Prevalence Of Physical Frailty Research Articles

Association between CD4+T lymphocyte and body composition with physical frailty among elderly HIV-infected patients in Chongqing City

Objective: To identify the association between CD4+T lymphocyte (CD4) counts and physical frailty among HIV-infected people aged 65 years and older, and evaluate whether this association will be modified by the indicators of body composition. Methods: From May to October 2022, 485 elderly HIV-infected patients receiving antiretroviral therapy (ART) were recruited from 7 antiviral treatment sites in Jiangjin District Center for Disease Control and Prevention, Chongqing. The data of basic characteristics (age and gender), living habits (smoking and drinking) and disease history (metabolic diseases, cardiovascular and cerebrovascular diseases, respiratory disease and malignant tumors) were collected through the face-to-face investigation with self-made questionnaires. Fried Frailty Scale was used to evaluate the status of physical frailty. Physical fitness (walking speed, grip strength, height, and weight) and body composition (skeletal muscle mass, body fat mass, and basal metabolic rate) were measured. The antiretroviral treatment data were obtained from the China AIDS Integrated Prevention and Treatment Data information management system. The prevalence of physical frailty was calculated among the HIV-infected patients. The potential effects of CD4 counts on physical frailty were explored by using multivariate logistic regression. Subgroup analyses were repeated in the logistic regression with muscle mass, body fat mass, and other indicators of body composition as subgroup variables to determine whether the association might be modified by body composition. Results: The age of 485 patients were (72±5) years old, of which 48.2% (234 cases) were>70 years old and 70.9% (344 cases) were male, and all of whom had initiated the ART treatment. The prevalence of physical frailty among these patients was 7.4% (36/485). Multivariate logistic regression showed that after adjusting for age, sex, smoking, drinking, body composition index, ART duration, viral load and the number of comorbidities, increased CD4 cell level was associated with decreased prevalent risk of physical frailty among elderly HIV-infected patients. For every increase of 5.0×107 CD4 cells/L, the prevalent risk of physical frailty decreased by 12% [OR (95%CI): 0.88 (0.76-1.01)]. Compared with the low CD4 cell level group, the risk of physical frailty in those with normal CD4 cell level decreased by 69% [OR (95%CI): 0.31 (0.10-0.92)]. Subgroup analysis of body composition indicators showed that the protective effect of normal CD4 cell level on physical frailty was more pronounced in the high skeletal muscle mass and high basal metabolic rate group (Pinteraction<0.05). Conclusion: The prevalence of physical frailty among elderly HIV-infected patients is relatively lower in Chongqing, and the CD4 cell level, skeletal muscle mass and basal metabolic rate are related to physical frailty.

Prevalence of physical frailty and impact on survival in patients with chronic kidney disease: a systematic review and meta-analysis

BackgroundFrailty is common in chronic kidney disease (CKD) patients and becomes more prevalent as kidney disease progresses. This study aimed to investigate the prevalence of physical frailty and quantify the relationship between frailty and mortality risk in patients with CKD.MethodsPubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, Clinicaltrial.gov, and major renal academic conferences were systematically searched, and additional references to relevant articles were manually searched. The prevalence of physical frailty and the risk of mortality based on random-effects models were assessed using percentages and hazard ratio (HR) with a 95% confidence interval (CI).ResultsA total of 139 articles, including 1,675,482 participants, met the eligibility criteria for the meta-analysis. The results showed that 34.5% (95% CI 31.0 to 38.1%) of CKD patients showed signs of frailty, and 39.4% (95% CI 35.4 to 43.5%) had prefrail symptoms. Compared to non-frail patients, the risk of mortality was increased by 94.1% (95% CI 1.586 to 2.375) in frail patients and 34.5% (95% CI 1.231 to 1.469) in prefrail patients.ConclusionThe high prevalence of frailty and prefrail in adults with CKD and resulting in premature death emphasize the importance of measuring frailty, which provides important prognostic information and may provide opportunities for interventions to improve the prognosis of patients with CKD.

Prevalence of physical frailty, including risk factors, up to 1 year after hospitalisation for COVID-19 in the UK: a multicentre, longitudinal cohort study.

