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Background: previously, frailty indices were constructed using mostly subjective health measures. The reporting error in this type of measure can have implications on the robustness of frailty findings. Objective: to examine whether frailty assessment differs when we construct frailty indices using solely self-reported or test-based health measures. Design: secondary analysis of data from The Irish LongituDinal study on Ageing (TILDA). Subjects and methods: 4,961 Irish residents (mean age: 61.9 ± 8.4; 54.2% women) over the age of 50 years who underwent a health assessment were included in this analysis. We constructed three frailty indices using 33 self-reported health measures (SRFI), 33 test-based health measures (TBFI) and all 66 measures combined (CFI). The 2-year follow-up outcomes examined were all-cause mortality, disability, hospitalisation and falls. Results: all three indices had a right-skewed distribution, an upper limit to frailty, a non-linear increase with age, and had a dose--response relationship with adverse outcomes. Levels of frailty were lower when self-reported items were used (SRFI: 0.12 ± 0.09; TBFI: 0.17 ± 0.15; CFI: 0.14 ± 0.13). Men had slightly higher frailty index scores than women when test-based measures were used (men: 0.17 ± 0.09; women: 0.16 ± 0.10). CFI had the strongest prediction for risk of adverse outcomes (ROC: 0.64-0.81), and age was not a significant predictor when it was included in the regression model. Conclusions: except for sex differences, characteristics of frailty are similar regardless of whether self-reported or test-based measures are used exclusively to construct a frailty index. Where available, self-reported and test-based measures should be combined when trying to identify levels of frailty. [ABSTRACT FROM AUTHOR]

Introduction: Falls are common among older adults and are associated with injury, hospitalisation and mortality (Rubenstein Age & Aging 2006 35-S2,ii37). Obesity is associated with many recognised risk factors for falls in the elderly and recent research indicates that obesity may itself be an independent risk factor for falls (Himes & Reynolds J AM Geriatr Soc 2012 60,124). The aim of this analysis was to investigate obesity as a risk factor for incident falls in community dwelling older adults after a 2 year follow up.Methods: 4701 community dwelling adults aged 50+ from the Irish Longitudinal Study on Aging (TILDA) had their baseline height and weight measured during a comprehensive health assessment. Obesity was defined as having a Body Mass Index (BMI) ≥30 kg.m2. After a 2 year follow up participants were asked if they had experienced any falls since the previous interview, and if so how many falls were sustained. Logistic regression was used to assess the relationship between baseline obesity and incident falls. Covariates studied include baseline demographics, history of chronic and cardiovascular disease, physical disability, previous falls, gait speed, self-rated vision, chronic pain, cognitive function, mental health and medication use.Results: Mean (SD) age of participants at baseline was 61.0 years (8.8) and 55.6% were female. 32.9% of the sample was classified as obese at baseline. 12.5% of obese participants reported one fall during follow up compared to 13.9% of non-obese participants. A further 11.2% of obese participants reported 2 or more falls compared to 7% of non-obese participants. Adjusting for several covariates, baseline obesity was independently associated with reporting 2 or more falls after a 2-year follow up (Odds Ratio = 1.31, p = 0.023).Conclusion: Obesity is associated with recurrent falls in community dwelling older adults over a two year follow up period. [ABSTRACT FROM PUBLISHER]

Aim: Homeostatic blood pressure responses to standing play a pivotal role in identifying individuals at risk of syncope and unexplained falls. Here we examine the relationship between beat-to-beat orthostatic blood pressure responses and falls in a nationally representative population sample.Methods: Participants were recruited from The Irish Longitudinal Study on Ageing, a nationally representative cohort study of Irish adults aged 50+. Beat-to-beat blood pressure records were analysed among those who underwent an active stand test. Individuals were identified as having orthostatic hypotension (OH), if on standing they demonstrated sustained blood pressure drops of ≥20/10mmHg below resting values at 10 second intervals. Relationships with a history of falls were assessed by logistic regression adjusting for age, gender, education, comorbidities and medications.Results: A sample of N = 4490 older adults was considered. The prevalence of OH is 6.9% (95% CI: 5.9–7.8) being higher in women (8.2% (95% CI: 6.8–9.5) vs. 5.6% (95% CI: 5.9–7.8)) and increases with age to 18.9% (95% CI: 6.21–31.60) in older men. Impaired recovery at 40 seconds, affecting 24.5% (95% CI: 18.9–30.0) of the sample, is associated with an increased odds of having a history of falls OR: 1.57 (95% CI:1.2–2.0); p < 0.001).Conclusions: Using beat-to-beat approaches sustained blood pressure drops at 40 seconds are associated with increased odds of having a falls history. When considering health outcomes in older adults, the time course of blood pressure responses to standing are paramount with impaired recovery at 40 seconds independently associated with falls. [ABSTRACT FROM PUBLISHER]