Archives of Gerontology and Geriatrics Plus最新文献

Background

Despite rapid population ageing in Africa, research on frailty in the region remains limited and fragmented. This systematic review aimed at summarising the available data to determine the prevalence of frailty in Africa.

Methods

Original research articles that reported the prevalence and associated factors of frailty in older people were included. The PubMed, Web of Science, SCOPUS, CINAHL, Science Direct, African Index Medicus, African Journals Online, WHO Global Health Library, and HINARI databases were searched between July 30 and September 30, 2022. Eleven studies were selected based on predefined eligibility criteria. To ensure methodological quality, the included studies were independently assessed by two authors. Data were extracted using a standardised data extraction checklist. Due to high heterogeneity among the studies, data were systematically examined using a narrative review.

Results

This review included a sample of 4,112 older people from different regions in Africa. Of the 11 included studies, five (45.5%) recruited study participants from community settings whereas two studies were from nursing homes. A variety of frailty measurement instruments were employed across the studies. The prevalence of frailty considerably varies across the studies: ranging from 9.25% to 77.1%. Increasing age, multimorbidity, nutritional problems, depression, and physical inactivity were identified as risk factors for frailty.

Conclusions

The findings revealed a varying degree of frailty among older people in Africa. It is recommended that institutions provide opportunities for physical activity, ensure adequate nutrition, promote social interaction, and manage chronic illnesses to mitigate frailty.

Registration

PROSPERO ID of CRD42021272920.

Background

Previously, we have shown that movement path distance and displacement during a 20-sec stepping test (ST) discriminates between independent and dependent-living older adults. The present study aims to determine whether movement and displacement characteristics during ST are an indicator of risk of falling in independent-living, community-dwelling older women

Methods

Independent-living older women recruited for this cross-sectional study were divided into a fall (F: n = 154) or no fall (NF: n = 847) history group. Each participant completed one trial of an eyes open, ST. ST outcome measures included head total movement distance (TMD), maximum movement displacement of the head (MMD), total knee movement distance (KMD), maximum height of the left and right knees (MKH), and step number (STEP) as determined with a KINECT^TM infrared depth sensor. Ratio of KMD/TMD was calculated to index upper- body sway relative to the lower-body.

Results

Age, height, body mass, and BMI were not different between groups. KMD (F: median: 4.812 m, interquartile range (IQR): 3.720–7.718 m; NF: 5.309 m, 4.266–6.600 m), TMD / KMD (F: 0.145 m, 0.107–0.196 m; NF: 0.127 m, 0.100–0.170 m) and MKH (F: 0.073 m, 0.052–0.106 m, NF: 0.091 m, 0.060–0.135 m) were different between F and NF (Mann-Whitney, P < 0.05). Logistic regression revealed an association between falls and KMD (OR 1.232, 95 % CI 1.108–1.370).

Conclusions

Characteristics of ST movement and displacement assessed with Kinect^TM provide useful indicators for fall risk assessment among independent-living, community-dwelling older women.

Background

This study aimed to investigate the determinants of decline in activities of daily living (ADL) among people with dementia following the onset of the coronavirus disease of 2019 (COVID-19).

Methods

A retrospective analysis was performed, including 37 individuals with dementia residing in group and nursing homes. The study cohort experienced a resurgence in facility admissions following COVID-19 outbreak, spanning from September to December 2022. Multivariate generalized linear mixed-effects models were employed to assess the Barthel Index at the time of readmission, which served as the dependent variable. Demographic variables before contracting COVID-19 were considered independent predictors if they were significantly associated with the Barthel Index at the time of readmission. Random intercepts were applied to account for variations among facilities in which individuals resided before contracting COVID-19.

Results

Care level, degree of independent living for disabled older adults, and the ability to perform daily ambulatory movements were significantly associated with the Barthel Index at the time of readmission. When used as independent variables, both daily ambulatory movement (beta = 0.350) and care level (beta = -0.347) showed significant associations with the Barthel Index at the time of readmission. Whereas using daily ambulatory movements and the degree of independent living for disabled older adults as independent variables, only the degree of independent living for disabled older adults (beta = -0.757) was significantly associated with the Barthel Index at the time of readmission.

Conclusion

The ability to engage in daily ambulatory movement affects the decline in ADLs due to COVID-19.

Background

This study aimed to examine the impact of periodontal management on the occurrence of acute coronary syndrome and stroke using retrospective analysis of Japanese health insurance claims data.

Methods

The analysis included health insurance claims data of individuals aged ≥ 75 years who had been diagnosed with periodontal disease and received treatment between September 2016 and February 2017. Hospitalizations related to acute coronary syndrome and stroke were observed as outcome events during the follow-up period from March 2017 to March 2019. Covariates such as sex, age, place of residence, and chronic diseases were adjusted for using a generalized linear mixed model.

Results

The study involved 117,010 participants with a mean age of 80.0 ± 4.0 years, and 44.7 % were male. The analysis suggested that supportive periodontal therapy significantly reduced the risk of hospitalization for acute coronary syndrome (adjusted odds ratio: AOR 0.88, P = 0.017). Supportive periodontal therapy also showed a borderline significant 13 % reduction in stroke hospitalizations.

Conclusions

Periodontal treatment is associated with a decreased risk of acute hospitalization. Regular periodontal management, aimed at minimizing oral chronic inflammation, can potentially lower the risk of developing acute coronary syndrome and stroke.

