Search

Aim: The aim of this study was to assess the internal consistency, hypothesis testing and criterion‐related validity of the Spanish versions of the Kihon Checklist (KCL) – the original 25‐item and reduced 15‐item versions – for screening frailty in community‐dwelling older adults. Methods: A cross‐sectional study was carried out between March and September 2018 in Valencia province (Spain). A sample of 251 participants was recruited. Construct validity was assessed using four different frailty instruments, and alternative measures corresponding to the KCL domains (handgrip strength, gait speed, the Short Physical Performance Battery, skeletal muscle mass index, physical activity level, functional status, cognitive function, depressive mood, health‐related quality of life and nutritional status). Fried's Frailty Phenotype was used to evaluate criterion validity. Results: Internal consistency assessed with Kuder–Richardson Formula had a value of 0.69 for the 25‐item version, slightly lower than the usual 0.7 for considering good reliability, and 0.71 for the 15‐item version. There were significant correlations between KCL versions and Fried's Frailty Phenotype, Edmonton Scale, Tilburg Indicator and FRAIL Scale. Consistent significant correlations were also obtained with all frailty measurements and instrumental activities of daily living, physical strength, eating, socialization, and mood domains of the KCL. The KCL closely correlated with other standardized measurements of physical function, cognitive function, depressive mood, and health‐related quality of life. The KCL also showed satisfactory diagnostic accuracy for frailty (area under the curve 0.891 for KCL‐25; area under the curve 0.857 for KCL‐15). The optimal cut‐off points were 5/6 and 3/4, respectively. Conclusions: The findings suggest that both versions of the KCL, especially KCL‐15, showed adequate evidence of validity and internal consistency as a preliminary screening of frailty among community‐dwelling older adults in Spain. Geriatr Gerontol Int 2021; 21: 262–267. [ABSTRACT FROM AUTHOR]

The main aim was to analyse the associations between several physical fitness variables and bone parameters in a sample of elderly people. 129 participants (94 females and 35 males, 76.2 ± 5.4 y) from the EXERNET cohort of Zaragoza (Spain) were included in the study. Physical fitness was assessed using the Senior Fitness Test Battery. Peripheral quantitative computed tomography (pQCT) at the tibia and dual-energy X-ray absorptiometry (DXA) at the hip and lumbar spine were used to assess bone and muscle parameters. Partial correlations were used to describe the associations between fitness and bone parameters. A stepwise regression analysis was used to determine the influence of fitness variables on bone parameters. In males, significant correlations were found between lower body strength and agility with bone total mineral density (Tt.BMD) (r = 0.41 and -0.50) and cortical thickness (r = 0.40 and -0.50, respectively) and walking speed with total and cortical density (r = − 0.41 and -0.40, respectively), all measured at tibia (all p < 0.05). Regarding DXA, neck areal bone mineral density (aBMD) correlated with flexibility (r = − 0.37) and walking speed (r = 0.39) and Ward's triangle with walking speed (r = 0.39). Agility predicted Tt.BMD and cortical thickness ( r 2 change = 24.8 % and 23.0%), while walking speed predicted cortical bone mineral density ( r 2 change = 19.5 %) (all p < 0.05). Females showed correlations between balance and total hip aBMD (r = 0.27) and trochanter aBMD (r = 0.25). Balance predicted trochanter ( r 2 change = 4.2 %) and total hip aBMD ( r 2 change = 4.9 %) (both p < 0.05). In conclusion, bone mass in elderly males seems to be more influenced by physical fitness than in females, being agility and walking speed the variables showing greater associations. Other variables should be taken into account in females for future research. [ABSTRACT FROM AUTHOR]

Background Although clinical gait speed may indicate health and well-being in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes. Objective The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44-m walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults. Design A cross-sectional design was used. Methods The study population comprised 432 high-functioning, community-dwelling older adults (287 women) aged between 65 and 92 years. Clinical and ambulatory gait speeds were measured using the 2.44-m walk test and a portable gait analysis device, respectively. Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (body mass index, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper- and lower-body strength, physical and mental health status, cognitive status, and self-rated cognitive status). Results The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared. Clinical gait speed was associated with 7 health outcomes, and the ambulatory gait speed was associated with 6 health outcomes. The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied; however, the strength of associations was singly different between measures. Limitations The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study. Conclusion The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed. Both measures have construct validity because they have been associated with physical and health outcomes; however, they may have different predictive validity. Further research should be conducted to compare their predictive validity in longitudinal designs. [ABSTRACT FROM AUTHOR]

