Factors In Community-dwelling Older Adults Research Articles

Comorbidities, medications, depression, and physical performance measures associated with severe cognitive impairments in community-dwelling adults

Cognitive impairment negatively impacts health, psychological, social, and economic domains. Cognitive impairment commonly affects physical functions in older adults, whereas these are deteriorated. However, the prevalence and associated factors of cognitive impairment among community-dwelling adults in Saudi Arabia have not been investigated yet. This study aimed to examine the prevalence of severe cognitive impairment and its associated factors in community-dwelling older adults in Saudi Arabia. This cross-sectional study involved adults aged ≥50 years. Demographic data and clinical data, including number of medications and body mass index (BMI), were collected. Cognitive impairment and depressive symptoms were measured using Arabic versions of the Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9), respectively. The participants were divided into severe cognitive impairment and mild cognitive impairment or normal cognitive function groups based on a score of <20 or ≥20, respectively, using the MoCA. Physical measures included dynamic gait index (DGI) scores, timed up-and-go (TUG), 5 times sit-to-stand (5XSST), functional reach test, and 6-minute walk test. A total of 206 participants (female: n = 96) were included. The prevalence of severe cognitive impairment in the community-dwelling older adults was 12.6%. The number of chronic conditions (odds ratio [OR]: 2.31, p<0.001), number of medications (OR: 1.36, p = 0.003), and depressive symptoms using PHQ-9 (OR: 1.11, p = 0.009) were significantly associated with severe cognitive impairment after adjustment for other covariates, including age, sex, and BMI. Based on the physical function measures, only the scores for DGI (OR: 0.86, p = 0.003), TUG (OR: 1.16, p = 0.035) and 5XSST (OR: 1.25, p <0.001) were significantly associated with severe cognitive impairment. This study revealed a high prevalence of severe cognitive impairment among community-dwelling adults in Saudi Arabia. Its major risk factors include depressive symptoms, number of chronic conditions and medications, and physical measures, including DGI, TUG, and 5XSST.

Prevalence of tight glycemic control based on frailty status and associated factors in community-dwelling older adults.

Tight control of type 2 diabetes (T2DM) in frail older adults has shown to be associated with adverse outcomes. The objective of this study is to determine the prevalence of tight glycemic control based on underlying frailty status and its association with functional and cognitive measures in community-dwelling older adults. Ancillary study of the Singapore Population Health Studies on older adults aged ≥65years with T2DM. Tight glycemic control cut-offs were based on the 2019 Endocrine Society guideline using HbA1c target range based on a patient's overall health status measured by the FRAIL scale. Data on basic demographics, frailty, cognitive, and functional statuses were collected. Multivariable regression was used to assess potential factors associated with tight glycemic control. Of 172 community-dwelling older adults with diabetes mellitus and HbA1c done, frail (65%) and pre-frail (64.4%) participants were more likely to have tight glycemic control than robust participants (31.6%, P< 0.001). In multi-variate analysis, frailty (OR 6.43, 95% CI 1.08-38.1, P= 0.041), better cognition (OR 1.15, 95% CI 1.02-1.32, P= 0.028), and multi-morbidity (OR 7.36, 95% CI 1.07-50.4, P= 0.042) were found to be significantly associated with increased odds of tight glycemic control. Tight glycemic control was highly prevalent in frail and pre-frail older adults, especially in those with multi-morbidity and better cognition. Future prospective longitudinal studies are required to evaluate effectiveness of frailty screening in making treatment decisions and long-term outcomes. Key messages What is already known on this topic: There is growing recognition that glycemic targets should be adjusted based on health or frailty status. However, there is no consensus on how health status or frailty should be defined when determining glycemic control targets. What this study adds: Our study found that tight glycemic control was highly prevalent in frail and pre-frail older adults. Our findings highlight the importance of assessing for tight glycemic control based on frailty status and further work is needed to aid implementation of screening and intervention policies to avoid the attendant harms of tight glycemic control.

Self-care ability and associated factors in community-dwelling older adults living with oral frailty using the COM-B model.

