Special Issue "Prevention and Management of Frailty"

Special Issue Editors

Prof. Dr. Haewon Byeon
Website
Guest Editor
College of AI Convergence, Inje University, Gimhae 50834, Korea
Interests: frailty; gerontology; dementia; health promotion; biological statistics
Prof. Dr. Jaewon Nah
Website
Guest Editor
Department of Automotive Engineering, Honam University, 417, Eodeung-daero, Gwangsan-gu, Gwangju, Korea
Interests: gerontology; IoT for public health monitoring; big data science in all aging disciplines; driving control; driving assist system; driver behavior; driving emotions; vehicle safety

Special Issue Information

Dear Colleagues,

We would like to invite you to send contributions to the Special Issue of IJERPH entitled “Prevention and Management of Frailty”.

It is important to prevent and manage the frailty of the elderly because their muscle strength and physical activity decrease in old age, making them prone to falling, depression, and social isolation. In the end, they need to be admitted to a hospital or a nursing home.

When successful aging fails and motor ability declines due to illness, malnutrition, or reduced activity, frailty eventually occurs. Once frailty occurs, people with frailty do not have the power to exercise or the power to move. The functions of the heart and muscles are deteriorated more rapidly when they are not used. Consequently, frailty goes through a vicious cycle. As one’s physical fitness is deteriorated, the person has less power to exercise, poorer cognitive functions, and inferior nutrition intake. Consequently, the whole body of the person deteriorates. Therefore, in addition to observational studies to identify risk factors for preventing aging, various intervention studies have been conducted to develop exercise programs and apply them to communities, hospitals, and nursing homes for helping the elderly maintain healthy lives. The British Geriatrics Society published the “Fit for Frailty”, a clinical guideline, that can be used in the community and in the outpatient environment in order to actively manage frailty. Moreover, the International Association of Gerontology and Geriatrics (IAGG) formed “Frailty.net” using the Internet media and has provided training and promotional materials for more clinical applications, as well as up-to-date information on frailty.

Until now, most aging studies have focused on physical frailty. However, social frailty and cognitive frailty affect senile health negatively just as much as physical frailty. Nevertheless, little is known about social frailty and cognitive frailty. This Special Issue invites you to submit original experimental studies, reviews, systematic reviews, and meta-analysis studies on frailty (i.e., physical frailty, cognitive frailty, and social frailty) prevention, the detection of high-risk groups, differentiation, and interventions. We also welcome studies on aging, hearing (presbycusis), presbyphonia, cognition, IoT for public health monitoring, and big data science in all aging disciplines.

Prof. Haewon Byeon
Prof. Jaewon Nah
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • social frailty
  • aging
  • dementia
  • mild cognitive impairment
  • public health
  • physical activity
  • physical frailty
  • cognitive frailty
  • presbycusis
  • presbyphonia
  • cognitive function
  • prevention
  • depression
  • intervention
  • social network
  • IoT for public health monitoring
  • big data science in all aging disciplines

