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03/2014 journal articles

A NEW GRIP STRENGTH MEASURING DEVICE FOR DETAILED EVALUATION OF MUSCLE CONTRACTION AMONG THE ELDERLY

Y. Matsui, R. Fujita, A. Harada, T. Sakurai, T. Nemoto, N. Noda, K. Toba

J Frailty Aging 2014;3(3):142-147

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Background: We developed a new grip strength measuring device, which considers the time axis, for evaluating muscle contraction in detail in elderly people. Objectives: To present the novel device and preliminary results concerning agility in gripping. Design: Cross-sectional analysis. Participants: One hundred and twenty-one older persons (48 men and 73 women, mean age 74.4 years) referring for memory disorders to the outpatient clinic of our institute. Measurements: A novel device taking advantage of an industrial force-gauge was developed for measuring gripping performance. The instrument graphically described participants’ strength production. Nine indices were derived from four points identified by the graph: 1) starting point (“Go signal”), 2) time when gripping starts, 3) turning point (TP) when the inclination of the curve depicting strength production changes, and 4) peak of strength production. Results obtained from the study sample of older persons were compared (as ratios) to a control group of 30 healthy young adults in their thirties in order to calculate age-related decline rates. Differences between right and left side were compared. Results: A significant difference was observed between right and left hands concerning the time to reach peak of strength, and time from TP to strength peak in both men and women. For women, the following indices were also significantly different: time to reach TP, strength at TP, time from TP to strength peak, curve inclination from TP to strength peak, and ratio of TP strength divided by peak strength. Conclusion: Declines in several indices of gripping agility were measured. The parameters which were more closely related to time than strength itself showed significant differences between right and left hands, especially in women.

CITATION:
Y. Matsui ; R. Fujita ; A. Harada ; T. Sakurai ; T. Nemoto ; N. Noda ; K. Toba (2014): A NEW GRIP STRENGTH MEASURING DEVICE FOR DETAILED EVALUATION OF MUSCLE CONTRACTION AMONG THE ELDERLY. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.15

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RELATIONSHIP BETWEEN THE LEVEL OF EDUCATION AND FUNCTIONAL CAPACITY IN ACTIVE ELDERLY ADULTS

M.-M. Dubuc, S. Barbat-Artigas, A.D. Karelis, M. Aubertin-Leheudre

J Frailty Aging 2014;3(3):148-152

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Background: Both the level of education and functional capacity seems to be associated with the level of physical activity in the elderly. However, the relationship between the level of education and functional capacity in active elderly adults is poorly understood. Objective: To examine the association between the level of education and the functional capacity profile of active elderly adults. Design: Cross-sectional. Participants: One hundred and four elderly men and 198 postmenauposal women (mean age: 62.7 ± 7.6 years old) were recruited among registered members of the YMCAs of Montreal who practiced at least one hour of structured physical activity per week. Participants were then divided in two groups based on their level of education (the cut-off point was the high-school diploma). Measurements: Body composition (DXA), muscle strength (knee extensors, handgrip), estimated maximal oxygen consumption (2-km walk test), perceived health (SF-36) and functional capacity (timed up and go, alternate step and one-leg stance tests) were measured. The level of education of the participants was assessed by questionnaire. Results: Body composition was similar between groups. We observed that all functional capacity tests as well as the global functional capacity score were significantly higher in the most educated group compared to the least educated group (p<0.05). In addition, the most educated group had significantly higher levels of knee extensors strength, estimated maximal oxygen consumption and perception of physical functioning. Conclusions: A higher level of education was associated with a favourable functional capacity profile in our cohort of active elderly adults. However, the mechanism(s) which could mediate this association remain(s) unknown.

