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04/2012 journal articles

APPENDICULAR SKELETAL MUSCLE MASS: DEVELOPMENT AND VALIDATION OF ANTHROPOMETRIC PREDICTION EQUATIONS

R. Visvanathan, S. Yu, J. Field, I. Chapman, R. Adams, G. Wittert, T. Visvanathan

J Frailty Aging 2012;1(4):147-151

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Objectives: Sarcopenia is the loss of muscle mass and function seen with increasing age. Central to making the diagnosis of sarcopenia is the assessment of appendicular skeletal muscle mass (ASM). The objective of this study was to develop and validate novel anthropometric prediction equations (PEs) for ASM that would be useful in primary or aged care. Design: PEs were developed using best subset regression analysis. Three best performing PEs (PE1, PE2, PE3) were selected and validated using the Bland-Altman and Sheiner & Beal methods. Setting: Community dwelling adults in South Australia. Participants: 188 healthy subjects were involved in the development study. 2275 older(age > 50years) subjects were involved in the validation study. Measurements: ASM was assessed using dual x-ray abosrptiometry (DEXA). Weight and height was measured and body mass index (BMI) estimated. Results: A strong correlation between PE derived ASM and the DEXA derived ASM was seen for the three selected PEs. PE3: ASM= 10.047427 + 0.353307(weight) - 0.621112(BMI) - 0.022741(age) + 5.096201(if male) performed the best. PE3 over-estimated (P<0.001) ASM by 0.36 kg (95% CI 0.28-0.44 Kg) and the adjusted R2 was 0.869. The 95% limit of agreement was between -3.5 and 4.35 kg and the standard error of the estimate was 1.95. The root mean square error was 1.91(95% CI 1.80-2.01). PE3 also performed the best across the various age (50-65, 65-<80, 80+ years) and weight (BMI <18.5, 18.5-24.9, 25-29.9, >30 kg/m2) groups. Conclusions: A new anthropometric PE for ASM has been developed for use in primary or aged care but is specific to Caucasian population groups.

CITATION:
R. Visvanathan ; S. Yu ; J. Field ; I. Chapman ; R. Adams ; G. Wittert ; T. Visvanathan (2012): Appendicular Skeletal Muscle Mass: Development and Validation of Anthropometric Prediction Equations . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.23

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NEIGHBORHOOD PERCEPTION AND OBESITY IN AGED MEXICAN AMERICANS

C. Siordia, J. Saenz

J Frailty Aging 2012;1(4):152-161

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Background: Hypotheses on the relationship between neighborhood perception and obesity (as measured by body mass index) seem to generally posit that a positive neighborhood perception may be related with behaviors that positively moderate body weight. Objective: To determine if and how there is an association between positive neighborhood perception and obesity—while accounting for frailty- and disability-related factors. Design: Cross-sectional study from Wave-5 of the Hispanic Established Population for the Epidemiological Study of the Elderly (HEPESE). Setting: Data files housed by the Sociomedical Division in the department of Community Health and Preventive Medicine at the University of Texas Medical Branch in Galveston, Texas. Participants: A total of 889, aged 75-90 community-dwelling Mexican Americans in the Southwest United States. Measurements: Body mass index (BMI=Kg/m2), neighborhood perception, grip strength, gait speed, depression symptomatology, chronic conditions, presence of limitations with basic and instrumental basic activities of daily living (ADLs), and other health and demographic variables are used in logistic regressions predicting the likelihood of being obese (BMI > 30 Kg/m2) versus being of normal weight (BMI 18.5-25.4 Kg/m2). Results: The odds of being obese increase: as the level of positive neighborhood perception increases; grip strength increases; and with having any limitations with basic-ADLs. Conclusions: These findings provide evidence that a positive neighborhood perception need not always be accompanied with a reduced risk of being obese. Because functional limitations in older ages may influence how positive neighborhood perception affects BMI, more research is needed.