Published Papers (10 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review

Open AccessArticle
Determinants of Multidimensional and Physical Frailty and Their Individual Components: Interactions between Frailty Deficits
Int. J. Environ. Res. Public Health 2020, 17(22), 8656; https://doi.org/10.3390/ijerph17228656 - 21 Nov 2020
Abstract
Purpose: To identify the interrelations among determinants of multidimensional frailty, physical frailty, and their individual components. Methods: A group of 1024 community-dwelling people older than 65 years completed questionnaires regarding: multidimensional frailty (Tilburg Frailty Indicator, TFI) and physical frailty (FRAIL scale), and common [...] Read more.
Purpose: To identify the interrelations among determinants of multidimensional frailty, physical frailty, and their individual components. Methods: A group of 1024 community-dwelling people older than 65 years completed questionnaires regarding: multidimensional frailty (Tilburg Frailty Indicator, TFI) and physical frailty (FRAIL scale), and common frailty risk factors. Results: Multidimensional frailty was recognized in 559 subjects (54.6%) and determined by 13 factors (R2 = 0.21 in logistic regression). After incorporating TFI components to the models, the majority of previous risk factors became non-essential, and the frailty deficits mainly determined each other with R2 ranging between 0.07–0.67. Physical frailty and non-robust status (i.e., either physical frailty or pre-frailty) were recognized in 64 (6.3%) and 542 (52.9%) participants, and were determined by 5 factors (R2 = 0.33) and 11 factors (R2 = 0.34), respectively. Associations between the frailty deficits were detected within and between different dimensions (i.e., physical, psychological and social); the physical domain was mainly related to the psychological one which in turn was additionally associated with the social one. Conclusion: Frailty is the accumulation of deficits and is determined by factors other than the determinants of the individual deficits. The associations between deficits coming from various dimensions of human functioning presumably amplify their effects and accelerate frailty development. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Open AccessArticle
Prevalence of Physical Frailty and Its Multidimensional Risk Factors in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study
Int. J. Environ. Res. Public Health 2020, 17(21), 7883; https://doi.org/10.3390/ijerph17217883 - 27 Oct 2020
Abstract
Frailty is defined as a state of increased vulnerability to stressors, and it predicts disability and mortality in the older population. This study aimed to investigate the standardized prevalence and multidimensional risk factors associated with frailty among Korean community-dwelling older adults. We analyzed [...] Read more.
Frailty is defined as a state of increased vulnerability to stressors, and it predicts disability and mortality in the older population. This study aimed to investigate the standardized prevalence and multidimensional risk factors associated with frailty among Korean community-dwelling older adults. We analyzed the baseline data of 2907 adults aged 70–84 years (mean age 75.8 ± 3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and prefrailty was 7.9% (95% confidence interval (CI) 6.8–8.9%) and 47.0% (95% CI, 45.1–48.8%), respectively. The following 14 risk factors were significantly associated with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive symptoms, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer Timed Up and Go, and low Short Physical Performance Battery score (p < 0.05). Physiconutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Show Figures

Figure 1

Open AccessArticle
Evaluation of Psychophysical Factors in Individuals with Frailty Syndrome Following a 3-Month Controlled Physical Activity Program
Int. J. Environ. Res. Public Health 2020, 17(21), 7804; https://doi.org/10.3390/ijerph17217804 - 25 Oct 2020
Abstract
Background: The aim of the study was to compare the emotional state and strength-velocity parameters of patients with frailty and pre-frailty syndrome undertaking a 12-week training programme. Methods: The study was completed by 36 individuals, including 17 with frailty syndrome (FS) and 19 [...] Read more.
Background: The aim of the study was to compare the emotional state and strength-velocity parameters of patients with frailty and pre-frailty syndrome undertaking a 12-week training programme. Methods: The study was completed by 36 individuals, including 17 with frailty syndrome (FS) and 19 with pre-frailty syndrome (PFS). The age of the subjects ranged from 63 to 89 years, with a mean 69.2 years (±5.0). The Beck Depression Inventory (BDI), Spielberg’s State-Trait Anxiety Inventory (STAI), and Satisfaction with Life Scale (SWLS) were used. The strength of knee muscles was evaluated. The above tests were conducted at two time points: before the training sessions (T1); and after 12 weeks of regular training sessions (T2). Results: After completion of the training programme, statistically significant differences in BDI were observed between the PFS and FS groups (especially in somatic symptoms). Following the training, BDI values in the PFS group were significantly lower (fewer depressive symptoms) than in the FS group. The parameter values describing strength capacities of the lower limbs, both at T1 and T2, proved to be higher in the PFS group. Conclusions: In individuals with pre-frailty and frailty syndrome, the 3-month physical training programme improved the strength parameters of lower limb muscles. An improvement in mood and reduction in depressive symptoms were only observed in the group of subjects with pre-frailty syndrome. Rehabilitation programmes for people with frailty syndrome should include psychotherapeutic activities in addition to physical training in order to improve the psychophysical condition of patients. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Show Figures

