{"title":"Editorial: Front-Door Geriatrics: Frailty-Ready Emergency Department to Achieve the Quadruple Aim.","authors":"E Chong, T Ong, W S Lim","doi":"10.14283/jfa.2023.42","DOIUrl":"10.14283/jfa.2023.42","url":null,"abstract":"","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"12 4","pages":"254-257"},"PeriodicalIF":3.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite the importance of physical exercise for older people, only a fraction of them receive advice to do so by primary care physicians. This study aims to examine whether gender disparities exist in primary care regarding General Practitioners’ (GPs’) advice for exercise in older European adults. A total of N=21,703 participants from 14 countries were employed from the Survey of Health, Ageing, and Retirement in Europe and analysed with the use of multivariate ordered logistic regressions. Being female reduced the odds of receiving advice from a primary care physician (OR=0.83; 95% CI: 0.78–0.88) irrespective of health, behavioural, demographic, and socioeconomic factors. In conclusion, older European women may have reduced odds of receiving advice for exercise because of their gender, which in turn may affect their frailty.
{"title":"Are General Practitioners More Reluctant to Give Advice for Exercise to Older Women? A Cross-Sectional Survey of European Adults","authors":"K. Christopoulos","doi":"10.14283/jfa.2023.40","DOIUrl":"https://doi.org/10.14283/jfa.2023.40","url":null,"abstract":"Despite the importance of physical exercise for older people, only a fraction of them receive advice to do so by primary care physicians. This study aims to examine whether gender disparities exist in primary care regarding General Practitioners’ (GPs’) advice for exercise in older European adults. A total of N=21,703 participants from 14 countries were employed from the Survey of Health, Ageing, and Retirement in Europe and analysed with the use of multivariate ordered logistic regressions. Being female reduced the odds of receiving advice from a primary care physician (OR=0.83; 95% CI: 0.78–0.88) irrespective of health, behavioural, demographic, and socioeconomic factors. In conclusion, older European women may have reduced odds of receiving advice for exercise because of their gender, which in turn may affect their frailty.","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135600235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Cesari, R. Bernabei, B. Vellas, R. Fielding, D. Rooks, D. Azzolino, J. Mariani, A. Oliva, S. Bhasin, Y. Rolland
Sarcopenia and frailty represent two burdensome conditions, contributing to a broad spectrum of adverse outcomes. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met virtually in September 2021 to discuss the challenges in the development of drugs for sarcopenia and frailty. Lifestyle interventions are the current mainstay of treatment options in the prevention and management of both conditions. However, pharmacological agents are needed for people who do not respond to lifestyle modifications, for those who are unable to adhere, or for whom such interventions are inaccessible/unfeasible. Preliminary results of ongoing trials were presented and discussed. Several pharmacological candidates are currently under clinical evaluation with promising early results, but none have been approved for either frailty or sarcopenia. The COVID-19 pandemic has reshaped how clinical trials are conducted, in particular by enhancing the usefulness of remote technologies and assessments/interventions.
