Ahead of print articles
DEFINING FRAILTY IN RESEARCH ABSTRACTS: A SYSTEMATIC REVIEW AND RECOMMENDATIONS FOR STANDARDIZATION
E. Yaksic, V. Lecky, S. Sharnprapai, T. Tungkhar, K. Cho, J.A. Driver, A.R. Orkaby
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Multiple definitions of frailty are used. We sought to quantify the frequency that frailty is insufficiently defined in published abstracts. We conducted a systematic review of MEDLINE/PubMed for English abstracts of original research investigating frailty as an exposure or outcome in humans from 2015-2017. A complete definition of frailty included: 1) a named measure of frailty, including “frailty” alone, 2) details on variables included (e.g. grip strength), 3) number of variables included (e.g. 33-item frailty index), and 4) details on cutoffs or levels of frailty unless a definition was used continuously. Our search yielded 1,110 titles; 490 abstracts met review criteria, 348 abstracts had any definition of frailty and were included. Majority reported a single measure of frailty (n=313, 90%). The most commonly used measures were variations of Fried’s phenotype (n=167, 48%) and Rockwood’s cumulative deficit model (n=101, 29%). Only 56 abstracts had complete definitions (16%). In 123 abstracts (35%), a means of measuring frailty was named, but no additional details were given. When details of the frailty measure were described, they generally referred to cutoffs or levels rather than variables used in the measure. A minority of abstracts of original manuscripts related to frailty research had adequate definitions of frailty. We encourage scientists to adopt a standardized approach to defining the term for all abstracts related to frailty research to facilitate systematic reviews, meta-analysis, and accurate reporting of frailty science.
E. Yaksic ; V. Lecky ; S. Sharnprapai ; T. Tungkhar ; K. Cho ; J.A. Driver ; A.R. Orkaby (2019): Defining Frailty in Research Abstracts: A Systematic Review and Recommendations for Standardization. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.4
PSOAS AND PARASPINOUS MUSCLE MEASUREMENTS ON COMPUTED TOMOGRAPHY PREDICT MORTALITY IN EUROPEAN AMERICANS WITH TYPE 2 DIABETES MELLITUS
B.M. Tucker, F.C. Hsu, T.C. Register, J. Xu, S.C. Smith, M. Murea, D.W. Bowden, B.I. Freedman, L. Lenchik
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Background: Appendicular skeletal muscle mass index and muscle attenuation (density) are negatively associated with mortality in European-derived populations. Objectives: The present analyses assessed association between axial skeletal muscle density and muscle index with mortality in European Americans with type 2 diabetes mellitus (T2D). Design: Single-center observational study. Setting: Diabetes Heart Study. Participants: 839 European Americans with T2D. Methods: Computed tomography-measured psoas and paraspinous muscle mass index (cross sectional area/height2) and radiographic density (Hounsfield Units) were assessed in all participants. A Cox proportional hazards model was computed. The fully-adjusted model included covariates age, sex, body mass index, smoking, alcohol use, diabetes duration, insulin use, hormone replacement therapy (women), prevalent cardiovascular disease (CVD), hypertension, and coronary artery calcified atherosclerotic plaque mass score. Deaths were recorded in the National Death Index data through December 31, 2015. Results: Participants included 428 women and 411 men with median (25th, 75th quartile) age 62.8 (56.1, 69.1) years and diabetes duration 8.0 (5.0, 14.0) years. After 11.9 (9.4, 13.3) years of follow-up, 314 (37.4%) of participants were deceased. In the fully-adjusted model, psoas muscle density (hazard ratio [HR] 0.81, p<0.001), psoas muscle index (HR 0.82, p=0.008), and paraspinous muscle density (HR 0.85, p=0.003) were inversely associated with mortality. Paraspinous muscle index was not significantly associated with mortality (HR 0.90, p=0.08). Results did not differ significantly between men and women. Conclusions: In addition to established risk factors for mortality and CVD, higher psoas muscle index, psoas muscle density, and paraspinous muscle density were significantly associated with lower all-cause mortality in European Americans with T2D.