Figure 1

Open AccessArticle
Frailty Status Typologies in Spanish Older Population: Associations with Successful Aging
Int. J. Environ. Res. Public Health 2020, 17(18), 6772; https://doi.org/10.3390/ijerph17186772 - 17 Sep 2020
Abstract
Background: Defining frailty typologies would contribute to guiding specific care interventions. These typologies could additionally be related to different health outcomes. This study aims at identifying subgroups of frail older adults based on the physical frailty phenotype and examining the relationships of these [...] Read more.
Background: Defining frailty typologies would contribute to guiding specific care interventions. These typologies could additionally be related to different health outcomes. This study aims at identifying subgroups of frail older adults based on the physical frailty phenotype and examining the relationships of these frailty profiles with quality of life and perceived health. Methods: This study relies on data from the SHARE project, namely a representative sample of 1765 Spanish-dwelling older adults identified as frail or pre-frail. Analysis included general descriptive statistics, exploratory latent class analysis (LCA) to determine the number of frailty subgroups, and LCA with covariates to examine differential relationships with markers of successful aging. Results: Statistical criteria and interpretability of the classes suggested that the LCA model with four classes should be retained. Class 1 was identified as the “frail people” group, Class 2 “activity problems” group, Class 3 “fatigued” group, and those belonging to Class 4 “lack of strength” group. Final LCA with covariates showed lower levels of quality of life and perceived health of the “frail” as compared to other frailty subgroups. Conclusion: This study revealed four different patterns of frailty attributes and further offered evidence on individuals’ differential status of health regarding distinct frailty conditions. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Show Figures

