01/2023 journal articles
ASSESSMENT AND MANAGEMENT OF APPETITE LOSS IN OLDER ADULTS: AN ICFSR TASK FORCE REPORT
P. de Souto Barreto, M. Cesari, J.E. Morley, E. Gonzalez-Bautista, Y. Rolland, D. Azzolino, B. Vellas, R.A. Fielding
J Frailty Aging 2023;12(1)1-6Show summaryHide summary
The Appetite loss in older people is an important unmet clinical need in geriatrics. The International Conference on Frailty and Sarcopenia Research (ICFSR) organized a Task Force on April 20th 2022, in Boston, to discuss issues related to appetite loss in older people, in particular, the assessment tools currently available, its evaluation in the primary care setting, and considerations about its management. There is a high heterogeneity in terms of the etiology of appetite loss in older people and a gold standard assessment tool for evaluating this condition is still absent. Although this may render difficult the management of poor appetite in clinical practice, validated assessment tools are currently available to facilitate early identification of appetite loss and support care decisions. As research on biomarkers of appetite loss progresses, assessment tools will soon be used jointly with biomarkers for more accurate diagnosis and prognosis. In addition, efforts to foster the development of drugs with a favorable risk/benefit ratio to combat poor appetite should be strengthened.
P. de Souto Barreto ; M. Cesari ; J.E. Morley ; E. Gonzalez-Bautista ; Y. Rolland ; D. Azzolino ; B. Vellas ; R.A. Fielding ; (2022): Assessment and Management of Appetite Loss in Older Adults: An ICFSR Task Force Report . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.64
ASSOCIATION OF INTRINSIC CAPACITY WITH FRAILTY, PHYSICAL FITNESS AND ADVERSE HEALTH OUTCOMES IN COMMUNITYDWELLING OLDER ADULTS
L. Tay, E.-L. Tay, S.M. Mah, A. Latib, C. Koh, Y.-S. Ng
J Frailty Aging 2023;12(1)7-15Show summaryHide summary
Background: Intrinsic capacity (IC) and frailty are complementary in advancing disability prevention through maintaining functionality.
Objectives: We examined the relationship between IC and frailty status at baseline and 1-year, and evaluated if IC decline predicts frailty onset among robust older adults. The secondary objectives investigated associations between IC, physical fitness and health-related outcomes.
Design: Prospective cohort study.
Setting: Community-based assessments.
Participants: Older adults aged>55 years, who were independent in ambulation (walking aids permitted).
Measurements: 5 domains of IC were assessed at baseline: locomotion (Short Physical Performance Battery, 6-minute walk test), vitality (nutritional status, muscle mass), sensory (self-reported hearing and vision), cognition (self-reported memory, age- and education adjusted cognitive performance), psychological (Geriatric Depression Scale-15, self-reported anxiety/ depression). Composite IC (0-10) was calculated, with higher scores representing greater IC. Frailty status was based on modified Fried criteria, with frailty progression defined as incremental Fried score at 1-year.
Results: 809 participants (67.6+6.8 years) had complete data for all 5 IC domains. 489 (60.4%) participants were robust but only 213 (26.3%) had no decline in any IC domain. Pre-frail and frail participants were more likely to exhibit decline in all 5 IC domains (p<0.05), with decremental composite IC [9 (8-9), 8 (6-9), 5.5 (4-7.5), p<0.001] across robust, prefrail and frail. IC was significantly associated with fitness performance, independent of age and gender. Higher composite IC reduced risk for frailty progression (OR=0.62, 95% CI 0.48-0.80), and reduced frailty onset among robust older adults (OR=0.53, 95% CI 0.37-0.77), independent of age, comorbidities and social vulnerability. Participants with higher IC were less likely to experience health deterioration (OR=0.70, 95% CI 0.58-0.83), falls (OR=0.76, 95% CI 0.65-0.90) and functional decline (OR=0.64, 95% CI 0.50-0.83) at 1-year.
