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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 May 2019) | Viewed by 48724

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Prof. Dr. Hyuma Makizako

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Guest Editor

Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
Interests: geriatric physical therapy; frailty and sarcopenia in older adults

Special Issue Information

Dear Colleagues,

Population age is rapidly increasing around the world, and geriatric syndromes are clinical conditions common in older adults.

Geriatric syndromes including frailty, cognitive impairment, falls, functional decline, chronic pain, weight loss, anorexia, depression, and multi-morbidity increase in the risk for adverse outcomes, such as disability, hospitalization, and mortality. Therefore, geriatric syndrome prevention strategies must be important to realize a “society of health and longevity.” In addition, it would be useful to implement these strategies in a community setting.

This Special Issue seeks papers on geriatric syndrome prevention in the community setting, including papers on the impacts of health outcomes and environmental conditions related to public health. Epidemiological and mechanistic studies will be considered. Systematic reviews will be also considered.

Prof. Hyuma Makizako
Guest Editor

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Keywords

Geriatic symdrome
Frailty
Sarcopenia
Falls
Cognitive impairment
Depressive symptom
Chronic pain
Chronic disease
Rehabilitaion
Ageing

Published Papers (11 papers)

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Editorial

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2 pages, 222 KiB

Open AccessEditorial

Frailty and Sarcopenia as a Geriatric Syndrome in Community-Dwelling Older Adults

by Hyuma Makizako

Int. J. Environ. Res. Public Health 2019, 16(20), 4013; https://doi.org/10.3390/ijerph16204013 - 19 Oct 2019

Cited by 10 | Viewed by 2266

Abstract

Geriatric syndrome refers to a series of symptoms and observations caused by a variety of factors associated with aging, where the older adults show the treatment consciously or otherwise, and long-term care becomes important at the same time [...] Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

Research

Jump to: Editorial

12 pages, 434 KiB

Open AccessArticle

Association Between Carotid Artery Intima-Media Thickness and Combinations of Mild Cognitive Impairment and Pre-Frailty in Older Adults

by Jinkee Park, Jong-Hwan Park and Hyuntae Park

Int. J. Environ. Res. Public Health 2019, 16(16), 2978; https://doi.org/10.3390/ijerph16162978 - 19 Aug 2019

Cited by 9 | Viewed by 3203

Abstract

Carotid intima-media thickness (CIMT) has been proposed as a surrogate marker of cardiovascular disease. Mild cognitive impairment (MCI) and pre-frailty are reportedly associated with increased CIMT. As the evidence on the association of CIMT with combinations of MCI and pre-frailty is limited, this association is examined. A total of 231 older adults participated. MCI was defined according to clinical consensus or psychometric criteria by a dementia specialist, and considering detailed neuropsychological assessments. Also, pre-frailty was defined as subjects with frail component of 1 or 2. Carotid variables were measured using a B-mode ultrasound. The analysis of covariance (ANCOVA) was performed to assess independent differences in CIMT among the four groups, according to the cognitive function and frailty status after a multivariate adjustment. Increased CIMT is associated with combinations of MCI and pre-frailty. ANCOVA showed that CIMTs were significantly different among the four groups according to the cognitive function and frailty status. CIMTmax combined with MCI and pre-frailty was the thickest (1.04 ± 0.3 mm), whereas the CIMT of no MCI and no pre-frailty was the thinnest (0.82 ± 0.2 mm). The results suggest that combinations of MCI and pre-frailty are associated with increased CIMT in older adults. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

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11 pages, 639 KiB

Open AccessArticle

Instrumental Activities of Daily Living: The Processes Involved in and Performance of These Activities by Japanese Community-Dwelling Older Adults with Subjective Memory Complaints

by Yuriko Ikeda, Noriyuki Ogawa, Kazuhiro Yoshiura, Gwanghee Han, Michio Maruta, Maki Hotta and Takayuki Tabira

Int. J. Environ. Res. Public Health 2019, 16(14), 2617; https://doi.org/10.3390/ijerph16142617 - 23 Jul 2019

Cited by 21 | Viewed by 3804

Abstract

Subjective memory complaints (SMCs) may predict the onset of dementia. The purpose of this study was to clarify characteristics of performance of activities of daily living (ADL) for older adults with SMCs and to offer support options that enable them to maintain their community-based lifestyle. A self-administered questionnaire was sent to 2000 randomly selected members of CO-OP Kagoshima, and 621 responded. 270 responders answered all questions were categorized into SMC (+) group and SMC (−) group (n = 133). Participants were evaluated the Process Analysis of Daily Activity for Dementia. A 2-sample t-test or the Chi-square test were used to compare the averages of continuous variables or the proportions of categorical variables. The results showed the SMC (+) group ranked significantly lower in ability to use the telephone, shop, cook, do housekeeping, manage finances, and manage medications compared with the SMC (−) group. In addition, the SMC (+) group was significantly less independent than the SMC (−) group in many processes requiring the use of tools, operation of machines, management of goods, selection of tools, and monitoring. To enable continued independence of older adults’ experiencing SMCs, it may be important to analyze their performance of ADL and to develop plans for supporting their strengths. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