{"title":"Challenges in the Development of Drugs for Sarcopenia and Frailty - Report from the International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force","authors":"M. Cesari, R. Bernabei, B. Vellas, R. Fielding, D. Rooks, D. Azzolino, J. Mariani, A. Oliva, S. Bhasin, Y. Rolland","doi":"10.14283/jfa.2022.30","DOIUrl":"https://doi.org/10.14283/jfa.2022.30","url":null,"abstract":"Sarcopenia and frailty represent two burdensome conditions, contributing to a broad spectrum of adverse outcomes. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met virtually in September 2021 to discuss the challenges in the development of drugs for sarcopenia and frailty. Lifestyle interventions are the current mainstay of treatment options in the prevention and management of both conditions. However, pharmacological agents are needed for people who do not respond to lifestyle modifications, for those who are unable to adhere, or for whom such interventions are inaccessible/unfeasible. Preliminary results of ongoing trials were presented and discussed. Several pharmacological candidates are currently under clinical evaluation with promising early results, but none have been approved for either frailty or sarcopenia. The COVID-19 pandemic has reshaped how clinical trials are conducted, in particular by enhancing the usefulness of remote technologies and assessments/interventions.","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"11 1","pages":"135 - 142"},"PeriodicalIF":3.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45039323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matteo Cesari, M. Canevelli, R. Calvani, I. Aprahamian, M. Inzitari, E. Marzetti
Frailty is today a hot topic in the scientific community and among clinicians. Geriatricians are no longer the only specialists discussing this age-related condition. Many medical disciplines (e.g., oncologists (1), cardiologists (2), neurologists (3), nephrologists (4), infectious disease specialists (5), pneumologists (6), anesthesiologists (7)) have finally started looking at this critical aspect in older persons, particularly impactful on prognosis and treatment modalities (e.g., (8, 9)). In the debate about this “novel” condition, it may sometimes happen that the word “frailty” is inappropriately used, suggesting a still incomplete understanding of the condition of interest. Some concepts seem difficult to get through, especially in those fields that are not used to the holistic approach and multidisciplinarity typical of geriatrics. For example, there is considerable confusion about the difference between 1) the theoretical concept of frailty (10), 2) the models to capture this condition (e.g., the physical phenotype model (11), the accumulation of health deficit model (12), the bio-psycho-social model (13)), and 3) the instruments to translate the model into a score for clinical use. Not surprisingly, the different models are often interchangeably used, which generates confusion and misunderstandings (14). An ambiguity around frailty is related to the ageistic connotation it has been assuming over the past years (15). Today, frailty is often translated with “do not” and excludes persons from interventions. Indeed, it seems a more elegant way than chronological age to discriminate. Differently, frailty was conceived as a target condition to implement interventions with the aim of 1) increasing the individual’s reserves (16) and 2) offering him/her the most suitable and effective solution (17). The detection of frailty paradoxically nests the inclusive idea of “doing more” (sometimes even invasively) for persons who would otherwise be inadequately/insufficiently considered. Furthermore, it is not easy for many to see frailty outside the monodimensional paradigm of a “disease”. Frailty is not a disease and, as such, does not fit with the approach used for traditional nosological conditions: one biological abnormality resulting in a monodimensional clinical expression that needs a “one-fits-all” treatment. Another controversial point, frequently stemming from the erroneous framing of frailty as a disease, is related to the interventions to implement. It is not infrequent to see recommendations indicating lifestyle modifications (particularly, physical activity and healthy diet) as definitive solutions for the problem. It is evident to clinicians familiar with the biological, clinical, and social complexity of an older person with frailty how these statements oversimplify the reality. First, virtually any clinical condition benefits from physical activity and optimal nutrient intake. A healthy lifestyle is critical for the well-being of every i
{"title":"The Management of Frailty: Barking Up the Wrong Tree","authors":"Matteo Cesari, M. Canevelli, R. Calvani, I. Aprahamian, M. Inzitari, E. Marzetti","doi":"10.14283/jfa.2022.29","DOIUrl":"https://doi.org/10.14283/jfa.2022.29","url":null,"abstract":"Frailty is today a hot topic in the scientific community and among clinicians. Geriatricians are no longer the only specialists discussing this age-related condition. Many medical disciplines (e.g., oncologists (1), cardiologists (2), neurologists (3), nephrologists (4), infectious disease specialists (5), pneumologists (6), anesthesiologists (7)) have finally started looking at this critical aspect in older persons, particularly impactful on prognosis and treatment modalities (e.g., (8, 9)). In the debate about this “novel” condition, it may sometimes happen that the word “frailty” is inappropriately used, suggesting a still incomplete understanding of the condition of interest. Some concepts seem difficult to get through, especially in those fields that are not used to the holistic approach and multidisciplinarity typical of geriatrics. For example, there is considerable confusion about the difference between 1) the theoretical concept of frailty (10), 2) the models to capture this condition (e.g., the physical phenotype model (11), the accumulation of health deficit model (12), the bio-psycho-social model (13)), and 3) the instruments to translate the model into a score for clinical use. Not surprisingly, the different models are often interchangeably used, which generates