Conclusion: Declining IC may present before frailty becomes clinically manifest, increasing risk for poor outcomes. Monitoring of IC domains potentially facilitates personalized interventions to avoid progressive frailty.
L. Tay ; E.-L. Tay ; S.M. Mah ; A. Latib ; C. Koh ; Y.-S. Ng (2022): Association of Intrinsic Capacity with Frailty, Physical Fitness and Adverse Health Outcomes in Community-Dwelling Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.28
SLEEP QUALITY AND DURATION AS DETERMINANTS OF HEALTHY AGING TRAJECTORIES: THE HELIAD STUDY
V. Gkotzamanis, D.B. Panagiotakos, M. Yannakoulia, M. Kosmidis, E. Dardiotis, G. Hadjigeorgiou, P. Sakka, N. Scarmeas6
J Frailty Aging 2023;12(1)16-23Show summaryHide summary
Background: The aging of global population has increased the scientific interest in the concept of healthy aging and its determinants. Aim: The aim of this study was to investigate the association of sleep characteristics with trajectories of healthy aging.
Design and Setting: Prospective observational study conducted in two cities, Maroussi and Larissa.
Participants: A total of 1226 older adults (≥65 years, 704 women) were selected through random sampling.
Measurements: Sleep quality was assessed with the Sleep Index II, and sleep duration was self-reported. A healthy aging metric was introduced using an Item Response Theory approach based on validated questionnaires that assessed functionality. Four healthy aging trajectories were developed based on whether the healthy aging status of the participants was above (High) or below (Low) the median at baseline and follow-up, i.e., High-High, High-Low, Low-High, and Low-Low. The association of sleep characteristics with the trajectories was investigated using a multinomial logistic regression with the Low-Low group as reference, adjusting for potential confounders.
Results: 34.3% participants classified to the High-High group, 15.7% to the High-Low, 18.6% to the Low-High, and 31.4% to the Low-Low group. Better sleep quality was associated with the probability of belonging to the High-High group (p-value<0.001); while, long sleep duration was inversely associated with likelihood of being classified in the High-High group (p-value < 0.05).
Conclusion: Poor sleep quality and long sleep duration seem to have a significant negative association with healthy aging. Public health policies are needed to raise awareness about the importance of sleep characteristics on human health.
V. Gkotzamanis ; D.B. Panagiotakos ; M. Yannakoulia ; M. Kosmidis ; E. Dardiotis ; G. Hadjigeorgiou ; P. Sakka ; N. Scarmeas ; (2022): Sleep Quality and Duration as Determinants of Healthy Aging Trajectories: The HELIAD Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.37
RISK OF FRAILTY ACCORDING TO THE VALUES OF THE ANKLEBRACHIAL INDEX IN THE TOLEDO STUDY FOR HEALTHY AGING
F. Quiñónez-Bareiro, J.A. Carnicero, A. Alfaro-Acha, C.Rosado-Artalejo, M.C. Grau-Jimenez, L. Rodriguez-Mañas, F.J. García-Garcia
J Frailty Aging 2023;12(1)24-29Show summaryHide summary
Background: Vascular function (VF) is a general term used to describe the regulation of blood flow, arterial pressure, capillary recruitment, filtration and central venous pressure, it´s well known that age has direct effects on the VF, and this may affect the frailty status.
Objectives: To analyse the association between Frailty Trait Scale 5 (FTS 5) with VF and its changes at values below and above a nadir.
Design: Prospective population-based cohort study.
Setting and Participants: Data from 1.230 patients were taken from the first wave (2006-2009) of the Toledo Study for Healthy Aging.
