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PHYSICAL FRAILTY AND COGNITIVE FUNCTION AMONG OLDER CHINESE ADULTS: THE MEDIATING ROLES OF ACTIVITIES OF DAILY LIVING LIMITATIONS AND DEPRESSION

C. Peng, J.A. Burr, Y. Yuan, K.L. Lapane

J Frailty Aging 2023;12(3)156-165

BACKGROUND: Physical frailty and cognitive impairment are prevalent globally, particularly in China, which is experiencing an unprecedented aging of its large population. OBJECTIVES: Examine the association between physical frailty and the level and rate of change of cognitive function, globally and by domain, among community-dwelling Chinese older adults, and quantify the mediation effects from activities of daily living (ADL) limitations and depressive symptoms. DESIGN: Longitudinal. SETTING: China Health and Retirement Longitudinal Study (2011-2018). PARTICIPANTS: 5,431 eligible adults aged ≥ 60 years with valid information on physical frailty. MEASUREMENTS: Physical frailty, cognitive function, ADL limitations, and depressive symptoms were respectively assessed by frailty phenotypes, the Telephone Interview for Cognitive Status (episodic memory, executive function, and orientation), performance in six daily tasks, and the eight-item Center for Epidemiological Studies Depression Scale. Latent growth curve models were used to address the objectives. RESULTS: Compared to adults who were non-frail, those who were pre-frail (β = −0.06) and frail (β = −0.13) reported significantly worse global cognitive function and episodic memory (pre-frail: β = −0.05; frail: β = −0.14), executive function (pre-frail: β = −0.04, frail: β = −0.10), and orientation (pre-frail: β = −0.06; frail: β = −0.07) at baseline; those who were frail were more likely to experience faster decline in global cognitive function (β = 0.12) and episodic memory (β = 0.08). ADL limitations (β = −0.07) and depressive symptoms (β = −0.14) significantly mediated the association between physical frailty and the level of cognitive function, but not its rate of decline. CONCLUSIONS: Intervention strategies that help maintain cognitive function may benefit from early screening and assessment of physical frailty. For pre-frail and frail older Chinese adults, programs designed to help improve or maintain activities of daily living and reduce number of depressive symptoms may contribute to better cognitive performance.

CITATION:
C. Peng ; J.A. Burr ; Y. Yuan ; K.L. Lapane ; (2023): Physical Frailty and Cognitive Function among Older Chinese Adults: The Mediating Roles of Activities of Daily Living Limitations and Depression. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.1

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LONGITUDINAL MEASUREMENTS OF FGF23, SARCOPENIA, FRAILTY AND FRACTURE IN OLDER COMMUNITY DWELLING WOMEN

L. Egund, T.K. Paulin, H. Ekstubbe, P. Bartosch, L. Malmgren

J Frailty Aging 2023;12(3)166-174

Background: FGF23 has been associated with frailty and functional performance in older individuals, but the association to sarcopenia is unknown. Objectives: To investigate the association between FGF23, frailty, sarcopenia and fractures in older community dwelling women. Design: Prospective longitudinal cohort study. Setting: Malmö, Sweden. Participants: 995 75-year-old women, followed prospectively for ten years, with re-investigations after five (n=667) and ten (n=324) years. Measurements: C-terminal levels of FGF23 were measured and a frailty index of ‘deficits in health’ created. Sarcopenia was defined by low muscle mass and strength and “probable sarcopenia” by low muscle mass only. Incident fractures were continuously registered for 10-years. Based on tertiles of FGF23, odds ratio for frailty, sarcopenia and probable sarcopenia was investigated using logistic regression models adjusted for: eGFR, PTH, calcium, vitamin D and phosphate. Fracture-free survival during 10-year follow-up was depicted using Kaplan Meier curves. Results: While fracture-free survival did not differ between tertiles, women in the highest tertile of FGF23 had lower muscle strength and gait speed, and higher proportion with impaired mobility at baseline. At age 75, these women had higher odds of also being frail (ORadj 1.6 (95% CI 1.1-2.4)) and suffering from probable sarcopenia (ORadj 1.8 (95% CI 1.1-3.1)), but not sarcopenia. At follow-up the association between FGF23 and probable sarcopenia was not evident. While the association with frailty was attenuated at age 80 after adjustment (ORadj 1.6 (95% CI 1.0-2.5)), women in the highest tertile had higher odds of being frail at age 85 (ORadj 3.4 (95% CI 1.7-6.6)). Conclusions: FGF23 may be a promising clinical marker for muscle strength, functional performance, and frailty in older women, but not for future fragility fractures. Whether FGF23 is also associated with sarcopenia requires further investigation.

