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To investigate the impact of COVID-19 lockdown on quality of life (QoL), meaningful daily activities, and (pre)frailty in community-dwelling octogenarians.Cross-sectional design with bivariate and multiple linear regression modeling using a stepwise approach examining the level of QoL during the COVID-19 lockdown in a group of 215 community-dwelling octogenarians (MParticularly, a decrease in daily activities, social activities, and an increase in free times activities were observed, but the decrease in QoL could be explained by the meaningfulness in activities, together with experiencing emptiness in life, taking ≥ 4 medications a day and feeling down or depressed.We tried to understand which components contribute to and might affect a person's QoL caused by restrictions imposed by the governance and its influence on the lives of the community-dwelling octogenarians. As such, this output could be a baseline for the development of minimally impacting countermeasures during future lockdowns.Studying lifestyle changes and thus also variables related to QoL during a pandemic, may support policymakers and practitioners to develop relevant interventions.

BackgroundFatigue might influence the losses in activities of daily living (ADL). When fatigue parameters are present before the experience of losses in ADL and gait speed, they can be used as early warning signals. This study aimed to explore the predictive value of muscle endurance and fatigue on changes in ADL and gait speed in community-dwelling older adults aged 80 and older.MethodsThree hundred twenty four community-dwelling older adults aged 80 and older of the BUTTERFLY study were assessed after 1 year for muscle endurance, self-perceived fatigue, ADL, and gait speed. Exploratory factor analysis (EFA) was performed to explore, whether there is an underlying arrangement of the fatigue parameters. Mediating logistic regression analyses were used to investigate whether muscle endurance mediated by self-perceived fatigue predicts the decline in gait speed and ADL after 1-year follow-up.ResultsEFA indicated a 2-factor model (muscle endurance factor and self-perceived fatigue factor) and had a moderate fit (X2: 374.81, df: 2, comparative fit index; 0.710, Tucker–Lewis index (TLI): 0.961, root mean square error of approximation [90%]: 0.048 [0.00–0.90]). Muscle endurance mediated by self-perceived fatigue had an indirect effect on the prediction of decline in Basal-ADL (−0.27), Instrumental-ADL (−0.25), and gait speed (−0.28) after 1-year follow-up.ConclusionThis study showed that low muscle endurance combined with high self-perceived fatigue can predict changes in ADL after 1-year follow-up. These parameters might be very suitable for use in evaluating intrinsic capacity and can help to reduce the limitations in clinical usage of the vitality domain in the framework of intrinsic capacity.

Objectives:Understanding of prefrailty’s relationship with limitations in activities of daily living (ADLs) moderated by psychological resilience is needed, as resilience might support ADLs’ maintenance and thus protect against frailty. Therefore, this study aims to analyze the influence of psychological resilience (using the Connor–Davidson Resilience Scale; CD-RISC) on the relation between ADLs and frailty status of older individuals (i.e. prefrail versus robust).Design:Cross-sectional design.Setting:UZ Brussels, Belgium.Participants:Robust (Fried 0/4;n = 214; Age = 82.3 ± 2.1yrs) and prefrail (Fried 1-2/4; n = 191; Age = 83.8 ±3.2yrs) community-dwelling older individuals were included.Measurements:Frailty scores were obtained from weight loss, exhaustion, gait speed, and grip strength. A total Disability Index (DI) expressed dependency for basic (b-), instrumental (i-), and advanced (a-)ADLs. Mediation was investigated by estimating direct and indirect effects of all levels of ADLs and CD-RISC total score on prefrailty/robustness using a stepwise multiple regression approach.Results:Prefrailty/robustness significantly correlated with a-ADL-DI (point-biserial correlation (rpb) = 0.098; pConclusions:Less limitation in a-ADLs is a directly correlated factor of prefrailty and might represent a higher likelihood of robustness.

Introduction: Low grip work and high feelings of self-perceived fatigue could be an early characteristic of decline in reserve capacity, which comes to full expression as physical frailty in a later stage. When grip work and self-perceived fatigue can be identified as characteristics differentiating between robustness and pre-frailty it might allow to identify pre-frailty earlier. Therefore, this study aimed to investigate whether the combination of grip work and self-perceived fatigue is related to pre-frailty in well-functioning older adults aged 80 and over. Methods: Four-hundred and five community-dwelling older adults aged 80 and over (214 robust and 191 pre-frail) were assessed for muscle endurance (grip Work corrected for body weight (GW_bw)), self-perceived fatigue (MFI-20) and frailty state (Fried Frailty Index, FFI). A Capacity to Perceived Vitality ratio (CPV) was calculated by dividing GW_bw by the MFI-20 scores. ANCOVA analysis (corrected for age and gender) was used to compare robust and pre-frail older adults, and binary logistic regressions were applied to analyze the relationship between CPV and pre-frailty status. Results: Pre-frail older adults who scored negative on the exhaustion item of the FFI still showed significantly lower GW (p < 0.001), CPV ratios (p < 0.001) and higher self-perceived fatigue (p < 0.05) compared to the robust ones. The likelihood for pre-frailty related significantly to higher age, being men and lower CPV ratios. In women, every unit increase in CPV ratio decreased the likelihood for pre-frailty by 78% (OR 0.22; 95% CI: 0.11–0.44), for men this effect was less strong (34%, OR 0.66; 95% CI: 0.47–0.93). Conclusions: Pre-frail community-dwelling persons aged 80 years and over without clinical signs of exhaustion on the FFI still experience significantly higher fatigue levels (lower Grip Work, higher self-perceived fatigue and lower CPV levels) compared to robust ones. CPV ratio could therefore be a good tool to identify subclinical fatigue in the context of physical (pre-)frailty.