CITATION:
M.-M. Dubuc ; S. Barbat-Artigas ; A.D. Karelis ; M. Aubertin-Leheudre (2014): RELATIONSHIP BETWEEN THE LEVEL OF EDUCATION AND FUNCTIONAL CAPACITY IN ACTIVE ELDERLY ADULTS. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.16

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RELATIONSHIP BETWEEN FRAILTY AND COGNITIVE FUNCTION AMONG OLDER ADULTS IN TAIWAN

H.-C. Hsu

J Frailty Aging 2014;3(3):153-157

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Background: The causal relationship between physical frailty and cognitive function is not yet completely confirmed. Objectives: This study aimed at exploring the reciprocal relationship of frailty and cognitive function among Taiwanese older adults. Participants and setting: The study evaluated data from a five-wave survey conducted in Taiwanese older persons (n=3,155 respondents, 10,631 observations). Measurements: Frailty was defined as low physical activity, exhaustion, poor appetite, poor grip strength, and difficulty in carrying 10-pound objects; individuals were defined as frail if they met three or more of the above criteria. Cognitive function was assessed using five items from the Short Portable Mental Status Questionnaire (SPMSQ) scale. Time-lagged and time-concurrent models were performed to examine the reciprocal relationship between cognitive function and frailty. Growth-curve hierarchical linear modeling was applied. Results: Concurrent frailty was related to low cognitive function at the intercept and time slope and vice versa. Previous frailty also predicted later decline of cognitive function. Nevertheless, previous cognitive function was not found to have a significant relationship with subsequent frailty. Education, physical function and social support represented shared factors to both frailty and cognitive function. Conclusions: Frailty and cognitive function are correlated, and frailty may occur prior to cognitive impairment.

CITATION:
H.-C. Hsu (2014): RELATIONSHIP BETWEEN FRAILTY AND COGNITIVE FUNCTION AMONG OLDER ADULTS IN TAIWAN. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.17

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FRAILTY AND PRE-FRAILTY IN A CONTEMPORARY COHORT OF HIV-INFECTED ADULTS

N.F. Önen, P. Patel, J. Baker, L. Conley, J.T. Brooks, T. Bush, K. Henry, J. Hammer, E.M. Kojic, E.T. Overton, for the SUN Study Investigators

J Frailty Aging 2014;3(3):158-165

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Objectives: To determine the prevalence of pre-frailty among HIV-infected persons and associations with pre-frailty and frailty in this population. Design, Setting and Participants: From a contemporary, prospective observational cohort of HIV-infected persons (SUN Study), we determined, using a cross-sectional analytic study design, the proportions of non-frail, pre-frail, and frail persons by the respective presence of 0, 1-2, and ≥ 3 of 5 established frailty criteria: unintentional weight loss, exhaustion, physical-inactivity, weak-grip and slow-walk. We evaluated associations with pre-frailty/frailty using multivariate analysis. Results: Of 322 participants assessed (79% men, 58% white non-Hispanic, median age 47 years, 95% on combination antiretroviral therapy [cART], median CD4 + cell count 641 cells/mm3 and 93% HIV RNA < 400 copies/mL), 57% were non-frail, 38% pre-frail, and 5% frail. Age increased from non-frailty through frailty. Notably, however, half of pre-frail and frail participants were < 50 years, and of those, 42% and 100%, respectively, were long-term unemployed (versus 16% of non-frail counterparts). In multivariate analysis, pre-frail/frail participants were more likely to have Hepatitis C seropositivity (adjusted odds ratio [aOR] 3.24, 95% CI: 1.35-7.78), a history of AIDS-defining-illness (aOR 3.51, 95% CI: 1.82-6.76), greater depressive symptoms (aOR 1.16, 95% CI:1.09-1.23), higher D-dimer levels (aOR 2.94, 95% CI:1.10-7.87), and were less likely to be white non-Hispanic (aOR 0.35, 95% CI: 0.20-0.61). Conclusions: Pre-frailty and frailty are prevalent in the cART era and are associated with unemployment even among persons < 50 years. Pre-frailty appears to be an intermediate state in the spectrum from non-frailty through frailty and our characterization of pre-frailty/frailty suggests complex multifactorial associations.

