Frailty and Determinants of Health Among Older Adults in the United States 2011–2016

Kurnat-Thoma, Emma L.; Murray, Meghan; Juneau, Paul

doi:10.1177/08982643211040706

Cited by 15 publications

(14 citation statements)

References 43 publications

(92 reference statements)

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“…64,65 In this study, we used frailty characteristics derived from the physical domain, since preoperative mental and social assessments were not yet standardized in clinical practice during the study period. 23,[44][45][46][47][48][49] Evaluation of outcomes with regard to a complete preoperative frailty assessment could be the focus for future research.…”

Section: Discussionmentioning

confidence: 99%

“…42 Resection margins were considered positive if tumor cells were present within 1 mm of the resection margins, apart from the anterior surface. 43 Frailty characteristics consisted of polypharmacy (use of five or more medicaments at the time of diagnosis), 44 preoperative anemia (female hemoglobin \7.4 mmol/L, male hemoglobin \8.1 mmol/L), 45 decreased renal function, 46,47 CCI C2 44 , body mass index (BMI) \18.5 or C31, 23 and American Society of Anesthesiologists (ASA) score C3. 44,48,49 A decreased renal function was, in terms of the preoperative estimated glomerular filtration rate (eGFR), defined as mild (60-89 mL/min/1.73 m 2 ), mild to moderate (45-59 mL/min/1.73 m 2 ), moderate to severe 30-44 mL/min/1.73 m 2 , or severe 15-29 mL/min/1.73 m 2 .…”

Section: Data Collectionmentioning

confidence: 99%

“…was 38 months (interquartile range [IQR] [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. Major complications (31% vs. 28%; p = 0.43) and 90-day mortality (8% vs. 5%; p = 0.18) did not differ.…”

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confidence: 99%

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Short- and Long-Term Outcomes of Pancreatic Cancer Resection in Elderly Patients: A Nationwide Analysis

et al. 2022

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Background The number of elderly patients with pancreatic cancer is growing, however clinical data on the short-term outcomes, rate of adjuvant chemotherapy, and survival in these patients are limited and we therefore performed a nationwide analysis. Methods Data from the prospective Dutch Pancreatic Cancer Audit were analyzed, including all patients undergoing pancreatic cancer resection between January 2014 and December 2016. Patients were classified into two age groups: <75 and ≥75 years. Major complications (Clavien–Dindo grade 3 or higher), 90-day mortality, rates of adjuvant chemotherapy, and survival were compared between age groups. Factors associated with start of adjuvant chemotherapy and survival were evaluated with logistic regression and multivariable Cox regression analysis. Results Of 836 patients, 198 were aged ≥75 years (24%) and 638 were aged <75 years (76%). Median follow-up was 38 months (interquartile range [IQR] 31–47). Major complications (31% vs. 28%; p = 0.43) and 90-day mortality (8% vs. 5%; p = 0.18) did not differ. Adjuvant chemotherapy was started in 37% of patients aged ≥75 years versus 69% of patients aged <75 years (p < 0.001). Median overall survival (OS) was 15 months (95% confidence interval [CI] 14–18) versus 21 months (95% CI 19–24; p < 0.001). Age ≥75 years was not independently associated with OS (hazard ratio 0.96, 95% CI 0.79–1.17; p = 0.71), but was associated with a lower rate of adjuvant chemotherapy (odds ratio 0.27, 95% CI 0.18–0.40; p < 0.001). Conclusions The rate of major complications and 90-day mortality after pancreatic resection did not differ between elderly and younger patients; however, elderly patients were less often treated with adjuvant chemotherapy and their OS was shorter.