Self-care can improve overall oral health. However, few studies have investigated this in community-dwelling older adults with oral frailty. The Capability, Opportunity, Motivation and Behaviour (COM-B) model may be an appropriate framework to identify factors that affect self-care ability. The purpose of this study was to investigate the current status of and factors influencing self-care ability in community-dwelling older adults living with oral frailty, and to analyse the risk factors of low self-care ability. Two hundred seventy-five community-dwelling older adults with oral frailty participated in this cross-sectional study from October 2022 to March 2023. Participants underwent evaluations of oral health knowledge and behaviour, oral health literacy, nutritional condition, social support, oral health-related quality of life, self-efficacy and self-care ability using questionnaires. The self-care ability of older adults was assessed using the Chinese version of self-care ability scale for the elderly (SASE). The influencing factors were evaluated by single-factor analysis, correlation analysis and multi-factor analysis. Furthermore, we conducted additional analysis, wherein self-care ability was analysed as a categorical variable. Of the participants, the SASE score was 62.43 ± 7.33, and 73.09% were inadequate at self-care ability. There was a positive correlation between the level of self-care ability and each variable (p < .001). Multiple linear regression showed that health literacy (p < .001), age (p < .001), nutritional condition (p = .001), gender (p = .003), quality of life (p = .014) and self-efficacy (p = .040) were significantly associated with decreased self-care ability (R2 = 0.444, F = 19.241). Binomial logistic regression analysis showed that gender, educational level, nutritional condition, oral health literacy and quality of life (all P<0.05) were risk factors for developing low levels of self-care ability. This study suggests that health literacy, age, nutritional condition, quality of life, gender and self-efficacy are important factors that influence self-care ability in community-dwelling older adults living with oral frailty.

Prevalence and factors associated with sarcopenia among Brazilian older adults: An exploratory network analysis

ObjectivesThis study aimed to verify the prevalence of sarcopenia and its associations with sociodemographic, clinical and psychological factors in community-dwelling older adults. Study designA randomized cross-sectional study was extracted from a probabilistic cluster conducted on individuals aged 65 years or older residing in the community. MethodsSarcopenia was defined according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Body composition was assessed using dual-energy X-ray absorptiometry (DXA). Associations were analyzed using networks based on mixed graphical models. Predictability indices of the estimated networks were assessed using the proportion of explained variance for numerical variables and the proportion of correct classification for categorical variables. ResultsThe study included 278 participants, with a majority being female (61 %). The prevalence of sarcopenia was 39.57 %. Among those with sarcopenia, 67 % were women and 33 % were men. In the network model, age, race, education, family income, bone mass, depression, cardiovascular disease, diabetes, total cholesterol levels and rheumatism were associated with sarcopenia. The covariates demonstrated a high accuracy (62.9 %) in predicting sarcopenia categories. ConclusionThe prevalence of sarcopenia was high, especially in women. In addition, network analysis proved useful in visualizing complex relationships between sociodemographic and clinical factors with sarcopenia. The results suggest early screening of sarcopenia for appropriate treatment of this common geriatric syndrome in older adults in Brazil.

Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data

ObjectiveThis study aims to examine temporal trends and the association between falls and self-rated oral health (SROH) status in community-dwelling older Korean adults.DesignSecondary analysis of a serial cross-sectional study.MethodsWe analysed...

Abstract P284: Effects of a Laughter Program on Cardiovascular Risk Factors in Community-Dwelling Older Adults

Introduction: While there have been several intervention studies on the psychological effects of laughter, few have examined both the psychological and physical effects in community-dwelling older people. This study aimed to examine the effects of a laughter program on body weight, waist circumference, heart rate, blood pressure, grip strength, and health-related quality of life (HRQOL) in community-dwelling older adults using an intervention trial in Japan. Hypothesis: Laughter-based interventions are effective in reducing cardiovascular risk factors and improving quality of life in the community-dwelling elderly population. Methods: In Yao City, Osaka Prefecture, two school districts were selected and participants were recruited for a laughter program for seniors aged 70 and older in each district. One of the two districts was assigned to receive the laughter program first (laughter intervention group), and the other was assigned to receive the laughter program later (control group). A total of 87 people applied to participate (40 in the intervention group, mean age 75 years; 37 in the control group, mean age 75 years), and the intervention group received 10 laughter programs over 12 weeks. The laughter program was composed of an approximately 30-min lecture about laughter and health, or an approximately 30-min appreciation of rakugo by a professional performer of rakugo , a traditional form of Japanese comic storytelling, and an approximately 60-min laughter yoga class by the laughter yoga teachers. Rakugo was regarded as part of the laughter lectures, and three lectures were given. In both groups, participants were measured for weight, waist circumference, blood pressure, grip strength, and HRQOL at baseline and after 12 weeks. The effects of the laughter program on these factors were analyzed using analysis of covariance for change in each measure, adjusted for age, sex, baseline values, and medication use. Results: None of the participants were injured or physically ill from the laughter program. The laughter program significantly improved the mean waist circumference ( p &lt;0.001), heart rate ( p = 0.04), grip strength ( p &lt;0.001), and mental component summary scores of HRQOL ( p = 0.04). A similar tendency occurred for the mean changes in diastolic blood pressure and physical component summary scores of HRQOL. No significant changes were observed for body weight and systolic blood pressure. Conclusion: The comprehensive 12-week laughter intervention program, consisting primarily of laughter yoga, significantly improved physical and psychological functions such as waist circumference, heart rate, grip strength, and HRQOL among community-dwelling older adults.

