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Adequacy of nutrient intake among elderly persons receiving home care.

https://arctichealth.org/en/permalink/ahliterature154657
Source
J Nutr Elder. 2008;27(1-2):65-82
Publication Type
Article
Date
2008
Author
C Shanthi Johnson
Monirun Nessa Begum
Author Affiliation
Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada. shanthi.johnson@uregina.ca
Source
J Nutr Elder. 2008;27(1-2):65-82
Date
2008
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Diet - methods - statistics & numerical data
Eating
Female
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods - statistics & numerical data
Health status
Home Care Services - statistics & numerical data
Humans
Male
Nutrition Assessment
Nutritional Status
Ontario
Questionnaires
Risk assessment
Risk factors
Sex Distribution
Abstract
This study examines the adequacy of the dietary intake based on age, sex, and level of nutritional risk among 98 frail elderly persons receiving home care through Community Care Access Centres. The dietary intakes were measured using 24-hour recalls and were compared with the dietary reference intake. The participants' intakes of both macronutrients and micronutrients were found to be inadequate. On average, elderly persons were consuming more than the recommended amount of protein, but the average intakes of many vitamins and minerals were less than optimal based on the average intakes. Paradoxically, more than half of elderly participants were overweight or obese. The results highlight the need for appropriate nutrition, education, and support for elderly persons receiving home care.
PubMed ID
18928191 View in PubMed
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Analgesic use and frailty among community-dwelling older people: a population-based study.

https://arctichealth.org/en/permalink/ahliterature117548
Source
Drugs Aging. 2013 Feb;30(2):129-36
Publication Type
Article
Date
Feb-2013
Author
Marjaana P H Koponen
J Simon Bell
Niina M Karttunen
Irma A Nykänen
Franciska A M Desplenter
Sirpa A Hartikainen
Author Affiliation
Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, 70211 Kuopio, Finland. marjaana.koponen@uef.fi
Source
Drugs Aging. 2013 Feb;30(2):129-36
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aged
Analgesics - therapeutic use
Drug Utilization - statistics & numerical data
Female
Finland - epidemiology
Frail Elderly - statistics & numerical data
Humans
Male
Pain - drug therapy - epidemiology
Pain Measurement
Residence Characteristics
Abstract
Frail older people have a decreased ability to respond to stressors and may therefore be more susceptible to adverse events related to inadequately treated pain. Conversely, aging- and frailty-related changes in pharmacokinetics and pharmacodynamics may predispose frail older people to adverse events of analgesics.
The aim of this study was to explore whether analgesic use is associated with frailty status and whether there are differences in the types of analgesics used between frailty groups among community-dwelling older people.
The study population consisted of 605 community-dwelling people aged >75 years. Demographic, diagnostic and drug use data were collected during standardized nurse interviews. Participants were classified as frail, pre-frail or robust using the Cardiovascular Health Study frailty criteria (weight loss, weakness, exhaustion, slowness and low physical activity).
Overall, 11.4 % (n = 69) of the study participants were frail and 49.4 % (n = 299) were pre-frail. The prevalence of prescription and non-prescription analgesic use was higher among frail (68.1 %) than among pre-frail (54.5 %) and robust (40.5 %) older people (p
PubMed ID
23288603 View in PubMed
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Association of midlife obesity and cardiovascular risk with old age frailty: a 26-year follow-up of initially healthy men.

https://arctichealth.org/en/permalink/ahliterature124173
Source
Int J Obes (Lond). 2012 Sep;36(9):1153-7
Publication Type
Article
Date
Sep-2012
Author
T E Strandberg
J. Sirola
K H Pitkälä
R S Tilvis
A Y Strandberg
S. Stenholm
Author Affiliation
Institute of Health Sciences/Geriatrics, University of Oulu and Oulu University Hospital, Unit of General Practice, Oulu, Finland. timo.strandberg@oulu.fi
Source
Int J Obes (Lond). 2012 Sep;36(9):1153-7
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging
Body mass index
Cardiovascular Diseases - epidemiology - etiology - mortality
Disability Evaluation
Disease Progression
Finland - epidemiology
Follow-Up Studies
Frail Elderly - statistics & numerical data
Geriatric Assessment
Health Behavior
Humans
Longitudinal Studies
Male
Middle Aged
Obesity - complications - epidemiology - mortality
Prevalence
Questionnaires
Risk factors
Abstract
To investigate whether old age frailty is predicted by midlife overweight/obesity and cardiovascular disease (CVD) risk.
Longitudinal observational study (the Helsinki Businessmen Study).
In their midlife in 1974, 1815 initially healthy men (mean age 47 years) were clinically investigated, whereupon their weight status (normal weight
PubMed ID
22614054 View in PubMed
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Changes in frailty-related characteristics of the hip fracture population and their implications for healthcare services: evidence from Quebec, Canada.

