Journal of Frailty & Aging最新文献

Managing pre-frailty and frailty is crucial for maintaining the health and independence of older adults. Through "Systemic Approach to Frailty with a Focus on Pre-Frailty for Healthy and High-Quality Aging" project, Slovenia is establishing a systematic approach to identify and address frailty, while developing solutions to support preventive measures across healthcare and community levels. Key steps include integrating health and social care systems, strengthening health literacy, adapting and co-creating healthy living environments through a community-based approach and social participation, all essential for promoting healthier and higher-quality aging in the population. This paper outlines the innovative conceptual and methodological approach to project development and its anticipated outcomes.

Background: Going outdoors is crucial in promoting older adults' health. This study examined the association between incident disability and the frequency of going outdoors in certain life spaces.

Methods: This prospective study included 19,822 older adults (mean age ± standard deviation: 73.5 ± 5.8 years; 53.6 % women). The frequency of going outdoors within the past month was collected based on life space, categorized by distance from home (up to 1 km; 1-10 km; and >10 km). Participants were classified into three groups (called "Rarely": less than 1 day, "Sometimes": 1 to 3 days, and "Often": 4 days or more) for each life space. Incident disability was defined using the Long-Term Care Insurance system data (mean follow-up: 23.3 months). A Cox proportional hazards model was used to examine the association between incident disability and the frequency of going outdoors for each life space, adjusted for covariates.

Results: A total of 1038 (5.2 %) participants had an incident disability. Within the "up to 1 km" category, no frequency group was associated with disability; within "1-10 km," two frequency groups were associated with disability ("Sometimes" group: hazard ratio [HR] 0.85, [95 % confidence interval [CI]: 0.73-0.99]; "Often" group: HR 0.68, [95 % CI: 0.57-0.81]); within ">10 km," similar results were observed ("Sometimes" group: HR 0.84, [95 % CI: 0.72-0.98]; "Often" group: HR 0.75, [95 % CI: 0.53-1.07]).

Conclusions: The frequency of going outdoors at specific distances from home is associated with disability.

Neurocognitive disorders, particularly in older adults, significantly affect functional abilities and global health. Physical activity has emerged as a potential non-pharmacological intervention to improve cognitive performance in patients with neurodegenerative diseases. This review specifically addressed the issue of tailored physical activity interventions for individuals with various neurocognitive disorders. This literature review analyzed studies investigating the effects of physical activity on cognitive function in patients with Alzheimer's disease (AD), vascular cognitive impairment, Parkinson's disease, and Lewy body dementia. The studies were evaluated for methodological rigor, participant characteristics, types of physical activities, and cognitive outcomes. Of the 21 studies reviewed, 14 reported beneficial effects of physical exercise on cognitive function, particularly with aerobic activities. While most studies observed improvements in cognitive performance and physical functional capacity, results were inconsistent, and effect sizes were modest. Mechanisms proposed for cognitive improvement in AD included reductions in β-amyloid and tau protein burdens, improved glucose metabolism, and enhanced brain-derived neurotrophic factor levels. Specific improvements were noted in Parkinson's disease, with evidence suggesting mediation through dopamine pathways. Despite evidence of short-term benefits, significant variability exists among studies, highlighting the need for individualized exercise programs tailored to specific neurocognitive conditions. Physical activity stands as a cornerstone non-pharmacological intervention, essential for supporting cognitive health in individuals with neurodegenerative diseases. Further research is necessary to establish long-term effects and optimal exercise modalities, along with standardized evaluation criteria to assess the cognitive impacts of physical activity reliably.

Purpose: Sarcopenia and sarcopenic obesity are defined by the loss of muscle strength and mass. Both diseases pose a growing global challenge. Their prevalences vary between studied populations. The aim of this study is to estimate the prevalences of sarcopenia and sarcopenic obesity in sample of community-dwelling older adults attending a geriatric day clinic.

Methods: A secondary analysis of the Paint-II Data (single-center randomized controlled trial on the effects of art therapy) was used to estimate the prevalence of sarcopenia and sarcopenic obesity. Furthermore, a machine learning model predicted factors associated with both diseases.

Results: We had body composition information on 255 of the 409 Paint-II participants. Their mean age was 81 ± 5 years and 78 % were female. Depending on the appendicular skeletal muscle mass (ASM) definition, the prevalence of sarcopenia ranged between 10 % and 24 % using ASM/height² or absolute ASM respectively. The prevalence of sarcopenic obesity was 15 %. Weight was the most influential predictor, with higher weight being linked to sarcopenic obesity and lower weight associated with sarcopenia.

Conclusions: The prevalence of sarcopenia and sarcopenic obesity among community-dwelling older adults attending geriatric day clinics is higher than among the general geriatric population. There is a significant discrepancy in sarcopenia prevalence depending on whether muscle mass is measured absolutely or adjusted for body size. Diagnosis is further complicated by varying recommended cut-offs. We support efforts to simplify and standardize the diagnostic criteria.

