Distinguishing Comorbidity, Disability, and Frailty

Espinoza, Sara; Quiben, Myla; Hazuda, Helen P.

doi:10.1007/s13670-018-0254-0

Cited by 51 publications

(38 citation statements)

References 48 publications

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“…A limitation can also be that we have no knowledge of the participant's postural balance before stroke onset, which of course could have affected the results. Postural balance improvement post-stroke could be explained by the physical adaptations that might occur when individuals are back in the community performing ADL, but at the same time the risk of cormobidity burden and multimorbidity affects this group (54, 55), considering the average age in the study is 70 years. Often in chronic stroke, the impairments brought on by the initial injury can be compounded by secondary complications over time, compounders that together with the stroke impairments can affect postural balance negatively.…”

Section: Discussionmentioning

confidence: 99%

Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study

et al. 2019

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Background: Impaired postural balance is a common symptom after stroke and a common cause of falling. Most common daily tasks use arm and hand movements. Impairment in an upper extremity is a common stroke symptom, affecting 50–80% in the acute phase after stroke, and 40–50% in the sub-acute phase. The impact of leg function on postural balance has been investigated in several studies, but few have stressed the importance of arm function on postural balance. Objective: To explore whether there is any association between arm function and postural balance after stroke. Method: A cross sectional study where 121 adults (mean age: 70 ± 12.3 years, 72 men) from two different data sources, Gothenburg Very Early Supported Discharge (GOTVED), and a study by Carvalho et al. were merged. Time for assessments ranged from 1 to 13 years when the patients were in the chronic phase. The dependent variables were Berg Balance scale (BBS) and Time Up and Go (TUG) both dichotomized to “impaired postural balance” and “not impaired postural balance.” As independent variables, the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scale was used. The FMA-UE was presented with the total score. Results: The motor function in the arm affected after stroke onset correlated with postural balance both measured with the BBS (0.321, p < 0.001 ) and the TUG (−0.315, p = 0.001 ) . Having impaired motor function in the arm was significantly associated with impaired postural balance assessed with the BBS with OR = 0.879 (CI 0.826–0.934, p < 0.001). Regression analysis with the TUG showed the same result, OR = 0.868 (CI 0.813–0.927, p < 0.001) for FM-UE. Conclusion: The motor function of the affected arm was significantly associated with impaired postural balance post stroke, as assessed by BBS or TUG. It could be of clinical importance to be aware of the fact that not only lower extremity impairment, but also arm function can have an impact on postural balance in a late stage after stroke. Trial Registration: VGFOUGSB-669501.

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Section: Discussionmentioning

confidence: 99%

Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study

et al. 2019

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“…Although research indicates that advancing age increases risk for frailty, chronologic age is only loosely correlated with biological age and is not the most reliable indicator for frailty [4]. In addition, although older age, comorbidity, and disability may overlap in the frailty experience, particularly in more advanced stages, they are distinctly different [52,53]. Similarly, while advanced age brings a higher likelihood of multiple and interacting chronic diseases that may lead to frailty, it is notable that not all older people with comorbidity are frail, and younger persons may experience frailty [2,54,55].…”

Section: Older Chronological Age As Synonymous With Frailtymentioning

confidence: 99%

Definitions of Frailty in Qualitative Research: A Qualitative Systematic Review

Lekan

Collins

Hayajneh

2021

Journal of Aging Research

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The purpose of this qualitative systematic review was to examine how frailty was conceptually and operationally defined for participant inclusion in qualitative research focused on the lived experience of frailty in community-living frail older adults. Search of six electronic databases, 1994–2019, yielded 25 studies. Data collection involved extracting the definition of frailty from the study aim, background, literature review, methods, and sampling strategy in each research study. Quality appraisal indicated that 13 studies (52%) demonstrated potential researcher bias based on insufficient information about participant recruitment, sampling, and relationship between the researcher and participant. Content analysis and concept mapping were applied for data synthesis. Although frailty was generally defined as a multidimensional, biopsychosocial construct with loss of resilience and vulnerability to adverse outcomes, most studies defined the study population based on older age and physical impairments derived from subjective assessment by the researcher, a healthcare professional, or a family member. However, 13 studies (52%) used objective or performance-based quantitative measures to classify participant frailty. There was no consistency across studies in standardized measures or objective assessment of frailty. Synthesis of the findings yielded four themes: Time, Vulnerability, Loss, and Relationships. The predominance of older age and physical limitations as defining characteristics of frailty raises questions about whether participants were frail, since many older adults at advanced age and with physical limitations are not frail. Lack of clear criteria to classify frailty and reliance on subjective assessment introduces the risk for bias, threatens the validity and interpretation of findings, and hinders transferability of findings to other contexts. Clear frailty inclusion and exclusion criteria and a standardized approach in the reporting of how frailty is conceptually and operationally defined in study abstracts and the methodology used is necessary to facilitate dissemination and development of metasynthesis studies that aggregate qualitative research findings that can be used to inform future research and applications in clinical practice to improve healthcare.

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“…Muscle weakness is commonly associated with physical frailty syndrome, besides weight loss, exhaustion, low physical activity, and slow walking speed [ 4 ]. Frailty and multimorbidity are predictors and outcomes of each other’s, as well as predictors of disability and mortality [ 5 ]. Moreover, physical frailty predicts both the onset and course of a late-life depressed mood [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Association of Grip Strength with Depressive Symptoms among Middle-Aged and Older Adults with Different Chronic Diseases

Marconcin

Peralta

Ferrari

et al. 2020

IJERPH

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Low grip strength has been associated with an increase in depressive symptoms, independent of age group or gender, although the literature has not investigated this association among different chronic diseases. The present study aims to investigate the association of grip strength and depressive symptoms among middle-aged and older adults with different chronic diseases. A cross-section of data from the Survey of Health, Ageing, and Retirement in Europe wave 6 (collected in 2015) was analysed. Grip strength was measured by a handgrip dynamometer, and the European Depression Symptoms 12-item scale (EURO-D) was used to assess depressive symptoms. Multivariable logistic regression analysis was conducted. Those in the high strength tertile had 42% (95% confidence interval: 0.50, 0.71; p < 0.005) and 41% (95% confidence interval: 0.50, 0.70; p < 0.001) lower odds of depressive symptoms in the ‘no disease’ and in the ‘metabolic diseases’ groups of participants, respectively, compared with those in the lower strength tertile. No statistically significant relationship between grip strength and depression was observed in the ‘arthritis diseases’ group of participants. The association of grip strength with depressive symptoms must consider, besides gender and age group, the chronic conditions that an individual could have.

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Distinguishing Comorbidity, Disability, and Frailty

Cited by 51 publications

References 48 publications

Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study

Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study

Definitions of Frailty in Qualitative Research: A Qualitative Systematic Review

The Association of Grip Strength with Depressive Symptoms among Middle-Aged and Older Adults with Different Chronic Diseases

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