B.M. Tucker ; F.C. Hsu ; T.C. Register ; J. Xu ; S.C. Smith ; M. Murea ; D.W. Bowden ; B.I. Freedman ; L. Lenchik (2019): Psoas and paraspinous muscle measurements on computed tomography predict mortality in European Americans with type 2 diabetes mellitus. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.5
AGE OF HIV ACQUISITION AFFECTS THE RISK OF MULTI-MORBIDITY AFTER 25 YEARS OF INFECTION EXPOSURE
G. Guaraldi, A. Malagoli, J. Milic, I. Pintassilgo, E. Rossi, N. Riva, I. Franconi, A. Santoro, P. Sorin, A. Streinu-Cercel, M. De Rosa, C. Mussini
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Introduction: Understanding the intersection of HIV, aging and health is crucial due to the increasing number of people aging with HIV. Objective: The objective of the study was to assess the prevalence of, and risk factors for individual comorbidities and multi-morbidity in people living with HIV with similar duration of HIV infection, notwithstanding a 25-year difference at the time of HIV acquisition. Methods: In a cross-sectional multicentre retrospective study, we compared three match-control age groups. The “Young” were selected from Romania and included HIV-positive patients prenatally infected and assessed at the age of 25-30 years. The “Old” and the “Geriatric” were selected from Italy. These respectively included subjects infected with HIV at the age of 25 years and assessed at the age of 50-55 years, and those infected at the age of 50 years and assessed at the age of 75-80 years. Each group was sex and age matched in a 1:5 ratio with controls selected from the CINECA ARNO database from Italy. We described non-infectious comorbidities (NICM), including cardiovascular disease, hypertension, dyslipidaemia, diabetes, chronic kidney disease, and multi-morbidity (MM≥ 3 NICM). Results: MM prevalence in the “Young” group compared to controls was 6.2% vs 0%, while in the “Geriatric” was “68.2% vs 3.6%. Using “Young” as a reference, in multivariate analyses, predictors for MM were as follows: HIV serostatus (OR=47.75, IQR 14.78-154.25, p<0.01) and “Geriatric” vs “Young” (OR=30.32, IQR 5.89-155.98, p<0.01). Conclusion: These data suggest that age at acquisition of HIV should be considered as a risk factor for NICM and MM.
G. Guaraldi ; A. Malagoli ; J. Milic ; I. Pintassilgo ; E. Rossi ; N. Riva ; I. Franconi ; A. Santoro ; P. Sorin ; A. Streinu-Cercel ; M. De Rosa ; C. Mussini (2019): Age OF HIV acquisition affects the risk of multi-morbidity after 25 years of infection exposure. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.6
PREDICTIVE ABILITY OF SEVEN DOMAINS OF THE KIHON CHECKLIST FOR INCIDENT DEPENDENCY AND MORTALITY
S. Satake, H. Shimokata, K. Senda, I. Kondo, H. Arai, K. Toba
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The Kihon Checklist (KCL) is a structured questionnaire consisting of 7 domains to assess seniors’ function in daily living. The aim of this study was to examine which domains of the KCL can predict incident dependency and mortality. The municipality sent a KCL questionnaire to independent seniors in Higashi-ura Town and collected the answers of the 5542 seniors who provided complete answers. Their incident dependency and mortality were followed-up for 2.5 years. A Cox proportional hazard model indicated that meeting any of the criteria in instrumental activities of daily living, physical, nutrition, and mood domains significantly predicted the risk of dependency, whereas meeting any of the criteria in physical, nutrition and socialization domains significantly predicted the risk of mortality. Category assessment by the KCL could be useful to predict incident dependency and all-cause mortality.
S. Satake ; H. Shimokata ; K. Senda ; I. Kondo ; H. Arai ; K. Toba (2019): Predictive ability of seven domains of the Kihon Checklist for incident dependency and mortality. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.3
LOSS OF POSTERIOR OCCLUDING TEETH AND ITS ASSOCIATION WITH PROTEIN-MICRONUTRIENTS INTAKE AND MUSCLE MASS AMONG THAI ELDERS: A PILOT STUDY
B. Treesattayakul, T. Winuprasith, B. Theeranuluk, D. Trachootham
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Contact between upper and lower posterior teeth is crucial for chewing. However, the influence of posterior occluding teeth loss on protein intake and muscle mass was unclear. This cross-sectional study compared consumption frequency of protein food, amount of protein and relevant micronutrient intakes and muscle mass indices among older adults with different Eichner indices (EI) of posterior occluding teeth loss. Ninety Thai healthy adults were divided into three groups (N=30 each) according EI with statistically comparable characters. Food frequency questionnaire, 4-days diet record, and bioelectrical impedance analysis were used for outcome measurement. Our findings suggested that loss of posterior occluding teeth on both sides was associated with less frequent consumption of meat, nut, egg, fish and dairy products, inadequate intakes of protein (< 0.8 g/kg body weight), iron and vitamin B12, and reduced muscle mass indices in older adults. Future large-scale cohort studies are warranted to confirm these findings.
