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Objectives To test whether women aged 55 and older with increasing evidence of a frailty phenotype would have greater risk of fractures, disability, and recurrent falls than women who were not frail, across geographic areas ( Australia, Europe, and North America) and age groups. Design Multinational, longitudinal, observational cohort study. Setting Global Longitudinal Study of Osteoporosis in Women ( GLOW). Participants Women (N = 48,636) aged 55 and older enrolled at sites in Australia, Europe, and North America. Measurements Components of frailty (slowness and weakness, poor endurance and exhaustion, physical activity, and unintentional weight loss) at baseline and report of fracture, disability, and recurrent falls at 1 year of follow-up were investigated. Women also reported health and demographic characteristics at baseline. Results Women younger than 75 from the United States were more likely to be prefrail and frail than those from Australia, Canada, and Europe. The distribution of frailty was similar according to region for women aged 75 and older. Odds ratios from multivariable models for frailty versus nonfrailty were 1.23 (95% confidence interval ( CI) = 1.07-1.42) for fracture, 2.29 (95% CI = 2.09-2.51) for disability, and 1.68 (95% CI = 1.54-1.83) for recurrent falls. The associations for prefrailty versus nonfrailty were weaker but still indicated statistically significantly greater risk of each outcome. Overall, associations between frailty and each outcome were similar across age and geographic region. Conclusion Greater evidence of a frailty phenotype is associated with greater risk of fracture, disability, and falls in women aged 55 and older in 10 countries, with similar patterns across age and geographic region. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the effect of a theory-based oral health promotion intervention in a community environment by a nondental peer educator on the oral hygiene and gingival health of independent-living Italian older adults. Design A quasiexperimental design with a pretest-posttest nonequivalent control group with no intervention. Setting Ten Melbourne-based Italian social clubs participated in this evaluation. Participants One hundred forty-four active members of the social clubs. Intervention A series of oral health seminars and four supervised brushing sessions at club premises. The intervention did not involve any direct oral health professional clinical care. Clubs were allocated to the control or intervention group. Measurements Dental plaque levels and gingival bleeding scores were determined. A series of one-way analyses of covariance were conducted using the baseline measures as covariates. Results Controlling for pretest scores, the experimental group was significantly more likely than the control group to have improved gingival status and self-efficacy. No significant effects were found regarding dental plaque. Conclusion Within the setting of Italian social clubs, the intervention was effective at increasing self-efficacy and reducing gingival bleeding. As such, it represents a useful approach for the design of oral health interventions in older migrant adults. [ABSTRACT FROM AUTHOR]

Objectives To determine the strength of the relationship between physical activity and physical function in older adults. Design Cross-sectional. Setting The 45 and Up Study baseline questionnaire, New South Wales, Australia. Participants Ninety-one thousand three hundred seventy-five Australian men and women aged 65 and older from the 45 and Up Study. Measurements Physical activity engagement ( Active Australia Survey), physical function ( Medical Outcomes Study Physical Functioning), psychological distress ( Kessler-10), and self-reported age, smoking history, education, height, and weight were all measured. Results Higher levels of physical activity were associated with better physical function in older adults (correlation coefficient = 0.166, P < .001). Participants engaging in higher levels of physical activity had progressively lower likelihoods of functional limitation (middle tertile: odds ratio ( OR) = 0.39, 95% confidence interval ( CI) = 0.38-0.41; highest tertile: OR = 0.28, 95% CI = 0.27-0.29). This relationship remained significant, but weakened slightly, when adjusted for age, sex, body mass index, smoking history, psychological distress, and educational attainment (middle tertile: adjusted OR ( AOR) = 0.48, 95% CI = 0.46-0.50; highest tertile: AOR = 0.36, 95% CI = 0.34-0.37). Conclusion There is a significant, positive relationship between physical activity and physical function in older adults, with older adults who are more physically active being less likely to experience functional limitation than their more-sedentary counterparts. Level of engagement in physical activity is an important predictor of physical function in older adults. [ABSTRACT FROM AUTHOR]

Objectives To compare the risk profiles of mild cognitive impairment ( MCI) subtypes in a population-based elderly sample. Design Cross-sectional study. Setting The population-based Sydney Memory and Ageing Study. Participants Seven hundred fifty-seven English-speaking, community-dwelling individuals without dementia aged 70 to 90. Measurements Comprehensive neuropsychological assessments were used to diagnose MCI and its subtypes, categorized as amnestic ( aMCI) or nonamnestic ( naMCI) and as single- ( sdMCI) or multiple- ( mdMCI) domain. Risk profiles were derived from sociodemographic; lifestyle; and cardiac, physical, mental, and general health data. Whole-sample and sex-specific comparisons between aMCI and naMCI and between mdMCI and sdMCI were made using age- (and sex-) adjusted multiple regressions comprising initially significant univariate factors. Results Risk factors for MCI were presence of the apolipoprotein E ( APOE) ε4 allele, heart disease, high homocysteine, poor odor identification ability, low visual acuity, and lower mental activity. The odds of having naMCI rather than aMCI were lower with greater levels of social activity and greater if taking antihypertensives, the latter particularly in men. The odds of naMCI were greater in men taking antidepressants or with a longer 6-meter walk time and in women with hypertension. The odds of having mdMCI rather than sdMCI were greater in participants with a history of depression or having the APOE ε4 allele. Greater odds of mdMCI were also associated with lower mental activity, particularly for women. For men, the odds of mdMCI were greater with the APOE ε4 allele and lower if diagnosed with high cholesterol. Conclusion MCI subtypes exhibit distinctive, sex-dependent risk profiles. This is consistent with MCI subtypes having different etiologies and outcomes and supports the idea that subtyping MCI may offer predictive validity and clinical application. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which is concerned with the assessment of frailty in older Australian women.