred or on the waiting list for lung transplantation from May 2013 to December 2017 underwent frailty assessment using the modified Fried's frailty phenotype. Frailty was defined as a positive response to ≥3 of the following 5 components: weak grip strength, slowed walking speed, poor appetite, physical inactivity, and exhaustion. RESULTS:One hundred patients (82 male:18 female; age, 59 ± 7 y; range, 30-70) underwent frailty assessment. Twenty-four of 100 (24%) were assessed as frail. Frailty was associated with anemia, hypoalbuminemia, low creatinine, and the use of supplemental oxygen (all P < 0.05). Frailty was independent of age, gender, measures of pulmonary dysfunction (PaO2, forced vital capacity percentage predicted, total lung capacity, total lung capacity percentage predicted, DLCO, or DLCO percentage predicted), cognitive impairment, or depression. Frailty and DLCO % predicted were independent predictors of increased all-cause mortality: 1-year actuarial survival was 86 ± 4% in the nonfrail group compared with 58 ± 10% for the frail group (P = 0.002). CONCLUSIONS:Frailty is common among patients referred for lung transplant with a diagnosis of ILD and is associated with a marked increase in mortality.
10.1097/TP.0000000000002901
Trajectories of Frailty and Cognitive Decline Among Older Mexican Americans.
The journals of gerontology. Series A, Biological sciences and medical sciences
BACKGROUND:Progressive physical frailty and cognitive decline in older adults is associated with increased risk of falls, disability, institutionalization, and mortality; however, there is considerable heterogeneity in progression over time. We identified heterogeneous frailty and cognitive decline trajectory groups and examined the specific contribution of health conditions to these trajectories among older Mexican origin adults. METHODS:We use a sample from the Hispanic Established Population for the Epidemiological Study of the Elderly (HEPESE) with at least two measures of frailty criteria during 18 years follow-up: slow gait, weak handgrip strength, exhaustion, and unexplained weight loss (n = 1362, mean age 72). Cognition was measured using the Mini-Mental State Examination (MMSE). RESULTS:Using group-based trajectory models we identified three frailty groups-non-frail (n = 331), moderate progressive (n = 855), and progressive high (n = 149)-and three cognitive decline groups-non-cognitively impaired (476), moderate decline (677) and rapid decline (n = 209). The probability of membership in a high-frailty group given membership in a progressive cognitive decline group was 63%, while the probability of being in a non-frail group given membership in a non-cognitively impaired group was 68%. Predictors of membership into both the progressive high frailty and rapid cognitive decline groups combined were low education and diabetes. Weekly church attendance was associated with a 66% reduction in the odds of being in the combined groups. CONCLUSIONS:Interventions to reduce frailty rates and cognitive decline might focus on the management of underlying chronic disease and on increasing participation in activities outside the home.
10.1093/gerona/glz295
Association between heart diseases, social factors and physical frailty in community-dwelling older populations: The septuagenarians, octogenarians, nonagenarians investigation with centenarians study.
Klinpudtan Nonglak,Kabayama Mai,Gondo Yasuyuki,Masui Yukie,Akagi Yuya,Srithumsuk Werayuth,Kiyoshige Eri,Godai Kayo,Sugimoto Ken,Akasaka Hiroshi,Takami Yoichi,Takeya Yasushi,Yamamoto Koichi,Ikebe Kazunori,Yasumoto Saori,Ogawa Madoka,Inagaki Hiroki,Ishizaki Tatsuro,Rakugi Hiromi,Kamide Kei
Geriatrics & gerontology international
AIM:Heart diseases and social factors are associated with physical frailty, but there are few studies of older people living in the community. Consequently, the aim of this study was to examine the association between heart diseases, social factors and physical frailty in community-dwelling older populations including the oldest-old people. METHODS:The cross-sectional study included 1882 participants of community-dwelling older and oldest-old people. The survey site assessed questionnaires on medical history, social factors, blood samples and physical examination. Physical frailty was based on slow gait speed or weak grip strength. Associations were analyzed using multiple logistic regression with adjustments for covariate factors. RESULTS:Subjects with heart disease had a higher prevalence of physical frailty than those without heart disease. After adjusting the covariate factors, heart diseases were associated with a slow gait speed (odds ratio [OR] = 1.62; 95% confidence interval [CI]: 1.13-2.32, P = 0.009). Frequency of going outdoors and direct interaction with relatives or friends were associated with a slow gait speed (OR = 0.83, 95% CI 0.75-0.91, P ≤ 0.001 and OR = 0.87, 95% CI 0.81-0.94, P < 0.001), and associated with physical frailty (OR = 0.80, 95% CI 0.72-0.89, P ≤ 0.001 and OR = 0.88, 95% CI 0.82-0.95, P = 0.002). Living alone and frequency of direct interaction with relatives or friends were associated with physical frailty in subjects with heart disease. CONCLUSIONS:Our findings indicate that in community-dwelling older people, heart diseases and social factors were associated with physical frailty. Older people with heart disease, those living alone and the frequency of direct interaction with relatives or friends were associated with physical frailty. Geriatr Gerontol Int 2020; 20: 974-979.