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9 pages, 288 KiB

Open AccessArticle

Falls in Parkinson’s Disease Subtypes: Risk Factors, Locations and Circumstances

by Paulo H. S. Pelicioni, Jasmine C. Menant, Mark D. Latt and Stephen R. Lord

Int. J. Environ. Res. Public Health 2019, 16(12), 2216; https://doi.org/10.3390/ijerph16122216 - 23 Jun 2019

Cited by 97 | Viewed by 9925

Abstract

People with Parkinson’s disease (PD) can be classified into those with postural instability and gait difficulty (PIGD subtype) and those manifesting tremor as the main symptoms (non-PIGD subtype). In a prospective cohort study of 113 people with PD we aimed to contrast fall rates and circumstances as well as a range of disease-related, clinical, and functional measures between the PD subtypes. Compared with non-PIGD participants, PIGD participants were significantly more likely to suffer more falls overall as well as more falls due to freezing of gait, balance-related falls and falls at home. The PIGD group also performed significantly worse in a range of fall-related clinical and functional measures including general cognitive status, executive function, quadriceps muscle strength, postural sway and the timed up and go test. These findings document the extent to which people with the PIGD subtype are at increased risk of falls, the circumstances in which they fall and their disease-related, clinical and functional impairments. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

10 pages, 526 KiB

Open AccessArticle

Positive Effects of Openness on Cognitive Aging in Middle-Aged and Older Adults: A 13-Year Longitudinal Study

by Yukiko Nishita, Chikako Tange, Makiko Tomida, Rei Otsuka, Fujiko Ando and Hiroshi Shimokata

Int. J. Environ. Res. Public Health 2019, 16(12), 2072; https://doi.org/10.3390/ijerph16122072 - 12 Jun 2019

Cited by 7 | Viewed by 2811

Abstract

The relationship between openness (a psychological trait of curiosity) and a cognitive change was examined in middle-aged and older adults. Participants were 2214 men and women (baseline age range: 40 to 81 years). They were tested up to seven times over approximately 13 years. Openness at the baseline was assessed by the NEO Five-Factor Inventory. Cognitive abilities were assessed at each examination using the Wechsler adult intelligence scale-revised short form, which includes information, similarities, picture completion, and digit symbol subscales. General linear mixed models comprised fixed effects of openness, age at the baseline, follow-up time, their interactions, and the covariates. The results indicated that the main effects of openness were significant for all scores. Moreover, the interaction term openness × age × time was significant for the information and similarities test scores, indicating that changes in the information and similarities scores differed depending on the level of openness and baseline age. The estimated trajectory indicated that the differences in slopes between participants with high and low openness were significant after 60 years of age for the information, and after 65 years of age for the similarities scores. It is concluded that openness has a protective effect on the decline in general knowledge and logical abstract thinking in old age. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

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18 pages, 792 KiB

Open AccessArticle

Sarcopenia Is Associated with Cognitive Impairment Mainly Due to Slow Gait Speed: Results from the Korean Frailty and Aging Cohort Study (KFACS)

by Miji Kim and Chang Won Won

Int. J. Environ. Res. Public Health 2019, 16(9), 1491; https://doi.org/10.3390/ijerph16091491 - 27 Apr 2019

Cited by 60 | Viewed by 6006

Abstract

Sarcopenia and cognitive impairment may share common risk factors and pathophysiological pathways. We examined the association between impairments in specific cognitive domains and sarcopenia (and its defining components) in community-dwelling older adults. We analyzed 1887 patients who underwent cognitive function tests and dual-energy X-ray absorptiometry from the baseline data of adults aged 70–84 years obtained from the Korean Frailty and Aging Cohort Study. Those with disability in activities of daily living, dementia, severe cognitive impairment, Parkinson’s disease, musculoskeletal complaints, neurological disorders, or who were illiterate were excluded. Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet, the Frontal Assessment Battery. For sarcopenia, we used the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 9.6% for men and 7.6% for women. Sarcopenia (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.04–2.99) and slow gait speed (OR 2.58, 95% CI 1.34–4.99) were associated with cognitive impairment in men. Only slow gait speed (OR 1.88, 95% CI 1.05–3.36) was associated with cognitive impairment in women. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed. Our results suggested that cognitive impairment domains, such as processing speed and executive function, are associated with sarcopenia-related slow gait speed. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

