Suchergebnisse

"Dieser Beitrag befasst sich mit der soziologischen Dimension des gerontologisch-geriatrischen Konzepts Frailty. Dieses Konzept ist in einem biopsychosozialen Modell des Alterns verortet. Diskutiert werden sozialstrukturelle Faktoren, mikrosoziale Handlungsmuster und gesellschaftliche Folgen des Frailty-Konzepts. Die dazu angeführten Forschungsarbeiten lassen erkennen, dass der Einfluss sozialer Determinanten auf den Prozess des Gebrechlichwerdens eine bedeutende Rolle spielt. Frailty ist nicht nur eine physiologische Veränderung, sondern eng verknüpft mit entsprechenden subjektiven Bearbeitungsmustern (role-making). Defizitär ist weiterhin eine hinreichende gesellschaftstheoretische Begründung des Frailty-Konzepts." (Autorenreferat)

This review article provides an update of the empirical research on cognitive fragility conducted in the last four years. The studies retrieved were classified in four different categories. The first category includes articles relating cognitive frailty to cognitive reserve and which continue to highlight the importance of educational level. The second category includes recent research on cognitive fragility biomarkers, involving neuroimaging, metabolism and, in a novel way, microbiota. The third category includes research on how cognitive frailty is related to motor development and physical functioning, exploring e.g. the use of technology to study motor markers of cognitive frailty. Finally, in the fourth category, research clarifying the difference between reversible frailty and potentially reversible cognitive frailty has led to new interventions aimed at reducing cognitive frailty and preventing negative health outcomes. Interventions based on physical activity and multicomponent interventions are particularly emphasized. In addition, recent research explores the long-term effects of dual interventions in older adults living in nursing homes. In summary, research on cognitive frailty has increased in recent years, and applied aspects have gained importance ; This work was financially supported through FEDER founds (A way to make Europe) by the Spanish AEI (doi:10.13039/501100011033; Refs. PID2020-114521RB-C21 and PSI2017-89389-C2-1-R) and by the Galician Government (Consellería de Cultura, Educación e Ordenación Universitaria; GI-1807-USC: Ref. ED431C 2021/04). CB was supported by a Research Initiation Grant from the University of Santiago de Compostela, co-financed by Banco Santander. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication ; SI

WOS: 000368322100003 ; Introduction: Frailty is characterized by increased vulnerability to stressors that poses the older subject at risk of adverse health-related outcomes, including hospitalization, disability and mortality. Early identification of community-dwelling frail older subjects is important in order to implement preventive strategies against negative health-related outcomes, in particular disability. Validated brief screening tools are needed to detect frail community-dwelling elders. Materials and methods: The aim of the present study, promoted by the European Union Geriatric Medicine Society (EUGMS) working group on "Frailty in older persons", is to determine the agreement between the Gerontopole Frailty Screening Tool (GFST) (administered by the general practitioner) and the Fried' criteria for frailty phenotype as reference measure (administered by a blinded assessor). The study is performed in older primary care patients in nine European countries after translation of the GFST into eight languages. Results: The sample (n = 109 older patients,) included 37.6%, 56.9%, and 5.5% robust, pre-frail or frail, and disabled individuals, respectively. The GFST showed a sensitivity of 71.0%, a specificity of 70.2%, a positive predictive value of 75.9% and a negative predictive value of 64.7% at the identification of non-disabled frail elders. The positive and negative likelihood ratios were 2.38 and 0.41, respectively. In logistic regression models only slow gait speed (odds ratio [OR]: 19.65,95% confidence interval [95% Cl]: 4.69-82.35) and mobility issues (OR: 18.04, 95% CI: 3.11-104.78) were significantly associated with the condition of frailty in the absence of disability. Conclusions: Our findings demonstrate an overall moderate agreement between the GFST and the frailty phenotype. (c) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. ; Nutricia ; This work was supported by an unrestricted grant provided by Nutricia to the European Union Geriatric Medicine Society (EUGMS). Authors want to sincerely thank all the general practitioners who agreed to participate in this research and without whom this study would not have been possible. In particular: Marco Grandi (Ancona, Italy), Kerem Derya (Instanbul, Turkey), Julie Subra and Bruno Chicoulaa (Toulouse, France), Ivo Forgnone and Ana Siguero (Madrid, Spain), Carole Clouter (Southampton, United Kingdom), Claudia Schmeer and Odile Ciaroni-Rappaz (Geneva, Switzerland), David Macharacek and Pavla Madlova (Prague, Czech Republic); Heidi Kanala, (Helsinki, Finland).; Rein Baarsma (Leeuwarden, The Netherlands).

