04/2022 journal articles
EDITORIAL: RESILIENCE AND THE FUTURE
Reshma A. Merchant, M. Izquierdo, J. Woo, J.E. Morley
J Frailty Aging 2022;11(4)339-341
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CITATION:
Reshma A. Merchant ; M. Izquierdo ; J. Woo ; J.E. Morley ; (2022): Editorial: Resilience and the Future. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.61
RESILIENCE: BIOLOGICAL BASIS AND CLINICAL SIGNIFICANCE - A PERSPECTIVE REPORT FROM THE INTERNATIONAL CONFERENCE ON FRAILTY AND SARCOPENIA RESEARCH (ICFSR) TASK FORCE
M. Cesari, D. Azzolino, N.K. LeBrasseur, H. Whitson, D. Rooks, S. Sourdet, D. Angioni, R.A. Fielding, B. Vellas, Y. Rolland
J Frailty Aging 2022;11(4)342-347
Show summaryHide summaryscientific community in geriatrics and gerontology. Older adults show extremely heterogeneous (and often unpredictable) responses to stressors. Such heterogeneity can (at least partly) be explained by differences in resilience (i.e., the capacity of the organism to cope with stressors). The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met in Boston (MA,USA) on April 20, 2022 to discuss the biological and clinical significance of resilience in older adults. The identification of persons with low resilience and the prompt intervention in this at-risk population may be critical to develop and implement preventive strategies against adverse events. Unfortunately, to date, it is still challenging to capture resilience, especially due to its dynamic nature encompassing biological, clinical, subjective, and socioeconomic factors. Opportunities to dynamically measure resilience were discussed during the ICFSR Task Force meeting, emphasizing potential biomarkers and areas of intervention. This article reports the results of the meeting and may serve to support future actions in the field.
CITATION:
M. Cesari ; D. Azzolino ; N.K. LeBrasseur ; H. Whitson ; D. Rooks ; S. Sourdet ; D. Angioni ; R.A. Fielding ; B. Vellas ; Y. Rolland ; (2022): Resilience: Biological Basis and Clinical Significance - A Perspective Report from the International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.62
SINGAPORE CLINICAL PRACTICE GUIDELINES FOR SARCOPENIA: SCREENING, DIAGNOSIS, MANAGEMENT AND PREVENTION
W.S. Lim, C.Y. Cheong, J.P. Lim, M.M.Y. Tan, J.Q. Chia, N.A. Malik, L. Tay
J Frailty Aging 2022;11(4)348-369
Show summaryHide summaryObjectives: To present the local evidence and final recommendations of the Clinical Practice Guidelines workgroup convened by the Chapter of Geriatricians and the Society for Geriatric Medicine Singapore. The aim is to develop contextualized evidence-based recommendations that facilitate adoption of the Asian Working Group for Sarcopenia (AWGS) 2019 consensus into current practice in Singapore.
Methods: The workgroup drew upon the AWGS’2019 consensus, updated literature review of Singapore studies till 31 Dec 2020, and evidence from recent systematic reviews. From 40 local studies included for data extraction, we constructed evidence tables organized as: definition and epidemiology; diagnosis and evaluation; and treatment and intervention. Twenty recommendations - case-finding, diagnosis, treatment, prevention, research - were developed, and graded for strength and quality using the GRADE approach. Consensus from an expert panel(N=23) was achieved after two rounds of the modified Delphi process.
Results: The local prevalence of sarcopenia among community-dwelling older adults ranged from 13.6% to 25%. Most studies adopted the AWGS’2019 and AWGS’2014 criteria. Reported case finding tools include SARC-F, calf circumference (CC) and SARC-CalF. Gender-specific AWGS cut-offs for appendicular skeletal mass were used to define low muscle mass. Different protocols and dynamometers were used to assess handgrip strength, whilst gait speed and 5-times chair stand were commonly used to assess physical performance.