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9 pages, 733 KiB

Open AccessArticle

Association between Chronic Pain and Physical Frailty in Community-Dwelling Older Adults

by Yuki Nakai, Hyuma Makizako, Ryoji Kiyama, Kazutoshi Tomioka, Yoshiaki Taniguchi, Takuro Kubozono, Toshihiro Takenaka and Mitsuru Ohishi

Int. J. Environ. Res. Public Health 2019, 16(8), 1330; https://doi.org/10.3390/ijerph16081330 - 13 Apr 2019

Cited by 39 | Viewed by 4448

Abstract

This cross-sectional study investigated the association between chronic pain and physical frailty in community-dwelling older adults. We analyzed data obtained from 323 older adults (women: 74.6%) who participated in a community-based health check survey (the Tarumizu Study, 2017). Physical frailty was defined in terms of five parameters (exhaustion, slowness, weakness, low physical activity, and weight loss). We assessed the prevalence of chronic low back and knee pain using questionnaires. Participants whose pain had lasted ≥two months were considered to have chronic pain. Among all participants, 138 (42.7%) had chronic pain, and 171 (53.0%) were categorized as having physical frailty or pre-frailty. Logistic regression analysis showed that chronic pain was significantly associated with the group combining frailty and pre-frailty (odds ratio 1.68, 95% confidence interval 1.03–2.76, p = 0.040) after adjustment for age, sex, body mass index, score on the 15-item Geriatric Depression Scale, and medications. Comparing the proportions of chronic pain among participants who responded to the sub-items, exhaustion (yes: 65.9%, no: 39.4%) demonstrated a significant association (p < 0.001). Chronic pain could be associated with the group combining frailty and pre-frailty and is particularly associated with exhaustion in community-dwelling older adults. Therefore, there is a need for early intervention and consideration of the role of exhaustion when devising interventions for physical frailty in older individuals with chronic pain. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

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18 pages, 675 KiB

Open AccessArticle

Impact of Outpatient Rehabilitation Service in Preventing the Deterioration of the Care-Needs Level Among Japanese Older Adults Availing Long-Term Care Insurance: A Propensity Score Matched Retrospective Study

by Michio Maruta, Takayuki Tabira, Hyuma Makizako, Akira Sagari, Hironori Miyata, Koji Yoshimitsu, Gwanghee Han, Kazuhiro Yoshiura and Masahiro Kawagoe

Int. J. Environ. Res. Public Health 2019, 16(7), 1292; https://doi.org/10.3390/ijerph16071292 - 10 Apr 2019

Cited by 19 | Viewed by 4521

Abstract

Outpatient rehabilitation (OR) and outpatient day long-term care (ODLC) services are frequently used by older adult patients in Japan. However, there is a need to clarify that OR service, which has more rehabilitation professionals than ODLC, has the role of providing rehabilitation. This retrospective study examined the impact of OR services by comparing the two services based on City A data from the care-needs certification survey conducted between 2015 to 2017. We performed a propensity score matched analysis to compare the changes in the care level and function of OR and ODLC users after two years. The results showed that OR users showed a lower deterioration in care levels and less decline in the activities of daily living (ADL) in dementia and adaptation to social life. In the analysis of older adults requiring support, OR users had a lower deterioration in care levels and less decline in the ADL in dementia and behavioral and psychological symptoms than ODLC users did. There was no difference between the two services with respect to older adults requiring long-term care. The OR service has had an increasingly preventive effect on the deterioration of care levels compared to the ODLC service, which was particularly evident in older adults requiring support. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

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8 pages, 692 KiB

Open AccessArticle

The Association between Osteoporosis and Grip Strength and Skeletal Muscle Mass in Community-Dwelling Older Women

by Yoshiaki Taniguchi, Hyuma Makizako, Ryoji Kiyama, Kazutoshi Tomioka, Yuki Nakai, Takuro Kubozono, Toshihiro Takenaka and Mitsuru Ohishi

Int. J. Environ. Res. Public Health 2019, 16(7), 1228; https://doi.org/10.3390/ijerph16071228 - 06 Apr 2019

Cited by 24 | Viewed by 4082

Abstract

This cross-sectional study investigated the association between osteoporosis, grip strength, and skeletal muscle mass in community-dwelling older women. Data obtained from 265 older women who participated in a community-based health check survey (Tarumizu Study) were analyzed. Face-to-face interviews with participants revealed their history of osteoporosis. Appendicular skeletal muscle mass was assessed through bioelectrical impedance analysis, and appendicular skeletal muscle index was calculated. Dominant grip strength was also assessed. Loss of skeletal muscle mass (appendicular skeletal muscle mass < 5.7 kg/m²) and muscle weakness (grip strength < 18 kg) were determined based on criteria for sarcopenia put forth by the Asian Working Group for Sarcopenia. The prevalence rates of osteoporosis, muscle weakness, and loss of skeletal muscle mass were 27.2%, 28.7%, and 50.2%, respectively. Loss of skeletal muscle mass was more prevalent in participants with osteoporosis than in those without (65.3% vs. 44.6%, p < 0.01). The association between osteoporosis and muscle strength was not significant (30.6% vs. 28.0%, p = 0.68). After covariate adjustment, loss of skeletal muscle mass was found to be independently associated with osteoporosis (odds ratio 2.56, 95% confidence interval 1.33–4.91). In sum, osteoporosis was found to be associated with loss of skeletal muscle mass, but not with muscle weakness in community-dwelling older women. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

