jfa journal
IF 2023 : 3.3

AND option

OR option

Archives

Back to all journals

03/2024 journal articles

INTRINSIC CAPACITY AND ITS BIOLOGICAL BASIS: A SCOPING REVIEW

M.B. Beyene, R. Visvanathan, A.T. Amare

J Frailty Aging 2024;13(3)193-202

Show summaryHide summary

BACKGROUND: In 2015, the World Health Organization (WHO) introduced the concept of intrinsic capacity (IC) to define healthy aging based on functional capacity. In this scoping review, we summarized available evidence on the development and validation of IC index scores, the association of IC with health-related factors, and its biological basis. The review specifically focused on identifying current research gaps, proposed strategies to leverage biobank datasets, and opportunities to study the genetic mechanisms and gene-environment interactions underlying IC. METHODS: The literature search was conducted across six databases, including PubMed, CINAHL, Web of Science, Scopus, AgeLine, and PsycINFO, using keywords related to IC. RESULTS: This review included 84 articles, and most of them (n=38) adopted the 5-domains approach to operationalize IC, utilizing correlated five factors or bifactor structures. Intrinsic capacity has consistently shown significant associations with socio-demographic and health-related outcomes, including age, sex, wealth index, nutrition, exercise, smoking, alcohol use, ADL, IADL, frailty, multimorbidity, and mortality. While studies on the biological basis of the composite IC are limited, with only one study finding a significant association with the ApoE gene variants, studies on specific IC domains — locomotor, vitality, cognitive, psychological, and sensory suggest a heritability of 20-85% of IC and several genetic variants associated with these subdomains have been identified. However, evidence on how genetic and environmental factors influence IC is still lacking, with no available study to date. CONCLUSION: Our review found that there was inconsistency in the use of standardized IC measurement tools and indicators, but the IC indices had shown good construct and predictive validity. Research into the genetic and gene-to-environment interactions underlying IC is still lacking, which calls for the use of resources from large biobank datasets in the future.

CITATION:
M.B. Beyene ; R. Visvanathan ; A.T. Amare (2024): Intrinsic Capacity and Its Biological Basis: A Scoping Review. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.30

OPEN ACCESS

Download PDF (939.53 Ko)View HTML

Read more...

CIRCULATING ANGIOGENIC AND SENESCENT T LYMPHOCYTES IN AGEING AND FRAILTY

T. Byrne, J. Cooke, E. McNeela, P. Bambrick, R.P. Murphy, M. Harrison

J Frailty Aging 2024;13(3)203-212

Show summaryHide summary

BACKGROUND: There is a need to identify vascular and geroscience-relevant markers and mediators that can physiologically link ageing to vascular disease. There is evidence of specific T cell subsets, all influenced by age, that exert positive and negative effects on vascular health. CD31+, termed angiogenic T cells, have been linked to vascular repair whereas CD28null, termed senescent T cells, display pro-inflammatory and cytotoxic effector functions. OBJECTIVE: This study sought to determine the combined influence of increasing age and frailty status on these circulating CD31+ and CD28null T cell subsets. METHODS: This cross-sectional study recruited four different cohorts of men and women; young (20-30 years, n=22), older (65-75 years, n=17), robust non-frail (76+ years, n=17), and frail (76+ years, n=15) adults. Frailty was determined using the Fried Frailty method. T cell subsets were determined by whole blood flow cytometry based on the expression of CD3, CD4, CD8, CD31 and CD28. Cognitive impairment (CI) was measured via the Montreal Cognitive Assessment test. RESULTS: Whether expressed as circulating counts or as a % of total T cells, there was a progressive decrease (p<0.05) in CD31+ T cells with increasing age but paradoxically higher values (p<0.05) in the frail compared to the robust non-frail group. These changes were similar in the CD4+ and CD8+ fractions. CD28null T cells were considerably higher (p<0.05) in the frail compared to the robust non-frail group, including in the CD8+ (47% vs 29%, p<0.05) and CD4+ (4% vs 1%, p<0.05) fractions. CD28null T cell percentage was also higher (p<0.05) in those with moderate CI compared to mild CI and normal function. CONCLUSION: CD8+CD28null T cells are considerably elevated in frailty and with cognitive impairment and may serve as a useful target for intervention. Currently, the utility of CD31+ T cells as an ageing biomarker may be confined to healthy ageing cohorts.

CITATION:
T. Byrne ; J. Cooke ; E. McNeela ; P. Bambrick ; R.P. Murphy ; M. Harrison ; (2024): Circulating Angiogenic and Senescent T Lymphocytes in Ageing and Frailty. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.38

OPEN ACCESS

Download PDF (796.26 Ko)View HTML

Read more...