Recommendations: We conditionally recommend a case-finding approach in at-risk older adults using validated case-finding tools. Screen-positive individuals should be assessed for ‘possible sarcopenia’ and underlying causes. For diagnosis, we conditionally recommend using the AWGS’2019 algorithm, and dual-energy X-ray absorptiometry when necessary to determine low lean mass for a confirmatory diagnosis of sarcopenia. For treatment, we strongly recommend resistance-based exercises and conditionally recommend a quality protein-rich diet/protein supplementation, with Vitamin D supplementation for insufficiency (<30 micrograms/L). For prevention, we recommend regular resistance-based physical activity and adequate protein intake (≥1.0g/kg bodyweight). We encourage more research to address local evidence gaps.
CITATION:
W.S. Lim ; C.Y. Cheong ; J.P. Lim ; M.M.Y. Tan ; J.Q. Chia ; N.A. Malik ; L. Tay ; (2022): Singapore Clinical Practice Guidelines For Sarcopenia: Screening, Diagnosis, Management and Prevention. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.59
FRAILTY STATUS AS A NOVEL RISK STRATIFICATION TOOL IN PATIENTS WITH ACUTE PANCREATITIS
C.J. Acosta, J.A. Barkin, S. Amin
J Frailty Aging 2022;11(4)370-377
Show summaryHide summaryBackground: Although frailty is a known predictor of mortality and complications across various disease states, it remains an understudied topic among patients with acute pancreatitis (AP).
Objectives: Our aim was to assess the impact of frailty on outcomes in patients with AP.
Design: Retrospective cohort study.
Setting: Appended data was obtained from the 2016-2017 National Inpatient Sample (NIS) database.
Participants: 574,895 adult patients with a primary discharge diagnosis of AP.
Measurements: We performed a nationwide cohort study utilizing International Classification of Diseases (ICD) diagnostic codes to identify adult patients with AP. The Hospital Frailty Risk Score (HFRS) was used to classify patients as frail or non-frail. The primary outcome was complications related to AP including all-cause mortality. Secondary outcomes were length of stay and total hospitalization costs. Multivariable logistic regression models were used to determine the association between frailty and complications.
Results: 574,895 patients were represented; 24.7% (141,999) characterized as frail and 75.3% (432,896) as non-frail. 26.7% of frail patients suffered composite complications related to AP versus 13.3% of non-frail patients (P < 0.001). Frail patients had more cardiovascular, pulmonary, gastrointestinal, and infectious adverse events compared to non-frail patients. Frail patients also had higher mortality rates (2.0% vs 0.1% P < 0.001), increased length of stay (6.5 days vs 3.6, P < 0.001) and total hospitalization charges ($60,136 vs $31,095, P < 0.001). On multivariable analysis, positive frailty status was associated with 2.33 times increased odds of having composite complications.
Conclusions: Frailty assessments can be utilized as an adjunct to validated scoring systems to improve risk stratification and clinical management of patients with AP.
CITATION:
C.J. Acosta ; J.A. Barkin ; S. Amin ; (2022): Frailty Status as a Novel Risk Stratification Tool in Patients with Acute Pancreatitis. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.58
FUNCTIONAL LIMITATIONS AMONG EUROPEAN OLDER ADULTS: CROSS-COUNTRY DIFFERENCES IN HEALTH IMPROVEMENTS AND SOCIAL ENVIRONMENT INFLUENCE
S. Rueda-Salazar, J. Spijker, D. Devolder
J Frailty Aging 2022;11(4)378-386
Show summaryHide summaryThis study explores differences on health status transitions based on functional health and dead records among older population in Europe. We also study the influence of residence pattern on health changes over time. Method: Data used came from EU-SILC registers on individuals aged 50 + from 19 countries. Fixed and Mixed effect Cox Proportional Hazards Models are used to ascertain any country differences on health outcomes and then by co-residence pattern. Results: There are remarkable country heterogeneity among older people to experience changes on their health status, specially, for health improvements and mortality risk. As expected, Baltic and Eastern European countries have a higher propensity for health deterioration and Southern European countries for health improvements on their functional capacities. However, there are exceptions as Bulgaria and Romania, which have a lower risk of deterioration and death transition than average. Overall, living with partner and adult children-rather than living only with a couple shown positive effects for older European to experience health improvements with notably differences in Southern countries as in Italy and Spain. Discussion: country framework differences play a fundamental role to understand changes on health status at older ages, in particular, how health care support toward older people is managed by health systems within European countries and the availability of close relatives among older adult population.