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11 pages, 324 KiB

Open AccessArticle

Adverse Drug Events in Patients with Dementia and Neuropsychiatric/Behavioral, and Psychological Symptoms, a One-Year Prospective Study

by Marta H. Hernández, Conxita Mestres, Pilar Modamio, Jaume Junyent, Lluís Costa-Tutusaus, Cecilia F. Lastra and Eduardo L. Mariño

Int. J. Environ. Res. Public Health 2019, 16(6), 934; https://doi.org/10.3390/ijerph16060934 - 15 Mar 2019

Cited by 11 | Viewed by 3268

Abstract

Older people usually present with adverse drug events (ADEs) with nonspecific symptoms such as cognitive decline, recurrent falls, reduced mobility, and/or major deterioration. The aims of this study were to assess the ADEs of patients with dementia and presenting neuropsychiatric/behavioral, and psychological symptoms in dementia (BPSD) and to categorize and identify the principal factors that allow to prevent ADEs, and separately ADEs that result in falls. To that end, a one-year prospective study in a psychogeriatric ward (July 2015 to July 2016) was performed. All patients admitted to this ward were eligible for enrolment. Patients who met any of the following criteria were excluded from the study: Patients without cognitive impairment, a length of stay under 7 days, and palliative or previous psychiatric pathology. We included 65 patients (60% women, 84.9 years ± 6.7) with mild to moderate cognitive impairment, moderate to severe functional dependence, and a high prevalence of geriatric syndromes and comorbidity. A total of 87.7% were taking five or more drugs (mean 9.0 ± 3.1). ADEs were identified during the interdisciplinary meeting and the follow up by clinical record. Sixty-eight ADEs (81.5% patients) were identified, of which 73.5% were not related to falls. From these, 80% were related to drugs of the nervous system. The Naranjo algorithm determined that 90% of ADEs were probable. The severity of the ADEs was Category E in 34 patients (68%). The number of preventable ADE according to the Schumork–Thornton test was 58%. The main ADE was drowsiness/somnolence (27.7%). ADEs related to falls represented a 26.5%. The balance between effective treatment and safety is complex in these patients. A medication review in interdisciplinary teams is an essential component to optimize safety prevention. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

11 pages, 447 KiB

Open AccessArticle

Cognitive Assessment of Older People: Do Sensory Function and Frailty Matter?

by Ruby Yu and Jean Woo

Int. J. Environ. Res. Public Health 2019, 16(4), 662; https://doi.org/10.3390/ijerph16040662 - 24 Feb 2019

Cited by 11 | Viewed by 3720

Abstract

Background: To examine the associations of visual and hearing functions, and frailty with subjective memory complaints (SMCs) in a community primary care pilot project of older people aged 60 years and over. Methods: The study was conducted in 24 community centers. A total of 1949 community-dwelling older people aged between 60–97 years were evaluated for which detailed information regarding socio-demographics, lifestyle, and clinical factors were documented at baseline and an average of 12 months later. SMCs were assessed using the 5-item Abbreviated Memory Inventory for the Chinese (AMIC). Visual and hearing functions were measured with two separate single questions. Frailty was assessed using a simple frailty question (FRAIL). Results: At baseline, 1685 (74.6%) participants had reported at least 3 SMCs (AMIC score ≥ 3). Of the 573 participants without / with 1–2 SMCs (AMIC score = 0–2) at baseline, 75 had incomplete data regarding SMCs and 190 developed at least 3 SMCs after 12 months. After adjustments for age, sex, marital status, educational level, hypertension, and diabetes at baseline, poor vision (OR 2.2 95% CI 1.8–2.7), poor hearing (OR 2.2 95% CI 1.8–2.8), and frailty (OR 4.6 95% CI 3.1–6.7) at baseline were each significantly associated with an increased risk of at least 3 SMCs at follow-up. After a further adjustment for baseline SMCs, the associations remained significant. Similar results were obtained when incident SMCs and improvement in subjective memory were used as the outcome variables; and Conclusions: In the care of older people, detection of sensory impairment and frailty through screening may allow formulation of strategies to prevent or delay the onset of cognitive decline. Full article

(This article belongs to the Special Issue Geriatrics Syndromes Prevention)

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