PROGNOSTIC VALUE OF A LABORATORY INDEX OF FRAILTY IN OLDER PATIENTS HOSPITALIZED FOR COVID-19: THE COMEPA STUDY

N. Veronese, V. Briganò, S. Ciriminna, A. Ganci, F. Bifara, F. Pollicino, M.C. Garlisi, F. Tantillo, S. Amodeo, G. Rizzo, L. Vernuccio, P. Mansueto, A. Licata, L. Giannitrapani, L.J. Dominguez, M. Barbagallo, the COMEPA group

J Frailty Aging 2024;13(3)213-217

Show summaryHide summary

BACKGROUND: Several indexes based on clinical and laboratory tests to identify frailty and to predict mortality have been produced. Only two studies, mixing clinical and laboratory parameters were made about a frailty index made of laboratory tests (FI-Lab) and mortality in older patients hospitalized for COVID-19. The aim of this study was to explore the accuracy and precision of an FI-Lab constructed with some common bio-humoral tests and mortality in a cohort of patients hospitalized for COVID-19. METHODS: The FI-Lab was constructed using 40 different bio-humoral tests during the first four days of hospitalization, with a score from 0 to 1. The association between FI-Lab and mortality was assessed using a multivariate Cox’s regression analysis, reported as hazard ratios (HRs) and 95% confidence intervals (CIs). The accuracy of the FI-Lab was reported as area under the curve (AUC) and the precision with the C-Index. RESULTS: 376 patients (mean age: 65 years; 53.7% males) were initially included. During the follow-up period, 41 deceased. After adjusting for five different factors, an FI-Lab value >0.54, the median value of our cohort, was associated with a relative risk about five times greater than lower values. Modeling FI-LAB as a continous variable, each increase in 0.01 points was associated with an increased risk in mortality of 8.4% (HR=1.084; 95%CI: 1.039-2.044). The FI-Lab was highly accurate (AUC=0.91; 95%CI: 0.87-0.95) and precise (C-Index=0.81) in predicting death. CONCLUSIONS: A simple index based on common laboratory tests can be used to predict mortality among older people hospitalized for COVID-19.

CITATION:
N. Veronese ; V. Briganò ; S. Ciriminna ; A. Ganci ; F. Bifara ; F. Pollicino ; M.C. Garlisi ; F. Tantillo ; S. Amodeo ; G. Rizzo ; L. Vernuccio ; P. Mansueto ; A. Licata ; L. Giannitrapani ; L.J. Dominguez ; M. Barbagallo ; the COMEPA group ; (2024): Prognostic Value of a Laboratory Index of Frailty in Older Patients Hospitalized for COVID-19: The COMEPA Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.29

Download PDFView HTML

Read more...

ASSOCIATION OF FINGER TAPPING MOVEMENTS WITH FRAILTY STATUS IN OLDER JAPANESE ADULTS: A CROSS-SECTIONAL STUDY

R. Shi, W. Hao, W. Zhao, T. Kimura, T. Mizuguchi, S. Ukawa, K. Kondo, A. Tamakoshi

J Frailty Aging 2024;13(3)218-223

Show summaryHide summary

BACKGROUND: Finger tapping impairment and frailty share overlapping pathophysiology and symptoms in older adults, however, the relationship between each other has not been previously studied. OBJECTIVES: To investigate how finger tapping movements correlate with frail status in older Japanese adults. DESIGN, SETTING, AND PARTICIPANTS: Data were from a cross-sectional study called the Cognition and Activity in Rural Environment of Hokkaido Senior Survey 2018. A total of 244 community-dwelling older adults (mean age 75.3 years) were included. MEASUREMENTS: Participants underwent physical examinations, gait and finger tapping tests, and completed self-administered questionnaires. Frailty was assessed using Fried’s frailty phenotype, and factor analysis was conducted to extract relevant finger tapping factors. Multinomial logistic regression was employed to analyze associations, generating adjusted odds ratios. RESULTS: Of the participants, 18 were frail, and 145 pre-frail. Analysis identified three distinct finger tapping patterns: “Range of Motion - Nondominant Hand,” “Variability - Dominant Hand - Anti,” and “Variability - Nondominant Hand - Anti.” These patterns showed significant associations with aspects of Fried’s frailty phenotype, particularly low physical activity (P = 0.002), weakness (P = 0.003), and slowness (P = 0.004). A larger range of motion in the nondominant hand correlated with a lower frailty risk (Odds Ratio: 0.09, 95% CI: 0.02-0.46), while higher variability in the same hand increased the risk of pre-frailty (Odds Ratio: 2.19, 95% CI: 1.09-4.39). CONCLUSION: Finger tapping movements are significantly associated with frailty status as determined by Fried’s phenotype. The findings underscore the importance of further longitudinal studies to understand the relationship between motor function and frailty.

CITATION:
R. Shi ; W. Hao ; W. Zhao ; T. Kimura ; T. Mizuguchi ; S. Ukawa ; K. Kondo ; A. Tamakoshi (2024): Association of Finger Tapping Movements with Frailty Status in older Japanese Adults: A Cross-Sectional Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.34

Download PDFView HTML

Read more...

