Frailty In Elders Research Articles

Inertial measurement unit signal-based machine learning methods for frailty assessment in geriatric health

Frailty is a geriatric syndrome that may result in poor health outcomes such as hospitalization, disability, psychological distress, and reduced life satisfaction, and it is also associated with higher healthcare costs. The aim of this study is to classify frailty in elders at an early stage (pre-frail) to lower the risk of frailty and, hence, improve the quality of life. The other two classes in the classification task are frail and robust (non-frail). To achieve this, a dataset based on gait was utilized, which was recorded by an Inertial Measurement Unit (IMU) sensor, including gyroscope and accelerometer data. In this study, two approaches were assessed: the first used advanced Deep Learning (DL) algorithms to analyze raw IMU signals, and the second used conventional Machine Learning (ML) methods with hand-crafted features. The DL model, i.e., InceptionTime, beat the other algorithms in the DL approach with a remarkable test accuracy of 98%. On the ML side, Random Forest reported the most successful ML method, which achieved a test accuracy of 63.3%. For a careful assessment of the models, other evaluation metrics like Precision, Recall, and F1-score were also evaluated. The evaluation of both approaches produces research benefits for the classification of frailty in older people and allows for the investigation of new areas, promoting deeper comprehension and well-informed decision-making, particularly in healthcare systems.

Association between Dietary Patterns and Frailty Prevalence in Shanghai Suburban Elders: A Cross-Sectional Study.

Objective: To investigate the association between dietary patterns with frailty phenotypes in an elderly Chinese population. Methods: A cross-sectional study was performed in 780 Shanghai suburban elders aged 65–74 in 2019. Dietary data were collected using a food frequency questionnaire. Adherence to a priori dietary patterns, including the Chinese Healthy Eating Index (CHEI), Dietary Approaches to Stop Hypertension (DASH) diet and Mediterranean Diet (MD) were calculated. Three a posteriori dietary patterns were identified by factor analysis, namely, “protein-rich”; “vegetables”; and “sugar, oil, and condiments”. Frailty was defined using the Fried frailty phenotype scale. Ordinal multiple logistic regression was applied to examine the associations between dietary patterns and frailty prevalence. Results: The prevalences of pre-frailty and frailty were 47.69% and 3.85%, respectively. Participants with a higher DASH score had a lower frailty prevalence in the sex- and age-adjusted models of the 780 subjects (OR = 0.97 (95% CI: 0.94–0.99), p < 0.05). The association slightly strengthened in the multivariate adjusted model of the 555 subjects after excluding the participants with chronic diseases may influence frailty (OR = 0.96 (95% CI: 0.92–1.00), p < 0.05). High “protein-rich” dietary pattern scores were negatively associated with frailty prevalence in the multivariate adjusted model of the 780 subjects (OR = 0.82 (95% CI: 0.69–0.98), p < 0.05). The association attenuated in the sex- and age-adjusted model of the 555 subjects (OR = 0.84 (95% CI: 0.69–1.00, p = 0.056). Conclusion: A better diet quality as characterized by DASH and “protein-rich” was associated with a reduced prevalence of frailty in Shanghai suburban elders. The correlation of CHEI, MD or a posteriori dietary patterns with the development of frailty in Chinese older people remains to be explored.

Changes in Kihon Checklist items and new Certification of long-term care needs among Japanese community-dwelling elders.

Objective: Physical frailty has been considered a risk factor for certification of long-term care needs (hereafter referred to as Certification) under Japan’s long-term care insurance (LTCI). Therefore, assessment of frailty in elders should be studied from multiple perspectives. The Kihon Checklist (KCL) is widely used to identify need for support/care among Japanese older adults. This study aims to examine the relationship between changes in KCL items and Certification among Japan’s young-old and old-old.Material and Methods: The KCL responses of 7,092 participants were assessed in April 2012 and March 2016, along with gender, age, and living environment. Deaths, Certifications, and relocations were tracked until March 2018. Changes in KCL items were categorized as bad, worse, improved, or good.Results: Between March 2016 and March 2018, about 7.3% of respondents obtained Certifications. KCL item changes increased the risk of new Certification for bad and worse groups, while improved cognitive function among the old-old possibly reduced the risk of new Certification.Conclusion: Therefore, rather than administering the KCL once, identifying KCL changes among people at risk could help prevent or delay their need for long-term care.

