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02/2017 journal articles

TRANSDISCIPLINARY RESEARCH IN FRAILTY: KNOWLEDGE TRANSLATION TO INFORM NEW MODELS OF CARE

M. Archibald, A. Kitson, D. Frewin, R. Visvanathan

J Frailty Aging 2017;6(2):62-64

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Transforming care for frail older adults requires more than rigorous research. While preventing, identifying and managing frailty are critical to reducing the personal and health systems impact of frailty worldwide, collaborative approaches to research and research application that reflect stakeholder perspectives and priorities are necessary to create meaningful solutions to frailty-related challenges. In South Australia, a new Centre for Research Excellence in Frailty was recently launched with funding from the National Health and Medical Research Council of Australia. Comprised of a national team with international partnerships and expertise spanning geriatric medicine, nursing, general practice, health economics, pharmacy and rehabilitation medicine, the team is working across traditional disciplinary silos to achieve system level improvements. Drawing from this exemplar, we discuss how a co-design approach to knowledge translation underpins this transdisciplinary research, and how successfully restructuring health services to meet the physical, emotional and social needs of older adults hinges upon such collaboration.

CITATION:
M. Archibald ; A. Kitson ; D. Frewin ; R. Visvanathan (2017): Transdisciplinary Research In Frailty: Knowledge Translation To Inform New Models of Care. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.6

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ROLE OF ANTI-INFLAMMATORY CYTOKINES ON MUSCLE MASS AND PERFORMANCE CHANGES IN ELDERLY MEN AND WOMEN

A.P. Rossi, S. Budui, E. Zoico, C. Caliari, G. Mazzali, F. Fantin, M. D’Urbano, R. Paganelli, M. Zamboni

J Frailty Aging 2017;6(2):65-71

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Objectives: investigate the presence of a correlation between systemic inflammatory profile of community-dwelling individuals and the loss of muscular mass and performance in old age over a 4.5y follow-up, focusing on the role of anti-inflammatory cytokines in muscular changes in elderly. Design: Longitudinal clinical study. Setting: Subjects were randomly selected from lists of 11 general practitioners in the city of Verona, Italy. Partecipants: The study included 120 subjects, 92 women and 28 men aged 72.27±2.06 years and with BMI of 26.52±4.07 kg/m2 at baseline. Measurements: Six minutes walking test (6MWT), appendicular and leg fat free mass (FFM) as measured with Dual Energy X-ray absorptiometry, were obtained at baseline and after 4.5 years (4.5y) of mean follow-up. Height, weight, body mass index (BMI), and circulating levels of TNFα, IL-4, IL-10, and IL-13 were evaluated at baseline. Results: A significant reduction of appendicular FFM, leg FFM and 6MWT performance (all p<0.001) was observed after 4.5 y follow-up. In a stepwise regression model, considering appendicular FFM decline as dependent variable, lnIL-4, BMI, baseline appendicular FFM, lnTNFα and lnIL-13 were significant predictors of appendicular FFM decline explaining 30.8% of the variance. While building a stepwise multiple regression considering leg FFM as a dependent variable, lnIL-4, BMI and leg FFM were significant predictors of leg FFM decline and explained 27.4% of variance. When considering 6MWT decline as a dependent variable, baseline 6MWT, lnIL-13 and lnTNFα were significant predictors of 6MWT decline to explain 22.9% of variance. Conclusions: Our study suggest that higher serum levels of anti-inflammatory markers, and in particular IL-4 and IL-13, may play a protective role on FFM and performance maintenance in elderly subjects.

CITATION:
A.P. Rossi ; S. Budui ; E. Zoico ; C. Caliari ; G. Mazzali ; F. Fantin ; M. D’Urbano ; R. Paganelli ; M. Zamboni (2017): Role of Anti-inflammatory Cytokines on Muscle Mass and Performance Changes in Elderly Men and Women . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.4

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CAN WE PREDICT MORBIDITY AND MORTALITY OF PATIENTS AGED 75 YEARS AND OLDER UNDERGOING CYSTECTOMY?