B. Treesattayakul ; T. Winuprasith ; B. Theeranuluk ; D. Trachootham (2019): Loss of posterior occluding teeth and its association with protein-micronutrients intake and muscle mass among Thai elders: A pilot study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.2
THE TRIGGERING RECEPTOR EXPRESSED ON MYELOID CELLS-2 (TREM-2) AS EXPRESSION OF THE RELATIONSHIP BETWEEN MICROGLIA AND ALZHEIMER’S DISEASE: A NOVEL MARKER FOR A PROMISING PATHWAY TO EXPLORE
C. Gussago, M. Casati, E. Ferri, B. Arosio
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Alzheimer’s disease (AD) is a common neurodegenerative disorder, strongly related with age. It has been reported that genetic variants of the Triggering Receptor Expressed on Myeloid Cells-2 (TREM2), a cell-surface receptor expressed in microglial cells, greatly increase the risk of AD, thus suggesting an involvement of the microglia in the AD pathogenesis. The aim of this report is to provide an overview of the TREM2 and of its possible implication in the pathogenesis of AD.
C. Gussago ; M. Casati ; E. Ferri ; B. Arosio (2018): The Triggering Receptor Expressed on Myeloid cells-2 (TREM-2) as expression of the relationship between microglia and Alzheimer’s disease: a novel marker for a promising pathway to explore. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.43
JFA N°01 - 2019
PREVENTION OF DISABILITY IN THE FRAIL CHINESE OLDER POPULATION
J.K. Chhetri, P. Chan, L. Ma, D. Peng, L. Rodríguez-Mañas, M. Cesari, B. Vellas
J Frailty Aging 2018;8(1):2-6Show summaryHide summary
As aging is becoming a global phenomenon, the burden of population aging is increasing rapidly, and is soon expected to be the highest in low-and middle-income countries. China represents the world’s largest population, and will face the largest number of older individuals, while the economy still remains developing. There is an urgent need to address the negative consequences of aging such as disability, that creates a myriad of challenges, including financial burden to the economy. In order to achieve successful aging-i.e., aging without being frail or disabled, the traditional healthcare model based on a disease-centered approach is not enough, but require a more holistic course. Here, we briefly outline the current scenario of aging and disability in the Chinese older population, its impact and challenges. We strongly believe that public health initiatives centered on frailty, a clinically distinguishable state of extreme vulnerability in older adults, could be the most relevant approach to meet the current needs of the aging population. Such initiatives are immediately needed to reshape the existing model of geriatric healthcare, to promote healthy aging and to reduce the burden of disability in the Chinese population.
J.K. Chhetri ; P. Chan ; L. Ma ; D. Peng ; L. Rodríguez-Mañas ; M. Cesari ; B. Vellas (2018): PREVENTION OF DISABILITY IN THE FRAIL CHINESE OLDER POPULATION. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.27
NEUROMUSCULAR CHANGES WITH AGING AND SARCOPENIA
J Frailty Aging 2018;8(1):7-9Show summaryHide summary
Sarcopenia was originally conceptualized as the age-related loss of skeletal muscle mass. Over the ensuing decades, the conceptual definition of sarcopenia has changed to represent a condition in older adults that is characterized by declining muscle mass and function, with “function” most commonly conceived as muscle weakness and/or impaired physical performance (e.g., slow gait speed). Findings over the past 15-years, however, have demonstrated that changes in grip and leg extensor strength are not primarily due to muscle atrophy per se, and that to a large extent, are reflective of declines in the integrity of the nervous system. This article briefly summarizes findings relating to the complex neuromuscular mechanisms that contribute to reductions in muscle function associated with advancing age, and the implications of these findings on the development of effective therapies.