The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group-robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)-at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained pre-frail or frail. This suggests comprehensive assessment and interventions targeting pre-frailty and frailty beyond the initial illness are required. UK Research and Innovation and National Institute for Health Research.

Wealth disparity and frailty among community-dwelling older adults in India

BackgroundDue to the vast socioeconomic diversity among its residents, studying health inequality in India is of particular interest. This study aimed to investigate the wealth-based inequalities in physical frailty and to quantify the contributions of potential predictors of frailty to this inequality.MethodsData were drawn from the first wave of the Longitudinal Ageing Study in India (LASI) conducted during 2017–18. Logistic regression analysis was used to examine the association between wealth status and frailty. We used the concentration index to measure the magnitude of wealth-related inequality in frailty. A decomposition analysis based on the logit model was used to assess the contribution of each predictor to the total inequality.ResultsThe prevalence of physical frailty was significantly higher among the older adults in the poor group than in the non-poor group [Difference (poor vs. non-poor): 6.4%; p < 0.001]. Regression results indicated that older adults in the poorest group were 23% more likely to be physically frail than those in the richest category [Adjusted odds ratio (AOR) = 1.23; 95% confidence interval (CI): 1.11, 1.38]. The overall concentration index of frailty was 0.058 among the older adults, indicating that frailty is more concentrated among older adults with poor wealth status. Body mass index, wealth index, educational status, and region were the major and significant contributors to the socioeconomic status (SES) related inequalities in frailty.ConclusionsResults suggest the need for formulating effective prevention and intervention strategies to decelerate the development of physical frailty among older adults in India, especially those with poor socioeconomic background.

Early life factors associated with old age physical frailty: evidence from India

BackgroundPhysical frailty is one of the most important phenotypes used to understand the vulnerable nature of older adults. The paper examined the association of childhood factors, including birth order, childhood socioeconomic status, and other exposures with old age physical frailty. The study further explored the gender dimensions of physical frailty prevalence. MethodsData from the Longitudinal Ageing Study in India (LASI, 2017-18), wave-1 were used. The sample size for the study was 24,513 older adults aged 60 years and above (12,510 females and 12,003 males). Physical frailty was assessed using the measurement approach proposed by Fried and colleagues. ResultsThe results indicated significant gender difference in the prevalence of physical frailty with 39.03% of older women and 32.49% of men being frail. Older adults with lower levels of mothers’ (adjusted odds ratio (aOR): 1.26; 95% confidence interval (CI):1.01–1.58) or fathers’ education (aOR: 1.33; 95% CI:1.18–1.50) or poor childhood health status (aOR: 1.48; 95% CI:1.27–1.71) had higher odds of physical frailty. Compared to older women with a well-off childhood financial condition, women with average childhood financial status had 38% (aOR: 1.38, 95% CI:1.01-1.89) higher odds of reporting physical frailty. In contrast, older men with poor childhood financial status had lower odds (aOR: 0.73; 95% CI:0.56-0.96) of physical frailty than older men with well-off childhood financial status. ConclusionEarly life disadvantages in health, financial condition and lack of parental education had significant positive associations with old age physical frailty. The findings suggest the importance of childhood factors in policy and practice in terms of addressing old age physical frailty.

Socioeconomic vulnerability and frailty among community-dwelling older adults: cross-sectional findings from longitudinal aging study in India, 2017\u201318

