01/2022 journal articles
POST ACUTE CARE FOR FRAIL OLDER PERSONS: TIME FOR A STANDARDIZED MODEL OF CARE
L. Calcaterra, M. Cesari
J Frailty Aging 2022;11(1)1-2Show summaryHide summary
L. Calcaterra ; M. Cesari ; (2021): Post Acute Care for Frail Older Persons: Time for a Standardized Model of Care. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.52
NUTRITION AND PHYSICAL ACTIVITY CLINICAL PRACTICE GUIDELINES FOR OLDER ADULTS LIVING WITH FRAILTY
A.L. Lorbergs, J.C. Prorok, J. Holroyd-Leduc, D.R. Bouchard, A. Giguere, L. Gramlich, H. Keller, A. Tang, M. Racey, M.U. Ali, D. Fitzpatrick-Lewis, D. Sherifali, P. Kim, J. Muscedere
J Frailty Aging 2022;11(1)3-11Show summaryHide summary
Background: We developed clinical practice guidelines to provide health care providers with evidence-based recommendations for decisions related to the effective management of frailty and pre-frailty using nutrition and physical activity interventions.
Methods: We based the recommendations on two systematic reviews with meta-analyses. Nutrition, physical activity, and combined nutrition and physical activity interventions for adults ≥65y were considered if study populations were identified as frail using a frailty tool or assessment. Risk of bias and certainty of evidence were evaluated. We included physical outcomes, mobility, frailty, cognitive function, activities of daily living, falls, quality of life, diet quality, energy/fatigue levels, health services use, and caregiver outcomes.
Results: Overall, mobility improvements were moderate with nutritional strategies that optimize dietary intake, various types of physical activity interventions, and interventions that combine nutrition and physical activity. Physical outcomes, such as body mass and muscle strength, improved moderately with nutritional strategies and interventions that combined nutrition with physical activity. Frailty status improved with multi-component physical activity interventions. Strong recommendations include optimizing dietary intake, performing physical activity, and adopting interventions that combine nutrition and physical activity. We strongly recommend various types of physical activity including muscle strengthening activities, mobilization or rehabilitation exercises, and multi-component physical activity interventions.
Interpretation: Tailored nutrition and physical activity interventions based on individual goals and health status are associated with improved clinical and physical outcomes. While the recommendations facilitate shared decision-making, we identified sparse application of validated frailty assessments and lack of standardized research outcomes as critical gaps in knowledge.
A.L. Lorbergs ; J.C. Prorok ; J. Holroyd-Leduc ; D.R. Bouchard ; A. Giguere ; L. Gramlich ; H. Keller ; A. Tang ; M. Racey ; M.U. Ali ; D. Fitzpatrick-Lewis ; D. Sherifali ; P. Kim ; J. Muscedere (2021): Nutrition and Physical Activity Clinical Practice Guidelines for Older Adults Living with Frailty. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.51
LONG-TERM ASPIRIN USE AND SELFREPORTED WALKING SPEED IN OLDER MEN: THE PHYSICIANS’ HEALTH STUDY
A.R. Orkaby, A.B. Dufour, L. Yang, H.D. Sesso, J.M. Gaziano, L. Djousse, J.A. Driver, T.G. Travison
J Frailty Aging 2022;11(1)12-17Show summaryHide summary
Background: Mobility limitation is a component of frailty that shares a bidirectional relationship with cardiovascular disease (CVD). Data are limited on the role of established CVD prevention therapies, such as aspirin, for prevention of frailty and mobility limitation.
Objectives: Examine the association between long-term aspirin use and walking speed.
Design, Setting, Participants: Prospective cohort of 14,315 men who participated in the Physicians’ Health Study I, a completed randomized controlled trial of aspirin (1982-1988), with extended post-trial follow-up.
Measurements: Annual questionnaires collected data on aspirin use, lifestyle and other factors. Average annual aspirin use was categorized for each participant: ≤60 days/year and >60 days/year. Mobility was defined according to self-reported walking pace, categorized as: don’t walk regularly (reference), easy/casual <2mph, normal ≥2-2.9mph, or brisk/very brisk ≥3mph. Propensity scoring balanced covariates between aspirin categories. Multinomial logistic regression models estimated odds of being in each self-reported walking category.