10.1111/ggi.14002
Prevalence and Correlates of Frailty Syndrome among Older Adults Attending Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan.
Ajayi S A,Adebusoye L A,Olowookere O O,Akinyemi R O,Afolayan K O,Akinyemi J O,Labaeka E O
West African journal of medicine
BACKGROUND:Frailty has emerged as an important clinical measurement among older adults because of its negative health outcomes. OBJECTIVE:This study measured the prevalence and factors associated with frailty among older adults aged 60 years and above at a Geriatric Centre in Nigeria. METHODS:In this descriptive cross-sectional study, 971 older adults were recruited consecutively. Data on sociodemographics characteristics and clinical parameters were obtained using an interviewer-administered questionnaire and physical examination performed. The Frailty syndrome and Frailty Index were assessed using the Fried Frailty Criteria (FFC) and Canadian Study of Health and Aging (CSHA) scale respectively. Bivariate and multivariate analyses were carried out using SPSS version 21 at a p <0.05. RESULTS:The mean age of the participants was 71.3 (± 7.1) years with a female to male ratio of 2.4:1. Based on FFC scale, 498 older persons (51.3%) had frailty syndrome while only 148 (15.2%) were frail using the CSHA scale. The measure of agreement (Kappa statistics) was 0.22 (p<0001) indicating weak agreement between the two scales. Logistic regression analysis revealed increasing age (OR=1.948 [1.219-3.113]), multiple morbidities (OR= 1.584, [1.177-2.201]), depression (OR= 5.050, [2.501-9.442,]), imbalance or increased risk of fall (OR 1.623, [1.192-2.211,]), and inability to perform IADL (OR= 0.599 [0.535-0.670,]) to be the most significant determinants of frailty syndrome while obesity (OR=0.660, [0.449-0.971]), unusually appeared a deterrent. CONCLUSION:The prevalence of frailty syndrome was high among the older adults. Targeted and timely interventions on the modifiable factors may delay progression into frailty and the eventual negative health outcomes.
[Frailty syndrome: evaluation of its knowledge and screening tools by general medicine interns].
Piedallu Jean-Baptiste,Lorenzo-Villalba Noël,Chassagne Philippe,Schuers Mathieu,Zulfiqar Abrar-Ahmad
Geriatrie et psychologie neuropsychiatrie du vieillissement
Screening and management of frail elderly patients is essential in general practice. OBJECTIVE:This study aims to describe and evaluate the knowledge about frailty, its screening tests and management in a population of general practice interns. METHOD:A prospective, descriptive and mono-centric study using an online survey was conducted. The 2018's promotion of general practice interns in Rouen's University participated. Evaluation of the general knowledge (e.g diagnostic criteria) and specific knowledge (e.g ranking different conditions such as: undernourishment leading to asthenia) and management algorithm (e.g to address the patient for geriatric evaluation) Results: 90 questionnaires were analyzed. Ten interns (11%) stated to know at least one screening test or to know a set of 4 major frailty criteria. Thirty four interns knew at least 4 frailty criteria (major or minor) and 46 interns had partial knowledge. Fried's phenotype was the most known. Seventy-five interns (83%) stated to know the frailty syndrome. However, 88% of the interns had little knowledge about its pathophysiology. Concerning frailty management, 78% (70 interns) stated to know how to screen frailty and prescribe first line treatments. Thirty-one among them knew how to reassess initial treatment if failure. In 59 interns (65%), identifying frailty would have led to a geriatric consultation. Seventy-nine interns (87%) were favorable to go through further training on frailty. CONCLUSION:These general practice interns were able to identify frailty criterion but, in contrast, global understanding of the syndrome was missing. Further training about this topic seems to be necessary.
10.1684/pnv.2019.0840