Prevalence and correlates of frailty among community-dwelling older men and women: findings from the Hertfordshire Cohort Study

Syddall, Holly; Roberts, Helen; Evandrou, Maria; Cooper, Cyrus; Bergman, Howard; Sayer, Avan Aihie

doi:10.1093/ageing/afp204

Cited by 184 publications

(161 citation statements)

References 29 publications

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“…A group of researchers from the United Kingdom, for example, using data from the Cohort Study Hertfordshire, showed that frailty is partly determined by social inequality (32) .…”

Section: Discussionmentioning

confidence: 99%

Elderly who take care of elderly: a study on the Frailty Syndrome

et al. 2017

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Objective: Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method: Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results: 10% of elderly caregivers were frail. There was a signifi cant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion: Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services. Descriptors: Caregivers; Fragile Elderly; Geriatric Nursing; Social Vulnerability; Family Health. RESUMO Objetivo: Identifi car a prevalência de fragilidade em cuidadores idosos inseridos em contexto de alta vulnerabilidade social e sua correlação com aspectos sociodemográfi cos e de saúde. Método: Estudo descritivo, correlacional, transversal. Foram avaliados 40 cuidadores idosos utilizando-se: questionário para caracterização do cuidador, Mini Exame do Estado Mental, Índice de Katz, Escala de atividades instrumentais de vida diária de Lawton, Escala de Depressão Geriátrica e o fenótipo de fragilidade proposto por Fried. As entrevistas foram realizadas no domicílio, sendo previamente agendadas. Todos os cuidados éticos foram observados. Os dados foram analisados com apoio do pacote estatístico Stata versão 11.0. Resultados: 10,0% dos cuidadores idosos eram frágeis. Houve correlação signifi cativa entre fragilidade e: sexo, atividades instrumentais de vida diária e cognição. Conclusão: Cuidadoras do sexo feminino, indivíduos parcialmente dependentes em relação às atividades instrumentais de vida diária e com pior estado cognitivo merecem especial atenção dos serviços de saúde. Descritores: Cuidadores; Idoso Fragilizado; Enfermagem Geriátrica; Vulnerabilidade Social; Saúde da Família. RESUMENObjetivo: Identifi car la existencia de la fragilidad en ancianos cuidadores en un contexto de elevada vulnerabilidad social y su correlación con aspectos sociodemográfi cos y sanitarios. Método: Estudio descriptivo, correlacional, transversal. Se evaluaron a cuarenta ancianos cuidadores empleando: un cuestionario para conocer el cuidador, el Miniexamen del Estado Mental, el Índice de Katz, la Escala de actividades instrumentales de la vida diaria de Lawton, la Escala de depresión geriátrica y el fenotipo de fragilidad, de Fried. Se realizaron las entrevistas en las residencias con fecha y horario agendado. Se observaron todos los cuidados éticos. Se evaluaron los datos mediante el software Stata, ve...

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“…A group of researchers from the United Kingdom, for example, using data from the Cohort Study Hertfordshire, showed that frailty is partly determined by social inequality (32) .…”

Section: Discussionmentioning

confidence: 99%

Elderly who take care of elderly: a study on the Frailty Syndrome

et al. 2017

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“…It is useful to have these data in females as there are more older women than men, and more frail women than men (Walston and Fried 1999;Syddall et al 2010); however, these observations need to be extended to male nonhuman primates. Although the females were presumably having menstrual cycles, observations were made without respect to time of cycle because activity levels do not vary by menstrual cycle phase in macaques or women (Barger et al 2008).…”

Section: Discussionmentioning

confidence: 99%

“…In humans, declines in physical performance as measured by such indices as muscle strength, balance, and gait speed are characteristic of aging and predictive of disability, hospitalization, and death (Era and Heikkinen 1985;Guralnik et al 1994;Guralnik et al 2000;Cesari et al 2005;Cooper et al 2010). While these measures can each contribute to the prediction of future risk, gait speed has emerged as a preferred measure because it can be reliably measured at low cost and can be easily interpreted (Cesari et al 2005;Cooper et al 2010).…”

