Psychological distress and frailty transitions over time in community-dwelling older adults

McHugh, Joanna E.; Dowling, Marcus; Butler, Aine; Lawlor, Brian A.

doi:10.1017/ipm.2015.67

Cited by 19 publications

(19 citation statements)

References 34 publications

(42 reference statements)

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“…This is similar to a cross-sectional study from India that showed twice the odds of frailty in women compared with men 12. A recent systematic review of cohort studies reported both positive29 30 and no association31 32 with gender. Higher prevalence of frailty among women may be due poor grip strength, lower average amounts of lean body mass and increased risk of sarcopenia compared with men 33…”

Section: Discussionsupporting

confidence: 85%

Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study

Kendhapedi

Devasenapathy

2019

BMJ Open

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ObjectiveThere is sparse data on the prevalence of frailty from rural parts of India. Our aim was to estimate prevalence of frailty among community-dwelling older people in rural South Indian population and explore socio-demographic factors associated with frailty. We further explored the associations between frailty with fear of falling and falls.DesignCommunity based cross-sectional study.SettingFour villages in Thanjavur district of Southern India.ParticipantsRandom sample of adults aged 60 years and above from four villages.MethodsWe sampled community-dwelling older adults from the electoral list of four villages using stratified random sampling. We report prevalence of frailty as defined by physical definition (Fried’s Phenotype), accumulation of deficits (Frailty Index) and multi-domain definition (Tilburg Frailty Indicator). We report proportion of agreement of frailty status between the frailty tools. We used logistic regressions with robust SEs to examine the associations between socio-demographic determinants with frailty and the association between frailty with fear of falling and falls.ResultsAmong the 408 participants, the weighted (non-response and poststratification for sex) prevalence and 95% CI of frailty was 28% (18.9 to 28.1) for physical definition, 59% (53.9 to 64.3) for accumulation of deficits and 63% (57.4 to 67.6) for multi-domain definition. Frailty Index and Tilburg Frailty Indicator had good agreement (80%). Age, female, lower education, lower socioeconomic status, minimum physical activity in routine work were independently associated with frailty irrespective of the frailty definitions. Frail elderly had higher odds of falls as well as fear of falling compared with non-frail, irrespective of the definitions.ConclusionPrevalence of frailty among older people in rural Thanjavur district of South India was high compared with low-income and middle-income countries. Understanding the modifiable determinants of frailty can provide a valuable reference for future prevention and intervention.

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Section: Discussionsupporting

confidence: 85%

Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study

Kendhapedi

Devasenapathy

2019

BMJ Open

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“…Overall, the results of the phenotypic analyses are in line with previous studies examining the association between neuroticism and frailty, using both measures of physical frailty (i.e. the frailty phenotype) and the frailty index (10)(11)(12). Our study expanded the follow-up time up to 29 years, elucidating the stability of neuroticism in midlife as a predictor of late life frailty.…”

Section: Discussionsupporting

confidence: 85%

“…depressed mood, worry, fear), has been consistently associated with a wide range of physical and mental health problems such as cardiovascular disease, disrupted immune functioning, asthma, irritable bowel syndrome, atopic eczema, migraine, mood and anxiety disorders, and even increased risk of premature mortality (7)(8)(9), potentially also affecting frailty. The association between neuroticism and frailty has been investigated in three previous studies, all suggesting that high neuroticism is associated with higher frailty concurrently and longitudinally, over up to eight years (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Neuroticism as a predictor of frailty in old age: a genetically informative approach

Daníelsdóttir¹,

Jylhävä²,

Hägg³

et al. 2019

Preprint

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Objective: Neuroticism is associated with poor health outcomes, but its contribution to the accumulation of health deficits in old age, i.e. frailty, is largely unknown. We aimed to explore associations between neuroticism and frailty cross-sectionally and over up to 29 years, and to investigate the contribution of shared genetic influences.Method: Data were derived from the UK Biobank (UKB, n=502,631), the Australian Over 50's Study (AO50, n=3,011) and the Swedish Twin Registry (SALT n=23,744, SATSA n=1,637).Associations between neuroticism and the Frailty Index were investigated using regression analysis cross-sectionally in UKB, AO50 and SATSA, and longitudinally in SALT (25-29y follow-up) and SATSA (6 and 23y follow-up). The co-twin control method was applied to explore the contribution of underlying shared familial factors (SALT, SATSA, AO50). Genome-wide polygenic risk scores for neuroticism in all samples were used to further assess whether common genetic variants associated with neuroticism predict frailty. Results: High neuroticism was consistently associated with greater frailty cross-sectionally (adjusted β, 95% confidence intervals in UKB= 0.32, 0.32-0.33; AO50= 0.35, 0.31-0.39; SATSA= 0.33, 0.27-0.39) and longitudinally up to 29 years (SALT= 0.24; 0.22-0.25; SATSA 6y= 0.31, 0.24-0.38; SATSA 23y= 0.16, 0.07-0.25). When controlling for underlying shared genetic and environmental factors the neuroticism-frailty association remained significant, although decreased.Polygenic risk scores for neuroticism significantly predicted frailty in the two larger samples (metaanalyzed total β= 0.06, 0.05-0.06). Conclusion:High neuroticism is associated with the development and course of frailty. Both environmental and genetic influences, including neuroticism-associated genetic variants, contribute to this relationship.