confusion and misunderstandings (14). An ambiguity around frailty is related to the ageistic connotation it has been assuming over the past years (15). Today, frailty is often translated with “do not” and excludes persons from interventions. Indeed, it seems a more elegant way than chronological age to discriminate. Differently, frailty was conceived as a target condition to implement interventions with the aim of 1) increasing the individual’s reserves (16) and 2) offering him/her the most suitable and effective solution (17). The detection of frailty paradoxically nests the inclusive idea of “doing more” (sometimes even invasively) for persons who would otherwise be inadequately/insufficiently considered. Furthermore, it is not easy for many to see frailty outside the monodimensional paradigm of a “disease”. Frailty is not a disease and, as such, does not fit with the approach used for traditional nosological conditions: one biological abnormality resulting in a monodimensional clinical expression that needs a “one-fits-all” treatment. Another controversial point, frequently stemming from the erroneous framing of frailty as a disease, is related to the interventions to implement. It is not infrequent to see recommendations indicating lifestyle modifications (particularly, physical activity and healthy diet) as definitive solutions for the problem. It is evident to clinicians familiar with the biological, clinical, and social complexity of an older person with frailty how these statements oversimplify the reality. First, virtually any clinical condition benefits from physical activity and optimal nutrient intake. A healthy lifestyle is critical for the well-being of every i","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"11 1","pages":"127 - 128"},"PeriodicalIF":3.9,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46555010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. McGrath, P. Cawthon, B. Clark, R. Fielding, J. Lang, G. Tomkinson
Handgrip dynamometers are widely used to measure handgrip strength (HGS). HGS is a safe and easy to obtain measure of strength capacity, and a reliable assessment of muscle function. Although HGS provides robust prognostic value and utility, several protocol variants exist for HGS in clinical settings and translational research. This lack of methodological consistency could threaten the precision of HGS measurements and limit comparisons between the growing number of studies measuring HGS. Providing awareness of the protocol variants for HGS and making suggestions to reduce the implications of these variants will help to improve methodological consistency. Moreover, leveraging recent advancements in HGS equipment may enable us to use more sophisticated HGS dynamometer technologies to better assess muscle function. This Special Article will 1) highlight differences in HGS protocols and instrumentation, 2) provide recommendations to better specify HGS procedures and equipment, and 3) present future research directions for studies that measure HGS. We also provided a minimum reporting criteria framework to help future research studies avoid underreporting of HGS procedures.
{"title":"Recommendations for Reducing Heterogeneity in Handgrip Strength Protocols","authors":"R. McGrath, P. Cawthon, B. Clark, R. Fielding, J. Lang, G. Tomkinson","doi":"10.14283/jfa.2022.21","DOIUrl":"https://doi.org/10.14283/jfa.2022.21","url":null,"abstract":"Handgrip dynamometers are widely used to measure handgrip strength (HGS). HGS is a safe and easy to obtain measure of strength capacity, and a reliable assessment of muscle function. Although HGS provides robust prognostic value and utility, several protocol variants exist for HGS in clinical settings and translational research. This lack of methodological consistency could threaten the precision of HGS measurements and limit comparisons between the growing number of studies measuring HGS. Providing awareness of the protocol variants for HGS and making suggestions to reduce the implications of these variants will help to improve methodological consistency. Moreover, leveraging recent advancements in HGS equipment may enable us to use more sophisticated HGS dynamometer technologies to better assess muscle function. This Special Article will 1) highlight differences in HGS protocols and instrumentation, 2) provide recommendations to better specify HGS procedures and equipment, and 3) present future research directions for studies that measure HGS. We also provided a minimum reporting criteria framework to help future research studies avoid underreporting of HGS procedures.","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"11 1","pages":"143 - 150"},"PeriodicalIF":3.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47365043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. de Souto Barreto, M. Cesari, J. Morley, S. Roberts, F. Landi, T. Cederholm, Y. Rolland, B. Vellas, R. Fielding
Appetite loss/anorexia of aging is a highly prevalent and burdensome geriatric syndrome that strongly impairs the quality of life of older adults. Loss of appetite is associated with several clinical conditions, including comorbidities and other geriatric syndromes, such as frailty. Despite its importance, appetite loss has been under-evaluated and, consequently, under-diagnosed and under-treated in routine clinical care. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met virtually on September 27th 2021 to debate issues related to appetite loss/anorexia of aging. In particular, topics related to the implementation and management of appetite loss in at-risk older adult populations, energy balance during aging, and the design of future clinical trials on this topic were discussed. Future actions in this field should focus on the systematic assessment of appetite in the care pathway of older people, such as the Integrated Care for Older People (ICOPE) program recommended by the World Health Organization. Moreover, clinical care should move from the assessment to the treatment of appetite loss/anorexia. Researchers continue to pursue their efforts to find out effective pharmacologic and non-pharmacologic interventions with a favorable risk/benefit ratio.
