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Clin Interv Aging ; 16: 415-429, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33692620


Purpose: Older persons have been identified as a vulnerable population with respect to the novel coronavirus outbreak, COVID-19. Aiming to "flatten the curve" a strict Movement Control Order (MCO) was implemented in Malaysia. Older adults with cognitive frailty are prone to physical, cognitive and psychosocial decline. This study aims to compare physical activity patterns, psychological wellbeing and coping strategies of older persons with cognitive frailty in the "WE-RISE" trial (intervention versus control) throughout this period. Materials and Methods: This study was conducted as a sub-analysis of the ongoing "WE-RISE" randomized controlled trial. This study included 42 community-dwelling older adults, aged 60 years and above, with cognitive frailty, stratified into intervention (n=21) and control (n=21) groups who are receiving a multi-domain intervention and usual care, respectively, within the Klang Valley, Malaysia. Phone call interviews were conducted during the MCO period. Physical activity patterns were assessed using International Physical Activity Questionnaire (IPAQ) and Functional Activities Questionnaire (FAQ). Psychological wellbeing was assessed using Flourishing Scale (FS) and General Health Questionnaire (GHQ-12), while the Brief Coping Orientation to Problems Experienced (COPE) assessed coping strategies. Data were analysed descriptively and with independent samples t-test. Results: The WE-RISE intervention group had significantly higher levels of estimated resting energy expenditure (MET) for "walking activity" (I:µ=1723.1±780.7;C:µ=537.4±581.9)(p<0.001), "moderate activity" (I:µ=1422.8±1215.1;C:µ=405.7±746.9)(p=0.002) and "total physical activity" (I: µ=3625.9±3399.3;C:µ=994.6±1193.9)(p=0.002). The intervention group was also significantly more independent in functional activities (µ=1.76±1.73) as compared to the control group (µ=5.57±8.31) (p<0.05). Moreover, significant higher self-perception of living a meaningful life and feeling respected (p<0.05) was demonstrated in regard to psychological well-being in the intervention group. Regarding coping strategies, the intervention group relied significantly on the domains of religion (I:µ=6.43±0.99;C:µ=6.09±1.09)(p<0.05) and planning (I:µ=4.81±0.75; C:µ=4.04±1.28)(p<0.05) whilst the control group relied on humour (C:µ=3.14±1.19; I:µ=2.38±0.74)(p<0.05). Conclusion: Participants of the WE-RISE intervention group were more physically active, functionally independent and had higher self-perceived social-psychological prosperity regarding living a meaningful life and feeling respected; whilst both groups relied on positive coping strategies during the MCO. These results indicate that it is vital to ensure older persons with cognitive frailty remain physically active and preserve their psychosocial wellbeing to be more resilient in preventing further decline during a crisis such as the COVID-19 pandemic.

Adaptação Psicológica , Exercício Físico , Idoso Fragilizado/psicologia , Fragilidade/psicologia , Idoso , Idoso de 80 Anos ou mais , Cognição , Metabolismo Energético , Feminino , Fragilidade/epidemiologia , Humanos , Vida Independente , Entrevistas como Assunto , Estudos Longitudinais , Malásia , Masculino , Pessoa de Meia-Idade , Pandemias
Metas enferm ; 23(10): 7-16, dic.-ene. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-197941


OBJETIVO: describir el proceso de validación psicométrica del instrumento COPE-Index en población española. MÉTODO: estudio de validación del cuestionario COPE-Index, que cuenta con 15 ítems divididos en tres subescalas: valoración del impacto negativo, valoración del impacto positivo y calidad del apoyo. Los sujetos de estudio fueron 165 figuras cuidadoras de personas mayores, pertenecientes a la Asociación de Familiares de Alzheimer de la Comunidad de Madrid. Mediciones principales: factibilidad del instrumento COPE, consistencia interna, efecto techo y suelo, análisis factorial exploratorio, validez convergente y divergente (para ello se usaron los cuestionarios PACS, Duke-Unc y SF-12). RESULTADOS: la muestra de estudio estuvo formaba por 150 sujetos (tasa de respuesta del 90,9%). El 65,33% (n= 98) era mujer; la edad media (DE) fue de 64 (12,23). Los resultados se mostraron fiables en cuanto a su homogeneidad interna en relación con la subescala negativa y la subescala de calidad (alfas de Cronbach > 0,7) y menor en la subescala positiva (alfa de Cronbach: 0,61). No se apreció efecto techo ni suelo. La validez de constructo confirmó tres dimensiones del cuestionario COPE, que explicaban el 52% de la varianza total. En las pruebas de validez convergente/divergente se correlacionaron las puntuaciones de la subescala positiva del cuestionario COPE con los ítems del cuestionario PACS, la subescala negativa del cuestionario COPE se relacionó con las preguntas del cuestionario Duke-Unc y, finalmente, la subescala de calidad del cuestionario COPE se correlacionó con los ítems del instrumento SF-12 versión dos. CONCLUSIÓN: la versión española del cuestionario COPE-Index fue válida y confiable para identificar los aspectos positivos, negativos y de calidad del cuidado en cuidadoras de personas mayores

