Dataset Information

Multidimensional Frailty and Vaccinations in Older People: A Cross-Sectional Study.

ABSTRACT: It is known that influenza, herpes zoster, pneumococcal and pertussis infections may increase morbidity and mortality in older people. Vaccinations against these pathogens are effective in older adults. Frailty seems to be an important determinant of vaccination rates, yet data supporting this association are still missing. Therefore, we aimed to investigate the prevalence of four recommended vaccinations (influenza, herpes zoster, pneumococcal and diphtheria-tetanus-pertussis) and the association with multidimensional frailty assessed using a self-reported comprehensive geriatric assessment tool, i.e., the multidimensional prognostic index (SELFY-MPI). Older participants visiting the outpatient clinic of Azienda Ospedaliera Universitaria, Palermo, Italy were included. The SELFY-MPI questionnaire score was calculated based on eight different domains, while the vaccination status was determined using self-reported information. We included 319 participants from the 500 initially considered (63.8%). Vaccination against influenza was observed in 70.5% of the cases, whilst only 1.3% received the vaccination against diphtheria-tetanus-pertussis. Participants with higher SELFY-MPI scores were more likely to report vaccination against pneumococcus (45.6 vs. 28.3%, p = 0.01), whilst no significant differences were observed for the other vaccinations. In conclusion, the coverage of recommended vaccinations is low. Higher SELFY-MPI scores and vaccination status, particularly anti-pneumococcus, appear to be associated, but future studies are urgently needed for confirming that frailty is associated with vaccination status in older people.

SUBMITTER: Veronese N

PROVIDER: S-EPMC9028390 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Multidimensional Frailty and Vaccinations in Older People: A Cross-Sectional Study.

Veronese Nicola N Vassallo Giusy G Armata Maria M Cilona Laura L Casalicchio Salvatore S Masnata Roberta R Costantino Claudio C Vitale Francesco F Giammanco Giovanni Maurizio GM Maggi Stefania S Sabico Shaun S Al-Daghri Nasser M NM Dominguez Ligia J LJ Barbagallo Mario M

Vaccines 20220403 4

It is known that influenza, herpes zoster, pneumococcal and pertussis infections may increase morbidity and mortality in older people. Vaccinations against these pathogens are effective in older adults. Frailty seems to be an important determinant of vaccination rates, yet data supporting this association are still missing. Therefore, we aimed to investigate the prevalence of four recommended vaccinations (influenza, herpes zoster, pneumococcal and diphtheria-tetanus-pertussis) and the associati ...[more]

PMID: 35455304

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Project description:BackgroundDue to the rapidly increasing number of older people worldwide, the prevalence of frailty among older adults is expected to escalate in coming decades. It is crucial to recognize early onset symptoms to initiate specific preventive care. Therefore, early detection of frailty with appropriate screening instruments is needed. The aim of this study was to evaluate the underlying dimensionality of the Groningen Frailty Indicator (GFI), a widely used self-report screening instrument for identifying frail older adults. In addition, criterion validity of GFI subscales was examined and composition of GFI scores was evaluated.MethodsA cross-sectional study design was used to evaluate the structural validity, internal consistency and criterion validity of the GFI questionnaire in older adults aged 65 years and older. All subjects completed the GFI questionnaire (n = 1508). To assess criterion validity, a smaller sample of 119 older adults completed additional questionnaires: De Jong Gierveld Loneliness Scale, Hospital Anxiety Depression Scale, RAND-36 physical functioning, and perceived general health item of the EuroQol-5D. Exploratory factor analysis and Mokken scale analysis were used to evaluate the structural validity of the GFI. A Venn diagram was constructed to show the composition of GFI subscale scores for frail subjects.ResultsThe factor structure of the GFI supported a three-dimensional structure of the scale. The subscales Daily Activities and Psychosocial Functioning showed good internal consistency, scalability, and criterion validity (Daily Activities: Cronbach's ? = 0.81, H(s) = .84, r = -.62; Psychosocial Functioning: Cronbach's ? = 0.80, H(s) = .35, r = -.48). The subscale Health Problems showed less strong internal consistency but acceptable scalability and criterion validity (Cronbach's ? = .57, H(s) = .35, r = -.48). The present data suggest that 90% of the frail older adults experience problems in the Psychosocial Functioning domain.ConclusionsThe present findings support a three-dimensional factor structure of the GFI, suggesting that a multidimensional assessment of frailty with the GFI is possible. These GFI subscale scores produce a richer assessment of frailty than with a single overall sum GFI score, and likely their use will contribute to more directed and customized care for older adults.