Fatigue might influence the losses in activities of daily living (ADL). When fatigue parameters are present before the experience of losses in ADL and gait speed they can be used as early warning signals. This study aimed to explore the predictive value of muscle endurance and fatigue on changes in ADL and gait speed in community-dwelling older adults aged 80 and over.324 community-dwelling older adults aged 80 and older of the BUTTERFLY study were assessed after one year for muscle endurance, self-perceived fatigue, Activities of Daily Living and gait speed. Exploratory factor analysis (EFA) was performed to explore, whether there is an underlying arrangement of the fatigue parameters. Mediating logistic regression analyses were used to investigate whether muscle endurance mediated by self-perceived fatigue predicts decline in gait speed and ADL after one year follow-up.Exploratory factor analysis indicated a 2-factor model (muscle endurance factor and self-perceived fatigue factor) and had a moderate fit (X 2: 374.81, df: 2, CFI; 0.710, TLI: 0.961, RSMEA(90%): 0.048 (0.00-0.90)). Muscle endurance mediated by self-perceived fatigue had an indirect effect on the prediction of decline in Basal- (-0.27), Instrumental-ADL (-0.25) and gait speed (-0.28) after one year follow-up.This study showed that low muscle endurance combined with high self-perceived fatigue can predict changes in ADL after one-year follow-up. These parameters might be very suitable for use in evaluating intrinsic capacity and can help to reduce the limitations in clinical usage of the vitality domain in the framework of intrinsic capacity.

Background and Objectives The relationship between frailty and disability in activities of daily living (ADLs) can be seen in different ways, with disability being—to varying degrees—a characteristic, negative outcome, or predictor of frailty. This conflation of definitions is partly a result of the different frailty tools used in research. Aiming to provide a comprehensive overview, this systematic literature search analyzed (i) if, (ii) to what extent, and (iii) how ADLs are evaluated by frailty instruments. Research Design and Methods A search was performed in PubMed, Web of Knowledge, and PsycINFO to identify all frailty instruments, followed by categorization of the ADL items into basic (b-), instrumental (i-), and advanced (a-) ADLs. Results In total, 192 articles described 217 frailty instruments, from which 52.1% contained ADL items: 45.2% b-ADLs, 35.0% i-ADLs, and 10.1% a-ADLs. The most commonly included ADL items were bathing (b-ADLs); using transportation (i-ADLs); and semiprofessional work engagement in organized social life or leisure activities (a-ADLs). These instruments all had a multidomain origin (χ 2 = 122.4, p < .001). Discussion and Implications Because 52.1% of all instruments included ADL items, the concepts of frailty and disability appear to be highly entangled. This might lead to circular reasoning, serious concerns regarding contamination, and invalid research results.

Purpose To identify the different fatigue items in existing frailty scales. Methods PubMed, Web of Knowledge and PsycINFO were systematically screened for frailty scales. 133 articles were included, describing 158 frailty scales. Fatigue items were extracted and categorized in 4 fatigue constructs: “mood state related tiredness”, “general feeling of tiredness”, “activity based feeling of tiredness” and “resistance to physical tiredness”. Results 120 fatigue items were identified, of which 100 belonged to the construct “general feeling of tiredness” and only 9 to the construct “resistance to physical tiredness”. 49,4% of the frailty scales included at least 1 fatigue item, representing 15 ± 9,3% of all items in these scales. Fatigue items have a significantly higher weight in single domain (dominantly physical frailty scales) versus multi domain frailty scales (21 ± 3.2 versus 10.6 ± 9.8%, p= Conclusion Fatigue is prominently represented in frailty scales, covering a great diversity in fatigue constructs and underlying pathophysiological mechanisms by which fatigue relates to frailty. Although fatigue items were more prevalent and had a higher weight in physical frailty scales, the operationalization of fatigue leaned more towards psychological constructs. This review can be used as a reference for choosing a suitable frailty scale depending on the type of fatigue of interest.