Prevalence of geriatric syndromes and associated factors in Iranian older adults with type 2 diabetes: A population-based correlational study

Background &amp; Aim: Geriatric syndromes are known as a major obstacle in the treatment and care of older adults with diabetes. This study aimed to determine the prevalence of geriatric syndromes and associated factors in community-dwelling older adults with diabetes in the south of Tehran, Iran, in 2022.&#x0D; Methods &amp; Materials: A population-based correlational study was conducted among 392 older adults with diabetes, covered by selected health centers in the south of Tehran, Iran, using the multistage sampling method. Persian forms of geriatric assessment tools were used, including Mini-Mental State Examination, Activities of Daily Living, Instrumental Activities of Daily Living, Mini Nutritional Assessment, and Geriatric Depression Scale. The obtained data were analyzed by descriptive and chi-square test in SPSS-26.&#x0D; Results: The mean age of the participants was 69.5±6 years (63% female, 37% male). About 54.6% of the older adults with diabetes studied had three or more Geriatric syndromes. Polypharmacy was the most prevalent geriatric syndrome (76.5%). The number of geriatric syndromes had a significant association with female gender (p&lt;0.001), lower education (p&lt;0.001), loss of the spouse (p= 0.004), and lower-income (p=0.019). Also, with the increase in the number of diabetes comorbidities, the occurrence of all geriatric syndromes increased significantly (p&lt;0.001).&#x0D; Conclusion: The prevalence of geriatric syndromes in older adults with diabetes in the south of Tehran is very high and warning. Due to the increasing population of older adults in Iran, policymakers and healthcare providers should take appropriate actions to confront the issue with a comprehensive understanding of the present condition.

Evaluation of a Physical Therapist-Delivered Technology Literacy Algorithm and Protocol for Older Adults: A Pilot Study.

Introduction Technology literacy is the ability to comfortably understand, use, and navigate digital devices. It is considered a "super social determinant of health", and yet 39% of adults aged 65+ report not using a smartphone, and 25% of seniors still lack internet access. The purpose of this study was to examine the applicability of a physical therapist-delivered clinical assessment tool related to technological literacy and to identify relationships between technology utilization and perceptions related to sociodemographic factors in community-dwelling older adults. Methods A prospective mixed-methods observational-descriptive study where physical therapists (PTs) administered a newly designed technology literacy algorithm to older adults and evaluated the results of the algorithm. A convenience sample of 30 participants aged 65 and older was evaluated for their technology literacy. The exclusion criteria were if the person had a vision deficit, lived in a nursing home or extended care facility, was unable to fluently read and understand the English language, or was not willing to have an in-home visit by a licensed PT. After informed consent was obtained, the participant completed a Past Experience with Technology Questionnaire assessing participant confidence with technology usage and a demographic questionnaire. A PT data collector visited participants' homes and administered a novel technology literacy algorithm. The PTs also provided subjective feedback after patient visits as to their perceptions of the algorithm. Inferential statistics were performed for key variables, including a Kruskal-Wallis test being utilized for variables with three or more levels and a two-sample Wilcoxon test being utilized for variables with two levels. The binary results were evaluated with chi-squared tests. Trends in distribution and measures of central tendency were analyzed for demographic data. Statistical significance was set at P<0.05 with a confidence interval of 95%. Results Participants (n=30) were evenly distributed with regard to age, and 66% of people had a college degree. Most were female, of the white race, and retired. There were statistically significant relationships between older age and decreased comfort level with using the internet (P=0.30) and sending messages (P=0.31), with individuals 80+ years old having a mean confidence of 6.78 out of 10. A statistically significant relationship was also found between higher income and increased confidence in browsing the internet (P = 0.07). Most qualitative data from physical therapist experiences included positive trends such as ease of use, efficiency, and confidence instilled. Constructive feedback included a lack of resources to assist with more advanced technology-related needs and recommendations to refine the algorithm when advanced needs were identified. Conclusion Technology literacy is a vital component of accessing health and medical care and maximizing the quality of that care, especially in the older adult population. The tools created may assist clinicians with identifying and addressing issues related to technology in older adults. This may help a patient navigate health issues that require the use of technology in their home. This study provided evidence that a PT-administered algorithm may be feasible to address technology literacy issues in the homes of older adults.