IntroductionThe Indian population is rapidly aging with huge proportion of illiterate and socioeconomically disadvantaged people and there is a dearth of research on the relationships between factors of socioeconomic vulnerability and frailty in older people. The present study examined the cross-sectional associations between socioeconomic vulnerability and physical frailty in community-dwelling older individuals in India.Materials and methodsThe data for the study were obtained from the Longitudinal Aging Study in India (LASI), which was conducted in 2017–18. The effective sample size was 14,652 older males and 15,899 older females aged 60 and over. The outcome variable was physical frailty phenotype measured from exhaustion, unintentional weight loss, weak grip strength, low physical activity, and slow walking time. The main explanatory variable was vulnerability status based on education, wealth and caste. The study carried out bivariate analysis to observe the association between vulnerability status and physical frailty. Further, multivariable binary logistic regression analysis was conducted to fulfil the objective of the study.ResultsA proportion of 10.5 and 14.4% of older males and females respectively were in the overall vulnerable category. The prevalence of physical frailty was high among older males from vulnerable population (31.4% vs 26.9%; p < 0.001). The adjusted estimates from multivariate analysis revealed that older adults from vulnerable category had 14% significantly higher odds of being frail in comparison to non-vulnerable category [AOR: 1.14; CI: 1.06,1.24]. The adjusted model further revealed that there were no significant gender differentials in physical frailty among older adults. Model-3 (adjusted model) revealed that older males and females from vulnerable population had 18% [AOR: 1.18; CI: 1.04,1.34] and 8% [AOR: 1.08; CI: 1.01,1.21] significantly higher odds of being physically frail in comparison to older males from non-vulnerable population respectively.ConclusionsAdverse socioeconomic circumstances such as low education, lower wealth and caste status that are associated with increased prevalence of physical frailty raise urgent questions both for public health practitioners and clinicians. The current findings may help to adapt public policies focusing on screening physical frailty in the clinical settings, especially among vulnerable populations as a marker of a possibly reversible vulnerability to adverse outcomes in old age.

Frailty in a Frailty Prevention Program Participants During COVID-19 pandemic: A Cross-Sectional Japanese Study

Physical frailty (PF) has various clinical presentations and often co-occurs with cognitive impairment in older adults. In older adults in nursing homes (NHs), no research has examined the heterogeneous profile of PF and its association with cognitive impairment. Minimum Data Set 3.0 was used to identify older, long-stay, newly-admitted NH residents (2014-16; n=871,801). Latent class analysis was used to identify PF subgroups with FRAIL-NH items as indicators. Logistic regression was used to estimate the association between PF subgroups and cognitive impairment. The final model indicated three PF subgroups (prevalence): “mild PF” (7.6%), “moderate PF” (44.5%), and “severe PF” (47.9%). In all subgroups, residents had high probability of needing help with dressing. Older adults likely to belong to the “moderate PF” or the “severe PF” subgroups had high probabilities of requiring physical assistance to transfer between locations and inability to walk in a room. Additionally, residents likely to be in the “severe PF” subgroup had greater probability of bowel incontinence. Greater cognitive impairment was associated with increasingly higher odds to be in the “moderate PF” and “severe PF” subgroups: older residents with severe cognitive impairment were 20% more likely [adjusted odds ratio (aOR): 1.20, 95% confidence interval (CI): 1.17-1.23] and almost 7 times as likely (aOR: 6.86, 95%CI: 6.66-7.06) to belong to the “moderate PF” and “severe PF” subgroups, respectively. Findings provide new evidence for the interrelationship between PF and cognitive impairment in older NH residents and have implications for the development of interventions tailored to older residents’ specific PF experience.

Frailty in a Frailty Prevention Program Participants During COVID-19 pandemic: A Cross-Sectional Japanese Study

Background: Cognitive frailty is a newly proposed clinical entity, referring to concurrent cognitive impairment and physical frailty in the absence of dementia. The clinical significance of cognitive frailty remains poorly understood. We aimed to investigate the association between cognitive frailty and functional disability in older adults. Methods: A total of 1,644 non-demented older adults aged ≥65 years (mean age: 73 ± 6 years; men: 41.8%) and without functional disability at baseline were followed-up for 4 years. Cognitive frailty was defined as the presence of both physical frailty (based on the modified Cardiovascular Health Study criteria) and cognitive impairment (Mini-Mental State Examination score of <24 points). Functional disability was identified using the database of Japan’s Long-term Care Insurance System. Association between cognitive frailty and functional disability was assessed by using the Cox proportional hazard models. Results: During the follow-up, 152 participants were identified as being functionally disabled. There was a significant interaction between physical frailty and cognitive impairment on the development of functional disability (P <0.1). Compared with being robust both physically and cognitively, the hazard ratio (95% confidence interval) of functional disability was 8.40 (4.05-17.42) for cognitively frailty, after adjustment for age, sex, education, living alone, smoking, drinking, number of comorbidities (hypertension, stroke, chronic heart disease, diabetes, chronic kidney disease, poor hearing, poor vision, osteoarthritis or rheumatism, minor trauma fracture, or cancer). Conclusion: Cognitive frailty was associated with an increased risk of functional disability in community-dwelling older adults. Cognitive frailty could be an underrecognized risk factor for functional disability.

