Differential associations of functional and cognitive health outcomes with pre-frailty and frailty states in community-dwelling older adults.
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ABSTRACT:
SUBMITTER: Sleight C
PROVIDER: S-EPMC7759022 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectivesFrailty and hypertension often coexist in older adults, which may lead to fall risks. This study aimed to examine the relationship between frailty status, hypertension, and fall risk.MethodsIn this cross-sectional study, a total of 401 older adults were conveniently recruited from communities in Wuxi, China, between September 2022 and November 2022. The fall risk self-assessment checklist from the Stopping Elderly Accidents, Deaths & Injuries (STEADI) Toolkit was used to evaluate their fall risks. The FRAIL scale questionnaire was used to assess frailty status. Participants' demographic information and comorbidities were collected. Multivariate logistic regression, generalized additive model, and smooth curve fitting were used to analyze the association between frailty, hypertension, and fall risk.ResultsFrailty had a strong association with increased prevalence of fall risk among the participants (OR 8.52, 95% CI 3.21-22.57; P < 0.001). Hypertension significantly increased the fall risk among older adults (OR 1.87, 95% CI 1.11-3.13; P = 0.019). The group with hypertension and frailty had the highest prevalence of fall risk (OR 12.24, 95% CI 3.51-42.65). Smooth curve fitting showed a nonlinear association between frailty and fall risk in hypertension status. In the progress of pre-frailty to frailty status, a higher tendency to fall was found among older adults with hypertension.ConclusionsFrailty status and hypertension independently and jointly influenced the increased prevalence of fall risk. Enhanced frailty and hypertension management may help decrease fall risk among this population.
| S-EPMC10859585 | biostudies-literature
Project description:Background and objectivesThis review aimed to summarize the association between cognitive frailty (presence of frailty and cognitive impairment) and the risk of disabilities in activities of daily living (ADL), instrumental ADL (IADL), mobility, or other functional disabilities among older adults.Research design and methodsPubMed, Embase, CINAHL Plus, and PsycINFO were searched from January 2001 to May 14, 2022, for observational studies that reported cognitive frailty among community-dwelling individuals aged 60 years and above. Results were narratively synthesized.ResultsEleven studies encompassing 44 798 participants were included, with a prevalence of cognitive frailty ranging from 1.4% to 39.3%. Individuals with cognitive frailty were more likely to develop disabilities in ADL and IADL compared to robust (absence of frailty and cognitive impairment) individuals. Significant disability burden and elevated risk of combined ADL/IADL disability or physical limitation among participants with cognitive frailty were reported. There was limited evidence on the association between cognitive frailty and mobility disability.Discussion and implicationsIndividuals with cognitive frailty were likely at higher risk of developing functional disability and incurring higher disability burden than robust individuals, but evidence remains limited for those with prefrailty with cognitive impairment. Further research on this gap and standardization of cognitive frailty assessments would facilitate comparisons across populations.Prospero registrationCRD42021232222.
| S-EPMC9999676 | biostudies-literature
Project description:To assess the directionality of the association between physical and cognitive decline in later life, we compared patterns of decline in performance across groups defined by baseline presence of cognitive and/or physical impairment [none (n = 217); physical only (n = 169); cognitive only (n = 158), or both (n = 220)] in a large sample of participants in a cognitive aging study at the Knight Alzheimer's Disease Research Center at Washington University in St. Louis who were followed for up to 8 years (3,079 observations). Rates of decline reached 20% for physical performance and varied across cognitive tests (global, memory, speed, executive function, and visuospatial skills). We found that physical decline was better predicted by baseline cognitive impairment (slope = -1.22, p<0.001), with baseline physical impairment not contributing to further decline in physical performance (slope = -0.25, p = 0.294). In turn, baseline physical impairment was only marginally associated with rate of cognitive decline across various cognitive domains. The cognitive-functional association is likely to operate in the direction of cognitive impairment to physical decline although physical impairment may also play a role in cognitive decline/dementia. Interventions to prevent further functional decline and development of disability and complete dependence may benefit if targeted to individuals with cognitive impairment who are at increased risk.
