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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

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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.

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IDENTIFYING BIOMARKERS FOR BIOLOGICAL AGE: GEROSCIENCE AND THE ICFSR TASK FORCE

N.K. LeBrasseur, R. de Cabo, R. Fielding, L. Ferrucci, L. Rodriguez-Manas, J. Viña, B. Vellas

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The International Conference on Frailty and Sarcopenia Research Task Force met in March 2020, in the shadow of the COVID-19 pandemic, to discuss strategies for advancing the interdisciplinary field of geroscience. Geroscience explores biological mechanisms of aging as targets for intervention that may delay the physiological consequences of aging, maintain function, and prevent frailty and disability. Priorities for clinical practice and research include identifying and validating a range of biomarkers of the hallmarks of aging. Potential biomarkers discussed included markers of mitochondrial dysfunction, proteostasis, stem cell dysfunction, nutrient sensing, genomic instability, telomere dysfunction, cellular senescence, and epigenetic changes. The FRAILOMICS initiative is exploring many of these through various omics studies. Translating this knowledge into new therapies is being addressed by the U.S. National Institute on Aging Translational Gerontology Branch. Research gaps identified by the Task Force include the need for improved cellular and animal models as well as more reliable and sensitive measures.

CITATION:
N.K. LeBrasseur ; R. de Cabo ; R. Fielding ; L. Ferrucci ; L. Rodriguez-Manas ; J. Viña ; B. Vellas (2021): Identifying Biomarkers for Biological Age: Geroscience and the ICFSR Task Force. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.5

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MULTICOMPONENT EXERCISE PROGRAM IN OLDER ADULTS WITH LUNG CANCER DURING ADJUVANT/PALLIATIVE TREATMENT: A SECONDARY ANALYSIS OF AN INTERVENTION STUDY

N. Martínez-Velilla, M.L. Saez de Asteasu, R. Ramírez-Vélez, I.D. Rosero, A. Cedeño-Veloz, I. Morilla, R.V. García, F. Zambom-Ferraresi, A. García-Hermoso, M. Izquierdo

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Background: Lung cancer is the second most prevalent common cancer in the world and predominantly affects older adults. This study aimed to examine the impact of an exercise programme in the use of health resources in older adults and to assess their changes in frailty status. Design: This is a secondary analysis of a quasi-experimental study with a non-randomized control group. Setting: Oncogeriatrics Unit of the Complejo Hospitalario de Navarra, Spain. Participants: Newly diagnosed patients with NSCLC stage I–IV. Intervention: Multicomponent exercise programme that combined resistance, endurance, balance and flexibility exercises. Each session lasted 45–50 minutes, and the exercise protocol was performed twice a week over 10 weeks. Measurements: Mortality, readmissions and Visits to the Emergency Department. Change in frailty status according to Fried, VES-13 and G-8 scales. Results: 26 patients completed the 10-weeks intervention (IG). Mean age in the control group (CG) was 74.5 (3.6 SD) vs 79 (3 SD) in the IG, and 78,9% were male in the IG vs 71,4% in the CG. No major adverse events or health-related issues attributable to the testing or training sessions were noted. Significant between-group differences were obtained on visits to the emergency department during the year post-intervention (4 vs 1; p:0.034). No differences were found in mortality rate and readmissions, where an increasing trend was observed in the CG compared with the IG in the latter (2 vs 0; p 0.092). Fried scale was the unique indicator that seemed to be able to detect changes in frailty status after the intervention. Conclusions: A multicomponent exercise training programme seems to reduce the number of visits to the emergency department at one-year post-intervention in older adults with NSCLC during adjuvant therapy or palliative treatment, and is able to modify the frailty status when measured with the Fried scale.

CITATION:
N. Martínez-Velilla ; M.L. Saez de Asteasu ; R. Ramírez-Vélez ; I.D. Rosero ; A. Cedeño-Veloz ; I. Morilla ; R.V. García ; F. Zambom-Ferraresi ; A. García-Hermoso ; M. Izquierdo (2021): Multicomponent exercise program in older adults with lung cancer during adjuvant/palliative treatment: A secondary analysis of an intervention study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.2

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REHABILITATION IN ADULT POST-COVID-19 PATIENTS IN POST-ACUTE CARE WITH THERAPEUTIC EXERCISE

C. Udina, J. Ars, A. Morandi, J. Vilaró, C. Cáceres, M. Inzitari

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COVID-19 patients may experience disability related to Intensive Care Unit (ICU) admission or due to immobilization. We assessed pre-post impact on physical performance of multi-component therapeutic exercise for post-COVID-19 rehabilitation in a post-acute care facility. A 30-minute daily multicomponent therapeutic exercise intervention combined resistance, endurance and balance training. Outcomes: Short Physical Performance Battery; Barthel Index, ability to walk unassisted and single leg stance. Clinical, functional and cognitive variables were collected. We included 33 patients (66.2±12.8 years). All outcomes improved significantly in the global sample (p<0.01). Post-ICU patients, who were younger than No ICU ones, experienced greater improvement in SPPB (4.4±2.1 vs 2.5±1.7, p<0.01) and gait speed (0.4±0.2 vs 0.2±0.1 m/sec, p<0.01). In conclusion, adults surviving COVID-19 improved their functional status, including those who required ICU stay. Our results emphasize the need to establish innovative rehabilitative strategies to reduce the negative functional outcomes of COVID-19.

CITATION:
C. Udina ; J. Ars ; A. Morandi ; J. Vilaró ; C. Cáceres ; M. Inzitari (2021): Rehabilitation in adult post-COVID-19 patients in post-acute care with Therapeutic Exercise. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.1

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LETTER TO THE EDITOR: IT IS IMPORTANT TO EXAMINE PHYSICAL FUNCTIONING AND INFLAMMATORY RESPONSES DURING POST-HOSPITALIZATION COVID-19 RECOVERY

R. McGrath, P.J. Carson, D.A. Jurivich

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CITATION:
R. McGrath ; P.J. Carson ; D.A. Jurivich (2020): Letter to the editor: It is Important to Examine Physical Functioning and Inflammatory Responses During Post-Hospitalization COVID-19 Recovery . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.73

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MUSCLE LOSS IS ASSOCIATED WITH RISK OF ORTHOSTATIC HYPOTENSION IN OLDER MEN AND WOMEN

M.J. Benton, A.L. Silva-Smith, J.M. Spicher

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Background: Muscle provides a reservoir for water to maintain fluid volume and blood pressure, so older adults may be at risk for orthostatic hypotension due to muscle loss with age. Objectives: To evaluate the association between muscle loss with age and postural blood pressure. Design: Longitudinal comparison of overnight changes in hydration, postural blood pressure, and strength. Setting: Community field study. Participants: Sixty-nine men and women (76.0 ± 0.8 years) with low (Low) or normal (Normal) muscle based on the Lean Mass Index. Measurements: Body composition was measured with bioelectrical impedance analysis. Postural blood pressure was measured sequentially (lying, sitting, standing). Strength was measured with a handgrip dynamometer, Arm Curl test, and Chair Stand test. Results: On Day 1, Low had less hydration and a significant drop in postural systolic blood pressure compared to Normal (lying to standing: -11.06 ± 2.36 vs. +1.14 ± 2.20 mmHg, p < 0.001). Overnight, both groups lost significant total body water, while fluid volume was unchanged. On Day 2, both groups experienced significant drops in postural systolic blood pressure, although the drop in Low was more profound and significantly greater than Normal (lying to standing: -16.85 ± 2.50 vs. -3.89 ± 2.52 mmHg, p = 0.001). On both days, Normal compensated for postural changes with increases in postural diastolic blood pressure not observed in Low. Only Low experienced significant overnight decreases in all strength measures. Conclusions: In older men and women, muscle loss with age is accompanied by loss of hydration and less stable early morning postural systolic blood pressure that increase risk for orthostatic hypotension and can also increase risk for falls.