Common and different characteristics among combinations of physical frailty and sarcopenia in community-dwelling older adults: The Korean Frailty and Aging Cohort Study.

Physical frailty and sarcopenia are geriatric syndromes associated with adverse health outcomes. However, the common and different conditions associated with physical frailty and sarcopenia remain unclear. This study aimed to compare the clinical characteristics of older adults with physical frailty and sarcopenia. This cross-sectional study analyzed 2028 community-dwelling older adults, aged 70-84 years (mean age 75.9 ± 4.0 years; 50.1% men). Physical frailty was defined using the Fried frailty phenotype, whereas sarcopenia was defined using the Asian Working Group for Sarcopenia 2014 and 2019 criteria. The prevalence of physical frailty was 5.5%, whereas that of sarcopenia, using the Asian Working Group for Sarcopenia 2014 and 2019, was 9.1% and 17.5%, respectively. The concordance of physical frailty with sarcopenia was higher in the Asian Working Group for Sarcopenia 2019 criteria than in 2014. Frail-only participants had a higher incidence of disability, cognitive dysfunction, poor self-perceived health, and depressive symptoms than the sarcopenic-only participants. Frail-and-sarcopenic participants showed a lower body mass index (≥23 kg/m2 ) than frail-only participants. Furthermore, in frail-and-sarcopenic participants, recurrent falls (16.9% vs 5.5%) were higher than in the neither-frail-nor-sarcopenic participants; falls with fracture (11.5% vs 1.7%) and fear of falling (59.0% vs 36.7%) were higher in frail-and-sarcopenic participants than in sarcopenic-only participants. This study showed significant differences between physical frailty and sarcopenia among community-dwelling older adults. Older adults with physical frailty and sarcopenia were more likely to have higher fall-related outcomes than the others. Geriatr Gerontol Int 2022; 22: 42-49.

Frailty Measures in Patients Listed for Lung Transplantation.

The study aimed to determine whether the addition of cognitive impairment, depression, or both, to the assessment of physical frailty (PF) is associated with the risk of lung transplant (LTX) waitlist mortality. Since March 2013, all patients referred for LTX evaluation underwent PF assessment. Cognition was assessed using the Montreal Cognitive Assessment and depression assessed using the Depression in Medical Illness questionnaire. We assessed the association of 4 composite frailty measures: PF ≥3 of 5 = frail, cognitive frailty (CogF ≥3 of 6 = frail), depressive frailty (DepF ≥3 of 6 = frail), and combined frailty (ComF ≥3 of 7 = frail) with waitlist mortality. The prevalence of PF was 78 (22%), CogF 100 (28%), DepF 105 (29%), and ComF 124 (34%). Waitlist survival in the non-PF group was 94% ± 2% versus 71% ± 7% in the PF group (P < 0.001). Cox proportional hazards regression analysis demonstrated that PF (adjusted hazard ratio [HR], 4.88; 95% confidence interval [CI], 2.06-11.56), mild cognitive impairment (adjusted HR, 3.03; 95% CI, 1.05-8.78), and hypoalbuminemia (adjusted HR, 0.89; 95% CI, 0.82-0.97) were independent predictors of waitlist mortality. There was no significant difference in the area under the curve of the 4 frailty measures. The addition of cognitive function and depression variables to the PF assessment increased the number of patients classified as frail. However, the addition of these variables does not strengthen the association with LTX waitlist mortality compared with the PF measure.

Physical Frailty in COPD Patients with Chronic Respiratory Failure.

