Defining Vitality: Associations of Three Operational Definitions of Vitality with Disability in Instrumental Activities of Daily Living and Frailty among Elderly Over a 3-Year Follow-Up (MAPT Study)
This study aimed to examine the associations of three operational definitions of vitality with variation in instrumental activities of daily living (IADL) and frailty over a 3-year follow-up among non-demented, community-dwelling elderly.
Setting and participants
1,679 elderly >70y (64.7% female) participants of the Multidomain Alzheimer Preventive Trial (MAPT).
Vitality was defined as a psychological concept using three items from the Geriatric Depression Scale; as a physical construct using the highest quartile for hand grip strength; and as global physiological reservoir using a combination of good physical and cognitive functions. Variables were assessed at baseline, 6, 12, 24 and 36 months of follow-up.
Prevalence of high vitality at baseline was 57.1%, 28.5% and 21.6% for psychological, physical, and physiological reservoir, respectively. People with high vitality presented higher IADL scores compared to people with low vitality for all definitions. Analysis from the mixed-effect model found no differences between vitality groups for IADL performance across all definitions. IADL scores improved among subjects with high vitality over time, independent on the definition; while no significant variation was observed among those with low vitality. Participants with low vitality presented 2.0 to 6.1 higher odds of having more frailty components over time (p<0.0001).
High vitality defined as a concept related to psychological, physical, or physiological reservoir constructs were positively associated with better IADL performance and with reduced likelihood of frailty worsening over time.
Key wordsVitality elderly activities of daily living frailty cognition
- ADCS ADL-PI
Alzheimer’s Disease Cooperative Study Activities of Daily Living-Prevention Instrument
activities of daily living
analysis of variance
body mass index
Clinical Dementia Rating
Geriatric Depression Scale
Instrumental Activities of Daily Living
Multidomain Alzheimer Preventive Trial
Mini-Mental State Examination
Statistical Analysis Software
Short Physical Performance Battery
World Health Organization
- 1.Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, Cooper C, Martin FC, Reginster J-Y, et al. Evidence for The Domains Supporting The Construct of Intrinsic Capacity. J Gerontol A Biol Sci Med Sci 2018.Google Scholar
- 2.Pérès K, Helmer C, Amieva H, Orgogozo J-M, Rouch I, Dartigues J-F, et al. Natural history of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia: a prospective population-based study. J Am Geriatr Soc. 2008;56(1):37–44.CrossRefGoogle Scholar
- 4.Ravindrarajah R, Hazra NC, Charlton J, Jackson SHD, Dregan A, Gulliford MC. Incidence and mortality of fractures by frailty level over 80 years of age: cohort study using UK electronic health records. BMJ Open. 2018;8(1):e018836.Google Scholar
- 9.Femia EE, Zarit SH, Johansson B. Predicting change in activities of daily living: a longitudinal study of the oldest old in Sweden. J Gerontol B Psychol Sci Soc Sci. 1997;52(6):P294-302.Google Scholar
- 13.Takemasa S, Nakagoshi R, Uesugi M, Inoue Y, Gotou M, Naruse S, et al. Interrelationship among the health-related and subjective quality of life, daily life activities, instrumental activities of daily living of community-dwelling elderly females in orthopedic outpatients. J Phys Ther Sci. 2017;29(5):880–883.CrossRefGoogle Scholar
- 16.Vellas B, Carrie I, Gillette-Guyonnet S, Touchon J, Dantoine T, Dartigues JF, et al. MAPT Study: a multidomain approach for preventing Alzheimer’s disease: design and baseline data. J Prev Alzheimers Dis. 2014;1(1):13–22.Google Scholar
- 17.Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol. 2017;16(5):377–389.CrossRefGoogle Scholar
- 19.Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.Google Scholar
- 24.Galasko D, Bennett DA, Sano M, Marson D, Kaye J, Edland SD, et al. ADCS Prevention Instrument Project: assessment of instrumental activities of daily living for community-dwelling elderly individuals in dementia prevention clinical trials. Alzheimer Dis Assoc Disord. 2006;20(4 Suppl 3):S152-169.Google Scholar
- 26.Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-156.Google Scholar
- 27.World Health Organization (WHO). Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1–452.Google Scholar
- 31.López-Teros T, Gutiérrez-Robledo LM, Pérez-Zepeda MU. Gait Speed and Handgrip Strength as Predictors of Incident Disability in Mexican Older Adults. J Frailty Aging. 2014;3(2):109–112.Google Scholar
- 35.Wanderley FAC, Silva G, Marques E, Oliveira J, Mota J, Carvalho J. Associations between objectively assessed physical activity levels and fitness and self-reported health-related quality of life in community-dwelling older adults. Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 2011;20(9):1371–1378.CrossRefGoogle Scholar