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Patterns, predictors, and outcomes of frailty trajectories in community-dwelling older adults: Results from the FREEDOM Cohort Study.
Tchalla, Achille; Cardinaud, Noëlle; Gayot, Caroline; Dumoitier, Nathalie; Druet-Cabanac, Michel; Laroche, Marie-Laure; Rudelle, Karen; Mouret, Cécile Laubarie; Boyer, Sophie.
Afiliação
  • Tchalla A; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France; Unité de Recherche Clinique et d'Innovation (URCI) de
  • Cardinaud N; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France.
  • Gayot C; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France; Unité de Recherche Clinique et d'Innovation (URCI) de
  • Dumoitier N; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; Département de Médecine Générale, Faculté de Médecine de Limoges, Limoges, France.
  • Druet-Cabanac M; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France.
  • Laroche ML; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; Centre de Pharmacovigilance et de Pharmaco-épidémiologie, CHU de Limoges, Limoges, France.
  • Rudelle K; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; Département de Médecine Générale, Faculté de Médecine de Limoges, Limoges, France.
  • Mouret CL; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France.
  • Boyer S; Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut Omega Health, Université de Limoges, Limoges, France; CHU de Limoges, Pôle HU Gérontologie Clinique, F-87042 Limoges, 2 Avenue Martin-Luther King, France; Unité de Recherche Clinique et d'Innovation (URCI) de
Arch Gerontol Geriatr ; 114: 105101, 2023 11.
Article em En | MEDLINE | ID: mdl-37321127
OBJECTIVES: To identify subgroups of people with distinct frailty trajectories, identify baseline characteristics associated with these trajectories, and determine their coincident clinical outcomes. DESIGN: This study examined the longitudinal database from the FREEDOM Cohort Study. SETTING AND PARTICIPANTS: All 497 participants of the FREEDOM (French Acronym for "FRagilitéEtEvaluation àDOMicile" / In English "Frailty and Evaluation at Home") cohort requested a comprehensive geriatric assessment. Community-dwelling subjects over 75 years, or over 65 years with at least two comorbidities were included. METHODS: Frailty was assessed using Fried's criteria, depression using the Geriatric Depression Scale (GDS) and cognitive function using the Mini Mental State Examination (MMSE) questionnaire. Frailty trajectories were modelled using k-means algorithms. Predictive factors were determined by multivariate logistic regression. Clinical outcomes included incident cognitive deficit, falls and hospitalization. RESULTS: The trajectory models allowed determine four frailty trajectories: "robust stable" (Trajectory A, 26.8%), "pre-frail worsening to frailty" (Trajectory B, 35.8%), "frail improving to less frailty" (Trajectory C, 23.3%), and "frail worsening to more frailty" (Trajectory D, 14.1%). Trajectory B was associated with age (OR 1.2 (95CI, 1.05 - 1.17)), potential cognitive deficit/dementia (OR 2.01 (95CI, 1.01- 4.05)) and depressive symptoms (OR 2.36 (95CI, 1.36 - 4.12)). Hypertension was distinguishing factor between" trajectory B vs. C and D. Depressive symptoms were two time more associated with D (OR 10.51) vs. C (OR 4.55). The incidence of clinical outcomes was significantly increased in poor frailty trajectories. CONCLUSIONS AND IMPLICATIONS: This study allowed to determine frailty trajectories among older subjects requested a comprehensive geriatric assessment. The more significant predictive factors associated with poor frailty trajectory were advanced in age, potential cognitive deficit/dementia, depressive symptoms and hypertension. This emphasizes the need for adequate measures to controlled hypertension, depressive symptoms and to maintain or improve cognition in older adults.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Demência / Fragilidade / Hipertensão Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Demência / Fragilidade / Hipertensão Idioma: En Ano de publicação: 2023 Tipo de documento: Article