OBJECTIVE: to describe the psychometric validation process of the COPE-Index instrument for the Spanish population. METHOD: a validation study of the COPE-Index questionnaire, which consists of 15 items classified into three sub-scales: assessment of negative impact, assessment of positive impact, and quality of support. The study subjects were 165 carers for older people, from the Madrid Association of Relatives of Alzheimer's Patients. The main measurements were: the feasibility of the COPE instrument, internal consistency, ceiling and floor effect, exploratory factor analysis, convergent and divergent validity (the PACS, Duke-Unc and SF-12 questionnaires were used for this). RESULTS: the study sample was formed by 150 subjects (90.9% response rate). Of these, 65.33% (n= 98) were female, and their mean age (SD) was 64 (12.23). Results appeared reliable in terms of internal homogeneity regarding the negative sub-scale and the quality sub-scale (Cronbach's alphas > 0.7), and lower in the positive sub-scale (Cronbach's alpha: 0,61). Neither ceiling nor floor effect were observed. The construct validity confirmed three dimensions of the COPE questionnaire, which explained 52% of the total variance. In the convergent / divergent validity tests, the scores from the positive sub-scale of the COPE questionnaire were correlated with the PACS questionnaire items, the negative sub-scale of the COPE questionnaire was associated with the questions from the Duke-Unc questionnaire, and finally, the quality sub-scale of the COPE questionnaire was correlated with the items from the second version of the SF-12 instrument. CONCLUSION: the Spanish version of the COPE-Index questionnaire was valid and reliable to identify the positive, negative and quality aspects of care in caregivers for elderly persons

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Inquéritos e Questionários , Psicometria/métodos , Cuidadores/estatística & dados numéricos , Idoso/psicologia , Psicometria/estatística & dados numéricos , Idoso Fragilizado/psicologia
J Frailty Aging ; 10(1): 31-37, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33331619


BACKGROUND: Given the important association between cardiovascular disease and cognitive decline, and their significant implications on frailty status, the contribution of neurocognitive frailty measure helping with the assessment of patient outcomes is dearly needed. OBJECTIVES: The present study examines the prognostic value of the Neurocognitive Frailty Index (NFI) in the elderly with cardiovascular disease. DESIGN: Secondary analysis of the Canadian Study of Health and Aging (CSHA) dataset was used for prediction of 5-year cognitive changes. SETTING: Community and institutional sample. PARTICIPANTS: Canadians aged 65 and over [Mean age: 80.4 years (SD=6.9; Range of 66-100)]. MEASUREMENT: Neurocognitive Frailty Index (NFI) and Modified Mini-Mental State (3MS) scores for cognitive functioning of all subjects at follow-up and mortality rate were measured. RESULTS: The NFI mean score was 9.63 (SD = 6.04) and ranged from 0 to 33. This study demonstrated that the NFI was significantly associated with cognitive changes for subjects with heart disease and this correlation was a stronger predictor than age. CONCLUSION: The clinical relevance of this study is that our result supports the prognostic utility of the NFI tool in treatment planning for those with modifiable cardiovascular disease risk factors in the development of dementia.

Envelhecimento/psicologia , Doenças Cardiovasculares/mortalidade , Cognição/fisiologia , Fragilidade/psicologia , Avaliação Geriátrica/métodos , Idoso , Idoso de 80 Anos ou mais , Canadá/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Envelhecimento Cognitivo , Análise de Dados , Idoso Fragilizado/psicologia , Humanos , Taxa de Sobrevida
PLoS One ; 15(12): e0243548, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326452


As older adults in an early stage (prefrailty) of frailty may return to a healthy state, it is necessary to examine the prevention of prefrailty. In this context, the number and types of social participation activities associated with physical prefrailty in community-dwelling older adults have remained relatively unexplored. This cross-sectional study investigates this issue by analyzing 616 participants living in Okinoshima, Shimane, a rural area of Japan, in 2019. Frailty was assessed using the 5-item frailty phenotype (unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity). Data on social participation were obtained using a questionnaire based on participants' level of involvement with volunteer groups, sports clubs/groups, neighborhood associations, religious organizations/groups, and community elderly salons; their answers were categorized as "yes" if they answered "several times per year or more" and "no" if they answered "never." Binominal logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) of prefrailty by the number or types of social participation activities, adjusted for gender, age, body mass index, smoking, medication-taking, educational attainment, working status, and living arrangement. Of the 616 participants, 273 (44.3%) and 28 (4.5%) had prefrailty and frailty, respectively. The analysis showed that the number of social participation activities was significantly associated with lower odds of prefrailty (OR = 0.83; 95% CI, 0.74-0.94). Regarding the types of social participation, sports clubs/groups were associated with lower odds of prefrailty (OR = 0.47; 95% CI, 0.31-0.73). Participation in neighborhood associations was associated with prefrailty/frailty (OR = 0.57; 95% CI, 0.37-0.86). These results suggest that increasing the number of social participation activities or involvement in sports clubs/groups and neighborhood associations may be important to prevent physical prefrailty in the older population.

Idoso Fragilizado/psicologia , Fragilidade/prevenção & controle , Participação Social/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Exercício Físico , Fadiga , Feminino , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/fisiopatologia , Humanos , Vida Independente/estatística & dados numéricos , Japão/epidemiologia , Modelos Logísticos , Masculino , Autorrelato , Inquéritos e Questionários , Perda de Peso
Artigo em Inglês | MEDLINE | ID: mdl-33352735


Frailty in middle-aged and older adults is associated with diabetes-related complications. The impact of and interaction between diabetes and frailty on psychosocial wellbeing and mortality in Ireland for adults aged ≥50 years were assessed using data from the Survey of Health, Ageing and Retirement in Europe. Measures included diabetes status (self-reported), frailty phenotype (≥3/5 criteria), low self-rated health ("fair" or "poor"), depression screening (EURO-D index score ≥4), and low quality of life (QoL) (CASP-12 index score < 35). Among the 970 participants, those with diabetes (n = 87) were more likely to be frail (23% vs. 8%; p < 0.001), have low self-rated health (46% vs. 19%; p < 0.001), depression (25% vs. 17%; p = 0.070), and low QoL (25% vs. 18%, p = 0.085). Adjusting for diabetes, age and sex, frailty independently predicted low self-rated health (OR: 9.79 (5.85-16.36)), depression (9.82 (5.93-16.25)), and low QoL (8.52 (5.19-13.97)). Adjusting for frailty, age and sex, diabetes independently predicted low self-rated health (2.70 (1.63-4.47)). The age-sex adjusted mortality hazard ratio was highest for frailty with diabetes (4.67 (1.08-20.15)), followed by frailty without diabetes (2.86 (1.17-6.99)) and being non-frail with diabetes (1.76 (0.59-5.22)). Frailty independently predicts lower self-reported wellbeing and is associated with reduced survival, underpinning its role as an integral part of holistic diabetes care.