CITATION:
L. Egund ; T.K. Paulin ; H. Ekstubbe ; P. Bartosch ; L. Malmgren ; (2023): Longitudinal Measurements of FGF23, Sarcopenia, Frailty and Fracture in Older Community Dwelling Women. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.22

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SENSITIVITY, SPECIFICITY, POSITIVE AND NEGATIVE PREDICTIVE VALUES OF A POSTAL MAIL SELF-SCREENING TOOL FOR FRAILTY IN FRENCH OLDER ADULTS

J. Shourick, P. Lucas, N. Tavassoli, M. Rego-Lopes, M.L. Seux, O. Hanon, S. Andrieu, B. Vellas, F. Forette

J Frailty Aging 2023;12(3)175-181

Background: Frailty has emerged as one of the major risk factors of loss of autonomy and it can be reverted through early and appropriate interventions. A wide range of available frailty screening tools are administered, mainly in clinical settings. However, few frailty instruments are self-administered. OBJECTIVES: The aim of this study was to determine the diagnostic test accuracy of a modified self-administered questionnaire derived from the Study of Osteoporotic Fractures (SOF) index against the Fried frailty phenotype in identifying frailty. DESIGN: Observational, multicenter, diagnostic test accuracy study. PARTICIPANTS: Participants aged 70 and over, living at home or in community-dwelling (n=5134) in two centers in France were contacted. MEASUREMENTS: Participants were mailed self-administered questionnaires derived from the SOF index. Responders who accepted the home evaluation were assessed by trained nurses, blinded to results of the questionnaire, using the Fried frailty phenotype as the reference method. RESULTS: The questionnaire was sent to 5134 participants, of which 1878 (36.6%) met inclusion criteria and returned the questionnaire. Fried frailty assessments were obtained in 691 (35.4%) participants. A total of 639 subjects had a complete evaluation on both the self-administered questionnaire and the Fried phenotype. Mean age was 78.9 (standard deviation [SD]: 5.95) years and 359 (56.2%) participants were women. According to the questionnaire, 159 (24.9%) subjects were considered frail, 172 (26.9%) pre-frail, and 308 (48.2) robust. With the home evaluation, Fried frailty phenotype results were respectively, 114 (17.8%), 295 (46.2%) and 230 (36%). The self-administered questionnaire presented a sensitivity of 66.6% (95% CI: 57.2-75.2) and a specificity of 84.2% (95% CI: 80.8-87.2). CONCLUSIONS: A self-administered questionnaire can be used in elders and represents an opportunity for empowering them in the management of their health in the context of frailty.

CITATION:
J. Shourick ; P. Lucas ; N. Tavassoli ; M. Rego-Lopes ; M.L. Seux ; O. Hanon ; S. Andrieu ; B. Vellas ; F. Forette ; (2023): Sensitivity, Specificity, Positive and Negative Predictive Values of a Postal Mail Self-Screening Tool for Frailty in French Older Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.11

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RELATIONSHIPS AMONG GRIP STRENGTH MEASUREMENT, RESPONSE TIME, AND FRAILTY CRITERIA

