Abstract Background: Multidimensional frailty, including physical, psychological, and social components, is associated to disability, lower quality of life, increased healthcare utilization, and mortality. In order to prevent or delay frailty, more knowledge of its determinants is necessary; one of these determinants is lifestyle. The aim of this study is to determine the association between lifestyle factors smoking, alcohol use, nutrition, physical activity, and multidimensional frailty. Methods: This cross-sectional study was conducted in two samples comprising in total 45,336 Dutch communitydwelling individuals aged 65 years or older. These samples completed a questionnaire including questions about smoking, alcohol use, physical activity, sociodemographic factors (both samples), and nutrition (one sample). Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI). Results: Higher alcohol consumption, physical activity, healthy nutrition, and less smoking were associated with less total, physical, psychological and social frailty after controlling for effects of other lifestyle factors and sociodemographic characteristics of the participants (age, gender, marital status, education, income). Effects of physical activity on total and physical frailty were up to considerable, whereas the effects of other lifestyle factors on frailty were small. Conclusions: The four lifestyle factors were not only associated with physical frailty but also with psychological and social frailty. The different associations of frailty domains with lifestyle factors emphasize the importance of assessing frailty broadly and thus to pay attention to the multidimensional nature of this concept. The findings offer healthcare professionals starting points for interventions with the purpose to prevent or delay the onset of frailty, so communitydwelling older people have the possibility to aging in place accompanied by a good quality of life.
Objective: The Tilburg Frailty Instrument (TFI) is an instrument for assessing frailty in community-dwelling older people. Since its development, many studies have been carried out examining the psychometric properties. The aim of this study was to provide a review of the main findings with regard to the reliability and validity of the TFI. Methods: We conducted a literature search in the PubMed and CINAHL databases on May 30, 2020. An inclusion criterion was the use of the entire TFI, part B, referring to the 15 components. No restrictions were placed on language or year of publication. Results: In total, 27 studies reported about the psychometric properties of the TFI. By far, most of the studies (n = 25) were focused on community-dwelling older people. Many studies showed that the internal consistency and test–retest reliability are good, which also applies for the criterion and construct validity. In many studies, adverse outcomes of interest were disability, increased health-care utilization, lower quality of life, and mortality. Regarding disability, studies predominantly show results that are excellent, with an area under the curve (AUC) >0.80. In addition, the TFI showed good associations with lower quality of life and the findings concerning mortality were at least acceptable. However, the association of the TFI with some indicators of health-care utilization can be indicated as poor (eg, visits to a general practitioner, hospitalization). Conclusion: Since population aging is occurring all over the world, it is important that the TFI is available and well known that it is a user-friendly instrument for assessing frailty and its psychometric properties being qualified as good. The findings of this assessment can support health-care professionals in selecting interventions to reduce frailty and delay its adverse outcomes, such as disability and lower quality of life.
Abstract: Background: Little is known about frailty among patients hospitalized with heart failure (HF). To date, the limited information on frailty in HF is based on a unidimensional view of frailty, in which only physical aspects are considered when determining frailty. The aims of this study were to study different dimensions of frailty (physical, psychological and social) in patients with HF and the effect of different dimensions of frailty on the incidence of heart failure. Methods: The study used a cross-sectional design and included 965 patients hospitalized for heart failure and 164 healthy controls. HF was defined according to the ESC guidelines. The Tilburg Frailty Indicator (TFI) was used to assess frailty. Probit regression analyses and chi-square statistics were used to examine associations between the occurrence of heart failure and TFI domains of frailty. Results: Patients diagnosed with frailty were 15.3% more likely to develop HF compared to those not diagnosed with frailty (p < 0.001). An increase in physical, psychological and social frailty corresponded to an increased risk of HF of 2.9% (p < 0.001), 4.4% (p < 0.001) and 6.6% (p < 0.001), respectively. Conclusions: We found evidence of the association between different dimensions of frailty and incidence of HF.
De samenwerking tussen de onderzoeksgroep FRIA van de Vrije Universiteit Brussel, afdeling oudergeneeskunde van het UMCG Groningen en de onderzoeksgroep (lectoraat) Healthy Ageing, Allied health Care and Nursing van de Hanzehogeschool Groningen is gericht op onderzoek naar bewegingsstoornissen bij veroudering. In het bijzonder wordt gekeken naar paratonic, een bewegingsstoornis bij dementie.The International Joint Research group ‘Move in Age’ concluded in a systematic review that paratonia still is a barely understood and devastating phenomenon in dementia and revealed the urgency of gaining more insight in the pathophysiology. Paratonia, a distinctive change in muscle tone, starts in early stages of dementia and develops further with progress of the disease. Resulting in severe discomfort for patients, but also affecting caregivers since daily care becomes increasingly difficult. It is hypothesized that changes in motor control due to dementia influences peripheral neurological control and biomechanical muscle structures (by crosslinking and inflammation caused by advanced glycation end-products (AGEs).This IJRG started in 2018 and aims to develop a long-term comprehensive research program on movement-related impairments at higher age. The three partners have a strong track record on research in the area of movement-related impairments in older persons; however, each focusing on a specific aspect. In fact, the Frailty in Ageing research group (FRIA) of the Vrije Universiteit Brussel (VUB) is running focused research program on the triad sarcopenia-dynapenia-inflammation with mainly a bio-gerontological and bio-psycho-medical approach; the department of General Practice and Elderly Care Medicine of the University Medical Center Groningen (UMCG) has anongoing research line on the medical aspects of mobility impairments in frail elderly persons and in elderly dementia patients; and finally Research Group Healthy Ageing, Allied Health Care and Nursing of the Hanze University of Applied Sciences Groningen (HUAS) developed a research program on physical, psycho-cognitive and social dimensions of frailty including the functional impact of mobility impairments. In the first 3-5 years, the focus will be on the movement-related impairments that occur in patients with dementia and in specific on paranoia. The programme will be extended towards movement-related impairments in the context of other geriatric syndromes.
