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04/2016 journal articles

SARCOPENIA TRIALS IN SPECIFIC DISEASES: REPORT BY THE INTERNATIONAL CONFERENCE ON FRAILTY AND SARCOPENIA RESEARCH TASK FORCE

B. Vellas, R. Fielding, S. Bhasin, F. Cerreta, B. Goodpaster, J.M. Guralnik, S. Kritchevsky, V. Legrand, C. Forkin, J. Magaziner, J.E. Morley, L. Rodriguez-Manas, R. Roubenoff, S. Studenski, D.T. Villareal, M. Cesari, on behalf of the International Conference on Frailty and Sarcopenia Research Task Force

J Frailty Aging 2016;5(4):194-200

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Muscle atrophy occurs as a consequence of a number of conditions, including cancer, chronic obstructive pulmonary disease (COPD), diabetes mellitus, heart failure, and other chronic diseases, where it is generally a predictor of poor survival. It also occurs as a consequence of disuse and an age-related loss of muscle mass and strength (sarcopenia). The aims of the 2016, International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force were to examine how these specific chronic conditions have been employed in treatment trials thus far and how future trials using these patient groups might be designed for efficient identification of effective sarcopenia interventions. Functional limitations assessed as gait speed, distance walked over a set time period, or other attributes of physical performance have been suggested as outcome measures in sarcopenia trials. Indeed, such measures have already been used successfully in a number of trials aimed at preventing disability in older adults.

CITATION:
B. Vellas ; R. Fielding ; S. Bhasin ; F. Cerreta ; B. Goodpaster ; J.M. Guralnik ; S. Kritchevsky ; V. Legrand ; C. Forkin ; J. Magaziner ; J.E. Morley ; L. Rodriguez-Manas ; R. Roubenoff ; S. Studenski ; D.T. Villareal ; M. Cesari ; on behalf of the International Conference on Frailty ; and Sarcopenia Research Task Force (2016): Sarcopenia Trials in Specific Diseases: Report by the International Conference on Frailty and Sarcopenia Research Task Force . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.110

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“MOVE ON AGAINST FRAILTY”: TIME TO RAISE AWARENESS ABOUT FRAILTY AND PREVENTION OF DISABILITY IN THE COMMUNITY

M. Inzitari, D. Ruiz, J. Martos, S. Santaeugenia

J Frailty Aging 2016;5(4):201-203

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CITATION:
M. Inzitari ; D. Ruiz ; J. Martos ; S. Santaeugenia (2016): “Move on against frailty”: time to raise awareness about frailty and prevention of disability in the community. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.114

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EFFECT OF LOW-DOSE RAPAMYCIN ON SENESCENCE MARKERS AND PHYSICAL FUNCTIONING IN OLDER ADULTS WITH CORONARY ARTERY DISEASE: RESULTS OF A PILOT STUDY

M. Singh, M.D. Jensen, A. Lerman, S. Kushwaha, C.S. Rihal, B.J Gersh, A. Behfar, T. Tchkonia, R.J. Thomas, R.J. Lennon, L.R. Keenan, A.G. Moore, J.L. Kirkland

J Frailty Aging 2016;5(4):204-207

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Rapamycin, an mTOR inhibitor affects senescence through suppression of senescence-associated secretory phenotype (SASP). We studied the safety and feasibility of low-dose rapamycin and its effect on SASP and frailty in elderly undergoing cardiac rehabilitation (CR). 13 patients; 6 (0.5mg), 6 (1.0mg), and 1 patient received 2mg oral rapamycin (serum rapamycin <6ng/ml) daily for 12 weeks. Median age was 73.9±7.5 years and 12 were men. Serum interleukin-6 decreased (2.6 vs 4.4 pg/ml) and MMP-3 (26 vs 23.5 ng/ml) increased. Adipose tissue expression of mRNAs (arbitrary units) for MCP-1 (3585 vs 2020, p=0.06), PPAR-γ (1257 vs 1166), PAI-1 (823 vs 338, p=0.08) increased, whereas interleukin-8 (163 vs 312), TNF-α (75 vs 94) and p16 (129 vs 169) decreased. Cellular senescence-associated beta galactosidase activity (2.2% vs 3.6%, p=0.18) tended to decrease. We observed some correlation between some senescence markers and physical performance but no improvement in frailty with rapamycin was noted. (NCT01649960).

