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Original Study| Volume 22, ISSUE 3, P583-589, March 2021

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Lifestyle Activity Patterns Related to Physical Frailty and Cognitive Impairment in Urban Community-Dwelling Older Adults in Japan

      Abstract

      Objectives

      Investigating the lifestyle activity patterns of urban community-dwelling Japanese older adults, focusing on physical frailty and cognitive impairment.

      Design

      Cross-sectional study.

      Setting and Participants

      Participants comprised 8003 older adults (4489 women; mean age: 72.5 years, SD = ±6.1, range 60-95 years) from the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes.

      Methods

      Participants reported on their lifestyle activity status, including using public transport, grocery shopping, light exercise, gardening, money management, meeting friends, participating in events, and travel. Several potential confounding variables, such as demographic characteristics, were considered. We assessed their lifestyle activity patterns using a latent class analysis and defined physical frailty by either slow walking speed or poor grip strength. Cognitive impairment was defined by participants exhibiting more than 1 of the following symptoms: poor word list memory, poor attention, reduced executive function, and low processing speed test scores. We also examined the relationship between their lifestyle activity patterns and physical frailty and cognitive impairment.

      Results

      The overall prevalence of robustness, physical frailty, cognitive impairment, and frailty and cognitive impairment was 54.6%, 21.4%, 13.3%, and 10.7%, respectively. We defined 4 classes using latent class analysis: greater engagement in multidomain activities, lower engagement in going-out activities, lower engagement in cognitive and physical activities, and lower engagement in multidomain activities. Moreover, physical frailty and cognitive impairment were independently associated with lower engagement in going-out activity, lower engagement in cognitive and physical activities, and lower engagement in multidomain activities, after adjusting for covariates.

      Conclusions and Implications

      Considering an older adult's lifestyle activity patterns in their day-to-day practice, clinicians can deliver more older adult-centered care, which in turn might lead to better outcomes in the primary prevention of disease.