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“…Factors associated with frailty transitions in older adults have been examined. Studies have identified some factors that are favorable to improvements in frailty, which include socio‐demographic factors (e.g., female, married, respondents with a higher level of education, and living alone), physical factors (e.g., overweight, respondents with greater leg power, good self‐reported health, and better cognitive function), and lifestyle‐related factors (e.g., low to moderate level of alcohol consumption and engaging in physical exercises and activities (Borrat‐Besson, Ryser, & Wernli, 2013; Gajic‐Veljanoski et al, 2018; McHugh, Dowling, Butler, & Lawlor, 2016; Pollack et al, 2017; Speca, Carlson, Goodey, & Angen, 2000; Trevisan et al, 2017). Other studies have identified factors contributing to the decline of frailty, which included socio‐demographic factors (e.g., older age, work in conditions with a low effort‐to‐reward ratio and effort‐to‐control ratio), physical factors (e.g., obesity, loss of vision, poor functional status, poor physical performance), respondents diagnosed with diseases (e.g., osteoarthritis, cancer, chronic lung diseases, stroke, diabetes mellitus, congestive heart failure, cardiovascular disease, hypovitaminosis D, hyperuricemia, and a high level of C‐reactive protein), and lifestyle‐related factors (e.g., smoking) (Espinoza, Jung, & Hazuda, 2012; Etman et al, 2012; Gajic‐Veljanoski et al, 2018; Kalousova & de Leon, 2015; Lee et al, 2014; Pollack et al, 2017; Trevisan et al, 2017).…”

mentioning

confidence: 99%

Factors Associated With Improving or Worsening the State of Frailty: A Secondary Data Analysis of a 5‐Year Longitudinal Study

Cheung

Kwan

Wong

et al. 2020

J of Nursing Scholarship

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Purpose This study aims to examine the frailty transition patterns of older adults recruited from both community and residential care settings within a 5‐year period, and to identify the physical and psychosocial factors associated with the transitions. Design This study is a secondary data analysis of a longitudinal study for tracking the change of health status of older adults 60 years of age or older. Participants who had undergone at least two assessments during 2013–2017 were selected for analysis. Guided by the Gobben’s Frailty Model, biopsychosocial predictors were comprehensively identified from the literature, and their relationship to frailty state transition was explored. Methods We compared the baseline characteristics of participants at the frail, pre‐frail, and robust states (categorized using the Fried Frailty Index). A generalized estimating equation was used to identify factors associated with an improvement or a deterioration in frailty. The probability of transitions between frailty states was calculated. Findings Among the 306 participants, 19% (n = 59) improved and 30% (n = 92) declined in frailty within the project period. Sleep difficulties (odds ratio [OR] = 1.76; 95% confidence interval [CI]: 1.07–2.90; p = .027), better cognitive status (OR = 0.80–0.84; 95% CI: 0.66–0.98 and 0.73–2.73; p = .031 and .018), good nutritional status (OR = 0.74; 95% CI: 0.59–0.91; p = .005), slow mobility (OR = 1.03–1.13; 95% CI: 1.00–1.05 and 1.03–1.25; p = .047 and .014), hearing impairment (OR = 2.83; 95% CI: 1.00–8.01; p = .05), better quality of health—physical domain (OR = 0.95; 95% CI: 0.92–0.99; p = .006), and better functional ability (OR = 0.85–0.97; 95% CI: 0.79–0.92 and 0.96–0.99; p < .001 and p = .003) were significant associated factors in the worsening group. More physical activity (OR = 1.01; 95% CI: 1.00–1.01 and 1.01–1.02; p = .026 and p < .001), hearing impairment (OR = 0.26; 95% CI: 0.08–0.86; p = .028), and slow mobility (OR = 0.93; 95% CI: 0.87–1.00; p = .037) were significant associated factors in the improvement group. Conclusions Frailty is a crucial global public health issue. This study provides evidence for nurses to holistically consider the associated factors and to design effective interventions to combat frailty in our ageing society. Clinical Relevance Frailty is a transient state that can be reversed. Professional nurses working in both community and residential care settings should be able to identify older adults at risk and improve their health conditions appropriately.

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Psychological distress and frailty transitions over time in community-dwelling older adults

Cited by 19 publications

References 34 publications

Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study

Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study

Neuroticism as a predictor of frailty in old age: a genetically informative approach

Factors Associated With Improving or Worsening the State of Frailty: A Secondary Data Analysis of a 5‐Year Longitudinal Study

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