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03/2017 journal articles

CO-LOCALIZATION OF MACROPHAGE INHIBITORY FACTOR AND NIX IN SKELETAL MUSCLE OF THE AGED MALE INTERLEUKIN 10 NULL MOUSE

P. Abadir, F. Ko, R. Marx, L. Powell, E. Kieserman, H. Yang, J. Walston

J Frailty Aging 2017;6(3):118-121

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Chronic inflammation is associated with muscle weakness and frailty in older adults. The antagonistic cross-talk between macrophage migration inhibitory factor (Mif), an anti-apoptotic cytokine and NIP3-like protein X (Nix), a pro-apoptotic mitochondrial protein, may play a role in mitochondrial free radical homeostasis and inflammatory myopathies. We examined Nix-Mif interaction in inflammation and aging using young and old, IL-10tm/tm (a rodent model of chronic inflammation) and C57BL/6 mice. In this study, we observed that Nix and Mif were co-localized in skeletal muscles of aged and inflamed mice. We show an inflammation- and age-related association between Nix and Mif gene expression, with the strongest positive correlation observed in old IL-10tm/tm skeletal muscles. The IL-10tm/tm skeletal muscles also had the highest levels of oxidative stress damage. These observations suggest that Nix-Mif cross-talk may play a role in the interface between chronic inflammation and oxidative stress in aging skeletal muscles.

CITATION:
P. Abadir ; F. Ko ; R. Marx ; L. Powell ; E. Kieserman ; H. Yang ; J. Walston (2017): Co-localization of Macrophage Inhibitory Factor and Nix in Skeletal Muscle of the Aged Male Interleukin 10 Null Mouse. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.18

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PREVALENCE OF FRAILTY IN NURSING HOME RESIDENTS ACCORDING TO VARIOUS DIAGNOSTIC TOOLS

F. Buckinx, J.-Y. Reginster, S. Gillain, J. Petermans, T. Brunois, O. Bruyère

J Frailty Aging 2017;6(3):122-128

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Background: Although the theoretical foundations of frailty are well established in the literature, it remains an evolving concept lacking any unique definition or diagnostic criteria for use in clinical practice and epidemiological research. No consensus exists about the accurate prevalence rates of frailty. The various operational definitions of frailty can at least partly explain such discrepancies. Objective: To compare the prevalence of frailty, measured with different diagnostic tools, among elderly nursing home residents. Design: This is an analysis of baseline data collected among the SENIOR (Sample of Nursing home Elderly Individuals: an Observational Research) cohort. Setting: Nursing homes. Population: A total of 662 volunteer subjects from 28 nursing homes were included in this analysis. Among them, the mean age was 83.2 ± 8.99 years and 484 (72.5%) of them were women. Measurement: The percentages of frail and non-frail subjects were calculated according to 10 different definitions. Results: Prevalence of frailty varies from 1.70% (Frailty Index) to 76.3% (Groningen Frailty Indicator) depending on the tool used. Conclusions: The prevalence of frailty is highly dependent on the diagnostic tool used. It would be necessary to reach a consensus on which diagnostic tools to use if one wishes to have comparable data obtained in epidemiological studies.

CITATION:
F. Buckinx ; J.-Y. Reginster ; S. Gillain ; J. Petermans ; T. Brunois ; O. Bruyère (2017): Prevalence of frailty in nursing home residents according to various diagnostic tools. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.20

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GENDER AND AGE DIFFERENCES IN LEVELS, TYPES AND LOCATIONS OF PHYSICAL ACTIVITY AMONG OLDER ADULTS LIVING IN CAR-DEPENDENT NEIGHBORHOODS

W. Li, E. Procter-Gray, L. Churchill, S.E. Crouter, K. Kane, J. Tian, P.D. Franklin, J.K. Ockene, J. Gurwitz

J Frailty Aging 2017;6(3):129-135

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Background: A thorough understanding of gender differences in physical activity is critical to effective promotion of active living in older adults. Objectives: To examine gender and age differences in levels, types and locations of physical activity. Design: Cross-sectional observation. Setting: Car-dependent urban and rural neighborhoods in Worcester County, Massachusetts, USA. Participants: 111 men and 103 women aged 65 years and older. Measurements: From 2012 to 2014, participants were queried on type, frequency and location of physical activity. Participants wore an accelerometer for 7 consecutive days. Results: Compared to women, men had a higher mean daily step count (mean (SD) 4385 (2122) men vs. 3671(1723) women, p=0.008). Men reported higher frequencies of any physical activity and moderate-to-vigorous physical activity, and a lower frequency of physical activity inside the home. Mean daily step counts and frequency of physical activity outside the home decreased progressively with age for both men and women. Women had a sharper decline in frequencies of self-reported physical activity. Men had a significant decrease in utilitarian walking, which women did not (p=0.07). Among participants who reported participation in any physical activity (n=190), more women indicated exercising indoors more often (59% vs. 44%, p=0.04). The three most commonly cited locations for physical activity away from home for both genders were streets or sidewalks, shopping malls, and membership-only facilities (e.g., YMCA or YWCA). The most common types of physical activity, performed at least once in a typical month, with over 40% of both genders reporting, included light housework, brisk walking, leisurely walking, and stretching. Conclusion: Levels, types and location preferences of physical activity differed substantially by gender. Levels of physical activity decreased progressively with age, with greater decline among women. Consideration of these gender differences is necessary to improve the effectiveness of active living promotion programs among older adults.

