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AWARENESS AND SELF-REPORTED KNOWLEDGE AND TRAINING ON NUTRITION IN OLDER PEOPLE AMONG PRIMARY CARE PRACTITIONERS

L. Rodríguez-Mañas, J.M. Moreno-Villares, J. Álvarez Hernández, A.A. Romero Secín, M.L. López Díaz-Ufano, F. Suárez Gonzále, A. Costa-Grille, J. López-Miranda, J.M. Fernández-Garcia, on behalf of the Working Group on Nutrition in Older People-DANONE Institute

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OBJECTIVES: To assess the awareness and training of primary care physicians on nutrition in older patients. DESIGN: Observational, real-world data survey. SETTING: Primary Care. PARTICIPANTS: One hundred sixty-two physicians, generalists and specialists, working in primary care. MEASUREMENTS: Participants received an online questionnaire with 18 questions concerning the importance of nutrition, degree of knowledge, needs, and training in nutrition. The results were evaluated using univariate descriptive analysis, with a percentage for each chosen answer. Logistic regression models were used to evaluate if answers were related to training in nutrition and professional experience. RESULTS: 43.2% of participants reported that nutrition is very important in individuals over 65 years old, and 90% were aware of the importance of nutrition in healthy aging. Nutritional problems affect 30 to 50% of patients, according to 44.7% of participants. 89.2% agree about the need for nutritional assessment in older patients; however, the professionals believe they should be better prepared. Two out of three respondents consider the training received in nutrition during their undergraduate course or continuing medical education as deficient. Time of professional practice was mainly associated with conceptual facts, while continuing medical education did with practical issues, mainly the use of screening and diagnostic tools [FRAIL (OR: 3.16; 95%IC: 1.55-6.46), MNA-SF (OR: 6.455; 95%IC: 2.980-13.981) and SARC-F (OR: 3.063; 95%IC: 1.284-7.309)]. CONCLUSION: Although primary care professionals are aware of the importance of nutrition in older patients, there are still gaps in daily practice that could be improved by developing educational strategies.

CITATION:
L. Rodríguez-Mañas ; J.M. Moreno-Villares ; J. Álvarez Hernández ; A.A. Romero Secín ; M.L. López Díaz-Ufano ; F. Suárez González ; A. Costa-Grille ; J. López-Miranda ; J.M. Fernández-Garcia ; on behalf of the Working Group on Nutrition in Older People-DANONE Institute ; (2024): Awareness and Self-Reported Knowledge and Training on Nutrition in Older People among Primary Care Practitioners. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.11

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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

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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

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MYOKINES AND BIOMARKERS OF FRAILTY IN OLDER INPATIENTS WITH UNDERNUTRITION: A PROSPECTIVE STUDY

H. Liu, W. Li, M. Zhu, X. Wen, J. Jin, H. Wang, D. Lv, S. Zha, X. Wu, J. Jiao

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BACKGROUND: Population aging might increase the prevalence of undernutrition in older people, which increases the risk of frailty. Numerous studies have indicated that myokines are released by skeletal myocytes in response to muscular contractions and might be associated with frailty. This study aimed to evaluate whether myokines are biomarkers of frailty in older inpatients with undernutrition. METHODS: The frailty biomarkers were extracted from the Gene Expression Omnibus and Genecards datasets. Relevant myokines and health-related variables were assessed in 55 inpatients aged ≥ 65 years from the Peking Union Medical College Hospital prospective longitudinal frailty study. Serum was prepared for enzyme-linked immunosorbent assay using the appropriate kits. Correlations between biomarkers and frailty status were calculated by Spearman’s correlation analysis. Multiple linear regression was performed to investigate the association between factors and frailty scores. RESULTS: The prevalence of frailty was 13.21%. The bioinformatics analysis indicated that leptin, adenosine 5‘-monophosphate-activated protein kinase (AMPK), irisin, decorin, and myostatin were potential biomarkers of frailty. The frailty group had significantly higher concentrations of leptin, AMPK, and MSTN than the robust group (p < 0.05). AMPK was significantly positively correlated with frailty (p < 0.05). The pre-frailty and frailty groups had significantly lower concentrations of irisin than the robust group (p < 0.05), whereas the DCN concentration did not differ among the groups. Multiple linear regression suggested that the 15 factors influencing the coefficients of association, the top 50% were the ADL score, MNA-SF score, serum albumin concentration, urination function, hearing function, leptin concentration, GDS-15 score, and MSTN concentration. CONCLUSIONS: Proinflammatory myokines, particularly leptin, myostatin, and AMPK, negatively affect muscle mass and strength in older adults. ADL and nutritional status play major roles in the development of frailty. Our results confirm that identification of frailty relies upon clinical variables, myokine concentrations, and functional parameters, which might enable the identification and monitoring of frailty.

