A bio-psycho-social approach for frailty amongst Singaporean Chinese community-dwelling older adults – evidence from the Singapore Longitudinal Aging Study

Teo, Nigel; Yeo, Pei Shi; Gao, Qi; Nyunt, Ma Shwe Zin; Foo, Jie Jing; Wee, Shiou‐Liang; Ng, Tze Pin

doi:10.1186/s12877-019-1367-9

Cited by 44 publications

(48 citation statements)

References 34 publications

(53 reference statements)

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“…The possible explanation could be that older people who had been living in a private institution (more expensive in the metropolitan areas than public institution) usually have higher social economic status; they were more likely to feel lonely [30] and loss of appetite [31] when staying away from family and changing their ways of previous life, resulting in higher likelihood of being frailer. Compared with people living with their partners in the same nursing home, those who live with alone or share the room with unknown person may become more frail because of poorer social ties [32] and mental disorders [33]. In line with previous studies [34,35], we also found that regular exercise was associated with physical frailty.…”

Section: Discussionsupporting

confidence: 89%

Physical Frailty and Its Associated Factors Among Elderly Nursing Home Residents in China

Liu

Puts

Fen

et al. 2020

Preprint

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Background: Evidence is scarce on the trend in prevalence of physical frailty in China; the primary purpose of this study was to identify the prevalence and correlates of physical frailty among older nursing home residents in China.Methods: Cross-sectional study in 20 nursing homes in Changsha, China. Physical frailty was defined based on the frailty phenotype including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Participants with at least three affected criteria were defined as being frail. Participants with one or two affected criteria were considered as pre-frail, and those with no affected criteria were considered as robust. A total of 1004 nursing home residents aged 60 and over were included in this study. A multinomial logistic regression model was used to analyze the associations of physical frailty with its potential risk factors, including age, sex, education levels, marital status, type of institution, living status, current drinking, current smoking, regular exercise, and self-reported health.Results: The overall prevalence of physical frailty and prefrailty was 55.6%, and 38.5%, respectively. The rate of physical frailty substantially increased with age, and was higher in women than in men (69.5% vs. 30.5%). The multinomial logistic regression analysis showed that older age, being women, living in a private institution, living alone or with unknown person, having no regular exercise (≤ 2 times/week), and poor self-reported health were significantly associated with increased odds of being physically frail. Conclusion: We demonstrated physical frailty is highly prevalent among older residents in nursing homes in China, especially in women. The potential role of those associated factors of physical frailty warrant further investigations to explore their clinical application among elderly nursing home residents.

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Section: Discussionsupporting

confidence: 89%

Physical Frailty and Its Associated Factors Among Elderly Nursing Home Residents in China

Liu

Puts

Fen

et al. 2020

Preprint

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“…While the prevalence of frailty was 30.7% in all participants, the prevalence was 35.0% for pre-frailty and 34.3% for robust. The prevalence of frailty in our study was relatively high compared with previous estimates, which ranged from 11% up to 26% in community samples (34)(35)(36), which may be attributed to our study design and that participants came from primary care clinics. Frailty and cognitive impairment are distinguishable facets of aging that interact in the cycle of age-related decline.…”

Section: Discussioncontrasting

confidence: 74%

Mild behavioral impairment is related to frailty in cognitively normal older adults: a cross-sectional study

Fan

Liang

Yun

et al. 2020

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Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a neurobehavioral syndrome characterized by later-life emergence of sustained neuropsychiatric symptoms, has yet to be elucidated.We aimed to evaluate the associations between mild behavioral impairment and frailty in cognitively normal older adults.Methods: This is a cross-sectional study. A consecutive series of 137 cognitively normal older adults in the Anti-Aging study, recruited from primary care clinics, were enrolled. Frailty was estimated using the original Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist at a cut-off point of >8 (optimizing sensitivity and specificity), which was developed to assess emergent neuropsychiatric symptoms in accordance with the MBI criteria. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariate logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.6% of the older adults had frailty, 35.0% had prefrailty and 18.2% had MBI (MBI+ status). Multivariate logistic regression analysis demonstrated that compared to MBI- status (without MBI), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, p = 0.02). The frailty and MBI categories were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status are related to higher risk of cognitive impairment. MBI is significantly associated with an increased risk of having frailty before overt cognitive impairment. This association merits further study to identify strategies to the early detection, prevention and therapeutic intervention of frailty.