Measurements: Frailty was evaluated using FTS 5, which evaluates 5 items: Body mass index, progressive Romberg, physical activity, usual gait speed and hand grip strength. VF was assessed using the ankle-brachial index (ABI) as an indirect measure of VF. Screening for cardiovascular and cerebrovascular disease was also performed by self-reporting and by searching medical records, and was used as exclusion criteria
Results: The optimal ABI cut-off point that maximized the adjusted R2 was 1.071. We observed a statistically significant association for FTS 5 score above and below the ABI cut-off points. For every tenth that the ABI decreased below the cut-off point the patient had an increase in the FTS 5 score of 0.47 points and in every tenth that increased above the cut-off point the increase in the FTS 5 score was 0.41 points. Of all FTS 5 items, the gait speed was the only item that showed a significant association with an ABI changes 0.28 and 0.21 points for every tenth below and above the cut-off point, respectively.
Conclusions: Frailty is highly associated with VF. In addition, FTS 5 and its gait speed criteria are useful to detect VF impairments, via changes in ABI.
F. Quiñónez-Bareiro ; J.A. Carnicero ; A. Alfaro-Acha ; C.Rosado-Artalejo ; M.C. Grau-Jimenez ; L. Rodriguez-Mañas ; F.J. García-Garcia (2022): Risk of Frailty According to the Values of the Ankle-Brachial Index in the Toledo Study for Healthy Aging. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.25
ASSOCIATIONS BETWEEN DIETARY VARIETY AND FRAILTY IN COMMUNITY-DWELLING OLDER PEOPLE WHO LIVE ALONE: GENDER DIFFERENCES
M. Yokoro, N. Otaki, M. Yano, M. Tani, N. Tanino, K. Fukuo
J Frailty Aging 2023;12(1)30-36Show summaryHide summary
Objectives: This study aimed to investigate the influences of living arrangements on the association between dietary variety and frailty by gender in community-dwelling older people.
Design: A cross-sectional study.
Setting: Nishinomiya city, Hyogo prefecture, Japan.
Participants: A total of 4,996 randomly selected community-dwelling older people aged 65 years and older and living in Nishinomiya City.
Measurements: Survey questionnaires were distributed via mail. The frailty score was evaluated by the 5-item frailty screening index. Dietary variety was assessed using the dietary variety score developed for the general older Japanese population.
Results: A total of 2,764 community-dwelling participants aged ≥ 65 years responded to the questionnaires. After excluding missing data, 1,780 participants were included in the study analysis. The frailty scores in older men living alone were significantly higher than those in older men living with someone (P < 0.001). The dietary variety scores in older men living alone were significantly lower than those in older men living with someone (P < 0.001). However, differences in the frailty and dietary variety scores between living alone and living with someone were not were observed in older women (P = 0.360 and P = 0.265, respectively). In the multivariable regression analysis, the associations between dietary variety score and frailty score in living alone (β= −0. 271, P = 0.011) were stronger than those in living with someone in the case of older men (β= −0.131, P = 0.045). Similar associations between dietary variety and frailty were presented in older women living alone than in those living with someone (β −0.114, P = 0.002; β −0.088, P = 0.012, respectively).
Conclusions: Older men who live alone had higher frailty score and lower dietary variety. The associations between dietary variety and frailty were different according to living arrangements in both older men and older women.
M. Yokoro ; N. Otaki ; M. Yano ; M. Tani ; N. Tanino ; K. Fukuo ; (2022): Associations between Dietary Variety and Frailty in Community-Dwelling Older People Who Live Alone: Gender Differences. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.49
DYNAPENIC ABDOMINAL OBESITY AS A RISK FACTOR FOR FALLS
L. Dowling, E. McCloskey, D.J. Cuthbertson, J.S. Walsh
J Frailty Aging 2023;12(1)37-42Show summaryHide summary
Background: Obesity and low muscle strength (dynapenia) are independently associated with greater falls risk. It remains unclear whether dynapenia and obesity have an additive effect on falls risk, greater than either phenotype alone. Objectives: To determine whether a combination of abdominal obesity with dynapenia, dynapenic abdominal obesity (DAO), confers a greater risk of falls than either obesity or dynapenia alone in both men and women.