CITATION:
H. Liu ; W. Li ; M. Zhu ; X. Wen ; J. Jin ; H. Wang ; D. Lv ; S. Zhao ; X. Wu ; J. Jiao (2024): Myokines and Biomarkers of Frailty in Older Inpatients with Undernutrition: A Prospective Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.9

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DOSE-RESPONSIVE IMPACTS OF SOCIAL FRAILTY ON INTRINSIC CAPACITY AND HEALTHY AGING AMONG COMMUNITY-DWELLING MIDDLE-AGED AND OLDER ADULTS: STRONGER ROLES OF SOCIAL DETERMINANTS OVER BIOMARKERS

S.-T. Huang, W.-H. Lu, W.-J. Lee, L.-N. Peng, L.-K. Chen, F.-Y. Hsiao

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OBJECTIVE: The intricate relationship between social determinants, e.g., social frailty, biomarkers and healthy aging remains largely unexplored, despite the potential for social frailty to impact both intrinsic capacity (IC) and functional ability in the aging process. DESIGN: Retrospective longitudinal cohort study. SETTING AND PARTICIPANTS: Participants aged 50+ years from the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan, stratified into three age groups: 50-64, 65-74 and 75+. MEASUREMENTS: Social frailty was defined based on a score derived from four domains: exclusion from general resources, social resources, social activity, and fulfillment of basic social needs. The scores were categorized as score=0 (no social frailty), 1 (social pre-frailty), and 2+ (social frailty). Multivariable logistic regression and Cox proportional hazard models were employed to examine the dose-responsive relationship between social frailty, low IC, functional and psychological health, and mortality. RESULTS: Of 1015 study participants, 24.9% and 7.9% were classified as social pre-frailty and social frailty, respectively. No significant differences were observed in most biomarkers between those with social frailty and those without. A dose-responsive relationship was found between social frailty and increased risk of low IC (social pre-frailty: aOR 2.20 [95% CI 1.59-3.04]; social frailty: 5.73 [3.39-9.69]). Similar results were found for functional and psychological health. However, no significant association between social frailty and all-cause mortality was found at the 4-year follow-up (social pre-frailty: aHR 1.52 [95% CI 0.94-2.43]; social frailty: 1.59 [0.81-3.09]). CONCLUSIONS: The significant association between social frailty and low IC, functional limitations, cognitive declines, and depressive symptoms underscores the pressing need for research on intervention strategies to enhance healthy aging in the lifespan course.

CITATION:
S.-T. Huang ; W.-H. Lu ; W.-J. Lee ; L.-N. Peng ; L.-K. Chen ; F.-Y. Hsiao (2024): Dose-Responsive Impacts of Social Frailty on Intrinsic Capacity and Healthy Aging among Community-Dwelling Middle-aged and Older Adults: Stronger Roles of Social Determinants over Biomarkers. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.8

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NEW PERSPECTIVES IN THE ASSOCIATION BETWEEN ANTHROPOMETRY AND MORTALITY: THE ROLE OF CALF CIRCUMFERENCE

C. Ceolin, V. Acunto, C. Simonato, S. Cazzavillan, M. Vergadoro, M.V. Papa, G.S. Trapella, R. Sermasi, M. Noale, M. De Rui, B.M. Zanforlini, C. Curreri, A. Bertocco, M. Devita, A. Coin, G. Sergi