Results: Mean age was 70±8 years; mean aspirin use 11 years. There were 2,056 (14.3%) participants who reported aspirin use ≤60 days/year. Aspirin use >60 days/year was associated with drinking alcohol, smoking, hypertension, heart disease and stroke, while ≤60 days/year was associated with anticoagulation use and bleeding history. In all, 13% reported not walking regularly, 12% walked <2 mph, 44% walked ≥2-2.9 mph, and 31% walked ≥3 mph. After propensity score adjustment, regular aspirin use was associated with a faster walking speed. Odds ratios (95% confidence intervals) were 1.16 (0.97 to 1.39), 1.24 (1.08 to 1.43), and 1.40 (1.21 to 1.63) for <2 mph, ≥2-2.9 mph and ≥3 mph, respectively, compared to not walking regularly (p-trend<0.001).
Conclusions: In this cohort of older men, long-term aspirin use is associated with a greater probability of faster walking speed later in life.
A.R. Orkaby ; A.B. Dufour ; L. Yang ; H.D. Sesso ; J.M. Gaziano ; L. Djousse ; J.A. Driver ; T.G. Travison (2021): Long-Term Aspirin Use and Self-Reported Walking Speed in Older Men: The Physicians’ Health Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.36
PREVALENCE OF PHYSICAL FRAILTY: RESULTS FROM THE DOHEALTH STUDY
M. Gagesch, P.O. Chocano-Bedoya, L.A. Abderhalden, G. Freystaetter, A. Sadlon, J.A. Kanis, R.W. Kressig, S. Guyonnet, J.A.P. DaSilva, D. Felsenberg, R. Rizzoli, M. Blauth, E.J. Orav, A. Egli, H.A. Bischoff-Ferrari
J Frailty Aging 2022;11(1)18-25Show summaryHide summary
Background: Frailty is a geriatric syndrome associated with multiple negative health outcomes. However, its prevalence varies by population and instrument used. We investigated frailty and pre-frailty prevalence by 5 instruments in community-dwelling older adults enrolled to a randomized-controlled trial in 5 European countries.
METHODS: Cross-sectional baseline analysis in 2,144 DO-HEALTH participants recruited from Switzerland, Austria, France, Germany, and Portugal with complete data for frailty. Frailty status was assessed by the Physical Frailty Phenotype [PFP], SOF-Frailty Index [SOF-FI], FRAIL-Scale, SHARE-Frailty Instrument [SHARE-FI], and a modified SHARE-FI, and compared by country, age, and gender. Logistic regression was used to determine relevant factors associated with frailty and pre-frailty.
RESULTS: Mean age was 74.9 (±4.4) years, 61.6% were women. Based on the PFP, overall frailty and pre-frailty prevalence was 3.0% and 43.0%. By country, frailty prevalence was highest in Portugal (13.7%) and lowest in Austria (0%), and pre-frailty prevalence was highest in Portugal (57.3%) and lowest in Germany (37.1%). By instrument and overall, frailty and pre-frailty prevalence was highest based on SHARE-FI (7.0% / 43.7%) and lowest based on SOF-FI (1.0% / 25.9%). Frailty associated factors were residing in Coimbra (Portugal) [OR 12.0, CI 5.30-27.21], age above 75 years [OR 2.0, CI 1.17-3.45], and female gender [OR 2.8, CI 1.48-5.44]. The same three factors predicted pre-frailty.
CONCLUSIONS: Among relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.
M. Gagesch ; P.O. Chocano-Bedoya ; L.A. Abderhalden ; G. Freystaetter ; A. Sadlon ; J.A. Kanis ; R.W. Kressig ; S. Guyonnet ; J.A.P. DaSilva ; D. Felsenberg ; R. Rizzoli ; M. Blauth ; E.J. Orav ; A. Egli ; H.A. Bischoff-Ferrari (2021): Prevalence of Physical Frailty: Results from the DO-HEALTH Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.18
ASSOCIATION OF DIETARY INTAKE WITH THE TRANSITIONS OF FRAILTY AMONG JAPANESE COMMUNITY-DWELLING OLDER ADULTS
R. Otsuka, S. Zhang, C. Tange, Y. Nishita, M. Tomida, K. Kinoshita, Y. Kato, F. Ando, H. Shimokata
J Frailty Aging 2022;11(1)26-32Show summaryHide summary
Due to progressive population aging, a new dementia case occurs at every 3 seconds, placing a heavy burden of disease. Identifying potential risk or preventive factors is emphasized owing to a lack of effective treatment for dementia. There has been emerging evidence on the link of certain dietary components, particularly polyphenols, to brain wellness and cognitive outcomes. Findings from animal and in vitro studies appear more consistent and conclusive. However, such an association has not been investigated in depth in human beings. In this review, we examined studies on the effect of dietary polyphenols (including flavonoids, curcumin, and resveratrol) on cognitive function. Intervention in early stages of dementia/Alzheimer’s disease might be a target to slow down age-related cognitive decline before disease onset. We summarized 28 epidemiological studies (8 cross-sectional and 20 cohort studies) and 55 trials in this review. Preliminary evidence from epidemiological data provides the necessity for intervention trials, even though the measures of polyphenol intake tend to be less precise. Clinical trials are in favor of the role of some polyphenols in benefiting specific domains of cognition. This review also describes the divergence of results and current limitations of research in this field.
