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04/2021 journal articles

OLDER PERSONS “LOST” TO THE COVID-19 VACCINATION: WHERE ARE THEY?

M. Cesari , B. Vellas

J Frailty Aging 2021;10(4)308-309

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CITATION:
M. Cesari ; B. Vellas (2021): Older Persons “Lost” to the COVID-19 Vaccination: Where Are They?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.37

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ON SCHRÖDINGER’S CAT AND EVALUATION OF TRIALS DISRUPTED BY THE COVID19 PANDEMIC: A CRITICAL APPRAISAL

M. Cesari, R. Calvani, M. Canevelli, I. Aprahamian, P. de Souto Barreto, D. Azzolino, R.A. Fielding, N. Vanacore, M. Inzitari, E. Marzetti

J Frailty Aging 2021;10(4)310-312

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CITATION:
M. Cesari ; R. Calvani ; M. Canevelli ; I. Aprahamian ; P. de Souto Barreto ; D. Azzolino ; R.A. Fielding ; N. Vanacore ; M. Inzitari ; E. Marzetti (2021): On Schrödinger’s Cat and Evaluation of Trials Disrupted by the Covid19 Pandemic: A Critical Appraisal. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.23

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HEALTHY AGING BIOMARKERS: THE INSPIRE’S CONTRIBUTION

I. Ader, L. Pénicaud, S. Andrieu, J.R. Beard, N. Davezac, C. Dray, N. Fazilleau, P. Gourdy, S. Guyonnet, R. Liblau, A. Parini, P. Payoux, C. Rampon, I. Raymond-Letron, Y. Rolland, P. de Souto Barreto, P. Valet, N. Vergnolle, F. Sierra, B. Vellas, L. Casteilla

J Frailty Aging 2021;10(4)313-319

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The find solutions for optimizing healthy aging and increase health span is one of the main challenges for our society. A novel healthcare model based on integration and a shift on research and care towards the maintenance of optimal functional levels are now seen as priorities by the WHO. To address this issue, an integrative global strategy mixing longitudinal and experimental cohorts with an innovative transverse understanding of physiological functioning is missing. While the current approach to the biology of aging is mainly focused on parenchymal cells, we propose that age-related loss of function is largely determined by three elements which constitute the general ground supporting the different specific parenchyma: i.e. the stroma, the immune system and metabolism. Such strategy that is implemented in INSPIRE projects can strongly help to find a composite biomarker capable of predicting changes in capacity across the life course with thresholds signalling frailty and care dependence.

CITATION:
I. Ader ; L. Pénicaud ; S. Andrieu ; J.R. Beard ; N. Davezac ; C. Dray ; N. Fazilleau ; P. Gourdy ; S. Guyonnet ; R. Liblau ; A. Parini ; P. Payoux ; C. Rampon ; I. Raymond-Letron ; Y. Rolland ; P. de Souto Barreto ; P. Valet ; N. Vergnolle ; F. Sierra ; B. Vellas ; L. Casteilla ; (2021): Healthy Aging Biomarkers: The INSPIRE’s Contribution. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.15

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THE ASSOCIATION BETWEEN FRAILTY AND ALL-CAUSE MORTALITY IN COMMUNITY-DWELLING OLDER INDIVIDUALS: AN UMBRELLA REVIEW

A.R.M.S. Ekram, R.L. Wood, C. Britt, S. Espinoza, M.E. Ernst, J. Ryan

J Frailty Aging 2021;10(4)320-326

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Frailty is associated with multiple adverse health outcomes, including mortality. Several methods have been used to characterize frailty, each based on different frailty scales. These include scales based on phenotype, multidomain, and deficit accumulations. Several systematic reviews have examined the association between frailty and mortality; however, it is unclear whether these different frailty scales similarly predict mortality. This umbrella review aims to examine the association between frailty assessed by different frailty scales and all-cause mortality among community-dwelling older adults. A protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched. Methodological quality was assessed using the JBI critical appraisal checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried’s physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All of the systematic reviews found that frailty was significantly associated with all-cause mortality. This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.