IMPACT OF INTERVENTIONS ON SARCOPENIA FROM THE PERSPECTIVE OF OLDER PERSONS: A SYSTEMATIC LITERATURE REVIEW

G.L. Doza, S. van Heden, F. Oliveira Felix, V. Singh, C. Beaudart

J Frailty Aging 2024;13(3)224-232

Show summaryHide summary

Current interventions targeting sarcopenia are diverse, incorporating a blend of nutritional, exercise, and pharmacological strategies. Although muscle mass, muscle strength, or functional performance typically serve as the primary endpoints, regulatory agencies have recently emphasized integrating Patient-Reported Outcome Measures (PROMs) as primary or secondary outcomes in interventional studies. This shift acknowledges the importance of PROMs and Patient-Reported Experience Measures (PREMs) in assessing intervention effectiveness and aligns with patient-centered healthcare models. The aims of this systematic review are 1) to identify all sarcopenia-designed interventional studies that used PROMs/PREMs as the primary or secondary outcome, 2) to identify the different PROMs/PREMs used within those studies, and 3) to summarize the effects of sarcopenia-designed interventions on PROMs/PREMs of sarcopenic participants. For that, a systematic search of databases (Medline, EMBASE, Review- Cochrane Central of Register of Controlled Trials, and PsychINFO (Via Ovid)) was conducted in September 2023. The review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement, and the protocol was registered on Open Science Framework (https://osf.io/zxgwm/). The systematic review identified 17 RCTs as sarcopenia-designed interventional studies reporting PROMs. PROMs covered the assessment of various aspects, including quality of life, depressive symptoms, loneliness/social isolation, daytime sleepiness, insomnia impact, and sleep quality/disturbance. Only one sarcopenia-specific PROM, namely the SarQoL, was reported. The effect of sarcopenia-designed interventions on PROMs showed considerable heterogeneity, underscoring the need for standardization in sarcopenia research by developing a Core Outcome Set (COS). COS in sarcopenia studies would ensure consistent and comparable findings, ultimately enhancing the reliability and effectiveness of interventions.

CITATION:
G.L. Doza ; S. van Heden ; F. Oliveira Felix ; V. Singh ; C. Beaudart ; (2024): Impact of Interventions on Sarcopenia from the Perspective of Older Persons: A Systematic Literature Review. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.47

OPEN ACCESS

Download PDF (724.8 Ko)View HTML

Read more...

FRAILTY TRAJECTORIES AND ITS ASSOCIATED FACTORS IN JAPANESE OLDER ADULTS

Y. Taniguchi, A. Kitamura, T. Hata, K. Fujita, T. Abe, Y. Nofuji, S. Seino, Y. Yokoyama, S. Shinkai, Y. Fujiwara

J Frailty Aging 2024;13(3)233-239

Show summaryHide summary

BACKGROUND: Associated factors for frailty development according to age group remain unclear. OBJECTIVES: To identify frailty score trajectories among community-dwelling older Japanese individuals and examine their associated factors. DESIGN: 13-year longitudinal study. SETTING: Kusatsu Town in Gunma Prefecture, Japan. PARTICIPANTS: 1706 older adults aged ≥ 65 years who completed an annual frailty assessment at least once between 2007 and 2019. MEASUREMENTS: Frailty status was determined using an index based on the Fried frailty phenotype criteria. Potential associated factors for frailty trajectory included physical, biological, lifestyle-related, and psychological factors, as well as comorbidities. RESULTS: We identified five trajectory patterns in the frailty score from age of 65 to 90 years —individuals who were robust (Group 1, 10.5%) as well as individuals with late-onset frailty (Group 2, 16.1%), middle-onset frailty (Group 3, 25.6% and Group 4, 35.2%), and early-onset frailty (Group 5, 12.7%). Compared with the other groups, the early-onset group showed a higher prevalence of cerebrovascular diseases, bone and joint diseases, poor nutrition, sarcopenia, hospitalization, low cognitive function, and smoking at the end of follow-up. Associated factors in the middle-onset group largely overlapped with those of the early-onset group. The late-onset frailty group tended to have a higher association with heart disease and bone and joint diseases compared with the robust group. CONCLUSION: Our findings from a 13-year longitudinal study identified five frailty trajectory patterns and seven associated factors for frailty trajectory. Proposed effective population-based frailty prevention strategies in each age group may contribute to effective strategies to extend healthy life expectancy in aging, aged, and super-aged communities.

CITATION:
Y. Taniguchi ; A. Kitamura ; T. Hata ; K. Fujita ; T. Abe ; Y. Nofuji ; S. Seino ; Y. Yokoyama ; S. Shinkai ; Y. Fujiwara ; (2024): Frailty Trajectories and Its Associated Factors in Japanese Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.51

Download PDFView HTML

Read more...

