Sedative load and frailty among community-dwelling population aged ≥65 years.

To explore the association between use of sedative drugs and frailty. Cross-sectional study. First wave of The Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort of the community-dwelling population aged 50 years or older in Ireland. Participants were 1642 men and 1804 women aged 65 years or older. Regular use of sedative drugs determined according to the sedative load (SL) model, frailty phenotype status, and frailty deficit index (FI) score assessed using validated, established protocols. Overall, 19% of the participants took sedative drugs, most frequently hypnotics and antidepressants. Sedative drug use was at 46% for frail, 23% for prefrail, and 9% for nonfrail participants. After adjustment for covariates, SL was positively associated with being prefrail (odds ratio [OR] 1.27; 95% confidence interval [CI] 1.11-1.46) and frail (OR 1.30; 95% CI 1.02-1.64). Advancing age but not sex remained significant (P < .001). After adjustment for covariates, the association between SL and the FI was also significant at P ≤ .001 (β = 1.77; 95% CI 1.13-2.42). Higher SL was positively associated with phenotype frailty and the FI. This suggests that careful consideration must be given when prescribing sedatives to frail older adults, who are most vulnerable to adverse drug reactions and adverse health outcomes.

Peklar J ，O'Halloran AM ，Maidment ID ，Henman MC ，Kenny RA ，Kos M ... -  《-》

Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults.

Nishiguchi S ，Yamada M ，Fukutani N ，Adachi D ，Tashiro Y ，Hotta T ，Morino S ，Shirooka H ，Nozaki Y ，Hirata H ，Yamaguchi M ，Arai H ，Tsuboyama T ，Aoyama T ... -  《-》

Sedative Load in Community-Dwelling Older Adults with Mild-Moderate Alzheimer's Disease: Longitudinal Relationships with Adverse Events, Delirium and Falls.

Dyer AH ，Murphy C ，Lawlor B ，Kennelly SP ，NILVAD StudyGroup ... -  《-》

Self-Reported Hearing Impairment and Incident Frailty in English Community-Dwelling Older Adults: A 4-Year Follow-Up Study.

To examine the association between hearing impairment and incident frailty in older adults. Cross-sectional and longitudinal analyses with 4-year follow-up using data from the English Longitudinal Study of Ageing. Community. Community-dwelling individuals aged 60 and older with data on hearing and frailty status (N = 2,836). Hearing impairment was defined as poor self-reported hearing. Having none of the five Fried frailty phenotype components (slow walking, weak grip, self-reported exhaustion, weight loss and low physical activity) was defined as not frail, having one or two as prefrail, and having three or more as frail. Participants who were not frail at baseline were followed for incident prefrailty and frailty. Participants who were prefrail at baseline were followed for incident frailty. One thousand three hundred ninety six (49%) participants were not frail, 1,178 (42%) were prefrail, and 262 (9%) were frail according to the Fried phenotype. At follow-up, there were 367 new cases of prefrailty and frailty among those who were not frail at baseline (n = 1,396) and 133 new cases of frailty among those who were prefrail at baseline (n = 1,178). Cross-sectional analysis showed an association between hearing impairment and frailty (age- and sex-adjusted odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.37-2.01), which remained after further adjustments for wealth, education, cardiovascular disease, cognition, and depression. In longitudinal analyses, nonfrail participants with hearing impairment were at greater risk of becoming prefrail and frail at follow-up (OR = 1.43, 95% CI = 1.05-1.95), but the association was attenuated after further adjustment. Prefrail participants with hearing impairment had a greater risk of becoming frail at follow-up (OR = 1.64, 95% CI = 1.07-2.51) even after further adjustment. Hearing impairment in prefrail older adults was associated with greater risk of becoming frail, independent of covariates, suggesting that hearing impairment may hasten the progression of frailty.

Liljas AEM ，Carvalho LA ，Papachristou E ，Oliveira C ，Wannamethee SG ，Ramsay SE ，Walters K ... -  《-》

Frailty in INstitutionalized older adults from ALbacete. The FINAL Study: rationale, design, methodology, prevalence and attributes.

Little is known about frailty in institutionalized older adults, and there are few longitudinal studies on this topic. To determine the prevalence and attributes of frailty in institutionalized Spanish older adults. Cross-sectional analysis of basal data of a concurrent cohort study. Two nursing homes, Vasco Núñez de Balboa and Paseo de la Cuba, in Albacete, Spain. 331 institutionalized adults older than 65 years. Frailty was defined by the presence of 3 or more Fried criteria and prefrailty by the presence of 1 or 2: unintentional weight loss, low energy, exhaustion, slowness, and low physical activity. Covariables were sociodemographic, anthropometric, functional, cognitive, affective and of comorbidity. Hospitalization, emergency visits and falls in the 6 previous months was recorded. Differences between non-frail and prefrail as one group and frail participants were analyzed using χ(2) tests, t-Student and logistic regression. Mean age 84.1 (SD 6.7), with 209 (65.1%) women. 68.8% were frail, 28.4% pre-frail, 2.8% non-frail, and in 2.2% three criteria were not available to determine frailty status. Women were more frequently frail than men (77.1% vs. 22.9%; p<0.001), and frail participants were older (85.1 vs. 82.3; p<0.001) than non-frail ones. Female sex (OR 2.7 95%CI 1.2-6.2), Barthel index (OR 2.2 95%CI 1.2-4.4), depression risk (OR 2.2 95%CI 1.0-4.9) and Short Physical Performance Battery scores (0.7 95%CI 0.6-0.8) were independently associated with frailty status. Frailty had a non-significant association with hospitalization (OR 1.9 95%CI 0.8-4.5) and emergency visits (OR 1.5 95%CI 0.7-3.2) in the previous 6 months. In a cohort of institutionalized older adults the prevalence of frailty was 68.8% and was associated with adverse health geriatric outcomes.

González-Vaca J ，de la Rica-Escuín M ，Silva-Iglesias M ，Arjonilla-García MD ，Varela-Pérez R ，Oliver-Carbonell JL ，Abizanda P ... -  《-》