CITATION:
M.J. Benton ; A.L. Silva-Smith ; J.M. Spicher (2020): Muscle Loss is Associated with Risk of Orthostatic Hypotension in Older Men and Women. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.72

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TRENDS IN THE PREVALENCE OF FRAILTY IN JAPAN: A META-ANALYSIS FROM THE ILSA-J

H. MAKIZAKO, Y. NISHITA, S. JEONG, R. OTSUKA, H. SHIMADA, K. IIJIMA, S. OBUCHI, H. KIM, A. KITAMURA, Y. OHARA, S. AWATA, N. YOSHIMURA, M. YAMADA, K. TOBA, T. SUZUKI

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Objective: To examine whether age-specific prevalence of frailty in Japan changed between 2012 and 2017. Design: This study performed meta-analyses of data collected from 2012 to 2017 using the Integrated Longitudinal Studies on Aging in Japan (ILSA-J), a collection of representative Japanese cohort studies. Setting: The ILSA-J studies were conducted on community-living older adults. Participants: ILSA-J studies were considered eligible for analysis if they assessed physical frailty status and presence of frailty in the sample. Seven studies were analyzed for 2012 (±1 year; n = 10312) and eight studies were analyzed for 2017 (±1 year; n = 7010). Five studies were analyzed for both 2012 and 2017. Measurements: The study assessed the prevalence of frailty and frailty status according to 5 criteria: slowness, weakness, low activity, exhaustion, and weight loss.Results: The overall prevalence of physical frailty was 7.0% in 2012 and 5.3% in 2017. The prevalence of frailty, especially in people 70 years and older, tended to decrease in 2017 compared to 2012. Slight decreases were found in the prevalence of frailty subitems including weight loss, slowness, exhaustion, and low activity between 2012 and 2017, but change in the prevalence of weakness was weaker than other components. Conclusions: The prevalence of physical frailty decreased from 2012 to 2017. There are age- and gender-related variations in the decrease of each component of frailty.

CITATION:
H. MAKIZAKO ; Y. NISHITA ; S. JEONG ; R. OTSUKA ; H. SHIMADA ; K. IIJIMA ; S. OBUCHI ; H. KIM ; A. KITAMURA ; Y. OHARA ; S. AWATA ; N. YOSHIMURA ; M. YAMADA ; K. TOBA ; T. SUZUKI (2020): TRENDS IN THE PREVALENCE OF FRAILTY IN JAPAN: A META-ANALYSIS FROM THE ILSA-J. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.68

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RELATIONSHIP BETWEEN SERUM FATTY ACIDS AND COMPONENTS OF PHYSICAL FRAILTY IN COMMUNITY-DWELLING JAPANESE OLDER ADULTS

K. Kinoshita, R. Otsuka, C. Tange, Y. Nishita, M. Tomida, F. Ando, H. Shimokata, H. Arai

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Polyunsaturated fatty acids help maintain insulin sensitivity, mitochondrial function, and anti-inflammation. It is well known that deterioration in these areas can cause frailty. However, little is known about the differences in serum polyunsaturated fatty acid levels among frailty components. We investigated the cross-sectional relationship between frailty and serum fatty acids in 1,033 community-dwelling older adults aged 60–88 years. Polyunsaturated fatty acid concentrations were measured from fasting blood samples. The modified phenotype criteria defined frailty. Polyunsaturated fatty acid levels were compared among each component using general linear modeling after controlling for sex, age, body mass index, smoking status, household income, and medical history. Lower polyunsaturated fatty acid levels were associated with the modified frailty criteria, including shrinking and weakness (p < 0.05). Our findings suggest that serum polyunsaturated fatty acid levels differ depending on the frailty status of older adults.

CITATION:
K. Kinoshita ; R. Otsuka ; C. Tange ; Y. Nishita ; M. Tomida ; F. Ando ; H. Shimokata ; H. Arai (2020): Relationship between Serum Fatty Acids and Components of Physical Frailty in Community-Dwelling Japanese Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.67

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OBESITY MEASURES AND DEFINITIONS OF SARCOPENIC OBESITY IN SINGAPOREAN ADULTS – THE YISHUN STUDY

B.W.J. Pang, S.-L. Wee, L.K. Lau, K.A. Jabbar, W.T. Seah, D.H.M. Ng, Q.L.L. Tan, K.K. Chen, M.U. Jagadish T.P. Ng1,4

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Objectives: Due to the lack of a uniform obesity definition, there is marked variability in reported sarcopenic obesity (SO) prevalence and associated health outcomes. We compare the association of SO with physical function using current Asian Working Group for Sarcopenia (AWGS) guidelines and different obesity measures to propose the most optimal SO diagnostic formulation according to functional impairment, and describe SO prevalence among community-dwelling young and old adults. Design: Obesity was defined according to waist circumference (WC), percentage body fat (PBF), fat mass index (FMI), fat mass/fat-free mass ratio (FM/FFM), or body mass index (BMI). SO was defined as the presence of both obesity and AWGS sarcopenia. Muscle function was compared among phenotypes and obesity definitions using ANOVA. Differences across obesity measures were further ascertained using multiple linear regressions to determine their associations with the Short Physical Performance Battery (SPPB). Setting: Community-dwelling adults 21 years old and above were recruited from a large urban residential town in Singapore. Participants: 535 community-dwelling Singaporeans were recruited (21-90 years old, 57.9% women), filling quotas of 20-40 participants in each sex- and age-group. Measurements: We took measurements of height, weight, BMI, waist and hip circumferences, body fat, muscle mass, muscle strength, and functional assessments. Questionnaire-based physical and cognitive factors were also assessed. Results: Overall prevalence of SO was 7.6% (WC-based), 5.1% (PBF-based), 2.7% (FMI-based), 1.5% (FM/FFM-based), and 0.4% (BMI-based). SO was significantly associated with SPPB only in the FMI model (p<0.05), and total variance explained by the different regression models was highest for the FMI model. Conclusions: Our findings suggest FMI as the most preferred measure for obesity and support its use as a diagnostic criteria for SO.