CITATION:
C. Siordia ; J. Saenz (2012): Neighborhood Perception and Obesity in Aged Mexican Americans. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.24

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ASSOCIATION BETWEEN FUNCTIONAL ASSESSMENT INSTRUMENTS AND FRAILTY IN OLDER ADULTS: THE FRADEA STUDY

P. Abizanda, L. Romero, P.M. Sánchez-Jurado, P. Atienzar-Nünez, J.L. Esquinas-Requena, I. García-Nogueras

J Frailty Aging 2012;1(4):162-168

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Objectives: To determine the association between functional assessment instruments and frailty. Design: Concurrent cohort study. Setting: Albacete Health Area (Spain). Participants: 993 subjects aged ≥ 70 years, participating in the FRADEA Study. Measurements: The following functional instruments were applied: Barthel index, Lawton index and Short Form-Late Life Function and Disability Instrument (SF-LLFDI) as disability questionnaires; Holden´s Functional Ambulation Classification (FAC) as ambulation scale, and seven performance tests: gait speed (m/s), Timed up and go (TUG) (sec), unipodal balance time (sec), 5-chair-sit-to-stand test (sec), Short Physical Performance Battery (SPPB), hand grip strength (kg) and elbow flexion strength (kg). Frailty was assessed by Fried´s criteria. The association between functional instruments and frailty was assessed, ROC curves were constructed and the area under the curves (AUC) calculated. The best cut-point was identified for each instrument and their sensitivity (S) and specificity (SP) are described. Results: 16.9% participants were frail. The AUC, best cut-point, S and SP for each instrument were respectively: Barthel (0.916; ≤ 85; 0.90, 0.82), Lawton (0.917; ≤ 3; 0.86, 0.93), SF-LLFDI (0.948; ≤ 90; 0.87, 0.91), FAC (0.885; ≤ 4; 0.81, 0.83), gait speed (0.938; ≤ 0.62; 0.90, 0.90), TUG (0.984; ≥ 17.8; 0.93, 0.98), unipodal balance time (0.753; ≤ 5; 0.73, 0.71), 5-chair-sit-to-stand test (0.880; ≥ 15; 0.78, 0.76), SPPB (0.956; ≤ 6; 0.88, 0.88), hand grip strength (0.807; ≤ 26; 0.75, 0.75) and elbow flexion strength (0.924; ≤ 15; 0.89, 0.87). Conclusion: The best performance tests to identify frail subjects are the Timed Up and Go test, gait speed and the SPPB, and the best questionnaire is the SF-LLFDI.

CITATION:
P. Abizanda ; L. Romero ; P.M. Sánchez-Jurado ; P. Atienzar-Nunez ; J.L. Esquinas-Requena ; I. García-Nogueras (2012): ASSOCIATION BETWEEN FUNCTIONAL ASSESSMENT INSTRUMENTS AND FRAILTY IN OLDER ADULTS: THE FRADEA STUDY . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.25

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PREVALENCE OF FRAILTY AND MOBILITY LIMITATION IN A RURAL SETTING IN FRANCE

M. Cesari, L. Demougeot, H. Boccalon, B. Vellas

J Frailty Aging 2012;1(4):169-173

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Background: The prevalence of frailty is variable according to the adopted operational definition, the tested population, and the setting where it is explored. Objective: To estimate the prevalence of frailty and mobility disability in community-dwelling persons aged 60 years and older. Design: Cross-sectional analyses. Setting: The rural area of Labastide-Murat (France). Participants: All community-dwelling persons aged 60 years and older living in the area and answering to the study survey (n=572/1022). Measurements: The study questionnaire included questions defining mobility disability (as ability to walk 400 meters and climb up 2 flights of stairs) and frailty (according to the FRAIL instrument and a modified version of the original definition proposed by Fried and colleagues). Results: Mean age of participants was 72.4 years old. Mobility disability was reported by 47 (8.3%) participants. The sedentariness criterion of frailty was the most prevalent in the present population. Overall, according to the FRAIL instrument, 77.6%, 14.0%, and 8.3% could be defined as robust, pre-frail/frail, and disabled, respectively. When the alternative definition of frailty mirroring the definition proposed in the Cardiovascular Health Study was adopted, the prevalence of frailty increased and showed gender-specific differences (p=0.02). Conclusions: A relevant number of older persons living in rural areas experiences physical impairments and presents an increased risk for major negative health-related events. These results may support the ongoing clinical and research actions aimed at preventing the functional decline in elders.