https://arctichealth.org/en/permalink/ahliterature113289
Source
Osteoporos Int. 2013 Oct;24(10):2713-24
Publication Type
Article
Date
Oct-2013
Author
M. Auais
S. Morin
L. Nadeau
L. Finch
N. Mayo
Author Affiliation
International Centre for Health Innovation, Ivey Business School, Western University, London, ON, Canada.
Source
Osteoporos Int. 2013 Oct;24(10):2713-24
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Comorbidity
Databases, Factual
Delivery of Health Care - trends
Evidence-Based Medicine - methods
Female
Frail Elderly - statistics & numerical data
Hip Fractures - epidemiology
Hospitalization - statistics & numerical data
Humans
Incidence
Length of Stay - statistics & numerical data
Male
Osteoporosis - epidemiology
Osteoporotic Fractures - epidemiology
Patient Discharge - statistics & numerical data
Quebec - epidemiology
Residence Characteristics - statistics & numerical data
Risk factors
Sarcopenia - epidemiology
Sex Distribution
Abstract
This study provides evidence that a number of frailty-related characteristics (older age, de novo admission to long-term care (LTC), comorbidities [Charlson Index, osteoporosis, osteoporosis risk factors, sarcopenia risk factors, and dementia]) have increased in the hip fracture population from 2001-2008. This will have significant impact on community resources, as the number of people discharged to the community is also increasing.
The aim of this study is to estimate secular changes in the prevalence of selected frailty-related characteristics among the hip fracture population in the Canadian province of Quebec (2001-2008) and the potential impact of these changes on healthcare services.
The Quebec hospitalization database was used to identify nontraumatic hip fractures for the purposes of calculating age- and sex-specific rates. Also estimated were time trends for selected frailty-related characteristics and discharge destinations.
A significant decline in fracture rates was evident for all age groups except for those
PubMed ID
23743612 View in PubMed
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Changes in relative fitness and frailty across the adult lifespan: evidence from the Canadian National Population Health Survey.

https://arctichealth.org/en/permalink/ahliterature134815
Source
CMAJ. 2011 May 17;183(8):E487-94
Publication Type
Article
Date
May-17-2011
Author
Kenneth Rockwood
Xiaowei Song
Arnold Mitnitski
Author Affiliation
Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS. kenneth.rockwood@dal.ca
Source
CMAJ. 2011 May 17;183(8):E487-94
Date
May-17-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Canada - epidemiology
Chi-Square Distribution
Female
Frail Elderly - statistics & numerical data
Health status
Health Surveys
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Physical Fitness
Prevalence
Proportional Hazards Models
Sex Factors
Young Adult
Abstract
The prevalence of frailty increases with age in older adults, but frailty is largely unreported for younger adults, where its associated risk is less clear. Furthermore, less is known about how frailty changes over time among younger adults. We estimated the prevalence and outcomes of frailty, in relation to accumulation of deficits, across the adult lifespan.
We analyzed data for community-dwelling respondents (age 15-102 years at baseline) to the longitudinal component of the National Population Health Survey, with seven two-year cycles, beginning 1994-1995. The outcomes were death, use of health services and change in health status, measured in terms of a Frailty Index constructed from 42 self-reported health variables.
The sample consisted of 14,713 respondents (54.2% women). Vital status was known for more than 99% of the respondents. The prevalence of frailty increased with age, from 2.0% (95% confidence interval [CI] 1.7%-2.4%) among those younger than 30 years to 22.4% (95% CI 19.0%-25.8%) for those older than age 65, including 43.7% (95% CI 37.1%-50.8%) for those 85 and older. At all ages, the 160-month mortality rate was lower among relatively fit people than among those who were frail (e.g., 2% v. 16% at age 40; 42% v. 83% at age 75 or older). These relatively fit people tended to remain relatively fit over time. Relative to all other groups, a greater proportion of the most frail people used health services at baseline (28.3%, 95% CI 21.5%-35.5%) and at each follow-up cycle (26.7%, 95% CI 15.4%-28.0%).
Deficits accumulated with age across the adult spectrum. At all ages, a higher Frailty Index was associated with higher mortality and greater use of health care services. At younger ages, recovery to the relatively fittest state was common, but the chance of complete recovery declined with age.
Notes
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Comment In: CMAJ. 2011 May 17;183(8):889-9021540170
PubMed ID
21540166 View in PubMed
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Changes in the Lethality of Frailty Over 30 Years: Evidence From Two Cohorts of 70-Year-Olds in Gothenburg Sweden.