R. Otsuka ; S. Zhang ; C. Tange ; Y. Nishita ; M. Tomida ; K. Kinoshita ; Y. Kato ; F. Ando ; H. Shimokata ; H. Arai (2021): Association of Dietary Intake with the Transitions of Frailty among Japanese Community-Dwelling Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.42
COMPARISON OF AGREEMENT BETWEEN SEVERAL DIAGNOSTIC CRITERIA OF SARCOPENIA IN COMMUNITY-DWELLING OLDER ADULTS
N. Sosowska, M. Pig?owska, A. Guligowska, B. So?tysik, T. Kostka
J Frailty Aging 2022;11(1)33-39Show summaryHide summary
Purpose: Several diagnostic algorithms exist to detect sarcopenia in older adults. We compared the prevalence of sarcopenia according to the selected diagnostic algorithms.
Methods: This cross-sectional study compared the European Working Group of Sarcopenia in Older People (EWGSOP) 2010, updated EWGSOP 2019, the Foundation for National Institutes of Health (FNIH) and the International Working Group on Sarcopenia (IWGS) criteria in 778 outpatients of the Geriatric Clinic aged 60 to 89 years. Bioimpedance analysis (BIA) to estimate muscle mass, hand-held hydraulic dynamometer to measure muscle strength, the TUG test and gait speed to assess physical function were used.
Results: The prevalence of sarcopenia varied from 0% to 6.43% depending on the algorithm. For the majority of associations between the different definitions of sarcopenia the agreement was null or fair (Cohen’s kappa between 0.2 and 0.4). Moderate agreement (Cohen’s kappa between 0.4 and 0.6) was found for only three relationships. Nevertheless, for these three relationships, McNemar’s test has given different results, indicating that even in the moderately agreeing algorithms, the shared diagnoses of sarcopenia concerned only part of subjects.
Conclusions: According to diagnostic algorithms the prevalence of sarcopenia is low in independent community-dwelling older adults. The agreement between the different definitions is poor.
N. Sosowska ; M. Pigłowska ; A. Guligowska ; B. Sołtysik ; T. Kostka (2021): Comparison of Agreement between Several Diagnostic Criteria of Sarcopenia in Community-Dwelling Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.13
BODY COMPOSITION ACROSS THE ADULT LIFESPAN IN AFRICAN CARIBBEAN MEN: THE TOBAGO LONGITUDINAL STUDY OF AGING
A.J. Santanasto, I. Miljkovic, R.K. Cvejkus, R.M. Boudreau, .W. Wheeler, J.M. Zmuda
J Frailty Aging 2022;11(1)40-44Show summaryHide summary
Body composition and muscle strength change vary by age and ethnicity, and have a major impact on health and physical function. Little is known about the patterns of these changes in African-ancestry populations. Herein, we examined age-specific (5-year age groups) rates-of-change in lean and fat mass in 1918 African-ancestry men on the Caribbean island of Tobago (baseline age: 62.0±11.8 years, range: 40-99 years). Body composition (DXA) and grip strength were measured at three time points (baseline, 4- and 9-year follow-up). Annualized rates of change were calculated with all 3 time-points using Generalized Estimating Equations. We found that whole body lean mass declined at constant rate until age 65 (-0.72%/year; 95% CI: -0.76, -0.67), which accelerated to -0.92 %/year (-1.02, -0.82) among those 65-69, and again to -1.16 %/year (-1.30, -1.03 ) among those aged 70+. Whole body fat mass increased by a near constant rate of 2.93 %/year (2.72, 3.15%) across the lifespan. Finally, grip strength decline accelerated at age 50, and about 2x faster than lean mass through the lifespan after the age of 50. To conclude, in African-Caribbean men, the acceleration in muscle strength decline precedes the acceleration in lean mass decline by 10-15 years, suggesting decrements in factors other than lean mass drive this initial acceleration in muscle strength decline. We also found that African-Caribbean men undergo a constant shift to a more adipogenic phenotype throughout the adult lifespan (aged 40-99), which likely contributes to age-related loss of muscle and physical function.
