ABSTRACT
Social and physical frailty are common geriatric syndromes related to adverse health outcomes, including falls, hospitalization, institutionalization, and death. Social frailty leads to physical frailty in older adults who were not frail. Previous studies have demonstrated that pet ownership and robotic pets have physical and mental health benefits for older adults;however, no studies were found investigating the impact of robotic pets on social and physical frailty in community-dwelling older adults. The purpose of this study was to investigate the impact of a robotic pet on social and physical frailty in community-dwelling older adults using the Technology Acceptance Model as a framework. This was a clinical trial of adults aged 65 and over, hospitalized at a community hospital in Westchester County, New York. Intervention group participants received a robotic pet, and control group participants received usual post-discharge care. Participants were assessed at enrollment and at the 30-day discharge point using the Questionnaire to Define Social Frailty Status, FRAIL Questionnaire, the Geriatric Depression Scale Short Form, and the Short Portable Mental Status Questionnaire. For this study ,220 participants were enrolled;107 in the intervention group and 113 in the control group. Continuous outcomes were compared between groups using t-tests or Wilcoxon rank sum tests, as appropriate. Categorical outcomes were compared between groups using chi-square tests or Fisher's exact tests, as appropriate. The threshold for statistical significance was considered a p value of less than 0.05. There was no significant change in social frailty or physical frailty, cognitive status, or depression between the two groups. Participants who enjoyed doing things with their robotic pet had a statistically significant improvement in their SPMSQ scores (p = 0.02), which indicated a positive effect on cognition in participants who used their pet more. Prevalence of social frailty was high, likely attributable to pandemic control measures and unlikely to change on the social frailty questionnaire used in this study due to the ongoing pandemic. In contrast to this study, previous research has shown that robotic pets were effective for improving well-being in older adults and showed more positive impact in a group setting compared to individual use. A significant limitation of this study was that it took place during the COVID-19 pandemic. Other limitations were related to self-report of some measures which may introduce bias. Additionally, the social frailty questionnaire has not been validated in diverse populations;thus, its validity in the study population is not known. The geographic area where the study took place is non-diverse, which may impact generalizability to wider populations. The robotic pet positively impacted cognitive status in participants who reported they enjoyed doing activities with their pet. This supports the theoretical premise of this study that greater use of the robotic pet would yield greater benefit. Regarding implications, technology is an important tool to ameliorate social and physical frailty, especially in light of pandemic-related restrictions where in-person socialization is restricted. More research is needed on the impact of robotic pets in older adults living at home, particularly on social frailty, loneliness, and cognitive status, with larger sample sizes and diverse populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
Background: The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods: This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group-robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)-at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Findings: Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Interpretation: Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained pre-frail or frail. This suggests comprehensive assessment and interventions targeting pre-frailty and frailty beyond the initial illness are required. Funding: UK Research and Innovation and National Institute for Health Research.
ABSTRACT
Background: Most activities in community centers have declined as a countermeasure against the COVID-19 pandemic. Consequently, multidimensional frailty rates gradually worsened. This research aimed to explore coronavirus-related anxiety and others factors that influence physical, psychological, and social frailty in older community-dwellers in Taiwan during the COVID-19 pandemic. Methods: Two hundred and eight (208) elderlies over 65 years of age who lived in 12 administrative districts of Taipei City during the COVID-19 pandemic completed online questionnaires. The questionnaire asked for basic information, and included the coronavirus Pandemic Anxiety Scale, SARC-CalF of physical frailty, the Tilburg Frailty Indicator of psychological frailty, and the Questionnaire to define Social Frailty Status. Data were collected from 21 Ma y to 4 June 2022. They were analyzed using descriptive statistics, correlation coefficients, and one-way analysis of variance (ANOVA). Results: The average scores for coronavirus anxiety was 2.61, physical frailty was 1.28, psychological frailty was 1.67, and social frailty was 2.25. Regression analysis indicated that the degree of anxiety-related symptoms was associated with physical and psychological frailty in older community-dwellers (p < 0.01, p ¼ 0.002). Conclusions: The anxiety related to coronaviruses in older community-dwellers affected their physical, psychological, and social frailty in Taiwan. We considered anxiety-related symptoms when assessing the frailty status of elderly to better understand their physical and mental health. Thus, these data support policy recommendations to reduce the effects of the elderly's anxiety-related symptoms on their frailty in future pandemics. © 2023 College of Public Health Sciences, Chulalongkorn University. This is an open access article under the CC BY license.
ABSTRACT
Viral infections severely attack the physically frail elderly population, resulting in fatal drawbacks. The fact of having massive elderly population growth in Europe gives high priority to the detection of physical frailty and infectious diseases. This paper presents a safe, accurate, fast temperature detection system that could be integrated into homes or assisted living residences. The presented work aims to detect one of the symptoms of contagious diseases: elevated body temperature. In order to do so, we worked on recognizing eyes in thermal face images followed by scanning the detected eyes region for inner canthus temperature. Eyes detection was done by training four different sizes of You Only Look Once 5th version (YOLOv5) object detection algorithm: nano, small, medium and large. A total of 4,255 thermal images were implemented for the training process after merging two different datasets and applying data augmentation techniques. Results show a similar mAP score (99.5%) for the different trained models. The large YOLOv5 model was the fastest, working at 115 FPS. © 2022 IEEE.