Section: Introductionmentioning

confidence: 99%

“…While these measures can each contribute to the prediction of future risk, gait speed has emerged as a preferred measure because it can be reliably measured at low cost and can be easily interpreted (Cesari et al 2005;Cooper et al 2010). Slow gait is a pivotal dimension of physical frailty and is more common in persons with clinical and subclinical disease such as cardiovascular disease and is associated with elevated inflammatory cytokines and body composition Newman et al 2006).…”

Section: Introductionmentioning

confidence: 99%

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Aging and physical mobility in group-housed Old World monkeys

Shively

Willard

et al. 2011

AGE

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While indices of physical mobility such as gait speed are significant predictors of future morbidity/ mortality in the elderly, mechanisms of these relationships are not understood. Relevant animal models of aging and physical mobility are needed to study these relationships. The goal of this study was to develop measures of physical mobility including activity levels and gait speed in Old World monkeys which vary with age in adults. Locomotor behaviors of 21 old (x0 20 yoa) and 24 young (x09 yoa) socially housed adult females of three species were recorded using focal sample and ad libitum behavior observation methods. Selfmotivated walking speed was 17% slower in older than younger adults. Likewise, young adults climbed more frequently than older adults. Leaping and jumping were more common, on average, in young adults, but this difference did not reach significance. Overall activity levels did not vary significantly by age, and there were no significant age by species interactions in any of these behaviors. Of all the behaviors evaluated, walking speed measured in a simple and inexpensive manner appeared most sensitive to age and has the added feature of being least affected by differences in housing characteristics. Thus, walking speed may be a useful indicator of decline in physical mobility in nonhuman primate models of aging.

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“…In the UK, the Hertfordshire Cohort Study(N=638) (35) reported an overall prevalence of 6.3 percent of community dwelling 64-74 year olds, again with a female preponderance (8.5 percent versus 4.1 percent; p=0.02). The English Longitudinal study of ageing(N=3055) (30) reported a frailty prevalence of between 8 and 13 percent for community dwelling over 65 year olds, depending on frailty measurement utilised (the Phenotype and Frailty Index definitions respectively).…”

Section: Community Settingmentioning

confidence: 99%

Frailty Assessment in Acute Care

2015

The Gerontologist

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IntroductionFor some people, ageing is associated with the experience of increased co-morbidity, functional impairment, poor resilience and heightened vulnerability to external stressors, resulting in reduced lifespan as well as health-span. This frailty phenomenon poses challenges to health care systems in the form of increased patient complexity and resource utilisation. The acute care setting, characterised by time-pressure and high patient turn-over, is under strain and struggles to recognise and subsequently reliably intervene, to prevent, reverse or halt the decline of this vulnerable cohort. MethodsThis mixed-methods study probes existing evidence and 'real-world' processes with a systematic review of frailty assessments developed or validated in the acute care setting and a survey of contemporaneous clinical practice in London Acute Medical Units. Content validation and understanding of contextual factors for ideal frailty assessment in acute care is explored using Delphi consensus and Focus Group methodology respectively. The resultant model is developed on existing retrospective national Hospital Episode Statistics data, and prospectively tested on observational data in a local Acute Medical Unit setting. ResultsExisting frailty scores are preponderantly biophysical in nature, and have poor predictive power for adverse outcomes in the acute care setting. In clinical practice, single-dimension assessment tools predominate. Frailty syndromes and previous high resource utilisation in the form of a simple, clinically relevant tool useful to the multidisciplinary team gain consensus as optimal assessment for the setting. Retrospective testing of the frailty model displays moderate predictive powers for adverse events (inpatient mortality, emergency readmission and institutionalisation) and prospective testing provides concurrent (Frailty Index, Age, Co-Morbidity) and comparative predictive validity (Frailty Index, Co-Morbidity, 2 admission National Early Warning Score) with existing risk stratification models in this setting. ConclusionsA risk prediction model based on frailty syndromes and previous high resource utilisation is a valid, feasible and useful for the acute care setting.

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Prevalence and correlates of frailty among community-dwelling older men and women: findings from the Hertfordshire Cohort Study

Abstract: frailty is not uncommon even among community-dwelling young-old men and women in the UK. There are social inequalities in frailty which appear to be mediated by co-morbidity.

Cited by 184 publications

References 29 publications

Elderly who take care of elderly: a study on the Frailty Syndrome

Elderly who take care of elderly: a study on the Frailty Syndrome

Aging and physical mobility in group-housed Old World monkeys

Frailty Assessment in Acute Care

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