CITATION:
W. Li ; E. Procter-Gray ; L. Churchill ; S.E. Crouter ; K. Kane ; J. Tian ; P.D. Franklin ; J.K. Ockene ; J. Gurwitz (2017): Gender and age differences in levels, types and locations of physical activity among older adults living in car-dependent neighborhoods . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.15

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FRAILTY AND FEAR OF FALLING: THE FISTAC STUDY

M. Esbrí-Víctor, I. Huedo-Rodenas, M. López-Utiel, J.L. Navarro-López, M. Martínez-Reig, J.A. Serra-Rexach, L. Romero-Rizos, P. Abizanda

J Frailty Aging 2017;6(3):136-140

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Objective: To analyze the association between frailty and Fear of Falling (FoF) in a cohort of older adults with previous falls. Design: Cross-sectional study (FISTAC). Setting: Falls Unit, Complejo Hospitalario Universitario of Albacete (Spain). Participants: 183 adults older than 69 years, from the Falls Unit, with a history of a previous fall in the last year. Measurements: FoF was assessed at baseline using the Falls Efficacy Scale International (FES-I) and three questions previously validated. Frailty was assessed with the frailty phenotype criteria. Age, gender, comorbidity, nutritional status, cognitive status and risk of depression were determined. Results: Mean age 78.4, 80.3% women. FoF was present in 140 (76.5%) participants with the three questions and 102 (55.7%) presented high concern of falling with the FES-I. 88.8% of frail older adults presented FoF compared to 62.4% of those who were not frail, and only 37.8% of non frail had a high concern of falling, compared to 77.2% of those who were frail measured with the FES-I. Frail participants had an adjusted risk of FoF that was 3.18 (95% CI 1.32 to 7.65) higher compared to those who were not frail assessed with the three questions and 3.93 (95% CI 1.85 to 8.36) higher concern of falling when using the FES-I scale. Only female sex and depression risk were also associated to FoF in the final adjusted models. Conclusion: Frailty is independently associated with the FoF syndrome in older faller subjects.

CITATION:
M. Esbrí-Víctor ; I. Huedo-Rodenas ; M. López-Utiel ; J.L. Navarro-López ; M. Martínez-Reig ; J.A. Serra-Rexach ; L. Romero-Rizos ; P. Abizanda (2017): FRAILTY AND FEAR OF FALLING: THE FISTAC STUDY. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.19

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TWO-WAY BRIDGE BETWEEN MUSCULAR DYSFUNCTION AND COGNITIVE IMPAIRMENT: SECONDARY ANALYSES OF SABE – BOGOTA STUDY

E. Garcia-Cifuentes, D. G. David-Pardo, M. G. Borda, M.U. Perez-Zepeda, C.A. Cano-Gutiérrez

J Frailty Aging 2017;6(3):141-143

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Background and objective: Muscular dysfunction and cognitive impairment are both disabling states, affecting especially the elderly. Thus, are important subjects of research. Our goal is to describe the association between these two entities in the elderly. Methods: This is a secondary analysis from the SABE 2012 Bogota survey, which is a cross-sectional study. We define muscular dysfunction as an abnormal result in gait speed and/or handgrip strength tasks. Cognitive impairment was defined as an abnormal result in Mini Mental State Examination. Other independent variables were measured. Results: A total of 1,564 older adults were included in the analysis. Cognitive impairment showed statistically significant association with both low handgrip strength (OR: 2.25; CI 1.52 – 3.33) and low gait speed (OR: 2.76; CI 1.83 – 4.15) in the adjusted model. Conclusion: In older adults, muscular dysfunction is associated with cognitive impairment. New studies should address the causality and temporality of this relationship.