CITATION:
S. Rueda-Salazar ; J. Spijker ; D. Devolder ; (2022): Functional Limitations among European Older Adults: Cross-Country Differences in Health Improvements and Social Environment Influence. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.55
PREDICTIVE ABILITIES OF THE FRAILTY PHENOTYPE AND THE SWISS FRAILTY NETWORK AND REPOSITORY FRAILTY INDEX FOR NON-HOME DISCHARGE AND FUNCTIONAL DECLINE IN HOSPITALIZED GERIATRIC PATIENTS
A.K. Stuck, N. Schilling, D. Bertschi, A. Limacher, M. Gagesch, H.A. Bischoff-Ferrari
J Frailty Aging 2022;11(4)387-392
Show summaryHide summaryBackground: Frailty is increasingly applied as a measure to predict clinical outcomes, but data on the predictive abilities of frailty measures for non-home discharge and functional decline in acutely hospitalized geriatric patients are scarce.
Objectives: The aim of this study was to investigate the predictive ability of the frailty phenotype and a frailty index currently validated as part of the ongoing Swiss Frailty Network and Repository Study based on clinical admission data for non-home discharge and functional decline in acutely hospitalized older patients.
Design: Prospective cohort study.
Setting and Participants: Data were analyzed from 334 consecutive hospitalized patients of a tertiary acute care geriatric inpatient clinic admitted between August 2020 and March 2021.
Measurements: We assessed frailty using 1) the frailty phenotype and 2) the Swiss Frailty Network and Repository Study (SFNR) frailty index based on routinely available clinical admission data. Predictive abilities of both frailty measures were analyzed for the clinical outcomes of non-home discharge and functional decline using multivariate logistic regression models and receiver operating characteristic curves (ROC).
Results: Mean age was 82.8 (SD 7.2) years and 55.4% were women. Overall, 170 (53.1%) were frail based on the frailty phenotype and 220 (65.9%) based on the frailty index. Frail patients based on the frailty phenotype were more likely to be discharged non-home (55 (32.4%) vs. 26 (17.3%); adjusted OR 2.4 (95% CI, 1.4, 5.1)). Similarly, frail patients based on the frailty index were more likely to be discharged non-home compared to non-frail patients (76 (34.6%) vs. 9 (7.9%); adjusted OR, 5.5 (95% CI, 2.6, 11.5)). Both, the frailty phenotype and the frailty index were similarly associated with functional decline (adjusted OR 2.7 (95% CI, 1.5, 4.9); adjusted OR 2.8 (95% CI 1.4, 5.5)). ROC analyses showed best discriminatory accuracy for the frailty index for non-home discharge (area under the curve 0.76).
Conclusions: Frailty using the SFNR-frailty index and the frailty phenotype is a promising measure for prediction of non-home discharge and functional decline in acutely hospitalized geriatric patients. Further study is needed to define the most valid frailty measure.
CITATION:
A.K. Stuck ; N. Schilling ; D. Bertschi ; A. Limacher ; M. Gagesch ; H.A. Bischoff-Ferrari (2022): Predictive Abilities of the Frailty Phenotype and the Swiss Frailty Network and Repository Frailty Index for Non-Home Discharge and Functional Decline in Hospitalized Geriatric Patients. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.44
PHYSICAL FRAILTY AND HEMOGLOBIN-TORED CELL DISTRIBUTION WIDTH RATIO IN JAPANESE OLDER OUTPATIENTS
K. Kinoshita, S. Satake, K. Murotani, M. Takemura, Y. Matsui, H. Arai
J Frailty Aging 2022;11(4)393-397
Show summaryHide summaryThe Frailty screening should be widely performed; however, simple and inexpensive biomarkers are missing. Biomarkers that can be routinely assessed in many patients are desirable. Recently, the hemoglobin-to-red cell distribution width ratio (Hb/RDW, HRR) has been suggested as a new prognostic marker and has been reported to be associated with inflammation, one of the factors contributing to frailty. Therefore, we aimed to address the role of HRR in frailty among 557 older outpatients (aged 65–96 years). Frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria, and HRR was calculated from clinical records. Participants were classified into five groups based on a sex-stratified quintile of HRR (Q1–Q5). Of the participants, 20.3% were frail. Using multiple logistic regression models with the Q5 group as a reference, after adjusting for sex, age, body mass index, polypharmacy, pre-orthopedic surgery, and the use of iron medications, the multivariable-adjusted odds ratios (95% confidence intervals) of the Q4 to Q1 groups were 0.92 (0.58–1.47), 1.04 (0.67–1.61), 1.29 (0.84–1.96), and 1.85 (1.22–2.82), respectively, indicating that a lower HRR was significantly associated with frailty. The robustness of these results was also shown in the multiple imputation analysis. The results suggest that HRR measurement may be one of the indicators to identify frail older adults in routine practice.