B.C. Clark (2018): Neuromuscular changes with aging and sarcopenia. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.35
THE MANAGEMENT OF GERIATRIC AND FRAIL HIV PATIENTS. A 2017 UPDATE FROM THE ITALIAN GUIDELINES FOR THE USE OF ANTIRETROVIRAL AGENTS AND THE DIAGNOSTIC-CLINICAL MANAGEMENT OF HIV-1 INFECTED PERSONS
G. Guaraldi, S. Marcotullio, R. Maserati, M. Gargiulo, J. Milic, I. Franconi, A. Chirianni, M. Andreoni, M. Galli, A. Lazzarin, A. D’Arminio Monforte, G. Di Perri, C.-F. Perno, M. Puoti, S. Vella, A. Di Biagio, L. Maia, C. Mussi, M. Cesari, A. Antinori
J Frailty Aging 2018;8(1):10-16Show summaryHide summary
Objective: This article deals with the attempt to join HIV and geriatric care management in the 2017 edition of the Italian guidelines for the use of antiretrovirals and the diagnostic-clinical management of HIV-1 infected persons. Methods: The outlined recommendations are based on evidence from randomized clinical trials and observational studies published in peer-reviewed journals and/or presented at international scientific conferences in recent years. The principles of starting antiretroviral therapy in elderly patients and the viro-immunological goals are the same as in the general HIV population. However, there are some specificities to consider, related to the host as well as the therapy itself. HIV care in elderly patients must shift from a combined AntiRetroviral Therapy specific approach to a more comprehensive management, and from a disease-based model (list of co-morbidities) to a multi-morbidity and frailty standpoint. The implementation of a geriatric approach, based on the Comprehensive Geriatric Assessment, is essential and consists of a broader evaluation of health status. This multidimensional and multidisciplinary evaluation is focused on the development of a tailored intervention plan. Polypharmacy is a frequent condition in the older population and an independent risk factor for negative health-related outcomes. This can be overcome with a multidisciplinary and cooperative approach involving HIV specialists, geriatricians and primary care physicians. Conclusion: The inclusion of geriatric care becomes necessary due to the novel needs of an evolving patient population. It is important to underline that the HIV specialist will continue to lead multidimensional interventions and optimize quality of care for HIV-positive people.
G. Guaraldi ; S. Marcotullio ; R. Maserati ; M. Gargiulo ; J. Milic ; I. Franconi ; A. Chirianni ; M. Andreoni ; M. Galli ; A. Lazzarin ; A. D’Arminio Monforte ; G. Di Perri ; C.-F. Perno ; M. Puoti ; S. Vella ; A. Di Biagio ; L. Maia ; C. Mussi ; M. Cesari ; A. Antinori (2018): The management of geriatric and frail HIV patients. A 2017 update from the Italian guidelines for the use of antiretroviral agents and the diagnostic-clinical management of HIV-1 infected persons. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.42
HBA1C IS ASSOCIATED WITH FRAILTY IN A GROUP OF ABORIGINAL AUSTRALIANS
Z. Hyde, K. Smith, L. Flicker, D. Atkinson, S. Fenner, L. Skeaf, R. Malay, D. Lo Giudice
J Frailty Aging 2018;8(1):17-20Show summaryHide summary
In this cross-sectional study of 141 Aboriginal Australians aged ≥45 years living in the remote Kimberley region of Western Australia, we explored whether glycated haemoglobin (HbA1c) levels were associated with frailty. Sixty-four participants (45.4%) had a HbA1c level ≥6.5% and 84 participants (59.6%) were frail. A significant trend was observed with regard to HbA1c levels and frailty, with those having HbA1c levels ≥6.5% having the greatest prevalence of frailty (70.3%). In binary logistic regression analyses, having a HbA1c level ≥6.5% was associated with being frail after adjustment for age, sex, and education. This association was attenuated after further adjustment for body mass index (BMI). Poorer glycaemic control is very common and a potential risk factor for frailty in remote-living Aboriginal Australians, and appears to be partly mediated by BMI, a known risk factor for diabetes mellitus. Obesity and diabetes mellitus are potentially important modifiable risk factors for frailty.
