Frailty: biological risk factors, negative consequences and quality of life

Deeg, D.J.H. [Promotor]Lips, P.T.A.M. [Promotor

Static and dynamic measures of frailty predicted decline in performance-based and self-reported physical functioning

OBJECTIVE: To determine the effect of frailty on decline in physical functioning and to examine if chronic diseases modify this effect. METHODS: The study sample was derived from the Longitudinal Aging Study Amsterdam and included respondents with initial ages 65 and over at T(2) (1995/1996), who participated at T(1) (1992/1993) and T(2) and performed physical performance tests (n = 1,152) or reported functional limitations (n = 1,321) at T(2) and T(3) (1998/1999). Nine frailty markers were determined in two ways: low functioning at T(2) (static definition); and decline in functioning between T(1) and T(2) (dynamic definition). Using logistic regression analyses, the effect of frailty was examined on change in physical functioning between T(2) and T(3), adjusting for sex, age, education, and additionally chronic diseases. RESULTS: Static frailty was associated with performance decline only in the middle-old group (OR 2.43; 95%CI 1.23-4.80) and associated with decline in self-reported functioning (OR 2.44; 95%CI 1.77-3.36). Dynamic frailty was associated with decline in performance only in women (OR 1.72; 95%CI 1.11-2.67) and with self-reported functional decline (OR 1.77; 95%CI 1.29-2.43). These associations were independent of chronic diseases. CONCLUSION: Frailty is more strongly associated with self-reported functional decline in older persons than with performance declin

The effect of frailty for residential/nursing home admission in the Netherlands independent of chronic diseases and disability

The aim of this study was to determine the effect of frailty on the risk of residential/nursing home admission independently of chronic diseases and functional limitations. Frailty consists of multisystem decline and is considered to be a consequence of changes in neuromuscular, endocrine and immune system functioning that occur as people age. Frailty is a combination of multiple impairments in functioning that might lead to functional limitations and disability but it is not clear whether frailty has an independent effect on residential/nursing home admission. Data were used from the Longitudinal Aging Study Amsterdam. The respondents participated at both

Low serum concentrations of 25-hydroxyvitamin D in older persons and the risk of nursing home admission

BACKGROUND: The prevalence of vitamin D deficiency in nursing home patients is high. OBJECTIVE: We aimed to ascertain whether lower serum 25-hydroxyvitamin D [25(OH)D] concentrations increase the risk of future nursing home admission and early death. DESIGN: We included 1260 independent, community-dwelling persons aged > or =65 y who were participating in the Longitudinal Aging Study Amsterdam (1995-1996). Study outcomes were time to nursing home admission during 6 y of follow-up and time to death until 1 April 2003. RESULTS: Vitamin D deficiency [25(OH)D or =75 nmol/L) concentrations (58 compared with 5 cases). After adjustment for potential confounders, the hazard ratio (95% CI) of nursing home admission was 3.48 (1.39, 8.75) for vitamin D-deficient, 2.77 (1.17, 6.55) for vitamin D-insufficient, and 1.92 (0.79, 4.66) for vitamin D-borderline persons as compared with persons with high 25(OH)D (P for trend = 0.002). The results remained after additional adjustment for frailty indicators. Lower 25(OH)D was associated with higher mortality risk, but this association was not significant after adjustment for frailty indicators. CONCLUSION: Lower serum 25(OH)D concentrations in older persons are associated with a greater risk of future nursing home admission and may be associated with mortality

Unhealthy lifestyles during the life course: association with physical decline in late life

Background and aims: This study aimed at examining the association between unhealthy lifestyle in young age, midlife and/or old age and physical decline in old age, and between chronic exposure to an unhealthy lifestyle throughout life and physical decline in old age. Methods: The study sample included 1297 respondents of the Longitudinal Aging Study Amsterdam (LASA). Lifestyle in old age (55-85 y) was assessed at baseline, whereas lifestyle in young age (around 25 y) and midlife (around 40 y) were assessed retrospectively. Lifestyle factors included physical activity, body mass index (BMI), number of alcohol drinks per week and smoking. Physical decline was calculated as a change in physical performance score between baseline and six-year follow-up. Results: Of the lifestyle factors present in old age, a BMI of 25-29 vs BMI <25 kg/m2 (OR=1.6; 95% CI: 1.1-2.2) and a BMI of ≥30 us BMI <25 kg/ m2 (OR=1.8; 95% CI. 1.2-2.7) were associated with physical decline in old age. Being physically inactive in old age was not significantly associated with an increased risk of physical decline, although, being physically inactive in both midlife and old age increased the odds of physical decline in old age to 1.6 (95% CI: 1.1-2.4), compared with respondents who were physically inactive in midlife and physically active in old age. Being overweight in both age periods was associated with an OR of 1.5 (95% CI: 1.1-2.2). Conclusions: These data suggest that overweight in old age, and chronic exposure to physical inactivity or overweight throughout life, increases the risk of physical decline in old age. Therefore, physical activity and prevention of excessive weight at all ages should be stimulated, to prevent physical decline in old age

Meeting the Needs of the Aging Population: The Canadian Network on Aging and Cancer—Report on the First Network Meeting, 27 April 2016

The aging of the Canadian population represents the major risk factor for a projected increase in cancer incidence in the coming decades. However, the evidence base to guide management of older adults with cancer remains extremely limited. It is thus imperative that we develop a national research agenda and establish a national collaborative network to devise joint studies that will help to accelerate the development of high-quality research, education, and clinical care and thus better address the needs of older Canadians with cancer. To begin this process, the inaugural meeting of the Canadian Network on Aging and Cancer was held in Toronto, 27 April 2016. The meeting was attended by 51 invited researchers and clinicians from across Canada, as well as by international leaders in geriatric oncology from the United States and France. The objectives of the meeting were to (1) review the present landscape of education, clinical care, and research in the area of cancer and aging in Canada; (2) identify issues of high research priority in Canada within the field of cancer and aging; (3) identify current barriers to geriatric oncology research in Canada and develop potential solutions; (4) develop a Canadian collaborative multidisciplinary research network between investigators to improve health outcomes for older adults with cancer; (5) learn from successful international efforts to stimulate the geriatric oncology research agenda in Canada. In the present report, we describe the education, clinical care, and research priorities that were identified at the meeting