CITATION:
B.W.J. Pang ; S.-L. Wee ; L.K. Lau ; K.A. Jabbar ; W.T. Seah ; D.H.M. Ng ; Q.L.L. Tan ; K.K. Chen ; M.U. Jagadish ; T.P. Ng (2020): Obesity Measures and Definitions of Sarcopenic Obesity in Singaporean Adults – the Yishun Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.65

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A REVIEW OF THE EVIDENCE BASE FOR NUTRITION AND NUTRITIONAL SUPPLEMENTS IN OLDER ADULTS WITH BIPOLAR DISORDER: A REPORT FROM THE OABD TASK FORCE

A.T. Olagunju, J.A. Morgan, A. Aftab, J.R. Gatchel, P. Chen, A. Dols, M. Sajatovic, W.T. Regenold

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Objectives: To better understand the role of nutrition in older adults (aged 50 years or older) with bipolar disorders (OABD), we conducted a systematic review of the literature and appraise existing evidence. Methods: Following PRISMA guidelines, we searched databases including Medline/PubMed, PsychINFO, EMBASE, CINAHL, Scopus, Web of Science, Cochrane Register, FDA website, and clinical trial registries through 2019 for eligible reports. The search string combined MeSH terms for bipolar disorder, nutrition and older adults. This was supplemented by snowball searching of references in relevant studies and authors were contacted to request their work where necessary. All included studies were rated with the National Institutes of Health Study Quality Assessment Tools based on study designs. Results: Of 2280 papers screened, ten studies including eight observational and two interventional studies. The topic foci of the papers examined several nutrients, (including vitamin B12, vitamin D, coenzyme Q10, homocysteine, and folate), nutritional deficiencies and biochemical correlates. The prevalence rates of deficiencies varied with specific nutrients (3.7% to 71.6% for Vitamin B12 and 34.6% for Vitamin D), and between inpatient versus outpatient populations. While nutritional interventions appeared to be associated with improvement in both affective and cognitive outcomes, the sample sizes of OABD varied and were generally small. Conclusion: While there is evidence for the benefits of nutritional interventions on affective, cognitive and overall outcome in OABD, the quality of the evidence is limited. Our findings underscore the need for high quality studies to inform evidence-based guidelines for nutritional assessment and supplemention in OABD.

CITATION:
A.T. Olagunju ; J.A. Morgan ; A. Aftab ; J.R. Gatchel ; P. Chen ; A. Dols ; M. Sajatovic ; W.T. Regenold (2020): A Review of the Evidence Base for Nutrition and Nutritional Supplements in Older Adults with Bipolar Disorder: A report from the OABD task force. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.64

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SARCOPENIA IN PRIMARY CARE: SCREENING, DIAGNOSIS, MANAGEMENT

S. Crosignani, C. Sedini, R. Calvani, E. Marzetti, M. Cesari

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Detection of sarcopenia in primary care is a first and essential step in community-dwelling older adults before implementing preventive interventions against the onset of disabling conditions. In fact, leaving this condition undiagnosed and untreated can impact on the individual’s quality of life and function, as well as on healthcare costs. This article summarizes the many instruments today available for promoting an earlier and prompter detection of sarcopenia in primary care, combining insights about its clinical management. Primary care physicians may indeed play a crucial role in the identification of individuals exposed to the risk of sarcopenia or already presenting this condition. To confirm the suspected diagnosis, several possible techniques may be advocated, but it is important that strategies are specifically calibrated to the needs, priorities and resources of the setting where the evaluation is conducted. To tackle sarcopenia, nutritional counselling and physical activity programs are today the two main interventions to be proposed. Multicomponent and personalized exercise programs can (and should) be prescribed by primary care physicians, taking advantage of validated programs ad hoc designed for this purpose (e.g., the Vivifrail protocol). It is possible that, in the next future, new pharmacological treatments may become available for tackling the skeletal muscle decline. These will probably find application in those individuals non-responding to lifestyle interventions.

CITATION:
S. Crosignani ; C. Sedini ; R. Calvani ; E. Marzetti ; M. Cesari (2020): SARCOPENIA IN PRIMARY CARE: SCREENING, DIAGNOSIS, MANAGEMENT. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.63

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A LITERATURE REVIEW OF HEALTHY AGING TRAJECTORIES THROUGH QUANTITATIVE AND QUALITATIVE STUDIES: A PSYCHO-EPIDEMIOLOGICAL APPROACH ON COMMUNITY-DWELLING OLDER ADULTS

A. Zamudio-Rodríguez, J.-F. Dartigues, H. Amieva, K. Pérès

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The population of older adults over 60 years is growing faster than any other age group and will more than double between 2020 and 2050. This increase has led to clinical, public health, and policy interest in how to age “successfully”. Before the Rowe and Kahn’s model proposed thirty years ago, aging was seen as a process of losses associated with diseases and disability. However, since the emergence of this model, there has been a shift towards a more positive view, serving for promoting diverse medical or psychosocial models, and personal perspectives. Several technical terms of “success” (e.g. “successful aging”, “healthy aging”, “active aging”, “aging well”…) coexist and compete for the meaning of the concept in the absence of a consensual definition. Our literature review article aims to study discrepancies and similarities between the main technical terms through quantitative or qualitative studies. A literature review using PubMed, SCOPUS, PsycINFO, Psycarticles, Psychology, and Behavioral Sciences Collection, Cochrane database, and clinicaltrials.gov databases was conducted. A total of 1057 articles were found and finally, 43 papers were selected for full extraction. We identified several components in these definitions, which reveal considerable inconsistency. The results particularly suggest that lay personals perspectives could bridge the gap between biomedical and psychosocial models in successful aging. In conclusion, an optimal definition would be a multidimensional one that could combine functional capacities, psychosocial abilities, environmental factors and subjective assessments of one’s own criteria to discriminate older adults at potential risk of “unsuccessful” aging to healthy aging trajectories.

CITATION:
A. Zamudio-Rodríguez ; J.-F. Dartigues ; H. Amieva ; K. Pérès (2020): A Literature Review of Healthy Aging Trajectories through Quantitative and Qualitative Studies: A Psycho-epidemiological Approach on Community-dwelling Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.62

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FRAILTY IS ASSOCIATED WITH INCREASED MORTALITY IN OLDER ADULTS 12 MONTHS AFTER DISCHARGE FROM POST-ACUTE CARE IN SWISS NURSING HOMES

C. Fompeyrine, L.A. Abderhalden, N. Mantegazza, N. Hofstetter, G. Bieri-Brüning, H.A. Bischoff-Ferrari, M. Gagesch

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Frail older adults with ongoing care needs often require post-acute care (PAC) following acute hospitalization when not eligible for specific rehabilitation. Long-term outcomes of PAC in this patient group have not been reported for Switzerland so far. In the present report, we investigated 12-month mortality in regard to frailty status upon admission to PAC in a nursing home setting. In our sample of 140 patients (mean age 84 [±8.6] years) 4.3% were robust, 37.1% were pre-frail, 54.3% were frail and 4.3% were missing frailty status. Mortality at 12-months follow-up stratified by baseline frailty was 0% (robust), 11.5% (pre-frail) and 31.6% (frail). Kaplan-Meier analysis stratified by frailty status showed a decreased probability of 12-months survival for frail individuals compared to their pre-frail and robust counterparts (P = 0.0096). Being frail was associated with more than 4-fold increased odds of death at follow-up (OR 4.19; 95% CI 1.53-11.47).

CITATION:
C. Fompeyrine ; L.A. Abderhalden ; N. Mantegazza ; N. Hofstetter ; G. Bieri-Brüning ; H.A. Bischoff-Ferrari ; M. Gagesch ; (2020): Frailty is associated with increased mortality in older adults 12 months after discharge from post-acute care in Swiss nursing homes. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.58

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LETTER TO THE EDITOR: CAREFUL HAND FEEDING PROGRAM IN A GERIATRIC STEP-DOWN HOSPITAL IN HONG KONG – IS THIS FEASIBLE?