| S-EPMC4395358 | biostudies-literature
Project description:Pain is inversely associated with cognitive function in older adults, but the effects of pain on cognitive decline are not fully clear. This study examined the associations of baseline pain, pain persistence, and incident pain with changes in cognition across 10 years in a sample of healthy community-dwelling older adults (n = 688; Mage = 74, SD = 6.05) from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. While ACTIVE was a four-arm single-blind cognitive training randomized controlled trial, the present study includes only participants from the no-contact control group. Pain was examined using the Medical Outcomes Survey SF-36-Item (MOS SF-36) and cognitive tests examined simple processing speed, complex processing speed, divided and selective attention, memory, reasoning, and cognitive status. Multilevel models tested the associations of baseline pain, incident pain, and pain persistence on cognitive function and cognitive decline, adjusted for baseline age, time (years after follow-up), race, gender, education, marital status, and depressive symptoms at baseline and over time. Thirty-one percent reported pain at baseline which was related to worse baseline memory and accelerated decline in processing speed. Forty-two percent of older adults reported incident pain had accelerated decline in complex processing speed, divided attention, memory, reasoning, and cognitive status. On average, older adults reported a mean of two waves of pain persistence related to accelerated decline in memory. In sum, pain is common in community-dwelling older adults and is related to accelerated cognitive decline, especially when the incident. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
| S-EPMC10058056 | biostudies-literature
Project description:ObjectivesThe present study aimed to explore the social support among community-dwelling older adults with frailty and pre-frailty and to ascertain associated factors.MethodsThe frailty status of the participant was assessed via the Chinese FRAIL Scale. The dependent variable, level of social support, was evaluated using the Social Support Rating Scale (range: 12-66). This study explored the influencing factors from three aspects containing sociodemographic characteristics, family environment, and community environment. Independent-sample t-test, Analysis of Variance, and multiple linear regression analyses were conducted to examine determinants of social support.ResultsThere were significant differences in overall social support between non-frail, pre-frail, and frail participants [38.01 (SD = 6.48) vs. 33.62 (SD = 6.25) vs. 30.50 (SD = 6.68), F = 62.157, p < 0.001]. Older adults with frailty and pre-frailty who were single would have lower levels of overall social support. In the pre-frail group, living alone was associated with lower overall social support. In contrast, the relationship with children and the availability of recreational activities were associated factors for the frail group.ConclusionsThe level of social support among frail and pre-frail community-dwelling older adults was lower than the robust older adults and influenced by different factors according to the frailty category, which suggests taking targeted measures for social support improvement.
| S-EPMC9329702 | biostudies-literature
Project description:The presence of olfactory dysfunction in individuals at higher risk of Alzheimer's disease has significant diagnostic and screening implications for preventive and ameliorative drug trials. Olfactory threshold, discrimination and identification can be reliably recorded in the early stages of neurodegenerative diseases. The current study has examined the ability of various olfactory functions in predicting cognitive decline in a community-dwelling sample. A group of 308 participants, aged 46-86 years old, were recruited for this study. After 3 years of follow-up, participants were divided into cognitively declined and non-declined groups based on their performance on a neuropsychological battery. Assessment of olfactory functions using the Sniffin' Sticks battery indicated that, contrary to previous findings, olfactory discrimination, but not olfactory identification, significantly predicted subsequent cognitive decline (odds ratio = 0.869; P<0.05; 95% confidence interval = 0.764-0.988). The current study findings confirm previously reported associations between olfactory and cognitive functions, and indicate that impairment in olfactory discrimination can predict future cognitive decline. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia.