Design: An observational cohort study was conducted. Setting and Participants: Data from English adults (n=4239, 60-87 years) who took part in the English Longitudinal Study of Ageing were included. Measurements: Dynapenia, was defined as hand-grip strength <20kg (female), <30kg (male). Abdominal obesity was defined as waist circumference >88cm (female), >102cm (male). Data on falls and fall-related injuries over a 2-year follow-up were collected. Multiple logistic regression analyses were performed adjusting for age and sex, with results expressed as odds ratios (OR) and areas under the receiver operating characteristic curve (AUC).
Results: Falls occurred in 1049 participants, with 284 reporting a related injury during follow-up. DAO was associated with greater OR of falls in men (OR 2.1, 95% Confidence Intervals (CI) 1.3–3.2). Dynapenia rather than obesity was associated with falls in women, with greatest OR observed in those with low hand-grip strength (OR 1.4, 95% CI 1.1–1.7). Individual discrimination was low for measures of obesity or dynapenia either alone or in combination (AUC 0.51–0.58). There was no relationship between fall-related injuries and obesity or dynapenia.
Conclusion: Our findings suggest a synergistic effect of obesity with dynapenia on falls risk in men but not women.
L. Dowling ; E. McCloskey ; D.J. Cuthbertson ; J.S. Walsh ; (2022): Dynapenic Abdominal Obesity as a Risk Factor for Falls. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.18
THE RELATIONSHIP BETWEEN PSYCHOLOGICAL DISTRESS AND PHYSICAL FRAILTY IN JAPANESE COMMUNITY-DWELLING OLDER ADULTS: A CROSSSECTIONAL STUDY
X. Liu, T. Chen, S. Chen, H. Yatsugi, T. Chu, H. Kishimoto
J Frailty Aging 2023;12(1)43-48Show summaryHide summary
Background: Older adults’ mental health and physical frailty have been a frequent research focus, but few studies have investigated the relationship between them.
Objectives: To investigate the association between mental health and physical frailty in community-dwelling older Japanese people.
Design: Cross-sectional study from the Itoshima Frail Study.
Setting: Itoshima City, Fukuoka, Japan.
Participants: A total of 919 community-dwelling older individuals aged 65–75 years.
Measurements: Physical frailty was measured based on five criteria proposed by the Fried scale, and the subjects were classified into three groups: robust, pre-frailty, and frailty. Psychological distress was used to assess the subjects’ mental health, with the Kessler 6-Item Psychological Distress Scale (K6) score; the subjects were divided into three groups based on their K6 score: 0–1, 2–4, and ≥5. Psychological distress was defined by K6 score ≥5. Ordinal logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CIs) between the psychological distress and physical frailty status.
Results: Psychological distress was identified in 190 subjects (20.7%). Forty-six subjects (5.0%) presented with physical frailty, and 24 subjects (2.6%) had both psychological distress and physical frailty. With the increase in the K6 score, more subjects had pre-frailty and physical frailty (p<0.001). Significant positive associations were observed between psychological distress and the risks of pre-frailty (OR 2.94, 95%CI: 1.95–4.43) and frailty (OR 10.71, 95%CI: 4.68–24.51), even in a multivariable-adjusted analysis. In a subgroup analysis of components of frailty, one-point increment in K6 score was associated with higher odds of shrinking and fatigue.
Conclusion: A severe psychological distress was associated with increased risks of physical frailty and the frailty sub-items of shrinking and fatigue in community-dwelling older Japanese adults.
