Early life determinants of frailty in old age: the Helsinki Birth Cohort Study

Haapanen, Markus J; Perälä, Mia-Maria; Salonen, Minna K.; Kajantie, Eero; Simonen, Mika; Pohjolainen, Pertti; Eriksson, Johan G.; Bonsdorff, Mikaela von

doi:10.1093/ageing/afy052

Cited by 39 publications

(45 citation statements)

References 26 publications

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“…Frailty was assessed in 2011-2013 using five criteria: weight loss, exhaustion, low physical activity, slowness and weakness as in a previous publication (1,10). Briefly, weight loss, exhaustion and low physical activity were assessed using questionnaires.…”

Section: Frailtymentioning

confidence: 99%

Infant and childhood growth and frailty in old age: the Helsinki Birth Cohort Study

et al. 2018

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Section: Frailtymentioning

confidence: 99%

Infant and childhood growth and frailty in old age: the Helsinki Birth Cohort Study

et al. 2018

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“…6 Frailty is at least partly programmed in early life and is also associated with lower socio-economic status in adulthood. 7 Second, frailty is conceptualized as a state of decreased physiological reserve and compromised capacity to maintain homeostasis as a consequence of agerelated, multiple, accumulated deficits. 4 Frail older people are highly vulnerable to adverse health outcomes when exposed to an internal or external stressor.…”

Section: Introductionmentioning

confidence: 99%

<p>Frailty syndrome: implications and challenges for health care policy</p>

Kojima

Liljas

Iliffe

2019

RMHP

307

220

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Older adults are a highly heterogeneous group with variable health and functional life courses. Frailty has received increasing scientific attention as a potential explanation of the health diversity of older adults. The frailty phenotype and the Frailty Index are the most frequently used frailty definitions, but recently new frailty definitions that are more practical have been advocated. Prevalence of frailty among the community-dwelling population aged 65 years and older is ~10% but varies depending on which frailty definitions are used. The mean prevalence of frailty gradually increases with age, but the individual's frailty level can be improved. Older adults, especially frail older adults, form the main users of medical and social care services. However, current health care systems are not well prepared to deal with the chronic and complex medical needs of frail older patients. In this context, frailty is potentially a perfect fit as a risk stratification paradigm. The evidence from frailty studies has not yet been fully translated into clinical practice and health care policy making. Successful implementation would improve quality of care and promote healthy aging as well as diminish the impact of aging on health care systems and strengthen their sustainability. At present, however, there is no effective treatment for frailty and the most effective intervention is not yet known. Based on currently available evidence, multi-domain intervention trials, including exercise component, especially multicomponent exercise, which includes resistance training, seem to be promising. The current challenges in frailty research include the lack of an international standard definition of frailty, further understanding of interventions to reverse frailty, the best timing for intervention, and education/training of health care professionals. The hazards of stigmatization should also be considered. If these concerns are properly addressed, widespread application of public health approaches will be possible, including screening, identification, and treatment of frailty, resulting in better care and healthier aging for older people.

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“…These are mostly findings in developed countries, while there are few researches on low-and-middle income countries on this subject. In addition, childhood may represent a key life stage for designing interventions to address health inequality in later life and socioeconomic status in childhood stage also influences the incidence and progression of physical, cognitive, and mental health in old life [9,11,12]. Therefore, the value of life course approach or perspective has been increasingly recognized in the study of aging worldwide [12].…”

Section: Introductionmentioning

confidence: 99%

Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective

2020

IJERPH

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Background: China has the largest number of aging people in need of long-term care, among whom 70% have chronic diseases. For policy planners, it is necessary to understand the different levels of needs of long-term care and provide long-term care insurance to ensure the long-term care needs of all people can be met. Methods: This study combines the 2013 wave of CHARLS survey and the Life Course Survey of 2014. The combination allows us to factor in both childhood and adulthood data to provide life-course analysis. We identified 7,734 older adults with chronic diseases for analysis. The need for long-term care is defined by the presence of functional limitations based on the performance of basic activities of daily living (ADLs) and of instrumental activities of daily living (IADLs). Two dummy variables, ADLs disability and IADLs disability, and two count variables, ADLs score and IADLs score, were defined to measure incidence and severity of long-term care need, respectively. The concentration index was used to capture the inequality in long-term care need, and a decomposition method based on Probit Regression and Negative Binomial Regression was exploited to identify the contribution of each determination. Results: At least a little difficulty was reported in ADLs and IADLs in 20.44% and 19.25% of respondents, respectively. The concentration index of ADLs disability, ADLs score, IADLs disability, IADLs score were −0.085, −0.109, −0.095 and −0.120, respectively, all of which were statistically significant, indicating the pro-poor inequality in the incidence and severity of long-term care need. Decomposition analyses revealed that family income, education attainment, aging, and childhood experience played a significant role in explaining the inequalities. Conclusions: The long-term care need among older adults with chronic disease is high in China and low socioeconomic groups had a higher probability of needing long-term care or need more long-term care. It is urgent to implement long-term care insurance, especially for the individuals from lower socioeconomic groups.

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Early life determinants of frailty in old age: the Helsinki Birth Cohort Study

Abstract: those who were small at birth were at an increased risk of developing frailty in old age, suggesting that frailty is at least partly programmed in early life. A less privileged socioeconomic status in adulthood was associated with an increased risk of frailty in old age.

Cited by 39 publications

References 26 publications

Infant and childhood growth and frailty in old age: the Helsinki Birth Cohort Study

Infant and childhood growth and frailty in old age: the Helsinki Birth Cohort Study

<p>Frailty syndrome: implications and challenges for health care policy</p>

Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective

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