Incidence of the Risk of Malnutrition and Excess Fat Mass, and Gait Speed as Independent Associated Factors in Community-Dwelling Older Adults.

Only one cohort study exists on the incidence of the risk of malnutrition (RM) in older adults, though numerous cross-sectional reports, identified several risk factors associated with the prevalence and incidence of this condition. However, alterations in body composition and impaired physical performance as exposition variables of RM have not been explored. This study assessed the incidence of RM and determined its association with excess fat mass, low total lean tissue, gait speed, and handgrip strength as exposition variables for RM in community-dwelling older adults. This is a secondary analysis of older adults (≥60 years) derived from the study "Frailty, dynapenia, and sarcopenia in Mexican adults (FraDySMex)", a prospective cohort project conducted from 2014 to 2019 in Mexico City. At baseline, volunteers underwent body composition analysis and physical performance tests. Several covariates were identified through comprehensive geriatric assessment. At baseline and follow-up, RM was assessed using the long form of the mini nutritional assessment (MNA-LF) scale. Associations between the exposition variables and RM were assessed by multiple logistic regression. The cohort included 241 subjects. The average age was 75.6 ± 7.8 years, and 83.4% were women. The mean follow-up period was 4.1 years, during which 28.6% of subjects developed RM. This condition was less likely to occur in those with an excess fat mass, even after adjusting for several covariates. Regarding total lean tissue, the unadjusted model showed that RM was more likely to occur in men and women with a low TLT by the TLTI classification, compared to the normal group. However, after adjusting for several covariates (models 1 and 2), the association lost significance. Results on the association between gait speed and RM showed that this condition was also more likely to occur in subjects with low gait speed, according to both the unadjusted and adjusted models. Similar results were found for RM in relation to low handgrip strength; however, after adjusting for the associated covariates, models 1 and 2 no longer reached the level of significance. RM diagnosed by MNA-LF was significantly less likely to occur among subjects with excess fat mass, and a significant association emerged between low gait speed and RM after 4.1 years of follow-up in these community-dwelling older adults. These results confirm the association between some alterations of body composition and impaired physical performance with the risk of malnutrition and highlight that excess fat mass and low gait speed precede the risk of malnutrition, not vice versa.

Trajectories of Cognitive Function and Their Associated Factors in Community-Dwelling Older Adults by Living Arrangement Using the Korean Longitudinal Study of Aging

The purpose of this study was to describe the distinct cognitive trajectories for 8 years according to living arrangement among community-dwelling older adults using the Korean longitudinal study of ageing.We analyzed data from a final sample of 3,049 community-dwelling older adults aged 65 years or older who participated in at least three cognitive function measures in an 8-year period (2012-2020). Cognitive function was assessed by Korean mini mental state examination. Latent class growth model analysis was applied to determine the number and shape of trajectories of older adults according to living arrangement. Multinomial logistic regression analysis was used to determine risk factors for cognitive function trajectories.We identified five trajectory patterns in cognitive function among older adults living alone; ‘high-stable (35.6%)’, ‘high-declining (32.5%)’, ‘moderate-steep declining (6.2%)’, ‘low-stable (18.9%)’, and ‘low declining (6.8%)’. In older adults living with family, there were four trajectory patterns; ‘high-stable (46.4%)’, ‘high-declining (32.0%)’, ‘low-stable (15.9%)’, and ‘low-declining (5.7%)’. Age, instrumental activities of daily living, and depression were common factors of cognitive changes in both older adults living alone and those living with family members. However, monthly incomes was only associated with the risk of cognitive function in older adults living alone.We found that cognitive function trajectories among older adults may differ depending on the type of living arrangement. Therefore, further studies and health policies are required for avoiding cognitive impairment by living arrangement among older adults based on the results of this study.