BackgroundThe prevalence of physical frailty and its clinical characteristics in advanced chronic obstructive pulmonary disease (COPD) is unknown, as well as the usefulness of functional capacity tests to screen for physical frailty. The aim of the study was to evaluate the proportion and clinical portrait of COPD patients with chronic respiratory failure exhibiting physical frailty at the time of referral to home-based pulmonary rehabilitation. We also evaluate the usefulness of the short physical performance battery (SPPB) and timed-up and go (TUG) as potential screening tools for physical frailty. Finally, we evaluated the specific contribution of gait speed to the frailty Fried total score.MethodsThis was a prospective observational study in which physical frailty was defined using Fried criteria (body mass loss, exhaustion, low physical activity, slower walking and weakness). Clinical portrait was documented from daily physical activity, exercise tolerance, functional capacity, anxiety and depressive symptoms, health-related quality of life, and fatigue scores. The ability of the SPPB and TUG to predict physical frailty was investigated using receiver operating characteristic curves. Contribution of each Fried criteria was evaluated with a principal component analysis (PCA).ResultsAmongst the 44 included participants (FEV1, 33 ± 13% of predicted), 19 were physically frail. Frail individuals had lower daily steps number, exercise tolerance and functional capacity, and higher fatigue, anxiety, and depressive symptom scores (p<0.05) compared to non-frail individuals. SPPB and TUG did not have an acceptable detection accuracy for screening physical frailty. PCA indicated that gait speed was the main contributor to the Fried total score of physical frailty.ConclusionPhysical frailty affects a large proportion of COPD patients with chronic respiratory failure starting a home-based intervention and was associated with worse clinical status. Although the present results need to be confirmed by adequately powered studies, gait speed seems to have the potential to become a simple screening tool for physical frailty in this population.

Physical Frailty and Cognitive Impairment in Older Adults in United States Nursing Homes

Introduction: In older US nursing home (NH) residents, there is limited research on the prevalence of physical frailty, its potential dynamic changes, and its association with cognitive impairment in older adults’ first 6 months of NH stay. Methods: Minimum Data Set (MDS) 3.0 is the national database on residents in US Medicare-/Medicaid-certified NHs. MDS 3.0 was used to identify older adults aged ≥65 years, newly admitted to NHs during January 1, 2014, and June 30, 2016, with life expectancy ≥6 months at admission and NH length of stay ≥6 months (N = 571,139). MDS 3.0 assessments at admission, 3 months, and 6 months were used. In each assessment, physical frailty was measured by FRAIL-NH (robust, prefrail, and frail) and cognitive impairment by Brief Interview for Mental Status and Cognitive Performance Scale (none/mild, moderate, and severe). Demographic characteristics and diagnosed conditions were measured at admission, while presence of pain and receipt of psychotropic medications were at each assessment. Distribution of physical frailty and its change over time by cognitive impairment were described. A nonproportional odds model was fitted with a generalized estimation equation to longitudinally examine the association between physical frailty and cognitive impairment, adjusting for demographic and clinical characteristics. Results: Around 60% of older residents were physically frail in the first 6 months. Improvement and worsening across physical frailty levels were observed. Particularly, in those who were prefrail at admission, 23% improved to robust by 3 months. At admission, 3 months, and 6 months, over 37% of older residents had severe cognitive impairment and about 70% of those with cognitive impairment were physically frail. At admission, older residents with moderate cognitive impairment were 35% more likely (adjusted odds ratio [aOR]: 1.35, 95% confidence interval [CI]: 1.33–1.37) and those with severe impairment were 74% more likely (aOR: 1.74, 95% CI: 1.72–1.77) to be frail than prefrail/robust, compared to those with none/mild impairment. The association between the 2 conditions remained positive and consistently increased over time. Discussion/Conclusion: Physical frailty was prevalent in NHs with potential to improve and was strongly associated with cognitive impairment. Physical frailty could be a modifiable target, and interventions may include efforts to address cognitive impairment.

The Association between Dietary Variety and Physical Frailty in Community-Dwelling Older Adults.