CORRELATION BETWEEN MUSCLE MASS AND PHYSICAL ACTIVITY LEVEL IN OLDER ADULTS AT RISK OF FALLING: THE FITNESS STUDY

J.-B. Gauvain, S. Mandigout, M. Pambet, M. Monseu, P. Gillain, J. Gautier, C. Annweiler, F. Puisieux

J Frailty Aging 2024;13(3)240-247

Show summaryHide summary

BACKGROUND: The study investigates the correlation between muscle mass and physical activity level measured objectively and subjectively in older adults who fall or are at high risk of falling. METHODS: FITNESS (Fall Interest to Target Newly Sarcopenic Society) is a multi-center (French university hospitals of Angers, Lille, Limoges and Orléans), cross-sectional, observational study of routine care within a French multidisciplinary hospital consultation. Inclusion criteria were ≥ 75 years old, living at home and consulting for fall or gait disorder. A standardized geriatric assessment, muscle mass evaluation by impedancemetry, physical activity by continuous actimetry (5 days) and Incidental and Planned Exercise Questionnaire (IPEQ) were performed at patient inclusion. RESULTS: 170 people aged 75 and over were included in the FITNESS study (mean age 82.9 ± 4.7 years, women 72.9%). Muscle mass (whole body and lower limbs) correlated with active energy expenditure (AEE, ρ whole body = 0.32, p-value < 0.001; ρ lower limbs = 0.25, p-value = 0.003), but not with number of daily steps, nor with IPEQ score. Multivariate analysis of whole-body muscle mass showed a positive and significant association with AEE and albumin levels and for lower limb muscle mass, a positive association with AEE and Charlson. CONCLUSION: This study suggests that in the particular population of older adults who fall and/or are at high risk of falling, loss of muscle mass correlates with reduced physical activity. So subjects who fall or at high risk of falling constitute a special group for whom the fight against sedentary lifestyles and the maintenance of physical activity should be a dual priority.

CITATION:
J.-B. Gauvain ; S. Mandigout ; M. Pambet ; M. Monseu ; P. Gillain ; J. Gautier ; C. Annweiler ; F. Puisieux (2024): Correlation between Muscle Mass and Physical Activity Level in Older Adults at Risk of Falling: The FITNESS Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.53

OPEN ACCESS

Download PDF (364.8 Ko)View HTML

Read more...

ANALYSIS OF THE CORRESPONDENCE OF THE DEGREE OF FRAGILITY WITH THE WAY TO EXERCISE THE FORCE OF THE HAND

E.P. Guindal, X. Parra, M. Musté, C. Pérez, O. Macho, A. Català

J Frailty Aging 2024;13(3)248-253

Show summaryHide summary

BACKGROUND: Frailty is a geriatric syndrome characterized by increased individual vulnerability with an increase in both dependence and mortality when exposed to external stressors. The use of Frailty Indices in routine clinical practice is limited by several factors, such as the cognitive status of the patient, times of consultation, or lack of prior information from the patient. OBJECTIVES: In this study, we propose the generation of an objective measure of frailty, based on the signal from hand grip strength (HGS). DESIGN AND MEASUREMENTS: This signal was recorded with a modified Deyard dynamometer and processed using machine learning strategies based on supervised learning methods to train classifiers. A database was generated from a cohort of 138 older adults in a transverse pilot study that combined classical geriatric questionnaires with physiological data. PARTICIPANTS: Participants were patients selected by geriatricians of medical services provided by collaborating entities. SETTING AND RESULTS: To process the generated information 20 selected significant features of the HGS dataset were filtered, cleaned, and extracted. A technique based on a combination of the Synthetic Minority Oversampling Technique (SMOTE) to generate new samples from the smallest group and ENN (technique based on K-nearest neighbors) to remove noisy samples provided the best results as a well-balanced distribution of data. CONCLUSION: A Random Forest Classifier was trained to predict the frailty label with 92.9% of accuracy, achieving sensitivities higher than 90%.

CITATION:
E.P. Guindal ; X. Parra ; M. Musté ; C. Pérez ; O. Macho ; A. Català ; (2024): Analysis of the Correspondence of the Degree of Fragility with the Way to Exercise the Force of the Hand. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.46

OPEN ACCESS

Download PDF (1.08 Mo)View HTML

Read more...

IMPACT OF FRAILTY ON GAIT SPEED IMPROVEMENTS IN HOME HEALTH AFTER HOSPITAL DISCHARGE: SECONDARY ANALYSIS OF TWO RANDOMIZED CONTROLLED TRIALS

M. Tran, A. Garbin, R.E. Burke, E. Cumbler, J.E. Forster, J. Stevens-Lapsley, K.K. Mangione

J Frailty Aging 2024;13(3)254-258

Show summaryHide summary

More than half of older adults are frail or prefrail in the United States, and hospital-associated deconditioning likely increases this risk. However, the impact of frailty on potential functional improvements after hospital discharge is poorly understood. We sought to identify the influence of baseline frailty on gait speed change in older adults receiving home health physical therapy (PT) after hospital discharge. The severity of frailty was assessed using Cardiovascular Health Study frailty criteria (weakness, slowness, weight loss, physical inactivity, and exhaustion). Gait speed was measured at baseline and 60-days post-hospital discharge. Upon admission to home health rehabilitation services, half of older adults (total N=250) were considered frail, with slowness (90%) and weakness (75%) being the most common characteristics. Older adults, whether pre-frail or frail, demonstrated similar and clinically meaningful improvements in gait speed after receiving home health rehabilitation for 60 days following hospital discharge. These results suggest that clinicians caring for older adults in the hospital can counsel both pre-frail and frail patients that, with home health rehabilitation, clinically significant improvements in function can be expected over the 2 months following discharge. Furthermore, we observed encouraging gait speed improvement with physical therapy following hospitalization in older adults. Results can inform anticipatory guidance on hospital discharge.