Project description:BACKGROUND:Many instruments to identify frail older people have been developed. One of the consequences is that the prevalence rates of frailty vary widely dependent on the instrument selected. The aims of this study were 1) to examine the concordances and differences between a unidimensional and multidimensional assessment of frailty, 2) to assess to what extent the characteristics of a 'frail sample' differ depending on the selected frailty measurement because 'being frail' is used in many studies as an inclusion criterion. METHOD:A cross-sectional study was conducted among 196 community-dwelling older adults (≥60 years), which were selected from the census records. Unidimensional frailty was operationalized according to the Fried Phenotype (FP) and multidimensional frailty was measured with the Comprehensive Frailty Assessment Instrument (CFAI). The concordances and differences were examined by prevalence, correlations, observed agreement and Kappa values. Differences between sample characteristics (e.g., age, physical activity, life satisfaction) were investigated with ANOVA and Kruskall-Wallis test. RESULTS:The mean age was 72.74 (SD 8.04) and 48.98% was male. According to the FP 23.59% was not-frail, 56.92% pre-frail and 19.49% frail. According to the CFAI, 44.33% was no-to-low frail, 37.63% was mild frail and 18.04% was high frail. The correlation between FP and the CFAI was r = 0.46 and the observed agreement was 52.85%. The Kappa value was κ = 0.35 (quadratic κ = 0.45). In total, 11.92% of the participants were frail according to both measurements, 7.77% was solely frail according to the FP and 6.21% was solely frail according to the CFAI. The 'frail sample respondents' according to the FP had higher levels of life satisfaction and net income, but performed less physical activities in comparison to high frail people according to the CFAI. CONCLUSION:The present study shows that the FP and CFAI partly measure the same 'frailty-construct', although differences were found for instance in the prevalence of frailty and the composition of the 'frail participants'. Since 'being frail' is an inclusion criterion in many studies, researchers must be aware that the choice of the frailty measurement has an impact on both the estimates of frailty prevalence and the characteristics of the selected sample.

Project description:BackgroundFemale sex is an important factor predisposing individuals to frailty. Appropriate nutrition is one of the most effective ways to prevent older adults from developing frailty; Sex-related differences have also been detected in the association between nutritional intervention and health-related outcomes. However, few studies have discussed these sex-related differences. The aim of the present study was to investigate the sex-related differences in the association between frailty and dietary consumption.MethodsWe conducted a cross-sectional study which investigated community-dwelling older adults aged ≥65 years. We surveyed age, sex, body mass index, family arrangement (living alone, living with a partner or living with parent(s) and/or child (ren)), dietary consumption and frailty status. Dietary consumption was surveyed using a food frequency questionnaire that included 13 major food categories (fish, meat, eggs, dairy products, soybean products, vegetables, seaweeds, potatoes, fruits, fats or oils, snacks, salty foods and alcohol). Frailty was defined by the Kihon Checklist score. The Kihon Checklist is composed of 25 simple yes/no questions, and it has been validated as a metric for frailty. A higher score indicates a greater degree of frailty. Multinomial regression analysis was performed to clarify the association between frailty and dietary consumption for each sex.ResultsWe analyzed 905 older adults (420 (46.4%) were male). After adjusting for cofounders, a low frequency of meat consumption (less than twice/week) was associated with a high prevalence of frailty in men (odds ratio: 2.76 (95%CI: 1.12-6.77), p = 0.027). In contrast, in women, low frequencies of consumption of fish, meat, vegetables, potatoes and snacks were associated with a higher prevalence of frailty compared with those who consumed foods from those categories daily (odds ratios: fish 2.45 (1.02-5.89), p = 0.045; meat 4.05 (1.67-9.86), p = 0.002; vegetables 5.03 (2.13-11.92), p < 0.001; potatoes 3.84 (1.63-9.05), p = 0.002; snacks 2.16 (1.02-4.56), p = 0.043).ConclusionsMore food categories were associated with frailty in women than in men. Nutritional intervention to prevent frailty is presumably more effective for women than for men.