Nutritional Status and Risk of Sarcopenia among Hospitalized Older Adults Residing in a Rural Region in Turkey.

This study aimed to determine the prevalence of sarcopenia and its associated factors in community-dwelling older adults at risk of malnutrition based on the Mini Nutritional Assessment (MNA), Prognostic Nutritional Index (PNI), and Geriatric Nutritional Risk Index (GNRI). The study participants were 345 adults aged &gt;65 years who visited Geriatric Internal Medicine outpatient clinics. The study included people without acute illness for whom the risk of malnutrition could be assessed and appropriate measurements taken. At the baseline visit, participants' data and measurements were gathered. The primary data included sociodemographic details, anthropometric measurements, malnutrition screening tests, and functional assessments. The participants' mean age was 76.21±5.59 years, and 57.1% were men (n=97). The prevalence rate of sarcopenia was 45.5%. Compared to individuals without sarcopenia, those with it were older; had lower MNA, PNI, and GNRI scores; and had lower muscle mass, muscle strength, and lower leg circumferences (p&lt;0.001). After adjusting for potential confounding factors, we found that sarcopenia, advanced age, male sex, high risk of malnutrition, calf circumference, and a low PNI score were all significantly associated with a low GNRI score (p&lt;0.001). Sarcopenia was significantly associated with advanced age, male sex, and high risk of malnutrition. Patients' nutritional and functional status should always be assessed for therapeutic interventions and lifestyle changes.

The Relationship Between Contextual Factors and the Mobility Ability

Objective: To examine how the relationship between Mobility limitation is influenced by Contextual Factors in community-dwelling older adults. Design: This is a cross-sectional study. Participants: A total of 769 persons aged 65 years or above living in the community-dwelling of the Algarve region. Methods: We study eighteen categories of Personal and Environmental Factors agreement of the International Classification of Functioning (ICF) and their relationship with six categories of the Mobility domain. Multiple logistic regression was used in analyzing functional outcomes in the Mobility. Main Results: The proportion of older adults reporting disability in Mobility activities ranged from 17.4% (Moving Around Within the Home) and 53.2% (Using Private or Public Motorized Transportation). The Contextual Factors with a greater impact in explaining the limitations in Mobility outcomes were Assistance Activities of Daily Living (OR = 3.0 to OR = 11.9), JobWithout Qualification (OR=2.5 toOR=6.3), Inadequate Nr of Meals (OR = 2.6 to OR = 3.8) and Self-Rated Physical Health (OR = 2.1 to OR = 3.1). The variable sex contributed to explaining the results of the most difficult activities to perform as Moving Around Outside the Home, Climbing and Use of Transports. The contribution of age was observed only in the Use of Transports. Conclusions: Contextual Factors are important predictors of Mobility functioning, namely, those related to Behaviors and Health Events but also those related to Social and Cultural variables.

Medication adherence and its influencing factors in community-dwelling older adults with chronic illnesses in a rural area

Background &amp; Aim: Older adults with chronic diseases are usually required to manage multiple medications and complex medication regimens. Medication adherence is crucial in older adults which is increasingly being recognized due to its potential to impact healthcare utilization and treatment efficacy. The current study aimed to assess medication adherence and its influencing factors in community-dwelling older adults with chronic illnesses in rural areas. ‎&#x0D; Methods &amp; Materials: A cross-sectional study design was used to achieve the study aim. The study sample was composed of 310 older patients from a rural area in Sharkia Governorate, Egypt. Medication adherence was assessed by the Arabic version of the General Medication Adherence Scale. Association between medication adherence and older patients' characteristics was identified through the Chi-square test, Pearson's correlation coefficient, and Logistic regression.&#x0D; Results: Among 310 older patients, 84.8% of them were non-adherent to their medications. Significant relationships were found between medication adherence and age, gender, educational level, marital status, and monthly income. Aging less than 70 years, female gender, sufficient income, fewer illnesses, and medication number were significant predictors for medication adherence.&#x0D; Conclusion: The current study findings revealed that most rural older adults with chronic illnesses were non-adherent to their medications, with many influencing factors such as age, gender, educational level, monthly income, and illnesses and medication number. So, the study recommends the importance of developing strategies to improve medication adherence in community-dwelling older adults in rural areas.

Latent classes based on fall risk factors in community-dwelling older adults: The 2017 National Survey of Older Persons.