CITATION:
K. Kinoshita ; S. Satake ; K. Murotani ; M. Takemura ; Y. Matsui ; H. Arai (2022): Physical Frailty and Hemoglobin-to-Red Cell Distribution Width Ratio in Japanese Older Outpatients. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.49
SOCIOECONOMIC DISADVANTAGE IS ASSOCIATED WITH PROBABLE SARCOPENIA IN COMMUNITY-DWELLING OLDER ADULTS: FINDINGS FROM THE ENGLISH LONGITUDINAL STUDY OF AGEING
L. Swan, A. Warters, M. O’Sullivan
J Frailty Aging 2022;11(4)398-406
Show summaryHide summaryBackground: Sarcopenia is characterized by the accelerated loss of muscle strength, mass, and function in aging. The disease is a major public health issue with emerging evidence of a disproportionate burden in areas of socioeconomic disadvantage.
Objectives: To estimate the prevalence of probable sarcopenia overall, and according to Socioeconomic Position (SEP). To explore the association between markers of SEP and probable sarcopenia.
Design: Cross-sectional analysis of the English Longitudinal Study of Ageing data.
Setting: England, United Kingdom (UK).
Participants: This study comprised 6,052 older adult participants from Wave 6 of the English Longitudinal Study of Ageing (ELSA) aged 60 years and older.
Measurements: Probable sarcopenia was identified by the EWGSOP2 guidelines as low hand grip strength (females <16kg and males <27kg) or poor chair rise test performance (completion of 5 chair rises >15 seconds). Socioeconomic position was defined by educational attainment and subjective social status (SSS). Weighted multivariable regression analysis was employed to identify determinants of probable sarcopenia.
Results: Over one-third of older adults met the criteria for probable sarcopenia (33.7%; weighted, 36.1%) in the study population of mean age 70.7 (SD 7.7) years. When examined by SEP, the prevalence of probable sarcopenia was over 2-fold higher in adults in the most vs the least disadvantaged SEP groups (47.0% vs 20.6%, respectively, p<0.001). Multivariable regression analysis identified disadvantaged SEP, as measured by educational attainment and SSS, as independent predictors of probable sarcopenia, along with older age, physical inactivity, underweight BMI, chronic conditions, osteoarthritis, and minority group ethnicity.
Conclusions: Disadvantaged SEP was associated with an increased likelihood of probable sarcopenia when controlled for other known risk factors. The findings suggest a need and opportunity for sarcopenia prevention and treatment strategies to address socioeconomic disadvantage in policies and practice.
CITATION:
L. Swan ; A. Warters ; M. O’Sullivan ; (2022): Socioeconomic Disadvantage is Associated with Probable Sarcopenia in Community-Dwelling Older Adults: Findings from the English Longitudinal Study of Ageing. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.32
EFFECTS OF TRADITIONAL CHINESE EXERCISES ON FRAILTY, QUALITY OF LIFE, AND PHYSICAL FUNCTION ON FRAIL AND PRE-FRAIL OLDER PEOPLE: A SYSTEMATIC REVIEW AND META-ANALYSIS
X. Wan, J. Shen, G. He
J Frailty Aging 2022;11(4)407-415
Show summaryHide summaryPURPOSE: To explore the effects of traditional Chinese exercises (TCEs) on the frailty status, quality of life, and physical function of frail and pre-frail older adults.
Methods: Eight databases were searched from inception to March 28, 2022. Methodological quality and heterogeneity were assessed. Mean difference (MD) or standardized MD (SMD) were pooled using random-effects or fixed-effects meta-analysis, depending on heterogeneity.