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AIMS: Considering the impact of sarcopenia on mortality, and the difficulty to assessment of body composition, the hypothesis of the study is that calf circumference (CC) is closely related to mortality in older patients. The aim of the study was to analyze the potential role of CC to predict mortality in old individuals at 3, 6 and 12 months after discharge from hospital. METHODS: Patients aged >65 years were recruited for this retrospective study from September 2021 to March 2022. Their physical and body composition characteristics (including Body Mass Index-BMI and Mini Nutritional Assessment-MNA) were measured; data on mortality at 3 (T3), 6 (T6) and 12 (T12) months after discharge were recorded. Sarcopenia was diagnosed according to the 2019 European Consensus criteria. RESULTS: Participants were 192 older adults (92 women), with a mean age of 82.8±7.0 years. Sarcopenic people were 41. The mortality rate was higher in sarcopenic people only at T3 and T6. CC had comparable validity in predicting mortality to that of MNA and ASMMI (Appendicular Skeletal Muscle Mass), and was better than BMI and serum albumin at each time point. Youden’s index showed that the best cut-off for CC for predicting mortality was 30.6 cm both at T3 (sensitivity: 74%; specificity: 75%) and T6 (sensitivity: 75%; specificity: 67%). At the Cox regression model for mortality, high values of CC (HR 0.73, CI95% 0.60-0.89/p<0.001) and ADL scores (HR 0.72, CI95% 0.54-0.96/p=0.04) were protective factors at T6 and T12 respectively; at T12 high comorbidity rate was a risk factor (HR 1.28, IC95% 1.02-1.62/p=0.04). CONCLUSIONS: CC has a validity comparable to MNA and ASMMI in predicting mortality at 3, 6 and 12 months after hospital discharge. Moreover, it can be considered an independent predictor of medium-term mortality in the hospitalized older population. CC can be an effective method for the prognostic stratification of these patients, due to its simplicity and immediacy.

CITATION:
C. Ceolin ; V. Acunto ; C. Simonato ; S. Cazzavillan ; M. Vergadoro ; M.V. Papa ; G.S. Trapella ; R. Sermasi ; M. Noale ; M. De Rui ; B.M. Zanforlini ; C. Curreri ; A. Bertocco ; M. Devita ; A. Coin ; G. Sergi (2024): New Perspectives in the Association between Anthropometry and Mortality: The Role of Calf Circumference. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.4

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POOR NUTRITIONAL STATUS IS ASSOCIATED WITH DEATH IN A POPULATION OF DIALYZED OLDER PERSONS

D. Azzolino, S. Vettoretti, M.M. Poggi, A. Soldati, L. Caldiroli, L.A. Dalla Vecchia, M. Cesari

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BACKGROUND: Older patients in hemodialysis have high prevalence of malnutrition that is often associated with rapid weight loss till cachexia. OBJECTIVESs: We aimed to investigate whether in older patients undergoing hemodialysis the association between poor nutritional status and mortality may be independent of comorbidities and other risk factors. DESIGN: Retrospective longitudinal study. SETTING: Unit of Nephrology, Dialysis and Kidney Transplantation of the Policlinic Hospital of Milan, Milan, Italy. PARTICIPANTS: A total of 107 prevalent patients undergoing hemodialysis for at least three months. MEASUREMENTS: Sociodemographic, clinical, and biological data were recorded. Unintentional weight loss (UWL) was defined as loss of body weight > 5% in 3 months or > 10% in 6 months. We computed a 21-item Frailty Index that included clinical conditions associated with malnutrition and mortality in this population. Unadjusted and adjusted Cox proportional hazard models were performed to test the association of UWL, albumin and transferrin levels with death. Survival analyses based on Kaplan-Meier estimates were performed. RESULTS: Patients’ age was 79 (±7.7) years; 38 (35%) were women. Thirty-one patients (29%) died during follow-up. Eighteen (16.8%) patients experienced UWL during the follow-up period. UWL was positively associated with death in the unadjusted model and even after the progressive inclusion of potential confounders. Low albumin levels were positively associated with death only in the unadjusted and partially adjusted models while low transferrin levels were not associated with death in none of the models. Mortality was significantly higher in those patients experiencing both UWL and albumin levels below 3.5 mg/dL. CONCLUSIONS: In older patients undergoing chronic hemodialysis UWL is associated with mortality independently of comorbidities and other risk factors. Patients presenting both UWL and low albumin levels were those experiencing the worst outcomes in terms of mortality.