Z. Hyde ; K. Smith ; L. Flicker ; D. Atkinson ; S. Fenner ; L. Skeaf ; R. Malay ; D. Lo Giudice (2018): HbA1c is associated with frailty in a group of Aboriginal Australians. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.41
A COMPARISON BETWEEN 6-POINT DIXON MRI AND MR SPECTROSCOPY TO QUANTIFY MUSCLE FAT IN THE THIGH OF SUBJECTS WITH SARCOPENIA
A. Grimm, H. Meyer, M.D. Nickel, M. Nittka, E. Raithel, O. Chaudry, A. Friedberger, M. Uder, W. Kemmler, K. Engelke, H.H. Quick
J Frailty Aging 2018;8(1):21-26Show summaryHide summary
Background: Changes in muscle fat composition as for example observed in sarcopenia, affect physical performance and muscular function, like strength and power. Objectives: The purpose of this study was to compare 6-point Dixon magnetic resonance imaging and multi-echo magnetic resonance spectroscopy sequences to quantify muscle fat. Setting, participants and measurements: Two groups were recruited (G1: 23 healthy young men (28 ± 4 years), G2: 56 men with sarcopenia (80 ± 5 years)). Proton density fat fraction was measured with a 6-point product and a 6-point prototype Dixon sequence in the left thigh muscle and with a high-speed multi-echo T2*-corrected H1 magnetic resonance spectroscopy sequence within the semitendinosus muscle of the left thigh. To evaluate the comparability among the different methods, Bland-Altman and linear regression analyses of the proton density fat fraction results were performed. Results: Mean differences ± 1.96 * standard deviation between spectroscopy and 6pt Dixon sequences were 1.9 ± 3.3% and 1.5 ± 3.6% for the product and prototype sequences, respectively. High correlations were measured between the proton density fat fraction results of the 6-point Dixon sequences and spectroscopy (R = 0.95 for the product sequence and R = 0.97 for the prototype sequence). Conclusions: Dixon imaging and spectroscopy sequences show comparable accuracy for fat measurements in the thigh. Spectroscopy is a local measurement, whereas Dixon sequences provide maps of the fat distribution. The high correlations of the 6-point Dixon sequences with spectroscopy support their clinical use. They provide higher spatial resolution than spectroscopy, but are not suitable for a more complicated spectral analysis to separate extra- and intramyocellular lipids.
A. Grimm ; H. Meyer ; M.D. Nickel ; M. Nittka ; E. Raithel ; O. Chaudry ; A. Friedberger ; M. Uder ; W. Kemmler ; K. Engelke ; H.H. Quick ; (2018): A Comparison between 6-point Dixon MRI and MR Spectroscopy to Quantify Muscle Fat in the Thigh of Subjects with Sarcopenia. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.16
THE ASSOCIATION BETWEEN PHYSICAL ACTIVITY AND METABOLIC SYNDROME IN OLDER ADULTS WITH OBESITY
F. Xu, S.A. Cohen, I.E. Lofgren, G.W. Greene, M.J. Delmonico, M.L. Greaney
J Frailty Aging 2018;8(1):27-32Show summaryHide summary
Background: Physical activity reduces the likelihood of developing metabolic syndrome (MetS). However, the association between different physical activity levels and MetS remains unclear in older adults with obesity. Methods: This cross-sectional study used four waves of data (2007-2008, 2009-2010, 2011-2012, 2013-2014) from two datasets: The National Health and Nutrition Examination Survey and United Sates Department of Agriculture’s Food Patterns Equivalents Database. The sample included adults 60+ years of age (n= 613) with obesity who had physical activity and MetS data. Physical activity was assessed using the Global Physical Activity Questionnaire and categorized into three physical activity levels (low, medium, and high); and medium or high physical activity levels are aligned with or exceed current physical activity recommendations. Participants were classified as having MetS using a commonly agreed upon definition. Multiple logistic regression models examined the association between the three physical activity levels and MetS risk factors and MetS. All analyses adjusted for potential confounding variables and accounted for complex sampling. Results: Of 613 respondents, 72.1% (n=431) were classified as having MetS, and 44.3% (n = 263) had not met physical activity recommendations. Participants with high levels of physical activity had a lower risk of MetS (OR = 0.31, 95%CI: 0.13, 0.72) and more healthful levels of high-density lipoprotein cholesterol (OR = 0.39, 95%CI: 0.18, 0.84), blood pressure (OR = 0.39, 95%CI: 0.20, 0.77), fasting glucose (OR = 0.34, 95%CI: 0.15, 0.78) than participants categorized as having low physical activity. Conclusions: Physical activity is associated with lower risk of MetS only for participants with the highest level of physical activity, which suggests that physical activity dosage is important to reduce MetS risk in older adults with obesity.