Project description:IntroductionFrailty is a state of being vulnerable to adverse health outcomes such as falls, delirium, and disability in older people. Identifying frailty is important in a low-income setting to prevent it from progressing, reducing healthcare costs, increasing the chances of reversibility, and implementing effective interventions. The factors affecting frailty in older people living in old age homes could differ from those living in the community. This study was conducted to identify the factors associated with frailty in older people residing in old age homes and communities in Kathmandu Valley, Nepal.MethodsThis is a cross-sectional study conducted from April to June 2019 in three districts of Kathmandu Valley, Nepal. Data were collected from 193 older people residing in old age homes and 501 residing in communities aged 60 and above using convenience sampling. Frailty was measured using the Groningen Frailty Indicator. Data were collected via face-to-face interviews. Multiple linear regression analyses were used to examine the association between independent variables and frailty.ResultsFrailty was more prevalent among older people in old age homes (71.5%) compared to those in the community (56.3%). Older people who were satisfied with their living environment had lower frailty scores in both old age homes (β = -0.20, p<0.01) and the community (β = -0.15, p<0.001). Those who had self-rated unhealthy lifestyle had higher frailty scores in both old age homes (β = 0.45, p<0.001) and the community (β = 0.25, p<0.001). In the community, those over 80 years of age had higher frailty scores (β = 0.15, p<0.01) and those with higher education had lower scores (β = -0.13, p<0.05).ConclusionThe living environment and lifestyle are key modifiable risk factors of frailty, both in old age homes and the community. The findings suggest a need for lifestyle modification and reforms in building standards, especially in old age homes, to promote age-friendly communities.

Project description:BackgroundFrailty is a dynamic condition that is clinically expected to change in older individuals during and around admission to an intermediate care (IC) facility. We aimed to characterize transitions between degrees of frailty before, during, and after admission to IC and assess the impact of these transitions on health outcomes.MethodsMulticentre observational prospective study in IC facilities in Catalonia (North-east Spain). The analysis included all individuals aged ≥ 75 years (or younger with chronic complex or advanced diseases) admitted to an IC facility. The primary outcome was frailty, measured by the Frail-VIG index and categorized into four degrees: no frailty, and mild, moderate, and advanced frailty. The Frail-VIG index was measured at baseline (i.e., 30 days before IC admission) (Frail-VIG0), on IC admission (Frail-VIG1), at discharge (Frail-VIG2), and 30 days post-discharge (Frail-VIG3).ResultsThe study included 483 patients with a mean (SD) age of 81.3 (10.2) years. At the time of admission, 27 (5.6%) had no frailty, and 116 (24%), 161 (33.3%), and 179 (37.1%) mild, moderate, and severe frailty, respectively. Most frailty transitions occurred within the 30 days following admission to IC, particularly among patients with moderate frailty on admission. Most patients maintained their frailty status after discharge. Overall, 135 (28%) patients died during IC stay. Frailty, measured either at baseline or admission, was significantly associated with mortality, although it showed a stronger contribution when measured on admission (HR 1.16; 95%CI 1.10-1.22; p < 0.001) compared to baseline (HR 1.10; 1.05-1.15; p < 0.001). When including frailty measurements at the two time points (i.e., baseline and IC admission) in a multivariate model, frailty measured on IC admission but not at baseline significantly contributed to explaining mortality during IC stay.ConclusionsFrailty status varied before and during admission to IC. Of the serial frailty measures we collected, frailty on IC admission was the strongest predictor of mortality. Results from this observational study suggest that routine frailty measurement on IC admission could aid clinical management decisions.

Dataset Information

Multidimensional Frailty and Vaccinations in Older People: A Cross-Sectional Study.

Publications

Multidimensional Frailty and Vaccinations in Older People: A Cross-Sectional Study.

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