This work aimed to classify the elderly according to fall risk factors and to identify the characteristics of the latent classes. Falls mainly occur due to combinations of various risk factors, and each older adult has a different combination of risk factors. This was a secondary data analysis using data from the 2017 National Survey of Older Persons conducted by the Korean Ministry of Health and Welfare. Latent class analysis and multiple logistic regression were performed using data from 1556 older adults who experienced at least one fall during 1 year (1 January 2016 to 31 December 2016). Indicator variables included eight fall risk factors. A 3-class solution was selected according toacceptable goodness of fit. The 'healthy falls risk class' included over half of the cohort, and the comprised older adults did not show typical health problems. The 'complex falls risk class' included older people with physical and mental problems, and the 'musculoskeletal falls risk class' included older people with osteoarthritis and back pain. The results identified combinations of fall risk factors and characteristics among community-dwelling older adults that may contribute to the planning of effective fall prevention programmes.

Association between lower body strength and related factors in community-dwelling older adults

The aim of this study is identify the association between lower body strength and some related factors in community-dwelling older adults. This is a cross-sectional study with people ≥ 60 years old. Variables including demographic information, body mass index, 30-second chair stand test, frailty, time up and go test, cognitive function, falls risk, depression risk, functional independence and nutrional status, and history of fall. Lower body strength was defined by 30 seconds stand test. A total of 396 participants with mean of age was 69.6 ± 7.9 were tested. The mean of thirty second chair stand test was 11.44 ± 2.9. Cognitive function impairment and time up and go test &lt; 12s were significant associated with lower body strength in multivariate logistics (p &lt; 0.05). Evaluating the strength of the lower body is important to identify imbalance problems and falls. It is essential to have early screening for cognitive function and time up and go test.

Frailty knowledge level and its influencing factors among older adults in China.

Raising older adults' frailty knowledge level and encouraging them to actively engage in the prevention and treatment of frailty is essential to promote healthy aging. This cross-sectional study investigated frailty knowledge level and its influencing factors in community-dwelling older adults in China. A total of 734 older adults were included in the analysis. About half of them misjudged their frailty state (42.50%), and 17.17% obtained frailty knowledge in the community. Those who were female, lived in rural areas, lived alone, had not attended school, had a monthly income <3,000RMB, were at risk for malnutrition, were depressed, and were socially isolated were more likely to have lower frailty knowledge level. Those with advanced age and pre-frailty or frailty stage were more knowledgeable about frailty. The group with the highest proportion of low frailty knowledge level was those who had never attended school or completed primary school and had loose friend ties (98.7%). It is crucial to develop tailored intervention to raise frailty knowledge level in older adults in China.

Digital Health Service for Identification of Frailty Risk Factors in Community-Dwelling Older Adults: The SUNFRAIL+ Study Protocol

This article reports the study protocol of a nationwide multicentric study in seven Italian regions aimed at assessing the effectiveness of a digitally supported approach for the early screening of frailty risk factors in community-dwelling older adults. SUNFRAIL+ is a prospective observational cohort study aimed at carrying out a multidimensional assessment of community-dwelling older adults through an IT platform, which allows to connect the items of the SUNFRAIL frailty assessment tool with a cascading multidimensional in-depth assessment of the bio-psycho-social domains of frailty. Seven centers in seven Italian regions will administer the SUNFRAIL questionnaire to 100 older adults. According to the answers provided by older adults, they will be subjected to one or more validated in-depth scale tests in order to perform further diagnostic or dimensional evaluations. The study aims to contribute to the implementation and validation of a multiprofessional and multistakeholder service model for the screening of frailty in community-dwelling older adult population.

Prevalence and association of frailty with SARS-CoV-2 infection in older adults in Southern Switzerland—Findings from the Corona Immunitas Ticino Study