{"title":"Appetite Loss and Anorexia of Aging in Clinical Care: An ICFSR Task Force Report","authors":"P. de Souto Barreto, M. Cesari, J. Morley, S. Roberts, F. Landi, T. Cederholm, Y. Rolland, B. Vellas, R. Fielding","doi":"10.14283/jfa.2022.14","DOIUrl":"https://doi.org/10.14283/jfa.2022.14","url":null,"abstract":"Appetite loss/anorexia of aging is a highly prevalent and burdensome geriatric syndrome that strongly impairs the quality of life of older adults. Loss of appetite is associated with several clinical conditions, including comorbidities and other geriatric syndromes, such as frailty. Despite its importance, appetite loss has been under-evaluated and, consequently, under-diagnosed and under-treated in routine clinical care. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met virtually on September 27th 2021 to debate issues related to appetite loss/anorexia of aging. In particular, topics related to the implementation and management of appetite loss in at-risk older adult populations, energy balance during aging, and the design of future clinical trials on this topic were discussed. Future actions in this field should focus on the systematic assessment of appetite in the care pathway of older people, such as the Integrated Care for Older People (ICOPE) program recommended by the World Health Organization. Moreover, clinical care should move from the assessment to the treatment of appetite loss/anorexia. Researchers continue to pursue their efforts to find out effective pharmacologic and non-pharmacologic interventions with a favorable risk/benefit ratio.","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"11 1","pages":"129 - 134"},"PeriodicalIF":3.9,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42506124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to synthesize available evidence on the effectiveness and safety of COVID-19 vaccines for frail older adults through a rapid review, supplemented with geriatricians’ consensus statements. References were identified through MEDLINE and Web of Science on 1st February 2021 using relevant terms related to COVID-19, vaccine, and older adults. Searches were also conducted on reference lists of review articles and Google Scholar. The content was updated on 8th April via hand searching. We included studies on Phase III randomized controlled trials, and data from real world administration of vaccines. A two-round Delphi study was conducted with 15 geriatricians to elicit their thoughts and recommendations regarding COVID-19 vaccination for frail older adults. Five Phase III randomized controlled efficacy trials reported vaccine efficacy ranging from 66.7% to 95% among participants aged 16 to 95. The vaccine efficacy for participants aged 65 and above is 94.7% and 86.4% for Pfizer-BioNTech and Moderna respectively. Sputnik V reported a vaccine efficacy of 91.8% for participants 60 and above. Serious adverse events were reported by 0.27% to 1% of participants who received at least one dose of the four vaccines. For the Delphi study, 16 out of 24 statements achieved consensus. The Delphi panel opined that frail or very old adults, except those with limited life expectancy, should be vaccinated due to their vulnerability. They also agree that vaccination decisions should be made by patients when possible, with the involvement of next-of-kin should the frail older adult be unable to do so. Lastly, the panel thought that frail older adults should be included in future clinical trials. In early clinical trials, there is paucity of evidence on efficacy and safety of current COVID-19 vaccines among frail older adults. Geriatricians’ consensus indicate that frail older adults should be vaccinated except where life expectancy is limited. Future trials assessing efficacy and safety should include frail older adults.