ABSTRACT
The general population, but especially older adults, were forced or encouraged to stay home during the recent COVID-19 pandemic. In this context, indoor mobility (IM, the number of steps performed daily at home) may be informative about the general health status of older adults. The present study aimed at evaluating the relationship between IM, frailty (loss of functional reserve including both physical and psychosocial domains), and disability (loss of autonomy measured as activities of daily life, ADLs) in a sample of community-dwelling Italian older adults. Specifically, the primary objective was to investigate IM and disability differences between robust and frail older adults. The secondary objective was to test if frailty is in the causal sequence between IM and disability, i.e., as a mediator in their relationship. Thirty-two participants (mean age = 70 ± 6 years; 56.2% women) were recruited. Frailty and disability were evaluated using the Tilburg Frailty Indicator and the Groningen Activity Restriction Scale, respectively. IM at home was measured via an Adamo wristwatch (a connected accelerometer). One-way analyses of covariance, controlling for age and gender, showed that robust participants, classified according to a score higher than five points in the Tilburg Frailty Indicator, performed significantly more IM (F1,28 = 4.639; p = 0.04) and presented lower disability grade than frail ones (F1,28 = 4.342; p =0.046). Only physical frailty was a mediator in the relationship between IM and disability (F2,29 = 8.538, p < 0.001), with a fully mediated model (z = -2.073, p < 0.04). Conversely, the total frailty score was not a mediator in the same relationship, but with IM accounted for the variance in disability (F2,29 = 8.538, p < 0.001; R2 = 33.7%). Our results suggested that frail older adults restricted their IM more and presented a higher level of disability compared to robust older adults. Moreover, data suggest that IM reduction may have a negative impact on physical frailty and indirectly increase disability.
Subject(s)
COVID-19 , Frailty , Aged , COVID-19/epidemiology , Female , Frail Elderly/psychology , Frailty/complications , Geriatric Assessment/methods , Humans , Independent Living , Male , Middle Aged , PandemicsABSTRACT
Background: The present study aimed to examine age differences in the relationship between trajectories of loneliness and physical frailty among Chinese older adults. Methods: A total of 4618 participants aged ≥60 years old were taken from pooled data created from the 2011–2015 China Health and Retirement Longitudinal Study (CHARLS). Loneliness was assessed by a single question from the Centre for Epidemiological Studies scale, whereas physical frailty (PF) was examined by the physical frailty phenotype scale. We characterized trajectories of loneliness and PF using transition types and changes within the survey period. Results: Logistic regression models revealed that baseline loneliness was significantly related to remaining robust PF (OR = 0.55, 95% CI = 0.49–0.63, p < 0.001) and worsening in PF (OR = 1.17, 95% CI = 1.05–1.30, p < 0.01) at follow-up. Baseline PF status was also significantly related to the transitions in loneliness (worsen: OR = 1.41, 95% CI = 1.11–1.78, p < 0.01;improve: OR = 0.65, 95% CI = 0.47–0.91, p < 0.05). The cross-lagged panel model found that baseline PF or loneliness had a significant predictive effect on the changes in each other. The associations between trajectories of loneliness and PF were weakened with age and clustered in the under 75 age groups. Conclusions: Bidirectional associations may exist between trajectories of loneliness and PF among Chinese older adults. Interventions should mainly target the young-old to reduce the adverse reciprocal effects of loneliness and PF.
ABSTRACT
BACKGROUND/OBJECTIVES: Frailty, loneliness, and social isolation are all associated with adverse outcomes in older adults, but little is known about their combined impact on mortality. DESIGN: Prospective cohort study. SETTING: The Longitudinal Aging Study Amsterdam. PARTICIPANTS: Community-dwelling older adults aged 65 and older (n = 1,427). MEASUREMENTS: Frailty was measured with the frailty phenotype (Fried criteria). Loneliness was assessed with the De Jong Gierveld Loneliness Scale. Social isolation was operationalized using information on partner status, social support, and network size. Two categorical variables were created, for each possible combination regarding frailty and loneliness (FL) and frailty and social isolation (FS), respectively. Mortality was monitored over a period of 22 years (1995-2017). Survival curves and Cox proportional hazard models were used to study the effects of the FL and FS combinations on mortality. Analyses were adjusted for sociodemographic factors, depression, chronic diseases, and smoking. RESULTS: Frailty prevalence was 13%, and 5.9% of the sample were frail and lonely, and 6.2% frail and socially isolated. In fully adjusted models, older adults who were only frail had a higher risk of mortality compared with people without any of the conditions (hazard ratio [HR] range = 1.40-1.48; P < .01). However, the highest risk of mortality was observed in people with a combined presence of frailty and loneliness or social isolation (HRFL = 1.83; 95% confidence interval [CI] = 1.42-2.37; HRFS = 1.77; 95% CI = 1.36-2.30). Sensitivity analyses using a frailty index based on the deficit accumulation approach instead of the frailty phenotype showed similar results, confirming the robustness of our findings. CONCLUSION: Frail older adults are at increased risk of mortality, but this risk is even higher for those who are also lonely or socially isolated. To optimize well-being and health outcomes in physically frail older adults, targeted interventions focusing on both subjective and objective social vulnerability are needed.