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1.
Shahrul Kamaruzzaman George B Ploubidis Astrid Fletcher Shah Ebrahim 《Health and quality of life outcomes》2010,8(1):123
Background
Frailty remains an elusive concept despite many efforts to define and measure it. The difficulty in translating the clinical profile of frail elderly people into a quantifiable assessment tool is due to the complex and heterogeneous nature of their health problems. Viewing frailty as a 'latent vulnerability' in older people this study aims to derive a model based measurement of frailty and examines its internal reliability in community dwelling elderly. 相似文献2.
Mitnitski A Fallah N Rockwood MR Rockwood K 《The journal of nutrition, health & aging》2011,15(10):863-867
Objectives
Cognitive decline is related to frailty. Frailty can be operationalized in different ways, which have an unknown impact on the estimation of risk. Here, we compared 3 frailty measures in relation to cognitive changes and mortality in the Canadian Study of Health and Aging (CSHA). 相似文献3.
N. Martínez-Velilla Pablo Aldaz Herce Álvaro. Casas Herrero Marta Gutiérrez-Valencia Mikel López Sáez de Asteasu Alberto Sola Mateos Ana Conde Zubillaga Berta Ibáñez Beroiz Arkaitz Galbete Jiménez Mikel Izquierdo 《Journal of the American Medical Directors Association》2017,18(10):898.e1-898.e8
Background and objective
The identification of frail individuals has been recognized as a priority for the effective implementation of healthy aging strategies. Only a limited number of studies have examined frailty in nursing homes, and there is a big heterogeneity in the methods used. The primary objective of this study was to determine the prevalence and feasibility of different frailty screening tools in nursing homes as well as its relationship with multimorbidity and disability.Design, setting, and participants
Cross-sectional analysis from a concurrent cohort study, which included 110 participants aged over 65 years and with different degrees of disability at 2 nursing homes.Measurements
The study used 4 different frailty scales: The Fried frailty criteria, the imputed Fried frailty criteria, the Rockwood clinical frailty scale, and the frailty in nursing home scale, and we analyzed their relationship with disability and multimorbidity.Results
The mean age of the study population was 86.3 years (standard deviation 7.3), and 71.8% were female. Most residents had a high percentage of cognitive and functional impairment, multimorbidity, and risk of malnutrition. The following prevalence rates for frailty were determined: 71.8% (62.8, 79.4), 42.7% (33.9, 52.1), and 36.4% (23.8, 51.1) as per according to the Rockwood clinical frailty scale, frailty in nursing home scale, and Fried index (95% confidence interval), respectively. In the case of the Fried index, the prevalence of frailty is based on the percentage of patients meeting the criteria, which is 40% due to the large number of missing values. After the imputation of variables with the multivariate imputation by chained equation software, the prevalence of frailty increased to 66.4% (57.1, 74.5). We observed different statistically significant associations between the frailty scales and the clinical and demographic variables, and also with disability and multimorbidity.Conclusions
Most residents of nursing homes are likely to be frail, but there is no single operational definition of frailty. Although all measures of frailty had similar associations with the clinical variables of the study, there are important conceptual differences that must be considered in addressing the relationships between frailty, disability, and multimorbidity. Further research is required, and homogeneous frailty criteria must be used so that studies and interventions can be compared. 相似文献4.
Jacobs JM Cohen A Ein-Mor E Maaravi Y Stessman J 《The journal of nutrition, health & aging》2011,15(8):678-682
Introduction
Both frailty and cognitive impairment are increasingly prevalent with advancing age. Nonetheless among the oldest old their relationship is poorly described This study examines the association between frailty status and cognitive impairment at age 85 and their impact on 5-year mortality. 相似文献5.
A. Lucicesare R. E. Hubbard N. Fallah P. Forti S. D. Searle A. Mitnitski G. Ravaglia K. Rockwood 《The journal of nutrition, health & aging》2010,14(4):278-281
Objectives
Uncertainty about the definition of frailty is reflected by the development of many ways to identify frail people. We aimed to compare the validity of two frailty measures in participants of the Conselice Study of Brain Aging. 相似文献6.
