scholarly journals 131 Meta-analysis of Primary Care Interventions to Address Frailty Among Adults Aged 65+

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Steve Macdonald ◽  
John Travers ◽  
Éidín Ní Shé ◽  
Jade Bailey ◽  
Roman Romero-Ortuno ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Best Practice ◽  
Meta Analysis ◽  
Relative Effectiveness ◽  
Or Education ◽  
Frailty Status ◽  
Nutrition Supplementation ◽  
Quantitative Synthesis ◽  
Meta Analyses

Abstract Background Frailty can contribute to poor clinical outcomes including disability, illness, and death. Intervention against frailty may help older adults maintain overall health and independence, and a growing body of recent literature describes interventions specifically targeting frailty. The diversity of measurement constructs and intervention types raises a challenge for those seeking to identify best-practice strategies to manage frailty in the primary care setting, therefore this study aimed to quantify the relative effectiveness of reported interventions. Methods PubMed, CINAHL, Cochrane Register of Controlled Trials, and PEDr databases were interrogated, and reference lists of retrieved studies were also examined. For comparisons, articles were grouped by intervention and meta-analysis using the random effects model was performed wherever two or more studies examined the same outcome measure using similar interventions. Results 29 studies with a total of 4430 participants were included in this series of meta-analyses. Interventions included exercise (alone or plus nutrition supplementation or education), nutrition supplementation alone, comprehensive geriatric assessment (CGA), and hormone supplementation. Outcome measures included frailty (Fried criteria), physical performance, leg strength, and grip strength, among others. Interventions varied in relative effectiveness. When comparing studies that assessed frailty status using Fried’s criteria, exercise alone (n=3, RR=0.63 (CI 0.47–0.85), I2=0%) appeared effective versus control in improving status, as did exercise plus nutritional supplementation (n=2, RR=0.62 (CI 0.48–0.79), I2=0%), and exercise plus nutritional education (n=3, RR=0.69 (CI 0.58–0.82), I2=0%). CGA also appeared effective in improving frailty status (n=3, RR=0.77 (CI 0.64–0.93), I2=0%). Conclusion This series of meta-analyses indicates that several intervention types are associated with positive improvements in frailty status, and frailty-associated indicators. These results agree with previous findings, and represent an up-to-date quantitative synthesis of available literature on primary care interventions addressing frailty among older adults.

scholarly journals TRENDS IN THE PREVALENCE OF FRAILTY IN JAPAN: A META-ANALYSIS FROM THE ILSA-J

2020 ◽  
pp. 1-8
Author(s):  
H. MAKIZAKO ◽  
Y. NISHITA ◽  
S. JEONG ◽  
R. OTSUKA ◽  
H. SHIMADA ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Meta Analysis ◽  
Physical Frailty ◽  
Age And Gender ◽  
Frailty Status ◽  
Japanese Cohort ◽  
And Gender ◽  
Meta Analyses ◽  
Low Activity

Objective: To examine whether age-specific prevalence of frailty in Japan changed between 2012 and 2017. Design: This study performed meta-analyses of data collected from 2012 to 2017 using the Integrated Longitudinal Studies on Aging in Japan (ILSA-J), a collection of representative Japanese cohort studies. Setting: The ILSA-J studies were conducted on community-living older adults. Participants: ILSA-J studies were considered eligible for analysis if they assessed physical frailty status and presence of frailty in the sample. Seven studies were analyzed for 2012 (±1 year; n = 10312) and eight studies were analyzed for 2017 (±1 year; n = 7010). Five studies were analyzed for both 2012 and 2017. Measurements: The study assessed the prevalence of frailty and frailty status according to 5 criteria: slowness, weakness, low activity, exhaustion, and weight loss.Results: The overall prevalence of physical frailty was 7.0% in 2012 and 5.3% in 2017. The prevalence of frailty, especially in people 70 years and older, tended to decrease in 2017 compared to 2012. Slight decreases were found in the prevalence of frailty subitems including weight loss, slowness, exhaustion, and low activity between 2012 and 2017, but change in the prevalence of weakness was weaker than other components. Conclusions: The prevalence of physical frailty decreased from 2012 to 2017. There are age- and gender-related variations in the decrease of each component of frailty.

scholarly journals Low Protein Intake Is Associated with Frailty in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1334 ◽  
Author(s):  
Hélio Coelho-Júnior ◽  
Bruno Rodrigues ◽  
Marco Uchida ◽  
Emanuele Marzetti
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Protein Intake ◽  
Observational Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Frailty Status ◽  
Search Terms ◽  
Meta Analyses