CITATION:
M. Singh ; M.D. Jensen ; A. Lerman ; S. Kushwaha ; C.S. Rihal ; B.J. Gersh ; A. Behfar ; T. Tchkonia ; R.J. Thomas ; R.J. Lennon ; L.R. Keenan ; A.G. Moore ; J.L. Kirkland (2016): Effect of Low-Dose Rapamycin on Senescence Markers and Physical Functioning in Older Adults with Coronary Artery Disease: Results of a Pilot Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.112

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FRAILTY IS A GERIATRIC SYNDROME CHARACTERIZED BY MULTIPLE IMPAIRMENTS: A COMPREHENSIVE APPROACH IS NEEDED

L.-K. Chen, A.-C. Hwang, L.-K. Liu, W.-J. Lee, L.-N. Peng

J Frailty Aging 2016;5(4):208-213

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Objective: To evaluate the prevalence of frailty and the associated multimorbidity and functional impairments among community-dwelling middle-aged and elderly people in Taiwan. Design: a cross-sectional study. Setting: communities in I-Lan County of Taiwan. Participants: 1839 community-dwelling people aged 50 years and older. Intervention: None. Measurements: Frailty defined by Fried’s criteria, Charlson’s comorbidity index (CCI), Functional Autonomy Measurement System (SMAF), Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Nutrition Assessment (MNA), Mini–Mental State Examination (MMSE), and Short Form-12 quality of life questionnaire. Results: Overall, 1839 subjects (mean age: 63.9±9.3 years, 47.5% males) participated in this study and men were more likely to have higher educational level, more smoking and alcohol drinking habit. The prevalence of frailty was 6.8% in this study, while pre-frailty was 40.5% and 53.7% of all participants were robust. Compared to subjects with different frailty status, age, education year, alcohol drinking, hypertension, diabetes mellitus, hyperlipidemia, CCI, walking speed, handgrip strength, score of SMAF, CES-D, MNA, MMSE, quality of life were significantly different between groups (P all< 0.05). Older age, poorer physical function, poorer cognitive function, poorer nutritional status, more depressive symptoms, higher CCI and poorer quality of life were all independently associated with frailty. Conclusions: Frailty was not simply a geriatric syndrome, but the combination of multiple geriatric syndromes. Further study is needed to evaluate the clinical benefits of intervention programs for community-dwelling middle-aged and older people to reverse frailty and its associated functional impairments.

CITATION:
L.-K. Chen ; A.-C. Hwang ; L.-K. Liu ; W.-J. Lee ; L.-N. Peng (2016): Frailty Is a Geriatric Syndrome Characterized by Multiple Impairments: A Comprehensive Approach Is Needed. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.109

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EXERCISE INTERVENTIONS FOR PRESERVING PHYSICAL FUNCTION AMONG CANCER SURVIVORS IN MIDDLE TO LATE LIFE

C.W. Daum, S.K. Cochrane, J.D. Fitzgerald, L. Johnson, T.W. Buford

J Frailty Aging 2016;5(4):214-224

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The purpose of this review was to evaluate randomized controlled trials aiming to preserve the functional status, i.e. physical capabilities, of middle-aged and older cancer survivors through a structured, physical exercise intervention. The study team performed a thorough search of the literature using six online databases. This literature search limited included studies to randomized controlled trials which implemented a structured physical activity intervention for middle- and older-aged adults diagnosed with cancer. Studies were also required include at least one objective measure of physical function as a dependent outcome. This literature search yielded thirty-eight studies. The majority of the literature reviewed was successful in improving several functional outcomes including time needed to rise from a chair or distance covered during the six-minute walk test. A large number of published trials also suggest that exercise is effective in decreasing fatigue. However, a lack of trials investigating outcomes in older populations (≥ 65 years) was noted in this review. The results of this review suggest that a structured exercise program may be physically beneficial for middle-aged to older cancer survivors. Particularly, such interventions could preserve the functional status of cancer patients and, consequently, improve their long-term health outcomes. Future implications include further investigation into strictly older cancer patient populations, as outcomes related to exercise might differ between older and middle-aged adults.

