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Objectives: Intrinsic capacity (IC) declines progressively with age, thereby increasing the risk of disability. However, it is less known whether IC trajectories are associated with disability. This study aims to identify the different patterns of IC trajectories in older people, and examine their determinants and associations with Instrumental Activities of Daily Living (IADL). Design: Cohort study. Setting: Community centres in different regions in Hong Kong. Participants and Measurements: Longitudinal data from community-dwelling older people aged 60 years or above (n = 1371) collected between 2016 and 2021 was analysed. Their mean age was 74.5 years, and 78.7% of them were female. Repeated measurements of a set of 14 self-reported items were used to generate IC scores at four time points using a bi-factor model. Latent class growth analysis was performed to identify classes with distinct IC trajectories. The association between class membership and IADL disability was then examined using logistic regression. Results: Three distinct IC trajectories were identified. The 1st class included those with the highest level of baseline IC and the least declining trajectory, whereas the 3rd class was composed by those with the lowest level of baseline IC and the most declining trajectory. Older age, female gender, lower perceived financial adequacy, living in public or subsidized housing, and chronic diseases were associated with the 3rd class. After adjusting for demographic factors, socioeconomic status, and the number of chronic diseases, the 1st class was more likely to preserve IADL when compared against the 2nd class, with OR being 3.179 (95% CI: 2.152–4.793), whereas for the 3rd class, the OR was 0.253 (95% CI: 0.178–0.359). Conclusion: Monitoring IC trajectories is of relevance to clinical practice, as it helps shift the focus from treating acute episodes of illness to preserving the functional ability of older people. [ABSTRACT FROM AUTHOR]

Objectives: Few studies have investigated the link between diet and intrinsic capacity (IC), and the potential sex difference in such association. This study examined the association between dietary patterns and IC and its sub-domains in Chinese community-dwelling older adults. Design: Cross-sectional analysis using baseline data from the MrOs and MsOs study. Setting: Community. Participants: Chinese community-dwelling older adults aged ≥65 years in Hong Kong. Measurements: Dietary intake was assessed using a validated food frequency questionnaire and priori and posteriori dietary pattern scores were generated. IC including measures of cognitive, locomotor, vitality, sensory and psychological domains was assessed. Multiple logistic regression was performed to examine the associations between dietary pattern scores and the likelihood of greater IC and sub-domain scores with adjustment for sociodemographic and lifestyle factors. Results: Data of 3730 participants (aged 72.2±5.0 years, 50.4% men) was available. In men, higher Diet Quality Index-International (DQI-I) and Okinawan diet scores, and lower "meat-fish" pattern scores were associated with greater IC. A higher DQI-I score was associated with greater locomotion, whereas higher "snacks-drinks-milk products" pattern score was associated with a greater sensory function. In women, none of the dietary pattern scores was associated with IC. Higher DQI-I score, Mediterranean-DASH Intervention for Neurodegenerative Delay Diet (MIND) score and "vegetables-fruits" pattern score were associated with greater psychological function. Conclusion: Various dietary patterns were associated with greater IC and its sub-domains in Chinese community-dwelling older adults, and more associations were observed in men than women. Strategies to improve diet and IC should take sex differences into account. [ABSTRACT FROM AUTHOR]

Objectives: To document the trend in a quality of life indicator for the older Hong Kong population as an assessment of the impact of age friendly city policies, political conflicts and the covid-19 pandemic. Design: Random telephone survey and collection of government data over four years (2017–2020). Setting: Community living older people. Participants: People aged 50 years and over. Measurements: The Hong Kong Quality of Life Index covering four domains of in income security, health status, capability and enabling environment. Results: From 2017–9, improvements were seen in various domains in parallel with the adoption of the World Health Organization's Age Friendly City concept by government policy together with a territory wide initiative supported by a major philanthropic organization. However scores of all domains dropped markedly as a result of political conflicts as well as the onset of the pandemic. Conclusion: The documentation of the trend in HKEQOL shows that while it may be used as a macro indicator that is able to reflect policies affecting the well-being of older people, it is also able to reflect the impact of societal unrest and pandemics, and that the latter may override the effect of existing ageing policies. It also follows that during social unrest and pandemics, specific policies targeting older people may be needed to maintain well-being. [ABSTRACT FROM AUTHOR]