A.J. Santanasto ; I. Miljkovic ; R.K. Cvejkus ; R.M. Boudreau ; V.W. Wheeler ; J.M. Zmuda (2021): Body Composition Across the Adult Lifespan in African Caribbean Men: The Tobago Longitudinal Study of Aging. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.47
FRUIT AND VEGETABLE CONSUMPTION AND INCIDENT FRAILTY IN OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
G. Kojima, Y. Taniguchi, T. Urano
J Frailty Aging 2022;11(1)45-50Show summaryHide summary
Background: There is limited evidence regarding associations between fruit and vegetable consumption and incident frailty risk among older people.
Objectives: The objective of this study was to conduct a systematic review and meta-analysis regarding the association between fruit and vegetable consumption and incident frailty risk among older adults.
Methods: A systematic search of the literature was conducted according to the PRISMA guidelines using PubMed in January 2021 for studies that prospectively examined risk of incident frailty in relation to fruit and vegetable consumption in older adults aged 60 and older. Methodological quality and heterogeneity were assessed. Odds ratios (OR) were pooled using random-effects or fixed-effects meta-analysis, depending on the presence of heterogeneity.
Results: Among three studies included in this review, data of four cohorts were provided by two studies and used in meta-analysis. The highest fruit and vegetable consumption was significantly associated with lower risk of incident frailty compared with the lowest consumption (pooled OR=0.38, 95%CI=0.24-0.59, p=<0.001).
Conclusions: This study provided the pooled evidence that high fruit and vegetable consumption may be beneficial for preventing the development of frailty in older adults. Increasing fruit and vegetable consumption can be a relevant strategy to prevent frailty.
G. Kojima ; Y. Taniguchi ; T. Urano (2021): Fruit and Vegetable Consumption and Incident Frailty in Older Adults: A Systematic Review and Meta-Analysis. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.32
SARCOPENIC OBESITY AND DEPRESSION: A SYSTEMATIC REVIEW
I. Pilati, A. Slee, R. Frost
J Frailty Aging 2022;11(1)51-58Show summaryHide summary
Background: Sarcopenic obesity (SO) is a condition combining two important public health issues commonly seen amongst older individuals, obesity and sarcopenia. Depressive symptoms are common among older people, whose population is increasing worldwide. Obesity and sarcopenia alone, are clearly associated with depression while the coexistence of these two conditions (SO) upon depressive disorders is currently unclear. We aimed to systematically review the association between primary SO and depressive disorders.
Methods: Searches were run on MEDLINE, EMBASE, PsycINFO, and CINAHL (inception to June 2019). One reviewer screened titles, abstracts, and full-texts, with 10% checked independently by a second reviewer. Cohort and cross-sectional studies were included. Two reviewers independently assessed risk of bias using the Mixed Methods Appraisal Tool. Results were narratively synthesised.
Results: Out of the 7 studies eligible for inclusion, evidence of sarcopenic obesity as a predictor of depressive symptoms was found in two studies. The main observed trend was that diagnosing sarcopenia using muscle strength led to significant associations between sarcopenic obesity and depressive symptoms. Two cross-sectional studies found a significant association between SO and depressive symptoms, whilst three others found no statistically significant associations. All possessed some methodological limitations.
Discussion: This is the first review to systematically examine a potential relationship between sarcopenic obesity and depressive disorders. Currently, the results are heterogeneous due to the large variability in assessment methods and outcome measurements. Future longitudinal studies would achieve greater confidence in the provisional conclusion that sarcopenic obesity, when measured using muscle strength, is associated with depressive symptoms.
