Determinants of preservation of function in elderly (PROFIEL study)
Background
According to the majority of older people preservation of physical and psychosocial functioning is important in their live. However, two third of older people have one or more chronic disease, with a mean number of conditions of 2.5. For older people these chronic conditions become problematic as soon as these conditions threat daily live activities and vitality. Functional decline and loss of vitality can change the balance in daily living negatively with the risk of a cascade breakdown. Although disability is studied in a growing number of studies, the pathway to disability is almost unknown. Age, disease, loss of muscle mass and bone mineral density are considered as key factors in the process of disability. The lack of understanding of the physiology and etiology of disability causes a problem in the development of effective preventive interventions.
Aim
The aim of this project is to gain insight in which somatic, cognitive and psychosocial factors contribute to preservation of functioning, in order to identify older people with potential risk of functional decline in an early stage and develop interventions to prevent or delay functional decline to enable older people to stay independent.
Methods
PROFIEL is a longitudinal population-based study among approximately 600 older men and women. We will make use of the data that were collected for two studies conducted in 1999-2000 and 2001-2002 among 402 older women and 400 older men. Both studies had a cross-sectional design, and their aim was to find determinants of aging and frailty. In these studies extensive information is collected on medical history, lifestyle behaviour (smoking, alcohol, diet, physical activity), and somatic, cognitive, functional and psychosocial status have been characterized. Participants of these studies will be invited for a follow-up visit.
The main outcome parameter will be functional status (being able to function independently). It will be measured using the KATZ questionnaire and the physical performance score by Guralnik. Use of care which was not planned will also be an important outcome parameter.
Characteristics of somatic, functional, cognitive and psychosocial status will be assessed as potential determinants. Somatic status will be characterized with vascular status (large artery stiffness and carotid intima-media thickness) and bone and body fat status (bone mineral density, lean and fat mass, intra-abdominal and peripheral fat). Functional status will be further characterized by hand grip strength, lung function, 6-minute walking distance and physical activity. Cognitive status will be assessed in the domains of memory, processing capacity and speed, and executive functions. Psychosocial status will be characterized by quality of life, depression, anxiety and panic disorder, and self management ability questionnaires.
Research co-ordinators: Prof. Y.T. van der Schouw, PhD, and prof. M.J. Schuurmans, PhD
More information