CITATION:
C.W. Daum ; S.K. Cochrane ; J.D. Fitzgerald ; L. Johnson ; T.W. Buford (2016): Exercise Interventions for Preserving Physical Function Among Cancer Survivors in Middle to Late Life. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.92

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ASSOCIATION BETWEEN CONTINUOUS WEARABLE ACTIVITY MONITORING AND SELF-REPORTED FUNCTIONING IN ASSISTED LIVING FACILITY AND NURSING HOME RESIDENTS

J. Merilahti, I. Korhonen

J Frailty Aging 2016;5(4):225-232

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Background: Physical functioning is a key factor in independent living, and its preclinical state assessment and monitoring during the subject’s normal life would be beneficial. Objectives: The aim of the study is to analyse associations between ambulatory measured physical activity behaviour and sleep patterns (wrist actigraphy) and self-reported difficulties in performing activities of daily living. Participants, setting and design: 36 residents in assisted living facilities and nursing homes (average age=80.4±9.0 years) without dementia in free living conditions participated. Actigraphic monitoring is integrated with the facilities’ social alarm system. Measurements: Indices on activity level, activity rhythm, sleep pattern and external stimuli response of sleep-wake behaviours were extracted from the actigraph data and correlated (Spearman rank-order correlation) with activities of daily living measures. Bonferroni correction for multiple comparisons was applied. Results: Activity level (ρ=-0.49, p<0.05) and night-time activity variance (ρ=-0.69, p<0.01) had correlation with the activities of daily living scores. The similarity of subject-wise activity pattern to facility common activities had a trend with activities of daily living (ρ=-0.44, p<0.1). In longitudinal case analysis, sleep and activity patterns were found to be associated with local weather variables. Conclusions: Activity patterns as measured by actigraphy may provide objective information on older people’s behaviour related to functioning state and its changes in nursing home and assisted living facility settings. However, variance between individuals was large in this dataset which decreases the reliability of the results. Furthermore, external stimuli such as weather and facility-related activities can affect subjects’ activity and sleep behaviour and should be considered in the related studies as well.

CITATION:
J. Merilahti ; I. Korhonen (2016): Association between continuous wearable activity monitoring and self-reported functioning in assisted living facility and nursing home residents. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.102

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MACVIA-LR (FIGHTING CHRONIC DISEASES FOR ACTIVE AND HEALTHY AGEING IN LANGUEDOC-ROUSSILLON): A SUCCESS STORY OF THE EUROPEAN INNOVATION PARTNERSHIP ON ACTIVE AND HEALTHY AGEING

J. Bousquet, R. Bourret, T. Camuzat, P. Augé, J. Bringer, M. Noguès, O. Jonquet, J.E. de la Coussaye, J. Ankri, M. Cesari, O. Guérin, et al.

J Frailty Aging 2016;5(4):233-241

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The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of elderly people. All sub-activities (poly-pharmacy, falls prevention initiative, prevention of frailty, chronic respiratory diseases, chronic diseases with multimorbidities, chronic infectious diseases, active and independent living and disability) have been included in MACVIA-LR which has a strong political commitment and involves all stakeholders (public, private, patients, policy makers) including CARSAT-LR and the Eurobiomed cluster. It is a Reference Site of the EIP on AHA. The framework of MACVIA-LR has the vision that the prevention and management of chronic diseases is essential for the promotion of AHA and for the reduction of handicap. The main objectives of MACVIA-LR are: (i) to develop innovative solutions for a network of Living labs in order to reduce avoidable hospitalisations and loss of autonomy while improving quality of life, (ii) to disseminate the innovation. The three years of MACVIA-LR activities are reported in this paper.

