Frailty is associated with objectively assessed sedentary behaviour patterns in older adults: Evidence from the Toledo Study for Healthy Aging (TSHA)

Objective: The aim of this study was to examine the association of sedentary behaviour patterns with frailty in older people. Setting: Clinical setting. Design: Cross-sectional, observational study. Participants and measurements: A triaxial accelerometer was used in a subsample from the Toledo Study for Healthy Aging (519 participants, 67–97 years) to assess several sedentary behaviour patterns including sedentary time per day, the number and duration (min) of breaks in sedentary time per day, and the proportion of the day spent in sedentary bouts of 10 minutes or more. Frailty was assessed using the Frailty Trait Scale (FTS). Regression analysis was used to ascertain the associations between sedentary behaviour patterns and frailty. Results: Sedentary time per day and the proportion of the day spent in sedentary bouts of 10 minutes or more, were positively associated with frailty in the study sample. Conversely, the time spent in breaks in sedentary time was negatively associated with frailty. Conclusion: In summary, breaking up sedentary time and time spent in sedentary behaviour are associated with frailty in older people

Secondary Prevention of Cancer in the Older Individual

The incidence and the mortality of cancer increase with age. This article explores the possibility of decreasing cancerrelated mortality in the aged with secondary prevention of cancer deaths that entails early diagnosis of cancer through the screening of asymptomatic older individuals. We establish that screening of asymptomatic individuals should be based on physiologic rather than chronologic age that may be estimated from a comprehensive geriatric assessment and possibly with the utilization of biologic markers of aging. It is reasonable to offer some form of screening for lung and colorectal cancer to individuals with a life expectancy of at least five years and screening for breast and prostate cancer to women and men respectively with a life expectancy of at least ten years. The ideal number of screening sessions and the ideal interval between screening sessions is unestablished. The aging of the population, the diversity of the older population, the development of new and more sensitive screening interventions, the discovery of new biologic markers of cancer and age represent the main challenges in studying the value of cancer screening in the aged. Probably the most reliable information may be obtained from rapid-learning databases in which information related to each person's physiologic age is included. Worldwide, the incidence and prevalence of cancer increase with age [1]. In the meantime the risk of cancer-related mortality increases with age at diagnosis [2-4]. As the world population is aging, cancer in the older person is an ever more common problem, and the reduction of cancer deaths in older individuals represents the most urgent goal of cancer control. In this article we explore secondary cancer prevention as representing a strategy to reduce the risk of mortality in the aged.This hypothesis is based on four considerations: i. Several studies showed that the practice of screening asymptomatic individuals for cancer becomes less common with the aging of the population [5]. ii. The average life expectancy of the Western population is rapidly increasing1. Consequently the benefits of early detection of cancer that emerges several years after diagnosis may be present even for those undergoing screening at an advanced age. iii. New forms of cancer treatment, including minimally invasive surgery [6], stereotactic radio surgery [7], and targeted systemic therapy [8], are associated with decreased risk of complications. They may be safely utilized in individuals with limited tolerance of stress who might be hurt by more aggressive treatments. It is now possible to personalize cancer screening according to individual life expectancy and tolerance of stress, as the estimate of a person's physiologic age is becoming more precise [1,9]. After reviewing the principles and the effectiveness of cancer screening and early detection, this article will explore the benefits and risks of secondary cancer prevention in older individuals. In particular we will review the current evidence and the limitations of previous clinical trials. At the end we will propose a conceptual framework to guide the screening of older individuals for cancer, and we will propose a research agenda

Changes in health behaviors, mental and physical health among older adults under severe lockdown restrictions during the covid-19 pandemic in spain

We used data from 3041 participants in four cohorts of community-dwelling individuals aged =65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If an-other lockdown were imposed during this or future pandemics, public health programs should spe-cially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

ICFSR TASK FORCE PERSPECTIVE ON BIOMARKERS FOR SARCOPENIA AND FRAILTY

Biomarkers of frailty and sarcopenia are essential to advance the understanding of these conditions of aging and develop new diagnostic tools and effective treatments. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force – a group of academic and industry scientists from around the world — met in February 2019 to discuss the current state of biomarker development for frailty and sarcopenia. The D3Cr dilution method, which assesses creatinine excretion as a biochemical measure of muscle mass, was suggested as a more accurate measure of functional muscle mass than assessment by dual energy x-ray absorptiometry (DXA). Proposed biomarkers of frailty include markers of inflammation, the hypothalamic-pituitary-adrenal (HPA) axis response to stress, altered glucose insulin dynamics, endocrine dysregulation, aging, and others, acknowledging the complex multisystem etiology that contributes to frailty. Lack of clarity regarding a regulatory pathway for biomarker development has hindered progress; however, there are currently several international efforts to develop such biomarkers as tools to improve the treatment of individuals presenting these conditions

"Touchscreen Assessment Tool" (TATOO), an Assessment Tool Based on the Expanded Conceptual Model of Frailty

Frailty is a common clinical syndrome in older adults; it carries an increased risk of negative health events and outcomes including falls, incident disability, hospitalization, and mortality. Therefore, it is critical to identify high-risk subsets of the elderly population and explore new arenas for frailty prevention and treatment. This chapter will provide an overview of the current state of assessment models for frailty syndrome in the elderly and will describe a new assessment tool based on mobile technology, which takes account and advantage of the ways in which elderly people interact with a touchscreen. While healthcare providers and researchers in the field of aging have long been aware of the changing characteristics and needs of older people living in the community, there has not been any marked change in frailty syndrome assessment models until now. In the twenty-first century world with its technological advancements, the elderly require new, special physical skills combining perceptual, motor, and cognitive abilities for their functional daily activities and for maintaining their independence and quality of life

ARIA 2016:Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease

ARIA 2016 : Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.Peer reviewe

Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

[This corrects the article DOI: 10.1186/s13601-016-0116-9.]