Y. Suzuki, Y. Matsui, Y. Hirano, I. Kondo, T. Nemoto, M. Tanimoto, H. Arai

J Frailty Aging 2023;12(3)182-188

BACKGROUND: Muscle response in older adults is believed to decrease with maximal muscle strength, although it has not been adequately assessed; further, the relationship between frailty and muscle response remains unexamined. OBJECTIVES: This study aimed to develop a practical method for measuring muscle response using grip strength in older adults and to clarify the relationship between frailty and grip strength response. DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional, clinical, observational study. A total of 248 patients (94 men and 154 women, mean age: 78.2 years) who visited the outpatient unit in the Integrated Healthy Aging Clinic of our Hospital for the first time were enrolled. MEASUREMENTS: Using a grip strength measuring device originally developed by us, we measured grip strength response indices, such as reaction time, time constant, rate of force development (response speed), and maximum grip strength. Grip strength response indices were compared among three groups (robust, pre-frail, and frail) according to the Fried and Kihon checklist assessments for frailty. RESULTS: Based on Fried’s assessment, marked differences were found between groups not only in maximal grip strength but also in response time and response speed. Based on the Kihon checklist assessment, there was no significant difference in response time; however, a considerable difference in response speed for the left hand was observed. Moreover, according to the Kihon checklist assessment, some cases showed differences in muscle response although not in maximal muscle strength. CONCLUSIONS: The response speed of grip strength was suggested to decrease with frailty. The results suggest that measurement of grip strength response in both hands is useful to examine the relationship between frailty and grip strength response.

CITATION:
Y. Suzuki ; Y. Matsui ; Y. Hirano ; I. Kondo ; T. Nemoto ; M. Tanimoto ; H. Arai (2023): Relationships among Grip Strength Measurement, Response Time, and Frailty Criteria. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.18

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COGNITION IN PEOPLE AGED 80 YEARS AND OLDER: DETERMINANTS AND PREDICTORS OF CHANGE FROM A POPULATION-BASED REPRESENTATIVE STUDY IN GERMANY

A. Ophey, T. Brijoux, A. Conrad, A.-K. Folkerts, S. Zank, E. Kalbe

J Frailty Aging 2023;12(3)189-197

BACKGROUND: The number of people aged 80 years and older (80+) will increase drastically in the upcoming decades. The preservation of cognitive functions will contribute to their quality of life and independence. OBJECTIVES: To identify determinants of cognition and predictors of change in cognitive performance in the population 80+. DESIGN: Cross-sectional and longitudinal population-based on the representative NRW80+ survey. SETTING: Randomly drawn cases of people aged 80+ from the municipal registration offices, including people living in private homes and institutional settings. PARTICIPANTS: The participants in the cross-sectional sample (N=1503, 65.5%female) were 84.7 years old (95%CI[84.5,85.0]) and had 12.3 years of education (95%CI[12.1,12.4]). The participants in the longitudinal sample (N=840, 62.5%female) were 84.9 years old (95%CI[84.6,85.2]) and had 12.3 years of education (95%CI[12.0,12.5]). MEASUREMENTS: The cognitive screening DemTect, age, sex, education, and social, physical, and cognitive lifestyle activities, as well as subjective general health status and depressive symptoms, were assessed at baseline and 24-month follow-up. RESULTS: Younger age, more years of education, and more cognitive lifestyle activities were identified as the most consistent determinants of both better cognitive performance and preservation of cognitive performance for both global cognition as well as the DemTect subtests on memory and executive functions. CONCLUSIONS: Our findings reveal that commonly investigated determinants of, and change in, cognitive performance are valid for the people 80+ and highlight the importance of cognitive lifestyle activities for cognitive health. The maintenance of cognitive functions is a key aspect of healthy aging in terms of preserving independence in people 80+.