CITATION:
M. Tran ; A. Garbin ; R.E. Burke ; E. Cumbler ; J.E. Forster ; J. Stevens-Lapsley ; K.K. Mangione (2024): Impact of Frailty on Gait Speed Improvements in Home Health after Hospital Discharge: Secondary Analysis of Two Randomized Controlled Trials. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.52

Download PDFView HTML

Read more...

SELF-REPORTED ORAL DISEASES AND THEIR ASSOCIATION WITH THE FRAILTY INDEX AMONG OLDER JAPANESE PEOPLE: FOURYEAR FOLLOW-UP

R.C. Castrejón-Pérez, S.A. Borges-Yáñez, R. Ramírez-Aldana, I. Nasu, Y. Saito

J Frailty Aging 2024;13(3)259-266

Show summaryHide summary

BACKGROUND: Oral health is a relevant component for overall health. Oral disease onset at an early age and may harm several health dimensions, especially among older people, and has been associated with frailty. OBJECTIVE: To evaluate associations between the Frailty Index (FI) and self-reported oral diseases among older, community-dwelling Japanese people. DESIGN: Cross-sectional and prospective analyses were performed. SETTING AND PARTICIPANTS: We analyzed data from 2,529 participants at the baseline and four-year follow-up of the Nihon University Japanese Longitudinal Study of Aging, which had a four-year follow-up. MEASUREMENTS: We used the self-reported number of teeth, self-reported satisfaction with dentures, and self-reported ability to chew hard food as independent variables. We computed an FI that included 40 deficits as the dependent variable. The FI score ranged from 0 to 1, with a higher score associated with adverse health outcomes and mortality. Considering a gamma distribution and controlling for age, gender, marital status, education, working status, and residence area, we fitted generalized linear models. RESULTS: We found that dissatisfied denture users had a 2.1% (95% CI 1.006–3.279) higher frailty score than non-denture users at the baseline and a 2.1% (95% CI 0.629–3.690) higher frailty score than non-denture users at the four-year follow-up. In the cross-sectional analysis, with each additional reported tooth at the baseline, the FI score was lower by 1.5% (95% CI -2.878 to -0.208) at the four-year follow-up. In both the cross-sectional and the prospective analyses, the FI scores increased as the ability to chew hard food decreased. CONCLUSIONS: Self-reported oral diseases are associated with the FI score cross-sectionally and prospectively. Identifying factors prospectively associated with frailty may improve strategies for the next generation of older people. Considering oral diseases may help clinicians personalize treatment plans for older people.

CITATION:
R.C. Castrejón-Pérez ; S.A. Borges-Yáñez ; R. Ramírez-Aldana ; I. Nasu ; Y. Saito (2024): Self-Reported Oral Diseases and Their Association with the Frailty index among Older Japanese People: Four-Year Follow-Up. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.10

Download PDFView HTML

Read more...

INTERACTION BETWEEN HABITUAL GREEN TEA AND COFFEE CONSUMPTION AND ACTN3 GENOTYPE IN ASSOCIATION WITH SKELETAL MUSCLE MASS AND STRENGTH IN MIDDLE-AGED AND OLDER ADULTS

C. Iwasaka, H. Nanri, M. Hara, Y. Nishida, C. Shimanoe, Y. Yamada, T. Furukawa, Y. Higaki, Y. Momozawa, M. Nakatochi, K. Wakai, K. Matsuo, K. Tanaka

J Frailty Aging 2024;13(3)267-275

Show summaryHide summary

BACKGROUND: Recent studies have suggested the potential benefits of habitual coffee and green tea consumption on skeletal muscle health. However, it remains unclear whether these benefits are modified by genetic factors, particularly the alpha-actinin-3 (ACTN3) genotype, which is associated with the skeletal muscle phenotype. This study aimed to investigate the interaction between habitual coffee or green tea consumption and the ACTN3 genotype in association with skeletal muscle mass (SMM) and strength. METHODS: This cross-sectional study was conducted on 1,023 Japanese middle-aged and older adults (619 females, aged 45–74 years) living in the community. SMM was gauged using a bioelectrical impedance spectroscopy device, and handgrip strength (HGS) was used to measure muscle strength. The ACTN3 genotype (RR, RX, and XX) was determined from blood samples. Sex-specific linear regression models were used to analyze the interactions between coffee or green tea consumption and the ACTN3 genotype in association with SMM and HGS. RESULTS: In females, a significant interaction was observed between green tea consumption and the ACTN3 genotype in association with HGS (P interaction < 0.05). Furthermore, stratified analysis revealed a positive association between green tea consumption and HGS, specifically in females with the ACTN3 XX genotype (P trend < 0.05). In males, no significant interactions were observed between coffee or green tea consumption and the ACTN3 genotype in association with SMM or HGS (P interaction > 0.05). CONCLUSION: Our findings suggest that the skeletal muscle strength benefits associated with habitual green tea consumption may be contingent upon sex and the ACTN3 genotype.