I. Pilati ; A. Slee ; R. Frost (2021): Sarcopenic Obesity and Depression: A Systematic Review. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.39
FRAILTY IN CAREGIVERS AND ITS RELATIONSHIP WITH PSYCHOLOGICAL STRESS AND RESILIENCE: A CROSS-SECTIONAL STUDY BASED ON THE DEFICIT ACCUMULATION MODEL
M. Canevelli, F.S. Bersani, F. Sciancalepore, M. Salzillo, M. Cesari, L. Tarsitani, M. Pasquini, S. Ferracuti, M. Biondi, G. Bruno
J Frailty Aging 2022;11(1)59-66Show summaryHide summary
Background: Studies increasingly suggest that chronic exposure to psychological stress can lead to health deterioration and accelerated ageing, thus possibly contributing to the development of frailty. Recent approaches based on the deficit accumulation model measure frailty on a continuous grading through the “Frailty Index” (FI), i.e. a macroscopic indicator of biological senescence and functional status.
OBJECTIVES: The study aimed at testing the relationship of FI with caregiving, psychological stress, and psychological resilience.
DESIGN: Cross-sectional study, with case-control and correlational analyses.
PARTICIPANTS: Caregivers of patients with dementia (n=64), i.e. individuals a priori considered to be exposed to prolonged psychosocial stressors, and matched controls (n=64) were enrolled.
MEASUREMENTS: The two groups were compared using a 38-item FI condensing biological, clinical, and functional assessments. Within caregivers, the association of FI with Perceived Stress Scale (PSS) and Brief Resilience Scale (BRS) was tested.
RESULTS: Caregivers had higher FI than controls (F=8.308, p=0.005). FI was associated directly with PSS (r=0.660, p<0.001) and inversely with BRS (r=-0.637, p<0.001). Findings remained significant after adjusting for certain confounding variables, after excluding from the FI the conditions directly related to psychological stress, and when the analyses were performed separately among participants older and younger than 65 years.
CONCLUSIONS: The results provide insight on the relationship of frailty with caregiving, psychological stress, and resilience, with potential implications for the clinical management of individuals exposed to chronic emotional strain.
M. Canevelli ; F.S. Bersani ; F. Sciancalepore ; M. Salzillo ; M. Cesari ; L. Tarsitani ; M. Pasquini ; S. Ferracuti ; M. Biondi ; G. Bruno ; (2021): Frailty in Caregivers and Its Relationship with Psychological Stress and Resilience: A Cross-Sectional Study Based on the Deficit Accumulation Model. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.29
ASSOCIATION OF PATIENT REPORTED GLOBAL HEALTH MEASURES WITH FRAILTY SCORES IN ACUTELY INJURED OLDER ADULTS
S. Tejiram, C. Galet, J. Cartwright, V.H. Hatcher, D.A. Skeete, C. Cocanour, K.S. Romanowski
J Frailty Aging 2022;11(1)67-73Show summaryHide summary
Purpose: The older population is particularly vulnerable to traumatic injury. Frailty scores, used to estimate the physiologic status of an individual, are key to identifying those most at risk for injury. Global health measures such as the Veterans RAND 12 Item Health Survey (VR-12) are quality of life measures that assess older adults’ overall perception of their health and may serve as a useful adjunct when predicting frailty. Herein, we evaluated whether components of the VR-12 correlated with worse frailty scores over time.
Methods: Older adults (≥65) admitted to burn, trauma, or emergency general surgery services were prospectively enrolled. Demographics, frailty determined using the Trauma Specific Frailty Index (TSFI), and VR-12 surveys were collected at enrollment and 3, 6, 9, and 12-month follow-ups. A physical component score (PCS) and mental component score (MCS) was produced by VR-12 surveys for comparison purposes.
Results: Fifty-eight patients were enrolled, of which 8 died. No significant changes in PCS (p = 0.25) and MCS (p = 0.56) were observed over time. PCS (p = 0.97) and MCS (p = 0.78) at enrollment did not predict mortality. PCS (OR = 0.894 [0.84-0.95], p = 0.0004) and age (OR = 1.113 [1.012-1.223], p = 0.03) independently predicted enrollment frailty.
Conclusion: These global measures of health could be utilized in lieu or in addition to frailty scores when assessing patients in the setting of acute injury. Studies are warranted to confirm this association.