X. Liu ; T. Chen ; S. Chen ; H. Yatsugi ; T. Chu ; H. Kishimoto ; (2022): The Relationship between Psychological Distress and Physical Frailty in Japanese Community-Dwelling Older Adults: A Cross-Sectional Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.63
FRAILTY AND AGING IN HIV– STATUS POST 13 YEARS OF NATIONAL AWARENESS
U.A. Eke, K. Mohanty, A.L. Gruber-Baldini, A.S. Ryan4
J Frailty Aging 2023;12(1)49-58Show summaryHide summary
The People aged 50 years and above comprise over 50% of people living with HIV (PLWH) in the US. Despite the advances made with anti-retroviral therapy in increasing their life span, PLWH are plagued with non-AIDS associated conditions which increase their risk for morbidity and mortality. Frailty, a decline in physical and functional reserve, is one of the manifestations of aging, has a prevalence of 5-30%, and occurs up to 2 decades earlier in people aging with HIV (PAWH). The majority of providers for PAWH have minimal experience with the concept of gerontology, frailty, and aging. Hence, there is a gap in clinicians’ knowledge on how to address frailty and aging in PAWH. This review will focus on the clinical interventions that mitigate frailty and aging in PAWH as well as highlight areas of investigation towards achieving these mediations. Beyond the identification of the roles of exercise and nutrition, more studies are needed on the pragmatic approach to apply these resources to routine care. There should be continued reinforcement of the proven strategy of combination antiretroviral therapy as well as treatment of co-infections and age-appropriate health and cancer screening in PAWH.
U.A. Eke ; K. Mohanty ; A.L. Gruber-Baldini ; A.S. Ryan ; ; (2022): Frailty and Aging in HIV– Status Post 13 Years of National Awareness. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.45
RISK OF FOUR GERIATRIC SYNDROMES: A COMPARISON OF MENTAL HEALTH CARE AND GENERAL HOSPITAL INPATIENTS
J. Douairi, E.G.T. Bos, B.C. van Munster, K. Boudestein, C. Benraad, L. Disselhorst, R.C. Oude Voshaar, F.M.M. Oud, R.M. Kok
J Frailty Aging 2023;12(1)59-62Show summaryHide summary
An observational, cross-sectional study is conducted to compare elevated risk scores of four geriatric syndromes (falls, malnutrition, physical impairment, delirium) in older hospitalized psychiatric patients (n=178) with patients hospitalized in a general hospital (n=687). The median age of all patients was 78 years (IQR 73.3-83.3), 53% were female. After correction for age and gender, we found significantly more often an elevated risk in the mental health care group, compared to the general hospital group of falls (Odds Ratio (OR) = 1.75; 95% Confidence Interval (CI) 1.18-2.57), malnutrition (OR = 4.12; 95% CI 2.67-6.36) and delirium (OR = 6.45; 95% CI 4.23-9.85). The risk on physical impairment was not statistically significantly different in both groups (OR = 1.36; 95% CI .90-2.07). Older mental health care patients have a higher risk to develop geriatric syndromes compared to general hospital patients with the same age and gender, which might be explained by a higher level of frailty.
J. Douairi ; E.G.T. Bos ; B.C. van Munster ; K. Boudestein ; C. Benraad ; L. Disselhorst ; R.C. Oude Voshaar ; F.M.M. Oud ; R.M. Kok (2022): Risk of Four Geriatric Syndromes: A Comparison of Mental Health Care and General Hospital Inpatients. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.8
STOP AND GO: BARRIERS AND FACILITATORS TO CARE HOME RESEARCH
L.A. Ritchie, A.L. Gordon, P.E. Penson, D.A. Lane, A. Akpan
J Frailty Aging 2023;12(1)63-66Show summaryHide summary
Barriers to care home research have always existed, but have been thrown into sharp relief by the COVID-19 pandemic. Existing infrastructure failed to deliver the research, or outcomes, which care home residents deserved and we need to look, again, at how these barriers can be taken down. Barriers can be categorised as procedural (encountered before research starts), system (encountered during research) or resident-specific. To tackle these, research regulatory bodies need to adopt a standardised approach to how care home research is developed and designed, reviewed and regulated, and how such approaches can enable recruitment of as wide a range of residents and their representatives as possible, including those without the mental capacity to consent for research. Establishment of local, inter-disciplinary collaborations between universities, general practices, health and social care providers and care homes is another priority. This should be based on pre-existing models such as the ‘Living lab’ model developed in The Netherlands and now being implemented in the UK and Austria. These changes are critical to develop a sustainable research model. If well designed this will deliver better outcomes for residents and align with the individual and organisational priorities of those who care for them.