CITATION:
M. Cesari ; L. Demougeot ; H. Boccalon ; B. Vellas (2012): PREVALENCE OF FRAILTY AND MOBILITY LIMITATION IN A RURAL SETTING IN FRANCE. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.26

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DIET LIBERALISATION IN OLDER AUSTRALIANS DECREASES FRAILTY WITHOUT INCREASING THE RISK OF DEVELOPING CHRONIC DISEASE

L. Baulderstone, A. Yaxley, M. Luszcz, M. Miller

J Frailty Aging 2012;1(4):174-182

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Background: Successful ageing relies on the prevention of frailty and chronic disease, many of which have a strong link with diet. Despite evidence suggesting diet is important in the management of frailty, there is little evidence investigating the impact of a liberal diet on the prevention of frailty and development of chronic diseases in the elderly. Objectives: To determine the impact of a liberal diet on the development of frailty and whether this affects the incidence of obesity, diabetes, hypertension and hyperlipidaemia. Design: Secondary data analysis of the Australian Longitudinal Study of Ageing, 1992 to 2000. Setting: Random selection of older adults from the South Australian electoral roll. Participants: 1298 older Australians (629 women, 669 men), mean age 77 years. Measurements: A validated food frequency questionnaire was used to measure the dietary exposure; liberal diet defined as: energy >10% estimated requirements; sodium >1600mg; total fat >35% energy; saturated fat >10%; refined sugar >10%; fibre <38g males and <28g females. Frailty was determined using the Fried phenotype in combination with Cesari’s biological definition of frailty. Chronic disease outcomes were measured by medication usage and obesity defined as BMI >30kg/m². Binary logistic regression was performed using participants free of chronic disease at baseline to determine the impact of each dietary exposure independently, and combined, on the development of frailty and the incidence of chronic disease over the subsequent eight years. Results: Incidence of frailty after 8 years of follow up was 14%. The incidence of diabetes after 8 years of follow up was 5.3%, hypertension 39%, hyperlipidaemia 15% and obesity 6%. A liberal energy intake adjusted for age and sex, significantly reduced the risk of developing frailty eight years post baseline (OR 0.48, 95% CI 0.30, 0.77). After adjustment for age, sex and body weight, a liberal saturated fat intake (>10% of energy) increased the risk of hyperlipidaemia (OR 2.11, 95% CI 1.27, 3.54). A liberal intake of sodium, total fat, refined sugar and fibre did not increase the risk of diabetes, hypertension, hyperlipidaemia or obesity. Conclusions: This study suggests that a liberal intake of energy may decrease the risk of developing frailty in the elderly without increasing the risk of developing obesity, diabetes, hypertension or hyperlipidaemia. Caution should remain however in the prescription of diets high in saturated fat as the link established with hyperlipidaemia in young adults appears to be consistent in the elderly. Further research is required to explore the optimal sources of energy for a liberalised diet and the effect of a liberalised diet on other diet related health conditions.

CITATION:
L. Baulderstone ; A. Yaxley ; M. Luszcz ; M. Miller (2012): Diet liberalisation in older Australians decreases frailty without increasing the risk of developing chronic disease . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.27

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ASSOCIATION BETWEEN THE USE OF COMPLETE DENTURES AND FRAILTY IN EDENTULOUS MEXICAN ELDERS