Results: A total of 12 articles were included. Results showed relieved frailty status of frail and pre-frail older adults (SMD = −1.46; 95% CI [−2.39, −0.53]; p < 0.01); quality of life improved (SMD = 0.91, 95% CI [0.19, 1.63]; p < 0.01); grip strength enhanced doing Badaunjin (MD = 2.51, 95% CI [1.09, 3.93]; p < 0.01), but no significant improvement with Taichi (MD = 0.10, 95% CI [−2.3,2.5]; p = 0.93); dynamic balance ability improved (MD = −2.57, 95% CI [−2.90, −2.25], p < 0.01); 4.5-m walking time shortened (MD = −0.95; 95% CI [−1.70, −0.20]; p < 0.001); gait speed improved (MD = 0.04; 95% CI [0.01, 0.07]; p = 0.003); lower body endurance increased (MD = 33.78; 95% CI [10.99, 56.68]; p = 0.004); Lower limb flexibility improved (SMD = −2.07; 95% CI [−2.94, −1.21]; p < 0.01).
Conclusions: This study showed that TCEs may be helpful in alleviating frailty status and improving the quality of life and physical functions of frail and pre-frail older adults. Lastly, additional high-quality clinical trials are warranted despite the limited strong evidence.
CITATION:
X. Wan ; J. Shen ; G. He ; (2022): Effects of Traditional Chinese Exercises on Frailty, Quality of Life, and Physical Function on Frail and Pre-Frail Older People: A Systematic Review and Meta-Analysis. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.52
EXPLORING THE RELATIONSHIP BETWEEN FALLS IN LONG TERM CARE AND PSYCHOACTIVE PRESCRIBING
L.D. Hughes
J Frailty Aging 2022;11(4)416-419
Show summaryHide summaryAlmost half of patients of nursing home residents experience one fall per year. Falls have associated significant morbidity and mortality, and a proportion of falls can be deemed avoidable. There are a variety of risk factors associated with falls, many of which are not modifiable. There has been increasing focus upon the relationship between psychotropic medications and falls as this is seen a potentially modifiable risk factor. This article reviews some of the clinical challenges about balancing falls risk mitigation strategies with the management of behavioral and psychological symptoms of dementia.
CITATION:
L.D. Hughes ; (2022): Exploring the Relationship between Falls in Long Term Care and Psychoactive Prescribing. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.53
DOES ZOLEDRONIC ACID IMPROVE APPENDICULAR LEAN MASS IN OLDER WOMEN WITH OSTEOPOROSIS? A SUB-ANALYSIS OF A RANDOMIZED CLINICAL TRIAL
N.S. Haeri, S. Perera, S.L. Greenspan
J Frailty Aging 2022;11(4)420-425
Show summaryHide summaryBackground: Coexistence of osteoporosis and sarcopenia (osteosarcopenia), is associated with increased risk for fractures, falls, and mortality. Although there are multiple medications for management of osteoporosis, there are no approved pharmacotherapy for sarcopenia.
Objectives: We examined the effect of zoledronic acid on muscle mass indices including ALM (Appendicular Lean Mass) and ALM/Height2 in a cohort of older women with osteoporosis who were residents of Long-Term Care Communities (LTCCs).
Design: A secondary analysis of a 2-year double-blind, randomized, placebo-controlled clinical trial.
Setting: Residents of LTCCs.
Participants: Sixty-two postmenopausal women with osteoporosis.
Intervention: Participants either received 5 mg infusion of zoledronic acid or placebo, once at the start of the study.
Measurements: Participant’s ALM/Height2, ALM, total hip BMD (Bone Mineral Density) and spine BMD were measured in 6, 12 and 24 months.