Background the potential benefits of dual-task interventions on older adults living in long-term nursing homes (LTNHs) from a multidimensional perspective are unknown. We sought to determine whether the addition of simultaneous cognitive training to a multicomponent exercise program offers further benefits to dual-task, physical and cognitive performance, psycho-affective status, quality of life and frailty in LTNH residents. Design: a single-blind randomized controlled trial. Setting nine LTNHs in Gipuzkoa, Spain. Subjects 85 men and women (ACTRN12618000536268). Methods participants were randomly assigned to a multicomponent or dual-task training group. The multicomponent group performed two sessions per week of individualized and progressive strength and balance exercises for 3 months. The dual-task group performed simultaneous cognitive tasks to the same tasks as in the multicomponent group. Gait speed under single- and dual-task conditions, physical and cognitive performance, psycho-affective status, quality of life and frailty were measured at baseline and after 3 months of intervention. Results both groups showed clinically significant improvements on gait performance under single- and dual-task conditions and on the short physical performance battery (P  < 0.05). Both interventions were effective in maintaining cognitive function (P  > 0.05). Only the multicomponent group significantly improved quality of life, and reduced anxiety and Fried frailty score (P  < 0.05). No group-by-time interactions were found except for the chair-stand test in favour of the multicomponent group (P  < 0.05). Conclusions the addition of simultaneous cognitive training does not seem to offer significantly greater benefits to the evaluated multicomponent exercise program in older adults living in LTNHs. [ABSTRACT FROM AUTHOR]

Background the association between vitamin intake and frailty has hardly been studied. The objective was to assess the association of dietary vitamin intake with incident frailty in older adults from Spain. Methods data came from a cohort of 1,643 community-dwelling individuals aged ≥65, recruited in 2008–10 and followed up prospectively throughout 2012. At baseline, 10 vitamins were assessed (vitamin A, thiamine, riboflavin, niacin, vitamins B6, B12, C, D, E and folates) using a validated face-to-face diet history. Incident frailty was identified using Fried's definition as having ≥3 of the following five criteria: unintentional weight loss of ≥4.5 kg, exhaustion, weakness, slow walking speed and low physical activity. Nonadherence to the recommended dietary allowances (RDA) was considered when the intake of a vitamin was below the recommendation. Analyses were performed with logistic regression and adjusted for main confounders. Results during a 3.5-year follow-up, 89 (5.4%) participants developed frailty. The odds ratios (95% confidence interval) of frailty for those in the lowest versus the highest tertile of vitamin intake were 2.80 (1.38–5.67), P -trend: 0.004, for vitamin B6; 1.65 (0.93–2.95), P -trend: 0.007, for vitamin C; 1.93 (0.99–3.83), P -trend: 0.06, for vitamin E and 2.34 (1.21–4.52), P -trend: 0.01, for folates. Nonadherence to the RDAs of vitamins was related to frailty for thiamine odds ratio (OR): 2.09 (1.03–4.23); niacin OR: 2.80 (1.46–5.38) and vitamin B6; 2.23 (1.30–3.83). When considering tertiles of RDAs for the 10 vitamins those who met <5 RDAs had a higher risk of frailty, OR: 2.84 (1.34–6.03); P -trend: <0.001, compared to those who met >7. Conclusion a lower intake of vitamins B6, C, E and folates was associated with a higher risk of frailty. Not meeting RDAs for vitamins was also strongly associated. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness is related to worse health status outcome. Objectives: The present study aims to identify how longitudinal patterns of loneliness associated with health in old age. Methods: A total of 1,287 individuals aged 50+ were interviewed in 2011-12, 2014-15 and 2017-18 in a follow-up study conducted over a nationally representative sample of Spain. The three-item UCLA Loneliness Scale was used to assess loneliness. Chronic loneliness was defined as the presence of loneliness in the three measurements, whereas transient loneliness expressed the presence of these feelings only at one period of study. Health status was measured with self-reported questions regarding ten domains (vision, mobility, and self-care, among others), and seven measured tests (including grip strength, walking speed and immediate and delayed verbal recall). A multilevel linear regression was used to examine association between loneliness patterns and health over time. Results: Almost a-ten percent of participants reported feeling lonely throughout the three waves, who showed the worst health status. Both the group of chronic and transient loneliness showed a negative significant relationship with health status at follow-up, (ß = -6.2, p<0.001 and ß = -2.50, p = 0.02, respectively). Nevertheless, a significant change in the relationship between loneliness pattern and health status was not observed across time. Conclusions: Loneliness was longitudinally associated with poorer health, although health status of each loneliness pattern did not worsen over time. Different patterns of loneliness could benefit from the appropriate interventions. [ABSTRACT FROM AUTHOR]