https://arctichealth.org/en/permalink/ahliterature285261
Source
J Gerontol A Biol Sci Med Sci. 2017 Jul 01;72(7):945-950
Publication Type
Article
Date
Jul-01-2017
Author
Kristoffer Bäckman
Erik Joas
Hanna Falk
Arnold Mitnitski
Kenneth Rockwood
Ingmar Skoog
Source
J Gerontol A Biol Sci Med Sci. 2017 Jul 01;72(7):945-950
Date
Jul-01-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Female
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods - statistics & numerical data
Health Status Disparities
Health Status Indicators
Humans
Male
Mortality - trends
Sweden - epidemiology
Abstract
With aging, health deficits accumulate: people with few deficits for their age are fit, and those with more are frail. Despite recent reports of improved health in old age, how deficit accumulation is changing is not clear. Our objectives were to evaluate changes over 30 years in the degree of deficit accumulation and in the relationship between frailty and mortality in older adults.
We analyzed data from two population based, prospective longitudinal cohorts, assembled in 1971-1972 and 2000-2001, respectively. Residents of Gothenburg Sweden, systematically drawn from the Swedish population registry. The 1901-1902 cohort (N = 973) had a response rate of 84.8%; the 1930 cohort (N = 500) had a response rate of 65.1%. A frailty index using 36 deficits was calculated using data from physical examinations, assessments of physical activity, daily, sensory and social function, and laboratory tests. We evaluated mortality over 12.5 years in relation to the frailty index.
Mean frailty levels were the same (x¯ = 0.20, p = .37) in the 1901-1902 cohort as in the 1930 cohort. Although the frailty index was linked to the risk of death in both cohorts, the hazards ratio decreased from 1.67 per 0.1 increment in the frailty index for the first cohort to 1.32 for the second cohort (interaction term p = .005).
Although frailty was as common at age 70 as before, its lethality appears to be less. Just why this is so should be explored further.
Notes
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PubMed ID
27522060 View in PubMed
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Changes with age in the distribution of a frailty index.

https://arctichealth.org/en/permalink/ahliterature179246
Source
Mech Ageing Dev. 2004 Jul;125(7):517-9
Publication Type
Article
Date
Jul-2004
Author
Kenneth Rockwood
Alexander Mogilner
Arnold Mitnitski
Author Affiliation
Division of Geriatric Medicine, Department of Medicine, Dalhousie University, 1421-5955 Veterans Memorial Lane, Halifax, Nova Scotia B3H 1C6, Canada. Kenneth.Rockwood@dal.ca
Source
Mech Ageing Dev. 2004 Jul;125(7):517-9
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Aging
Canada
Female
Frail Elderly - statistics & numerical data
Humans
Male
Middle Aged
Sample Size
Abstract
Models of human mortality include a factor that summarises intrinsic differences in individual rates of ageing, commonly called frailty. Frailty also describes a clinical syndrome of apparent vulnerability. In a representative, cross-sectional, Canadian survey (n = 66,589) we calculated a frailty index as the mean accumulation of deficits and previously showed it to increase exponentially with age. Here, its density function exhibited a monotonic change in shape, being least skewed at the oldest ages. Although the shape gradually changed, the frailty index was well fitted by a gamma distribution. Of note, the variation coefficient, initially high, decreased from middle age on. Being able to quantify frailty means that health risks can be summarised at both the individual and group levels.
PubMed ID
15246748 View in PubMed
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Comparing the validity of different sources of information on emergency department visits: a latent class analysis.

https://arctichealth.org/en/permalink/ahliterature176075
Source
Med Care. 2005 Mar;43(3):266-75
Publication Type
Article
Date
Mar-2005
Author
Nandini Dendukuri
Jane McCusker
François Bellavance
Sylvie Cardin
Josée Verdon
Igor Karp
Eric Belzile
Author Affiliation
Technology Assessment Unit, McGill University Health Center, Montreal, Canada. nandini.dendukuri@mcgill.ca
Source
Med Care. 2005 Mar;43(3):266-75
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Data Collection - methods
Emergency Service, Hospital - utilization
Female
Frail Elderly - statistics & numerical data
Hospitals, University - utilization
Humans
Insurance Claim Review
Male
Medical Records
Quebec - epidemiology
Research Design
Self Disclosure
Utilization Review - statistics & numerical data
Abstract
Emergency department (ED) use in Quebec may be measured from varied sources, eg, patient's self-reports, hospital medical charts, and provincial health insurance claims databases. Determining the relative validity of each source is complicated because none is a gold standard.
We sought to compare the validity of different measures of ED use without arbitrarily assuming one is perfect.
Data were obtained from a nursing liaison intervention study for frail seniors visiting EDs at 4 university-affiliated hospitals in Montreal.
The number of ED visits during 2 consecutive follow-up periods of 1 and 4 months after baseline was obtained from patient interviews, from medical charts of participating hospitals, and from the provincial health insurance claims database.
Latent class analysis was used to estimate the validity of each source. The impact of the following covariates on validity was evaluated: hospital visited, patient's demographic/clinical characteristics, risk of functional decline, nursing liaison intervention, duration of recall, previous ED use, and previous hospitalization.
The patient's self-report was found to be the least accurate (sensitivity: 70%, specificity: 88%). Claims databases had the greatest validity, especially after defining claims made on consecutive days as part of the same ED visit (sensitivity: 98%, specificity: 98%). The validity of the medical chart was intermediate. Lower sensitivity (or under-reporting) on the self-report appeared to be associated with higher age, low comorbidity and shorter length of recall.
The claims database is the most valid method of measuring ED use among seniors in Quebec compared with hospital medical charts and patient-reported use.
PubMed ID
15725983 View in PubMed
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84 records – page 1 of 9.