J.K.H. Luk, T.C. Chan, F.H.W. Chan

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CITATION:
J.K.H. Luk ; T.C. Chan ; F.H.W. Chan (2020): Letter to the editor: Careful hand feeding program in a geriatric step-down hospital in Hong Kong – is this feasible? . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.50

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ICSFR: 10th International Conference on Frailty, Sarcopenia Research & Geroscience. March 11-13, 2020, Toulouse – France

Symposia, Conferences, Oral Communications

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CITATION:
I. Oral Communications (2020): 10th International Conference on Frailty, Sarcopenia Research & Geroscience (ICFSR), March 11-13, 2020, Toulouse, France. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.8

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JFA N°02 - 2021

 

SARCOPENIA, FRAILTY, AND GERO-SCIENCE: A DECADE OF PROGRESS AND A BRIGHT FUTURE OF DISCOVERY

R.A. Fielding

J Frailty Aging 2021;10(2)82-83

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CITATION:
R.A. Fielding (2020): Sarcopenia, Frailty, and Gero-science: a decade of progress and a bright future of discovery. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.37

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INTEGRATED CARE FOR OLDER PEOPLE (ICOPE): FROM GUIDELINES TO DEMONSTRATING FEASIBILITY

A. Banerjee, R. Sadana

J Frailty Aging 2021;10(2)84-85

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CITATION:
A. Banerjee ; R. Sadana (2020): Integrated care for older people (ICOPE): from guidelines to demonstrating feasibility . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.40

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THE INSPIRE RESEARCH INITIATIVE: A PROGRAM FOR GEROSCIENCE AND HEALTHY AGING RESEARCH GOING FROM ANIMAL MODELS TO HUMANS AND THE HEALTHCARE SYSTEM

P. de Souto Barreto, S. Guyonnet, I. Ader, S. Andrieu, L. Casteilla, N. Davezac, C. Dray, N. Fazilleau, P. Gourdy, R. Liblau, A. Parini, P. Payoux, L. Pénicaud, C. Rampon, Y. Rolland, P. Valet, N. Vergnolle, B. Vellas, for the INSPIRE Program Group

J Frailty Aging 2021;10(2)86-93

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Aging is the most important risk factor for the onset of several chronic diseases and functional decline. Understanding the interplays between biological aging and the biology of diseases and functional loss as well as integrating a function-centered approach to the care pathway of older adults are crucial steps towards the elaboration of preventive strategies (both pharmacological and non-pharmacological) against the onset and severity of burdensome chronic conditions during aging. In order to tackle these two crucial challenges, ie, how both the manipulation of biological aging and the implementation of a function-centered care pathway (the Integrated Care for Older People (ICOPE) model of the World Health Organization) may contribute to the trajectories of healthy aging, a new initiative on Gerosciences was built: the INSPIRE research program. The present article describes the scientific background on which the foundations of the INSPIRE program have been constructed and provides the general lines of this initiative that involves researchers from basic and translational science, clinical gerontology, geriatrics and primary care, and public health.

CITATION:
P. de Souto Barreto ; S. Guyonnet, ; I. Ader ; S. Andrieu ; L. Casteilla ; N. Davezac ; C. Dray ; N. Fazilleau ; P. Gourdy ; R. Liblau ; A. Parini ; P. Payoux ; L. Pénicaud ; C. Rampon ; Y. Rolland ; P. Valet ; N. Vergnolle ; B. Vellas ; for the INSPIRE Program Group (2020): The INSPIRE research initiative: a program for GeroScience and healthy aging research going from animal models to humans and the healthcare system. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.18

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FREQUENCY OF CONDITIONS ASSOCIATED WITH DECLINES IN INTRINSIC CAPACITY ACCORDING TO A SCREENING TOOL IN THE CONTEXT OF INTEGRATED CARE FOR OLDER PEOPLE

E. González-Bautista, P. de Souto Barreto, K. Virecoulon Giudici, S. Andrieu, Y. Rolland, B. Vellas, for the MAPT/DSA group

J Frailty Aging 2021;10(2)94-102

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Background: The screening tool of the Integrated Care for Older People (ICOPE Step 1), designed to detect declines in the domains of intrinsic capacity, has been incipiently investigated in older adult populations. Objectives: To retrospectively estimate the frequency of priority conditions associated with declines in intrinsic capacity according to an adaptation of the screening tool ICOPE Step 1 among participants of the Multidomain Alzheimer Preventive Trial (MAPT). Design: A cross-sectional retrospective analysis from the baseline assessment of the MAPT. Setting: The data was gathered during a preventive consultation for cardiovascular risk factors in memory clinics in France. Participants : Seven hundred fifty-nine older adults aged 70-89 years with memory complaints, allocated to the multidomain groups of the MAPT study. Measurements: Five domains of intrinsic capacity (cognition, locomotion, nutrition, sensorial, and psychological) were assessed using a screening tool similar to the ICOPE Step 1 (MAPT Step 1). The frequency of six conditions associated with declines in intrinsic capacity (cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms) was obtained for older adults with memory complaints participating in the MAPT study. Results: Overall, 89.3% of the participants had one or more conditions associated with declines in intrinsic capacity. The overall frequency of each condition was: 52.2% for cognitive decline, 20.2% for limited mobility, 6.6% for malnutrition, 18.1% for visual impairment, 56.2% for hearing loss, and 39% for depressive symptoms. Conclusion: After being screened with an adaptation of the ICOPE step 1 (MAPT step 1) tool, 9/10 older adults had one or more conditions associated with declines in intrinsic capacity. The relative frequency differs across conditions and could probably be lower in a population without memory complaints. The frequency of screened conditions associated with declines in IC highlights how relevant it is to develop function-centered care modalities to promote healthy aging.

CITATION:
E. González-Bautista ; P. de Souto Barreto ; K. Virecoulon Giudici ; S. Andrieu ; Y. Rolland ; B. Vellas ; for the MAPT/DSA group (2020): Frequency of conditions associated with declines in intrinsic capacity according to a screening tool in the context of Integrated care for older people. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.42

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FRAMEWORK IMPLEMENTATION OF THE INSPIRE ICOPE-CARE PROGRAM IN COLLABORATION WITH THE WORLD HEALTH ORGANIZATION (WHO) IN THE OCCITANIA REGION

N. Tavassoli, A. Piau, C. Berbon, J. De Kerimel, C. Lafont, P. De Souto Barreto, S. Guyonnet, C. Takeda, I. Carrie, D. Angioni, F. Paris, C. Mathieu, P.J. Ousset, L. Balardy, T. Voisin, S. Sourdet, J. Delrieu, V. Bezombes, V. Pons-Pretre, S. Andrieu, F. Nourhashemi, Y. Rolland, M.E. Soto, J. Beard, Y. Sumi, I. Araujo Carvalho, B. Vellas