CITATION:
E. Garcia-Cifuentes ; D. G. David-Pardo ; M. G. Borda ; M.U. Perez-Zepeda ; C.A. Cano-Gutiérrez (2017): TWO-WAY Bridge between muscular dysfunction and cognitive impairment: Secondary analyses of SABE – Bogota study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.17

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DEPRESSIVE SYMPTOMS, FALLS, AND FEAR OF FALLING IN OLD KOREAN ADULTS: THE KOREAN LONGITUDINAL STUDY ON HEALTH AND AGING (KLOSHA)

Y. Park, N.-J. Paik, K.W. Kim, H.-C. Jang, J.-Y. Lim

J Frailty Aging 2017;6(3):144-147

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Fall is a common cause of disability and death in old adults, and much research has been focused on identifying risk factors and developing preventive measures. Yet the majority of preceding research has been focused on physical performance. This study aims to evaluate the association between fall and depressive symptoms in community-dwelling elderly. Cross-sectional data of 431 men and 546 women was collected from old Korean adults living in Seongnam, Korea. Geriatric fall assessment was conducted by self-report questionnaires. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale. Results indicated that depressive symptoms were associated with both fall and fear of falling in old adults. A clear gender difference was newly discovered, as depression played a stronger role in women. These results imply that clinicians should consider the negative affect of geriatric patients when assessing fall risk. Also, measures against depression might be effective in reducing falls.

CITATION:
Y. Park ; N.-J. Paik ; K.W. Kim ; H.-C. Jang ; J.-Y. Lim (2017): Depressive symptoms, falls, and fear of falling in old Korean adults: the Korean Longitudinal Study on Health and Aging (KLoSHA). The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.21

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INFLUENCE OF AGE ON DECISION-MAKING PROCESS TO LIMIT OR WITHDRAW LIFE-SUSTAINING TREATMENT IN THE INTENSIVE CARE UNIT – A SINGLE CENTER PROSPECTIVE OBSERVATIONAL STUDY

G. Ducos, O. Mathe, L. Balardy, S. Lozano, M. Kurrek, J. Ruiz, B. Riu-Poulenc, O. Fourcade, S. Silva, V. Minville

J Frailty Aging 2017;6(3):148-153

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Background: The increasing age in the industrialized countries places significant demands on intensive care unit (ICU) resources and this triggers debates about end-of-life care for the elderly. Objectives: We sought to determine the impact of age on the decision-making process to limit or withdraw life-sustaining treatment (DWLST) in an ICU in France. We hypothesized that there are differences in the decision-making process for young and old patients. Design, setting, participants: We prospectively studied end-of-life decision-making for all consecutive admissions (n=390) to a tertiary care university ICU in Toulouse, France over a period of 11 months between January and October 2011. Results: Among the 390 patients included in the study (age ≥70yo, n=95; age <70yo, n=295) DWLST were more common for patients 70 years or older (43% for age ≥70yo vs. 16% for age <70yo, p <0.0001). Reasons for DWLST were different in the 2 groups, with the ‘no alternative treatment options’ and ‘severity of illness’ as the most frequent reasons cited for the younger group whereas it was ‘severity of illness’ for the older group. ‘Advanced age’ led to DWLSTs in 43% of the decisions in the group ≥70yo (vs. 0% in the group <70yo, p <0.0001). Multivariate logistic regression showed a high SAPS II score and age ≥70yo as independent risk factors for DWLSTs in the ICU. We did not find age ≥70yo as an independent risk factor for mortality in ICU. Conclusion: We found that age ≥70yo was an independent risk factor for DWLSTs for patients in the ICU, but not for their mortality. Reasons leading to DWLSTs are different according to the age of patients.

CITATION:
G. Ducos ; O. Mathe ; L. Balardy ; S. Lozano ; M. Kurrek ; J. Ruiz ; B. Riu-Poulenc ; O. Fourcade ; S. Silva ; V. Minville (2017): Influence of age on decision-making process to limit or withdraw life-sustaining treatment in the intensive care unit – A single center prospective observational study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.22

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ORAL HEALTH AND THE FRAIL ELDERLY

L. Rapp, S. Sourdet, B. Vellas, M.-H. Lacoste-Ferré

J Frailty Aging 2017;6(3):154-160

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Introduction: The relationships between oral health conditions and frailty have rarely been explored. A systematic review of frailty components and oral health concluded that differences in study population endpoint criteria and study design cannot establish a relationship between frailty and oral health. Objective: This study aims to describe the distribution of the OHAT (Oral Health Assessment Tool) score in a population of frail subjects and to assess associated parameters (age, socio-economic status, living conditions, education level, nutritional habits, cognitive functioning, autonomy). Design: Cross-sectional observational study among patients referred to the Geriatric Frailty Clinic. Measurements: 1314 patients participated in different standardized tests to evaluate their health status, cognitive and affective functioning, adaptation to usual daily activities, nutritional status, and oral health status. Results: The risk of oral health deterioration was higher with the appearance of frailty: the OHAT increased significantly with the Fried Frailty Score (p<0.001). Physical performance and oral health were correlated (p<0.001). The OHAT score and the MNA (Mini Nutritional Assessment) score were significantly correlated: oral status seemed better for malnourished subjects (p<0.001). Dementia significantly increased the risk of an unhealthy oral status (p<0.001). There was no significant correlation between oral status and depression, just a trend. Conclusion: This pilot study establishes a relationship between the OHAT and Fried Frailty Criteria in a population of frail elderly. It must be expanded to follow the distribution of the different items composing the OHAT score (items assessing lips; tongue; gums and tissues; saliva; natural teeth; dentures; oral cleanliness; and dental pain) with different parameters (age, socio-economic status, living conditions, educational level, medical history, drug treatment, nutritional habits, cognitive functioning, disabilities and handicaps).