S. Tejiram ; C. Galet ; J. Cartwright ; V.H. Hatcher ; D.A. Skeete ; C. Cocanour ; K.S. Romanowski (2021): Association of Patient Reported Global Health Measures with Frailty Scores in Acutely Injured Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.25
A BEHAVIORAL LIFESTYLE INTERVENTION TO IMPROVE FRAILTY IN OVERWEIGHT OR OBESE OLDER ADULTS WITH TYPE 2 DIABETES: A FEASIBILITY STUDY
R. Jiwani, J. Wang, C. Li, B. Dennis, D. Patel, J. Gelfond, Q. Liu, N. Siddiqui, C. Bess, S. Monk, M. Serra, S. Espinoza
J Frailty Aging 2022;11(1)74-82Show summaryHide summary
Background: Older adults with Type 2 diabetes (T2D) are more likely to be frail, which increases the risk for disability and mortality.
Objectives: To determine the feasibility of a behavioral lifestyle intervention, enhanced with mobile health technology for self-monitoring of diet and activity, to improve frailty in overweight/obese older adults (≥65 years) diagnosed with T2D.
Design, Setting, and Participants: Single arm, 6-month study of a behavioral lifestyle intervention in 20 overweight/obese (BMI>25) older adults (≥ 65 years) with self-reported T2D diagnosis who owned a smartphone. A Fitbit tracker was provided to all participants for self-monitoring of diet and physical activity. Our primary outcome of feasibility was measured by session attendance, adherence to Fitbit usage to self-monitor diet and physical activity, and study retention. Secondary outcomes included the preliminary efficacy of the intervention on frailty, physical function, quality of life, and T2D-related outcomes.
Results: Eighteen participants completed the study. The mean age was 71.5 (SD ± 5.3) years, 56% were female, and half were Hispanic. At baseline, 13 (72%) were pre-frail, 4 (22%) were frail, and 1 (6%) were non-frail. At follow-up, frailty scores improved significantly from 1.61 ± 1.15 to 0.94 ± 0.94 (p=0.01) and bodyweight improved from 205.66 ± 45.52 lbs. to 198.33 ± 43.6 lbs. (p=<0.001).
Conclusion: This study provides evidence for the feasibility of a behavioral lifestyle intervention in overweight/obese older adults with T2D and preliminary results support its potential efficacy in improving frailty score.
R. Jiwani ; J. Wang ; C. Li ; B. Dennis ; D. Patel ; J. Gelfond ; Q. Liu ; N. Siddiqui ; C. Bess ; S. Monk ; M. Serra ; S. Espinoza ; (2021): A Behavioral Lifestyle Intervention to Improve Frailty in Overweight or Obese Older Adults with Type 2 Diabetes: A Feasibility Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.17
MECHANISMS OF MUSCULOSKELETAL FRAILTY IN PEOPLE LIVING WITH HIV
A.K. Nelson, G. Fiskum, C. Renn, S. Zhu, S. Kottilil, N.J. Klinedinst
J Frailty Aging 2022;11(1)83-90Show summaryHide summary
People over age 50 living with HIV experience frailty including functional declines and illnesses usually attributed to aging, more frequently and ten years earlier than people without HIV. As the number of people living with HIV over age 50 is expected to triple by the year 2040, those experiencing early frailty will continue to grow. This review synthesizes the known correlates and contributors to musculoskeletal frailty in people living with HIV. A conceptual model of musculoskeletal frailty in HIV that outlines chronic inflammation, altered energy metabolism, immune activation, and endocrine alterations as mechanisms associated with frailty development is presented. Additionally, the potential ability of aerobic exercise to modify the risk of frailty is highlighted as an important intervention.
A.K. Nelson ; G. Fiskum ; C. Renn ; S. Zhu ; S. Kottilil ; N.J. Klinedinst (2021): Mechanisms of Musculoskeletal Frailty in People Living with HIV. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.44
EFFECTIVENESS OF A WEIGHT-LOSS INTERVENTION IN PREVENTING FRAILTY AND FUNCTIONAL DECLINE IN COMMUNITYDWELLING OBESE OLDER PEOPLE. A RANDOMIZED CONTROLLED TRIAL
M. Serra-Prat, M. Terradellas, I. Lorenzo, M. Arús, E. Burdoy, A. Salietti, S. Ramírez, E. Palomera, M. Papiol, E. Pleguezuelos
J Frailty Aging 2022;11(1)91-99Show summaryHide summary
Background: Obesity is a risk factor for frailty and muscle weakness, so weight loss in obese older adults may prevent frailty and functional decline.
