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01/2015 journal articles

NUTRITION AND FRAILTY

L.M. Donini

J Frailty Aging 2015;4(1):3

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CITATION:
L.M. Donini (2015): NUTRITION AND FRAILTY. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2015.33

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NUTRITION, FRAILTY AND DISABILITIES

D.L. Waters

J Frailty Aging 2015;4(1):4-5

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CITATION:
D.L. Waters (2015): Nutrition, Frailty and Disabilities. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2015.34

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PREVALENCE AND TYPES OF ANEMIA AND ASSOCIATIONS WITH FUNCTIONAL DECLINE IN GERIATRIC INPATIENTS

J.A.C. Triscott, B.M. Dobbs, R.M. McKay, O. Babenko, E. Triscott

J Frailty Aging 2015;4(1):7-12

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Background: The prevalence of anemia in hospitalized seniors has been linked to poor functional outcomes, increased mortality, and longer hospital stays, and has been associated with advancing age, male sex, and cognitive impairment. Despite the potential for complications, anemia often is undiagnosed and/or untreated in seniors. Objectives: Examine (a) the distribution of anemia diagnosis and treatment in patients in a rehabilitation hospital, and (b) patients’ cognitive and functional outcomes. Design: Retrospective chart review of medical records of 132 patients. Measurements: The presence and type of anemia were determined based on the World Health Organization criteria for adults and Smith’s algorithm, respectively. The Mini-Mental State Exam (MMSE) was used to measure cognitive status. Functional impairment was assessed using the Functional Independence Measure (FIM). Results: The mean age of the sample was 82.20 years, with 68% being female, the mean MMSE and FIM scores were 23.95 (SD = 4.3) and 82.82 (SD = 15.63), respectively. In total, 67% of males and 46% of females were anemic (P < 0.05). The majority of anemias were caused by nutritional deficiencies. The percent of anemic females receiving treatment for anemia was higher (71%) than the percent of anemic males (46%) (P < 0.05). The majority of the patients improved functionally regardless of anemia status. Conclusions: Results indicated that a substantial number of patients in a geriatric hospital were anemic, with significant percentage going untreated. The overall improvement in patients’ functional abilities suggests that remedial rehabilitation of frail seniors has an impact on recovery during their hospital stay.

CITATION:
J.A.C. Triscott ; B.M. Dobbs ; R.M. McKay ; O. Babenko ; E. Triscott (2015): Prevalence and Types of Anemia and Associations with Functional Decline in Geriatric Inpatients. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2015.35

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NUTRITION, FRAILTY AND PREVENTION OF DISABILITIES WITH AGING

S. Guyonnet, M. Secher, A. Ghisolfi, P. Ritz, B. Vellas

J Frailty Aging 2015;4(1):13-25

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The heterogeneous group of older adults may be differentiated into three subgroups in order to facilitate the development and implementation of personalized healthcare interventions: 1) “disabled individuals” (i.e., those needing assistance in the accomplishment of basic activities of daily living), 2) “frail individuals” (i.e., those presenting some limitations and impairments in the absence of functional disability), and 3) the “robust individuals” (i.e., those who are neither frail or disabled). Despite the growing evidence linking frailty to poor outcomes, this syndrome is yet adequately considered in the clinical practice. There is indeed a lack of recognition of frail individuals, frequently leading to inadequate or inappropriate offer of healthcare services. The assessment of frailty in older adults is recommended to preventively act before the activation of the irreversible cascade of disability. Characteristic features of frailty (e.g., weakness, low energy, slow walking speed, low physical activity, and weight loss) clearly suggest the existence of a close link between nutrition and the status of extreme vulnerability (to intend both from a physical and cognitive viewpoint). Interestingly, recent clinical experiences in the field of frailty and nutrition have demonstrated that this syndrome is often related to relevant prevalence of malnutrition and risk of becoming malnourished. In the present article, it is proposed a review of existing evidence in the field of nutrition and frailty. Potential nutritional interventions for preventing frailty and age-related disabling conditions are also discussed.