R.C. Castrejón-Pérez, S.A.Borges-Yánez

J Frailty Aging 2012;1(4):183-188

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Objectives: Edentulism and use of complete dentures (CD), which are common among elderly people, increase the risk for malnutrition and weight loss, components of frailty syndrome. Objectives: To identify if CD use is associated with the presence of frailty in a group of edentulous people aged ≥70 years, residing in Mexico City. Design: This was a cross-sectional analysis of baseline data of a cohort study. Setting and Participants: The study population consisted of 33,347 people living independently in one district of Mexico City, 149 edentulous subjects were interviewed and examined for this analysis. Measurements: Frail people experienced 3 or more of the following 5 components: unintentional weight loss, poor endurance and energy, low physical activity, slowness, and weakness. Dental variables were CD use, CD functionality, self-perception of oral health, use of dental services the previous year, xerostomia, and chewing problems. Age, sex, education level, cognitive impairment, urinary incontinence, number of falls, hospitalization, and number of drugs consumed were considered. Univariate analysis and a logistic regression model were used. Results: The prevalence of frailty was 23.5%. The probability of being frail increased among participants with osteoporosis (OR = 3.2), urinary incontinence (OR = 3.8), cognitive impairment (OR = 4.1), and non-use of CD (OR = 5.2); for each additional drug taken per day, the risk of frailty increased by 28.9%. Conclusions: The non-use of CD in edentulous older persons can be a risk marker for frailty, health evaluation of the elderly should include a dental assessment.

CITATION:
R.C. Castrejón-Pérez ; S.A. Borges-Yánez (2012): Association between the use of complete dentures and frailty in edentulous Mexican elders . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.28

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SOCIAL ENGAGEMENT OF FRAIL ELDERS

A. Barusch, D.L. Waters

J Frailty Aging 2012;1(4):189-194

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Background: Social isolation is a significant problem for frail older adults and the determinants of social engagement are poorly understood. Objectives: This study explored the social engagement of frail elders to identify personal attributes associated with social engagement. Design, Setting and Participants: A cross-sectional sample of seventy-three people receiving home-based care in one town on the South Island of New Zealand (mean age 82 (7.2) yrs, n=51 Females, 21 Males). Measurements: Face-to-face semi-structured interviews and questionnaires. Functional independence was measured using Nottingham Extended Activities of Daily Living (EADL), self-efficacy by General Self Efficacy Scale, and 2 open-ended questions were piloted on social activities and helping others. Results: Regression models identified two statistically associated components of social engagement: social activities and civic involvement. Contributions to families and community organizations and exercise were important social activities. Personal attributes included perceived functional independence and self-efficacy. Conclusions: In frail older adults, a measurement of social engagement should address activities older adults identify as important, including exercise. Independence, self -efficacy, and social engagement may interact in reinforcing cycles of empowerment and could play a role in developing interventions to retain and maintain function in frail older adults.

CITATION:
A. Barusch ; D.L. Waters (2012): Social Engagement of Frail Elders . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.29

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SENSITIVITY AND SPECIFICITY OF THE HANDGRIP STRENGTH IN THE PREDICTION OF LOW MUSCLE MASS IN HOSPITALIZED OLDER PATIENTS

V. Zanandrea, A.P. Rossi, M. Bertocchi, M. Zamboni

J Frailty Aging 2012;1(4):195-198

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CITATION:
V. Zanandrea ; A.P. Rossi ; M. Bertocchi ; M. Zamboni ; (2012): Letter to the editor: Sensitivity and specificity of the handgrip strength in the prediction of low muscle mass in hospitalized older patients. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.30

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FRAILTY AND COGNITION: NOT AS STRAIGHT-FORWARD AS IT MIGHT APPEAR

M.U. Pérez-Zepeda

J Frailty Aging 2012;1(4):195-198

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CITATION:
M.U. Pérez-Zepeda ; V.E. Arango-Lopera ; C. García-Peña (2012): Letter to the editor: Frailty and cognition: not as straight-forward as it might appear. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2012.31

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INTERNATIONAL CONFERENCE ON SARCOPENIA RESEARCH, 6 & 7 december 2012, Orlando, FL, USA

J Frailty Aging 2012;1(4):199-236

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