J Frailty Aging 2021;10(2)103-109

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Introduction: Limiting the number of dependent older people in coming years will be a major economic and human challenge. In response, the World Health Organization (WHO) has developed the «Integrated Care for Older People (ICOPE)» approach. The aim of the ICOPE program is to enable as many people as possible to age in good health. To reach this objective, the WHO proposes to follow the trajectory of an individual’s intrinsic capacity, which is the composite of all their physical and mental capacities and comprised of multiple domains including mobility, cognition, vitality / nutrition, psychological state, vision, hearing. Objective: The main objective of the INSPIRE ICOPE-CARE program is to implement, in clinical practice at a large scale, the WHO ICOPE program in the Occitania region, in France, to promote healthy aging and maintain the autonomy of seniors using digital medicine. Method: The target population is independent seniors aged 60 years and over. To follow this population, the 6 domains of intrinsic capacity are systematically monitored with pre-established tools proposed by WHO especially STEP 1 which has been adapted in digital form to make remote and large-scale monitoring possible. Two tools were developed: the ICOPE MONITOR, an application, and the BOTFRAIL, a conversational robot. Both are connected to the Gerontopole frailty database. STEP 1 is performed every 4-6 months by professionals or seniors themselves. If a deterioration in one or more domains of intrinsic capacity is identified, an alert is generated by an algorithm which allows health professionals to quickly intervene. The operational implementation of the INSPIRE ICOPE-CARE program in Occitania is done by the network of Territorial Teams of Aging and Prevention of Dependency (ETVPD) which have more than 2,200 members composed of professionals in the medical, medico-social and social sectors. Targeted actions have started to deploy the use of STEP 1 by healthcare professionals (physicians, nurses, pharmacists,…) or different institutions like French National old age insurance fund (CNAV), complementary pension funds (CEDIP), Departmental Council of Haute Garonne, etc. Perspective: The INSPIRE ICOPE-CARE program draws significantly on numeric tools, e-health and digital medicine to facilitate communication and coordination between professionals and seniors. It seeks to screen and monitor 200,000 older people in Occitania region within 3 to 5 years and promote preventive actions. The French Presidential Plan Grand Age aims to largely implement the WHO ICOPE program in France following the experience of the INSPIRE ICOPE-CARE program in Occitania.

CITATION:
N. Tavassoli ; A. Piau ; C. Berbon ; J. De Kerimel ; C. Lafont ; P. De Souto Barreto ; S. Guyonnet ; C. Takeda ; I. Carrie ; D. Angioni ; F. Paris ; C. Mathieu ; P.J. Ousset ; L. Balardy ; T. Voisin ; S. Sourdet ; J. Delrieu ; V. Bezombes ; V. Pons-Pretre ; S. Andrieu ; F. Nourhashemi ; Y. Rolland ; M.E. Soto ; J. Beard ; Y. Sumi ; I. Araujo Carvalho ; B. Vellas ; (2020): Framework Implementation of the INSPIRE ICOPE-CARE program in collaboration with the World Health Organization (WHO) in the Occitania region. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.26

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THE INSPIRE BIO-RESOURCE RESEARCH PLATFORM FOR HEALTHY AGING AND GEROSCIENCE: FOCUS ON THE HUMAN TRANSLATIONAL RESEARCH COHORT (THE INSPIRE-T COHORT)

S. Guyonnet, Y. Rolland, C. Takeda, P.-J. Ousset, I. Ader, N. Davezac, C. Dray, N. Fazilleau, P. Gourdy, R. Liblau, A. Parini, P. Payoux, L. Pénicaud, C. Rampon, P. Valet, N. Vergnolle, S. Andrieu, P. de Souto Barreto, L. Casteilla, B. Vellas, for the INSPIRE Platform group

J Frailty Aging 2021;10(2)110-120

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Background: The Geroscience field focuses on the core biological mechanisms of aging, which are involved in the onset of age-related diseases, as well as declines in intrinsic capacity (IC) (body functions) leading to dependency. A better understanding on how to measure the true age of an individual or biological aging is an essential step that may lead to the definition of putative markers capable of predicting healthy aging. Objectives: The main objective of the INStitute for Prevention healthy agIng and medicine Rejuvenative (INSPIRE) Platform initiative is to build a program for Geroscience and healthy aging research going from animal models to humans and the health care system. The specific aim of the INSPIRE human translational cohort (INSPIRE-T cohort) is to gather clinical, digital and imaging data, and perform relevant and extensive biobanking to allow basic and translational research on humans. Methods: The INSPIRE-T cohort consists in a population study comprising 1000 individuals in Toulouse and surrounding areas (France) of different ages (20 years or over - no upper limit for age) and functional capacity levels (from robustness to frailty, and even dependency) with follow-up over 10 years. Diversified data are collected annually in research facilities or at home according to standardized procedures. Between two annual visits, IC domains are monitored every 4-month by using the ICOPE Monitor app developed in collaboration with WHO. Once IC decline is confirmed, participants will have a clinical assessment and blood sampling to investigate markers of aging at the time IC declines are detected. Biospecimens include blood, urine, saliva, and dental plaque that are collected from all subjects at baseline and then, annually. Nasopharyngeal swabs and cutaneous surface samples are collected in a large subgroup of subjects every two years. Feces, hair bulb and skin biopsy are collected optionally at the baseline visit and will be performed again during the longitudinal follow up. Expected Results: Recruitment started on October 2019 and is expected to last for two years. Bio-resources collected and explored in the INSPIRE-T cohort will be available for academic and industry partners aiming to identify robust (set of) markers of aging, age-related diseases and IC evolution that could be pharmacologically or non-pharmacologically targetable. The INSPIRE-T will also aim to develop an integrative approach to explore the use of innovative technologies and a new, function and person-centered health care pathway that will promote a healthy aging.

CITATION:
S. Guyonnet ; Y. Rolland ; C. Takeda ; P.-J. Ousset ; I. Ader ; N. Davezac ; C. Dray ; N. Fazilleau ; P. Gourdy ; R. Liblau ; A. Parini ; P. Payoux ; L. Pénicaud ; C. Rampon ; P. Valet ; N. Vergnolle ; S. Andrieu ; P. de Souto Barreto ; L. Casteilla ; B. Vellas ; for the INSPIRE Platform group (2020): The INSPIRE Bio-resource Research Platform for Healthy Aging and Geroscience: Focus on the Human Translational Research Cohort (The INSPIRE-T Cohort). The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.38

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TOWARDS A LARGE-SCALE ASSESSMENT OF THE RELATIONSHIP BETWEEN BIOLOGICAL AND CHRONOLOGICAL AGING: THE INSPIRE MOUSE COHORT

Y. Santin, S. Lopez, I. Ader, S. Andrieu, N. Blanchard, A. Carrière, L. Casteilla, B. Cousin, N. Davezac, P. De Souto Barreto, C. Dray, N. Fazilleau, D. Gonzalez-Dunia, P. Gourdy, S. Guyonnet, N. Jabrane-Ferrat, O. Kunduzova, F. Lezoualc’h, R. Liblau, L.O. Martinez, C. Moro, P. Payoux, L. Pénicaud, V. Planat-Bénard, C. Rampon, Y. Rolland, J.-P. Schanstra, F. Sierra, P. Valet, A. Varin, N. Vergnolle, B. Vellas, J. Viña, B.P. Guiard, A. Parini