Depressão/epidemiologia , Diabetes Mellitus/epidemiologia , Idoso Fragilizado/psicologia , Fragilidade/epidemiologia , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos Transversais , Depressão/psicologia , Europa (Continente)/epidemiologia , Feminino , Idoso Fragilizado/estatística & dados numéricos , Avaliação Geriátrica , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Princípios Morais , Prevalência , Apoio Social
J Immunol Res ; 2020: 8375096, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33354578


Recently, the novel coronavirus epidemic occurred in China and spread worldwide to become a global pandemic. COVID-19 is a fatal viral infection causing death, particularly in aged individuals, due to impaired immunity. To date, no intervention is available to prevent COVID-19 and its manifestations. Physical exercise training generally has health benefits, and it assists in the prevention of several chronic diseases. Therefore, this review is aimed at exploring the role of physical exercise training in the face of COVID-19 in older adults and elderly individuals. From this point of view, this review suggests that physical exercise training plays a key role in promoting immune system regulation, delaying immunity dysfunction, reducing circulatory inflammation markers, and preventing sarcopenia and thus could prevent the risk of acquiring COVID-19 infection and reduce the complications of recommended self-isolation in older adults and elderly individuals. Additionally, immunity biomarkers were optimistically demonstrated in older adults following physical exercise training, thereby reducing mortality and morbidity rates. Finally, in accordance with recommendations to stay home and perform self-isolation to prevent the spread of COVID-19, all populations are strongly recommended to practice regular home exercise training at home to promote immune system functioning.

Exercício Físico/fisiologia , Exercício Físico/psicologia , Idoso , Idoso de 80 Anos ou mais , Idoso Fragilizado/psicologia , Humanos , Imunidade Celular/imunologia , Isolamento de Pacientes , Carência Psicossocial , Sarcopenia/prevenção & controle
Rev Med Suisse ; 16(714): 2160-2164, 2020 Nov 11.
Artigo em Francês | MEDLINE | ID: mdl-33174697


What are the criteria for admitting an elderly polymorbid patient to intensive care ? The multidimensional geriatric evaluation is a tool to screen for geriatric syndromes, with the division of elderly patients into 3 categories: robust, vulnerable and dependent. Targeting certain co-morbidities such as cognitive disorders, delirium, frailty, polymedication and malnutrition, allows clinicians to estimate the risks of mortality and functional and cognitive handicaps during a stay in intensive care. Based on a review of the literature, this article offers some guidelines for triage of older patients for admission to intensive care, using an ethical, multidisciplinary approach that takes into account the patient's fears and preferences.

Cuidados Críticos/estatística & dados numéricos , Idoso Fragilizado , Fragilidade/diagnóstico , Avaliação Geriátrica , Idoso , Transtornos Cognitivos/diagnóstico , Delírio/diagnóstico , Idoso Fragilizado/psicologia , Humanos , Desnutrição/diagnóstico
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193596


La soledad y el apoyo social deficiente están reconocidos como predictores de morbimortalidad. Cuando una persona mayor vive sola y no recibe soporte familiar ni social para corregir desviaciones en su autocuidado, se produce una sobreutilización de servicios sanitarios y, posiblemente, un aumento de los ingresos hospitalarios. En 2018, el Consell de Salut del Centro de Salud (CS) República Argentina de Valencia realizó un estudio piloto de detección y abordaje de soledad no deseada en las personas del barrio en el que se estableció que un 45% de las personas que vivían solas y eran mayores de 75 años tendrían un posible diagnóstico de aislamiento social. OBJETIVOS: implementar una red comunitaria de voluntariado de acompañamiento-vigilancia en autocuidados para personas mayores con aislamiento social en el área del CS República Argentina, con el soporte del «Programa de acompañamiento en salud constante» (PASC) de la Cruz Roja, en colaboración con el centro de salud, y estudiar la relación entre soledad y salud. MÉTODOS: mediante un diseño escalado de detección y diagnóstico de aislamiento social, con la participación de técnicos de la Cruz Roja, profesionales del centro de salud y la colaboración de voluntariado de acompañamiento a personas mayores participantes. RESULTADOS: en 7 meses 1.200 personas fueron sensibilizadas de forma directa sobre la soledad y 49 voluntarios del barrio desarrollaron labores de acompañamiento y asistencia a talleres formativos y lúdicos. Los profesionales sanitarios analizaron 216 casos: 149 (69%) no se sintieron solos y 67 (31%) fueron diagnosticados de aislamiento social (código correspondiente a V64.01 según CIE-9). Participaron en el proyecto 54 personas (25%). Existe asociación entre la escala de detección de la soledad existencial (EDSOL) y la participación en el proyecto. La sensación de soledad no deseada presenta correlación positiva con problemas de movilidad, cronicidad y una tendencia de asociación con otras variables de salud (consumo elevado de fármacos, percepción negativa de calidad de vida, etc.). CONCLUSIONES: las intervenciones comunitarias promovidas desde el centro de salud sobre personas que viven solas contribuyen al abordaje del aislamiento no deseado y a su vez generan un barrio más solidario