CITATION:
A. Ophey ; T. Brijoux ; A. Conrad ; A.-K. Folkerts ; S. Zank ; E. Kalbe ; (2023): Cognition in People Aged 80 Years and Older: Determinants and Predictors of Change from a Population-Based Representative Study in Germany. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.20

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SUBJECTIVE COGNITIVE DECLINE AS A PREDICTOR OF FRAILTY IN OLDER ADULTS: HELLENIC LONGITUDINAL INVESTIGATION OF AGING AND DIET STUDY (HELIAD)

E. Margioti, N. Scarmeas, M. Yannakoulia, E. Dardiotis, G. Hadjigeorgiou, P. Sakka, E. Ntanasi, E. Aretouli, M.H. Kosmidis

J Frailty Aging 2023;12(3)198-207

Background: Subjective cognitive decline (SCD) is a self-evaluation of cognitive impairment, in the absence of observed objective cognitive deficits on a neuropsychological assessment. Frailty refers to a multidimensional syndrome where the individual has poor health including falls, disabilities, hospitalization, and vulnerability. Both terms are associated with cognitive decline and increased incidence of dementia. The present longitudinal study explored whether the detection of SCD can predict the development of frailty over time. Methods: The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) is an epidemiological, population-based study. From the original testing sample of 1,984 older Greek individuals (≥65 years old), 1,121 remained in the longitudinal analysis. Participants diagnosed with frailty, Mild Cognitive Impairment (MCI), dementia, severe depression, and anxiety, in the baseline assessment were excluded from the analysis (n=146), resulting in a total sample of 975 participants. The average follow-up interval was 3.1 years (SD=0.84 years). SCD was assessed in the baseline assessment with a series of eighteen questions. The questions regarding SCD were categorized according to cognitive domains. Frailty was assessed according to a phenotypic-physiologic (Fried’s definition) and a multidomain approach (Frailty Index). Univariate and multivariate Cox regression analyses were used for exploring the role of SCD in developing frailty. Results: The proportion of individuals with frailty according to Fried’s definition was greater compared to the Frailty Index. At follow-up according to Fried’s definition, a greater proportion of cases with frailty was found in those who reported SCD complaints regarding orientation (OD) (HR=3.12 95% CI:1.45-6.73 p<0.004) or in those who reported at least three SCD complaints regarding their memory performance (SMC3) (HR=1.92 95% CI:1.05-3.52 p<0.035) at the baseline assessment. Subjective complaints regarding orientation were predictive of a greater hazard of frailty as defined by the Fried scale (HR=3.12 95% CI:1.45-6.73 p<0.004) and the Frailty Index (HR=3.59 95% CI:1.77-7.25 p<0.001). Conclusion: Our findings demonstrate that healthy older adults who report SCD complaints regarding orientation or state that they have at least three memory complaints have a higher risk of developing frailty. Additionally, the number of participants with a clinical diagnosis of MCI or dementia, compared to individuals with normal aging, at follow-up was found to be significantly greater in cases with frailty according to both frailty definitions applied (p<0.001). Consequently, it is advisable to use screening questionnaires for SCD covering multiple cognitive domains in clinical practice for identifying and managing frailty, thus, implementing effective interventions to promote healthy aging.

CITATION:
E. Margioti ; N. Scarmeas ; M. Yannakoulia ; E. Dardiotis ; G. Hadjigeorgiou ; P. Sakka ; E. Ntanasi ; E. Aretouli ; M.H. Kosmidis ; (2023): Subjective Cognitive Decline as a predictor of Frailty in older adults: Hellenic Longitudinal Investigation of Aging and Diet study (HELIAD). The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.28

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PREDICTING THE READMISSION AND MORTALITY IN OLDER PATIENTS HOSPITALIZED WITH PNEUMONIA WITH PREADMISSION FRAILTY

K. Yamada, K. Iwata, Y. Yoshimura, H. Ota, Y. Oki, Y. Mitani, Y. Oki, Y. Yamada, A. Yamamoto, K. Ono, A. Honda, T. Kitai, R. Tachikawa, N. Kohara, K. Tomii, A. Ishikawa