本研究旨在通过快速审查，结合老年医学专家的共识声明，综合现有证据，证明COVID-19疫苗对体弱老年人的有效性和安全性。参考文献于2021年2月1日通过MEDLINE和Web of Science检索，使用与COVID-19、疫苗和老年人相关的术语。还对综述文章和谷歌Scholar的参考文献列表进行了检索。内容已于4月8日手动搜索更新。我们纳入了III期随机对照试验的研究，以及来自真实世界疫苗接种的数据。对15名老年医学专家进行了两轮德尔菲研究，以征求他们对体弱老年人COVID-19疫苗接种的想法和建议。5项III期随机对照疗效试验报告，在16岁至95岁的参与者中，疫苗的疗效从66.7%到95%不等。辉瑞- biontech和Moderna疫苗对65岁及以上参与者的有效性分别为94.7%和86.4%。据Sputnik V报道，对于60岁及以上的参与者，疫苗效力为91.8%。在接种了至少一剂四种疫苗的参与者中，有0.27%至1%的人报告了严重不良事件。对于德尔菲研究，24个陈述中有16个达成了共识。德尔菲专家组认为，体弱多病或年老体弱的成年人，除了那些预期寿命有限的人，应该接种疫苗，因为他们的脆弱性。他们还同意，疫苗接种决定应尽可能由患者做出，如果体弱的老年人无法这样做，则应由其近亲参与。最后，专家组认为，未来的临床试验应该包括体弱多病的老年人。在早期临床试验中，目前COVID-19疫苗在体弱老年人中的有效性和安全性缺乏证据。老年病学家的共识表明，体弱多病的老年人应该接种疫苗，除非预期寿命有限。未来评估疗效和安全性的试验应包括体弱多病的老年人。
{"title":"COVID-19 Vaccination for Frail Older Adults in Singapore — Rapid Evidence Summary and Delphi Consensus Statements","authors":"J. Gao, P. Lun, Y. Ding, P. P. George","doi":"10.14283/jfa.2022.12","DOIUrl":"https://doi.org/10.14283/jfa.2022.12","url":null,"abstract":"This study aimed to synthesize available evidence on the effectiveness and safety of COVID-19 vaccines for frail older adults through a rapid review, supplemented with geriatricians’ consensus statements. References were identified through MEDLINE and Web of Science on 1st February 2021 using relevant terms related to COVID-19, vaccine, and older adults. Searches were also conducted on reference lists of review articles and Google Scholar. The content was updated on 8th April via hand searching. We included studies on Phase III randomized controlled trials, and data from real world administration of vaccines. A two-round Delphi study was conducted with 15 geriatricians to elicit their thoughts and recommendations regarding COVID-19 vaccination for frail older adults. Five Phase III randomized controlled efficacy trials reported vaccine efficacy ranging from 66.7% to 95% among participants aged 16 to 95. The vaccine efficacy for participants aged 65 and above is 94.7% and 86.4% for Pfizer-BioNTech and Moderna respectively. Sputnik V reported a vaccine efficacy of 91.8% for participants 60 and above. Serious adverse events were reported by 0.27% to 1% of participants who received at least one dose of the four vaccines. For the Delphi study, 16 out of 24 statements achieved consensus. The Delphi panel opined that frail or very old adults, except those with limited life expectancy, should be vaccinated due to their vulnerability. They also agree that vaccination decisions should be made by patients when possible, with the involvement of next-of-kin should the frail older adult be unable to do so. Lastly, the panel thought that frail older adults should be included in future clinical trials. In early clinical trials, there is paucity of evidence on efficacy and safety of current COVID-19 vaccines among frail older adults. Geriatricians’ consensus indicate that frail older adults should be vaccinated except where life expectancy is limited. Future trials assessing efficacy and safety should include frail older adults.","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"11 1","pages":"236 - 241"},"PeriodicalIF":3.9,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43109068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osteosarcopenia to Raise Awareness on the Complexity of the Older Person","authors":"F. Bellelli","doi":"10.14283/jfa.2022.10","DOIUrl":"https://doi.org/10.14283/jfa.2022.10","url":null,"abstract":"","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"11 1","pages":"244"},"PeriodicalIF":3.9,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43651496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Nguyen, T. Nguyen, A. Nguyen, H. Nguyen, R. Goldberg, H. Nguyen, T. H. T. Nguyen, T. Nguyen, H. T. Vu