L.A. Ritchie ; A.L. Gordon ; P.E. Penson ; D.A. Lane ; A. Akpan ; (2022): Stop and Go: Barriers and Facilitators to Care Home Research. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.51
FOOD ASSISTANCE PROGRAMS AND REDUCED HOSPITALIZATIONS FOR OLDER ADULTS WITH DIABETES
M.L. Johnson, S.E. Walsh
J Frailty Aging 2023;12(1)67-70Show summaryHide summary
Diabetes is an increasingly common and costly condition for older adults. Each year, as many as 1 in 3 Medicare dollars is spent to treat and manage diabetes and associated comorbidities for people with diabetes. To control health care spending in the US, it is imperative that we identify factors for reducing hospitalizations for these individuals. The purpose of this cross-sectional study was to identify predictors of hospitalization in the past 12 months for community-dwelling older adults with diabetes. Data from round five of the National Health and Aging Trends Study were analyzed to assess the impact of food assistance programs on the risk of hospitalization in the past 12 months for 1094 Medicare recipients ages 65 and older with diabetes. Previous research on the social determinants of health has demonstrated that social stressors like poverty and exposure to racism are associated with poorer health outcomes overall, but we did not find a statistically-significant association between race, gender, age or Medicare/ Medicaid dual-eligibility and hospitalization for our study population. Notably, receipt of Supplemental Nutrition Assistance Program (SNAP) benefits, Meals on Wheels services or other food assistance was associated with a 43% reduction in the risk of hospitalization in the past 12 months. Food assistance programs appear to be a promising strategy for reducing hospitalizations associated with diabetes and its comorbidities. Primary care providers, diabetes educators and other health professionals should be more proactive in their referrals to food assistance programs and other community supports.
M.L. Johnson ; S.E. Walsh (2022): Food Assistance Programs and Reduced Hospitalizations for Older Adults with Diabetes. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.13
EFFECTS OF VITAMIN D, OMEGA-3 FATTY ACIDS AND A HOME EXERCISE PROGRAM ON PREVENTION OF PRE-FRAILTY IN OLDER ADULTS: THE DO-HEALTH RANDOMIZED CLINICAL TRIAL
M. Gagesch, M. Wieczorek, B. Vellas, R.W. Kressig, R. Rizzoli, J. Kanis, W.C. Willett, A. Egli, W. Lang, E.J. Orav, H.A. Bischoff-Ferrari
J Frailty Aging 2023;12(1)71-77Show summaryHide summary
Background: The benefits of supplemental vitamin D3, marine omega-3 fatty acids, and a simple home exercise program (SHEP) on frailty prevention in generally healthy community-dwelling older adults are unclear.
Objective: To test the effect of vitamin D3, omega-3s, and a SHEP, alone or in combination on incident pre-frailty and frailty in robust older adults over a follow-up of 36 months.
Methods: DO-HEALTH is a multi-center, double-blind, placebo-controlled, 2x2x2 factorial randomized clinical trial among generally healthy European adults aged 70 years or older, who had no major health events in the 5 years prior to enrollment, sufficient mobility and intact cognitive function. As a secondary outcome of the DO-HEALTH trial, among the subset of participants who were robust at baseline, we tested the individual and combined benefits of supplemental 2,000 IU/day of vitamin D3, 1 g/day of marine omega-3s, and a SHEP on the odds of being pre-frail and frail over 3 years of follow-up.