F. Xu ; S.A. Cohen ; I.E. Lofgren ; G.W. Greene ; M.J. Delmonico ; M.L. Greaney (2018): The Association between Physical Activity and Metabolic Syndrome in Older Adults with Obesity. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.34
NOVEL FRAILTY SCREENING QUESTIONNAIRE (FSQ) PREDICTS 8-YEAR MORTALITY IN OLDER ADULTS IN CHINA
L. Ma, Z. Tang, P. Chan, J.D. Walston
J Frailty Aging 2018;8(1):33-38Show summaryHide summary
Background: Although frailty status greatly impacts health care in countries with rapidly aging populations, little is known about the frailty status in Chinese older adults. Objectives: Given the increased health care needs associated with frailty, we sought to develop an easily applied self-report screening tool based on four of the syndromic frailty components and sought to validate it in a population of older adults in China. Design: Prospective epidemiological cohort study. Setting: Community-dwelling residents living in Beijing, China. Participants: 1724 community-dwelling adults aged ≥60 years in 2004 with an 8-year follow up. Measurements: We developed a simple self-report frailty screening tool—the Frailty Screening Questionnaire (FSQ)—based on the modified Fried frailty components. The predictive ability for outcome was assessed by age and sex adjusted Cox proportional hazards model. Results: According to FSQ criteria, 7.1% of the participants were frail. Frailty was associated with poor physical function, fractures, falls, and mortality. Both frailty and pre-frailty were associated with a higher mortality rate: frailty—hazards ratio (HR), 3.94, 95% confidence interval (CI), 3.16–4.92, P<0.001; pre-frailty—HR, 1.89; 95% CI, 1.57–2.27, P <0.001; adjusted models for this variable did not affect the estimates of the association. Among the four frailty components, slowness was the strongest predictor of mortality. The combination of the four components provided the best risk prediction. Conclusions: FSQ is a self-report frailty measurement tool that can be rapidly performed to identify older adults with higher risk of adverse health outcomes.
L. Ma ; Z. Tang ; P. Chan ; J.D. Walston (2018): Novel Frailty Screening Questionnaire (FSQ) Predicts 8-year Mortality in Older Adults in China. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.38
MAXIMUM WALKING SPEED CAN IMPROVE THE DIAGNOSTIC VALUE OF FRAILTY AMONG COMMUNITY-DWELLING OLDER ADULTS A CROSS-SECTIONAL STUDY
M. do Carmo Correia de Lima, T. Loffredo Bilton, W. Jefferson de Sousa Soares, L. Paccini Lustosa, E. Ferriolli, M. Rodrigues Perracini
J Frailty Aging 2018;8(1):39-41Show summaryHide summary
This study investigates the diagnostic accuracy of the combination of usual walking speed (UWS) and maximum walking speed (MWS) to identify frailty in community-dwelling older adults. A population-based study with 758 participants aged 65 and older was conducted. Frailty syndrome was determined using the Fried phenotype. UWS and MWS were evaluated in a 4.6-meter path. Both measures were categorized using the 1.0 m/s cut points, and participants were categorized into three groups: those with “very good”, “good” and “insufficient” walking reserve capacity (WRC). Of all participants, 9% were identified as frail and 47% as prefrail. The “insufficient” WRC presented a low sensitivity of 0.55, high specificity of 0.91 and moderately useful likelihood ratios (LR+ 6.57, LR- 0.48) to identify frailty. Based on Fagan’s nomogram, an elder’s corresponding post-test probability of being frail with an “insufficient” WRC would be around 40%, which substantially increased the diagnostic accuracy of frailty.