Objective: To assess the safety and efficacy of a multimodal weight-loss intervention in improving functional performance and reducing frailty risk in obese older adults.
Design: Randomized controlled trial with 2 parallel arms.
Setting and participants: Community-dwelling obese adults aged 65-75 years with body mass index (BMI) 30-39 kg/m2.
Intervention: 6-month multimodal intervention based on diet and a physical activity program. Control group: Usual care.
Main and secondary outcome measures: Frailty (Fried criteria) rate and functional performance at 6, 12, and 24 months of follow-up, respectively.
Intermediate outcome measures: Weight loss, body composition changes, and metabolic and inflammatory biomarker changes.
Results: N=305. The study intervention increased gait speed at 12 and 24 months of follow-up, but had no significant effect on frailty prevention. It was effective in reducing weight, BMI, fat mass, interleukin 6, and insulin resistance and improving self-reported quality of life.
Conclusions: The study intervention was not demonstrated to be effective in preventing frailty in obese people aged 65-75 years at 24 months of follow-up. However, it allowed weight loss and a reduction in inflammatory and insulin resistance markers, which could have a long-term effect on frailty that requires further research.
M. Serra-Prat ; M. Terradellas ; I. Lorenzo ; M. Arús ; E. Burdoy ; A. Salietti ; S. Ramírez ; E. Palomera ; M. Papiol ; E. Pleguezuelos (2021): Effectiveness of a Weight-Loss Intervention in Preventing Frailty and Functional Decline in Community-Dwelling Obese Older People. A Randomized Controlled Trial. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.38
EFFECTS OF TIMING OF MEDIUM-CHAIN TRIGLYCERIDES (8:0 AND 10:0) SUPPLEMENTATION DURING THE DAY ON MUSCLE MASS, FUNCTION AND COGNITION IN FRAIL ELDERLY ADULTS
S. Abe, O. Ezaki, M. Suzuki
J Frailty Aging 2022;11(1)100-108Show summaryHide summary
Objectives: Supplementation with 6 g/day of medium-chain triglycerides (MCTs) at dinnertime increases muscle function and cognition in frail elderly adults relative to supplementation with long-chain triglycerides. However, suitable timing of MCT supplementation during the day is unknown.
Design: We enrolled 40 elderly nursing home residents (85.9 ± 7.7 years) in a 1.5-month randomized intervention trial. Participants were randomly allocated to two groups: one received 6 g/day of MCTs at breakfast (breakfast group) as a test group and the other at dinnertime (dinner group) as a positive control group.
Measurements: Muscle mass, strength, function, and cognition were monitored at baseline and 1.5 months after initiation of intervention.
Results: Thirty-seven participants completed the study and were included in the analysis. MCT supplementation in breakfast and dinner groups respectively increased right arm muscle area from baseline by 1.1 ± 0.8 cm2 (P<0.001) and 1.6 ± 2.5 cm2 (P<0.001), left arm muscle area by 1.1 ± 0.7 cm2 (P<0.001) and 0.9 ± 1.0 cm2 (P<0.01), right knee extension time by 39 ± 42 s (P<0.01) and 20 ± 32 s (P<0.05), leg open and close test time by 1.74 ± 2.00 n/10 s (P<0.01) and 1.67 ± 2.01 n/10 s (P<0.01), and Mini-Mental State Examination score by 1.5 ± 3.0 points (P=0.06) and 1.0 ± 2.1 points (P=0.06). These increases between two groups did not differ statistically significantly.
Conclusion: Supplementation with 6 g MCTs/day for 1.5 months, irrespective of ingestion at breakfast or dinnertime, could increase muscle mass and function, and cognition in frail elderly adults.
S. Abe ; O. Ezaki ; M. Suzuki (2021): Effects of Timing of Medium-Chain Triglycerides (8:0 and 10:0) Supplementation during the Day on Muscle Mass, Function and Cognition in Frail Elderly Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.33
IMPACT OF FRAILTY ON DIETARY HABITS AMONG COMMUNITYDWELLING OLDER PERSONS DURING THE COVID-19 PANDEMIC IN JAPAN
K. Kinoshita, S. Satake, H. Arai
J Frailty Aging 2022;11(1)109-114Show summaryHide summary
Background: The coronavirus disease (COVID-19) pandemic has resulted in reduced physical activity and social interaction. These restrictions may have affected the food intake habits of frail older people more than non-frail older people.