The aim of this cross-sectional study was to examine the association between diet variety and physical frailty in community-dwelling older adults. Data of 577 older adults (mean age: 74.0 ± 6.3 years, women: 62.5%) were analyzed. Diet variety was assessed using the Food Frequency Score (FFS) (maximum, 30 points). The FFS assessed the one-week consumption frequency of ten foods (meat, fish/shellfish, eggs, milk & dairy products, soybean products, green & yellow vegetables, potatoes, fruits, seafood, and fats & oil). Physical frailty was assessed using Fried’s component (slowness, weakness, exhaustion, low physical activity, and weight loss). The participants were classified into frail, pre-frail, and non-frail groups. The prevalence of physical frailty was 6.6%. This study found significant associations between physical frailty and low FFS after adjusting for covariates (odds ratio (OR) 0.90, 95% confidence interval (CI) 0.84–0.97, p < 0.01). The optimal cutoff point of the FFS for physical frailty was ≤16 points. FFS lower than the cutoff point were significantly associated with physical frailty after adjusting for covariates (OR 3.46, 95% CI 1.60–7.50, p < 0.01). Diet variety assessed using the FFS cutoff value of ≤16 points was related to the physical frailty status in community-dwelling older adults.

Prevalence of Physical Frailty: Results from the DO-HEALTH Study

BackgroundFrailty is a geriatric syndrome associated with multiple negative health outcomes. However, its prevalence varies by population and instrument used. We investigated frailty and pre-frailty prevalence by 5 instruments in community-dwelling older adults enrolled to a randomized-controlled trial in 5 European countries.MethodsCross-sectional baseline analysis in 2,144 DO-HEALTH participants recruited from Switzerland, Austria, France, Germany, and Portugal with complete data for frailty. Frailty status was assessed by the Physical Frailty Phenotype [PFP], SOF-Frailty Index [SOF-FI], FRAIL-Scale, SHARE-Frailty Instrument [SHARE-FI], and a modified SHARE-FI, and compared by country, age, and gender. Logistic regression was used to determine relevant factors associated with frailty and pre-frailty.ResultsMean age was 74.9 (±4.4) years, 61.6% were women. Based on the PFP, overall frailty and pre-frailty prevalence was 3.0% and 43.0%. By country, frailty prevalence was highest in Portugal (13.7%) and lowest in Austria (0%), and pre-frailty prevalence was highest in Portugal (57.3%) and lowest in Germany (37.1%). By instrument and overall, frailty and pre-frailty prevalence was highest based on SHARE-FI (7.0% / 43.7%) and lowest based on SOF-FI (1.0% / 25.9%). Frailty associated factors were residing in Coimbra (Portugal) [OR 12.0, CI 5.30–27.21], age above 75 years [OR 2.0, CI 1.17–3.45], and female gender [OR 2.8, CI 1.48–5.44]. The same three factors predicted pre-frailty.ConclusionsAmong relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.

Prevalence of cognitive frailty and associations with other frailty domains in a Spanish community‐dwelling sample

AbstractBackgroundThe concept of cognitive frailty has been defined as the simultaneous presence of frailty and mild cognitive impairment in absence of dementia, although recent approaches has considered cognitive frailty as a distinct construct and has taken into account different domains of physical frailty (De Roeck et al., 2020). The aim of the present study is to analyze the prevalence of cognitive frailty in groups with different degrees of cognitive impairment.MethodA total of 285 community‐dwelling middle‐age and older adults, aged &gt;50 years, from Galicia and Valencia (northwest and southeast of Spain respectively) participated. Cognitive function was assessed using MoCA test, and cognitive complaints with the Spanish version of the Everyday Memory Questionnaire. Participants were classified as objective cognitively impaired, cognitively unimpaired, and cognitively unimpaired with subjective cognitive complaints. Physical frailty criteria included: a) unintentional weight loss or lack of appetite in the last three months; b) self‐reported exhaustion, measured with the General Health Questionnaire‐12 question about affective state; c) weakness, measured with a dynamometer to determine handgrip strength; d) slow walking speed, measured through a timed‐up and go task; and e) low physical activity, measured with the reduced Spanish version of the Minnesota Leisure Time Physical Activity Questionnaire (VREM). Participants were classified as robust if they met none of the criteria, pre‐frail if they met 1 or 2 criteria, and frail if they met 3 or more criteria, corrected by gender and age.ResultsThe prevalence of frailty was 2.5% in the cognitively unimpaired group, 12.2% in the group with cognitive complaints, and 9.6% in the group with objective cognitive impairment (chi‐square=18.37;p&lt;0.01) (Table 1). The co‐occurrence with physical frailty is more frequent with slow walking speed and, in the group with complaints, with self‐reported exhaustion.ConclusionThe prevalence of physical frailty was higher in both cognitive complaints and cognitive impairment groups, compared with the cognitively unimpaired group. The subjective cognitive complaints can play a relevant role in characterizing the relation between physical and cognitive impairments.