CITATION:
C. Iwasaka ; H. Nanri ; M. Hara ; Y. Nishida ; C. Shimanoe ; Y. Yamada ; T. Furukawa ; Y. Higaki ; Y. Momozawa ; M. Nakatochi ; K. Wakai ; K. Matsuo1 ; K. Tanaka (2024): Interaction between Habitual Green Tea and Coffee Consumption and ACTN3 Genotype in Association with Skeletal Muscle Mass and Strength in Middle-Aged and Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.3

OPEN ACCESS

Download PDF (366.45 Ko)View HTML

Read more...

THE PREVALENCE OF FRAILTY AND ASSOCIATED FACTORS, INCLUDING FOOD SECURITY IN COMMUNITY DWELLING OLDER ADULTS WITH MULTIMORBIDITY: A CROSS-SECTIONAL ANALYSIS FROM THE LONGITUDINAL AGING STUDY IN INDIA

V. Maheshwari, P. Samanta, S. Basu

J Frailty Aging 2024;13(3)276-284

Show summaryHide summary

BACKGROUND: The global increase in multimorbidity among older adults is a result of ongoing epidemiological and demographic transitions. This study focuses on the prevalence and determinants of frailty in this demographic in India, accounting for the potential mediating role of food insecurity. OBJECTIVES: To determine the prevalence and determinants of frailty among older Indian adults with multimorbidity, and to ascertain the mediating effect of food insecurity on frailty. DESIGN: Cross-sectional analysis of cohort study data. SETTING: Analysis of data from the Longitudinal Aging Study in India (LASI) Wave 1 (2017-2018). PARTICIPANTS: 31,902 individuals aged 60 and above of whom 7900 were categorized as having multimorbidity. MEASUREMENTS: Frailty was assessed using a modified Fried scale. Details on sociodemographic factors, lifestyle choices, and health-related variables were collected through face-to-face participant interviews. Multimorbidity was defined as the presence of two or more chronic conditions such as hypertension, diabetes, cancer, chronic lung disease, chronic heart disease, stroke, bone disease, neurological or psychiatric problems, and high cholesterol. Statistical analysis was conducted using Stata 15.1. RESULTS: The weighted prevalence of frailty in individuals with multimorbidity was 30.31% (95% CI: 28.17, 32.54), significantly higher than those without multimorbidity (23.81%, 95% CI: 22.90, 24.74) (P<0.001). Frailty prevalence was higher in women (33.27%) than in men (26.56%) among those with multimorbidity. In the group with multimorbidity, age ≥75 (years), middle MPCE quintile, lower educational attainment, unemployment, and low body mass index was associated with higher odds of frailty. Mediation analysis showed that 3.47% of the association between multimorbidity and frailty was mediated by food insecurity. CONCLUSION: Frailty is prevalent among older adults with multimorbidity in India, with significant disparities based on gender, age, socioeconomic status, and body mass index. Food insecurity partially mediates the relationship between multimorbidity and frailty, highlighting the need for targeted interventions addressing both health and nutritional insecurities in this population.

CITATION:
V. Maheshwari ; P. Samanta ; S. Basu ; (2024): The Prevalence of Frailty and Associated Factors, Including Food Security in Community Dwelling Older Adults with Multimorbidity: A Cross-Sectional Analysis from the Longitudinal Aging Study in India. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.36

Download PDFView HTML

Read more...

FOOD INSECURITY, VISION IMPAIRMENT, AND LONGITUDINAL RISK OF FRAILTY AND FALLS IN THE NATIONAL HEALTH AND AGING TRENDS STUDY