CITATION:
A.R.M.S. Ekram ; R.L. Woods ; C. Britt ; S. Espinoza ; M.E. Ernst ; J. Ryan (2021): The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.20

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FRAILTY IN YOUNG AND MIDDLE-AGED ADULTS: AN INTEGRATIVE REVIEW

C. Loecker, M. Schmaderer, L. Zimmerman

J Frailty Aging 2021;10(4)327-333

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Background: Frailty is a public health priority resulting in poor health outcomes and early mortality in older adults. Early identification, management, and prevention of frailty may reduce frailty trajectory into later life. However, little is known about frailty in younger adults. Objective: Describe frailty prevalence, definitions, study designs, and components contributing to multidimensional frailty in 18 to 65-year-olds and impart guidance for future research, practice, and policies with potential to positively impact frail individuals. Methods: Integrative review approach was selected to explore frailty allowing for inclusion of diverse methodologies and varied persepectives while maintaining rigor and applicability to evidence-based practice initiatives. CINAHL, Embase, PsycInfo, PubMed databases were searched for studies describing frailty in adults age 18 to 65. Articles were excluded if published prior to 2010, not in English, lacked frailty focus, or non-Western culture. Results: Twelve descriptive correlational studies were included. No intervention or qualitative studies were identified. No standard conceptual definition of frailty was discovered. Studied in participants with health disparities (n=3) and chronic conditions (n=8); HIV was most common (n=4). Frailty prevalence ranged from 3.9% (313 of 8095) to 63% (24 of 38). Many factors associated with frailty were identified among physical (18) and social (14), and fewer among psychological (11) domains. Conclusions: Universal frailty definition and multidimensional assessment tool is needed to generate generalizable results in future studies describing frailty in young and middle-aged adults. Early frailty identification by clinicians has potential to facilitate development and implementation of targeted interventions to prevent or mitigate frailty progression, but additional research is needed because risk factors in younger populations may be different than older adults.

CITATION:
C. Loecker ; M. Schmaderer ; L. Zimmerman (2021): Frailty in Young and Middle-Aged Adults: An Integrative Review. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.14

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LETTER TO THE EDITOR: OBESITY DEFINITION FOR MUSCLE OUTCOMES IN SARCOPENIC OBESITY: UTILITY OF WAIST CIRCUMFERENCE REVISITED

J.P. Lim, J. Chew, N.H. Ismail, W.S. Lim

J Frailty Aging 2021;10(4)334-336

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CITATION:
J.P. Lim ; J. Chew ; N.H. Ismail ; W.S. Lim (2021): Obesity Definition for Muscle Outcomes in Sarcopenic Obesity: Utility of Waist Circumference Revisited. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.28

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COGNITIVE MOTOR DUAL TASK COSTS IN OLDER ADULTS WITH MOTORIC COGNITIVE RISK SYNDROME

N. Ward, A. Menta, S. Peach, S.A. White, S. Jaffe, C. Kowaleski, K. Grandjean da Costa, J. Verghese, K.F. Reid

J Frailty Aging 2021;10(4)337-342

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The purpose of this study was to characterize Cognitive Motor Dual Task (CMDT) costs for a community-based sample of older adults with Motoric Cognitive Risk Syndrome (MCR), as well as investigate associations between CMDT costs and cognitive performance. Twenty-five community-dwelling older adults (ages 60-89 years) with MCR performed single and dual task complex walking scenarios, as well as a computerized cognitive testing battery. Participants with lower CMDT costs had higher scores on composite measures of Working Memory, Processing Speed, and Shifting, as well as an overall cognitive composite measure. In addition, participants with faster single task gait velocity had higher scores on composite measures of Working Memory, Processing Speed, and overall cognition. Taken together, these results suggest that CMDT paradigms can help to elucidate the interplay between cognitive and motor abilities for older adults with MCR.

CITATION:
N. Ward ; A. Menta ; S. Peach ; S.A. White ; S. Jaffe ; C. Kowaleski ; K. Grandjean da Costa ; J. Verghese ; K.F. Reid (2021): Cognitive Motor Dual Task Costs in Older Adults with Motoric Cognitive Risk Syndrome. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.27

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IMPACT OF AGE, FRAILTY, AND DEMENTIA ON PRESCRIBING FOR TYPE 2 DIABETES AT HOSPITAL DISCHARGE 2012-2016

S.J. Wood, J.S. Bell, D.J. Magliano, L. Fanning, M. Cesari, C.S. Keen, J. Ilomäki