Loneliness and poor social support are widely recognized as predictors of morbidity and mortality. When an elderly person lives alone and does not receive family or social support to correct minor deviations in basic self-care processes, this leads to overuse of health services and possibly, increased hospital admissions. In 2018, the Consell de Salut of the República Argentina Primary Health Centre in Valencia, began a pilot study to detect and tackle unwanted loneliness in people from the neighbourhood, in which it was established that 45% of people aged over 75 years old who lived alone may be diagnosed with social isolation. OBJECTIVES: To establish a community network of accompanying-surveillance volunteers in self-care for socially isolated elderly people in the area of the República Argentina Primary Care Centre with the support of the Red Cross Constant Health Accompaniment Programme. The specific objective is to study the relationship between loneliness and health. METHODS: Using a scaled design for the detection and diagnosis of social isolation, with the participation of the Red Cross technicians, professionals from the health center, and the collaboration of volunteer support for elderly participants. RESULTS: Over seven months a total of 1200 people have been directly made aware about loneliness and 49 volunteers from the neighbourhood performed accompaniment work and attended training and recreational workshops. Health professionals analyzed 216 cases, of which 149 (69%) did not feel alone and the remaining 67 (31%) were diagnosed with social isolation (code V64.01 according to ICD-9). A total of 54 (25%) agreed to take part in the project. An association was observed between the scale for detection of existential loneliness (EDSOL) and participation in the project. The feeling of unwanted loneliness correlates positively with mobility problems, chronicity and a tendency of association with other health variables such as high consumption of drugs and negative perception of quality of life. CONCLUSIONS: Community interventions promoted by the Primary Health Centre on people who live alone contribute to tackling unwanted isolation, which at the same time generates a more supportive neighbourhood

Humanos , Masculino , Feminino , Idoso , Participação da Comunidade/métodos , Redes Comunitárias , Idoso Fragilizado/psicologia , Programas Voluntários , Agências Voluntárias , Solidão , Argentina , Qualidade de Vida
BMJ Open ; 10(9): e040569, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32994260


INTRODUCTION: This protocol describes an observational study which set out to assess whether frailty and/or multimorbidity correlates with short-term and medium-term outcomes in patients diagnosed with COVID-19 in a European, multicentre setting. METHODS AND ANALYSIS: Over a 3-month period we aim to recruit a minimum of 500 patients across 10 hospital sites, collecting baseline data including: patient demographics; presence of comorbidities; relevant blood tests on admission; prescription of ACE inhibitors/angiotensin receptor blockers/non-steroidal anti-inflammatory drugs/immunosuppressants; smoking status; Clinical Frailty Score (CFS); length of hospital stay; mortality and readmission. All patients receiving inpatient hospital care >18 years who receive a diagnosis of COVID-19 are eligible for inclusion. Long-term follow-up at 6 and 12 months is planned. This will assess frailty, quality of life and medical complications.Our primary analysis will be short-term and long-term mortality by CFS, adjusted for age (18-64, 65-80 and >80) and gender. We will carry out a secondary analysis of the primary outcome by including additional clinical mediators which are determined statistically important using a likelihood ratio test. All analyses will be presented as crude and adjusted HR and OR with associated 95% CIs and p values. ETHICS AND DISSEMINATION: This study has been registered, reviewed and approved by the following: Health Research Authority (20/HRA1898); Ethics Committee of Hospital Policlinico Modena, Italy (369/2020/OSS/AOUMO); Health and Care Research Permissions Service, Wales; and NHS Research Scotland Permissions Co-ordinating Centre, Scotland. All participating units obtained approval from their local Research and Development department consistent with the guidance from their relevant national organisation.Data will be reported as a whole cohort. This project will be submitted for presentation at a national or international surgical and geriatric conference. Manuscript(s) will be prepared following the close of the project.

Infecções por Coronavirus , Idoso Fragilizado , Fragilidade , Multimorbidade , Pandemias , Pneumonia Viral , Saúde Pública/métodos , Qualidade de Vida , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Correlação de Dados , Europa (Continente)/epidemiologia , Feminino , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Avaliação Geriátrica/métodos , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Estudos Multicêntricos como Assunto , Estudos Observacionais como Assunto , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Análise de Sobrevida
BMC Geriatr ; 20(1): 347, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928151


BACKGROUND: Moving into a long-term care facility (LTCF) can reduce the ability for older adults to engage in meaningful roles and activities and the size of their social network. These changes and losses can lead them to experience existential loneliness (EL)-the intolerable emptiness and lack of meaningful existence resulted from the losses they have experienced. While EL has often been understood as a universal human experience, it has primarily been studied in people from Western cultures; little is known about how EL may be experienced by and manifested in people from Eastern cultures. Hence, this qualitative study aimed to describe the experience and coping of EL in Hong Kong Chinese and Swedish older adults living in LTCFs. METHODS: A qualitative study using Thorne's (2004) interpretive description was conducted. Thirteen Chinese and 9 Swedes living in LTCFs in Hong Kong, China and Malmo, Sweden, respectively were interviewed about their experience of EL in two series of semi-structured interviews. Data were analyzed using thematic analysis. RESULTS: The core theme of "overcoming EL" described the participants' experience of EL, which came about through the combined process of "Feeling EL" and "Self-Regulating". Both Chinese and Swedish participants had similar experience with EL. Realizing that they did not want to living with EL anymore, they coped by reframing their experience and identifying new meaning in their life. CONCLUSIONS: The study findings suggested that early and clear counselling support that help older adults to define new meaning in life may help them cope. In addition, more opportunities should be available at the LTCFs to promote quality relationships, enable older adults to reflect on their lives with pride, and support their ability to do the things they enjoy.

