Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA)
Background: In this observational study, we compared continuous physiological signals during an active standing test in adults aged 50 years and over, characterised as frail by three different criteria, using data from The Irish Longitudinal Study on Ageing (TILDA). Methods: This study utilised data...
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MDPI AG
2024-01-01
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| Online Access: | https://www.mdpi.com/1424-8220/24/2/442 |
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| author | Feng Xue Silvin Knight Emma Connolly Aisling O’Halloran Morgana Afonso Shirsath Louise Newman Eoin Duggan Rose Anne Kenny Roman Romero-Ortuno |
| author_facet | Feng Xue Silvin Knight Emma Connolly Aisling O’Halloran Morgana Afonso Shirsath Louise Newman Eoin Duggan Rose Anne Kenny Roman Romero-Ortuno |
| author_sort | Feng Xue |
| collection | DOAJ |
| description | Background: In this observational study, we compared continuous physiological signals during an active standing test in adults aged 50 years and over, characterised as frail by three different criteria, using data from The Irish Longitudinal Study on Ageing (TILDA). Methods: This study utilised data from TILDA, an ongoing landmark prospective cohort study of community-dwelling adults aged 50 years or older in Ireland. The initial sampling strategy in TILDA was based on random geodirectory sampling. Four independent groups were identified: those characterised as frail only by one of the frailty tools used (the physical Frailty Phenotype (FP), the 32-item Frailty Index (FI), or the Clinical Frailty Scale (CFS) classification tree), and a fourth group where participants were not characterised as frail by any of these tools. Continuous non-invasive physiological signals were collected during an active standing test, including systolic (sBP) and diastolic (dBP) blood pressure, as well as heart rate (HR), using digital artery photoplethysmography. Additionally, the frontal lobe cerebral oxygenation (Oxy), deoxygenation (Deoxy), and tissue saturation index (TSI) were also non-invasively measured using near-infrared spectroscopy (NIRS). The signals were visualised across frailty groups and statistically compared using one-dimensional statistical parametric mapping (SPM). Results: A total of 1124 participants (mean age of 63.5 years; 50.2% women) were included: 23 were characterised as frail only by the FP, 97 by the FI, 38 by the CFS, and 966 by none of these criteria. The SPM analyses revealed that only the group characterised as frail by the FI had significantly different signals (<i>p</i> < 0.001) compared to the non-frail group. Specifically, they exhibited an attenuated gain in HR between 10 and 15 s post-stand and larger deficits in sBP and dBP between 15 and 20 s post-stand. Conclusions: The FI proved to be more adept at capturing distinct physiological responses to standing, likely due to its direct inclusion of cardiovascular morbidities in its definition. Significant differences were observed in the dynamics of cardiovascular signals among the frail populations identified by different frailty criteria, suggesting that caution should be taken when employing frailty identification tools on physiological signals, particularly the neurocardiovascular signals in an active standing test. |
| first_indexed | 2024-03-08T09:47:21Z |
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| institution | Directory Open Access Journal |
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| spelling | doaj.art-89962d27b04b4adeb9e72300dc60c8e52024-01-29T14:14:46ZengMDPI AGSensors1424-82202024-01-0124244210.3390/s24020442Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA)Feng Xue0Silvin Knight1Emma Connolly2Aisling O’Halloran3Morgana Afonso Shirsath4Louise Newman5Eoin Duggan6Rose Anne Kenny7Roman Romero-Ortuno8Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandBackground: In this observational study, we compared continuous physiological signals during an active standing test in adults aged 50 years and over, characterised as frail by three different criteria, using data from The Irish Longitudinal Study on Ageing (TILDA). Methods: This study utilised data from TILDA, an ongoing landmark prospective cohort study of community-dwelling adults aged 50 years or older in Ireland. The initial sampling strategy in TILDA was based on random geodirectory sampling. Four independent groups were identified: those characterised as frail only by one of the frailty tools used (the physical Frailty Phenotype (FP), the 32-item Frailty Index (FI), or the Clinical Frailty Scale (CFS) classification tree), and a fourth group where participants were not characterised as frail by any of these tools. Continuous non-invasive physiological signals were collected during an active standing test, including systolic (sBP) and diastolic (dBP) blood pressure, as well as heart rate (HR), using digital artery photoplethysmography. Additionally, the frontal lobe cerebral oxygenation (Oxy), deoxygenation (Deoxy), and tissue saturation index (TSI) were also non-invasively measured using near-infrared spectroscopy (NIRS). The signals were visualised across frailty groups and statistically compared using one-dimensional statistical parametric mapping (SPM). Results: A total of 1124 participants (mean age of 63.5 years; 50.2% women) were included: 23 were characterised as frail only by the FP, 97 by the FI, 38 by the CFS, and 966 by none of these criteria. The SPM analyses revealed that only the group characterised as frail by the FI had significantly different signals (<i>p</i> < 0.001) compared to the non-frail group. Specifically, they exhibited an attenuated gain in HR between 10 and 15 s post-stand and larger deficits in sBP and dBP between 15 and 20 s post-stand. Conclusions: The FI proved to be more adept at capturing distinct physiological responses to standing, likely due to its direct inclusion of cardiovascular morbidities in its definition. Significant differences were observed in the dynamics of cardiovascular signals among the frail populations identified by different frailty criteria, suggesting that caution should be taken when employing frailty identification tools on physiological signals, particularly the neurocardiovascular signals in an active standing test.https://www.mdpi.com/1424-8220/24/2/442frailty indexfrailty phenotypeclinical frailty scaleactive standcontinuous physiological monitoringneurovascular |
| spellingShingle | Feng Xue Silvin Knight Emma Connolly Aisling O’Halloran Morgana Afonso Shirsath Louise Newman Eoin Duggan Rose Anne Kenny Roman Romero-Ortuno Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA) Sensors frailty index frailty phenotype clinical frailty scale active stand continuous physiological monitoring neurovascular |
| title | Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA) |
| title_full | Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA) |
| title_fullStr | Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA) |
| title_full_unstemmed | Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA) |
| title_short | Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA) |
| title_sort | were frailty identification criteria created equal a comparative case study on continuous non invasively collected neurocardiovascular signals during an active standing test in the irish longitudinal study on ageing tilda |
| topic | frailty index frailty phenotype clinical frailty scale active stand continuous physiological monitoring neurovascular |
| url | https://www.mdpi.com/1424-8220/24/2/442 |
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