Prevalence of Physical Frailty and Its Multidimensional Risk Factors in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study.

Frailty is defined as a state of increased vulnerability to stressors, and it predicts disability and mortality in the older population. This study aimed to investigate the standardized prevalence and multidimensional risk factors associated with frailty among Korean community-dwelling older adults. We analyzed the baseline data of 2907 adults aged 70–84 years (mean age 75.8 ± 3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and prefrailty was 7.9% (95% confidence interval (CI) 6.8–8.9%) and 47.0% (95% CI, 45.1–48.8%), respectively. The following 14 risk factors were significantly associated with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive symptoms, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer Timed Up and Go, and low Short Physical Performance Battery score (p < 0.05). Physiconutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

Mid and Later Life Reproductive Factors Are Not Associated with Physical Frailty Among Women with Heart Failure

Background In heart failure (HF), the prevalence of physical frailty is high, and women are more likely to be frail than men; however, the reasons for gender differences in physical frailty in HF are unknown. Frailty has been associated with younger age at menopause and a history of hysterectomy, possibly reflecting accelerated aging. The relationship between physical frailty and later life reproductive factors might elucidate mechanisms of physical frailty among women with HF. Hypothesis : We hypothesized that, among women with HF, physical frailty will be associated with history of hysterectomy, post-menopause, and reproductive cancer. Methods : This was an analysis of data collected from a study of gender differences in physical frailty in HF. We examined reproductive factors of hysterectomy, post-menopause, and reproductive cancer history among women in the sample. Physical frailty was measured using the Frailty Phenotype Criteria: unintentional weight loss, weakness, slowness, physical exhaustion, and low physical activity. Comparative statistics were used to compare reproductive factors with physical frailty. Logistic regression was used to quantify associations between reproductive factors and physical frailty, accounting for age, etiology, HF type (reduced or preserved ejection fraction), and Charlson Comorbidity Index. Results The average age of women in our sample (n = 56) was 65.0±16.3 years and 83.9% had non-ischemic etiology of HF. The majority (82%) were in menopause transition or post-menopause. Physical frailty was identified in 58.9% of women. There was no significant association between physical frailty and history of a hysterectomy (χ2 = 1.52, p = 0.22), post-menopause (χ2 = 0.87, p = 0.65), or reproductive cancer (χ2 = 0.19, p = 0.67). In separate multivariate logistic regression models, history of hysterectomy (OR 1.75, 95% CI [0.48, 6.34]), post-menopause (OR 0.38, 95% CI [0.03, 5.07]), or reproductive cancer (OR 0.35, 95% CI [0.04, 2.95]) were not significantly associated with physical frailty in women. Conclusions Mid and later life reproductive factors, as well as age, do not appear to be significantly associated with physical frailty among women with HF, indicating that physical frailty affects women across the lifespan. However, future studies should explore a comprehensive reproductive history, including age of menarche, pregnancy, breastfeeding, and other reproductive life events, as variables that may impact physical frailty among women with HF.

Physical frailty and its associated factors among elderly nursing home residents in China

BackgroundEvidence is scarce on the trend in prevalence of physical frailty in China; the primary purpose of this study was to identify the prevalence and correlates of physical frailty among older nursing home residents in China.MethodsCross-sectional study in 20 nursing homes in Changsha, China. Physical frailty was defined based on the frailty phenotype including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Participants with at least three affected criteria were defined as being frail. Participants with one or two affected criteria were considered as pre-frail, and those with no affected criteria were considered as robust. A total of 1004 nursing home residents aged 60 and over were included in this study. A multinomial logistic regression model was used to analyze the associations of physical frailty with its potential risk factors, including age, sex, education levels, marital status, type of institution, living status, current drinking, current smoking, regular exercise, and self-reported health.ResultsThe overall prevalence of physical frailty and prefrailty was 55.6, and 38.5%, respectively. The rate of physical frailty substantially increased with age, and was higher in women than in men (69.5% vs. 30.5%). The multinomial logistic regression analysis showed that older age, being women, living in a private institution, living alone or with unknown person, having no regular exercise (≤ 2 times/week), and poor self-reported health were significantly associated with increased odds of being physically frail.ConclusionWe demonstrated physical frailty is highly prevalent among older residents in nursing homes in China, especially in women. The potential role of those associated factors of physical frailty warrant further investigations to explore their clinical application among elderly nursing home residents.