Frailty and Physical Fitness in Elderly People: A Systematic Review and Meta-analysis.

Frailty is an age-related condition that implies a vulnerability status affecting quality of life and independence of the elderly. Physical fitness is closely related to frailty, as some of its components are used for the detection of this condition. Thissystematic review and meta-analysiswas conducted to investigate the magnitude of the associations between frailty and different physical fitness components and to analyse if several health-related factors can act as mediators in the relationship between physical fitness and frailty. A systematic search was conducted of PubMed, SPORTDiscus, and Web of Science, covering the period from the respective start date of each database to March 2020, published in English, Spanish or Portuguese. Two investigators evaluated 1649 studies against the inclusion criteria (cohort and cross-sectional studies in humans aged ≥ 60years that measured physical fitness with validated tests and frailty according to the Fried Frailty Phenotype or the Rockwood Frailty Index). The quality assessment tool for observational cross-sectional studies was used to assess the quality of the studies. Twenty studies including 13,527 participantsmet the inclusion criteria. A significant relationship was found betweenfrailty and each physical fitness component. Usual walking speed was the physical fitness variable most strongly associated with frailty status, followed by aerobic capacity, maximum walking speed, lower body strength and grip strength. Potential mediators such as age, sex, body mass index or institutionalization status did not account for the heterogeneity between studies following a meta-regression. Taken together, these findings suggest a clear association between physical fitness components and frailty syndrome in elderly people, with usual walking speed being the most strongly associated fitness test. These results may help to design useful strategies, to attenuate or prevent frailty in elders. PROSPERO registration no. CRD42020149604 (date of registration: 03/12/2019).

RELATIONSHIP BETWEEN LEVEL OF SERUM ADIPONECTIN AND FRAILTY IN ELDERLY PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Elderly are especially prone to the adverse health effects of chronic obstructive pulmonary disease (COPD). COPD is a typical aging disease which is found to be about 12% in the age group more than 64 years old. Frailty is an important geriatics syndrome, while adiponectin is an important adipokine that regulate homeostasis of energy. Adiponectin is affected by age, especially in males. Adiponectin levels increases as subcutaneous fat cells in older men decreases. Increased adiponectin can lead to muscle wasting which will further reduce body weight and body mass index (BMI), which indirectly also increases the degree of frailty. Until now the relationship between adiponectin with frailty degree in advanced COPD is still unknown.The aims of this study was to investigate the relationship between plasma adiponectin level and frailty in COPD elders. This was an observational analytic cross-sectional study. All anthropometric parameters, including weight, height, and body mass index (BMI), were measured. Adiponectin was measured by ELISA methods obtained from venous blood samples. Aged more than or equal to 60 years old, the patients underwent spirometry to determine the degree of airflow limitation and the degree of frailty defined by the Fried criteria. Statistic analysis used Rank Spearman. Thirty-eight male COPD patients became the subject of the study. The average age was 70-74 years, with a total of 13 robust, 12 prefrails and 13 frail patients. Level of adiponectin (mean and SD) in robust, prefrail, and frail were 6.84+ 2.66 , 6.58 + 4.27, and 11.62 + 4.90 respectively, p=0.015. Further analysis showed that level of adiponectin rose progresively with an increasing number of components of frailty. The degree of obstruction mostly with mild (42.1%), and no subjects with very severe. There were an increase in serum adiponectin levels in all subjects. In conclusion, level of adiponectin serum correlates positively with the degree of frailty.

Association of Fruit and Vegetable Intake and Frailty among Chinese Elders: A Cross-Sectional Study in Three Cities.