Envelhecimento/psicologia , Comparação Transcultural , Idoso Fragilizado/psicologia , Solidão/psicologia , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Hong Kong , Humanos , Vida Independente/psicologia , Entrevistas como Assunto , Assistência de Longa Duração , Masculino , Pesquisa Qualitativa , Qualidade de Vida , Suécia
JMIR Mhealth Uhealth ; 8(9): e21845, 2020 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-32896832


BACKGROUND: Technological communication methods such as telephone calls and video calls can help prevent social isolation and loneliness in frail older adults during confinement. OBJECTIVE: Our objectives were to determine which virtual communication method (ie, telephone call or video call) was preferred by confined older hospital patients and nursing home residents and the variables influencing this preference. METHODS: The TOVID (Telephony Or Videophony for Isolated elDerly) study was a cross-sectional study that was designed to examine the preference between telephone calls and video calls among frail older adults who were either hospitalized in a geriatric acute care unit or institutionalized in a long-term care and nursing home during the COVID-19 confinement period. RESULTS: A total of 132 older people were surveyed between March 25 and May 11, 2020 (mean age 88.2 years, SD 6.2); 79 (59.8%) were women. Patients hospitalized in the geriatric acute care unit were more able to establish communication independently than residents institutionalized in the long-term care and nursing home (P=.03) and were more satisfied with their communication experiences (P=.02). Overall, older people tended to favor telephone calls (73/132, 55.3%) over video calls (59/132, 44.7%); however, their satisfaction degree was similar regardless of the chosen method (P=.1), with no effect of age (P=.97) or gender (P=.2). In the geriatric acute care unit, the satisfaction degrees were similar for telephone calls (40/41, 98%) and video calls (33/38, 87%) in older patients (P=.10). Conversely, in the long-term care and nursing home, residents were more satisfied with the use of video calls to communicate with their relatives (14/15, 93%) versus the use of telephone calls (6/12, 50%; P=.02). CONCLUSIONS: Older people confined to health care settings were able to complete telephone calls more independently than video calls, and they tended to use telephone calls more often than video calls. The satisfaction degrees were similar with both modalities and even greater with video calls among long-term care and nursing home residents when they were given assistance to establish communication. TRIAL REGISTRATION: NCT04333849:

Comportamento do Consumidor/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Idoso Fragilizado/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Isolamento Social , Telefone , Comunicação por Videoconferência , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Idoso Fragilizado/estatística & dados numéricos , Hospitalização , Humanos , Solidão , Masculino , Casas de Saúde , Pneumonia Viral/epidemiologia
PLoS One ; 15(8): e0236111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790685


A relationship between chronic pain and frailty has been reported. The early detection and prevention of frailty are recommended, in part because community-dwelling older adults in a pre-frailty state may return to a healthy state. The relationship between chronic pain and pre-frailty is not known. Toward the goal of promoting a reversible return to health from pre-frailty, we investigated the relationship between chronic pain and pre-frailty among community-dwelling older adults. We assessed the frailty and chronic pain of 107 older adults who were participating in community health checks. The status of physical frailty was based on the five components described by Fried (2001): muscle weakness shown by handgrip strength, slowness of gait speed, weight loss, low physical activity, and exhaustion. Chronic pain was assessed based on pain intensity, the Pain Catastrophizing Scale (PCS), the Japanese version of the Geriatric Depression Scale-15 (GDS-15), and the Central Sensitization Inventory (CSI). The prevalence of chronic pain with pre-frailty was 40.2%. A hierarchical analysis revealed that PCS-measured helplessness (odds ratio [OR]: 0.88) and the CSI (OR: 0.87) were significant factors associated with the presence of chronic pain with pre-frailty. The prevalence of chronic pain with pre-frailty was high, and chronic pain and pre-frailty were strongly related. New intervention or prevention programs that take into account both chronic pain and pre-frailty must be created as soon as possible.

Catastrofização/epidemiologia , Dor Crônica/epidemiologia , Fragilidade/prevenção & controle , Vida Independente , Debilidade Muscular/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Catastrofização/psicologia , Dor Crônica/complicações , Dor Crônica/diagnóstico , Dor Crônica/psicologia , Estudos Transversais , Feminino , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/diagnóstico , Fragilidade/etiologia , Avaliação Geriátrica , Força da Mão , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/diagnóstico , Debilidade Muscular/etiologia , Medição da Dor , Prevalência
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(4): 212-215, jul.-ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199469


INTRODUCCIÓN: La fragilidad puede ser detectada con distintas herramientas y en múltiples entornos. Entre los diferentes sistemas de cribado, la velocidad de marcha (VM) y el Timed Up-and- Go (TUG) se postulan como sistemas sencillos y fácilmente aplicables. Existen pocos datos sobre su aplicabilidad en pacientes hospitalizados en centros de atención intermedia. MATERIAL Y MÉTODOS: Estudio descriptivo para determinar la aplicabilidad de la VM y el TUG como herramientas de cribado de fragilidad en un hospital de atención intermedia, así como una estimación de la prevalencia de fragilidad al alta mediante estas pruebas de ejecución funcional. Se consideraron frágiles los pacientes con una VM<1m/s y/o un TUG>12s. Se incluyeron todos pacientes atendidos por la unidad de rehabilitación del centro a lo largo del año 2015. RESULTADOS: Novecientos nueve fueron los pacientes incluidos (edad media de 80,12 años). De estos, solo 205 (22,6%) estaban en condiciones de realizar la VM y TUG en el momento del alta; de estas 205 personas, el 89,8% (VM) y el 92,2% (TUG) presentaban criterios de fragilidad, no habiendo diferencias estadísticamente significativas entre ambas herramientas (p = 0,25). CONCLUSIONES: La utilización de la VM y el TUG para el cribado de fragilidad tiene una aplicabilidad limitada en el entorno de atención intermedia. A pesar de ello, los resultados obtenidos indican una alta prevalencia de fragilidad en este entorno. Serán necesarios más estudios para corroborar estos datos

