Prevalence and Incidence of Frailty in Community‐Dwelling Older People: Beijing Longitudinal Study of Aging <scp>II</scp>

Zhang, Zheng; Guan, Shaochen; Ding, Hui; Wang, Zhihui; Zhang, Jin; Zhao, Jing; Ma, Jinghong; Chan, Piu

doi:10.1111/jgs.14135

Cited by 86 publications

(91 citation statements)

References 28 publications

(47 reference statements)

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“…In secondary analyses, we included drugs, calcium and minerals, herbals, vitamins, supplements, and other items. The prevalence of polypharmacy observed in this study is consistent with previous estimates (that used cutoffs of four or more or five or more) …”

Section: Discussionsupporting

confidence: 92%

“…Additionally, JoCoOA participants had 5.5 years of follow‐up on average, whereas the follow‐up duration of other studies ranged from 1 to 8 years. There was a suggestion of a positive association between polypharmacy and frailty that is consistent with most published studies . Differences in definitions of transitions between frailty states and approaches to selection of covariates may explain the divergent results of our study compared with Jamsen and colleagues and Trevisan and colleagues, respectively.…”

Section: Discussionsupporting

confidence: 87%

“…Longitudinal analyses of the association between polypharmacy and incident frailty have been primarily conducted in older adults (mean age >65 years), and there has been substantial heterogeneity in the definitions of polypharmacy . Depending on the study, different durations of medication use were necessary for a medication to be included.…”

Section: Discussionmentioning

confidence: 99%

“…Results from longitudinal analyses of polypharmacy and frailty were reported; however, these studies were primarily conducted in non‐US regions including Australia, China, and Europe . These results may have limited generalizability to the US population because US‐based frailty research showed that prevalence varies by race, socioeconomic status, and geographic area .…”

mentioning

confidence: 99%

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Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study

Shmuel

Lund

Álvarez

et al. 2019

J American Geriatrics Society

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OBJECTIVES Polypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to quantify the prevalence of frailty and polypharmacy, and to estimate the association between polypharmacy and incident frailty. DESIGN Prospective cohort study. SETTING A community‐based cohort study of adults residing in Johnston County, North Carolina. PARTICIPANTS White and African American adults aged 50 to 95 years (n=1697). MEASUREMENTS At each study visit, all prescription and over‐the‐counter medications were recorded. We calculated annual polypharmacy (5‐9 medications) and excessive polypharmacy (≥10 medications) prevalence at the 2006‐2010 visit (n = 1697) and operationalized the Fried frailty phenotype to describe prevalent and incident frailty at two consecutive visits (2006‐2010 and 2013‐2015). We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between polypharmacy and incident frailty using weighted log‐binomial regression to account for measured confounding and attrition using inverse probability of treatment and attrition weights, respectively. RESULTS At the 2006‐2010 visit, 678 (41%) and 260 (16%) participants were exposed to polypharmacy and excessive polypharmacy, respectively. Overall, 353 (21%) participants and 180 (21%) participants were frail at the 2006‐2010 and 2013‐2015 visits, respectively. Frailty was more common among participants identifying as white, women, and having less educational attainment relative to those without these characteristics. Incident frailty at the 2013‐2015 visit was 15% (mean follow‐up = 5.5 years). Our results suggest that polypharmacy is positively associated with incident frailty (weighted RR = 1.4; 95% CI = .9‐2.0), yet estimates are imprecise and should be interpreted with caution. CONCLUSION Consistent with the current weight of evidence, our results suggest an association between polypharmacy and incident frailty. Prospective studies evaluating deprescribing interventions are needed to clarify whether reducing polypharmacy decreases frailty incidence. J Am Geriatr Soc 67:2482–2489, 2019

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study

Shmuel

Lund

Álvarez

et al. 2019

J American Geriatrics Society

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“…The Beijing Longitudinal Study of Aging is a prospective population‐based cohort study. Details of the sampling procedure were published elsewhere . In brief, 10 039 participants aged 55 years or older from three urban districts and one rural county were enrolled at baseline in 2009.…”

Section: Methodsmentioning

confidence: 99%

Postural Tremor Is Associated with Gait and Balance Impairments in Community‐Dwelling Older People

Chen

et al. 2019

J American Geriatrics Society

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Objectives We sought to assess associations of postural tremor with gait and balance impairments among community‐dwelling older people in both cross‐sectional and longitudinal analyses. Design A prospective cohort study. Setting Communities in Beijing, China. Participants This study included 7075 individuals aged 55 years or older. Measurements Postural tremor was assessed using a two‐step method (tremor screening followed by a confirmation examination of positive cases) at baseline. Gait and balance performances were measured with the Tinetti Mobility Test at baseline and 1 year later. Results At baseline, 45 (24.7%) of 182 tremor cases vs 663 (9.6%) of 6893 controls had gait and balance impairments. At 1‐year follow‐up, 19 (21.1%) of 90 tremor cases vs 416 (9.8%) of 4262 controls experienced a rapid decline in gait and balance performance. After controlling for potential confounders, postural tremor was associated with gait and balance impairments at baseline (odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.20‐2.62; p = .004) and a rapid decline in gait and balance performance at 1‐year follow‐up (OR = 1.99; 95% CI = 1.17‐3.39; p = .01). Conclusion In this population‐based cohort study, we found postural tremor was associated with gait and balance impairments among community‐dwelling older people in both cross‐sectional and longitudinal analyses. Our findings suggest that motor function should be routinely evaluated and monitored in older people with postural tremor. J Am Geriatr Soc 67:799–803, 2019.

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Decreased Penetrance of Parkinson's Disease in Elderly Carriers of Glucocerebrosidase Gene L444P/R Mutations: A Community‐Based 10‐Year Longitudinal Study

Wang

Qiao

et al. 2020

Movement Disorders

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A BS TRACT: Background: Heterozygous mutations in the glucocerebrosidase gene (GBA) have been shown to be an important genetic risk factor for Parkinson's disease (PD) worldwide. However, the penetrance of GBA heterozygote for L444P, the common mutation for Asian population, is not known in older Chinese people. Objectives: To assess the conversion rate to PD in identified carriers of GBA L444P/R mutations in Chinese community-dwelling older adults. Methods: The GBA gene was sequenced for mutations at position 444 in 8405 people older than 55 years who participated in the Beijing Longitudinal Study on Aging II cohort. Nine subjects were identified as heterozygous carriers of GBA L444P or L444R mutations at baseline and clinically followed up from 2009 to 2019 to investigate their PD conversion, motor and nonmotor symptoms, and change of vesicular monoamine transporter type 2 using tracer of [ 18 F]9-fluoropropyl-(+)-dihydrotetrabenazine ( 18 F-DTBZ, also known as 18 F-AV-133). Results: Eight heterozygous GBA L444P and 1 L444R mutation carriers were identified without PD at baseline, and none of them developed clinical parkinsonism after a 10-year follow-up. Conclusions: Although GBA mutations may lead to an earlier onset PD, the majority of GBA L444P heterozygotes in older adults may not convert to PD. Further studies are warranted to identify factors that modify the risk of conversion.

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Prevalence and Incidence of Frailty in Community‐Dwelling Older People: Beijing Longitudinal Study of Aging II

Cited by 86 publications

References 28 publications

Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study

Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study

Postural Tremor Is Associated with Gait and Balance Impairments in Community‐Dwelling Older People

Decreased Penetrance of Parkinson's Disease in Elderly Carriers of Glucocerebrosidase Gene L444P/R Mutations: A Community‐Based 10‐Year Longitudinal Study

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