Thomas?Krams M.?Cesari S.?Guyonnet G.?Abellan van Kan C.?Cantet B.?Vellas Y.?Rolland The Geriatric Frailty Clinic For Assessment of Frailty Prevention of Disability Teams 《The journal of nutrition, health & aging》2016,20(10):1034-1039
Introduction
The phenotype proposed by Fried and colleagues is a widely used operational definition of frailty defining such state of extreme vulnerability of older persons. Low serum 25-hydroxy-vitamin D (25(OH)D) has been suggested as biomarker of frailty in literature.Study design
Cross-sectional.Objectives
To explore the association of 25(OH)D concentrations with the frailty phenotype and its criteria.Methods
321 subjects referred by their general practitioner to a geriatric frailty clinic were assessed between January 1, 2013 and September 23, 2013. Adjusted logistic regression models were performed between serum concentrations of 25(OH)D and the frailty phenotype (global score as well as its specific criteria). Receivers operating curves were established in order to explore the existence of a possible threshold of vitamin D levels highly predictive of frailty.Results
Two hundred forty-one (75%) participants had 25(OH)D levels lower than 22 ng/ml. No significant association was reported between 25(OH)D levels and frailty. Among the five criteria of frailty, 25(OH)D was only associated with sedentariness (odds ratio 0.97 [95% confidence interval 0.95-0.99]).Conclusion
In our sample, no association was found between 25(OH)D levels and phenotype of frailty or the different frailty criterion except for sedentariness.7.
Vincenzo Solfrizzi Emanuele Scafato Davide Seripa Madia Lozupone Bruno P. Imbimbo Angela DAmato Rosanna Tortelli Andrea Schilardi Lucia Galluzzo Claudia Gandin Marzia Baldereschi Antonio Di Carlo Domenico Inzitari Antonio Daniele Carlo Sabbà Giancarlo Logroscino Francesco Panza 《Journal of the American Medical Directors Association》2017,18(1):89.e1-89.e8
Objectives
Cognitive frailty, a condition describing the simultaneous presence of physical frailty and mild cognitive impairment, has been recently defined by an international consensus group. We estimated the predictive role of a “reversible” cognitive frailty model on incident dementia, its subtypes, and all-cause mortality in nondemented older individuals. We verified if vascular risk factors or depressive symptoms could modify this predictive role.Design
Longitudinal population-based study with 3.5- and 7-year of median follow-up.Setting
Eight Italian municipalities included in the Italian Longitudinal Study on Aging.Participants
In 2150 older individuals from the Italian Longitudinal Study on Aging, we operationalized reversible cognitive frailty with the presence of physical frailty and pre-mild cognitive impairment subjective cognitive decline, diagnosed with a self-report measure based on item 14 of the Geriatric Depression Scale.Measurements
Incidence of dementia, its subtypes, and all-cause mortality.Results
Over a 3.5-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia [hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.02–5.18], particularly vascular dementia (VaD), and all-cause mortality (HR 1.74, 95% CI 1.07–2.83). Over a 7-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia (HR 2.12, 95% CI 1.12–4.03), particularly VaD, and all-cause mortality (HR 1.39, 95% CI 1.03–2.00). Vascular risk factors and depressive symptoms did not have any effect modifier on the relationship between reversible cognitive frailty and incident dementia and all-cause mortality.Conclusions
A model of reversible cognitive frailty was a short- and long-term predictor of all-cause mortality and overall dementia, particularly VaD. The absence of vascular risk factors and depressive symptoms did not modify the predictive role of reversible cognitive frailty on these outcomes. 相似文献8.
Claudio Bilotta Ann Bowling Alessandra Casè Paola Nicolini Sabrina Mauri Manuela Castelli Carlo Vergani 《Health and quality of life outcomes》2010,8(1):56
Background
There is a lack of knowledge concerning the relationship between two closely-linked multidimensional variables: frailty and quality of life (QOL). The aim of this study was to investigate dimensions and correlates of QOL associated with frailty status among community-dwelling older outpatients. 相似文献9.
Lee JS Auyeung TW Leung J Kwok T Leung PC Woo J 《The journal of nutrition, health & aging》2011,15(10):857-862
Objective
Metabolic and atherosclerotic diseases are known risk factors for disability in old age, and can result in sarcopenia as well as cognitive impairment, which are both components of frailty syndrome. As muscle loss increases with ageing, it is unclear whether muscle loss per se, or the diseases themselves, are the underlying cause of physical frailty in those suffering from these diseases. We tested the hypothesis that metabolic and atherosclerotic diseases and cognitive impairment are associated with physical frailty independent of muscle loss in old age, and further examined their impact on the relationship between physical frailty and mortality. 相似文献10.
Objective
To examine the association between baseline frailty measurements and cognitive function 4 years later. 相似文献11.
Abstract
The causes of frailty are complex and must be accepted as multidimensional based on the interplay of genetic, biological, physical, psychological, social and environmental factors, although inflammation and oxidative stress are two factors that play an important role in the development of symptoms with those fragile states. 相似文献12.