INTRODUCTION: Frailty screening can be performed with different tools and in multiple settings. Among the different evaluation systems, gait speed (GS) and Timed Up-and-Go (TUG) are postulated as simple and easy to apply systems. There are few data on the prevalence of frailty in intermediate care centre inpatients. MATERIAL AND METHODS: Descriptive study to determine the applicability of GS and TUG as frailty screening tools in an intermediate care hospital, as well as an estimate of frailty prevalence at discharge. Frailty was considered when GS<1m/s and / or TUG>12seconds. The study included all patients attending the rehabilitation unit of the centre throughout 2015. RESULTS: A total of 909 patients were included (mean age of 80.12 years). Only 205 (22.6%) were able to perform GS and TUG at discharge from the rehabilitation unit. Frailty prevalence for this group was between 89.8% (GS) and 92.2% (TUG), with no statistical differences between both tools (P=.25). CONCLUSIONS: The applicability of GS and TUG for frailty screening in intermediate care hospitals is limited. Despite this, the results obtained suggest a high prevalence of frailty. More studies will be necessary to corroborate this data

Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Função Executiva/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Fragilidade/diagnóstico , Reprodutibilidade dos Testes , Programas de Rastreamento/métodos , Idoso Fragilizado/psicologia , Instituições para Cuidados Intermediários/estatística & dados numéricos , Epidemiologia Descritiva , Velocidade de Caminhada/fisiologia , Centros de Reabilitação/estatística & dados numéricos , Fragilidade/reabilitação , Estudos Prospectivos
Health Qual Life Outcomes ; 18(1): 216, 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32631349


Rheumatoid arthritis (RA) has a large and varied impact on the quality of life as associated with patient health including both physical and mental well-being. The aim of the study was to assess the factors that affect the assessment of the quality of life of RA patients depending on the prevalence of frailty syndrome. MATERIAL AND METHODS: The study involved 106 patients with RA (82 women; mean age 65.83 ± 5.01), who had been hospitalized in the Silesian Centre for Rheumatology, Rehabilitation and Disability Prevention in Ustron, Poland. The patients that were included in the study were divided into two groups depending on the incidence of frailty syndrome: Group 1 - robust patients and Group 2 - patients with frailty syndrome. RESULTS: Frailty syndrome was identified in 34.9% of the patients with recognized/diagnosed RA; in women, it was 36.14% and in men, it was 25.92%. The average TFI value was 4.11 ± 2.05; in the physical domain, it was 3.39 ± 1.66; in the mental domain, it was 0.41 ± 0.55 and in the social domain, it was 0.31 ± 0.48. The robust patients assessed their quality of life associated with sleep as being worse compared to patients with recognized frailty syndrome. CONCLUSION: Frailty syndrome has no significant impact on the assessment of the quality of life of patients with diagnosed RA. The factors that determine quality of life are different in robust patients and in patients with frailty syndrome. The assessment of the quality of life is affected by the degree of an individual's fitness regardless of the occurrence of frailty syndrome.

Artrite Reumatoide/fisiopatologia , Artrite Reumatoide/psicologia , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/fisiopatologia , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/epidemiologia , Feminino , Fragilidade/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Prevalência
Artigo em Inglês | MEDLINE | ID: mdl-32698531


Frailty affects the elderly and leads to adverse health outcomes. Preliminary evaluations have suggested that sleep quality and psychological distress are predictors of frailty among older adults. However, the mechanisms by which sleep quality affect frailty had not been fully addressed in the previous research. This study aimed to explore the mediation effect of psychological distress on the association between sleep quality and frailty among the elderly with chronic diseases in rural China. A total of 2346 old adults were included in the analysis. Frailty status was measured by Fried Phenotype criteria. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), and psychological distress was examined by Kessler Psychological Distress Scale (K10). Ordinal logistic regressions were performed to assess the relationships between sleep quality and frailty. Mediation test was also conducted by bootstrap method. The prevalence rate of frailty among the elderly with chronic diseases was 21% in rural China. Compared with the elder of robust status, respondents identified as having frailty have lower SES, less vigorous physical activity, and worse self-reported health status. Poor sleep quality was a significant predictor of frailty with mediators (OR = 1.44, 95% CI = 1.19-1.76). Mediation analysis suggested that psychological distress mediated 41.81% of total effect between sleep quality and frailty. This study indicated that poor sleep quality was significantly related to frailty, and psychological was a mediator of this association. However, we could not investigate causal relationships between variables since this was one cross-sectional study. These findings suggested that an early detection of sleep problems and also psychological disorders should be taken to prevent frailty among the rural older adults in China.

Idoso Fragilizado/psicologia , Fragilidade , Angústia Psicológica , Sono/fisiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino
Cuad. psicol. deporte ; 20(3): 75-81, jul. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-193542


This study determined the effects of a 4-week individualized multicomponent exercise program (Vivifrail) on physical frailty and functional disability in older adults living in nursing homes.Fourteen institutionalized older adults (aged 81.7 ± 9.7 years) volunteered to completed 4 weeks of the individualized Vivifrail exercise program (5 days a week) according to their initial level: A, disability; B, frailty; C, pre-frailty and D, robust. Training sessions were directed by strength and conditioning trainers. Eleven participants completed the pre and post evaluations with very high levels of attendance (96% of the training sessions). Functional capacity (SPPB scores) significantly improved in all the participants (+48.2%, p < 0.001) and tests: sit-to-stand (24.1% faster, p = 0.003), gait speed 4 m (9.8% faster, p = 0.033) and 6 m (7.2% faster, p = 0.017) and Up and Go (11.2% faster, p = 0.004). Disability and sarcopenia decreased significantly (SARC-F, p = 0.026; Lawton index, p = 0.013). People with initial levels of disability (A), frailty (B) and pre-fragility (C) shown the greatest improvements. Six of the nine participants who started with physical frailty or pre-frailty status (66.7%) reversed this condition after the intervention. In addition, 33% of participants with disability, who were unable to perform the functional tests (sit-stand and walk), became able to complete them after the intervention. These important benefits found in such a shorter period of time (4 weeks) could be related to three key elements: individualization of the program, daily frequency and face-to-face coaching motivation by physical conditioning professionals