Objectives: To investigate the association between frailty and change in dietary habit during the pandemic.
Design: Cross-sectional mail survey
Participants: The study questionnaire was mailed to 4,436 older residents of Higashiura, Aich Japan, who were aged ≥75 years and who did not need care as of April 1, 2020. Of these, 2,738 participants provided complete answers to the questionnaires (75–96 years old, 49.3% males).
Measurements: The participants’ frailty status and changes in food consumption during social isolation were assessed. Frailty status was assessed using the five-item frailty screening index (i.e., weight loss, low physical function, low physical activity, cognition, and exhaustion). Any participant who reported an increase or a decrease in ≥1 of the 12 food categories was defined as having change in dietary habit. Using multivariate logistic regression analysis, the odds ratios (ORs) and 95% confidence intervals (CIs) of frailty for changes in diet were estimated by adjusting for age, sex, BMI, and living alone. In each of the 12 food categories, the proportion of participants with increased and decreased food intake was compared between the groups.
Results: Among the participants, 470 (17.2%) were frail, and 1,097 (40.1%) experienced a change in dietary habit under social restriction. The adjusted OR (95% CI) of the frail group for a change in dietary habit was 2.01 (1.63–2.47, p<0.001). Participants with decreased consumption of meat, fish, seaweed and mushroom, and fruits and those with increased consumption of eggs, bread, and noodles tended to be frail.
Conclusion: The nutritional intervention for frail older people should be strengthened during the pandemic.
K. Kinoshita ; S. Satake ; H. Arai (2021): Impact of Frailty on Dietary Habits among Community-Dwelling Older Persons during the COVID-19 Pandemic in Japan. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.45
PRONE POSITIONING OF OLDER ADULTS WITH COVID-19: A BRIEF REVIEW AND PROPOSED PROTOCOL
D.E. Brazier, N. Perneta, F.E. Lithander, E.J. Henderson
J Frailty Aging 2022;11(1)115-120Show summaryHide summary
COVID-19 disproportionately affects older people, with higher rates of infection and a higher risk of adverse outcomes. A brief review of literature was undertaken to inform development of a protocol describing the indications and process of prone positioning to aid the management of COVID-19 infection in non-mechanically ventilated, awake older adults. PubMed was searched up to 14th January 2021 to identify English language papers that described prone positioning procedures used in non-mechanically ventilated patients. Data were pooled to inform the development of a prone positioning protocol for use in hospital ward environments. The protocol was trialled and refined during routine clinical practice. Screening of 146 articles yielded five studies detailing a prone positioning protocol. Prone positioning is a potentially feasible and tolerated treatment adjunct for hypoxaemia in older adults with COVID-19. Future studies should further establish the efficacy, safety, and tolerability in respiratory illnesses in non-intensive care settings.
D.E. Brazier ; N. Perneta ; F.E. Lithander ; E.J. Henderson (2021): Prone Positioning of Older Adults with COVID-19: A Brief Review and Proposed Protocol. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.30
Letter to the Editor: Comparison of Risk-Prediction Instruments in Frail Older Patients Diagnosed with COVID-19
R. O’Caoimh, M. O’Donovan, K. McGrath, E. Moloney
J Frailty Aging 2022;11(1)121-122Show summaryHide summary
R. O’Caoimh ; M. O’Donovan ; K. McGrath ; E. Moloney ; (2021): Letter to the Editor: Comparison of Risk-Prediction Instruments in Frail Older Patients Diagnosed with COVID-19. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.26
COMMUNITY GROUP EXERCISE PROGRAM FOR ELDERLY CAN TEMPORARILY SHIFT ONLINE DURING COVID-19 PANDEMIC
M. Kaneko, Y. Yamamoto, N. Ishimaru, M. Shimizu
J Frailty Aging 2022;11(1)123-124Show summaryHide summary
M. Kaneko ; Y. Yamamoto ; N. Ishimaru ; M. Shimizu (2022): Community Group Exercise Program for Elderly Can Temporarily Shift Online during COVID-19 Pandemic. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.1
GOOD HEARING FOR ENSURING HEALTHY AGING
S. Boucher, G. Duval, C. Annweile
J Frailty Aging 2022;11(1)125-126Show summaryHide summary
S. Boucher ; G. Duval ; C. Annweiler (2021): Good Hearing for Ensuring Healthy Aging. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.19