CITATION:
D. Azzolino ; S. Vettoretti ; M.M. Poggi ; A. Soldati ; L. Caldiroli ; L.A. Dalla Vecchia ; M. Cesari (2024): Poor Nutritional Status Is Associated with Death in a Population of Dialyzed Older Persons. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.2

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JFA N°01 - 2024

 

A JUDO-BASED EXERCISE PROGRAM TO REDUCE FALLS AND FRAILTY RISK IN COMMUNITY-DWELLING OLDER ADULTS: A FEASIBILITY STUDY

A.D. Jadczak, M. Verma, M. Headland, G. Tucker, R. Visvanathan

J Frailty Aging 2024;13(1)1-9

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Objectives: This study aimed to explore the feasibility (including recruitment, safety and adherence) and the effects of a twice weekly supervised Judo-based exercise program over eight weeks on mobility, balance, physical performance, quality of life, fear of falling and physical activity (including by frailty status) in community-dwelling older people aged ≥65 years. Design: Pre-post study. Participants: A total of 17 participants (mean age 74.3±6.2; range 66-87 years; 76.5% female). Intervention: A Judo-based exercise program conducted twice weekly for 60 minutes per session over eight weeks. Measurements: Pre and post assessments included the Timed Up & Go (TUG); the Berg Balance Scale (BBS); the Short Physical Performance Battery (SPPB); the Short Form Health Survey-36 (SF-36); the Falls Efficiency Scale International (FES-I); and an ActivPal accelerometer to measure participants’ physical activity. Results: Most participants had low (≤3) Charlson’s Comorbidity Index scores (n=17, 100%), were well nourished (n=16, 94.1%), not sarcopenic (n=16, 94.1%), and not cognitively impaired (n=13, 76.5%), anxious or depressed (n=14, 82.4%). Ten participants (58.8%) were non-frail and seven were pre-frail (41.2%). Significant improvements (p<0.05) were seen for mobility (TUG), balance (BBS) and physical performance (SPPB). Pre-frail participants showed greater improvement in mobility (TUG) than non-frail participants (p=0.020). No changes (p≥0.05) were seen in quality of life, fear of falling, or physical activity. Participants’ adherence (i.e., attending sessions) was high (i.e., ≥81.2%). No serious adverse events or withdrawals were reported. Conclusion: Findings suggest that the eight week Judo-based exercise program can be delivered safely to older adults aged ≥65 years, including those at-risk of frailty, as long as there is close supervision with individualisation of the program in response to emergent health symptoms and the program is conducted on requisite Judo mats. This Judo-based exercise program is effective in improving physical function with potential to prevent falls and frailty risk.

CITATION:
A.D. Jadczak ; M. Verma ; M. Headland ; G. Tucker ; R. Visvanathan (2023): A Judo-Based Exercise Program to Reduce Falls and Frailty Risk in Community-Dwelling Older Adults: A Feasibility Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.17

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RELATIONSHIP OF FRAILTY, NUTRITIONAL STATUS AND ORAL HEALTH-RELATED QUALITY OF LIFE IN MEXICO CITY NURSING HOME RESIDENTS

M.E. Irigoyen-Camacho, M.C. Velazquez-Alva, M.A. Zepeda-Zepeda, M.F. Cabrer-Rosales, I. Rangel- Castillo, I. Lazarevich, F.R. Barroso-Villafuerte, A. Castaño-Seiquer, J. Flores-Fraile

J Frailty Aging 2024;13(1)10-20

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BACKGROUND: We aimed to identify the association among nutritional status, Oral Health-Related Quality of Life (OHRQoL) and frailty, and to estimate the mediation effect of these conditions between age and frailty in a group of Mexico City nursing home residents. METHODS: We conducted a cross-sectional study. Fried’s phenotype criteria, Full Mini Nutritional Assessment, and General Oral Health Assessment Index was applied. RESULTS: The participants (n = 286) mean age was 82.4 (± 9.2) years. The prevalence of frailty was 58%, and the prevalence of malnutrition and the risk of malnutrition were 22.7% and 59.5%, respectively. A higher risk of frailty was associated with older age (p = 0.015), sex (women) (p = 0.041), poor nutritional status (p <0.001) and compromised OHRQoL (p <0.001). Approximately 40% of the effect of age on frailty was mediated by nutritional status and OHRQoL (p <0.05). CONCLUSION: A strong association between nutritional status and frailty was observed. Additionally, OHRQoL was associated with frailty. The effect of age on frailty was mediated by OHRQoL and nutritional status. Interventions targeted to improve nutritional status and oral health may contribute to preventing or delaying the onset of frailty.