J Frailty Aging 2021;10(4)343-349

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Background: The risks of intensive blood glucose lowering may outweigh the benefits in vulnerable older people. Objectives: Our primary aim was to determine whether age, frailty, or dementia predict discharge treatment types for patients with type 2 diabetes (T2D) and related complications. Secondly, we aimed to determine the association between prior hypoglycemia and discharge treatment types. Design, Setting and Participants: We conducted a cohort study involving 3,067 patients aged 65-99 years with T2D and related complications, discharged from Melbourne’s Eastern Health Hospital Network between 2012 and 2016. Measurements: Multinomial logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CI) for the association between age, frailty, dementia and hypoglycemia, and being prescribed insulin-only, non-insulin glucose-lowering drugs (GLDs) or combined insulin and non-insulin GLDs compared to no GLD. International Classification of Diseases-10 codes were used to identify dementia status and prior hypoglycemia; frailty was quantified using the Hospital Frailty Risk Score. Results: Insulin-only, non-insulin GLDs, combined insulin and non-insulin GLDs, and no GLDs were prescribed to 19%, 39%, 20%, and 23% of patients, respectively. Patients >80 years were less likely than patients aged 65-80 to be prescribed any of the GLD therapies, (eg. non-insulin GLDs [OR 0.67; 95%CI 0.55-0.82]), compared to no GLD. Similarly, high vs. low frailty scores were associated with not being prescribed any of the three GLD therapies, (eg. non-insulin GLDs [OR 0.63; 95%CI 0.45-0.87]). However, dementia was not associated with discharge prescribing of GLD therapies. Patients with a hypoglycemia-related admission were more likely than those not hospitalized with hypoglycemia to receive insulin-only (OR 4.28; 95%CI 2.89-6.31). Conclusions: Clinicians consider age and frailty when tailoring diabetes treatment regimens for patients discharged from hospital with T2D and related complications. There is scope to optimize prescribing for patients with dementia and for those admitted with hypoglycemia.

CITATION:
S.J. Wood ; J.S. Bell ; D.J. Magliano ; L. Fanning ; M. Cesari ; C.S. Keen ; J. Ilomäki (2021): Impact of Age, Frailty, and Dementia on Prescribing for Type 2 Diabetes at Hospital Discharge 2012-2016. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.6

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Assessing and Managing Unintentional Weight Loss: A Global Survey of Geriatrician Practice and Their Use of Ice Cream to Address It

M. Gyenes, I.-Y. Wang, S.K. Sinha

J Frailty Aging 2021;10(4)350-356

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OBJECTIVES: Unintentional weight loss (UIWL) is common among older adults but lacks standardized methods for its diagnosis and management. With a limited understanding on how geriatricians actually address UIWL, we conducted a survey to examine how they diagnose and manage it, and their opinions regarding the use of ice cream to address it. DESIGN, SETTING, AND PARTICIPANTS: An international descriptive, cross-sectional, online survey conducted over a 16-week period in 2019 involving 1131 geriatricians in clinical practice across 51 countries. MEASUREMENTS: We collected information around respondent demographics, use of screening tools and diagnostic investigations, and pharmacological and non-pharmacological approaches to address UIWL. RESULTS: 89.1% of respondents reported frequently seeing UIWL. The most common methods reportedly used to evaluate UIWL were performing a comprehensive history and physical examination (97.4%) and assessing for cognitive impairment (86.5%). 74.2% noted that they routinely prescribed oral nutritional supplements and 71.6% involved non-medical professional(s) to help manage UIWL. While 50.4% reported recommending ice cream to their patients with UIWL, only 30.6% reported being aware of other colleagues recommending it. Geriatricians in practice for 30+ years were significantly more likely to recommend ice cream (P < 0.05). A thematic analysis of qualitative responses identified that prescribing ice cream tended to align both with patient preferences and socio-economic realities. CONCLUSION: While a majority of geriatricians surveyed routinely prescribe ONS and involve others to manage UIWL, at least half are also recommending ice cream. A key practice amongst experienced geriatricians, the use of ice cream could be better acknowledged as a practical and cost-effective way to address UIWL.