CITATION:
N.F. Önen ; P. Patel ; J. Baker ; L. Conley ; J.T. Brooks ; T. Bush ; K. Henry ; J. Hammer ; E.M. Kojic ; E.T. Overton for the SUN Study Investigators (2014): FRAILTY AND PRE-FRAILTY IN A CONTEMPORARY COHORT OF HIV-INFECTED ADULTS. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.18

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ASSOCIATIONS BETWEEN FRAILTY, COMPLEX CARE NEEDS AND QUALITY OF LIFE IN MULTI-MORBID OLDER PEOPLE

N. Bleijenberg, V.H. ten Dam, I. Drubbel, M.E. Numans, N.J. de Wit, M.J. Schuurmans

J Frailty Aging 2014;3(3):166-172

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Background: Little is known regarding the complex care needs, level of frailty or quality of life of multi-morbid older patients. Objectives: The objective of this study was to determine the relationship between frailty, complexity of care and quality of life in multi-morbid older people. Design: Cross-sectional study. Setting: Thirteen primary care practices in the Netherlands. Participants: 1,150 multi-morbid older people living in the community. Measurements: The level of frailty was assessed with the Groningen Frailty Indicator. Complexity of care needs was measured with the Intermed for the Elderly Self-Assessment. Quality of life (QoL) was measured with two items of the RAND-36. Results: In total, 758 out of 1,150 (65.9%) patients were frail, 8.3% had complex care needs, and the mean QoL score was 7.1 (standard deviation 1.2). Correlations between frailty and complexity, frailty and QoL, and complexity of care and QoL were 0.67, -0.51 and -0.52 (all p<0.001) respectively. All patients with complex care needs were frail, but, only 12.5% of the frail patients had complex care needs. Problems at climbing up stairs was associated with higher levels of frailty and complexity of care but with a lower QoL. Conclusions: Higher levels of frailty and complexity of care are associated with a lower QoL in multi-morbid older people. The results of this study contribute to a better understanding these concepts and are valuable for the development of tailored interventions for older persons in the future.

CITATION:
N. Bleijenberg ; V.H. ten Dam ; I. Drubbel ; M.E. Numans ; N.J. de Wit ; M.J. Schuurmans (2014): ASSOCIATIONS BETWEEN FRAILTY, COMPLEX CARE NEEDS AND QUALITY OF LIFE IN MULTI-MORBID OLDER PEOPLE. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.19

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IS THE LATIN AMERICAN AND CARIBBEAN FOOD SECURITY SCALE AN APPROPRIATE INSTRUMENT FOR MEXICAN URBAN OLDER ADULTS?

M. Vilar-Compte, A. Bernal-Stuart, D. Orta-Alemán, T. Ochoa-Rivera, R. Pérez-Escamilla

J Frailty Aging 2014;3(3):173-179

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Background: Older adults in Mexico are a growing share of the population and are a largely vulnerable group with increased risk of food insecurity and potential detrimental health effects stemming from it. Objectives: This study assesses the face validity of the Latin American and Caribbean Food Security Scale (ELCSA) among Mexican urban older adults of low socioeconomic status. Design: Qualitative study based on 4 focus groups. Setting: The focus groups were conducted in community organizations for the elderly in an area of Mexico City with a high proportion of poverty. Participants: The focus groups included a total of 36 older adults aged 65 and over who consented to participate. Measurements: Two initial focus groups were conducted to assess how older adults understood the food security construct and each of the ELCSA items. Based on these findings, ELCSA was modified and retested for face validity through two additional focus groups. Results: The initial focus groups suggested that several of the scale items were not well understood, leading to editorial modifications of the scale. The final focus groups indicated that the modified version of the scale improved substantially ELCSA’s face validity in this sample. Conclusions: The modified ELCSA led to a greater understanding of most scale items. Further qualitative research is needed to improve food insecurity measurements among older adults in Latin America.