J Frailty Aging 2021;10(2)121-131

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Aging is the major risk factor for the development of chronic diseases. After decades of research focused on extending lifespan, current efforts seek primarily to promote healthy aging. Recent advances suggest that biological processes linked to aging are more reliable than chronological age to account for an individual’s functional status, i.e. frail or robust. It is becoming increasingly apparent that biological aging may be detectable as a progressive loss of resilience much earlier than the appearance of clinical signs of frailty. In this context, the INSPIRE program was built to identify the mechanisms of accelerated aging and the early biological signs predicting frailty and pathological aging. To address this issue, we designed a cohort of outbred Swiss mice (1576 male and female mice) in which we will continuously monitor spontaneous and voluntary physical activity from 6 to 24 months of age under either normal or high fat/high sucrose diet. At different age points (6, 12, 18, 24 months), multiorgan functional phenotyping will be carried out to identify early signs of organ dysfunction and generate a large biological fluids/feces/organs biobank (100,000 samples). A comprehensive correlation between functional and biological phenotypes will be assessed to determine: 1) the early signs of biological aging and their relationship with chronological age; 2) the role of dietary and exercise interventions on accelerating or decelerating the rate of biological aging; and 3) novel targets for the promotion of healthy aging. All the functional and omics data, as well as the biobank generated in the framework of the INSPIRE cohort will be available to the aging scientific community. The present article describes the scientific background and the strategies employed for the design of the INSPIRE Mouse cohort.

CITATION:
Y. Santin ; S. Lopez ; I. Ader ; S. Andrieu ; N. Blanchard ; A. Carrière ; L. Casteilla ; B. Cousin ; N. Davezac ; P. De Souto Barreto ; C. Dray ; N. Fazilleau ; D. Gonzalez-Dunia ; P. Gourdy ; S. Guyonnet ; N. Jabrane-Ferrat ; O. Kunduzova ; F. Lezoualc’h ; R. Liblau ; L.O. Martinez ; C. Moro ; P. Payoux ; L. Pénicaud ; V. Planat-Bénard ; C. Rampon ; Y. Rolland ; J.-P. Schanstra ; F. Sierra ; P. Valet ; A. Varin ; N. Vergnolle ; B. Vellas ; J. Viña ; B.P. Guiard ; A. Parini (2020): Towards a large-scale assessment of the relationship between biological and chronological aging: The INSPIRE Mouse Cohort. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.43

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INTRINSIC CAPACITIY MONITORING BY DIGITAL BIOMARKERS IN INTEGRATED CARE FOR OLDER PEOPLE (ICOPE)

A. Piau, Z. Steinmeyer, M. Cesari, J. Kornfeld, Z. Beattie, J. Kaye, B. Vellas, F. Nourhashemi

J Frailty Aging 2021;10(2)132-138

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The WHO action plan on aging expects to change current clinical practices by promoting a more personalized model of medicine. To widely promote this initiative and achieve this goal, healthcare professionals need innovative monitoring tools. Use of conventional biomarkers (clinical, biological or imaging) provides a health status assessment at a given time once a capacity has declined. As a complement, continuous monitoring thanks to digital biomarkers makes it possible to remotely collect and analyze real life, ecologically valid, and continuous health related data. A seamless assessment of the patient’s health status potentially enables early diagnosis of IC decline (e.g. sub-clinical or transient events not detectable by episodic evaluations) and investigation of its probable causes. This narrative review aims to develop the concept of digital biomarkers and its implementation in IC monitoring.

CITATION:
A. Piau ; Z. Steinmeyer ; M. Cesari ; J. Kornfeld ; Z. Beattie ; J. Kaye ; B. Vellas ; F. Nourhashemi (2020): Intrinsic Capacitiy monitoring by digital biomarkers in Integrated Care for Older People (ICOPE). The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.51

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IMPLEMENTATION OF THE INTEGRATED CARE OF OLDER PEOPLE (ICOPE) APP IN PRIMARY CARE: NEW TECHNOLOGIES IN GERIATRIC CARE DURING QUARANTINE OF COVID-19 AND BEYOND

D. Sanchez-Rodriguez, C. Annweiler, S. Gillain, B. Vellas

J Frailty Aging 2021;10(2)139-140

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CITATION:
D. Sanchez-Rodriguez ; C. Annweiler ; S. Gillain ; B. Vellas (2020): Implementation of the Integrated Care of Older People (ICOPE) App in Primary Care: New technologies in geriatric care during quarantine of COVID-19 and beyond. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.24

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PHYSICAL FUNCTIONAL ASSESSMENT IN OLDER ADULTS

E. Patrizio, R. Calvani, E. Marzetti, M. Cesari

J Frailty Aging 2021;10(2)141-149

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The evaluation of the physical domain represents a critical part of the assessment of the older person, both in the clinical as well as the research setting. To measure physical function, clinicians and researchers have traditionally relied on instruments focusing on the capacity of the individual to accomplish specific functional tasks (e.g., the Activities of Daily Living [ADL] or the Instrumental ADL scales). However, a growing number of physical performance and muscle strength tests has been developed in parallel over the past three decades. These measures are specifically designed to: 1) provide objective results (not surprisingly, they are frequently timed tests) taken in standardized conditions, whereas the traditional physical function scales are generally self- or proxy-reported measures; 2) be more sensitive to changes; 3) capture the real biology of the function through the assessment of standardized tasks mirroring specific functional subdomains; and 4) mirror the quality of specific mechanisms underlying more complex and multidomain functions. Among the most commonly used instruments, the usual gait speed test, the Short Physical Performance Battery, the handgrip strength, the Timed Up-and-Go test, the 6-minute walk test, and the 400-meter walk test are widely adopted by clinicians and researchers. The clinical and research importance of all these instruments has been demonstrated by their predictive capacity for negative health-related outcomes (i.e., hospitalization, falls, institutionalization, disability, mortality). Moreover, they have shown to be associated with subclinical and clinical conditions that are also not directly related to the physical domain (e.g., inflammation, oxidative stress, overall mortality). For this reason, they have been repeatedly indicated as markers of wellbeing linked to the burden of multiple chronic conditions rather than mere parameters of mobility or strength. In this work protocols of the main tests for the objective assessment of physical function in older adults are presented.

CITATION:
E. Patrizio ; R. Calvani ; E. Marzetti ; M. Cesari (2020): Physical Functional Assessment in Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.61

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METHODOLOGICAL ISSUES AND THE IMPACT OF AGE STRATIFICATION ON THE PROPORTION OF PARTICIPANTS WITH LOW APPENDICULAR LEAN MASS WHEN ADJUSTING FOR HEIGHT AND FAT MASS USING LINEAR REGRESSION: RESULTS FROM THE CANADIAN LONGITUDINAL STUDY ON AGING

A.J. Mayhew, S.M. Phillips, N. Sohel, L. Thabane, P.D. McNicholas, R.J. de Souza, G. Parise, P. Raina