J Frailty Aging 2023;12(3)208-213

Background: In older people, frailty has been recognized as an important prognostic factor. However, only a few studies have focused on multidimensional frailty as a predictor of mortality and readmission among inpatients with pneumonia. Objective: The present study aimed to assess the association between preadmission frailty and clinical outcomes after the hospitalization of older patients with pneumonia. Design: Single-center, retrospective case-control study. Setting: Acute phase hospital at Kobe, Japan. Participants: The present study included 654 consecutive older inpatients with pneumonia. Measurements: Frailty status before admission was assessed using total Kihon Checklist (KCL) score, which has been used as a self-administered questionnaire to assess comprehensive frailty, including physical, social, and cognitive status. The primary outcome was a composited 6-month mortality and readmission after discharge. Results: In total, 330 patients were analyzed (median age: 79 years, male: 70.4%, median total KCL score: 10 points), of which 68 were readmitted and 10 died within 6 months. After multivariate analysis, total KCL score was associated with a composited 6-month mortality and readmission (adjusted hazard ratio, 1.07; 95% confidence interval, 1.02–1.12; p = 0.006). The cutoff value for total KCL score determined by receiver operating characteristic curve analysis was 15 points (area under the curve = 0.610). The group with a total KCL score ≥ 15 points had significantly higher readmission or mortality rates than the groups with a total KCL score < 15 points (p < 0.001). Conclusions: Preadmission frailty status in older patients with pneumonia was an independent risk factor for readmission and survival after hospitalization.

CITATION:
K. Yamada ; K. Iwata ; Y. Yoshimura ; H. Ota ; Y. Oki ; Y. Mitani ; Y. Oki ; Y. Yamada ; A. Yamamoto ; K. Ono ; A. Honda ; T. Kitai ; R. Tachikawa ; N. Kohara ; K. Tomii ; A. Ishikawa ; (2022): Predicting the Readmission and Mortality in Older Patients Hospitalized with Pneumonia with Preadmission Frailty. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.36

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EVALUATING QUALITY-OF-LIFE, LENGTH OF STAY AND COSTEFFECTIVENESS OF A FRONT-DOOR GERIATRICS PROGRAM: AN EXPLORATORY PROOF-OF-CONCEPT STUDY

M.J. Pereira, E. Chong, J.A.D. Molina, S.H.X. Ng, E.F. Goh, B. Zhu, M. Chan, W.S. Lim

J Frailty Aging 2023;12(3)214-220

Background: The Emergency Department Interventions for Frailty (EDIFY) program was developed to deliver early geriatric specialist interventions at the Emergency Department (ED). EDIFY has been successful in reducing acute admissions among older adults. Objectives: We aimed to examine the effectiveness of EDIFY in improving health-related quality-of-life (HRQOL) and length of stay (LOS), and evaluate EDIFY’s cost-effectiveness. Design: A quasi-experiment study. Setting: The ED of a 1700-bed tertiary hospital. Participants: Patients (≥85 years) pending acute hospital admission and screened by the EDIFY team to be potentially suitable for discharge or transfer to low-acuity care areas. Intervention: EDIFY versus standard-care. Measurements: Data on demographics, comorbidities, premorbid function, and frailty status were gathered. HRQOL was measured using EQ-5D-5L over 6 months. We used a crosswalk methodology to compute Singapore-specific index scores from EQ-5D-5L responses and calculated quality-adjusted life-years (QALYs) gained. LOS and bills in Singapore-dollars (SGD) before subsidy from ED attendances (including admissions, if applicable) were obtained. We estimated average programmatic EDIFY cost and performed multiple imputation (MI) for missing data. QALYs gained, LOS and cost were compared. Potential uncertainties were also examined. Results: Among 100 participants (EDIFY=43; standard-care=57), 61 provided complete data. For complete cases, there were significant QALYs gained at 3-month (coefficient=0.032, p=0.004) and overall (coefficient=0.096, p=0.002) for EDIFY, whilst treatment cost was similar between-groups. For MI, we observed only overall QALYs gained for EDIFY (coefficient=0.102, p=0.001). EDIFY reduced LOS by 17% (Incident risk ratio=0.83, p=0.015). In a deterministic sensitivity analysis, EDIFY’s cost-threshold was SGD$2,500, and main conclusions were consistent in other uncertainty scenarios. Mean bills were: EDIFY=SGD$4562.70; standard-care=SGD$5530.90. EDIFY’s average programmatic cost approximated SGD$469.30. Conclusions: This exploratory proof-of-concept study found that EDIFY benefits QALYs and LOS, with equivalent cost, and is potentially cost-effective. The program has now been established as standard-care for older adults attending the ED at our center.