Multidimensional and Physical Frailty in Elderly People: Participation in Senior Organizations Does Not Prevent Social Frailty and Most Prevalent Psychological Deficits.

Purpose: The study explores how the involvement in community-based senior organizations affects the prevalence of multidimensional and physical frailty among community dwelling elderly people.Materials and Methods: The group of 1,024 elderly people (270 males) over the age of 65 years (mean age 72.6 ± 6.3 years; range 65–93 years) took part in this study. The subjects completed a questionnaire regarding multidimensional (i.e., the Tilburg Frailty Indicator, TFI) and physical frailty (i.e., the FRAIL scale), as well as factors associated with frailty and participation in senior organizations.Results: The prevalence of multidimensional frailty (if at least 5 points in the TFI) was 54.6%, and the prevalence of physical frailty (if at least 3 points in the FRAIL scale) and a non-robust status (if any point in the FRAIL scale was positive) was 6.3 and 52.9%, respectively. The most prevalent frailty deficits were missing other people (66.6%), feeling nervous or anxious (65.9%), and feeling down (65.5%). Members of senior organizations presented a lower prevalence of multidimensional and physical frailty comparing with non-members. This was mainly caused by a lower prevalence of physical deficits and problems with memory; however, the prevalence of social deficits was similar in both groups. Senior organizations had no influence on the most widespread frailty deficits, i.e., missing other people, feeling nervous or anxious, and feeling down.Conclusions: Multidimensional frailty and physical non-robust status are common among people over the age of 65 years. Participation in senior organizations is associated with lower risk of physical frailty; however, it has no effect on social frailty and the most prevalent psychological deficits. This information has important implications for practical management with senior problems and may influence community strategies concerning elderly people.

Prevalence of Psychological Frailty in Japan: NCGG-SGS as a Japanese National Cohort Study.

There has been less research conducted on the psychological aspects of frailty than on the physical and cognitive characteristics of frailty. Thus, we aimed to define psychological frailty, clarify its prevalence, and investigate the relationship between psychological frailty and lifestyle activity or disability incidence in older adults in Japan. The participants in our study were 4126 older adults (average age 71.7 years) enrolled in the National Center for Geriatrics and Gerontology-i87uStudy of Geriatric Syndromes (NCGG-SGS). We characterized physical frailty of the following as ≥ 3: slow walking speed, muscle weakness, exhaustion, low physical activity, and weight loss. We used the Geriatric Depression Scale 15 items version (GDS-15) to screen for depressive mood, indicated by 5 points or more on the scale. The co-presence of physical frailty and depressive mood was defined as psychological frailty. The incidence of disability was determined using data from the Japanese long-term care insurance system over 49 months. We found that the prevalence of physical frailty, depressive mood, and psychological frailty were 6.9%, 20.3%, and 3.5%, respectively. Logistic regression indicated that the odds ratios for loss of lifestyle activities were significantly higher in participants with psychological frailty for going outdoors using the bus or train, driving a car, using maps to go to unfamiliar places, reading books or newspapers, cognitive stimulation, culture lessons, giving advice, attending community meetings, engaging in hobbies or sports, house cleaning, fieldwork or gardening, and taking care of grandchildren or pets. During the follow-up period, 385 participants (9.3%) developed a disability. The incidence of disability was associated with both physical and psychological frailty in the fully adjusted model. However, no significant association between disability and depressive mood was found. We conclude that individuals with psychological frailty had the highest risk of disability. Future policies should implement disability prevention strategies among older adults with psychological frailty.