F. Atallah, P. Letocart, B. Malavaud, M. Ahmad, M. Mazerolles, V. Minville

J Frailty Aging 2017;6(2):72-75

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Radical cystectomy is associated with a high postoperative mortality and morbidity in older patients. We aimed to define the predictive value of comorbidity scores and determine the prognostic factors of postoperative complications. Preoperative associated morbidities were collected and graded according to the American Society of Anesthesiologists (ASA) score system, the Adult Comorbidity Evaluation (ACE) scale and the Charlson comorbidity index. Surgical complications were graded according to Clavien classification. Early and late complications were recorded. Data are from 49 consecutive patients aged ≥ 75 years who had an open surgery for bladder cancer. The most commonly associated conditions were smoking, renal insufficiency, and arterial hypertension. Incidence of early and late complications was 49% and 16%, respectively. Four and 25 death events occurred during the early and late follow-up, respectively. The incidence of morbidity and mortality were not related to ASA, ACE or Charlson scores. Preoperative malnutrition, renal insufficiency, higher need of perioperative blood transfusions, and prolonged ileus were identified as risk factors of postoperative morbidity. Late complications seemed related to low weight.

CITATION:
F. Atallah ; P. Letocart ; B. Malavaud ; M. Ahmad ; M. Mazerolles ; V. Minville (2017): Can we predict morbidity and mortality of patients aged 75 years and older undergoing cystectomy?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.5

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COMPONENTS AND INDICATORS OF FRAILTY MEASURES: A LITERATURE REVIEW

B. Xie, J.L. Larson, R. Gonzalez, S.J. Pressler4, , B. Xie, J.L. Larson, R. Gonzalez, S.J. Pressler, C. Lustig, C. Arslanian-Engoren

J Frailty Aging 2017;6(2):76-82

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Background: Frailty is a debilitating condition in older adults that is associated with increased risks for adverse outcomes. However, the issue of quantifying frailty remains elusive. There is a lack of consistency in the frailty components and the corresponding indicators used to quantify these components. Objective: 1) to describe the components of frailty and examine the existing measures of frailty; and 2) to identify current gaps in knowledge of frailty measures. Methods: The PubMed, CINAHL, and Web of Science databases were searched. Each study was reviewed to determine its fit with inclusion/exclusion criteria. Results: A total of 49 studies were identified and comprised the sample. Each study described one unique measure of frailty. The frailty components and corresponding indicators within three domains (physical, psychological, and social) were described. The most frequently reported components of frailty were mobility and balance, nutrition, and cognitive function. Fifteen of 49 frailty measures included components across all three domains. Current frailty measures were critiqued and important areas for future study are identified. Conclusions: The frailty components and corresponding indicators vary considerably across different frailty measures. Future studies are needed to address inconsistences in frailty measures and models.

CITATION:
B. Xie ; J.L. Larson ; R. Gonzalez ; S.J. Pressler ; C. Lustig ; C. Arslanian-Engoren (2017): Components and Indicators of Frailty Measures: A Literature Review. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.11

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TEST-RETEST RELIABILITY OF MEASUREMENTS OF HAND- GRIP STRENGTH OBTAINED BY DYNAMOMETRY FROM OLDER ADULTS: A SYSTEMATIC REVIEW OF RESEARCH IN THE PUBMED DATABASE

R.W. Bohannon

J Frailty Aging 2017;6(2):83-87

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A systematic review was performed to summarize literature describing the test-retest reliability of grip strength measures obtained from older adults. Relevant literature was identified via a PubMed search. Seventeen articles were deemed appropriate based on inclusion and exclusion criteria. The relative test-retest reliability of grip strength measures obtained by dynamometry was good to excellent (intra-class correlation coefficients > 0.80) in all but 3 studies, which involved older adults with severe dementia. Absolute reliability, as indicated by summary statistics such as the minimum detectable change (95%), was more variable. As a percentage, that change ranged from 14.5% to 98.5%. Consequently, clinicians can be confident in the relative reliability of grip strength measures obtained from at risk older adults. However, relatively large percentage changes in grip strength may be necessary to conclude with confidence that a real change has occurred over time in some populations.