CITATION:
J. Bousquet ; R. Bourret ; T. Camuzat ; P. Augé ; J. Bringer ; M. Noguès ; O. Jonquet ; J.E. de la Coussaye ; J. Ankri ; M. Cesari ; O. Guérin ; B. Vellas ; H. Blain ; S. Arnavielhe ; A. Avignon ; B. Combe ; G. Canovas ; C. Daien ; G. Dray ; A. Dupeyron ; C. Jeandel ; I. Laffont ; D. Laune ; C. Marion ; E. Pastor ; J.Y. Pélissier ; B. Galan ; J. Reynes ; J.C. Reuzeau ; A. Bedbrook ; S. Granier ; P.A. Adnet ; M. Amouyal ; B. Alomène ; P.L. Bernard ; C. Berr ; D. Caimmi ; P.G. Claret ; D.J. Costa ; J.P. Cristol ; P. Fesler ; D. Hève ; J. Millot-Keurinck ; D. Morquin ; G. Ninot ; M.C. Picot ; N. Raffort ; F. Roubille ; A. Sultan ; J. Touchon ; V. Attalin ; C. Azevedo ; M. Badin ; Bakhti ; B. Bardy ; M.P. Battesti ; X. Bobia ; C. Boegner ; S. Boichot ; H.Y. Bonnin ; S. Bouly ; C. Boubakri ; J.L. Bourrain ; G. Bourrel ; V. Bouix ; V. Bruguière ; S. Cade ; W. Camu ; V. Carre ; G. Cavalli ; G. Cayla ; R. Chiron ; P. Coignard ; F. Coroian ; P. Costa ; Cottalorda ; B. Coulet ; A.L. Coupet ; M.C. Courrouy-Michel ; P. Courtet ; V. Cros ; F. Cuisinier ; M. Danko ; P. Dauenhauer ; M. Dauzat ; M. David ; J.M. Davy ; D. Delignières ; P. Demoly ; J. Desplan ; P. Dujols ; G. Dupeyron ; O. Engberink ; M. Enjalbert ; C. Fattal ; J. Fernandes ; M. Fouletier ; P. Fraisse ; P. Gabrion ; M. Gellerat-Rogier ; A. Gelis ; C. Genis ; N. Giraudeau ; A.Y. Goucham ; F. Gouzi ; F. Gressard ; J.C. Gris ; B. Guillot ; D. Guiraud ; V. Handweiler ; M. Hayot ; C. Hérisson ; C. Heroum ; D. Hoa ; S. Jacquemin ; S. Jaber ; D. Jakovenko ; C. Jorgensen ; P. Kouyoudjian ; R. Lamoureux ; L. Landreau ; M. Lapierre ; D. Larrey ; C. Laurent ; M.S. Léglise ; J.M. Lemaitre ; A. Le Quellec ; F. Leclercq ; S. Lehmann ; B. Lognos ; J.M. Lussert ; A. Makinson ; K. Mandrick ; P. Mares ; P. Martin-Gousset ; A. Matheron ; G. Mathieu ; M. Meissonnier ; G. Mercier ; P. Messner ; C. Meunier ; M. Mondain ; R. Morales ; J. Morel ; D. Mottet ; P. Nérin ; P. Nicolas ; F. Nouvel ; D. Paccard ; G. Pandraud ; M.P. Pasdelou ; J.L. Pasquié ; K. Patte ; S. Perrey ; Y.M. Pers ; F. Portejoie ; J.L. Pujol ; X. Quantin ; I. Quéré ; S. Ramdani ; J. Ribstein ; I. Rédini-Martinez ; S. Richard ; K. Ritchie ; J.P. Riso ; F. Rivier ; J.M. Robine ; C. Rolland ; E. Royère ; D. Sablot ; J.L. Savy ; L. Schifano ; P. Senesse ; R. Sicard ; Y. Stephan ; D. Strubel ; G. Tallon ; M. Tanfin ; H. Tassery ; I. Tavares ; K. Torre ; Tribout ; A. Uziel ; P. Van de Perre ; F. Venail ; C. Vergne-Richard ; G. Vergotte ; L. Vian ; F. Vialla ; F. Viart ; M. Villain ; E. Viollet ; M. Ychou ; J. Mercier (2016): MACVIA-LR (Fighting Chronic Diseases for Active and Healthy Ageing in Languedoc-Roussillon): A success story of the European Innovation Partnership on Active and Healthy Ageing. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.105