CITATION:
M.E. Irigoyen-Camacho, ; M.C. Velazquez-Alva ; M.A. Zepeda-Zepeda ; M.F. Cabrer-Rosales ; I. Rangel- Castillo ; I. Lazarevich ; F.R. Barroso-Villafuerte ; A. Castaño-Seiquer ; J. Flores-Fraile (2023): Relationship of Frailty, Nutritional Status and Oral Health-Related Quality of Life in Mexico City Nursing Home Residents. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.29

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RELATIONSHIP BETWEEN BODY MASS INDEX AND SARCOPENIA WITH ORAL FUNCTION DECLINE IN OLDER JAPANESE PATIENTS WHO REGULARLY ATTEND A GENERAL DENTAL CLINIC

Y. Matsushita, Y. Watanabe, R. Shirahase, Y. Yamazaki

J Frailty Aging 2024;13(1)21-30

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BACKGROUND AND OBJECTIVE: This study examined the relationship between body mass index (BMI) and sarcopenia with oral function decline in older patients as well as whether a combination of underweight BMI and sarcopenia was associated with decreased oral function in individuals with conservative restorative and prosthetic treatment for masticatory disorders. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included 290 older Japanese patients who regularly attended a general dental clinic. A detailed examination of oral function, sarcopenia, and BMI according to the Asian Working Group for Sarcopenia 2019 criteria was conducted for patients aged 65 years. This study used odds ratios as an epidemiological measure in the cross-sectional survey. RESULTS: Multinomial logistic regression analysis showed that the number of remaining teeth and tongue pressure was associated with both ideal and overweight BMI in individuals with sarcopenia when compared to healthy individuals. The underweight BMI plus sarcopenia group was associated with tongue and lip motor function [ka] sound test, swallowing function, and the presence of oral hypofunction. DISCUSSION: Our findings indicated that various aspects of oral function were impaired in community-dwelling older adult Japanese patients with sarcopenia and underweight BMI. Notably, among older adults with sarcopenia, both obese and thin patients exist, suggesting that distinct pathophysiological mechanisms influence oral function. CONCLUSION: The above findings support the hypothesis that the coexistence of sarcopenia and underweight BMI is associated with poor oral function. Regular oral function assessments and weight measurements in general dental practice can aid the prompt identification of sarcopenia and reduced swallowing function and can facilitate early intervention. The presence of sarcopenia and impaired swallowing function should be considered in patients with underweight BMI, reduced [ka] sound, and low tongue pressure following a thorough oral function examination.

CITATION:
Y. Matsushita ; Y. Watanabe ; R. Shirahase ; Y. Yamazaki (2024): Relationship between Body Mass Index and Sarcopenia with Oral Function Decline in Older Japanese Patients Who Regularly Attend a General Dental Clinic. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.5

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REDUCED HANDGRIP STRENGTH IS ASSOCIATED WITH 1 YEARMORTALITY IN BRAZILIAN FRAIL NONAGENARIANS AND CENTENARIANS

M.L. Sáez de Asteasu, E.L. Cadore, T. Steffens, E. Blanco-Rambo, T.C. Schneider, M. Izquierdo, C. Pietta-Dias

J Frailty Aging 2024;13(1)31-34

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The aim of the present study was to investigate the association between handgrip strength and mortality in Brazilian frail nonagenarians and centenarians. Eighty-one oldest old were included (mean age [SD]: 94.2 [3.8] years). Data on strength was assessed by handgrip strength. Mortality rate of the participants was evaluated at 1-year follow-up after the functional assessment. A logistic regression analysis was used to assess differences in categories of handgrip strength between groups regarding the mortality rate. Forty-six participants (56.8%) had reduced handgrip strength. After 1 year, there were 16 deaths. Those older adults with a low handgrip strength had higher prevalence (28.3% vs. 8.6%) and increased risk of mortality than those with preserved handgrip strength (Odds ratio=4.4, confidence interval 95% 1.1, 18.4) (p=0.042). Reduced handgrip strength is associated with higher mortality rate at 1-year follow-up in Brazilian frail nonagenarians and centenarians.