J Frailty Aging 2021;10(2)150-155

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Background: Using residual values calculated from models regressing appendicular lean mass on fat mass and height is one of several suggested strategies for adjusting appendicular lean mass for body size when measuring sarcopenia. However, special consideration is required when using this technique in different subgroups in order to capture the correct individuals as sarcopenic. Objectives: To provide guidance about how to conduct stratified analyses for the regression adjustment technique using age groups as an example. Design: Cross-sectional study. Setting: Data collected at baseline (2012-2015) for the Canadian Longitudinal Study on Aging. Participants: Community dwelling participants of European descent aged 45 to 85 years (n=25,399). Measurements: Appendicular lean mass, height, and weight were measured. Sex-specific residuals were calculated in participants before and after stratifying participants by age group (45-54, 55-64, 65-74, 75-85 years). Cut offs corresponding to the sex-specific 20th percentile residual values in participants ≥65 years were determined first in the residuals calculated in all participants and residuals calculated in only those aged ≥65 years. For each set of cut offs, the percentage of age and sex-stratified participants with low appendicular lean mass were compared for the residuals calculated in all participants and the residuals calculated after stratifying by age. Results: In 12,622 males and 12,737 females, regardless of the cut off used, the percentage of participants with low appendicular lean mass decreased with age when residuals were calculated after age stratification. When the residuals were calculated in all participants, the percentage of participants with sarcopenia increased from the youngest to the oldest age groups. Conclusions: Sex-specific residuals in all participants should be calculated prior to stratifying the sample by age group, or other stratification variables, for the purposes of developing appendicular lean mass cut offs or subgroup analyses.

CITATION:
A.J. Mayhew ; S.M. Phillips ; N. Sohel ; L. Thabane ; P.D. McNicholas ; R.J. de Souza ; G. Parise ; P. Raina (2020): METHODOLOGICAL ISSUES AND THE IMPACT OF AGE STRATIFICATION ON THE PROPORTION OF PARTICIPANTS WITH LOW APPENDICULAR LEAN MASS WHEN ADJUSTING FOR HEIGHT AND FAT MASS USING LINEAR REGRESSION: RESULTS FROM THE CANADIAN LONGITUDINAL STUDY ON AGING. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.48

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EFFICACY OF A COMPREHENSIVE DYSPHAGIA INTERVENTION PROGRAM TAILORED FOR THE RESIDENTS OF NURSING HOMES

R. Fong, S.W.K. Wong, J.K.L. Chan, M.C.F. Tong, K.Y.S. Lee

J Frailty Aging 2021;10(2)156-159

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Oropharyngeal dysphagia is a widespread condition in older people and thus poses a serious health threat to the residents of nursing homes. The management of dysphagia relies mainly on compensatory strategies, such as diet and environmental modification. This study investigated the efficacy of an intervention program using a single-arm interventional study design. Twenty-two participants from nursing homes were included and had an average of 26 hours of intervention, including oromotor exercises, orosensory stimulation and exercises to target dysphagia and caregiver training. Four of the 22 participants exhibited improvement in functional oral intake scale (FOIS) but was not statistically significant as a group. All oromotor function parameters, including the range, strength, and coordination of movements, significantly improved. These results indicate that this intervention program could potentially improve the oromotor function, which were translated into functional improvements in some participants’ recommended diets. The validity of this study could be improved further by using standardized swallowing and feeding assessment methods or an instrumental swallowing assessment.

CITATION:
R. Fong ; S.W.K. Wong ; J.K.L. Chan ; M.C.F. Tong ; K.Y.S. Lee (2020): Efficacy of a comprehensive dysphagia intervention program tailored for the residents of nursing homes. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.56

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COGNITIVE FUNCTION AND AMYLOID MARKER IN FRAIL OLDER ADULTS: THE COGFRAIL COHORT STUDY

S. Sourdet, G. Soriano, J. Delrieu, Z. Steinmeyer, S. Guyonnet, L. Saint-Aubert, P. Payoux, P.J. Ousset, A. Ghisolfi, B. Chicoulaa, S. Dardenne, T. Gemar, M. Baziard, F. Guerville, S. Andrieu, B. Vellas

J Frailty Aging 2021;10(2)160-167

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Background: Frailty and cognitive impairment are common manifestations of the ageing process and are closely related. But the mechanisms linking aging, physical frailty, and cognitive disorders, are complex and remain unclear. Objectives: We aim to explore the role of cerebral amyloid pathology, but also a range of nutritional, physical, biological or brain-aging marker in the development of cognitive frailty. Method: COGFRAIL study is a monocentric prospective study of frail older patients with an objective cognitive impairment (Clinical Dementia Rating Scale global score at 0.5 or 1). Three-hundred-and-twenty-one patients are followed up every 6 months, for 2 years. Clinical assessment at baseline and during follow-up included frailty, physical, mood, sensory, nutritional, and cognitive assessment (with a set of neuropsychological tests). Cerebral amyloid pathology is measured by amyloid Positron Emission Tomography (PET) or amyloid-β-1-42 level in cerebrospinal fluid. Brain magnetic resonance imaging, measurement of body composition using Dual X Ray Absorptiometry and blood sampling are performed. The main outcome of the study is to assess the prevalence of positive cerebral amyloid status according to amyloid PET or amyloid-β-1-42 level CSF. Secondary outcomes included biological, nutritional, MRI imaging, cognitive, clinical, physical and body composition markers to better understand the mechanisms of cognitive frailty. Perspective: COGFRAIL study will give the opportunity to better understand the link between Gerosciences, frailty, cognitive impairment, and Alzheimer’s disease, and to better characterize the physical and cognitive trajectories of frail older adults according to their amyloid status. Understanding the relationship between physical frailty and cognitive impairment is a prerequisite for the development of new interventions that could prevent and treat both conditions.

CITATION:
S. Sourdet ; G. Soriano ; J. Delrieu ; Z. Steinmeyer ; S. Guyonnet ; L. Saint-Aubert ; P. Payoux ; P.J. Ousset ; A. Ghisolfi ; B. Chicoulaa ; S. Dardenne ; T. Gemar ; M. Baziard ; F. Guerville ; S. Andrieu ; B. Vellas (2020): Cognitive function and amyloid marker in frail older adults: The COGFRAIL Cohort Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.57

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OSTEOPOROSIS IN FRAIL OLDER ADULTS: RECOMMENDATIONS FOR RESEARCH FROM THE ICFSR TASK FORCE 2020

Y. Rolland, M. Cesari, R.A. Fielding, J.Y. Reginster, B. Vellas, A.J. Cruz-Jentoft, and the ICFSR Task Force

J Frailty Aging 2021;10(2)168-175

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Interactions among physiological pathways associated with osteoporosis and sarcopenia are thought to contribute to the onset of frailty. The International Conference on Frailty and Sarcopenia Research Task Force thus met in March 2020 to explore how emerging interventions to manage fracture and osteoporosis in older adults may reduce frailty, disability, morbidity, and mortality in the older population. Both pharmacological and non-pharmacological interventions (including nutritional intervention, exercise, and other lifestyle changes) were discussed, including nutritional intervention, exercise, and other lifestyle changes. Pharmacological treatments for osteoporosis include bone-forming and antiresorptive agents, which may optimally be used in sequential or combination regimens. Since similar mechanisms related to resorption underlie physiological changes in muscle and bone, these interventions may provide benefits beyond treating osteoporosis. Clinical trials to test these interventions, however, often exclude frail older persons because of comorbidities (such as mobility disability and cognitive impairment) or polypharmacy. The Task Force recommended that future clinical trials use harmonized protocols, including harmonized inclusion criteria and similar outcome measures; and that they test a range of multidomain therapies. They further advocated more high-quality research to develop interventions specifically for people who are frail and old. The ICOPE program recommended by WHO appears to be highly recommended to frail older adults with osteoporosis.