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Section: Discussionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

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Short- and Long-Term Outcomes of Pancreatic Cancer Resection in Elderly Patients: A Nationwide Analysis

et al. 2022

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“…Frailty was assessed through both the PF and deficit accumulation approaches (FI). For PF classification, a modified Fried frailty model was employed, as previously described for NHANES data [ 25 ]. Briefly, PF was defined based on the following five measurements: weakness, low physical activity, exhaustion, slow walking speed, and unintentional weight loss.…”

Section: Methodsmentioning

confidence: 99%

Association of Frailty Status and Dietary Patterns in a Nationally Representative Sample of United States Adults with Olfactory Dysfunction

et al. 2022

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Background: Olfactory dysfunction (OD) is a strong, independent predictor of frailty and mortality risk. This study evaluated the association of dietary patterns and frailty status in older adults with OD. Methods: This cross-sectional study utilized the 2013–2014 National Health and Nutrition Examination Survey. Dietary patterns (DPs) characteristic of OD were derived using exploratory factor analysis (EFA). Multiple logistic regressions adjusted for demographics and frailty risk factors assessed the association of DPs with two frailty metrics: the frailty index (FI) and physical frailty (PF). Results: EFA yielded six distinct DPs in persons with OD. The protein/selenium (OR 0.82 [95% CI 0.74–0.92], p = 0.041) and β-carotene/vitamin A DPs (OR 0.76 [95% CI 0.66–0.88], p = 0.028) were independently associated with frailty by FI. Only the protein/selenium DP (OR 0.82 [95% CI 0.74–0.92], p = 0.036) was associated with frailty by PF. No DPs were associated with either frailty measure in normosmic persons. Conclusions: Dietary patterns high in protein/selenium and β-carotene/vitamin A are associated with lower frailty prevalence in adults with OD. While the relationship between OD and frailty is likely multifaceted, these findings suggest that dietary patterns are uniquely associated with frailty in older adults with OD.

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“…Older adults: The age at which a person becomes 60 years and above refers to the older adults (21,22,31,32).…”

Section: Operational De Nitionmentioning

confidence: 99%

Prevalence and associated factors of frailty among community dweller older adults living in Gondar town, northwest, Ethiopia: A community based cross-sectional study.

Takele

Sany

Getie

et al. 2023

Preprint

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Background: Frailty is a multidimensional geriatric condition that increases vulnerability to stressors, increases the risk of negative health outcomes, and lowers quality of life in older people. However, little attention has been paid to frailty in developing countries, particularly in Ethiopia. Therefore, this study aimed to investigate the prevalence and identify the contributing factors of frailty. Methods: A community-based cross-sectional study design was conducted from April to June 2022. A total of 607 study participants were included using a single cluster sampling technique. Data was collected by interviewing the participants using a structured questionnaire, and a pretest was conducted. Tilburg frailty indicator was used to measure frailty among older adults. Data was analyzed using descriptive statistics, binary and multivariate logistic. Variables with a P-value of less than 0.25 in the bivariate logistic regression were entered into a multivariable logistic regression model. Finally, variables with an odds ratio, a 95% confidence interval, and a P value less than 0.05 had a significant association were reported. Results: In this study the overall prevalence of frailty among older adults was 39% (CI 95%, 35.51-43.1). Older age (AOR=6.26 CI (3.41-11.48), presence of two or more morbidity (AOR = 6.05 CI (3.51-10.43), activity of daily life dependency (AOR = 4.12 CI (2.49-6.80), and depression (AOR = 2.68 CI (1.55-4.63) were found to be significant factors. Conclusion and recommendations: The prevalence of frailty was found to be remarkable, and we conclude that frailty should be recognized as a priority public health problem among older adults in the study area. Therefore, it is important to focus on educating the older adult population about healthy aging and orienting them on these modifiable risk factors should be considered to mitigate the problem.

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Frailty and Determinants of Health Among Older Adults in the United States 2011–2016

Cited by 15 publications

References 43 publications

Short- and Long-Term Outcomes of Pancreatic Cancer Resection in Elderly Patients: A Nationwide Analysis

Short- and Long-Term Outcomes of Pancreatic Cancer Resection in Elderly Patients: A Nationwide Analysis

Association of Frailty Status and Dietary Patterns in a Nationally Representative Sample of United States Adults with Olfactory Dysfunction

Prevalence and associated factors of frailty among community dweller older adults living in Gondar town, northwest, Ethiopia: A community based cross-sectional study.

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