CITATION:
S. Guyonnet ; M. Secher ; A. Ghisolfi ; P. Ritz ; B. Vellas (2015): Nutrition, Frailty and Prevention of Disabilities with Aging. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2015.36

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COMBINED INCREASES IN MUSCLE-STRENGTHENING ACTIVITY FREQUENCY AND PROTEIN INTAKE REVEAL GRADED RELATIONSHIP WITH FAT-FREE MASS PERCENTAGE IN U.S. ADULTS, NHANES (1999-2004)

J.M. Kurka, J. Vezina, D.D. Brown, J. Schumacher, R.W. Cullen, K.R. Laurson

J Frailty Aging 2015;4(1):26-33

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Background: Age-related loss of muscle mass and related ailments are of concern due to associations with disabilities and morbidity as well as constituting a substantial healthcare burden. Muscle-strengthening activities and adequate protein ingestion are recommended for all-age adults in an effort to stave off age-related muscle atrophy. Muscle building abilities decline with age but most research focuses on muscle wasting in the elderly. Objectives: To examine the independent and combined associations of protein intake (g∙kg-1∙day-1) and muscle-strengthening frequency (times∙week-1, MSF) on fat-free mass percentage (FFM%). Design Setting and Participants: This cross-sectional analysis of a population-based sample with data from the non-institutionalized persons in the United States participating in the National Health and Nutrition Examination Survey (cycles 1999-2000, 2001-2002, 2003-2004) consisted of male (n=2,499) and female (n=2,373) participants 20-49 years of age for analyses. Measurements: MSF was determined by self-report and protein intake was calculated from a 24-hour recall. Differences in FFM% from bioelectrical impedance analysis was estimated using multiple linear regression models controlling for education, race-ethnicity, standing height, and total Caloric intake. Results: One unit increase in MSF or protein intake (β-coefficient, ±SE) was associated with significantly more FFM% in males (0.6±0.1%; 3.5±0.4%) and females (0.4±0.1%; 5.9±0.4%). Independent of protein intake, males and females with MSF=0 had mean ±SE FFM% of 74.4±0.4 and 60.7±0.3, respectively, while mean ±SE FFM% of males and females who met the recommendation of ≥2 times per week were 77.9±0.5 and 63.0±0.4. Independent of MSF, males and females with protein intakes below the recommended dietary allowance (RDA) of 0.8 g∙kg-1∙day-1 had mean ±SE FFM% of 74.0±0.6 and 58.2±0.6, respectively, while mean ±SE FFM% of those whose intakes exceeded the recommendation were 75.6±0.4 and 62.0±0.4. The subgroup with the highest mean ±SE FFM% (80.9 ±0.73) comprised males with MSF ≥2 times per week who also consumed >1.4 g∙kg-1∙day-1. Conclusion: The MSF-protein intake dose relationship with FFM% suggests that performing muscle-strengthening activities >2 times per week while consuming protein above the RDA may result in more fat-free mass and slow age-related losses of muscle mass.

CITATION:
J.M. Kurka ; J. Vezina ; D.D. Brown ; J. Schumacher ; R.W. Cullen ; K.R. Laurson (2015): Combined Increases in Muscle-strengthening Activity Frequency and Protein Intake Reveal Graded Relationship with Fat-free Mass Percentage in U.S. Adults, NHANES (1999-2004). The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2015.37

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DETERMINING THE CUT-OFF VALUES FOR SARCOPENIA IN THE KOREAN ELDERLY POPULATION USING BIOIMPEDANCE ANALYSIS