CITATION:
Y. Rolland ; M. Cesari ; R.A. Fielding ; J.Y. Reginster ; B. Vellas ; A.J. Cruz-Jentoft ; and the ICFSR Task Force (2021): Osteoporosis in Frail Older Adults: Recommendations for Research from the ICFSR Task Force 2020. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2021.4

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SENSOR-BASED FRAILTY ASSESSMENT IN SURVIVORS OF CHILDHOOD CANCER: A PILOT STUDY

N.J. Krnavek, S. Ajasin, E.C. Arreola, M. Zahiri, M. Noun, P.J. Lupo, B. Najafi, M.M. Gramatges

J Frailty Aging 2021;10(2)176-181

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Background: Survivors of childhood cancer (CCS) are at risk for early aging and frailty. Frailty in CCS has been assessed with established clinical criteria, a time-intensive approach requiring specialized training. There is an unmet need for cost-effective, rapid methods for assessing frailty in at-risk adolescent and young adult (AYA) CCS, which are scalable to large populations. Objectives: To validate a sensor-based frailty assessment tool in AYA CCS, compare frailty status between CCS and controls, and assess the correlation between frailty and number of CCS comorbidities. Design, Setting, and Participants: Mean frailty index (MFI) was assessed by a frailty wrist sensor in 32 AYA CCS who were ≥1 year off therapy and in remission. Results were compared with 32 AYA controls without cancer or chronic disease. Measurements: Frailty assessments with and without a simultaneous cognitive task were performed to obtain MFI. Results were compared between cases and controls using a Student t test, and the number of pre-frail/frail subjects by Chi Square test. The contribution of radiation therapy (RT) exposure to MFI was assessed in a sub-analysis, and the correlation between the number of comorbidities and MFI was measured using the Pearson method. Results: MFI was strongly correlated with gait speed in AYA CCS. CCS were more likely to be pre-frail than controls without cancer history (p=0.032), and CCS treated with RT were more likely to be pre-frail than CCS not treated with RT (p<0.001). The number of comorbidities was strongly correlated with MFI (ρ=0.65), with a 0.028 increase in MFI for each added condition (p<0.001). Conclusions: Results from this study support higher risk for frailty among CCS, especially those with multiple comorbidities or who were treated with RT. A wrist-worn sensor-based method is feasible for application in AYA CCS, and provides an opportunity for cost-effective, rapid screening of at-risk AYA CCS who may benefit from early interventions.

CITATION:
N.J. Krnavek ; S. Ajasin ; E.C. Arreola ; M. Zahiri ; M. Noun ; P.J. Lupo ; B. Najafi ; M.M. Gramatges (2020): Sensor-based frailty assessment in survivors of childhood cancer: A pilot study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.71

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INTEGRATED CARE AND GERIATRICS: A CALL TO RENOVATION FROM THE COVID-19 PANDEMIC

P. Astrone, M. Cesari

J Frailty Aging 2021;10(2)182-183

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CITATION:
P. Astrone ; M. Cesari (2020): Integrated Care and Geriatrics: a call to renovation from the COVID-19 pandemic. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.59

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OLDER PEOPLE FACING THE CRISIS OF COVID-19: BETWEEN FRAGILITY AND RESILIENCE

H. Amieva, J.-A. Avila-Funes, S. Caillot-Ranjeva, J.-F. Dartigues, M. Koleck, L. Letenneur, M. Pech, K. Pérès, N. Raoux, N. Rascle, C. Ouvrard, M. Tabue-Teguo, R. Villeneuve, V. Bergua

J Frailty Aging 2021;10(2)184-186

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The health crisis we are facing is challenging seniors’ resources and capacities for adaptation and resilience. The PACOVID survey, set up a few days after containment, investigates their psychological and social experiences with regard to the COVID-19 crisis and to what extent these characteristics, representations and attitudes have an impact on health and mortality. A telephone survey is being carried out on 935 people already followed up in the framework of ongoing epidemiological studies. As we are writing this article, the interviews conducted during the containment have just ended. Even though we will have to wait for the analysis of the results to draw conclusions, words collected by the psychologists during the interviews already illustrate a great heterogeneity in the way older adults lived this experience: social isolation, anxiety, the importance of family and the difficulty of being deprived of it, but also remarkable coping skills and resilience capacities.

CITATION:
H. Amieva ; J.-A. Avila-Funes ; S. Caillot-Ranjeva ; J.-F. Dartigues ; M. Koleck ; L. Letenneur ; M. Pech ; K. Pérès ; N. Raoux ; N. Rascle ; C. Ouvrard ; M. Tabue-Teguo ; R. Villeneuve ; V. Bergua (2020): Older people facing the crisis of COVID-19: between fragility and resilience. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.60

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LETTER TO THE EDITOR: COVID-19 MORTALITY IN PERUVIAN OLDER ADULTS: A CHRONICLE OF A HEALTH CRISIS FORETOLD?

K.L. Aguirre-Amaya, M. Palomares-Custodio, C. Quispe-Vicuña, S. Abanto-Urbano, D. Urrunaga-Pastor

J Frailty Aging 2021;10(2)187-188

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CITATION:
K.L. Aguirre-Amaya ; M. Palomares-Custodio ; C. Quispe-Vicuña ; S. Abanto-Urbano ; D. Urrunaga-Pastor (2020): Letter to the editor: COVID-19 mortality in Peruvian older adults: a chronicle of a health crisis foretold? . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.66

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LETTER TO THE EDITOR: PREVALENCE OF FRAILTY IN PATIENTS WITH COVID-19: A META-ANALYSIS

C.S. Kow, S.S. Hasan

J Frailty Aging 2021;10(2)189-190

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CITATION:
C.S. Kow ; S.S. Hasan (2020): Letter to the editor: Prevalence of frailty in patients with COVID-19: a meta-analysis. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.70

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LETTER TO THE EDITOR: FRAILTY PHENOTYPE OF HOMEBOUND MONTREAL OLDER COMMUNITY DWELLERS DURING THE COVID-19 PANDEMIC: RESULTS OF A CROSS-SECTIONAL POPULATION STUDY

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

J Frailty Aging 2021;10(2)191-192

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CITATION:
C.P. Launay ; L. Cooper-Brown ; V. Ivensky ; O. Beauchet (2020): Letter to the editor: Frailty phenotype of homebound Montreal older community dwellers during the COVID-19 pandemic: Results of a cross-sectional population study . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.69

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LETTER TO THE EDITOR: DISCRIMINATIVE POWER OF THE SARCOPENIA QUALITY OF LIFE (SARQOL®) QUESTIONNAIRE WITH THE EWGSOP2 CRITERIA

A. Geerinck , M. Locquet, J.-Y. Reginster, O. Bruyère, C. Beaudart

J Frailty Aging 2021;10(2)193-194

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CITATION:
A. Geerinck ; M. Locquet ; J.-Y. Reginster ; O. Bruyère ; C. Beaudart (2020): Letter to the editor: Discriminative power of the Sarcopenia Quality of Life (SarQoL®) questionnaire with the EWGSOP2 criteria . The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2020.47

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