Objectives

We investigated the association of life-course socioeconomic status (SES) with all-cause mortality among older Singaporeans (aged ≥60 years) by applying three conceptual life-course models – critical period, accumulation of risk and social mobility.

Methods

Data from a nationally representative longitudinal survey of older Singaporeans (n = 4,518), coupled with mortality information, was utilized. Dichotomous (low/high) childhood (family financial status), adulthood (highest education) and older adulthood (current housing) SES indicators informed the operationalization of the models, which were evaluated through Cox proportional hazards analysis.

Results

Adulthood SES was associated with mortality (critical period). The mortality risk increased with increasing cumulative SES disadvantage (accumulation of risk). Stable low SES and downward SES mobility from childhood to adulthood increased mortality risk (social mobility).

Discussion

Improving adulthood SES and facilitating upward SES mobility, from childhood to adulthood, are promising for reducing mortality. Addressing SES disparities during childhood and older adulthood may also help.

Introduction

Various studies have supported the key role of altered levels of lipids and carotenoids in the pathogenesis of Alzheimer's disease (AD), as they have the potential to maintain neuronal and tissue homeostasis.

Methods

We conducted literature search on the PubMed and Google Scholar databases from the inception until December 2023. Two independent authors (AT and ASG) performed the data extraction, study selection, and quality assessment. The review outcomes were the level of lipids and carotenoids in cerebrospinal fluid (CSF) and peripheral fluids (serum and plasma) of patients with AD. The Cochrane Collaboration's Review Manager 5.4 was used to conduct this meta-analysis.

Results

107 studies showing levels of lipids and carotenoids in CSF and peripheral fluid of participants were included for the analysis. Peripheral cholesterol (p = 0.04) and CSF cholesterol (p = 0.04), CSF 24S-hydroxycholesterol (p = 0.01), CSF 27-hydroxycholesterol (p = 0.005), peripheral low-density lipoprotein (p = 0.02), and peripheral triglyceride (p = 0.03) from the lipid category were found to be associated with AD patients. However, the levels of carotenoids like α-carotene (p = 0.0006), β-carotene (p < 0.0001), β-cryptoxanthin (p = 0.0001), lutein (p < 0.0001), lycopene (p < 0.0001), and zeaxanthin (p < 0.0001) were decreased in AD patients compared to control.

Conclusion

We concluded that the level of lipids and carotenoids are clearly associated with AD pathology. These altered level of lipids and carotenoids may provide an insight into the early diagnosis of the disease.

Background

Dermal advanced glycation end-product (AGE) accumulation is associated with various diseases, as well as frailty and aging. Frailty and aging are well known to be associated with a decline in cognitive function. We placed middle-aged and older Japanese people into four groups according to their physical frailty status and age, and then evaluated the relationship their dermal AGE accumulation and cognitive function.

Materials and methods

We performed a cross-sectional study of 559 participants (236 men, mean age 67.3 years). Dermal AGE accumulation in the forearms of the participants was assessed using skin autofluorescence (SAF), and cognitive function was assessed using the touch panel-type dementia assessment scale (TDAS). Parameters relating to anthropometry, atherosclerosis, and frailty were evaluated at medical check-ups. The factors independently associated with TDAS score were identified by multivariate analysis.

Results

Multivariate analysis showed that age and frailty were inversely associated with TDAS. We then allocated risk scores (0–3) to reflect the combination of these parameters (age, 0 or 1; SAF score, 0, 1, or 2). The SAF corresponding to a score of 2-3 points on the receiver operating characteristic curve was 2.18 units in men (sensitivity 67.2 %, specificity 70.0 %, area under the curve (AUC) 0.695, p < 0.001) and 2.03 units in women (sensitivity 65.8 %, specificity 52.3 %, and AUC 0.600, p = 0.009), implying a closer relationship in men than women.

Conclusions

We have identified a relationship between dermal AGE accumulation and a high risk of cognitive decline in middle-aged and older Japanese people, especially in men.

Aim

Method

Results

Conclusion

Background

Various forms of exercise have been studied to improve parameters of physical functioning in pre-frail and frail older adults, however, specific parameters have not been identified as most beneficial to improve gait speed. This systematic review focused on evaluating power training and its effectiveness on gait speed pre-frail and frail adults over age 65 years.

Methods

A systematic review was conducted using Medline, CINAHL, and Cochrane Library to investigate articles published from 2010-2024. Articles were included if they met the following criteria: 1) frail or pre-frail population; 2) gait speed used as an outcome measure; 3) power training or described high-velocity resistance training; 4) intensity 40-60% 1RM with a described velocity component; 5) controlled trial. Qualitative analysis was performed using the PEDro scale.

Results

Six controlled trials, five randomized and one non-randomized, were included that met the eligibility criteria, ranging in quality from fair to excellent. No significant adverse events related to intervention were reported in any of the included studies. Overall, power resistance training exhibited significant improvements in gait speed.

Discussion

The narrow research question and eligibility criteria resulted in 6 articles for analysis. The results of all included articles exhibit significant improvements in gait speed following power training interventions, with the exception of one article.

Conclusion

It appears that power training is a safe and effective intervention to improve gait speed in pre-frail and frail older adults, however, further research is required.