CITATION:
M. Vilar-Compte ; A. Bernal-Stuart ; D. Orta-Alemán ; T. Ochoa-Rivera ; R. Pérez-Escamilla (2014): IS THE LATIN AMERICAN AND CARIBBEAN FOOD SECURITY SCALE AN APPROPRIATE INSTRUMENT FOR MEXICAN URBAN OLDER ADULTS?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.20

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FRAILTY FROM AN ORAL HEALTH POINT OF VIEW

R.C. Castrejón-Pérez, S.A. Borges-Yáñez

J Frailty Aging 2014;3(3):180-186

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Frailty commonly affects older persons, increasing their risk for adverse outcomes. Oral health is affected by those conditions related to the mouth and teeth, including caries, periodontal diseases, dysgeusia, presbyphagia and oral cancer among others. Oral health problems can be classified as development defects and acquired problems. These latter are related to infection or trauma, have a cumulative effect throughout life and their consequences are lifelong. Such acquired problems can be classified as primary or secondary, both interacting in a complex manner. Recovery to a previous state of tissue integrity is often impossible from these conditions. These complex interactions have negative impacts on the individual’s general health and quality of life. Oral status is an important contributor to general health, and has been linked to several chronic conditions such as cognitive impairment, diabetes, cardiovascular diseases, strokes, and cancer. An individual’s oral health is mostly stable throughout life. Tooth loss may be considered as the final outcome, resulting as a consequence of history of caries and periodontitis, as well as failure of prevention and treatment. The loss of a tooth may thus represent the first step of a vicious cycle. In fact, without intervention, one missing tooth may lead to further teeth loss, thus reducing the capability to chew and consume nutrients (essential for life and adequate physiological function), and finally contributing to the development of age-related chronic diseases.

CITATION:
R.C. Castrejón-Pérez ; S.A. Borges-Yáñez (2014): FRAILTY FROM AN ORAL HEALTH POINT OF VIEW. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.21

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PRECISION IN ESTIMATES OF DISABILITY PREVALENCE FOR THE POPULATION AGED 65 AND OVER IN THE UNITED STATES BY RACE AND ETHNICITY

C. Siordia

J Frailty Aging 2014;3(3):187-192

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Background: Populations are aging worldwide. In the United States (US), the older adult (aged ≥65) population will increase rapidly in the decades to come. Identifying public health needs in older adults requires that sample-derived estimates of disability prevalence be produced using transparent methodologies. Objectives: Produce estimates of disabilities for the US older adult population by race and ethnicity and present measures on the ‘level of precision’ in the estimates. Design: Cross-sectional study used American Community Survey (ACS) Public Use Microdata Sample (PUMS) 3-year file collected during 2009-2011 survey period. Setting: Community dwelling population aged ≥65 in US. Participants: The 1,494,893 actual survey participants (unweighted count) are said to represent 40,496,512 individuals after population weights are applied (weighted count). From the weighted counts, the average age is 75, about 56% are females, and most (80%) are Non-Latino-Whites (NLW). Results: Qualitative comparisons provide some evidence that except for hearing, disability prevalence is highest in Non-Latino-Blacks along the following disability items: independent living (25%); ambulatory (34%); self-care (15%); cognitive (11%); and vision (11%). Person inflation ratios, width of 95% confidence interval, and rates of allocations are smaller in NLWs than all the other race-ethnic groups—suggesting disability estimates for NLWs merit the highest level of confidence. Conclusions: Improving measures of health in the older adult population requires that efforts continue to highlight how estimates of disability prevalence have the potential to vary in precision and as a function of various known and unknown factors.

CITATION:
C. Siordia (2014): PRECISION IN ESTIMATES OF DISABILITY PREVALENCE FOR THE POPULATION AGED 65 AND OVER IN THE UNITED STATES BY RACE AND ETHNICITY. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.22

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LETTER TO THE EDITOR : HOW USEFUL ARE MULTIDOMAIN FRAILTY MEASURES IN RESEARCH AND CLINICAL PRACTICE?

Emiel O. Hoogendijk

J Frailty Aging 2014;3(3):193-194

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CITATION:
Emiel O. Hoogendijk (2014): LETTER TO THE EDITOR : HOW USEFUL ARE MULTIDOMAIN FRAILTY MEASURES IN RESEARCH AND CLINICAL PRACTICE?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.23

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