A.M. Wennberg, S. Ek, M. Na

J Frailty Aging 2024;13(3)285-292

Show summaryHide summary

BACKGROUND: Both food insecurity (FI) and vision impairment (VI), which are linked, have been independently associated with frailty and falls. OBJECTIVES: Understand how FI and VI may together contribute to frailty and fall risk could improve insight into these growing public health challenges. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: This study included 5,963 participants aged 65 and older enrolled in the National Health and Aging Trends Study. Participants were divided into four exposure groups (“No FI or VI,” “FI, no VI,” “VI, no FI,” and “Both”) based on self-report. The Fried Frailty Index and self-reported falls were assessed annually. We used adjusted logistic and Poisson regression models to examine cross-sectional associations and generalized estimating equations to examine longitudinal associations between FI/VI status and falls and frailty outcomes. RESULTS: Most study participants reported neither FI nor VI (n=5169, 86.7%); however, having both FI and VI (n=57, 1%) was cross-sectionally associated with higher frailty score and higher odds of falling multiple times in the last year. FI and/or VI were longitudinally associated with higher frailty score and increased frailty risk, with the strongest association for Both (RRR=1.29, 95% CI 1.23, 1.58; OR=3.18, 95% CI 1.78, 5.69), and with falling, again highest among those with Both, for one (OR=2.47, 95% CI 1.41, 3.96) and multiple (OR=2.46, 95% CI 1.50, 4.06) falls in the last year. CONCLUSION: Clinical and public health interventions could address the intersection of FI and VI with the aim of ameliorating the impact of these risk factors and health outcomes.

CITATION:
A.M. Wennberg ; S. Ek ; M. Na (2024): Food Insecurity, Vision Impairment, and Longitudinal Risk of Frailty and Falls in The National Health and Aging Trends Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.21

OPEN ACCESS

Download PDF (769.49 Ko)View HTML

Read more...

BODY COMPOSITION, FALLS, AND FREEZING OF GAIT IN PARKINSON’S DISEASE: GENDER-SPECIFIC EFFECTS

C. Pongmala, C. Stonsaovapak, M. van Emde Boas, H. Bhanderi, A. Luker, F. Michalakis, P. Kanel, R.L. Albin, J.M. Haus, N.I. Bohnen

J Frailty Aging 2024;13(3)293-299

Show summaryHide summary

BACKGROUND: Postural instability and gait difficulties (PIGD) are a significant cause of mobility loss and lower quality of life in Parkinson’s disease (PD). When PD progresses, patients may experience falls and freezing of gait (FoG) resulting in fear of falling and increasing sedentariness. Sedentary behavior results in sarcopenia associated with other changes in body composition, especially in older patients becoming frail. Previous studies have shown gender-specific changes in body composition with aging as well as gender disparities in symptoms and progression of PD, yet the association between gender-specific body composition and PIGD symptoms such as FoG along with falls, remains unexplored. OBECTIVE: This study aimed to investigate the association between gender-specific changes in body composition, FoG and falls assessment. Methods: 136 PD subjects underwent detailed clinical test batteries and had whole-body composition assessed using dual-energy X-ray absorptiometry (DXA). Multivariate logistic forward stepwise regression was performed to define body composition associations for FoG and falls. RESULTS: Multivariate regression analysis revealed that in males with PD, lower leg lean mass was significantly associated with the presence of FoG (OR, 0.429; 95% CI, 0.219-0.839; p=0.013) but not with falls. In females with PD, higher leg adipose mass was significantly associated with falls (OR, 4.780; 95% CI, 1.506-15.174; p=0.008) but not with FoG. CONCLUSION: These observations suggest gender specific associations between body composition and FoG vs. falls in PD. Future research should explore the impact of interventions on body composition in individuals with PD by paying specific attention to gender differences.

CITATION:
C. Pongmala ; C. Stonsaovapak ; M. van Emde Boas ; H. Bhanderi ; A. Luker ; F. Michalakis ; P. Kanel ; R.L. Albin ; J.M. Haus ; N.I. Bohnen (2024): Body Composition, Falls, and Freezing of Gait in Parkinson’s Disease: Gender-Specific Effects. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.31

Download PDFView HTML

Read more...

CHARACTERIZING DEFICIT ACCUMULATION AMONG GULF WAR ERA VETERANS

S.E. Petry, A.D. Thompson, Jr., E.R. Hauser, S.M. Lynch, S.H. Boyle, J. Upchurch, A. Press, K.J. Sims, C.D. Williams, E.J. Gifford

J Frailty Aging 2024;13(3)300-306

Show summaryHide summary

BACKGROUND: Veterans of the first Gulf War (1990-1991) are reaching middle and older adulthood in differing degrees of health and biological age. Many Gulf War veterans report myriad negative symptoms classified as Gulf War illness (GWI), a chronic multi-symptom illness. OBJECTIVES: To describe and analyze deficit accumulation, among veterans with Severe GWI (SGWI+) and those without Severe GWI (SGWI-), to assess the association between a medically unexplained illness and aging. DESIGN: This study uses a retrospective cohort design with quasi-longitudinal data. SETTING: The recruitment sample included 10,042 Gulf War era veterans across all four US Census regions. PARTICIPANTS: The analytic sample included 1,054 participants of the GWECB for whom SGWI case status could be determined and who had valid responses for at least 90% of the deficits included in the deficit accumulation index. MEASUREMENTS: Chronic health conditions were retroactively reported, including year of diagnosis, enabling us to create a longitudinal measure of deficit accumulation. This deficit accumulation index (DAI) ranged from 0-1 for each respondent in each year between 1991-2013. We compare veterans with SGWI+ to those with SGWI- using the CDC case definition. RESULTS: Most veterans in our sample could expect to spend more years with moderate or substantial deficits than without deficits. SGWI+ was associated with spending more years with substantial deficits than those with SGWI-. Veterans in middle age (age 35-65) experienced more years with substantial deficits than younger veterans. Individuals with SGWI+ had 13 times the hazard of accumulating substantial deficits than those without. CONCLUSIONS: This study demonstrated that veterans with SGWI+, even those in midlife, experienced aging as measured by accumulating deficits. Practitioners should consider patients with multi-symptom illnesses as at risk of accelerated aging, tailoring treatments to address patients’ holistic needs.