(1) Background: Several factors have been suggested to be associated with the physiopathology of frailty in older adults, and nutrition (especially protein intake) has been attributed fundamental importance in this context. The objective of this study was to conduct a systematic review and meta-analysis to investigate the relationship between protein intake and frailty status in older adults. (2) Methods: A search of scientific studies was conducted in the main databases (Medline, Scopus, Cochrane library), and in the reference lists of selected articles. The search terms included synonyms and Medical Subject Headings and involved the use of Boolean operators which allowed the combination of words and search terms. Observational studies—cross-sectional and longitudinal—that met the eligibility criteria were included in the review. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects were performed. Publication bias was measured using the Strengthening the Reporting of Observational Studies in Epidemiology instrument. (3) Results: In the final sample, 10 articles, seven cross-sectional and three longitudinal, were included in the present study. Overall, studies investigated a total of 50,284 older adults from three different continents between 2006 and 2018. Four cross-sectional studies were included in the meta-analyses. The results demonstrated that a high protein intake was negatively associated with frailty status in older adults (odds ratio: 0.67, confidence interval = 0.56 to 0.82, p = 0.0001). (4) Conclusions: Our findings suggest that a high consumption of dietary protein is inversely associated with frailty in older adults.

Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Diego Urrunaga-Pastor ◽  
Diego Chambergo-Michilot ◽  
Fernando M. Runzer-Colmenares ◽  
Josmel Pacheco-Mendoza ◽  
Vicente A. Benites-Zapata
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
High Altitude ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Language Restriction ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

<b><i>Introduction:</i></b> Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. <b><i>Methods:</i></b> We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. <b><i>Results:</i></b> Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, <i>I</i><sup>2</sup>: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, <i>I</i><sup>2</sup>: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, <i>I</i><sup>2</sup>: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. <b><i>Conclusions:</i></b> The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.

scholarly journals The Effect of Bilingualism on Older Adults’ Inhibitory Control: A Meta-Analysis

2019 ◽  
Author(s):  
Bonnie A Armstrong ◽  
Natalie Ein ◽  
Brenda I Wong ◽  
Sara N Gallant ◽  
Lingqian Li
Keyword(s):  
Older Adults ◽  
Second Language Acquisition ◽  
Inhibitory Control ◽  
Language Proficiency ◽  
Meta Analysis ◽  
Individual Characteristics ◽  
Bilingual Advantage ◽  
The Individual ◽  
Meta Analyses ◽  
Design And Methods

AbstractBackground and ObjectivesThe effect bilingualism has on older adults’ inhibitory control has been extensively investigated, yet there is continued controversy regarding whether older adult bilinguals show superior inhibitory control compared with monolinguals. The objective of the current meta-analysis was to examine the reliability and magnitude of the bilingualism effect on older adults’ inhibitory control as measured by the Simon and Stroop tasks. In addition, we examined whether individual characteristics moderate the bilingual advantage in inhibition, including age (young–old vs old–old), age of second language acquisition, immigrant status, language proficiency, and frequency of language use.Research Design and MethodsA total of 22 samples for the Simon task and 14 samples for the Stroop task were derived from 28 published and unpublished articles (32 independent samples, with 4 of these samples using more than 1 task) and were analyzed in 2 separate meta-analyses.ResultsAnalyses revealed a reliable effect of bilingualism on older adults’ performance on the Simon (g = 0.60) and Stroop (g = 0.27) tasks. Interestingly, individual characteristics did not moderate the association between bilingualism and older adults’ inhibitory control.Discussion and ImplicationsThe results suggest there is a bilingual advantage in inhibitory control for older bilinguals compared with older monolinguals, regardless of the individual characteristics previously thought to moderate this effect. Based on these findings, bilingualism may protect inhibitory control from normal cognitive decline with age.

scholarly journals A SYSTEMATIC REVIEW AND META-ANALYSIS OF AGE-RELATED DIFFERENCES IN TRUST

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S477-S477
Author(s):  
Phoebe E Bailey ◽  
Tarren Leon
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Young Adults ◽  
Meta Analysis ◽  
Self Report ◽  
Future Research ◽  
Age Group ◽  
Age Related ◽  
Meta Analyses ◽  
Effect Of Age