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“…The proportion of residents aged 65 and above has increased from 8.8% in 2009 to 14.4% in 2019 [24], and the prevalence of frailty ranges from 5.7-11.3% in the population [4], depending on the operationalization of frailty. Studies in Singapore established physical health determinants of frailty such as multimorbidity [4,[25][26][27][28], physical exercise [4], and other lifestyle factors, including smoking [29] and drinking [25,27]. Mental health determinants included cognitive impairment [4,27,28] and depressive symptoms [4, 25-27, 29, 30].…”

Section: Introductionmentioning

confidence: 99%

“…Studies in Singapore established physical health determinants of frailty such as multimorbidity [4,[25][26][27][28], physical exercise [4], and other lifestyle factors, including smoking [29] and drinking [25,27]. Mental health determinants included cognitive impairment [4,27,28] and depressive symptoms [4, 25-27, 29, 30]. However, compared to physical and mental domains, the social health domain is the least well studied, with social networks [27,28] and social activity [27], both of which evaluating the structural aspects of social health, found to be determinants of frailty.…”

Section: Introductionmentioning

confidence: 99%

“…Mental health determinants included cognitive impairment [4,27,28] and depressive symptoms [4, 25-27, 29, 30]. However, compared to physical and mental domains, the social health domain is the least well studied, with social networks [27,28] and social activity [27], both of which evaluating the structural aspects of social health, found to be determinants of frailty. Importantly, little research in Singapore investigated physical, social, and mental determinants of frailty concurrently.…”

Section: Introductionmentioning

confidence: 99%

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Psychosocial determinants of frailty among older adults in Singapore: a community-based survey

Chong

Lim

Mah

et al. 2020

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Background With increasing life expectancy, it is important to understand the role of non-physical aspects of health in frailty prevention. The study aimed to examine how multiple dimensions of mental and social health, in addition to physical health, were associated with frailty in the population of older adults. Methods A cross-sectional door-to-door survey was conducted with 497 older adults in Singapore. Frailty was assessed using the FRAIL scale. Physical health was assessed by multimorbidity and physical activity; social health by the Lubbens’ Social Network Scale, Community Integration Measure and UCLA loneliness scale; and mental health by the three-factor of the General Health Questionnaire (GHQ): anxiety/depression, loss of confidence and social dysfunction. Hierarchical ordinal regression was conducted to identify independent predictors of frailty, adjusting for socio-demographic variables. Results Compared to robust (59.5%) and pre-frail (32.6%) older adults, frail adults (7.9%) reported higher morbidity, lower physical activity, higher scores on all three subscales of GHQ, and had lower scores on all three social health scales that were assessed. In multiple regression model, frailty was significantly associated with 81–90 years old (adj. OR = 3.04), having 2–3 (adj. OR = 1.63) or > 3 (adj. OR = 2.01) chronic diseases, social dysfunction in GHQ (adj. OR = 4.31), and loneliness (adj. OR = 1.26). Physical activity did not remain significantly associated with frailty when mental and social health-related factors were entered in the regression. Conclusions The study findings highlight the importance of community intervention in mental and social health among older adults to prevent frailty in later life. Healthy aging is only possible when older adults’ psychosocial needs are addressed.

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A bio-psycho-social approach for frailty amongst Singaporean Chinese community-dwelling older adults – evidence from the Singapore Longitudinal Aging Study

Cited by 44 publications

References 34 publications

Physical Frailty and Its Associated Factors Among Elderly Nursing Home Residents in China

Physical Frailty and Its Associated Factors Among Elderly Nursing Home Residents in China

Mild behavioral impairment is related to frailty in cognitively normal older adults: a cross-sectional study

Psychosocial determinants of frailty among older adults in Singapore: a community-based survey

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