Are physically frail older persons more at risk of adverse outcomes if they also suffer from cognitive, social, and psychological frailty?

Ament, Bart; Vugt, Marjolein E. de; Verhey, Frans R.J.; Kempen, Gertrudis I. J. M.

doi:10.1007/s10433-014-0308-x

Cited by 46 publications

(53 citation statements)

References 35 publications

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“…27 Another study reported that physical frailty could predict the incidence of disability; however, the cognitive and social domains had no additional effects on disability among older people who already suffered from physical frailty. 28 The present results are in agreement with these previous studies, and highlighted the impact of physical status on the incidence of disability using statistical modeling.…”

Section: Discussionsupporting

confidence: 93%

“…One of the few studies that have compared the effects of the health deficit between the three domains (physical, cognitive and social) of health status on the onset of disability showed that physical frailty was mostly responsible for the predictive validity of adverse health outcomes, including disability . Another study reported that physical frailty could predict the incidence of disability; however, the cognitive and social domains had no additional effects on disability among older people who already suffered from physical frailty . The present results are in agreement with these previous studies, and highlighted the impact of physical status on the incidence of disability using statistical modeling.…”

Section: Discussionmentioning

confidence: 99%

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Structural analysis of impact of physical, cognitive and social status on the incidence of disability in community‐dwelling people aged ≥75 years

Makino

Ihira²,

Mizumoto³

et al. 2018

Geriatrics Gerontology Int

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Aim The present study aimed to propose a structural model to explain the interaction of physical, cognitive and social domains of health status in the incidence of disability in community‐dwelling people aged ≥75 years. Methods We analyzed 185 older adults (mean age 79.4 years, 58.4% female) who participated in a baseline assessment from 2012 to 2013. They were followed for incident certification of care needs in the national long‐term care insurance certification system during the 2 years. Baseline assessments included several measurements related to the physical, cognitive and social domains of health status. We compared the model fit index between two hypothesis models – the parallel model and the hierarchical model – using structural equation modeling. Results During the follow‐up period, 15 participants (8.1%) were newly certified as requiring personal support from the long‐term care insurance system. The structural equation modeling showed that the hierarchical model, indicating that cognitive and social status were indirectly associated with disability through physical status, had a better fit with the data than the parallel model, indicating that physical, cognitive and social status each were directly associated with disability. Conclusions The present results suggest that cognitive and social status might indirectly affect disability incidence through physical aging. Further research is required to examine the temporal relationship between physical, cognitive and social change using data over several time‐periods. Geriatr Gerontol Int 2018; 18: 1614–1619.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Structural analysis of impact of physical, cognitive and social status on the incidence of disability in community‐dwelling people aged ≥75 years

Makino

Ihira²,

Mizumoto³

et al. 2018

Geriatrics Gerontology Int

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show abstract

“…Furthermore, physical frailty predicts incident cognitive impairment (Canevelli et al, 2015). However, previous research yielded mixed results as to whether cognitive impairment had additional impact on disability for those who are already physically frail (Ament et al, 2014;Avila-Funes et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Pathways from physical frailty to activity limitation in older people: Identifying moderators and mediators in the English Longitudinal Study of Ageing

Ding

Kuha

Murphy

2017

Experimental Gerontology

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Physical frailty increases the risk of future activity limitation, which in turn, compromises independent living of older people and limits their healthspan. Thus, we seek to identify moderators and mediators of the effect of physical frailty on activity limitation change in older people, including gender- and age-specific effects. In a longitudinal study using data from waves 2, 4, and 6 of the English Longitudinal Study of Ageing, unique physical frailty factor scores of 4638 respondents aged 65 to 89years are obtained from confirmatory factor analysis of physical frailty, which is specified by three indicators, namely slowness, weakness, and exhaustion. Using a series of autoregressive cross-lagged models, we estimate the effect of physical frailty factor score on activity limitation change, including its moderation by social conditions, and indirect effects through physical and psychological conditions. We find that the effect of physical frailty on activity limitation change is significantly stronger with older age, while it has significant indirect effects through low physical activity, depressive symptoms, and cognitive impairment. In turn, indirect effects of physical frailty through low physical activity and cognitive impairment are stronger with older age. Sensitivity analyses suggest that these effects vary in their robustness to unmeasured confounding. We conclude that low physical activity, depressive symptoms, and cognitive impairment are potentially modifiable mediators on pathways from physical frailty to activity limitation in older people, including those who are very old. This evidence offers support for population-level interventions that target these conditions, to mitigate the effect of physical frailty on activity limitation, and thereby enhance healthspan.

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“… 87 Similarly, a Dutch study showed that almost half of frail participants still report a good to excellent quality of life. 88 …”

Section: Introductionmentioning

confidence: 99%

Exploring the efficiency of the Tilburg Frailty Indicator: a review

Gobbens

Schols

Assen

2017

CIA

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Due to rapidly aging human populations, frailty has become an essential concept, as it identifies older people who have higher risk of adverse outcomes, such as disability, institutionalization, lower quality of life, and premature death. The Tilburg Frailty Indicator (TFI) is a user-friendly questionnaire based on a multidimensional approach to frailty, assessing physical, psychologic, and social aspects of human functioning. This review aims to explore the efficiency of the TFI in assessing frailty as a means to carry out research into the antecedents and consequences of frailty, and its use both in daily practice and for future intervention studies. Using a multidimensional approach to frailty, in contexts where health care professionals or researchers may have no time to interview or examine the client, we recommend employing the TFI because there is robust evidence of its reliability and validity and it is easy and quick to administer. More studies are needed to establish whether the TFI is suitable for intervention studies not only in the community, but also for specific groups such as patients in the hospital or admitted to an emergency department. We conclude that it is important to not only determine the deficits that frail older people may have, but also to assess their balancing strengths and resources. In order to be able to meet the individual needs of frail older persons, traditional and often fragmented elderly care should be developed toward a more proactive elderly care, in which frail older persons and their informal network are in charge.

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Are physically frail older persons more at risk of adverse outcomes if they also suffer from cognitive, social, and psychological frailty?

Cited by 46 publications

References 35 publications

Structural analysis of impact of physical, cognitive and social status on the incidence of disability in community‐dwelling people aged ≥75 years

Structural analysis of impact of physical, cognitive and social status on the incidence of disability in community‐dwelling people aged ≥75 years

Pathways from physical frailty to activity limitation in older people: Identifying moderators and mediators in the English Longitudinal Study of Ageing

Exploring the efficiency of the Tilburg Frailty Indicator: a review

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