The modified Healthy Aging Index is associated with mobility limitations and falls in a community-based sample of oldest old

Li, Kailiang; Xu, Weihao; Hu, Bo; Qing, Shan; Liu, Lin; Cao, Jian

doi:10.1007/s40520-020-01560-w

Cited by 10 publications

(11 citation statements)

References 22 publications

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“…Selection bias is possible as participants were recruited from the health fora and not truly representative of the older adult population in the communities. Nonetheless, some community-based studies on falls [84][85][86][87] implemented a similar recruitment approach where it was difficult to enumerate all Table 8 Association between E 1 and gait speed in male and female * Indicates p ≤ 0.05, Adjusted covariates: Model 1 = Age, weight, smoking status, alcohol consumption, and use of walking devices; Model 2 = Model 1 + co-morbidities (dizziness, vestibular diseases, diabetes, and arthritis) Model 3 = Model 2 + markers of cardiovascular risk (natural-log-transformed levels of the use of anti-anxiety drugs, gender) Model 4 = Model 3 + BMI categories * Parameter estimates (β) can be interpreted as differences in mean gait speed (m/sec) for each increment of one standard deviation in the log-transformed E 1 among men (or women) † Parameter estimates (β) can be interpreted as differences in mean gait speed (m/sec) compared male (or female) subjects in the 2nd, 3rd, and 4th quartiles of E 1 to those in the lowest quartile Abbreviations: E 1 -Equality point for the regression lines of velocity and stride frequency on the VFD; SE, standard error…”

Section: Strength and Limitations Of The Studymentioning

confidence: 99%

Evaluating the discriminatory power of the velocity field diagram and timed-up-and-go test in determining the fall status of community-dwelling older adults: a cross-sectional observational study

Ibeneme

Eze

Okonkwo³

et al. 2022

BMC Geriatr

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Background Systematic reviews demonstrated that gait variables are the most reliable predictors of future falls, yet are rarely included in fall screening tools. Thus, most tools have higher specificity than sensitivity, hence may be misleading/detrimental to care. Therefore, this study aimed to determine the validity, and reliability of the velocity field diagram (VFD -a gait analytical tool), and the Timed-up-and-go test (TUG)-commonly used in Nigeria as fall screening tools, compared to a gold standard (known fallers) among community-dwelling older adults. Method This is a cross-sectional observational study of 500 older adults (280 fallers and 220 non-fallers), recruited by convenience sampling technique at community health fora on fall prevention. Participants completed a 7-m distance with the number of steps and time it took determined and used to compute the stride length, stride frequency, and velocity, which regression lines formed the VFD. TUG test was simultaneously conducted to discriminate fallers from non-fallers. The cut-off points for falls were: TUG times ≥ 13.5 s; VFD’s intersection point of the stride frequency, and velocity regression lines (E1) ≥ 3.5velots. The receiver operating characteristic (ROC) area under the curves (AUC) was used to explore the ability of the E1 ≥ 3.5velots to discriminate between fallers and non-fallers. The VFD’s and TUG’s sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. Alpha was set at p < 0.05. Results The VFD versus TUG sensitivity, specificity, PPV and NPV were 71%, 27%, 55%, and 42%, versus 39%, 59%, 55%, and 43%, respectively. The ROC’s AUC were 0.74(95%CI:0.597,0.882, p = 0.001) for the VFD. The optimal categorizations for discrimination between fallers/non-fallers were ≥ 3.78 versus ≤ 3.78 for VFD (fallers versus non-fallers prevalence is 60.71% versus 95.45%, respectively), with a classification accuracy or prediction rate of 0.76 unlike TUG with AUC = 0.53 (95% CI:0.353,0.700, p = 0.762), and a classification accuracy of 0.68, and optimal characterization of ≥ 12.81 s versus ≤ 12.81 (fallers and non-fallers prevalence = 92.86% versus 36.36%, respectively). Conclusion The VFD demonstrated a fair discriminatory power and greater reliability in identifying fallers than the TUG, and therefore, could replace the TUG as a primary tool in screening those at risk of falls.

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Section: Strength and Limitations Of The Studymentioning

confidence: 99%

Evaluating the discriminatory power of the velocity field diagram and timed-up-and-go test in determining the fall status of community-dwelling older adults: a cross-sectional observational study

Ibeneme

Eze

Okonkwo³

et al. 2022

BMC Geriatr

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“…A universal set of interconnected health indicators has been pooled to quantify the extent of healthy aging, but previous indicators failed to capture the multidimensional conceptualization of health and the interlinkages between these indicators [4,9,10]. Healthy aging assessment starts with disease-based conceptualizations [11][12][13], which have been criticized for their narrow biomedical focus. Following the definition of healthy aging proposed by the WHO, function-based approaches have been developed, and the indicators of healthy aging are extended to include freedom from disability, high physical functioning, sound mental health conditions, freedom from sensory limitations, subjectively rated health, and sound social health [3,5,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Following the definition of healthy aging proposed by the WHO, function-based approaches have been developed, and the indicators of healthy aging are extended to include freedom from disability, high physical functioning, sound mental health conditions, freedom from sensory limitations, subjectively rated health, and sound social health [3,5,[14][15][16]. These approaches tend to conceptualize healthy aging as a cumulative score based on the total number of deficits present in a person, leaving open the question of measuring health interlinkages [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Healthy aging index and its link with relative education between individual and neighborhood: a population-based, cohort study