Results: At baseline, 1,137 out of 2,157 participants were robust (mean age 74.3 years, 56.5% women, mean gait speed 1.18 m/s). Over a median follow-up time of 2.9 years, 696 (61.2%) became pre-frail and 29 (2.6%) frail. Odds ratios for becoming pre-frail were not significantly lower for vitamin D3, or omega 3-s, or SHEP, individually, compared to control (placebo for the supplements and control exercise). However, the three treatments combined showed significantly decreased odds (OR 0.61 [95% CI 0.38-0.98; p=0.04) of becoming pre-frail compared to control. None of the individual treatments or their combination significantly reduced the odds of becoming frail.
Conclusion: Robust, generally healthy and active older adults without major comorbidities, may benefit from a combination of high-dose, supplemental vitamin D3, marine omega-3s, and SHEP with regard to the risk of becoming pre-frail over 3 years.
M. Gagesch ; M. Wieczorek ; B. Vellas ; R.W. Kressig ; R. Rizzoli ; J. Kanis ; W.C. Willett ; A. Egli ; W. Lang ; E.J. Orav ; H.A. Bischoff-Ferrari ; (2022): Effects of Vitamin D, Omega-3 Fatty Acids and a Home Exercise Program on Prevention of Pre-Frailty in Older Adults: The DO-HEALTH Randomized Clinical Trial. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.48
LOW INTAKE OF CHOLINE IS ASSOCIATED WITH DIMINISHED STRENGTH AND LEAN MASS GAINS IN OLDER ADULTS
C.W. Lee, E. Galvan, T.V. Lee, V.C.W. Chen, S. Bui, S.F. Crouse, J.D. Fluckey, S.B. Smith, S.E. Riechman
J Frailty Aging 2023;12(1)78-83Show summaryHide summary
Objectives: Choline is an essential micronutrient for many physiological processes related to exercise training including biosynthesis of acetylcholine. Though dietary choline intake has been studied in relation to endurance training and performance, none have studied it during resistance exercise training (RET) in older adults. The objective of the study was to examine the relationship between choline intake and muscle responses to RET in older adults.
Methods: Forty-six, 60-69-year-old individuals (M=19, F=27) underwent 12 weeks of RET (3x/week, 3 sets, 8-12 reps, 75% of maximum strength [1RM], 8 exercises). Body composition (DEXA) and 1RM tests were performed before and after training. After analyzing 1,656 diet logs (3x/week, 46 participants, 12 weeks), participants’ mean choline intakes were categorized into three groups: Low (2.9-5.5 mg/kg lean/d), Med-Low (5.6-8.0 mg/kg lean/d), or Adequate (8.1-10.6 mg/kg lean/d). These correspond to <50%, ~63%, and ~85% of Adequate Intake (AI) for choline, respectively.
Results: Gains in composite strength (leg press + chest press 1RM) were significantly lower in the Low group compared with the other groups (Low: 30.9 ± 15.1%, Med-Low: 70.3 ± 48.5%, Adequate: 81.9 ± 68.4%; p=0.004). ANCOVA with cholesterol, protein, or other nutrients did not alter this result. Reduced gains in lean mass were also observed in the Low group, compared with higher choline intake of 5.6-10.6 mg/kg lean/d (1.3 ± 0.6% vs. 3.2 ± 0.6%, p<0.05).
Conclusion: These data suggest that this population of older adults does not consume adequate choline and lower choline intake is negatively and independently associated with muscle responses to RET.