CITATION:
M.L. Sáez de Asteasu ; E.L. Cadore ; T. Steffens ; E. Blanco-Rambo ; T.C. Schneider ; M. Izquierdo ; C. Pietta-Dias ; (2023): Reduced Handgrip Strength Is Associated with 1 Year-Mortality in Brazilian Frail Nonagenarians and Centenarians. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.21

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THE PICTORIAL FIT-FRAIL SCALE MALAY VERSION (PFFS-M): PREDICTIVE VALIDITY TESTING IN MALAYSIAN PRIMARY CARE

S.S. Ahip, O. Theou, S. Shariff-Ghazali, A.A. Samad, S. Lukas, U.K. Mustapha, R. Visvanathan

J Frailty Aging 2024;13(1)35-39

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The purpose of this study was to evaluate the association between Pictorial Fit Frail Scale-Malay version (PFFS-M) and adverse outcomes, such as falls, new disability, hospitalisation, nursing home placement, and/or mortality, in patients aged 60 and older attending Malaysian public primary care clinics. We assessed the baseline PFFS-M levels of 197 patients contactable by phone at 18 months to determine the presence of adverse outcomes. 26 patients (13.2%) reported at least one adverse outcome, including five (2.5%) who fell, three (1.5%) who became disabled and homebound, 15 (7.6%) who were hospitalized, and three (1.5%) who died. Using binary multivariable logistic regression adjusted for age and gender, we found that patients who were at-risk of frailty and frail at baseline were associated with 5.97(95% CI [1.89-18.91]; P=0.002) and 6.13 (95% CI [1.86-20.24]; P= 0.003) times higher risk of developing adverse outcomes at 18 months, respectively, than patients who were not frail. The PFFS-M was associated with adverse outcomes.

CITATION:
S.S. Ahip ; O. Theou ; S. Shariff-Ghazali ; A.A. Samad ; S. Lukas ; U.K. Mustapha ; R. Visvanathan (2023): The Pictorial Fit-Frail Scale Malay Version (PFFS-M): Predictive Validity Testing in Malaysian Primary Care. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.35

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FRAILTY-RELATED FACTORS AMONG WOMEN LIVING WITH AND WITHOUT HIV AGED 40 YEARS AND OLDER. THE WOMEN’S INTERAGENCY HIV STUDY

D.R. Gustafson, Q. Shi, M. Thurn, S. Holman, M.H. Kuniholm, M. Fischl, M. Floris-Moore, S. Gange, D. Konkle-Parker, M. Plankey, J.C. Price, R.D. Ross, A. Rubtsova, A. Sharma, D.R. Hoover

J Frailty Aging 2024;13(1)40-49

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BACKGROUND: Frailty is a clinical, geriatric syndrome linked to disability and mortality; and may be associated with a variety of factors among underrepresented and underserved women living with HIV (WLWH) and without HIV (WLWOH) transitioning through the adult life course. OBJECTIVES: Determine whether a published set of factors associated cross-sectionally with frailty in WLWH and similar WLWOH at average age 39 years in 2005/2006 were associated with frailty in 2018/2019 among women who initiated frailty assessments at age >40 years, or whether a new set of factors were associated with frailty. DESIGN: Cross-sectional analyses within a longitudinal cohort study. SETTING: The multi-center Women’s Interagency HIV Study (WIHS). PARTICIPANTS: 1285 participants (951 WLWH, 334 WLWOH), median age 53 years (interquartile range 47-58 years). MEASUREMENTS: The Fried Frailty Phenotype (FFP) in association with 23 factors representing HIV serostatus, other infections, sociodemographic factors, health behaviors, and chronic diseases. RESULTS: Frailty prevalence was 11.1% in 2018/2019 (12.6% among WLWOH, 9.6% among WLWH, p=0.121). The published 2005/2006 final multivariable stepwise regression model contained 9 predictors of frailty. When refit to women in 2018/2019, only age >50 years and annual income ≤$12,000 were independently positively associated with frailty; other significant 2005/2006 factors, HIV serostatus, CD4+ count <500 cells/mL among WLWH, smoking, drinking, FIB-4 and eGFR, were not. A newly-derived stepwise model considering all 23 predictors measured in 2018/2019, showed independent positive associations between frailty and age >50 years, annual income ≤$12,000, obesity (body mass index (BMI) >30kg/m2), and history of tuberculosis and cancer. CONCLUSION: Different chronic and infectious disease factors were associated with frailty among WLWH and WLWOH over the adult life course. Understanding factors associated with frailty by adult life stage, allows identification and implementation of novel, temporal interventions to alleviate frailty-associated outcomes and enhance quality of life among WLWH and WLWOH.