Yassuda MS Lopes A Cachioni M Falcao DV Batistoni SS Guimaraes VV Neri AL 《The journal of nutrition, health & aging》2012,16(1):55-61
Objectives
To assess the relationship between the CHS frailty criteria (Fried et al., 2001) and cognitive performance. 相似文献13.
Amy M. Matteini J. D. Walston K. Bandeen-Roche D. E. Arking R. H. Allen L. P. Fried A. Chakravarti S. P. Stabler M. D. Fallin 《The journal of nutrition, health & aging》2010,14(1):73-77
Objective
This project was designed to follow-up prior evidence that demonstrated a significant association between vitamin B12 transport and metabolism and the frailty syndrome in community-dwelling older women. The cross-sectional relationship between genetic variants within six candidate genes along this pathway with serum methylmalonic acid (MMA) levels and frailty was evaluated in this same population of older women. 相似文献14.
Sirola J Pitkala KH Tilvis RS Miettinen TA Strandberg TE 《The journal of nutrition, health & aging》2011,15(9):783-787
Objective
To explore the association of frailty according to questionnaire data (modified Fried criteria) with important endpoints in older men. 相似文献15.
Background
Currently, an estimated 25-30% of people ages 85 or older have dementia, with a projected 115 million people worldwide living with dementia by 2050. With this worldwide phenomenon fast approaching, early detection of at-risk older adults and development of interventions focused on preventing loss in quality of life are increasingly important. A new construct defined by the International Consensus Group (I.A.N.A/I.A.G.G) as «cognitive frailty» combines domains of physical frailty with cognitive impairment and provides a framework for research that may provide a means to identify individuals with cognitive impairment caused by non-neurodegenerative conditions. Using the integrative review method of Whittemore and Knafl., 2005 this study examines and appraises the optimal measures for detecting cognitive frailty in clinical populations of older adults.Methods
The integrative review was conducted using PubMed, CINAHL, Web of Science, PsycInfo, and ProQuest Dissertations & Theses. From the total 185 articles retrieved, review of titles and key words were conducted. Following the initial review, 168 articles did not meet the inclusion criteria for association of frailty and cognition. Of the 18 fulltext articles reviewed, 11 articles met the inclusion criteria; these articles were reviewed in-depth to determine validity and reliability of the cognitive frailty measures.Results
Predictive validity was established by the studies reviewed in four main areas: frailty and type of dementia MCI (OR 7.4, 95% CI 4.2-13.2), vascular dementia (OR 6.7, 95% CI 1.6-27.4) and Alzheimer’s dementia (OR 3.2, 95% CI 1.7-6.2), frailty and vascular dementia (VaAD) is further supported by the rate of change in frailty x macroinfarcts (r = 0.032, p < 0.001); frailty and the individual domains of cognitive function established with the relationship of neurocognitive speed and change in cognition using regression coefficients; individual components of frailty and individual domains of cognitive function associations inculded slow gait and executive function (β -0.20, p < 0.008 ), attention (β -0.25 p < 0.008), processing speed (β -0.16, p < 0.008), word recall (β - 0.18, p = 0.02), and logical memory (β = 0.04, p =0.04). Weak grip was predictive for changes in executive function (β - 0.16, p =0.008). Physical activity was associated with changes in executive function (β = -0.18, p= 0.02) and word recall (β = 0.17, p= 0.02), individual components of frailty and global cognitive function were found in several studies which included grip strength (r = - 0.51, p < 0.001), gait speed (r = - 0.067, p < 0.001), and exhaustion (β - 0.18, p < 0.008).Conclusions
This paper presents the first-known review of the measurement properties for the cognitive frailty construct since the published results from the International Consensus Group (I.A.N.A/I.A.G.G). Evidence presented in this review continues to support the link between physical frailty and cognition with developing validity to support distinct relationships between components of physical frailty and cognitive decline. Results call attention to inconsistencies in reporting of reliability, validity, and heterogeneity in the measurements and operational definition for cognitive frailty. Further research is needed to establish an operational definition and develop psychometrically appropriate clinical measures to construct an understanding of the relationship between physical frailty and cognitive decline.16.
Cano C Samper-Ternent R Al Snih S Markides K Ottenbacher KJ 《The journal of nutrition, health & aging》2012,16(2):142-147
Objective
Examine the association between frailty and cognitive impairment as predictors of mortality over a 10-year period in a selected sample of older Mexican Americans. 相似文献17.
Kristine?S?rensen Stephan?Van den Broucke James?Fullam Gerardine?Doyle Jürgen?Pelikan Zofia?Slonska Helmut?Brand Consortium Health Literacy Project European 《BMC public health》2012,12(1):80
Background
Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. 相似文献18.