Results: On average, participants were 86.7 years old and had a BMI of 27.4 kg/m2. There was no significant difference in change from baseline (mean ± SE) between the treatment group and the placebo group in ALM/Height2: (-0.15 vs -0.02, p = 0.541) and (-0.17 vs 0.001, p = 0.315) and (-0.29 vs -0.19, p = 0.646) or ALM: (-0.38 vs -0.09, p = 0.455) and (-0.45 vs -0.005, p = 0.216) and (-0.70 vs -0.48, p = 0.553) at 6, 12, and 24 months respectively. In addition, after adjusting for a possible confounding, the ALM/Height2 or ALM did not have significant improvements from baseline at 6 months, 12 months, and 24 months either in the treatment group or in the placebo group. However, there were significant improvements in the BMD at the total hip and the spine in the treatment group compared with the placebo group at all three time points.
Conclusions: Among older women residing in LTCCs, a single dose of zoledronic acid did not increase ALM/Height2 and ALM, despite improving the BMD at the total hip and the spine at the 2-year follow-up.
CITATION:
N.S. Haeri ; S. Perera ; S.L. Greenspan ; (2022): Does Zoledronic Acid Improve Appendicular Lean Mass in Older Women with Osteoporosis? A Sub-Analysis of a Randomized Clinical Trial. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.54
EFFECT OF A 12-WEEK MIXED TRAINING ON BODY QUALITY IN PEOPLE LIVING WITH HIV: DOES AGE AND HIV DURATION MATTER?
F. Buckinx, J. Granet, A. Bass, N. Kaur, L.K. Fellows, M.-J. Brouillette, N. Mayo, M. Aubertin-Leheudre
J Frailty Aging 2022;11(4)426-433
Show summaryHide summaryBackground: The impact of HIV duration on exercise adaptations has not yet been studied. Moreover, the age at which subjects living with HIV are the most responsive to exercise is not clear.
Aims: Investigate the effect of a mixed exercise training program on physical performance changes in individuals living with HIV and explore if age or HIV duration influence these adaptations in men.
Methods: In this feasibility study, participants followed a 12-week mixed exercise training program, three times/week, 45 min/session. Physical performance including functional capacities (normal 4-m walking test, 6min walking test), grip strength (hand dynamometer), muscle power, body composition (android and gynoid fat masses, appendicular lean mass) were evaluated pre- and post-intervention. Subgroup analysis according to the median age of the participants (age<50yrs vs. age≥50yrs) and median HIV duration (HIV<20yrs vs. HIV≥20yrs) were performed in men.
Results: A total of 27 participants (age: 54.5±6.8yrs, men: 85%; HIV duration: 19.3±7.6yrs) were included. At the end of the intervention, significant increases compared to baseline were seen in grip strength (p=0.017), leg power (p<0.001), normal walking speed (p<0.001) and 6-min walking distance (p=0.003). Following the intervention, parameters improved similarly in both age groups. However improvement was greater in those with HIV>20yrs than those with a shorter infection duration, with change (%) on total (p<0.001), android (p=0.02), and gynoid (p=0.05) fat masses as well as appendicular lean mass index (p=0.03).
Conclusion: Mixed exercise training seems to be an effective intervention to improve physical performance in individuals living with HIV. In addition, this study suggests that neither age nor HIV duration has influence on the effect of mixed training in this population.
CITATION:
F. Buckinx ; J. Granet ; A. Bass ; N. Kaur ; L.K. Fellows ; M.-J. Brouillette ; N. Mayo ; M. Aubertin-Leheudre ; ; (2022): Effect of a 12-Week Mixed Training on Body Quality in People Living with HIV: Does Age and HIV Duration Matter?. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.56
LETTER TO THE EDITOR: A FRAILTY FRAMEWORK FOR DEMENTIA
T. Daly
J Frailty Aging 2022;11(4)434-435
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CITATION:
T. Daly ; (2022): A Frailty Framework for Dementia. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.46
LETTER TO THE EDITOR: DOES HIGHER PREVALENCE OF FRAILTY IN GREEK OLDER COMMUNITY-DWELLING WOMEN ALSO RELATE TO HIGHER PREVALENCE OF PERCEIVED FINANCIAL EXPLOITATION? A NEW QUESTION TO PONDER UPON
V. Giannouli
J Frailty Aging 2022;11(4)436-437
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CITATION:
V. Giannouli ; (2022): Letter to the Editor: Does Higher Prevalence of Frailty in Greek Older Community-dwelling Women also Relate to Higher Prevalence of Perceived Financial Exploitation? A New Question to Ponder Upon. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.57