WOS: 000368322100003 ; Introduction: Frailty is characterized by increased vulnerability to stressors that poses the older subject at risk of adverse health-related outcomes, including hospitalization, disability and mortality. Early identification of community-dwelling frail older subjects is important in order to implement preventive strategies against negative health-related outcomes, in particular disability. Validated brief screening tools are needed to detect frail community-dwelling elders. Materials and methods: The aim of the present study, promoted by the European Union Geriatric Medicine Society (EUGMS) working group on "Frailty in older persons", is to determine the agreement between the Gerontopole Frailty Screening Tool (GFST) (administered by the general practitioner) and the Fried' criteria for frailty phenotype as reference measure (administered by a blinded assessor). The study is performed in older primary care patients in nine European countries after translation of the GFST into eight languages. Results: The sample (n = 109 older patients,) included 37.6%, 56.9%, and 5.5% robust, pre-frail or frail, and disabled individuals, respectively. The GFST showed a sensitivity of 71.0%, a specificity of 70.2%, a positive predictive value of 75.9% and a negative predictive value of 64.7% at the identification of non-disabled frail elders. The positive and negative likelihood ratios were 2.38 and 0.41, respectively. In logistic regression models only slow gait speed (odds ratio [OR]: 19.65,95% confidence interval [95% Cl]: 4.69-82.35) and mobility issues (OR: 18.04, 95% CI: 3.11-104.78) were significantly associated with the condition of frailty in the absence of disability. Conclusions: Our findings demonstrate an overall moderate agreement between the GFST and the frailty phenotype. (c) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. ; Nutricia ; This work was supported by an unrestricted grant provided by Nutricia to the European Union Geriatric Medicine Society (EUGMS). Authors want to sincerely thank all the general practitioners who agreed to participate in this research and without whom this study would not have been possible. In particular: Marco Grandi (Ancona, Italy), Kerem Derya (Instanbul, Turkey), Julie Subra and Bruno Chicoulaa (Toulouse, France), Ivo Forgnone and Ana Siguero (Madrid, Spain), Carole Clouter (Southampton, United Kingdom), Claudia Schmeer and Odile Ciaroni-Rappaz (Geneva, Switzerland), David Macharacek and Pavla Madlova (Prague, Czech Republic); Heidi Kanala, (Helsinki, Finland).; Rein Baarsma (Leeuwarden, The Netherlands).

AbstractTheoretical models of mortality selection have great utility in explaining otherwise puzzling phenomena. The most famous example may be the Black-White mortality crossover: at old ages, Blacks outlive Whites, presumably because few frail Blacks survive to old ages while some frail Whites do. Yet theoretical models of unidimensional heterogeneity, or frailty, do not speak to the most common empirical situation for mortality researchers: the case in which some important population heterogeneity is observed and some is not. I show that, when one dimension of heterogeneity is observed and another is unobserved, neither the observed nor the unobserved dimension need behave as classic frailty models predict. For example, in a multidimensional model, mortality selection can increase the proportion of survivors who are disadvantaged, or "frail," and can lead Black survivors to be more frail than Whites, along some dimensions of disadvantage. Transferring theoretical results about unidimensional heterogeneity to settings with both observed and unobserved heterogeneity produces misleading inferences about mortality disparities. The unusually flexible behavior of individual dimensions of multidimensional heterogeneity creates previously unrecognized challenges for empirically testing selection models of disparities, such as models of mortality crossovers.