CITATION:
M.J. Pereira ; E. Chong ; J.A.D. Molina ; S.H.X. Ng ; E.F. Goh ; B. Zhu ; M. Chan ; W.S. Lim (2022): Evaluating Quality-of-Life, Length of Stay and Cost-Effectiveness of a Front-Door Geriatrics Program: An Exploratory Proof-of-Concept Study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.40

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FRAILTY, QUALITY OF LIFE, AND LONELINESS OF AGING IN NATIVE AND DIASPORIC CHINESE ADULTS

S.L. Cheung, W.P. Krijnen, C.P. van der Schans, J.S.M. Hobbelen

J Frailty Aging 2023;12(3)221-230

Background: Global migration has increased in the past century, and aging in a foreign country is relevant to the Chinese diaspora. Objective: With regard to migration, this study focuses on the places of aging as the context of older Chinese adults. This study aimed to describe the general health and wellbeing of this population with respect to their location. Design: This study has a cross sectional design. Setting and participants: Participants were recruited who were “aging in place” from Tianjin, China (199 participants), and “aging out of place” from the Netherlands (134 participants). Data from April to May 2019 in China and November 2018 to March 2019 in the Netherlands were aggregated. Measurements: frailty, QoL and loneliness were used in both samples. Results: T-tests and regression analyses demonstrated that social domains of frailty and QoL, as well as loneliness and frailty prevalence characterized the major differences between both places of aging. A correlation analysis and visual correlation network revealed that frailty, quality of life (QoL), and loneliness were more closely related in the aging out of place sample. Social domains of frailty and QoL, as well as the prevalence of loneliness and frailty, characterized the major differences between both places of aging. Conclusions: The findings indicate that frailty, QoL, and loneliness have a complex relationship, confirming that loneliness is a major detriment to the general wellbeing of older Chinese adults aging out of place. This study examined the places of aging of the larger Chinese population and allows a comprehensive understanding of health and wellbeing. The social components, especially loneliness, among the aging out of place Chinese community should receive more attention practice and clinical wise. On the other hand, frailty as well as its prevention is of more importance for the Chinese community aging in place.

CITATION:
S.L. Cheung ; W.P. Krijnen ; C.P. van der Schans ; J.S.M. Hobbelen ; (2022): Frailty, Quality of Life, and Loneliness of Aging in Native and Diasporic Chinese Adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.27

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CLINICAL CHARACTERISTICS AND MORTALITY OF OLD AND VERY OLD PATIENTS HOSPITALIZED FOR HIP FRACTURE OR ACUTE MEDICAL CONDITIONS

D. Fluck, C.H. Fry, R. Lisk, K. Yeong, J. Robin, T.S. Han

J Frailty Aging 2023;12(3)231-235

Background: There is increasing interest in healthcare quality and economic implications for hip fracture patients of very old age. However, results are limited by access to comparable control groups. Objectives: We examined healthcare quality measures including mortality and length of stay (LOS) in hospital of adults aged 60-107 years undergoing hip operations, compared to an age-matched group admitted for acute general medical conditions. Design: Monocentric cross-sectional study. Setting: Ashford and St Peter’s Hospitals NHS Foundation Trust, Surrey, United Kingdom. Participants: A total of 3972 consecutive admissions for hip operation from 1st April 2009 to 30th June 2019 (dataset-1) and 6979 for acute general medical conditions from 1st April 2019 to 29th February 2020 (dataset-2). Respective ages, mean (±standard deviation), were 83.5 years (±9.1) and 79.8 years (±9.8). Measurements: Mortality and LOS were assessed with each group divided into five- year age bands and those ≥95 years. Results: There were proportionally more (P <0.001) females admitted for hip operations (72.8%) than for acute general medical conditions (53.8%). Amongst patients admitted with general medical conditions, the frequency of the most serious recorded conditions - including congestive heart failure, stroke, and pneumonia - increased with age. Amongst patients undergoing hip operations, 5.7% died in hospital and 29.3% had a LOS ≥3 weeks. Corresponding values for acute general medical conditions were 10.4% and 11.8%. For those undergoing hip operations in all age categories, the risk of death was lower than for acute general medical group: sex-adjusted odds ratios ranged between 0.27 and 0.67, but the risk of LOS ≥3 weeks was greater: odds ratios ranged between 2.46 and 2.95. Conclusions: Compared to those admitted with acute general medical conditions, patients admitted for hip operations had a lower risk of death, but a longer hospital LOS.