C.W. Lee ; E. Galvan ; T.V. Lee ; V.C.W. Chen ; S. Bui ; S.F. Crouse ; J.D. Fluckey ; S.B. Smith ; S.E. Riechman ; (2022): Low Intake of Choline Is Associated with Diminished Strength and Lean Mass Gains in Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.50
COULD A TAILORED EXERCISE INTERVENTION FOR HOSPITALISED OLDER ADULTS HAVE A ROLE IN THE RESOLUTION OF DELIRIUM? SECONDARY ANALYSIS OF A RANDOMISED CLINICAL TRIAL
N. Martinez Velilla, L. Lozano-Vicario, M.L. Sáez de Asteasu, F. Zambom-Ferraresi, A. Galbete, M. Sanchez-Latorre
J Frailty Aging 2023;12(1)84-85Show summaryHide summary
Delirium is a transient neurocognitive disorder. Nonpharmacological measures can be efficient in reducing the incidence and intensity of delirium, but there is a paucity of evidence when using a physical exercise program exclusively. This was a secondary analysis of a randomised clinical trial that provided evidence on the functional and cognitive benefits of an individualised exercise intervention in hospitalised older adults. Of the 370 patients who participated in the trial, 17.1% in the intervention group had delirium and 12.1% in the control group. After the exercise intervention, 84.6% of the patients in the intervention group showed improvement in delirium compared to 68.4% of patients in the control group. Despite the fluctuating nature of delirium,we show that it is feasible to establish individualised exercise interventions in hospitalised geriatric patients in the periods when patients are able to cooperate. Baseline functional status, measured by the Barthel Index, is a clinical marker that could help to identify those who will benefit most.
N. Martinez Velilla ; L. Lozano-Vicario ; M.L. Sáez de Asteasu ; F. Zambom-Ferraresi ; A. Galbete ; M. Sanchez-Latorre ; M. Izquierdo ; (2022): Could a Tailored Exercise Intervention for Hospitalised Older Adults Have a Role in the Resolution of Delirium? Secondary Analysis of a Randomised Clinical Trial. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.60
POOR HEALTH BEHAVIORS AMONG HOUSEBOUND JAPANESE COMMUNITY-DWELLING OLDER ADULTS DUE TO PROLONGED SELF-RESTRAINT DURING THE FIRST COVID-19 PANDEMIC: A CROSS-SECTIONAL SURVEY
T. Tanaka, B.-K. Son, K. Iijima
J Frailty Aging 2023;12(1)86-90Show summaryHide summary
Background: Prolonged self-restraining behaviors induced by the coronavirus disease 2019 (COVID-19) pandemic’s containment measures can limit various positive health behaviors.
Objective: We examined the decline in going-out and certain other positive health behaviors and investigated the relationship between excessive decreases in going-out frequency and declining engagement in positive health behaviors among community-dwelling older adults during the self-restraint period.
Design: This study employed a cross-sectional survey design.
Setting: This study was conducted in Nishi Tokyo City, Tokyo, Japan.
Participants: The participants were 294 respondents (150 women) aged 50 years and older who lived in public housing that were permitted to be surveyed during the self-restraint period.
Measurements: Their pre-pandemic going-out frequency around February 2020 and going-out frequency during the self-restraint period starting in April 2020 were reported. We mainly assessed the existence of home health behaviors (i.e., exercise, in-person and phone conversations, and healthy diet). A self-report questionnaire was used to obtain data.
Results: Going-out frequency decreased in 41.2% of the 294 respondents owing to the government’s request for self-restraint. In total, 13 individuals had been going out less than one time per week (housebound) before the request. Of the 281 people who were not housebound before the government’s self-restraint request, 13.9% were newly housebound. Newly housebound individuals were 5.3 times less likely to exercise, had 2.1 times fewer social contacts, and 2.6 times less balanced or healthy diets than those who maintained their frequency of going out.
Conclusions: Prolonged self-restraint due to the COVID-19 pandemic may lead to housebound status and poor health behaviors. Public health intervention is needed to prevent excessive self-restraint, along with new measures integrating information and communication technologies to enable older adults to live active lives.
T. Tanaka ; B.-K. Son ; K. Iijima (2022): Poor Health Behaviors among Housebound Japanese Community-Dwelling Older Adults Due to Prolonged Self-Restraint during the First COVID-19 Pandemic: A Cross-Sectional Survey. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.20