The objective of this observational study was to examine the association between appendicular lean mass and frailty in adults aged 60 years and older. This study was conducted in the Outpatient Department of the National Geriatric Hospital in Hanoi, Vietnam. Appendicular lean mass (kg) was assessed by using Dual energy X-ray absorptiometry scans. Frailty was defined according to Fried’s frailty criteria. A total of 560 outpatients were included in the study, with a mean age of 70 years. The prevalence of frailty was 12.0%. Frail patients had significantly lower appendicular lean mass compared with non-frail outpatients (9.6 ± 2.0 kg vs. 11.7 ± 3.1 kg, p<0.001). On multivariable logistic regression models, higher appendicular lean mass was associated with significantly reduced odds for frailty (adjusted OR = 0.74, 95%CI 0.59–0.93). These findings suggest that the assessment of appendicular lean mass should be considered in older patients attending outpatient geriatric clinics.
这项观察性研究的目的是检验60岁及以上成年人阑尾瘦块与虚弱之间的关系。这项研究是在越南河内国家老年医院门诊部进行的。使用双能X射线吸收仪扫描评估阑尾瘦质量（kg）。虚弱是根据弗里德的虚弱标准来定义的。共有560名门诊患者参与了这项研究，平均年龄为70岁。虚弱的患病率为12.0%。与非虚弱门诊患者相比，虚弱患者的阑尾瘦质量显著较低（9.6±2.0 kg vs.11.7±3.1 kg，p<0.001）。在多变量逻辑回归模型中，较高的阑尾瘦块与明显降低的虚弱几率相关（校正OR=0.74，95%CI 0.59-0.93）。这些发现表明，在老年门诊就诊的老年患者中应考虑评估阑尾瘦块。
{"title":"Appendicular Lean Mass and Frailty among Geriatric Outpatients","authors":"T. Nguyen, T. Nguyen, A. Nguyen, H. Nguyen, R. Goldberg, H. Nguyen, T. H. T. Nguyen, T. Nguyen, H. T. Vu","doi":"10.14283/jfa.2022.9","DOIUrl":"https://doi.org/10.14283/jfa.2022.9","url":null,"abstract":"The objective of this observational study was to examine the association between appendicular lean mass and frailty in adults aged 60 years and older. This study was conducted in the Outpatient Department of the National Geriatric Hospital in Hanoi, Vietnam. Appendicular lean mass (kg) was assessed by using Dual energy X-ray absorptiometry scans. Frailty was defined according to Fried’s frailty criteria. A total of 560 outpatients were included in the study, with a mean age of 70 years. The prevalence of frailty was 12.0%. Frail patients had significantly lower appendicular lean mass compared with non-frail outpatients (9.6 ± 2.0 kg vs. 11.7 ± 3.1 kg, p<0.001). On multivariable logistic regression models, higher appendicular lean mass was associated with significantly reduced odds for frailty (adjusted OR = 0.74, 95%CI 0.59–0.93). These findings suggest that the assessment of appendicular lean mass should be considered in older patients attending outpatient geriatric clinics.","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"11 1","pages":"177 - 181"},"PeriodicalIF":3.9,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49129947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julian Alcazar, I. Ara, F. García-García, L. Alegre
We read with great interest the recent Letter to the Editor published in this journal about the use of the 30-s chair stand test as a measure of muscle function in older people (1). As it is stated in the letter, the assessment of muscle function in the clinical setting is of high relevance, since muscle dysfunction can be the predecessor of frailty and disability among older people. In this sense, the assessment of handgrip strength may be considered the most popular measure of muscle function that is being used in the clinical setting, and it is the preferred choice by the European Working Group on Sarcopenia in Older People (2). The main limitation derived from handgrip strength testing is that it poorly reflects lower limb muscle function or changes in lower limb muscle function resulting from interventions targeting the lower limbs. We could fairly assert that lower limb muscle function has a higher relevance than handgrip strength for some of the main activities required for an independent living: walking, chair rising and stair climbing. Therefore, we agree with Prof. McGrath about the necessity of a lower limb muscle function measure suitable for the clinical setting in terms of feasibility and clinical relevance. However, we disagree with Prof. McGrath’s proposal on the use of chair stands as a measure of lower limb muscle function (1). As noted by Prof. McGrath, the Short