CITATION:
R.W. Bohannon (2017): Test-retest Reliability of Measurements of Hand- grip Strength Obtained by Dynamometry from Older Adults: A Systematic Review of Research in the PubMed Database. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.8

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THE ASSOCIATION BETWEEN DAILY WALKING BEHAVIOR AND SELF-REPORTED PHYSICAL FUNCTION IN COMMUNITY-DWELLING OLDER ADULTS

B. Bogen, M.K. Aaslund, A.H. Ranhoff, K. Taraldsen, R. Moe-Nilssen

J Frailty Aging 2017;6(2):88-90

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Many older people do not participate in organized exercise, and daily walking may be the most substantial contributor to physical activity. To investigate the association between daily walking behavior and self-reported health-related physical function, older community-dwelling volunteers wore activity-registering sensors for three days. Self-reported health-related physical functioning was measured using the SF36 10-item Physical Function subscale. Forty-six participants wore a sensor (mean age 77.6, SD 3.6, 61 % women). In a multiple regression model, steps per day (B=.005, p≤.001) and walks per day (B=-.174, p=.010) were associated with the SF36-PF subscale. The association between physical functioning and walks per day was negative: Those who took many walks per day may have been walking more indoors. Health professionals are likely justified in advising older people to incorporate walking into daily life for health purposes. The cross-sectional design does not allow for inferences about causality.

CITATION:
B. Bogen ; M.K. Aaslund ; A.H. Ranhoff ; K. Taraldsen ; R. Moe-Nilssen (2017): The association between daily walking behavior and self-reported physical function in community-dwelling older adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.12

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THE EFFECT OF PHYSICAL EXERCISE ON FRAIL OLDER PERSONS: A SYSTEMATIC REVIEW

R.B. Silva, H. Aldoradin-Cabeza, G.D. Eslick, S. Phu, G. Duque

J Frailty Aging 2017;6(2):91-96

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Physical exercise is one of the most effective non-pharmacological interventions aimed to improve mobility and independence in older persons. The effect of physical exercise and the most effective type of exercise in frail older persons remain undefined. This systematic review examines the effectiveness of physical exercise on frail older persons. Seven databases were search for randomized control trials which assessed the effect of exercise on participants who were identified as being frail using specific and validated criteria. Nine articles were reviewed from eight studies, from which seven used a validated definition of frailty. Based on the articles analyzed in our systematic review, the evidence suggests that exercise has a positive effect on various measures used to determine frailty including cognition, physical functioning, and psychological wellbeing. Some studies revealed that exercise may prevent or delay the onset of frailty which can enhance quality of life in older adults. Despite the evidence for exercise interventions in frail older adults, it appears that there is no clear guidance regarding the most effective program variables. The reviewed studies were generally long in duration (≥6 months) with sessions lasting around 60 minutes performed three or more times per week, including multicomponent exercises. In conclusion, although exercise interventions appear to be effective in managing the various components of frailty and preventing/delaying the onset of frailty, the most effective exercise program in this population remains unidentified.

CITATION:
R.B. Silva ; H. Aldoradin-Cabeza ; G.D. Eslick ; S. Phu ; G. Duque (2017): The Effect of Physical Exercise on Frail Older Persons: A Systematic Review. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.7

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DETERMINATION OF THE MECHANISMS THAT CAUSE SARCOPENIA THROUGH cDNA MICROARRAY

H.O. Jeong, D. Park, E. Im, J. Lee, D.S. Im, H.Y. Chung

J Frailty Aging 2017;6(2):97-102

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Background: Sarcopenia, the aging-related deterioration of skeletal muscle, is a disease that is directly associated with quality of life. Given the trend of an increasing aging population worldwide, the prevention of aging-related diseases such as sarcopenia has become ever more important and urgent. Objective: To identify potential therapeutic targets for this disease. Methods: we used a bioinformatics approach of combining cDNA microarray analysis and protein–protein interaction prediction. Results: We found 673 significant differentially expressed genes (128 upregulated and 545 downregulated) in sarcopenia patients of over 60 years of age. Most of the upregulated genes were involved in metabolic processes such as the PPAR signaling pathway. In particular, FABP4, PLIN1, and ADIPOQ were related to fatty acid and lipid metabolism. Some of the downregulated genes were located in the mitochondrial matrix. Additionally, through the protein interaction network analysis, we found two key molecules (MAP1LC3B and HSP90AB1) that were associated with autophagy. Conclusions: These results suggest that mitochondrial dysfunction and lipid metabolism are associated with sarcopenia.