| S-EPMC3365262 | biostudies-other
Project description: Not available
| S-EPMC11232342 | biostudies-literature
Project description:BackgroundFrailty and multimorbidity are independent prognostic factors for mortality, but their interaction has not been fully explored. We investigated the importance of multimorbidity patterns in older adults with the same level of frailty phenotype.MethodsIn a cohort of 7,197 community-dwelling adults aged 65 years and older, physical frailty status (robust, pre-frail, frail) was defined using shrinking, exhaustion, inactivity, slowness, and weakness. Latent class analysis was used to identify individuals with multimorbidity patterns based on 10 self-reported chronic conditions. We estimated hazard ratios (HR) and incidence rate differences (IRDs) for mortality comparing multimorbidity patterns within each frailty state.ResultsFive multimorbidity classes were identified: minimal disease (24.7%), cardiovascular disease (29.0%), osteoarticular disease (27.3%), neuropsychiatric disease (8.9%), and high multisystem morbidity (10.0%). Within each frailty state, the mortality rate per 1,000 person-years over 4 years was greatest in the neuropsychiatric class and lowest in the minimal disease class: robust (56.3 vs 15.7; HR, 2.11 [95% CI: 1.05, 4.21]; IRD, 24.1 [95% CI: -11.2, 59.3]), pre-frail (85.3 vs 40.4; HR, 1.74 [95% CI: 1.28, 2.37]; IRD, 27.1 [95% CI: 7.6, 46.7]), and frail (218.1 vs 96.4; HR, 2.05 [95% CI: 1.36, 3.10]; IRD, 108.4 [95% CI: 65.0, 151.9]). Although HRs did not vary widely by frailty, the excess number of deaths, as reflected by IRDs, increased with greater frailty level.ConclusionsConsidering both multimorbidity patterns and frailty is important for identifying older adults at greater risk of mortality. Of the five patterns identified, the neuropsychiatric class was associated with lower survival across all frailty levels.
| S-EPMC6625582 | biostudies-literature
Project description:This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22-4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73-0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.
| S-EPMC8001836 | biostudies-literature
Project description:BackgroundKorea is expected to become a super-aged society in 2026, and improving nutritional status, which is directly related to health problems, is therefore important for increasing healthy life expectancy. Frailty is the most complex phenotype of aging, and leads to adverse health outcomes, disability, poor quality of life, hospitalization, and mortality. Malnutrition is a major risk factor for frailty syndrome. This study aimed to investigate the incidence of pre-frailty or frailty in the second wave (T2, 2018-2019) according to general characteristics and nutritional status in the first wave (T1, 2016-2017); and examine the longitudinal association of nutritional status in T1 and the incidence of pre-frailty or frailty in T2 among older adults living in a community.MethodsA secondary data analysis was performed using the Korean Frailty and Aging Cohort Study (KFACS). Participants comprised 1125 community-dwelling older Korean adults aged 70-84 years (mean age: 75.03 ± 3.56 years; 53.8% males). Frailty was assessed using the Fried frailty index, and nutritional status was assessed using the Korean version of the Mini Nutritional Assessment Short-Form and blood nutritional biomarkers. Binary logistic regression was used to identify longitudinal associations between the nutritional status at T1 and pre-frailty or frailty at T2.ResultsOver the two-year follow-up period, 32.9% and 1.7% of the participants became pre-frail and frail, respectively. After the potential confounders were adjusted (sociodemographic, health behaviors, and health status characteristics), pre-frailty or frailty had a significant longitudinal association with severe anorexia (adjusted odds ratio [AOR], 4.17; 95% confidence interval [CI], 1.05-16.54), moderate anorexia (AOR, 2.31; 95% CI, 1.46-3.64), psychological stress or acute disease (AOR, 2.61; 95% CI, 1.26-5.39), and body mass index (BMI) less than 19 (AOR, 4.11; 95% CI, 1.20-14.04).ConclusionsAnorexia, psychological stress, acute disease, and low BMI are the most significant longitudinal risk factors for pre-frailty or frailty in older adults. As nutritional risk factors may be preventable or modifiable, it is important to develop interventions targeting the same. Community-based health professionals in health-related fields should recognize and manage these indicators appropriately to prevent frailty among older adults living in the community.
| S-EPMC10074647 | biostudies-literature