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6. Frailty differences across population characteristics associated with health inequality: a cross-sectional analysis of baseline data from the Canadian Longitudinal Study on Aging (CLSA)

Author

Griffith, Lauren E, primary, Raina, Parminder, additional, Kanters, David, additional, Hogan, David, additional, Patterson, Christopher, additional, Papaioannou, Alexandra, additional, Richardson, Julie, additional, Gilsing, Anne, additional, Thompson, Mary, additional, and van den Heuvel, Edwin, additional

Published
2021
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7. Frailty differences across population characteristics associated with health inequality: A cross-sectional analysis of baseline data from the Canadian Longitudinal Study on Aging (CLSA)

Author

Griffith, Lauren E., Raina, Parminder, Kanters, David, Hogan, David, Patterson, Christopher, Papaioannou, Alexandra, Richardson, Julie, Gilsing, Anne, Thompson, Mary, van den Heuvel, Edwin, Griffith, Lauren E., Raina, Parminder, Kanters, David, Hogan, David, Patterson, Christopher, Papaioannou, Alexandra, Richardson, Julie, Gilsing, Anne, Thompson, Mary, and van den Heuvel, Edwin

Abstract

Objective To evaluate the pattern of frailty across several of social stratifiers associated with health inequalities. Design, setting and participants Cross-sectional baseline data on 51 338 community-living women and men aged 45-85 years from the population-based Canadian Longitudinal Study on Aging (collected from September 2011 to May 2015) were used in this study. Primary outcomes and measures A Frailty Index (FI) was constructed using self-reported chronic conditions, psychological function and cognitive status and physical functioning variables. Social stratifiers were chosen based on the Pan-Canadian Health Inequalities Reporting Initiative, reflecting key health inequalities in Canada. Unadjusted and adjusted FIs and domain-specific FIs (based on chronic conditions, physical function, psychological/cognitive deficits) were examined across population strata. Results The overall mean FI was 0.13±0.08. It increased with age and was higher in women than men. Higher mean FIs were found among study participants with low income (0.20±0.10), who did not complete secondary education (0.17±0.09) or had low perceived social standing (0.18±0.10). Values did not differ by Canadian province of residence or urban/rural status. After simultaneously adjusting for population characteristics and other covariates, income explained the most heterogeneity in frailty, especially in younger age groups; similar patterns were found for men and women. The average frailty for people aged 45-54 in the lowest income group was greater than that for those aged 75-85 years. The heterogeneity in the FI among income groups was greatest for the psychological/cognitive domain. Conclusions Our results suggest that especially in the younger age groups, psychological/cognitive deficits are most highly associated with both overall frailty levels and the gradient in frailty associated with income. If this is predictive of later increases in the other two domains (and overall frailty), it raises

Published
2021

8. Parental perceptions of the impact of COVID-19 and returning to play based on level of sport.

Author

Edwards, Michael B., Bocarro, Jason N., Bunds, Kyle S., Bush, Kimberly A., Casper, Jonathan M., Dorsch, Travis E., Chalip, Laurence, Kanters, David, and Kanters, Michael A.

Subjects
PARENT attitudes, SPORTS participation, SCHOOL sports, COVID-19, ATHLETIC ability, HOME environment
Abstract

This study examined the impact of COVID-19 on youth sport parents based on competition level to understand how the pandemic affected youth sport and factors associated with youth returning to sport. Survey data were collected from samples of US sport parents in two waves - early in the pandemic (N = 751) and as programs began to resume (N = 707). Data showed elite sport parents were more willing to return. Although most participants returned to play, significant numbers had not resumed participation. Parent comfort was the most important factor associated with resuming. However, parents allowed children to resume play due to perceived external pressure, potentially creating stress among parents regarding sport participation decisions. Attending school in person and household income were associated with the ability to resume sport suggesting the need to provide school sport environments and consider the financial impacts of COVID-19 on sport families. [ABSTRACT FROM AUTHOR]

Published
2022
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13. Measuring Frailty in Older Canadians: An Analysis of the Canadian Longitudinal Study on Aging

Author

Kanters, David, Griffith, Lauren, and Clinical Epidemiology/Clinical Epidemiology & Biostatistics

Subjects
CLSA, Frailty, Frail Elderly, Epidemiologic measurements
Abstract

Introduction: Frailty is characterized by vulnerability to declining health and increased risk for adverse health outcomes. Measuring frailty would be beneficial for developing interventions and assessing healthcare resource needs. No standardized measurement tool for frailty has been established. The objective of this thesis was to evaluate the frailty of participants in the Canadian Longitudinal Study on Aging (CLSA). Methods: A Frailty Index (FI) was constructed for CLSA participants based on the cumulative deficit theory of frailty. Exploratory factor analysis was conducted to study the underlying constructs of frailty and identify key factors. A hypothesized measurement model for frailty was specified. The model was modified and tested using structural equation modelling (SEM) to improve goodness-of-fit. A new frailty measurement tool was created and the construct validity of the new tool and the Frailty Index were evaluated. Results: A FI was calculated for 20,874 CLSA participants (Mean 0.14 SD 0.07). The maximum FI value was 0.68. A model containing all hypothesized variables had good fit of the data, and all variables contributed significantly. A simplified model also showed good fit and included four domains: upper-body strength, lower-body strength, dexterity, and depressive symptoms. These results persisted in an independent dataset. A Simplified Frailty (SF) score was created based on this simplified model. The FI and SF scores showed significant agreement and associations with sociodemographic variables were as predicted. Conclusions: A FI was simple to construct in the CLSA, having good fit of the data and construct validity. These results are consistent with previous research on the cumulative deficit theory of frailty. A simplified frailty model revealed key domains of frailty and resulted in a potentially useful short screening tool. The FI is recommended as a valid and reproducible approach for measuring frailty in the CLSA and similar population datasets. Thesis Master of Science (MSc)

Published
2016

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