BackgroundFrailty is an age-associated state of increased vulnerability to stressors that strongly predicts poor health outcomes. Epidemiological evidence on frailty is limited during the COVID-19 pandemic, and whether frailty is associated with the risk of infection is unknown.ObjectivesWe derived a robust Frailty Index (FI) to measure the prevalence of frailty and its risk factors in community-dwelling older adults in Southern Switzerland (Ticino), and we explored the association between frailty and serologically confirmed SARS-CoV-2 infection.MethodsIn September 2020, we recruited a random sample of community-dwelling older adults (65 +) in the Corona Immunitas Ticino prospective cohort study (CIT) and assessed a variety of lifestyle and health characteristics. We selected 30 health-related variables, computed the Rockwood FI, and applied standard thresholds for robust (FI < 0.1), pre-frail (0.1 ≤ FI < 0.21), and frail (FI ≥ 0.21).ResultsComplete data for the FI was available for 660 older adults. The FI score ranged between zero (no frailty) and 0.59. The prevalence of frailty and pre-frailty were 10.3% and 48.2% respectively. The log-transformed FI score increased by age similarly in males and females, on average by 2.8% (p < 0.001) per one-year increase in age. Out of 481 participants with a valid serological test, 11.2% were seropositive to either anti-SARS-CoV-2 IgA or IgG. The frailty status and seropositivity were not statistically associated (p = 0.236).ConclusionAdvanced age increases the risk of frailty. The risk of COVID-19 infection in older adults may not differ by frailty status.

Fall Risk Factors in Community-Dwelling Older Adults: An Umbrella Review Protocol

BACKGROUND: Falls are among the leading cause of accidental injury in Canada, with one in three older adults experiencing a fall each year. This leads to disability, long-term pain, loss of independence, reduced quality of life, mental health challenges, and increased mortality risk. Alongside these injuries, falls are a growing national public health concern given their direct cost of over $2 billion a year. Further, with an aging Canadian population, the prevalence and incidence of falls are expected to increase at a rapid rate. A large body of literature has identified risk factors that contribute to falls in older adults, however, to date this literature has been disjointed and often groups together fall risks for different populations. To address these limitations, this review will aim to summarize the evidence identifying risk factors for falls in community-dwelling older adults (60 years).&#x0D; &#x0D; METHODS: We searched seven databases (Medline, Embase, CINAHL, Cochrane Library, PsychINFO, Ageline) for articles that: are systematic reviews (including scoping reviews), include a population of community dwelling older adults (60 years), and report modifiable and non-modifiable factors that have shown to increase the risk for falls in prospective studies. Multiple independent reviewers will screen titles, abstracts, and full text articles, and perform data extraction and quality assessment. Risk factors will be synthesized narratively. Wherever possible, findings will be grouped according to the International Classification of Functional Disability (ICF).&#x0D; &#x0D; ANTICIPATED IMPACT: Given the substantial amount of research conducted in this area, we anticipate that the identified risk factors for falls will cover a wide breadth. Further, our results will identify the risk factors that are of the utmost importance to consider when undertaking fall prevention efforts.

Brain and spinal cord arteriolosclerosis and its associations with cerebrovascular disease risk factors in community-dwelling older adults.

Arteriolosclerosis is common in older brains and related to cognitive and motor impairment. We compared the severity of arteriolosclerosis and its associations with cerebrovascular disease risk factors (CVD-RFs) in multiple locations in the brain and spinal cord. Participants (n = 390) were recruited in the context of a longitudinal community-based clinical-pathological study, the Rush Memory and Aging Project. CVD-RFs were assessed annually for an average of 8.7 (SD = 4.3) years before death. The annual assessments included systolic (SBP) and diastolic (DBP) blood pressure, diabetes mellitus (DM), low- and high-density lipoprotein cholesterol, triglyceride, body mass index, and smoking. Postmortem pathological assessments included assessment of arteriolosclerosis severity using the same rating scale in three brain locations (basal ganglia, frontal, and parietal white matter regions) and four spinal cord levels (cervical, thoracic, lumbar and sacral levels). A single measure was used to summarize the severity of spinal arteriolosclerosis assessments at the four levels due to their high correlations. Average age at death was 91.5 (SD = 6.2) years, and 73% were women. Half showed arteriolosclerosis in frontal white matter and spinal cord followed by parietal white matter (38%) and basal ganglia (27%). The severity of arteriolosclerosis in all three brain locations showed mild-to-moderate correlations. By contrast, spinal arteriolosclerosis was associated with brain arteriolosclerosis only in frontal white matter. Higher DBP was associated with more severe arteriolosclerosis in all three brain locations. DM was associated with more severe arteriolosclerosis only in frontal white matter. Controlling for DBP, higher SBP was inversely associated with arteriolosclerosis in parietal white matter. Blood cholesterol and triglyceride, high body mass index, or smoking were not related to the severity of arteriolosclerosis in any brain region. None of the CVD-RFs were associated with the severity of spinal arteriolosclerosis. These data indicate that severity of arteriolosclerosis and its associations with CVD-RFs may vary in different CNS locations.