CITATION:
M. Gyenes ; I.-Y. Wang ; S.K. Sinha (2021): Assessing and Managing Unintentional Weight Loss: A Global Survey of Geriatrician Practice and Their Use of Ice Cream to Address It. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.11

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EFFECTS OF THREE DIFFERENT EXERCISE STRATEGIES FOR OPTIMIZING AEROBIC CAPACITY AND SKELETAL MUSCLE PERFORMANCE IN OLDER ADULTS: A PILOT STUDY

D. Tavoian, D.W. Russ, T.D. Law, J.E. Simon, P.J. Chase, E.H. Guseman, B.C. Clark

J Frailty Aging 2021;10(4)357-360

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This Brief Report describes a pilot study of the effect of 12 weeks of stationary bicycle high-intensity interval training, stationary bicycle moderate-intensity continuous training, and resistance training on cardiorespiratory, muscular, and physical function measures in insufficiently-active older adults (N=14; 66.4±3.9 years; 3 male, 11 female). After baseline testing, participants were randomly assigned to one of the exercise groups. High-intensity interval training and moderate-intensity continuous training had small-to-large effect sizes on cardiorespiratory/endurance and physical function measures, but very small effect sizes on muscular measures. Resistance training had small-to-large effect sizes on cardiorespiratory, muscular, and physical function measures. This pilot study should be interpreted cautiously, but findings suggest that resistance exercise may be the most effective of the three studied exercise strategies for older adults as it can induce beneficial adaptations across multiple domains. These effect sizes can be used to determine optimal sample sizes for future investigations.

CITATION:
D. Tavoian ; D.W. Russ ; T.D. Law ; J.E. Simon ; P.J. Chase ; E.H. Guseman ; B.C. Clark (2021): Effects of Three Different Exercise Strategies for Optimizing Aerobic Capacity and Skeletal Muscle Performance in Older Adults: A Pilot Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.21

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FRAILTY AND HOME CONFINEMENT DURING THE COVID-19 PANDEMIC: RESULTS OF A PRE-POST INTERVENTION, SINGLE ARM, PROSPECTIVE AND LONGITUDINAL PILOT STUDY

C.P. Launay, L. Cooper-Brown, V. Ivensky, O. Beauchet

J Frailty Aging 2021;10(4)361-362

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CITATION:
C.P. Launay ; L. Cooper-Brown ; V. Ivensky ; O. Beauchet (2021): Frailty and Home Confinement during the COVID-19 Pandemic: Results of a Pre-Post Intervention, Single Arm, Prospective and Longitudinal Pilot Study . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.9

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MANAGEMENT OF COVID-19 IN A FRENCH NURSING HOME: EXPERIENCES FROM A MULTIDISCIPLINARY MOBILE TEAM

P. Poupin, D. N’Diaye, F. Chaumier, A. Lemaignen, L. Bernard, B. Fougère

J Frailty Aging 2021;10(4)363-366

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Background: Long-term residential care facilities and nursing homes are known to be particularly vulnerable to viral respiratory diseases and have expressed the need for multidisciplinary collaboration to help manage outbreaks when they occur. Method: In April 2020, Tours University Medical Center created a multidisciplinary mobile team to help local nursing homes deal with outbreaks of coronavirus disease 2019 (COVID-19). The team included a geriatrician, infectious disease experts, and palliative care specialists. Results: On April 8th, 2020, the first intervention took place in a 100 residents nursing home with a total of 18 confirmed cases among 26 symptomatic residents and five deaths. The nursing home staffs’ main requests were a multidisciplinary approach, consensus decision-making, and the dissemination of information on disease management. Conclusion: Three lessons emerged from this collaboration: (i) intensify collaborations between hospitals and nursing homes, (ii) limit disease transmission through the use of appropriate hygiene measures, broad screening, and the isolation of sick residents and sick employees, and (iii) provide sufficient human resources.

CITATION:
P. Poupin ; D. N’Diaye ; F. Chaumier ; A. Lemaignen ; L. Bernard ; B. Fougère (2021): Management of COVID-19 in a French Nursing Home: Experiences from a Multidisciplinary Mobile Team. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.16

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LETTER TO THE EDITOR: EXPLORING ASSOCIATIONS BETWEEN ORAL HEALTH AND FRAILTY IN COMMUNITY-DWELLING OLDER PEOPLE

R.C. Castrejón-Pérez

J Frailty Aging 2021;10(4)367

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CITATION:
R.C. Castrejón-Pérez (2021): Letter to the Editor: Exploring Associations Between Oral Health and Frailty in Community-Dwelling Older People. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.10

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ICSFR: 11th International Conference on Frailty, Sarcopenia Research & Geroscience. September 29 - October 2, 2021, 100% Virtual conference

Symposia - Conferences - Oral Communications

J Frailty Aging 2021;10(S1):S1-S40

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ICSFR: 11th International Conference on Frailty, Sarcopenia Research & Geroscience. September 29 - October 2, 2021, 100% Virtual conference

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J Frailty Aging 2021;10(S1):S41-S96

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