CITATION:
S.E. Petry ; A.D. Thompson, Jr. ; E.R. Hauser ; S.M. Lynch ; S.H. Boyle ; J. Upchurch ; A. Press ; K.J. Sims ; C.D. Williams ; E.J. Gifford (2024): Characterizing Deficit Accumulation Among Gulf War Era Veterans. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.44

Download PDFView HTML

Read more...

IMPLEMENTING OCCUPATIONAL THERAPY INTO AN ACUTE GERIATRIC WARD: EFFECTS ON PATIENTS’ FUNCTIONAL STATUS AT DISCHARGE

C. Sidoli, C. Okoye, A. Staglianò, A. Zambon, C. Pozzi, M.C. Ferrara, G. Bellelli

J Frailty Aging 2024;13(3)307-312

Show summaryHide summary

hospitalization. This retrospective cohort study aimed to evaluate the effect of an Occupational Therapy (OT) program on mobility at discharge in older patients admitted to an Acute Geriatric Unit (AGU). All patients aged >65 years consecutively admitted to the AGU in an 18-month period were included in the study if scoring <4 or ≥ 8 at the Clinical Frailty Scale. Overall, 807 patients (median age 85 years, 50.2% females) were included: 665 (82%) received OT, while 142 who did not receive OT were used as controls. The Cumulated Ambulation Scale (CAS) was used to assess mobility at discharge. By multivariable logistic regression, OT was independently associated with higher odds of achieving higher CAS score at discharge. These findings emphasize the potential benefits of OT in acute geriatric settings, providing valuable insights for preserving mobility of frail older individuals during hospitalization.

CITATION:
C. Sidoli ; C. Okoye ; A. Staglianò ; A. Zambon ; C. Pozzi ; M.C. Ferrara ; G. Bellelli ; (2024): Implementing Occupational Therapy into an Acute Geriatric Ward: Effects on Patients’ Functional Status at Discharge. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.43

OPEN ACCESS

Download PDF (400.88 Ko)View HTML

Read more...

INTEGRATED SERVICE DELIVERY MODEL IN PRIMARY CARE TO IMPROVE FRAILTY IN OLDER MALAYSIANS: GEKO INTEGRATED SERVICE DELIVERY

S.S. Ahip, C.Y. Ting, M.A.B. Abdillah, Y.J. Tan, S.A.B. Sabri, O. Theou, S. Shariff-Ghazali, R. Visvanathan

J Frailty Aging 2024;13(3)313-318

Show summaryHide summary

BACKGROUND: This study aimed to evaluate the implementation stage of Malaysia’s GeKo-Integrated Service Delivery (ISD) model for frailty management in primary care and explore its effectiveness in improving frailty scores. METHODS: The implementation stage of Malaysia’s first three GeKo- ISD clinics was assessed using the WHO-ICOPE (Integrated Care of the Older Persons) scorecard. This involved evaluating documents related to the GeKo services and conducting in-depth interviews with key informants identified from those documents. The efficacy of GeKo-ISD was assessed by documenting the change in mean frailty scores between baseline and 3 months post intervention, measured by the Pictorial Fit Frail Scale Malay Version (PFFS-M), in patients who received GeKo-ISD care from October 2022 to April 2023. RESULTS: All three GeKo clinics achieved the sustaining implementation level, scoring a total of 50 out of 52. The paired t-test reported a significant reduction (p= 0.001) in the PFFS-M scores from baseline to 3 months after the GeKo-ISD intervention. The mean (SD) scores were 8.6 (4.6) at baseline and 7.0 (4.1) at 3 months post-intervention. CONCLUSION: GeKo-ISD is a comprehensive approach of integrated care for older people, leveraging existing public funded primary care infrastructure. It shows promise, was impacted by the pandemic but now, with support from the government, exists in 32 centers across one state in Malaysia.

CITATION:
S.S. Ahip ; C.Y. Ting ; M.A.B. Abdillah ; Y.J. Tan ; S.A.B. Sabri ; O. Theou ; S. Shariff-Ghazali ; R. Visvanathan (2024): Integrated Service Delivery Model in Primary Care to Improve Frailty in Older Malaysians: GeKo Integrated Service Delivery. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.42

OPEN ACCESS

Download PDF (593.44 Ko)View HTML

Read more...