CITATION:
H.O. Jeong ; D. Park ; E. Im ; J. Lee ; D.S. Im ; H.Y. Chung (2017): Determination of the mechanisms that cause sarcopenia through cDNA microarray. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.13

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FRAILTY IN END-STAGE RENAL DISEASE PATIENTS UNDER DIALYSIS AND ITS ASSOCIATION WITH CLINICAL AND BIOCHEMICAL MARKERS

V. Poveda, M. Filgueiras, V. Miranda, A. Santos-Silva, C. Paúl, E. Costa

J Frailty Aging 2017;6(2):103-106

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Frailty is a common complication in elderly patients with end-stage renal disease (ESRD) under dialysis, which is a strong risk factor for low quality of life, morbidity, and mortality. In this work, we aimed to evaluate the prevalence of frailty in a group of Portuguese ESRD patients, and its association with socio-demographic, clinical and biochemical markers. We performed a cross-sectional study with 83 ESRD patients (44 males and 39 females, 64.3 [±14.6] years old) on regular dialysis. The classification of the ESRD patients as robust, pre-frail and frail was performed using the FRAIL questionnaire. Social support, data about sociodemographic and comorbidities, and haematological, iron status, dialysis adequacy, nutritional and inflammatory markers were also evaluated. Our results confirmed that frailty is a highly prevalent condition in ESRD patients, particularly in female patients. An association between FRAIL score and increased depressive symptoms, presence of hypertension and decrease nutritional status was also found.

CITATION:
V. Poveda ; M. Filgueiras ; V. Miranda ; A. Santos-Silva ; C. Paúl ; E. Costa (2017): Frailty in end-stage renal disease patients under dialysis and its association with clinical and biochemical markers. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.14

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HOW OLDER PERSONS PERCEIVE THE LOSS OF INDEPENDENCE: THE NEED OF A HOLISTIC APPROACH TO FRAILTY

E. Escourrou, M. Cesari, B. Chicoulaa, B. Fougère, B. Vellas, S. Andrieu, S. Oustric

J Frailty Aging 2017;6(2):107-112

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Background: Since 2004, the definition of the frailty syndrome has shifted from purely physical criteria to a more comprehensive consideration of the individual, including their psychosocial criteria. In this study, qualitative research methods were used as a complementary approach in order to enrich the existing quantitative results in this area. Objective: To understand the views of older persons on the risk of loss of independence. Methods: The study population comprised people over 75 years of age who were living at home in the south-west of France and were considered to be at risk of losing their independence. Data were collected using individual semi-structured in-depth interviews, accompanied by observations. Inductive analysis was carried out according to grounded theory methods. Results: Fifteen individual interviews were conducted to achieve theoretical data saturation. Analysis of the content of the interviews revealed seven risk factors for the loss of independence: poor mental health, poor physical health, social isolation, no longer leaving the home, an unsuitable environment, unsuitable living conditions, and few resources. Conclusions: These results complement the purely physical approach to screening for the frailty syndrome and lead us to reconsider our screening approach to include a more holistic view of the older person and their circumstances.

CITATION:
E. Escourrou ; M. Cesari ; B. Chicoulaa ; B. Fougère ; B. Vellas ; S. Andrieu ; S. Oustric (2017): How older persons perceive the loss of independence: The need of a holistic approach to frailty. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.3

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LETTER TO THE EDITOR: PROMOTION OF A PROPOSAL TO INCORPORATE ADVANCE CARE PLANNING CONVERSATIONS INTO FRAILTY PREVENTION PROGRAMS FOR FRAIL OLDER PEOPLE

K. Senda, S. Satake, M. Nishikawa, H. Miura

J Frailty Aging 2017;6(2):113-114

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CITATION:
K. Senda ; S. Satake ; M. Nishikawa ; H. Miura (2017): Letter to the editor : Promotion of a proposal to incorporate advance care planning conversations into frailty prevention programs for frail older people. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.10

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ICFSR 2017: INTERNATIONAL CONFERENCE ON FRAILTY & SARCOPENIA RESEARCH THURSDAY - FRIDAY, APRIL 27-28, 2017 BARCELONA, SPAIN

Abstracts

J Frailty Aging 2017;6(S1):3-180

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