En este estudio se determinaron los efectos de un programa de ejercicio multicomponente individualizado de 4 semanas (Vivifrail) sobre la fragilidad física y la discapacidad funcional en adultos mayores que viven en hogares de ancianos. Catorce personas institucionalizadas (edad 81,7 ± 9,7 años) se ofrecieron voluntarios para completar 4 semanas del programa de ejercicio individualizado Vivifrail (5 días a la semana) de acuerdo con su nivel inicial: A, discapacidad; B, fragilidad; C, pre-fragilidad y D, robusto. Los entrenamientos fueron dirigidos por educadores físico-deportivos titulados. Once participantes completaron las 4 semanas con niveles muy altos de asistencia (96%). La capacidad funcional (puntuación del SPPB) mejoró en todos los participantes (+46,6%, p < 0,001, ES = 0,79) y tests: levantarse de la silla (45,6% faster, p = 0,003, ES = 1,43), velocidad de marcha 4 m (19,3% faster, p = 0,033, ES = 0,38) y test Timed Up-and-Go (23,2% faster, p = 0,004, ES = 0,35). La discapacidad y sarcopenia disminuyeron significativamente (SARC-F, p = 0,026, ES = 0,59; Lawton index, p = 0,013, ES = 0,87). Las personas que empezaron con niveles de discapacidad (A), fragilidad (B) y pre-fragilidad (C) mostraron mejores resultados. Seis de los nueve participantes que comenzaron con fragilidad física o pre-fragilidad (66,7%) revirtieron esta condición tras la intervención. Además, el 33% de los participantes que fueron incapaces de realizar las pruebas funcionales (sentarse, levantase y caminar) al inicio, pudieron completarlas tras la intervención. Estos importantes beneficios en tan poco tiempo (4 semanas) podrían estar relacionados con tres elementos clave: individualización del programa, frecuencia diaria y motivación del entrenamiento dirigido

Neste estudo, foram determinados os efeitos de um programa individualizado de exercícios multicomponentes de quatro semanas (Vivifrail) sobre a fragilidade física e a incapacidade funcional em idosos residentes em casas de repouso. Quatorze indivíduos institucionalizados (idade 81,7 ± 9,7 anos) se voluntariaram para completar 4 semanas do programa de exercícios individualizado Vivifrail (5 dias por semana), de acordo com seu nível inicial: A, incapacidade; B, fragilidade; C, pré-fragilidade e D, robusto. Os treinamentos foram conduzidos por educadores físicos e esportivos certificados. Onze participantes completaram as 4 semanas com níveis muito altos de participação (96%). A capacidade funcional (escore SPPB) melhorou em todos os participantes (+46,6%, p < 0,001, ES = 0,79) e testes: levantar da cadeira (45,6% faster, p = 0,003, ES = 1,43), velocidade de caminhada 4m (19.3% faster, p = 0,033, ES = 0,38) e 6 m (19,3% faster, p = 0,033, ES = 0,38) e teste Timed Up and Go (23,2% faster, p = 0,004, ES = 0,35). Incapacidade e sarcopenia diminuíram significativamente (SARC-F, p = 0,026, ES = 0,59; Lawton index, p = 0,013, ES = 0,87). Pessoas que iniciaram com níveis de incapacidade (A), fragilidade (B) e pré-fragilidade (C) apresentaram melhores resultados. Seis dos nove participantes que iniciaram com a condição física ou pré-fragilidade (66,7%) reverteram essa condição após a intervenção. Além disso, 33% dos participantes que não conseguiram realizar os testes funcionais (sentar, levantar e andar) na linha de base, conseguiram concluí-los após a intervenção. Esses importantes benefícios em tão pouco tempo (4 semanas) podem estar relacionados a três elementos principais: individualização do programa, frequência diária e motivação do treinamento direcionado

Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Idoso Fragilizado , Atenção Primária à Saúde , Terapia por Exercício/métodos , Casas de Saúde , Idoso Fragilizado/psicologia , Terapia por Exercício/psicologia , Acidentes por Quedas/prevenção & controle , Desempenho Físico Funcional
Med. clín (Ed. impr.) ; 155(1): 18-22, jul. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-195690


ANTECEDENTES Y OBJETIVOS: Existen múltiples escalas para la detección de fragilidad en ancianos, pero no específicamente para población institucionalizada. El objetivo fue comprobar tras 3 años de seguimiento qué escala predice con mayor precisión el declive funcional y la mortalidad. MÉTODOS: Estudio longitudinal de cohortes con 110 pacientes mayores de 65 años institucionalizados en Pamplona (Navarra). Se aplicaron 4 escalas de fragilidad (Fried, Fried Imputada, Rockwood y FRAIL NH). El poder de la asociación entre las escalas y los resultados se comprobó mediante análisis de regresión lineal y de Cox. RESULTADOS: El 46,5% de la muestra falleció durante el seguimiento, el 68% de ellos en su residencia, con 43 meses de media de supervivencia. El 71,3% de los ancianos estudiados presentó discapacidad a los 3 años, especialmente los frágiles. Los pacientes robustos experimentaron hospitalizaciones más prolongadas (m=3,4 días) que los frágiles. Las escalas Fried Imputada y la FRAIL NH encontraron diferencias estadísticamente significativas entre grupos para las variables estudiadas; Fried Imputada mostró un HR significativo de muerte para sujetos frágiles (HR=3,3). CONCLUSIONES: Las escalas Fried Imputada y FRAIL NH mostraron una mayor capacidad predictiva para declive funcional y cognitivo, siendo la escala Fried Imputada la única que relaciona la mortalidad con la fragilidad