Abstract This systematic review and meta-analysis quantifies the magnitude and breadth of age-related differences in trust. Thirty-eight independent data sets met criteria for inclusion. Overall, there was a moderate effect of age group on trust (g = 0.22), whereby older adults were more trusting than young adults. Three additional meta-analyses assessed age-related differences in trust in response to varying degrees of trustworthiness. This revealed that older adults were more trusting than young adults in response to neutral (g = 0.31) and negative (g = 0.33), but not positive (g = 0.15), indicators of trustworthiness. The effect of age group on trust in response to positive and neutral cues was moderated by type of trust (financial vs. non-financial) and type of responding (self-report vs. behavioral). Older adults were more trusting than young adults in response to positive and neutral indicators of trustworthiness when trust was expressed non-financially, but not financially. There was also an age-related increase in self-reported, but not behavioral, trust in response to neutral cues. Older adults were more trusting than young adults in response to negative indicators of trustworthiness regardless of the type of trust or type of responding. The reliability of information about trustworthiness (superficial vs. genuine cues) did not moderate any effects of age on trust. Implications of these findings and directions for future research are discussed.

scholarly journals Rapid review and meta-meta-analysis of self-guided interventions to address anxiety, depression and stress during COVID-19 social distancing

2020 ◽  
Author(s):  
Ronald Fischer ◽  
Johannes Alfons Karl ◽  
Tiago Bortolini ◽  
Marcelo Zilberberg ◽  
Kealagh Robinson ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Relative Effectiveness ◽  
Well Being ◽  
Rapid Review ◽  
Subjective Well Being ◽  
Therapeutic Approaches ◽  
Social Distancing ◽  
Cultural Boundaries ◽  
Meta Analyses ◽  
Anxiety Depression

We conducted a rapid review and quantitative summary of meta-analyses that have examined interventions which can be used by individuals during quarantine and social distancing to manage anxiety, depression, stress and subjective well-being. A literature search yielded 34 meta-analyses (total number of studies k = 1,390, n = 145,744) that were summarized. Overall, self-guided interventions showed small to medium effects in comparison to control groups demonstrating their effectiveness. In particular, therapeutic approaches (including cognitive-behavioral, mindfulness, and acceptance-based interventions), selected positive psychology interventions, and multi-component and activity based interventions (music, physical exercise) showed promising evidence for effectiveness. Many of these interventions are available in online or smartphone app form. At the same time, self-guided interventions on average did not show the same degree of effectiveness as traditional guided individual or group therapies. The review points to activities and practices that can be adapted by individuals as a first step to manage their mental health during social distancing and quarantines. Further research is clearly needed on activities helping individuals to interact and live in constrained living conditions (e.g, improving social interactions during quarantine) and the relative effectiveness of self-guided interventions across cultural boundaries.

scholarly journals Individual patient data meta-analysis of delayed gastric emptying after pylorus-preserving versus pylorus-resecting pancreatoduodenectomy

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
P Probst ◽  
U Klaiber ◽  
S Seide ◽  
M Kawai ◽  
I Matsumoto ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
International Study ◽  
Postoperative Outcome ◽  
Patient Data ◽  
Individual Patient Level ◽  
Quantitative Synthesis ◽  
Meta Analyses

Abstract Objective Some studies have indicated that resecting the pylorus during partial pancreatoduodenectomy (PD) may lead to reduced delayed gastric emptying (DGE). Randomized controlled trials (RCTs) showed conflicting results regarding superiority of pylorus-resecting PD (prPD) compared to the pylorus-preserving procedure (ppPD). The aim of this individual patient data meta-analysis was to investigate risk factors on an individual patient level which may explain the observed differences between the existing RCTs. Methods RCTs comparing ppPD and prPD were searched systematically in MEDLINE, Web of Science and CENTRAL. Individual patient data (IPD) from existing RCTs were included. The primary endpoint was DGE according to the International Study Group of Pancreatic Surgery (ISGPS) adjusted for age, sex and body-mass-index (BMI). The meta-regression model was applied to the IPD of the RCTs. Mixed effects models were applied to perform meta-analyses. Results IPD from 418 patients (three RCTs) were used for quantitative synthesis. There was no significant statistical difference between ppPD and prPD regarding DGE adjusted for age, sex and BMI (OR 0.72; 95%-CI: 0.41 to 1.22) and DGE grade (RR 1.01; 95%-CI: 0.64 to 1.57). Regarding other relevant perioperative and postoperative outcome parameters, there were also no significant differences among the two techniques. Conclusion This IPD meta-analysis comparing preservation and resection of the pylorus during PD confirmed that the resection of the pylorus is not superior to the pylorus-preserving procedure regarding DGE. The pylorus should therefore be preserved whenever possible. Further RCT are futile, because their results are unlikely to change the pooled estimate for DGE.