CITATION:
D.R. Gustafson ; Q. Shi ; M. Thurn ; S. Holman ; M.H. Kuniholm ; M. Fischl ; M. Floris-Moore ; S. Gange ; D. Konkle-Parker ; M. Plankey ; J.C. Price ; R.D. Ross ; A. Rubtsova ; A. Sharma ; D.R. Hoover ; (2023): Frailty-Related Factors among Women Living with and without HIV Aged 40 Years and Older. The Women’s Interagency HIV Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.41

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SOCIAL VULNERABILITY, FRAILTY AND SELF-PERCEIVED HEALTH: FINDINGS FROM THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA)

L. Orlandini, E. Patrizio, A.M. O’Halloran, C.A. McGarrigle, R. Romero-Ortuno, R.A. Kenny, M. Proietti, M. Cesari

J Frailty Aging 2024;13(1)50-56

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BACKGROUND: Social vulnerability interacts with frailty and influences individuals’ health status. Although frailty and social vulnerability are highly predictive of adverse outcomes, their relationship with self-perceived health(SPH) has been less investigated. METHODS: Data are from the Irish Longitudinal Study on Ageing(TILDA), a population-based longitudinal study of ageing. We included 4,222 participants aged ≥50 years (age 61.4±8.5 years;women 56%) from Wave 1 (2009-2011) followed over three longitudinal waves (2012,2014-2015,2016). Participants responded to single questions with five response options to rate their 1)physical health, 2)mental health, and 3)health compared to peers. 30-item Frailty (FI) and Social Vulnerability (SVI) indices were calculated using standardised methods. Multivariable regression analyses were performed to establish the association between FI and SVI cross-sectionally and longitudinally over 6 years. RESULTS: Cross-sectionally, SVI (mean:0.40±0.08; range:0.14-0.81) and FI (mean: 0.13±0.08; range:0.10-0.58) were modestly correlated (r=0.256), and independently associated with poor physical health (SVI: OR 1.43, 95%CI 1.15-1.78; FI: OR 3.16, 95%CI 2.54-3.93), poor mental health (SVI: OR 1.65, 95%CI 1.17-2.35; FI: OR 3.64, 95%CI 2.53-5.24), and poor health compared to peers (SVI: OR 1.41,95%CI 1.06-1.89; FI: OR 3.86, 95%CI 2.9-5.14). Longitudinally, FI and SVI were independently and positively associated with poor physical health (SVI: β 1.08, 95%CI 0.76-1.39; FI: β 1.97, 95%CI 1.58-2.36), poor mental health (SVI: β 1.18, 95%CI 0.86-1.5; FI: β 1.58, 95%CI 1.2-1.97), and poor overall health compared to peers (SVI: β 0.78, 95%CI 0.89-1.33; FI: β 1.74, 95%CI 0.47-1.1). CONCLUSIONS: In a large cohort of community-dwelling older adults, frailty and social vulnerability were associated with poor SPH and with risk of SPH decline over six years.

CITATION:
L. Orlandini ; E. Patrizio ; A.M. O’Halloran ; C.A. McGarrigle ; R. Romero-Ortuno ; R.A. Kenny ; M. Proietti ; M. Cesari ; (2024): Social Vulnerability, Frailty and Self-Perceived Health: Findings from The Irish Longitudinal Study on Ageing (TILDA). The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.1

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THE EFFECT OF FRAILTY ON INDEPENDENT LIVING AFTER SURGERY: A POPULATION-BASED RETROSPECTIVE COHORT STUDY