      Keywords

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      References

        • Fried L.P.
        • Tangen C.M.
        • Walston J.
        • et al.
        Frailty in older adults: Evidence for a phenotype.
        J Gerontol A Biol Sci Med Sci. 2001; 56: M146-M156
        • Clegg A.
        • Young J.
        • Iliffe S.
        • et al.
        Frailty in elderly people.
        Lancet. 2013; 381: 752-762
        • Hoogendijk E.O.
        • Afilalo J.
        • Ensrud K.E.
        • et al.
        Frailty: Implications for clinical practice and public health.
        Lancet. 2019; 394: 1365-1375
        • Kojima G.
        Frailty as a predictor of disabilities among community-dwelling older people: A systematic review and meta-analysis.
        Disabil Rehabil. 2017; 39: 1897-1908
        • Kojima G.
        Frailty as a predictor of future falls among community-dwelling older people: A systematic review and meta-analysis.
        J Am Med Dir Assoc. 2015; 16: 1027-1033
        • Ensrud K.E.
        • Ewing S.K.
        • Taylor B.C.
        • et al.
        Frailty and risk of falls, fracture, and mortality in older women: The study of osteoporotic fractures.
        J Gerontol A Biol Sci Med Sci. 2007; 62: 744-751
        • Hoogendijk E.O.
        • Suanet B.
        • Dent E.
        • et al.
        Adverse effects of frailty on social functioning in older adults: Results from the Longitudinal Aging Study Amsterdam.
        Maturitas. 2016; 83: 45-50
        • Kojima G.
        • Iliffe S.
        • Jivraj S.
        • et al.
        Association between frailty and quality of life among community-dwelling older people: A systematic review and meta-analysis.
        J Epidemiol Community Health. 2016; 70: 716-721
        • Soysal P.
        • Veronese N.
        • Thompson T.
        • et al.
        Relationship between depression and frailty in older adults: A systematic review and meta-analysis.
        Ageing Res Rev. 2017; 36: 78-87
        • Robertson D.A.
        • Savva G.M.
        • Kenny R.A.
        Frailty and cognitive impairment—A review of the evidence and causal mechanisms.
        Ageing Res Rev. 2013; 12: 840-851
        • Kojima G.
        • Taniguchi Y.
        • Iliffe S.
        • et al.
        Frailty as a predictor of Alzheimer disease, vascular dementia, and all dementia among community-dwelling older people: A systematic review and meta-analysis.
        J Am Med Dir Assoc. 2016; 17: 881-888
        • Kojima G.
        Frailty as a predictor of hospitalisation among community-dwelling older people: A systematic review and meta-analysis.
        J Epidemiol Community Health. 2016; 70: 722-729
        • Kojima G.
        Frailty as a predictor of nursing home placement among community-dwelling older adults: A systematic review and meta-analysis.
        J Geriatr Phys Ther. 2018; 41: 42-48
        • Ensrud K.E.
        • Kats A.M.
        • Schousboe J.T.
        • et al.
        Frailty phenotype and healthcare costs and utilization in older women.
        J Am Geriatr Soc. 2018; 66: 1276-1283
        • Collard R.M.
        • Boter H.
        • Schoevers R.A.
        • et al.
        Prevalence of frailty in community-dwelling older persons: A systematic review.
        J Am Geriatr Soc. 2012; 60: 1487-1492
        • Bandeen-Roche K.
        • Seplaki C.L.
        • Huang J.
        • et al.
        Frailty in older adults: A nationally representative profile in the United States.
        J Gerontol A Biol Sci Med Sci. 2015; 70: 1427-1434
        • Santos-Eggimann B.
        • Cuenoud P.
        • Spagnoli J.
        • et al.
        Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries.
        J Gerontol A Biol Sci Med Sci. 2009; 64: 675-681
        • Hoogendijk E.O.
        • van Hout H.P.
        • Heymans M.W.
        • et al.
        Explaining the association between educational level and frailty in older adults: Results from a 13-year longitudinal study in the Netherlands.
        Ann Epidemiol. 2014; 24: 538-544.e532
        • Feng Z.
        • Lugtenberg M.
        • Franse C.
        • et al.
        Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies.
        PLoS One. 2017; 12: e0178383
        • McPhee J.S.
        • French D.P.
        • Jackson D.
        • et al.
        Physical activity in older age: Perspectives for healthy ageing and frailty.
        Biogerontology. 2016; 17: 567-580
        • Dent E.
        • Martin F.C.
        • Bergman H.
        • et al.
        Management of frailty: Opportunities, challenges, and future directions.
        Lancet. 2019; 394: 1376-1386
        • Landi F.
        • Cesari M.
        • Calvani R.
        • et al.
        The “Sarcopenia and Physical fRailty IN older people: Multi-componenT Treatment strategies” (SPRINTT) randomized controlled trial: Design and methods.
        Aging Clin Exp Res. 2017; 29: 89-100
        • Costanzo L.
        • Cesari M.
        • Ferrucci L.
        • et al.
        Predictive capacity of frailty phenotype toward patterns of disability identified using latent class analysis.
        J Am Med Dir Assoc. 2019; 20: 1026-1031
        • Shimada H.
        • Makizako H.
        • Lee S.
        Impact of cognitive frailty on daily activities in older persons.
        J Nutr Health Aging. 2016; 20: 729-735
        • Folstein M.F.