Figure 1

Open AccessFeature PaperArticle
Falls in Community-Dwelling Older Adults with Lower Back or Knee Pain Are Associated with Cognitive and Emotional Factors
Int. J. Environ. Res. Public Health 2020, 17(14), 4960; https://doi.org/10.3390/ijerph17144960 - 09 Jul 2020
Abstract
(1) Background: The present study aimed to examine physical, cognitive and emotional factors affecting falls in community-dwelling older adults with and without pain; (2) Methods: Data from 789 older adults who participated in a community-based health survey were analyzed. Participants completed questionnaires on [...] Read more.
(1) Background: The present study aimed to examine physical, cognitive and emotional factors affecting falls in community-dwelling older adults with and without pain; (2) Methods: Data from 789 older adults who participated in a community-based health survey were analyzed. Participants completed questionnaires on the presence of pain and previous falls. Muscle weakness (handgrip strength < 26.0 kg for men and < 18.0 kg for women) and low skeletal muscle mass (appendicular skeletal muscle mass index < 7.0 kg/m2 for men and < 5.7 kg/m2 for women) were determined. Mild cognitive impairment (MCI) and depressive symptoms were assessed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool and 15-item geriatric depression scale (GDS-15), respectively; (3) Results: In participants with pain, MCI and GDS-15 were associated with previous falls after adjusting for age, sex, education and medication use. In participants without pain, muscle weakness and low skeletal muscle mass were associated with previous falls when adjusting for the above covariates; (4) Conclusions: Falls in participants with pain were associated with cognitive and emotional factors, whereas falls in those without pain were associated with physical factors. Fall prevention interventions for older adults with pain may require tailored strategies to address cognitive and emotional factors. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Open AccessArticle
Spousal Concordance of Physical Frailty in Older Korean Couples
Int. J. Environ. Res. Public Health 2020, 17(12), 4574; https://doi.org/10.3390/ijerph17124574 - 25 Jun 2020
Cited by 2
Abstract
Marital status is an important risk factor for physical frailty. However, there are limited data on spousal concordance of physical frailty among married couples. Here, we evaluate the spousal concordance of frailty as defined by the Fried frailty phenotype and specific phenotype components [...] Read more.
Marital status is an important risk factor for physical frailty. However, there are limited data on spousal concordance of physical frailty among married couples. Here, we evaluate the spousal concordance of frailty as defined by the Fried frailty phenotype and specific phenotype components that contribute to this association. Data on 315 married couples (630 individuals) aged between 70 and 84 years were obtained from the Korean Frailty and Aging Cohort Study (KFACS). Multivariate logistic regressions were used for the analysis. After adjusting for covariates (age, body mass index, education, house ownership, comorbidity, cognition, depressive symptoms, cohabitation with adult children for both partners), a husband’s frailty was positively associated with his wife’s frailty (odds ratio (OR) 3.34, 95% confidence interval (CI) 1.04–10.73, p < 0.05), and a wife’s frailty was significantly associated with her husband’s frailty (OR 4.62, 95% CI 1.31–16.33, p < 0.05), indicating a greater effect of the frailty status of the spouse among women than among men. Among the five components of the Fried frailty phenotype, weight loss, slowness, and exhaustion were the main contributing factors to the spousal association for frailty. In conclusion, having a frail spouse is a strong and independent risk factor for frailty among community-living older adults. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Open AccessArticle
Association between Mixing Ability of Masticatory Functions Measured Using Color-Changing Chewing Gum and Frailty among Japanese Older Adults: The Kyoto–Kameoka Study
Int. J. Environ. Res. Public Health 2020, 17(12), 4555; https://doi.org/10.3390/ijerph17124555 - 24 Jun 2020
Cited by 1
Abstract
The relationship between mixing ability of masticatory functions and frailty has not been well evaluated. This study investigated the prevalence of physical and comprehensive frailty and its association with mixing ability in 1106 older adults aged ≥65 years who underwent physical examination as [...] Read more.
The relationship between mixing ability of masticatory functions and frailty has not been well evaluated. This study investigated the prevalence of physical and comprehensive frailty and its association with mixing ability in 1106 older adults aged ≥65 years who underwent physical examination as part of the Japanese Kyoto–Kameoka Study. Mixing ability was assessed using color-changing chewing gum (1–5 points, 5 representing the best mixing ability). Participants were divided into four groups (5 points, 4 points, 3 points, and 1 or 2 points). The modified Japanese versions of the Cardiovascular Health Study (mJ-CHS) criteria and the validated Kihon Checklist (KCL) were used to assess physical and comprehensive frailty, respectively. Multivariate logistic regression was used to evaluate the association between frailty and mixing ability. The prevalence of physical and comprehensive frailty was 11.8% and 27.9%, respectively. After adjusting for confounders, the odds ratios of physical and comprehensive frailty comparing the highest to the lowest chewing gum score groups were 3.64 (95% confidence interval (CI): 1.62 to 8.18; p for trend = 0.001) and 2.09 (95% CI: 1.09 to 4.03; p for trend = 0.009), respectively. Mixing-ability tests involving chewing gum may be an indicator associated with both physical and comprehensive frailty. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Open AccessArticle
Motoric Cognitive Risk Syndrome Using Three-Item Recall Test and Its Associations with Fall-Related Outcomes: The Korean Frailty and Aging Cohort Study
Int. J. Environ. Res. Public Health 2020, 17(10), 3364; https://doi.org/10.3390/ijerph17103364 - 12 May 2020
Cited by 1
Abstract
Motoric cognitive risk (MCR) syndrome is originally defined as the presence of subjective cognitive complaints (SCCs) and slow gait (SG). MCR is well known to be useful for predicting adverse health outcomes, including falls and dementia. However, around four out of five older [...] Read more.
Motoric cognitive risk (MCR) syndrome is originally defined as the presence of subjective cognitive complaints (SCCs) and slow gait (SG). MCR is well known to be useful for predicting adverse health outcomes, including falls and dementia. However, around four out of five older Korean adults reported SCCs, thereby, it may not be discriminative to define MCR in Korea. We adopted the three-item recall (3IR) test, instead of SCCs, to define MCR. This cross-sectional analysis included 2133 community-dwelling older adults aged 70–84 years, without dementia or any dependence in activities of daily living from the Korean Frailty and Aging Cohort Study. The newly attempted criteria of MCR using 3IR were met by 105 participants (4.9%). MCR using 3IR showed synergistic effects on fall-related outcomes, whereas the conventional definition of MCR using SCCs was not superior to SG only. MCR using 3IR was associated with falls (odds ratio [OR]: 1.92; 95% confidence interval (CI): 1.16–3.16), recurrent falls (OR: 2.19; 95% CI: 1.12–4.32), falls with injury (OR: 1.98; 95% CI: 1.22–3.22), falls with fracture (OR: 2.51; 95% CI: 1.09–5.79), fear of falling (OR: 3.00; 95% CI: 1.83–4.92), and low activities-specific balance confidence (OR: 3.13; 95% CI: 1.57–6.25). We found that MCR using 3IR could be useful in predicting fall-related outcomes in a cultural background reporting more SCCs, such as Korea. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Show Figures