CITATION:
D. Fluck ; C.H. Fry ; R. Lisk ; K. Yeong ; J. Robin ; T.S. Han (2022): Clinical Characteristics and Mortality of Old and Very Old Patients Hospitalized for Hip Fracture or Acute Medical Conditions. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2022.34

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REFERENCE STANDARD FOR THE MEASUREMENT OF LOSS OF AUTONOMY AND FUNCTIONAL CAPACITIES IN LONG-TERM CARE FACILITIES

F. Buckinx, E. Peyrusqué, M.J. Kergoat, M. Aubertin-Leheudre

J Frailty Aging 2023;12(3)236-243

The vast majority of people living in long-term care facilities (LTCFs) are octogenarians (i.e., in Québec, 57.4% of the residents are age 85 or older, 26.2% are between age 75 and 84, 10.7% are between age 65 and 74, and 5.7% are below age 65 (1)), who are affected by a great loss of physical or cognitive autonomy due to illnesses and are unable to maintain their independence, safety and mobility at home. For the majority of them, their last living environment will be a LTCF. Moreover, the annual turnover in LTCFs is one-third of all residents (2) while the average length of stay is 823 days (1). Therefore the main challenges for caregivers in LTCFs are the maintenance of functional capacities and preventing patients from becoming bedridden and isolated. Measuring the level of autonomy and functional capacities is therefore a key element in the care of institutionalized people. Several validated tools are available to quantify the degree of dependence and the functional capacities of older people living in long-term care facilities. This narrative review aims to present the characteristics of the specific population living in long-term care facilities and describe the most widely used and validated tools to measure their level of autonomy and functional capacities.

CITATION:
F. Buckinx ; E. Peyrusqué ; M.J. Kergoat ; M. Aubertin-Leheudre ; (2023): Reference Standard for the Measurement of Loss of Autonomy and Functional Capacities in Long-Term Care Facilities. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.4

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THE NUMBER OF MEDICATIONS IS ASSOCIATED WITH FRACTURES IN A POPULATION OF DIALYZED OLDER PATIENTS WITH FRAILTY

D. Azzolino, S. Vettoretti, M.M. Poggi, A. Soldati, M. Cesari

J Frailty Aging 2023;12(3)244-246

Older persons with chronic kidney disease (CKD) undergoing hemodialysis represent a growing portion of patients characterized by high vulnerability but still marginally studied. This study aimed at exploring the relationship between the number of prescriptions and fractures in older patients with CKD undergoing hemodialysis. A 24-item Frailty Index (FI) based on sociodemographic, clinical and biological data was computed. Unadjusted and adjusted logistic regression models were performed to test the association of prescribed medications with history of fractures. A total of 107 older patients undergoing hemodialysis (38 [35.5%] women, mean age 79.1 standard deviation, SD=7.7) were included in the study. Mean number of prescribed medications was 9.9 (SD=3.9) and was significantly associated with fractures (OR 1.18, 95% CI 1.06-1.32, p=0.003), even after adjustment for potential confounders (OR 1.16, 95% CI 1.03-1.30, p=0.016). If these results will be confirmed, interventions based on deprescribing will become essential in older persons undergoing hemodialysis.

