BMC Geriatrics最新文献

Background: Although physical frailty has long been recognized as a clinical condition, it has only recently gained attention in Bangladesh. This growing interest reflects the country's increasing focus on the health challenges faced by its aging population. This study examined the prevalence of physical frailty and its association with cognitive impairment among older adults.

Methods: The study used a cross-sectional design conducted among 540 older adults aged 65 and above using a multistage sampling technique. Physical frailty status was assessed using the Fried frailty phenotype, and cognitive function was measured with the 30-item Mini-Mental State Examination.

Results: Across two districts, 60% of participants were classified as frail, and 33% were classified as pre-frail. Significant demographic differences were observed across frailty categories, including age, gender, marital status, net monthly income level, and smoking history (p < 0.001). Multinomial logistic regression analyses indicated that several demographic and clinical factors were associated with cognitive impairment, including gender, education, household income, and multimorbidity. Higher household income (> 60,000 Bangladeshi Taka [BDT] per month) was associated with lower odds of severe cognitive impairment (OR = 0.14, 95% CI = 0.04, 0.45). Regular visits from family or friends showed a suggestive association with lower odds of cognitive impairment (OR = 0.59, 95% CI = 0.03, 1.54), although this association did not reach statistical significance at the 0.05 level. Cognitive function tended to be lower among frail participants aged 81 and above, with the lowest observed scores.

Conclusion: The findings demonstrate a significant association between physical frailty and cognitive impairment among older adults in Bangladesh, emphasizing the role of social determinants in shaping these outcomes. The results highlight the need for targeted interventions and policy strategies addressing these determinants to promote healthy aging and mitigate cognitive decline in this population.

Background: Skeletal muscle strength decline is related to cognitive impairment (CI). The longitudinal decline of upper and/or lower limb strength and CI remain poorly reported. We aimed to investigate the effects of independent or concurrent decline in upper and lower limb strength over a two-year period, on the future risk of CI.

Methods: We studied 2,443 participants (43.1% females) aged ≥ 60 years from the China Health and Retirement Longitudinal Study. The upper limb muscle strength (handgrip strength) and lower limb muscle strength (chair-rising time) were obtained at wave 1 (2011), and wave 2 (2013). At wave 3 (2015), 4 (2018), and 5 (2020) cognitive function was measured. According to the upper and lower limb muscle strength changes over two years, participants were classified into 4 groups: Stable-both (no decline in upper and lower limb strength), Upper decline-only (with a decline in upper limb strength only), Lower decline-only (with a decline in lower limb strength only), and Decline-both (with a decline in both upper and lower limb strength). We investigated the association between two-year muscle strength status and incident CI using discrete-time Cox regression.

Results: Over two years, participants with "Stable-both", "Upper decline-only", "Lower decline-only" and "Decline-both" were 60.6%, 18.2%, 16.0%, and 5.2%, respectively. There were 480 (19.65%) incident cases of CI over a mean follow-up of 5.73 years. Participants with "Lower decline-only" and "Decline-both" had increased risk of incident CI (HR = 1.62, P < 0.001, and HR = 1.80, P = 0.005, respectively). The associations remained significant when excluding participants with upper and lower limb muscle strength weakness at wave 1. However, the results were significant only in males and not in females.

Conclusions: A decline in muscle strength, particularly in the lower limbs or both upper and lower limbs, increases the risk of future CI, regardless of the baseline muscle strength. Therefore, dynamic monitoring of upper and lower limb strength is essential for early identification of individuals at risk of CI.

Background: Social Alienation (SA) is a global public health problem associated with chronic diseases. The reported prevalence of SA among community-dwelling older adults varied widely across different studies.

Objective: To review the pooled prevalence of SA among community-dwelling older adults globally and provide evidence-based support for policymakers and health experts.

Design: A Systematic Review and Meta-Analysis.

Methods: PubMed, Web of Science, Medline, EMBASE, EBSCO and the Cochrane Library were searched independently for relevant articles from inception to Oct 25, 2024 (published in English), and the literature screening process were performed between July 4, 2024 and Oct 25,2024. Studies on the prevalence of SA in community-dwelling older adults (age ≥ 60 years) were included in this analysis. The quality of studies included in the review was evaluated using the NOS and AHRQ scale for cohort and cross-section studies, respectively. Pooled effects of the prevalence of SA was calculated using random effect models. Two reviewers independently screened the literature, extracted the data and evaluated the quality of the included literature. If there was any disagreement, a third reviewer was necessary to settle the issue. Egger's Test was evaluated to address the publication bias. Heterogeneity was assessed using sensitivity analysis, subgroup analysis, and meta-regression. All statistical analyses were conducted using the Stata (version 17.0).

Results: A total of 24 studies with 64, 970 individuals were included and the pooled prevalence of SA among community-dwelling older adults was 31%. The results of the subgroup analysis showed that the overall prevalence of SA was 35.9% in females and 28.3% in males. The pooled prevalence of SA for those living alone and those not living alone was 35% and 22%, respectively. The overall estimates of SA prevalence in articles published after 2021 was 38%. Besides, the prevalence of SA was highest in China (44%).

Conclusion: This meta-analysis revealed that nearly a third of community-dwelling older adults had SA (31%). The subgroup analysis showed that the incidence of SA was higher in females and in China. Besides, the prevalence of SA has increased recently, posing a threat to the physical and mental health of them. Thus, effective preventive measures, regular screening and timely interventions are needed to address this highly prevalent public health problem.

Registration number: CRD42024615937 (PROSPERO).

Patient or public contribution: There is no patient or public involvement, as this article is a meta-analysis.