Figure 1

Open AccessArticle
Is the Random Forest Algorithm Suitable for Predicting Parkinson’s Disease with Mild Cognitive Impairment out of Parkinson’s Disease with Normal Cognition?
Int. J. Environ. Res. Public Health 2020, 17(7), 2594; https://doi.org/10.3390/ijerph17072594 - 10 Apr 2020
Cited by 4
Abstract
Because it is possible to delay the progression of dementia if it is detected and treated in an early stage, identifying mild cognitive impairment (MCI) is an important primary goal of dementia treatment. The objectives of this study were to develop a random [...] Read more.
Because it is possible to delay the progression of dementia if it is detected and treated in an early stage, identifying mild cognitive impairment (MCI) is an important primary goal of dementia treatment. The objectives of this study were to develop a random forest-based Parkinson’s disease with mild cognitive impairment (PD-MCI) prediction model considering health behaviors, environmental factors, medical history, physical functions, depression, and cognitive functions using the Parkinson’s Dementia Clinical Epidemiology Data (a national survey conducted by the Korea Centers for Disease Control and Prevention) and to compare the prediction accuracy of our model with those of decision tree and multiple logistic regression models. We analyzed 96 subjects (PD-MCI = 45; Parkinson’s disease with normal cognition (PD-NC) = 51 subjects). The prediction accuracy of the model was calculated using the overall accuracy, sensitivity, and specificity. Based on the random forest analysis, the major risk factors of PD-MCI were, in descending order of magnitude, Clinical Dementia Rating (CDR) sum of boxes, Untitled Parkinson’s Disease Rating (UPDRS) motor score, the Korean Mini Mental State Examination (K-MMSE) total score, and the K- Korean Montreal Cognitive Assessment (K-MoCA) total score. The random forest method achieved a higher sensitivity than the decision tree model. Thus, it is advisable to develop a protocol to easily identify early stage PDD based on the PD-MCI prediction model developed in this study, in order to establish individualized monitoring to track high-risk groups. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Show Figures

Figure 1

Review

Jump to: Research

Open AccessReview
Meta-Analysis on the Effects of Transcranial Direct Current Stimulation on Naming of Elderly with Primary Progressive Aphasia
Int. J. Environ. Res. Public Health 2020, 17(3), 1095; https://doi.org/10.3390/ijerph17031095 - 09 Feb 2020
Cited by 1
Abstract
Purpose: This study aimed to conduct a qualitative evaluation by synthesizing previous studies on the effect of transcranial direct current stimulation (tDCS) on primary progressive aphasia (PPA)’s naming ability and prove the effects of tDCS mediation on PPA naming using meta-analysis. Methods [...] Read more.
Purpose: This study aimed to conduct a qualitative evaluation by synthesizing previous studies on the effect of transcranial direct current stimulation (tDCS) on primary progressive aphasia (PPA)’s naming ability and prove the effects of tDCS mediation on PPA naming using meta-analysis. Methods: This study searched literature published from January 2000 to July 2019 using four academic databases (i.e., PubMed, Web of Science, MEDLINE, and Cochrane Library). The final seven publications were systematically evaluated and meta-analysis was conducted for two papers. The effect size was estimated by a standard mean difference (SMD) using Hedge’s g, and the significance of effect size was confirmed using the 95% confidence interval. Results: The results of seven previous studies’ quality assessments ranged from 15 to 26, which were rated above adequate. The results of the meta-analysis showed that the effect size was 0.82 (95% CI: 0.16–1.47), which was a significant ‘large effect’. Conclusions: This meta-analysis proved that tDCS intervention significantly improved the naming performance of PPA. Future studies must confirm the effects of tDCS on naming intervention by using meta-analysis including many RCT studies. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
Show Figures

Figure 1

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

  1. Development of deep learning model to discriminate hypokinetic dysarthria caused by Parkinson's disease in presbyphonia (senile voice)
  2. Artificial Intelligence-based predictive model for spasmodic dysphonia for sustainable voice health
  3. Development of Machine Learning-based Smart App for Predicting Laryngeal Lesions in Healthy Elderly
  4. The Relationship between Hearing Loss Levels and Falls in the Elderly: National Survey
  5. Factors Related to Practices of Health Behaviors of Community Elderly
  6. Prediction of Parkinson's Dementia High Risk Group using C-SVM and J48: National Survey
Back to TopTop