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FRAILTY IN POSTMENOPAUSAL AFRICAN AMERICAN AND HISPANIC HIV-INFECTED WOMEN

P. Young, J. Shah, C. Zhang, D.C. Ferris, I. Colon, M. Bucovsky, M. Punyanitya, D.J. McMahon, E. Shane, M.T. Yin

J Frailty Aging 2016;5(4):242-246

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Studies suggest frailty occurs earlier in HIV-infected individuals, but data in postmenopausal HIV-infected women are lacking. We assessed the prevalence of frailty and association with anthropometric measures in HIV-infected and uninfected postmenopausal women. Fried’s frailty phenotype was measured in HIV-infected and uninfected Hispanic and African American postmenopausal women participating in a study of bone metabolism; fat and lean mass were measured by whole body dual energy x-ray absorptiometry (DXA). Multivariable logistic regression evaluated frailty risk factors. The study was conducted at Columbia University Medical Center between 2002 and 2007. The participants were 61 HIV-infected and 27 uninfected Hispanic and African American postmenopausal women. The study compared prevalence and predictors of frailty in HIV-infected and uninfected postmenopausal women. Prevalence of frailty tended to be higher among HIV-infected than uninfected controls (11.5% vs 0% p=0.07). Surprisingly, among HIV-infected women, total body fat, not lean mass, was associated with frailty in multivariate analysis. Higher prevalence of frailty in African American and Hispanic HIV-infected postmenopausal women (11.5%) was similar to the 11% prevalence reported in minority women who were 10 years older in the general population. Our data suggest that frailty occurs earlier in HIV-infected postmenopausal women, but larger longitudinal studies are necessary to confirm whether musculoskeletal aging is accelerated by HIV infection.

CITATION:
P. Young ; J. Shah ; C. Zhang ; D.C. Ferris ; I. Colon ; M. Bucovsky ; M. Punyanitya ; D.J. McMahon ; E. Shane ; M.T. Yin (2016): Frailty in postmenopausal African American and Hispanic HIV-infected women. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.104

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CAN AN INTERVENTION WITH TESTOSTERONE AND NUTRITIONAL SUPPLEMENT IMPROVE THE FRAILTY LEVEL OF UNDER-NOURISHED OLDER PEOPLE?

O. Theou, I. Chapman, L. Wijeyaratne, C. Piantadosi, K. Lange, V. Naganathan, P. Hunter, I.D. Cameron, K. Rockwood, R. Visvanathan

J Frailty Aging 2016;5(4):247-252

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Objective: To examine whether a testosterone and a high calorie nutritional supplement intervention can reduce frailty scores in undernourished older people using multiple frailty tools. Design: Randomized controlled trial. Setting/Participants: 53 community-dwelling, undernourished men and women aged >65 years from South Australia, Victoria and New South Wales. Intervention: Intervention group received oral testosterone undecanoate and a high calorie supplement (2108-2416 kJ/day) whereas the control group received placebo testosterone and low calorie supplement (142-191 kJ/day). Measurements: Frailty was operationalized using three frailty indices (FI-lab, FI-self-report, FI-combined) and the frailty phenotype. Results: There were no significant differences in changes in frailty scores at either 6 or 12 months follow up between the two treatment groups for all scales. Participants at the intervention group were 4.8 times more likely to improve their FI-combined score at both time points compared to the placebo group. Conclusion: A testosterone and a high calorie nutritional supplement intervention did not improve the frailty levels of under-nourished older people. Even so, when frailty was measured using a frailty index combining self-reported and lab data we found that participants who received the intervention were more likely to show persistent improvement in their frailty scores.

CITATION:
O. Theou ; I. Chapman ; L. Wijeyaratne ; C. Piantadosi ; K. Lange ; V. Naganathan ; P. Hunter ; I.D. Cameron ; K. Rockwood ; R. Visvanathan (2016): Can an intervention with testosterone and nutritional supplement improve the frailty level of under-nourished older people?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2016.108

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