scholarly journals Prevalence of dementia in long-term care institutions: a meta-analysis

2021 ◽  
Vol 70 (1) ◽  
pp. 59-67
Author(s):  
Daniel Ferreira Fagundes ◽  
Marcos Túlio Costa ◽  
Bárbara Bispo da Silva Alves ◽  
Maria Madalena Soares Benício ◽  
Lanna Pinheiro Vieira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Long Term Care ◽  
Web Of Science ◽  
Meta Analysis ◽  
Term Care ◽  
Meta Analyses ◽  
Prevalence Of Dementia

ABSTRACT Objective: This study comprises a systematic review and meta-analysis that aimed to estimate the prevalence of dementia in long-term care institutions (LTCIs). Methods: We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Original transversal and longitudinal articles published until July 2020 were eligible in this review. Databases PubMed/MedLine, Web of Science, Scopus and ScienceDirect were searched. Overall prevalence and confidence intervals were estimated. Heterogeneity was calculated according to the index of heterogeneity (I2). Results: One hundred seventy-five studies were found in all databases and 19 studies were meta-analyses, resulting in an overall prevalence of 53% (CI 46-59%; p < 0.01) of demented older adults living in LTCIs. Conclusion: Prevalence of dementia is higher in older adults living in LTCIs than those living in general communities. This data shows a worrying reality that needs to be changed. There is a need for a better understanding of the elements that cause this increase in dementia in LTCFs to direct actions to improve the quality of life and health of institutionalized elderly.

Effectiveness of Outdoor Exercise Parks on Health Outcomes in Older Adults—A Mixed-Methods Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-13
Author(s):  
Yoke Leng Ng ◽  
Keith D. Hill ◽  
Pazit Levinger ◽  
Elissa Burton
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Meta Analysis ◽  
Small Sample ◽  
Activity Levels ◽  
Single Leg Stance ◽  
Small Sample Sizes ◽  
Meta Analyses

The objective of this systematic review was to examine the effectiveness of outdoor exercise park equipment on physical activity levels, physical function, psychosocial outcomes, and quality of life of older adults living in the community and to evaluate the evidence of older adults’ use of outdoor exercise park equipment. A search strategy was conducted from seven databases. Nine articles met the inclusion criteria. The study quality results were varied. Meta-analyses were undertaken for two physical performance tests: 30-s chair stand test and single-leg stance. The meta-analysis results were not statistically significant. It was not possible to conclude whether exercise parks were effective at improving levels of physical activity. The review shows that older adults value the benefits of health and social interaction from the use of exercise parks. Findings should be interpreted with caution due to the small sample sizes and the limited number of studies.

Dietary patterns and depression risk in older adults: systematic review and meta-analysis

2020 ◽  
Author(s):  
Pei-Yu Wu ◽  
Kuei-Min Chen ◽  
Frank Belcastro
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Dietary Patterns ◽  
Data Extraction ◽  
Meta Analysis ◽  
Screening Tools ◽  
Inverse Association ◽  
Depression Risk ◽  
Study Heterogeneity ◽  
Meta Analyses

Abstract Context Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However, previous reviews mainly focused on general adult populations. Objective The aim of this systematic review and meta-analysis was to explore the association between healthy dietary patterns and depression risk in older adults. Data Sources Eight databases were searched up to September 2019. The inclusion criteria were older adults aged ≥ 65 years, healthy dietary patterns, depression assessed by a physician or by validated screening tools, and quantitative study design. Data Extraction Data were extracted independently by 2 researchers, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. Data Analysis Meta-analysis was conducted by calculating the pooled odds ratio (OR) and 95% CIs. A total of 18 eligible studies were meta-analyzed. Results showed that a healthy dietary pattern is associated with a reduced risk of depression in older adults (OR, 0.85; 95%CI, 0.78–0.92; P &lt; 0.001). There was high heterogeneity (I2 = 64.9%; P &lt; 0.001) among the studies. Subgroup analyses indicated that sample size and depression screening tools were the main sources of study heterogeneity. Conclusions An inverse association between healthy dietary patterns and depression risk in older adults was found. However, the high heterogeneity among the studies should be considered. Systematic Review Registration PROSPERO registration no. CRD 42020169195.

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