A. Garland, T. Mutter, O. Ekuma, C. Papadimitropolous

J Frailty Aging 2024;13(1)57-63

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BACKGROUND: Most people value quality of life over mere duration. At least 50% of people are extremely averse to ever living in a nursing home (NH). OBJECTIVES: Assess whether pre-operative frailty is associated with new, post-operative NH placement. DESIGN, SETTING: Retrospective, population-based cohort study in the Canadian province of Manitoba, 2000-2017. PARTICIPANTS: 7408 persons ≥65 years undergoing any of 16 specific, elective, noncardiac surgeries of varying Operative Surgical Stress (OSS). MEASUREMENTS: The primary outcome was new admission to a NH, or being placed on a waiting list for a NH, within 180 days of index hospital admission, among index hospital survivors. Frailty was assessed from administrative data by the Preoperative Frailty Index (pFI), which ranges 0-1. Other outcomes were 30-day and 90-180 day mortality, and post-hospital medical resource use to 180 days. Analyses used multivariable regression models, adjusted for age, sex, OSS, year of surgery, anesthetic technique, and socioeconomic status. P-values were adjusted for the six outcomes. RESULTS: Subjects had mean age (±SD) of 74±7 yrs; 61% were male. pFI ranged 0-0.68, with a mean±SD of 0.21±0.09. All six outcomes were significantly associated with greater frailty. Each additional 0.1 unit increase in pFI was associated with a hazard ratio for new NH admission or wait-listing of 3.01 (p<0.0006). CONCLUSIONS: While our study agrees with prior work indicating that greater frailty is associated with higher probability of post-operative discharge to a NH, it overcomes a number of limitations of all prior work. Strong arguments follow that prospective surgical candidates be evaluated for their degree of frailty, and that their informed consent include discussion of the possibility of survival with loss of independence.

CITATION:
A. Garland ; T. Mutter ; O. Ekuma ; C. Papadimitropolous ; (2023): The Effect of Frailty on Independent Living After Surgery: A Population-Based Retrospective Cohort Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.27

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IMPACT OF COHABITATION DURING CONFINEMENT ON OLDER ADULTS’ NEGATIVE AFFECT: WHAT SPECIFICITY OF LIFE AS A COUPLE?

S. Caillot-Ranjeva, V. Bergua, C. Meillon, H. Amieva

J Frailty Aging 2024;13(1)64-70

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Background: Social isolation is a risk factor for older adults’ physical and psychological health. The beneficial effect of social connections in times of major health events is undeniable. Nevertheless, it remains unclear whether the positive effect of social support depends on the relationship type. Objectives: This study aimed to investigate the influence of older adults’ living conditions on the risk of experiencing negative affect during the first lockdown and post-lockdown. Design: An epidemiological study conducted during the COVID-19 crisis, at the time of the first lockdown, and 2 to 3 months following the lockdown. Setting: A subset sample of the PACOVID survey, a population-based survey of older adults. Participants: Altogether, 277 participants were included into three groups depending on their living conditions: Group 1 “living alone” (n = 141); Group 2 “living with their spouse” (n = 106); Group 3 “living in cohabitation with relatives” (n = 30). Measurements: Mixed logistic regression analyses were used to study the change in the risk of experiencing negative affects over time according to the living conditions. The presence of negative affects during lockdown was assessed using three items from the 20-item Center for Epidemiologic Studies Depression Scale : «Do you feel sad?»; «Do you feel depressed?; «Do you feel lonely? Results: Participants living with their relatives or partner were significantly less likely to experience negative affect than those living alone during lockdown. Moreover, over time, only those living with their spouse had this lesser risk compared to those living alone. Conclusions: These findings highlight the protective effect of social support over time and more specifically of that provided by the spouse. Couple functioning ought to be given consideration when studying the impact of health crisis situation on the mental health of older adults.

CITATION:
S. Caillot-Ranjeva ; V. Bergua ; C. Meillon ; H. Amieva ; (2023): Impact of Cohabitation during Confinement on Older Adults’ Negative Affect: What Specificity of Life as a Couple?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.25

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LETTER TO THE EDITOR: THE WHO ICOPE PROGRAM TO MONITOR INTRINSIC CAPACITY IN OLDER ADULTS WITH CANCER

Z. Steinmeyer, C. Berbon, S. Sourdet, S. Gérard, Y. Rolland, L. Balardy

J Frailty Aging 2024;13(1)71-72

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CITATION:
Z. Steinmeyer ; C. Berbon ; S. Sourdet ; S. Gérard ; Y. Rolland ; L. Balardy ; (2024): Letter to the Editor: The WHO ICOPE Program to Monitor Intrinsic Capacity in Older Adults with Cancer. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.6

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LETTER TO THE EDITOR: THE FRENCH MODEL OF SENIOR HOUSING TO TACKLE HOUSING INEQUALITIES

D. Boucaud-Maitre, L. Letenneur, J.-F. Dartigues, H. Amieva, M. Tabue-Teguo

J Frailty Aging 2024;13(1)73

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CITATION:
D. Boucaud-Maitre ; L. Letenneur ; J.-F. Dartigues ; H. Amieva ; M. Tabue-Teguo (2024): Letter to the Editor: The French Model of Senior Housing to Tackle Housing Inequalities. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.7

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