CITATION:
D. Azzolino ; S. Vettoretti ; M.M. Poggi ; A. Soldati ; M. Cesari (2023): The Number of Medications Is Associated with Fractures in a Population of Dialyzed Older Patients with Frailty. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.5

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ASSOCIATION OF BASELINE FRAILTY WITH PATIENT-REPORTED OUTCOMES IN SYSTEMIC LUPUS ERYTHEMATOSUS AT 1 YEAR

S.B. Lieber, M. Nahid, M. Rajan, M. Barbhaiya, L. Sammaritano, R.A. Lipschultz, M. Lin, M.C. Reid, L.A. Mandl

J Frailty Aging 2023;12(3)247-251

The relationship of baseline frailty with subsequent patient-reported outcomes in systemic lupus erythematosus (SLE) remains unclear. We assessed these associations in a pilot prospective cohort study. Frailty based on the FRAIL scale and the Fried phenotype and patient-reported outcomes, namely Patient Reported Outcomes Measurement Information System computerized adaptive tests and Valued Life Activities disability, were measured at baseline and 1 year among women aged 18-70 years with SLE enrolled at a single center. Differences in Patient Reported Outcomes Measurement Information System computerized adaptive tests between frail and non-frail participants were evaluated using Wilcoxon rank sum tests, and the association of baseline frailty with self-report disability at 1 year was estimated using linear regression. Of 51 participants, 24% (FRAIL scale) and 16% (Fried phenotype) met criteria for frailty at baseline despite median age of 55.0 and 56.0 years, respectively. Women with (versus without) baseline frailty using either measure had worse 1-year Patient Reported Outcomes Measurement Information System computerized adaptive test scores across multiple domains and greater self-report disability. Baseline frailty was significantly associated with self-report disability at 1 year (FRAIL scale: parameter estimate 0.55, 95% confidence interval (CI) 0.21-0.89, p<0.01; Fried phenotype: parameter estimate 0.61, 95% CI 0.22-1.00, p<0.01), including only slight attenuation after adjustment for SLE cumulative organ damage (FRAIL scale: parameter estimate 0.45, 95% CI 0.09-0.81, p=0.02; Fried phenotype: parameter estimate 0.49, 95% CI 0.09-0.90, p=0.02). These preliminary findings support frailty as an independent risk factor for clinically relevant patient-reported outcomes, including disability onset, among women with SLE.

CITATION:
S.B. Lieber ; M. Nahid ; M. Rajan ; M. Barbhaiya ; L. Sammaritano ; R.A. Lipschultz ; M. Lin ; M.C. Reid ; L.A. Mandl ; (2023): Association of Baseline Frailty with Patient-Reported Outcomes in Systemic Lupus Erythematosus at 1 Year. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.24

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ERRATUM TO: EFFECTS OF CURCUMIN C3 COMPLEX® ON PHYSICAL FUNCTION IN MODERATELY FUNCTIONING OLDER ADULTS WITH LOW-GRADE INFLAMMATION – A PILOT TRIAL

R.T. Mankowski, K.T. Sibille, C. Leeuwenburgh, Y. Lin, F.-C. Hsu, P. Qiu, B. Sandesara, S.D. Anton

J Frailty Aging 2023;12(3)252

CITATION:
R.T. Mankowski ; K.T. Sibille1 ; C. Leeuwenburgh ; Y. Lin ; F.-C. Hsu ; P. Qiu ; B. Sandesara ; S.D. Anton ; (2023): Erratum to: Effects of Curcumin C3 Complex® on Physical Function in Moderately Functioning Older Adults with Low-Grade Inflammation – A Pilot Trial. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.26

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ERRATUM TO: OPTIMIZING THE AGING BRAIN: THE BEAD STUDY ON THE ETHICS OF DEMENTIA PREVENTION

M. Andreoletti, C. Lazzaroni, N. Petersen, S. Segawa, A. Leibing, S. Schicktanz, A. Blasimme

J Frailty Aging 2023;12(3)253

CITATION:
M. Andreoletti ; C. Lazzaroni ; N. Petersen ; S. Segawa ; A. Leibing ; S. Schicktanz ; A. Blasimme ; (2023): Erratum to: Optimizing the Aging Brain: The BEAD Study on the Ethics of Dementia Prevention. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2023.13

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