Frailty research is a challenging topic in life sciences. In recent years, many scholars have conducted a number of prospective cohort studies regarding the treatment of frailty, and our scientific hypothesis is that by regulating people’s dietary and lifestyle characteristics before the onset of frailty, frailty can be reduced. This means that the threshold for treatment can be increased. As progress is made, medical efforts can shift the focus to prevention and health management. After field research in China, our hypothesis was confirmed. Chinese elderly women either do not exercise or spend less than 0.5 hectares of time at the same time, do occasional exercise or low-intensity exercise, are easily fatigued during work, and eat too much. Staple foods (more than 450 g per day) will not help you stay strong.
Prevalence of frailty in China’s elderly female population.
Our study found that the frailty prevalence among elderly women in China was 15.9%, which was higher than that in 2019 in China’s elderly community. [12.8%, (10.5%, 15.2%)] [5]. There is a certain relationship between value growth and COVID-19. Most of the poor prognosis due to COVID-19 occurs in the elderly. Test results of clinical samples showed elevated C-reactive protein, interleukin-6, lactate dehydrogenase, calcitonin, transferrin, and cortisol levels of varying degrees of significance and significantly lower vitamin D levels in older samples (generally accepted biomarkers of frailty) [14]. Social isolation has become a part of daily life for older people in China during the pandemic.Family conflicts, depression, anxiety, and other emotions caused by isolation reduce collective disease resistance and further exacerbate frailty. [15].
After 5 years of age stratification, the overall prevalence of frailty and prefrailty first increased and then decreased with age, showing an inverted “U”-shaped change. The inverted “U” peak appeared in the age group 70-74 years, indicating that the incidence of physical injury and disease among study participants increased from younger to older age groups (60-74 years). Masu. Self-care awareness and behavior among women over 75 years of age began to increase, and the prevalence of frailty decreased.
3 Fitting and performance evaluation of classification decision tree models.
To draw intuitive and detailed conclusions, we focused on detailed quantification of dietary intake and lifestyle behavioral factors that influence frailty. The constructed three-classification decision tree model focused on the systematic screening of influencing variables. That is, based on single factors, filters, and embedded variable screening techniques were adopted to analyze variable assignments in combination with expert knowledge. We adopted a decision tree model as an auxiliary model for this analysis because the result is an intuitive and easy-to-understand tree. In addition to rescreening the main factors that influence frailty, it also clearly shows the interaction between factors and the contribution of each type of influence, and solves the classification problem that complex parameter estimates cannot be expressed by functions. can be avoided. [16].
On the training and test sets, Model 3 performed better, with relatively average values for each index. The accuracy, sensitivity, and specificity of model 3 ranged from 75% to 84%, and the AUC was greater than 0.800. Fruit, milk and egg intake, sedentary behavior and sleep duration were not reflected in the final results, but this does not mean that older people did not need to pay attention. In fact, the final results were refined through multiple layers of screening, and the variables were of relatively high importance and required more attention.
Impact of dietary intake and lifestyle behaviors on populations.
The dietary and lifestyle questionnaires used in this study are a retrospective compilation of our group’s work experience in the context of women, combined with authoritative research and surveys. Before the survey, each investigator received uniform training and learned a clear definition of each indicator to ensure the reliability and reliability of the results as much as possible.
Eating too many staple foods (more than 450 g per day) has a negative impact on hardiness. Women in southern China mainly consume rice as a staple food, while women in northern China mainly consume pasta. However, rice and pasta are both major sources of carbohydrates, and excessive consumption of carbohydrates can lead to obesity and overweight. [17]. Sarcopenic obesity is a clinical dysfunction in which obesity and sarcopenia coexist. It is characterized by a loss of lean body mass with excessive accumulation of adipose tissue, especially visceral fat, and occurs more often in older women. [18]. Previous research on frailty has focused on supplementing diagnosed populations with protein diets to regulate metabolism and improve muscle mass. [19]however, our study suggests for the first time that carbohydrate restriction appears to be more important than protein supplementation in healthy people (those who have not progressed to frailty).Restricting carbohydrate intake has been shown to improve weight loss, insulin resistance, blood sugar levels and lipids in women [20]however, adequate carbohydrate intake (not a low or high carbohydrate diet) can increase muscle glycogen stores, muscle mass, and bone mass. [21] and prevent osteoporosis. In particular, combining exercise with reducing carbohydrates in the diet appears to reduce muscle mass loss caused by ketosis. [22].
Therefore, we specified exercise duration, intensity, and frequency within the model and conducted a comprehensive analysis of lifestyle behaviors. Further quantitative results show that inactivity or occasional or low-intensity exercise, but with less than 0.5 hectares of physical activity per day, does not contribute to the maintenance of physical robustness. was shown. Randomized clinical trial shows that exercise significantly improves quality of life in older adults, reduces age-related oxidative damage and chronic inflammation, and improves mitochondrial function, actin profile, IGF-1 signaling pathway, and insulin sensitivity It has been proven that it can be done. [23, 24].A combination of exercise and dietary nutrition is recommended for the prevention and treatment of frailty [25].
We propose that work fatigue in older women should be reduced after maintaining good diet and exercise habits. Self-perception of work is a comprehensive measure of women’s psychological and social health. In this study, “work” is defined as social work and family work. In society, Chinese women work until the age of 55 until they retire, and the working hours of freelancers and self-employed people are influenced by economic pressures. In families, women are expected to care for elderly parents, children, and grandchildren, as well as providing emotional support and household chores. As the population ages and women’s life expectancy increases, women remain in this stage for longer periods of time, with increased energy, emotional and financial investment. If they feel tired, it means that psychological pressure is increasing due to increasing age and changing social roles, which is also the root cause of mental illness.Frailty is a biopsychosocial syndrome [26]Epidemiological evidence shows that more than one-third of elderly patients with depression [27] He is frail. Therefore, we do not recommend that older women continue to experience stress at work. This is because it can easily lead to psychologically related disorders and thus frailty.
Although our study is based on a cross-sectional survey, it has three advantages: First, the survey can be conducted because the research perspective is based on representative provinces and cities in China, and the geographical and age distribution of the survey subjects is homogeneous. It reflects the objective reality of frailty among elderly women in China. Then, based on her two aspects of dietary intake and lifestyle behavior, we simultaneously and comprehensively evaluated the comprehensive influence of the factors of her two aspects on the population. Finally, we explain and predict the overall impact of frailty in two dimensions. The results demonstrate the simplicity and feasibility of the medical focus from frailty treatment to frailty prevention.
This study has some limitations. The strength of causality judgments in cross-sectional surveys in epidemiological studies is still low, and we do not know whether a negative combination of factors causes frailty or whether frailty causes a negative combination of these factors. Follow-up studies should obtain information on larger samples. Despite these limitations, our study innovatively suggests the potential to shift the focus of frailty efforts and provide positive information for routine prevention of frailty.