To examine the association of FVI and frailty in Chinese elders. A sectional study was conducted in three cities (Shanghai, Zhengzhou, and Baoji) in China from June 2017 to June 2018. A total of 5699 participants from 49 districts were included in the current study by two-stage sampling methods. Frailty was measured by a validated Chinese version of the FRAIL scale. FVI per day was measured by two single questions. The sample proportion with sufficient fruit intake was 36.7%, and 44.7% reported sufficient vegetable intake. The sample proportions that were robust, pre-frail, and frail were 43.6%, 38.3%, and 18.1%, respectively. Compared with low FVI, after including covariates, the odds ratio (OR) of frailty was 0.84 (95% CI: 0.73-0.97) for moderate fruit intake and 0.81 (95% CI: 0.70-0.94) for enough fruit intake; the OR of frailty was 0.83 (95% CI: 0.68-0.91) for moderate vegetable intake and 0.77 (95% CI: 0.64-0.93) for enough vegetable intake. High FVI was negatively associated with the OR of frailty in Chinese elders. This finding implies it is important to promote FVI among adults to prevent frailty.

A physical activity intervention to treat the frailty syndrome in older persons-results from the LIFE-P study.

The frailty syndrome is as a well-established condition of risk for disability. Aim of the study is to explore whether a physical activity (PA) intervention can reduce prevalence and severity of frailty in a community-dwelling elders at risk of disability. Exploratory analyses from the Lifestyle Interventions and Independence for Elders pilot, a randomized controlled trial enrolling 424 community-dwelling persons (mean age=76.8 years) with sedentary lifestyle and at risk of mobility disability. Participants were randomized to a 12-month PA intervention versus a successful aging education group. The frailty phenotype (ie, ≥3 of the following defining criteria: involuntary weight loss, exhaustion, sedentary behavior, slow gait speed, poor handgrip strength) was measured at baseline, 6 months, and 12 months. Repeated measures generalized linear models were conducted. A significant (p = .01) difference in frailty prevalence was observed at 12 months in the PA intervention group (10.0%; 95% confidence interval = 6.5%, 15.1%), relative to the successful aging group (19.1%; 95% confidence interval = 13.9%,15.6%). Over follow-up, in comparison to successful aging participants, the mean number of frailty criteria in the PA group was notably reduced for younger subjects, blacks, participants with frailty, and those with multimorbidity. Among the frailty criteria, the sedentary behavior was the one most affected by the intervention. Regular PA may reduce frailty, especially in individuals at higher risk of disability. Future studies should be aimed at testing the possible benefits produced by multidomain interventions on frailty.

Plasma Adiponectin Levels Correlate Positively with an Increasing Number of Components of Frailty in Male Elders

ObjectiveFrailty is an important geriatric syndrome. Adiponectin is an important adipokine that regulates energy homeostasis. The aim of this study is to investigate the relationship between plasma adiponectin levels and frailty in elders.MethodsThe demographic data, body weight, metabolic and inflammatory parameters, including plasma glucose, total cholesterol, triglyceride, tumor necrosis factor alpha (TNF-α), c-reactive protein (CRP) and adiponectin levels, were assessed. The frailty score was assessed using the Fried Frailty Index (FFI).ResultsThe mean (SD) age of the 168 participants [83 (49.4%) men and 85 (50.6%) women] was 76.86 (6.10) years. Judged by the FFI score, 42 (25%) elders were robust, 92 (54.7%) were pre-frail, and 34 (20.3%) were frail. The mean body mass index was 25.19 (3.42) kg/m2. The log-transformed mean (SD) plasma adiponectin (µg/mL) level was 1.00 (0.26). The log-transformed mean plasma adiponectin (µg/mL) levels were 0.93 (0.23) in the robust elders, 1.00 (0.27) in the pre-frail elders, and 1.10 (0.22) in the frail elders, and the differences between these values were statistically significant (p = 0.012). Further analysis showed that plasma adiponectin levels rose progressively with an increasing number of components of frailty in all participants as a whole (p for trend = 0.024) and males (p for trend = 0.037), but not in females (p for trend = 0.223).ConclusionPlasma adiponectin levels correlate positively with an increasing number of components of frailty in male elders. The difference between the sexes suggests that certain sex-specific mechanisms may exist to affect the association between adiponectin levels and frailty.

SP1-52 Prevalence of frailty in elders living in long-stay institutions in Brazil: correlations among four instruments of evaluation

IntroductionThe term frailty characterises elders at higher risk for the occurrence of adverse health outcomes in situations of environmental stress. We still do not have an assessment instrument that could...