CITATION:
L. Rapp ; S. Sourdet ; B. Vellas ; M.-H. Lacoste-Ferré (2017): ORAL HEALTH AND THE FRAIL ELDERLY. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.9

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MUSCLE MEASURES AND NUTRITIONAL STATUS AT HOSPITAL ADMISSION PREDICT SURVIVAL AND INDEPENDENT LIVING OF OLDER PATIENTS – THE EMPOWER STUDY

S. Verlaan, J.M. Van Ancum, V.D. Pierik, J.P. van Wijngaarden, K. Scheerman, C.G.M. Meskers, A.B. Maier

J Frailty Aging 2017;6(3):161-166

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Objectives: Older adults with sarcopenia and malnutrition are at risk for co-morbidities, hospitalization, institutionalization, and mortality. In case of hospitalization, risks may be further increased, especially in case of suboptimal dietary intake. The aim of our study was to assess whether muscle mass, muscle strength, functional performance, and nutritional status at hospital admission were associated with survival and independent living among older patients three months after discharge. Design, Setting, Participants: The EMPOWER study was an observational, prospective and longitudinal inception cohort of patients older than 70 years admitted to the VU University Medical Centre in Amsterdam, the Netherlands. Measurements: Patients were assessed for demographic and clinical characteristics, measurements of muscle mass (by bioelectrical impedance analysis), handgrip strength (by dynamometry), functional performance (self-reported ability to walk), and screened for risk of malnutrition (by SNAQ). Three months after hospital discharge, survival and living situation were assessed by a follow-up telephone interview. Results: The majority of the 378 patients enrolled were living independently at the time of hospitalization (90%) and three months post-discharge (83%). Fifty-two patients died in the period from hospital admission to three months after discharge (survival rate 86%). Higher absolute muscle mass measures and not being malnourished at admission were significantly associated with the likelihood of survival. Handgrip strength and self-reported ability to walk were positively associated with a higher chance of living independently three months after discharge, but not with survival. Conclusions: Older patients with greater muscle mass and without malnutrition at hospital admission had a higher survival rate, while measures of muscle strength and functional performance were predictive for living independently three months after hospital discharge. Different components of muscle health relate to different relevant outcomes and therefore require investigation of specifically targeted interventions in the hospitalized older population.

CITATION:
S. Verlaan ; J.M. Van Ancum ; V.D. Pierik ; J.P. van Wijngaarden ; K. Scheerman ; C.G.M. Meskers ; A.B. Maier (2017): Muscle measures and nutritional status at hospital admission predict survival and independent living of older patients – the EMPOWER study . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.23

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EFFECT OF A COMBINED TAI CHI, RESISTANCE TRAINING AND DIETARY INTERVENTION ON COGNITIVE FUNCTION IN OBESE OLDER WOMEN

F. Xu, M.J. Delmonico, I.E. Lofgren, K.M. Uy, S.A. Maris, D. Quintanilla, A.G. Taetzsch, J. Letendre, L. Mahler

J Frailty Aging 2017;6(3):167-171

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Cognitive decline in older adults is a major public health problem and can compromise independence and quality of life. Exercise and diet have been studied independently and have shown to be beneficial for cognitive function, however, a combined Tai Chi, resistance training, and diet intervention and its influence on cognitive function has not been undertaken. The current study used a 12-week non-randomized research design with experiment and control groups to examine the effect of a combined Tai Chi, resistance training, and diet intervention on cognitive function in 25 older obese women. Results revealed improvements in domain specific cognitive function in our sample. Baseline cognitive function was correlated with changes in dietary quality. These findings suggest that Tai Chi and resistance training combined with diet intervention might be beneficial for community-based programs aiming to improve cognitive function.

CITATION:
F. Xu ; M.J. Delmonico ; I.E. Lofgren ; K.M. Uy ; S.A. Maris ; D. Quintanilla ; A.G. Taetzsch ; J. Letendre ; L. Mahler (2017): Effect of a Combined Tai Chi, Resistance Training and Dietary Intervention on Cognitive Function in Obese Older Women. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2017.16

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