Objectives: We examined the relationship between absolute income, adequacy of disposable income, and self-rated health among participants aged 60 years and over. Design: Cross sectional study. Setting: Community living older people in Hong Kong. Participants: Older people aged 60 years and over in five districts in Hong Kong. Measurements: Data from a cross sectional survey of age friendly characteristics across five districts of Hong Kong carried out using stratified random sampling across a broad range of socioeconomic attributes. Results: Self-rated health showed a gradient for both absolute and adequacy of disposable income. The OR for the association between having just enough, or insufficient disposable income and poor health was higher: 2.0 and 3.6 respectively, and higher than that for absolute income (OR 1.8), and remained significant after adjustment for absolute income. No association between absolute income and self-rated health was observed among women. These findings suggest that adequacy of disposable income provide a stronger association with self-rated health compared with absolute income among older people aged 60 years and over, particularly for women. The absolute income corresponding to what is considered adequate disposable income lies between HK$4000–10000. Conclusion: Adequacy of disposable income may be a better indicator than absolute income for older people in examining the relationship with health outcomes, particularly for older women. [ABSTRACT FROM AUTHOR]

Objectives: Variation in repeated blood pressure measurements may represent a decline in homeostatic mechanisms in blood pressure regulation in response to various internal or external stressors, indicating a frail state. We tested this hypothesis by examining the association between variability in repeated blood pressure measurements (BPV) and frailty status, adjusting for other confounding factors.Design: A longitudinal cohort study.Setting: Community centres in all three regions of Hong Kong.Participants: 1156 community-living older adults aged 60 years and over participated in a community geriatric screening program with blood pressure measurements three times a week over one year. Participants were divided into three groups based on variability of repeated blood pressure measurements (low, medium, high) using machine learning methods.Measurements: Frailty status was assessed using the FRAIL scale. Logistic regression was used to examine cross sectional association between frailty status and BPV adjusting for confounding factors, and also frailty transition with BPV.Results: In multi-variate models adjusting for co-variates, high BPV was associated with frailty (OR 1.57; 95% CI 1.05-2.37) among all participants; however, this was only significant in women in subgroup analysis. Similar findings were observed when transition to a more frail state was examined over a twelve month period.Conclusions: The findings of this study support the concept of physiological dysregulation underlying the frail state, and that BPV calculated using machine learning methods may be used as a biomarker of such dysregulation. [ABSTRACT FROM AUTHOR]

Background Previous studies persistently showed that functional dependence was associated with higher long-term (≥1 year) mortality of older patients hospitalised with community-acquired pneumonia ( CAP). The importance of other factors was, however, not well reported. Aim This study aimed to investigate the relative contributions of comorbidity, nutritional status and frailty to 1-year mortality. Methods We prospectively recruited older patients, aged ≥65 years, hospitalised with CAP from October 2009 to September 2010 at the Prince of Wales Hospital, Hong Kong. Demographics, Charlson's Comorbidity Index, mid-arm circumference ( MAC) and Clinical Frailty Scale ( CFS) were recorded as baseline characteristics. The severity of pneumonia was evaluated by the CURB score ( confusion, blood urea nitrogen, respiratory rate and low blood pressure). The surviving patients were followed for 1 year since discharge to monitor readmission for CAP and all-cause mortality. We entered the following variables into the multivariate Cox regression model to identify independent predictors of 1-year all-cause mortality: age, sex, residential status, MAC, Charlson's Comorbidity Index, CFS and readmission for CAP. Results The final cohort consisted of 428 patients who were discharged from hospital. Within 1 year after hospital discharge, all-cause mortality and readmission for CAP were 22.4% and 32.0% respectively. Independent predictors of 1-year mortality were male sex (hazard ratio ( HR) = 1.57, 95% confidence interval ( CI) = 1.02-2.48), severe under-nutrition ( MAC ≤21 cm) ( HR = 3.75, 95% CI = 1.66-8.46), frailty ( CFS ≥5) ( HR = 2.36, 95% CI = 1.29-4.27) and readmission for CAP ( HR = 4.50, 95% CI = 2.82-7.17). Conclusions Recurrent pneumonia may be a terminal life event of frail older people so that advance care planning should be considered in those with recurrent admission for pneumonia. [ABSTRACT FROM AUTHOR]