Zong

Wang

et al. 2022

BMC Geriatr

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Objectives There is increasing recognition of the importance of neighborhood socioeconomic status (SES) for establishing an age-friendly society. Despite the benefits of improved neighborhood SES, little is known about the link of relative education between individuals and neighborhoods with healthy aging. This study aims to construct a healthy aging index (HAI) accounting for indicators’ interlinkages and to test the association of the HAI with relative education between neighborhoods and individuals. Methods The study used data from the China Health and Retirement Longitudinal Study from 2011 to 2018, including middle-aged and older adults (≥ 45 years). The final sample comprised 11633 participants residing in 443 neighborhoods with 34123 observations. Based on 13 health indicators, a hybrid method integrating network analysis with TOPSIS was applied to construct a HAI accounting for health interlinkages. Weighted multilevel linear and ordered logistic models were used to estimate the effects of neighborhood education. Results Among the 11633 participants (mean [SD] age, 58.20 [8.91] years; 6415 women [52.82%]), the mean (SD) HAI was 48.94 (7.55) at baseline, showing a downward trend with age. Approximately 10% of participants had a HAI trajectory characterized by a low starting point and fast decline. A one-year increase in neighborhood education was independently associated with a 0.37-point increase (95% CI, 0.23–0.52) in HAI. Regardless of individual education, each participant tended to gain benefits from a neighborhood with higher education. However, the effects of increased neighborhood education were weaker for individuals whose education was lower than the neighborhood average. Conclusions The HAI is an interaction system. Improving neighborhood education was beneficial to healthy aging, but individuals with lower education relative to the neighborhood average may experience poor person–environment fit and obtain fewer benefits from improved neighborhood education. Thus, in the process of improving neighborhood SES, individual-based interventions should be conducted for individuals whose education level is lower than the neighborhood average to achieve person–environment fit.

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“…In addition, the modified version of the HAI is still significantly and independently associated with adverse outcomes [6, 10]. However, whether the HAI is suitable for Chinese elderly adults remains an open question, and few studies have been conducted to evaluate the applicability of the HAI in the Chinese population [11, 12]. Wu et al [11] adopted the HAI in the China Health and Retirement Longitudinal Study (CHARLS) and found that the Chinese Healthy Ageing Index was associated with a high risk of all-cause death and incident instrumental activities of daily living disability.…”

Section: Introductionmentioning

confidence: 99%

“…Wu et al [11] adopted the HAI in the China Health and Retirement Longitudinal Study (CHARLS) and found that the Chinese Healthy Ageing Index was associated with a high risk of all-cause death and incident instrumental activities of daily living disability. Li et al [12] modified the HAI in community-dwelling older adults and found that a per unit increase in the modified HAI score was associated with low handgrip strength, slow gait speed, and lower extremity strength limitations. Considering the lack of studies validating the applicability of the HAI in China, we aimed to evaluate the association of the HAI with adverse outcomes (including all-cause mortality and functional disability) and validate whether the HAI was suitable for monitoring ageing status in the elderly population in China.…”

Section: Introductionmentioning

confidence: 99%

The Modified Healthy Ageing Index Is Associated with Mortality and Disability: The Rugao Longevity and Ageing Study

Zhang

Zhu²,

Meng

et al. 2021

Gerontology

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Introduction: The Healthy Ageing Index (HAI) has been shown not only to have wider applicability and predictive ability but also to adequately predict mortality in Western populations. There is still a lack of studies validating the applicability of the HAI in China. Objective: To evaluate the applicability of the HAI and validate whether the HAI is suitable for monitoring ageing in the elderly population in China. Methods: Data were obtained from the Rugao Longevity and Ageing Study. The modified HAI was constructed based on systolic blood pressure, chronic pulmonary diseases, cognitive function, fasting glucose, and kidney function. It was calculated in 1719 individuals aged 70–84 years at baseline. The adverse outcomes were mortality and disability. Demographic, physiologic, and clinical data were collected. Cox proportional hazards and logistic regression models were used to analyze the relationship between the modified HAI and adverse outcomes. Results: A total of 1,719 older adults were analyzed in our study. A total of 793 (46.13%) males were recruited. The mean age was 75.69 ± 3.93 years. At the 5-year follow-up, there were 266 deaths and 275 individuals with disabilities. In the multivariable models, the modified HAI was associated with mortality (hazard ratio = 1.11, 95% confidence interval [CI]: 1.03–1.20) and disability (odds ratio = 1.11, 95% CI: 1.05–1.18). In the sensitivity analyses, similar associations remained after imputing missing data using multiple imputation and excluding participants with major cardiovascular disease at baseline. Conclusion: The modified HAI was a robust and independent predictor of adverse outcomes. It is a valid and feasible tool for monitoring ageing in older adults.

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The modified Healthy Aging Index is associated with mobility limitations and falls in a community-based sample of oldest old

Cited by 10 publications

References 22 publications

Evaluating the discriminatory power of the velocity field diagram and timed-up-and-go test in determining the fall status of community-dwelling older adults: a cross-sectional observational study

Evaluating the discriminatory power of the velocity field diagram and timed-up-and-go test in determining the fall status of community-dwelling older adults: a cross-sectional observational study

Healthy aging index and its link with relative education between individual and neighborhood: a population-based, cohort study

The Modified Healthy Ageing Index Is Associated with Mortality and Disability: The Rugao Longevity and Ageing Study

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