E.-J. Chang, H.-W. Jung, S.-W. Kim, N.-J. Heo, H.-J. Chin, C.-H. Kim, K.-I. Kim

J Frailty Aging 2015;4(1):34-40

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Background: Bioimpedance analysis (BIA) is known to be a useful method for assessing sarcopenia because cost-effective and not involving radiation exposure. However, the cut-off values for sarcopenia using BIA have not yet been determined in the Korean population. Objectives: To establish the cut-off values for sarcopenia in the Korean elderly population with the use of BIA. Methods: Body composition assessed by BIA was obtained in 7,641 participants aged 20–34 years and 3,902 participants aged ≥65 years from data routinely collected during health examinations at Seoul National University Gangnam Center. Appendicular skeletal muscle mass was adjusted for height and weight. Gender-specific cut-points for class I and class II sarcopenia were defined as 1 and 2 standard deviations below the mean in the reference group aged 20–34 years, respectively. In addition, the gender-specific, lowest 20th percentile cut-offs for muscle mass in participants aged ≥65 years were determined. Results: The cut-offs for class I and class II sarcopenia in men for height-adjusted appendicular skeletal mass were 6.74 kg/m2 and 5.96 kg/m2 and for weight-adjusted appendicular skeletal mass were 29.4% and 27.4%, respectively; those in women for height-adjusted appendicular skeletal mass were 4.93 kg/m2 and 4.35 kg/m2, and for weight-adjusted appendicular skeletal mass were 25.6% and 23.9%, respectively. The lowest 20th percentile cut-offs for height-adjusted and weight-adjusted appendicular skeletal mass were 6.69 kg/m2 and 28.9% in men, and 5.76 kg/m2 and 24.5% in women, respectively. Based on the derived cut-offs, prevalence of class II sarcopenia in participants ≥65 years of age for height-adjusted and weight-adjusted appendicular skeletal mass was 3.7% and 3.5% in men, and 0.2% and 11.2% in women, respectively. Among the above-mentioned definitions, sarcopenia by height-adjusted appendicular skeletal mass was significantly associated with 2-year mortality in older participants. Conclusions: Muscle mass deficit in the Korean population can be assessed based on the cut-offs determined in this study using BIA.

CITATION:
E.-J. Chang ; H.-W. Jung ; S.-W. Kim ; N.-J. Heo ; H.-J. Chin ; C.-H. Kim ; K.-i. Kim (2015): DETERMINING THE CUT-OFF VALUES FOR SARCOPENIA IN THE KOREAN ELDERLY POPULATION USING BIOIMPEDANCE ANALYSIS. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2015.38

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FUNCTIONAL LIMITATIONS AND ADIPOKINES IN HIV-INFECTED OLDER ADULTS

K.N. Shah, Z. Majeed, H. Yang, J.J. Guido, T.N. Hilton, O. Polesskaya, W.J. Hall, A.E. Luque

J Frailty Aging 2015;4(1):41-46

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Background: There is a significant increase in the number of HIV-infected older adults (HOA). This population may experience functional decline at a much younger age. Little is known about the relationship between functional limitations and systemic adipokines in HOA. Objective: Our study aimed to evaluate the relationship between functional limitations and systemic adipokine levels in HOA population. Design: Cross-sectional. Setting: Academic hospital-based infectious disease clinic. Participants: The study investigated community-dwelling HIV-infected adults >50 years old and compared this group with age, gender and BMI comparable healthy controls. Measurements: We measured functional status, body composition and plasma concentrations of adipokines. Results: Fifty-four HOA were studied (mean: age 57 years, BMI 29 kg/m2, CD4 604, duration of HIV 17 years) and compared with thirty-two age, gender and BMI comparable healthy controls. The HOA group showed significantly higher functional limitations compared to the age, gender and BMI comparable controls (p<0.05). Levels of adipokines were significantly different between the two groups (p<0.05). Multiple regression analyses indicated that adiponectin and visfatin were significantly correlated with several physical function measures after controlling for age, sex, and metabolic comorbidities. Adiponectin was negatively correlated with functional limitations, and this relationship was stronger in the control group compared to the HOA group. Conversely, visfatin was positively correlated with functional limitations only in the HOA group. Conclusion: HOA have significant functional limitations and alteration in adipokine levels compared to controls. Adiponectin and visfatin were associated with functional limitations. Visfatin was a correlate of physical function only in the HOA group. Prospective longitudinal studies could provide further insight on the role of adipokines in HIV-related functional decline.

CITATION:
K.N. Shah ; Z. Majeed ; H. Yang ; J.J. Guido ; T.N. Hilton ; O. Polesskaya ; W.J. Hall ; A.E. Luque (2015): FUNCTIONAL LIMITATIONS AND ADIPOKINES IN HIV-INFECTED OLDER ADULTS. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2015.39

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ICFSR 2015: INTERNATIONAL CONFERENCE ON FRAILTY & SARCOPENIA RESEARCH THURSDAY - SATURDAY, APRIL 23-25, 2015 BOSTON, MA, USA

Abstracts

J Frailty Aging 2015;4(S1):19-108

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