Previous evidence suggests there are racial, genetic, and geographic differences in hand grip strength (HGS) underlying the need to define population-specific normative values and their determinants. We determined the normative values of HGS and investigated its correlates in an urban community sample in Nigeria. We assessed 607 participants from the Vascular heAlth, fraiLty, and cognItion in Ageing Nigerians sTudy [VALIANT] - a population-based cohort of 1031 older persons in Ibadan, a city in Southwestern Nigeria. They were recruited through a multi-stage, stratified cluster random sampling method. HGS was defined as the highest recorded/maximum HGS (max. HGS) of both hands. The determinants (β coefficient, p values) of HGS were identified using linear regression model. The mean (SD) age of the participants was 64.6 (11.5) with 67.8 % females. The mean (SD) max. HGS (in kg) of the study population was 19.65±10.16 overall; 24.51(14.01) among males and 17.31(6.51) among females (p < 0.001). Overall, female sex (β=-6.38, p < 0.001), clinical frailty (β=-1.35, p < 0.001), and baseline MoCA scores (β=0.37, p 0.001) were independently associated with max. HGS. In the subgroup analysis, presence of hypertension (β=2.64, p < 0.001) and diabetes mellitus (β=-2.61, p 0.05) were independently associated with max. HGS among females, but not males. Our findings buttress the intricate link between overall physical, cardiometabolic as well as cognitive health in this unique West African population.

Introduction: Sarcopenia, a progressive age-related loss of skeletal muscle mass and function, poses significant health risks in older adults. Phase angle (PhA), derived from bioimpedance analysis, has been proposed as an indicator of muscle quality and physical functioning. This study investigates the association between PhA and physical function, and its potential utility in case-finding phase of sarcopenia assessment based on EWGSOP2 functional cut-offs.

Methods: This cross-sectional observational study used baseline data from two clinical trials involving Dutch older adults (≥65 years, n=228) at risk of malnutrition or frailty. PhA was measured using multi-frequency bioimpedance vector analysis. Physical functioning was assessed through handgrip strength, knee extension strength, chair rise test, and gait speed (4m and 400-m/6-min walk tests). Associations were evaluated using linear mixed models adjusted for age, gender, height, and lean body mass. Receiver-operating characteristic (ROC) analyses identified PhA thresholds for low performance based on EWGSOP2 cut-offs.

Results: PhA was significantly associated with all performance outcomes in crude models. After adjustment, each unit increase in PhA was associated with a 43.5 ± 8.4 N increase in knee extension strength (P < 0.0001), a 1.5 ± 0.4 s reduction in chair rise time (P = 0.0004), and a 0.14 ± 0.02 m/s increase in gait speed (P < 0.0001). Associations with handgrip strength became non-significant after full adjustment. A PhA threshold of 5.4° showed high sensitivity (0.96) for detecting low physical performance via the chair rise test. However, misclassification rates exceeded 25 %.

Conclusions: PhA is associated with physical function, particularly lower-body performance measures, but without muscle mass assessment, it cannot support a complete diagnosis of sarcopenia. It may be valuable as a case-finding tool in older adults at risk.

Background: Knee osteoarthritis is a common disease that causes disability and loss of independence in middle-aged and older adults, and may interact with frailty through shared pathways. Understanding their bidirectional relationship is clinically meaningful for early intervention. This study aimed to investigate the associations between knee osteoarthritis and frailty among middle-aged and older adults in China.

Methods: The data for this study came from three waves (baseline 2011, follow-up 2013 and 2015) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 3560 participants were included. Frailty was assessed with the Frailty Index. Knee osteoarthritis was defined as physician-diagnosed arthritis with self-reported knee pain. Longitudinal bidirectional relationships were found using cross-lagged panel models and random-intercept cross-lagged panel models.

Results: A longitudinal bidirectional relationship between knee osteoarthritis and frailty was observed, with a stronger effect of frailty on subsequent knee osteoarthritis (Wald χ² = 11.416, P < 0.001). At the between-person level, individuals with knee osteoarthritis also tend to have a higher risk of frailty (β= 0.454, P < 0.001). At the within-person level, the predictive effect of knee osteoarthritis on frailty was significant only in the long term (β=0.055, P < 0.05). Subgroup analyses showed that this longitudinal bidirectional relationship was particularly strong among females as well as those with low education levels.

Conclusions: This study reveals a longitudinal bidirectional relationship between knee osteoarthritis and frailty in middle-aged and older adults. In particular, the dominant role of frailty in the development of knee osteoarthritis was found, as well as the negative impact of knee osteoarthritis accumulation on frailty over time. This result suggests that targeting frailty early interventions in an ageing society may help to interrupt the vicious cycle of knee osteoarthritis and reduce the risk of disability. It provides a scientific basis for public health strategies.

Background: The social domain of frailty is often poorly defined or missing from measures of frailty. The literature is still inconclusive on the nature and scope of social frailty, although studies indicate that it has a substantial impact on disability and mortality outcomes.

Aims: This Umbrella Review aimed to synthesise concepts and measures of social frailty.

Methods: A search for reviews was performed in Web of Science, CINAHL, SOCINDEX, Medline, PsychoINFO and COSMIN databases. This Umbrella Review was conducted and reported with reference to the Joanna Briggs Institute (JBI) Reviewer's Manual. The JBI Critical Appraisal Checklist for Systematic Review was used to assess the quality of studies.

Results: Sixteen reviews were included. The concept of social frailty was summarised as weakness in a person's social infrastructure compounded by a declining ability to change their circumstances. Forty-two measures of social frailty were identified which included a total of 228 items relating to social frailty. These were grouped into nine domains, of which participation in social activities was most commonly included within measures.

Conclusion: The use of diverse indicators creates a challenge for the measurement of social frailty. Their limited use in health and social care practice undermines the practical utility of the concept. This review helps to provide conceptual clarity and a platform for the development and validation of a robust social frailty measure which will facilitate the identification of people at risk and target interventions to prevent or alleviate the impact of social frailty on older people.