        • Folstein S.E.
        • McHugh P.R.
        “Mini-Mental State”. A practical method for grading the cognitive state of patients for the clinician.
        J Psychiatr Res. 1975; 12: 189-198
        • Iwasa H.
        • Masui Y.
        • Inagaki H.
        • et al.
        Development of the Japan Science and Technology Agency Index of Competence to Assess Functional Capacity in Older Adults: Conceptual definitions and preliminary items.
        Gerontol Geriatr Med. 2015; 1 (2333721415609490)
        • Arai H.
        • Satake S.
        English translation of the Kihon Checklist.
        Geriatr Gerontol Int. 2015; 15: 518-519
        • Shimada H.
        • Doi T.
        • Lee S.
        • et al.
        Reversible predictors of reversion from mild cognitive impairment to normal cognition: A 4-year longitudinal study.
        Alzheimers Res Ther. 2019; 11: 24
        • Jung S.
        • Lee S.
        • Bae S.
        • et al.
        Effectiveness of the KENKOJISEICHI local revitalization system on cognitive function change in older adults with mild cognitive impairment: Study protocol for a randomized controlled trial.
        Trials. 2018; 19: 276
        • Shimada H.
        • Lee S.
        • Doi T.
        • et al.
        Prevalence of psychological frailty in Japan: NCGG-SGS as a Japanese National Cohort Study.
        J Clin Med. 2019; 8: 1554
        • Shimada H.
        • Doi T.
        • Lee S.
        • et al.
        Cognitive frailty predicts incident dementia among community-dwelling older people.
        J Clin Med. 2018; 7: 250
        • Montero-Odasso M.M.
        • Barnes B.
        • Speechley M.
        • et al.
        Disentangling cognitive-frailty: Results from the gait and brain study.
        J Gerontol A Biol Sci Med Sci. 2016; 71: 1476-1482
        • Buracchio T.
        • Dodge H.H.
        • Howieson D.
        • et al.
        The trajectory of gait speed preceding mild cognitive impairment.
        Arch Neurol. 2010; 67: 980-986
        • Verghese J.
        • Lipton R.B.
        • Hall C.B.
        • et al.
        Abnormality of gait as a predictor of non-Alzheimer’s dementia.
        N Engl J Med. 2002; 347: 1761-1768
        • Shimada H.
        • Makizako H.
        • Doi T.
        • et al.
        Incidence of disability in frail older persons with or without slow walking speed.
        J Am Med Dir Assoc. 2015; 16: 690-696
        • Guralnik J.M.
        • Ferrucci L.
        • Simonsick E.M.
        • et al.
        Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability.
        N Engl J Med. 1995; 332: 556-561
        • Shimada H.
        • Makizako H.
        • Doi T.
        • et al.
        Combined prevalence of frailty and mild cognitive impairment in a population of elderly Japanese people.
        J Am Med Dir Assoc. 2013; 14: 518-524
        • Shimada H.
        • Suzuki T.
        • Suzukawa M.
        • et al.
        Performance-based assessments and demand for personal care in older Japanese people: A cross-sectional study.
        BMJ Open. 2013; 3: e002424
        • Chen L.K.
        • Liu L.K.
        • Woo J.
        • et al.
        Sarcopenia in Asia: Consensus report of the Asian Working Group for Sarcopenia.
        J Am Med Dir Assoc. 2014; 15: 95-101
        • Makizako H.
        • Shimada H.
        • Park H.
        • et al.
        Evaluation of multidimensional neurocognitive function using a tablet personal computer: Test-retest reliability and validity in community-dwelling older adults.
        Geriatr Gerontol Int. 2013; 13: 860-866
        • Shimada H.
        • Makizako H.
        • Park H.
        • et al.
        Validity of the National Center for Geriatrics and Gerontology-Functional Assessment Tool and Mini-Mental State Examination for detecting the incidence of dementia in older Japanese adults.
        Geriatr Gerontol Int. 2017; 17: 2383-2388
        • Liu L.K.
        • Chen C.H.
        • Lee W.J.
        • et al.
        Cognitive frailty and its association with all-cause mortality among community-dwelling older adults in Taiwan: Results from I-Lan Longitudinal Aging Study.
        Rejuvenation Res. 2018; 21: 510-517
        • Liu L.K.
        • Guo C.Y.
        • Lee W.J.
        • et al.
        Subtypes of physical frailty: Latent class analysis and associations with clinical characteristics and outcomes.
        Sci Rep. 2017; 7: 46417
        • Wu Y.H.
        • Liu L.K.
        • Chen W.T.
        • et al.
        Cognitive function in individuals with physical frailty but without dementia or cognitive complaints: Results from the I-Lan Longitudinal Aging Study.
        J Am Med Dir Assoc. 2015; 16: 899.e9-899.e16
        • Yesavage J.A.
        Geriatric Depression Scale.
        Psychopharmacol Bull. 1988; 24: 709-711
        • Nunez C.
        • Gallagher D.
        • Visser M.
        • et al.
        Bioimpedance analysis: Evaluation of leg-to-leg system based on pressure contact footpad electrodes.
        Med Sci Sports Exerc. 1997; 29: 524-531
        • Schwarz G.
        Estimating the dimension of a model.
        Ann Stat. 1978; 6: 461-464
        • Tsutsumimoto K.
        • Doi T.
        • Makizako H.
        • et al.
        Association of social frailty with both cognitive and physical deficits among older people.
        J Am Med Dir Assoc. 2017; 18: 603-607