G. Berrut S. Andrieu I. Araujo De Carvalho J. P. Baeyens H. Bergman B. Cassim F. Cerreta M. Cesari H. B. Cha L. K. Chen A. Cherubini M. Y. Chou A. J. Cruz-Jentoft L. De Decker P. Du B. Forette F. Forette A. Franco R. Guimaraes L. M. Gutierrez-Robledo J. Jauregui V. Khavinson W. J. Lee L. N. Peng C. Perret-Guillaume M. Petrovic F. Retornaz K. Rockwood L. Rodriguez-Manas C. Sieber G. Spatharakis O. Theou E. Topinkova B. Vellas Athanase Benetos 《The journal of nutrition, health & aging》2013,17(8):688-693
Abstract
Frailty tends to be considered as a major risk for adverse outcomes in older persons, but some important aspects remain matter of debate.Objectives
The purpose of this paper is to present expert’s positions on the main aspects of the frailty syndrome in the older persons.Participants
Workshop organized by International Association of Gerontology and Geriatrics (IAGG), World Health Organization (WHO) and Société Française de Gériatrie et de Gérontologie (SFGG).Results
Frailty is widely recognized as an important risk factor for adverse health outcomes in older persons. This can be of particular value in evaluating non-disabled older persons with chronic diseases but today no operational definition has been established. Nutritional status, mobility, activity, strength, endurance, cognition, and mood have been proposed as markers of frailty. Another approach calculates a multidimensional score ranging from “very fit” to “severely frail,” but it is difficult to apply into the medical practice. Frailty appears to be secondary to multiple conditions using multiple pathways leading to a vulnerability to a stressor. Biological (inflammation, loss of hormones), clinical (sarcopenia, osteoporosis etc.), as well as social factors (isolation, financial situation) are involved in the vulnerability process. In clinical practice, detection of frailty is of major interest in oncology because of the high prevalence of cancer in older persons and the bad tolerance of the drug therapies. Presence of frailty should also be taken into account in the definition of the cardiovascular risks in the older population. The experts of the workshop have listed the points reached an agreement and those must to be a priority for improving understanding and use of frailty syndrome in practice.Conclusion
Frailty in older adults is a syndrome corresponding to a vulnerability to a stressor. Diagnostic tools have been developed but none can integrate at the same time the large spectrum of factors and the simplicity asked by the clinical practice. An agreement with an international common definition is necessary to develop screening and to reduce the morbidity in older persons. 相似文献19.
M. Liset Rietman D. L. van der A S. H. van Oostrom H. S. J. Picavet M. E. T. Dollé H. van Steeg W. M. M. Verschuren A. M. W. Spijkerman 《The journal of nutrition, health & aging》2018,22(1):8-15
Objectives
Previous studies showed a U-shaped association between BMI and (physical) frailty. We studied the association between BMI and physical, cognitive, psychological, and social frailty. Furthermore, the overlap between and prevalence of these frailty domains was examined.Design
Cross-sectional study.Setting
The Doetinchem Cohort Study is a longitudinal population-based study starting in 1987-1991 examining men and women aged 20-59 with follow-up examinations every 5 yrs.Participants
For the current analyses, we used data from round 5 (2008-2012) with 4019 participants aged 41-81 yrs.Measurements
Physical frailty was defined as having ≥ 2 of 4 frailty criteria from the Frailty Phenotype (unintentional weight loss, exhaustion, physical activity, handgrip strength). Cognitive frailty was defined as the < 10th percentile on global cognitive functioning (based on memory, speed, flexibility). Psychological frailty was defined as having 2 out of 2 criteria (depression, mental health). Social frailty was defined as having ≥ 2 of 3 criteria (loneliness, social support, social participation). BMI was divided into four classes. Analyses were adjusted for sex, age, level of education, and smoking.Results
A U-shaped association was observed between BMI and physical frailty, a small linear association for BMI and cognitive frailty and no association between BMI and psychological and social frailty. The four frailty domains showed only a small proportion of overlap. The prevalence of physical, cognitive and social frailty increased with age, whereas psychological frailty did not.Conclusion
We confirm that not only underweight but also obesity is associated with physical frailty. Obesity also seems to be associated with cognitive frailty. Further, frailty prevention should focus on multiple domains and target individuals at a younger age (<65yrs).20.
Kota Tsutsumimoto Takehiko Doi Hyuma Makizako Ryo Hotta Sho Nakakubo Minji Kim Satoshi Kurita Takao Suzuki Hiroyuki Shimada 《Journal of the American Medical Directors Association》2018,19(6):504-510