BACKGROUND AND OBJECTIVES: There are multiple frailty detection tools, but they have not been specifically developed for the institutionalised population. The aim of this study is to ascertain at 3-year follow-up which tool predicts functional impairment and mortality most precisely. METHODS: Longitudinal cohort study with 110 patients in Pamplona (Navarra)>65 years. Four frailty tools were applied (Fried Criteria, Rockwood Frailty Scale, FRAIL-NH and Imputed Fried Frailty Criteria). The power of the association between the scales and the results was assessed by linear regression and Cox's analyses. RESULTS: 46.5% of the sample died during time to follow-up, 68% of whom died in their nursing home, with 43-month mean survival. Of the studied population, 71.3% showed disability at 3 years, especially the frail subjects. The robust patients had longer hospitalizations (m=3.4 days) than the frail. Imputed Fried and FRAIL-NH found statistically significant differences between groups for the variables studied. Imputed Fried Frailty Criteria showed a significant HR of death for the frail subjects (HR=3.3). CONCLUSIONS: The Imputed Fried and FRAIL-NH tools showed a higher predictive capability for functional and cognitive decline, but only the Imputed Fried Frailty Criteria found a significant relationship between frailty and mortality

Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Idoso Fragilizado/estatística & dados numéricos , Estudos de Coortes , Avaliação Geriátrica/métodos , Idoso Fragilizado/psicologia , Estudos Longitudinais , Modelos Lineares , Disfunção Cognitiva/epidemiologia , Tempo de Internação , Inquéritos e Questionários
J Nutr Health Aging ; 24(6): 582-590, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32510110


OBJECTIVES: Compare the diagnostic performance of FRAIL against Fried Phenotype and Frailty Index (FI), and identify clinical factors associated with pre-frailty/frailty. DESIGN: Cross-sectional analysis. SETTING: Community-based screenings in Senior Activity Centres, Residents' Corners and Community Centres in northeast Singapore. PARTICIPANTS: 517 community dwelling participants aged >55 years and ambulant independently (with/ without walking aids) were included in this study. Residents of sheltered or nursing homes, and seniors unable to ambulate at least four meters independently were excluded. MEASUREMENTS: The multidomain geriatric screen included assessments for social vulnerability, mood, cognition, sarcopenia and nutrition. Participants completed a battery of physical fitness tests for grip strength, gait speed, lower limb strength and power, flexibility, balance and endurance, with overall physical performance represented by Short Physical Performance Battery (SPPB). Frailty status was assigned on FRAIL, Fried and 35-item FI. RESULTS: Prevalence of frailty was 1.3% (FRAIL) to 3.1% (FI). Pre-frailty prevalence ranged from 17.0% (FRAIL) to 51.2% (FI). FRAIL demonstrated poor agreement with FI (kappa=0.171, p<0.0001), and Fried (kappa=0.194, p<0.0001). A lower FRAIL cut-off ≥1 yielded significantly improved AUC of 0.70 (95%CI 0.55 to 0.86, p=0.009) against Fried, and 0.71 (95%CI 0.55 to 0.86, p=0.008) against FI. All 3 frailty measures were diagnostic of impaired physical performance on SPPB, with AUCs ranging from 0.69 on FRAIL to 0.77 on Fried (all p values <0.01). Prevalence of low socio-economic status, depression, malnutrition and sarcopenia increased significantly, while fitness measures of gait speed, balance, and endurance declined progressively across robust, pre-frail and frail on all 3 frailty instruments (p <0.05). CONCLUSIONS: Our results suggest that different frailty instruments may capture over-lapping albeit distinct constructs, and thus may not be used interchangeably. FRAIL has utility for quick screening, and any positive response should trigger further assessment, including evaluation for depression, social vulnerability and malnutrition.

Equipamentos para Diagnóstico/normas , Idoso Fragilizado/psicologia , Fragilidade/psicologia , Avaliação Geriátrica/métodos , Vida Independente/normas , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
BMC Public Health ; 20(1): 932, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32539697


BACKGROUND: The purpose of this study was to estimate individuals' expected longevity based on self-assessed survival probabilities and determine the predictors of such subjective life expectancy in a sample of elderly people (50 years and older) in Côte d'Ivoire. METHODS: Paper-based questionnaires were administered to a sample (n = 267) of older adults residing in the city of Dabou, Côte d'Ivoire in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities was collected. We estimated self-assessed life expectancy and its determinants using a two-pronged approach by: (i) estimating individuals' life expectancy using the self-assessed survival probabilities (SSPs), and (ii) applying a finite mixture of regression models to form homogenous groups of individuals (clusters/components) and investigate the determinants. A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression models was used to identify homogeneous groups of individuals (i.e. clusters/components) of the overall subjective life expectancy distribution of the study participants. RESULTS: The mean subjective life expectancy in older people varied according to four components/clusters. The average subjective life expectancy among the elderly was 79.51, 78.89, 80.02, and 77.79 years in the first, second, third, and fourth component of the subjects' overall subjective life expectancy, respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. For instance, a U-shape relationship between household per capita income and subjective life expectancy was found for individuals classified into the third component, and an inverse U-shape relationship was found for individuals classified into the fourth component. CONCLUSIONS: We extended the estimation of subjective life expectancy by accounting for heterogeneity in the distribution of the estimated subjective life expectancy. This approach improved the usual methods for estimating individual subjective life expectancies and may provide insight into the elderly's perception of aging, which could be used to forecast the demand for health services and long-term care needs.

Atitude Frente a Morte , Atitude Frente a Saúde , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Expectativa de Vida , Longevidade , Idoso , Idoso de 80 Anos ou mais , Costa do Marfim , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autoavaliação , Inquéritos e Questionários