The alterations in multiple neurophysiological procedures are associated with frailty phenotype in older adults

Xin Jiang; Junhong Zhou; Chengyuan Yu; Wenbo Chen; Baofeng Huang; Yurong Chen; Lilian Zhong; Yi Guo; Qingshan Geng; Yurun Cai

doi:10.3389/fnagi.2023.1063322

The alterations in multiple neurophysiological procedures are associated with frailty phenotype in older adults

Front Aging Neurosci. 2023 Mar 28:15:1063322. doi: 10.3389/fnagi.2023.1063322. eCollection 2023.

Authors

Xin Jiang^{1

2

3}, Junhong Zhou^{4

5

6}, Chengyuan Yu^{1

2

3}, Wenbo Chen^{1

2

3}, Baofeng Huang^{1

2

3}, Yurong Chen¹, Lilian Zhong^{1

2

3}, Yi Guo^{2

3

7

8}, Qingshan Geng^{1

2

3}, Yurun Cai⁹

Affiliations

¹ Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, China.
² The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China.
³ The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China.
⁴ Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States.
⁵ Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States.
⁶ Harvard Medical School, Boston, MA, United States.
⁷ Department of Neurology, Shenzhen People's Hospital, Shenzhen, Guangdong, China.
⁸ Shenzhen Bay Laboratory, Shenzhen, Guangdong, China.
⁹ Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States.

Abstract

Background: Older adults oftentimes suffer from the conditions in multiple physiologic systems, interfering with their daily function and thus contributing to physical frailty. The contributions of such multisystem conditions to physical frailty have not been well characterized.

Methods: In this study, 442 (mean age = 71.4 ± 8.1 years, 235 women) participants completed the assessment of frailty syndromes, including unintentional weight loss, exhaustion, slowness, low activity, and weakness, and were categorized into frail (≥3 conditions), pre-frail (1 or 2 conditions), and robust (no condition) status. Multisystem conditions including cardiovascular diseases, vascular function, hypertension, diabetes, sleep disorders, sarcopenia, cognitive impairment, and chronic pain were assessed. Structural equation modeling examined the interrelationships between these conditions and their associations with frailty syndromes.

Results: Fifty (11.3%) participants were frail, 212 (48.0%) were pre-frail, and 180 (40.7%) were robust. We observed that worse vascular function was directly associated with higher risk of slowness [standardized coefficient (SC) = -0.419, p < 0.001], weakness (SC = -0.367, p < 0.001), and exhaustion (SC = -0.347, p < 0.001). Sarcopenia was associated with both slowness (SC = 0.132, p = 0.011) and weakness (SC = 0.217, p = 0.001). Chronic pain, poor sleep quality, and cognitive impairment were associated with exhaustion (SC = 0.263, p < 0.001; SC = 0.143, p = 0.016; SC = 0.178, p = 0.004, respectively). The multinomial logistic regression showed that greater number of these conditions were associated with increased probability of being frail (odds ratio>1.23, p < 0.032).

Conclusion: These findings in this pilot study provide novel insights into how multisystem conditions are associated with each other and with frailty in older adults. Future longitudinal studies are warranted to explore how the changes in these health conditions alter frailty status.

Keywords: frail status; frailty phenotype; multisystem comorbidities; neurophysiological alterations; vascular function.

Grants and funding

This work was supported by the Sustainable Development Science and Technology Project of Shenzhen Science and Technology Innovation Commission (KCXFZ20201221173411032 and KCXFZ20201221173400001), Basic Research Project of Shenzhen Natural Science Foundation, Shenzhen Science and Technology Planning Project (JCYJ20190807145209306), the Natural Science Foundation of Guangdong Province (2021A1515010983), “Five Threes” Clinical Research Program of Shenzhen People’s Hospital (SYWGSLCYJ202204), and Shenzhen Key Medical Discipline Construction Fund (Nos. SZXK012 and SZXK005). JZ was supported by the grant from the National Institute on Aging (1K01AG075180-01).