M. do Carmo Correia de Lima ; T. Loffredo Bilton ; W. Jefferson de Sousa Soares ; L. Paccini Lustosa ; E. Ferriolli ; M. Rodrigues Perracini (2018): Maximum walking speed can improve the diagnostic value of frailty among community-dwelling older adults a cross-sectional study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.44
PSYCHOSOCIOECONOMIC PRECARIOUSNESS AND FRAILTY: THE RESPECTIVE CONTRIBUTION IN PREDICTING MORTALITY
C. Ouvrard, C. Meillon, J.-F. Dartigues, M. Tabue Teguo, J.A. Avila-Funes, H. Amieva
J Frailty Aging 2018;8(1):42-47Show summaryHide summary
Background: Low socioeconomic status and frailty are factors of vulnerability in old age. They are both well-known risk factors of death. On the other hand, low socioeconomic status has been reported as a predictor of frailty, which questions the relationship between socioeconomic status, frailty and death. Objectives: The aim of this work was to explore the respective contribution of psychosocioeconomic precariousness – which covers socioeconomic status and also psychosocial vulnerability – and frailty in predicting mortality. Design: Prospective population-based study. Setting: Three-City (3C) Bordeaux study, France. Participants: The sample consisted of 1586 subjects aged 65 or older. Measurements: Psychosocioeconomic precariousness was assessed utilizing a structured instrument which assessed poor socioeconomic status, and psychosocial vulnerability. Frailty status was defined by Fried’s phenotype. Results: After 14 years of follow-up, 665 deaths (42%) occurred. Psychosocioeconomic precariousness and frailty had both an independent contribution to mortality prediction (hazard ratio (HR) 1.51 (95% confidence interval (CI) 1.11-2.07)) and (HR 1.68 (95% CI 1.19-2.38)), respectively. Such relationships were adjusted for age, sex, disability, and comorbidities. No interaction term was found between precariousness and frailty. Conclusions: If psychosocioeconomic precariousness and frailty are both aspects of vulnerability in old age, they have a non-overlapping contribution in the prediction of mortality. These findings emphasize the importance of considering both psychosocioeconomic precariousness and frailty when identifying elderly people at risk of death.
C. Ouvrard ; C. Meillon ; J.-F. Dartigues ; M. Tabue Teguo ; J.A. Avila-Funes ; H. Amieva (2018): Psychosocioeconomic precariousness and frailty: the respective contribution in predicting mortality. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.36
CAN A PREBIOTIC FORMULATION REDUCE FRAILTY LEVELS IN OLDER PEOPLE?
O. Theou, K. Jayanama, J. Fernández-Garrido, C. Buigues, L. Pruimboom, A.J. Hoogland, R. Navarro-Martínez, K. Rockwood, O. Cauli
J Frailty Aging 2018;8(1):48-52Show summaryHide summary
Objective: The purpose of this study was to examine whether a prebiotic formulation reduces frailty index (FI) levels in older people. Design: We conducted secondary analysis of a placebo-controlled, randomized, double-blind design study. Setting/Participants: The study included non-demented people over the age of 65 who were living in nursing homes and were able to walk. Fifty participants completed the study (75.3±7.3 years, 70% females). Intervention: Participants were randomly assigned to either a group who received daily Darmocare Pre® (inulin and fructooligosaccharides) for 13 weeks or a placebo group (maltodextrin). Measurement: The primary outcome in this secondary analysis was change in level of a 62-item FI compared to baseline. Results: At the 13-week follow-up, the placebo group had higher FI levels (preFI 0.23±0.11, postFI 0.24±0.12, p=0.012) and the intervention group had lower FI levels (preFI 0.22±0.09, postFI 0.20±0.08, p<0.001). There was an average increase of 0.01±0.01 in the FI score in the placebo group (0.4 deficits; Cohen’s d 0.61; standardized response mean 0.59) and an average reduction of 0.02±0.02 in the intervention group (1.1 deficits; Cohen’s d -1.35; standardized response mean -1.16). Among the 28 participants in the intervention group, FI levels were reduced for 25 people; five of them had an FI reduction greater than 0.03. The moderately/severely frail participants (FI >0.3, N=5) had the greatest reduction in their FI (0.04±0.01). Conclusion: A prebiotic intervention can reduce frailty levels in nursing home residents especially in those with higher levels of frailty.
O. Theou ; K. Jayanama ; J. Fernández-Garrido ; C. Buigues ; L. Pruimboom ; A.J. Hoogland ; R. Navarro-Martínez ; K. Rockwood ; O. Cauli (2018): Can a prebiotic formulation reduce frailty levels in older people?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.39