Physical Performance Battery, which includes the chair stand test, is used to examine physical performance, and not muscle function. Indeed, the 30-s chair stand test is widely considered a physical performance assessment. Although chair stand performance can be correlated to lower limb power and endurance, it is not a measure of muscle function, as well as gait speed is correlated to lower limb muscle function, but it is a measure of physical performance. Both tests indicate the rate at which an individual is able to perform a certain functional task (meters per second in the case of gait speed, and chair stands in a certain time period for the chair stand test). Importantly, the use of the chair stand test as a measure of muscle function can lead to erroneously diagnose muscle dysfunction in some – not infrequent – cases. For example, a lower count in the chair stand test might be the result of the individual presenting obesity, while he/she might present a normal lower limb muscle function (simply the excess of body mass impeded them to perform better in this functional task). So in this case the conclusion should be that physical performance is low, muscle function is normal, but there is an excessive body mass. This may lead to prescribe a different treatment (e.g. achieve a negative energy balance by diet and exercise) compared to the one that should be prescribed to a patient with low lower limb muscle function (e.g. power-oriented resistance training). However, there exists an alternative to use the chair stand test to assess lower limb muscle function in older
{"title":"Number of Chair Stands Should Not Be Considered a Muscle Function Measure, But a Physical Performance Measure. What Can We Do Then?","authors":"Julian Alcazar, I. Ara, F. García-García, L. Alegre","doi":"10.14283/jfa.2021.50","DOIUrl":"https://doi.org/10.14283/jfa.2021.50","url":null,"abstract":"We read with great interest the recent Letter to the Editor published in this journal about the use of the 30-s chair stand test as a measure of muscle function in older people (1). As it is stated in the letter, the assessment of muscle function in the clinical setting is of high relevance, since muscle dysfunction can be the predecessor of frailty and disability among older people. In this sense, the assessment of handgrip strength may be considered the most popular measure of muscle function that is being used in the clinical setting, and it is the preferred choice by the European Working Group on Sarcopenia in Older People (2). The main limitation derived from handgrip strength testing is that it poorly reflects lower limb muscle function or changes in lower limb muscle function resulting from interventions targeting the lower limbs. We could fairly assert that lower limb muscle function has a higher relevance than handgrip strength for some of the main activities required for an independent living: walking, chair rising and stair climbing. Therefore, we agree with Prof. McGrath about the necessity of a lower limb muscle function measure suitable for the clinical setting in terms of feasibility and clinical relevance. However, we disagree with Prof. McGrath’s proposal on the use of chair stands as a measure of lower limb muscle function (1). As noted by Prof. McGrath, the Short Physical Performance Battery, which includes the chair stand test, is used to examine physical performance, and not muscle function. Indeed, the 30-s chair stand test is widely considered a physical performance assessment. Although chair stand performance can be correlated to lower limb power and endurance, it is not a measure of muscle function, as well as gait speed is correlated to lower limb muscle function, but it is a measure of physical performance. Both tests indicate the rate at which an individual is able to perform a certain functional task (meters per second in the case of gait speed, and chair stands in a certain time period for the chair stand test). Importantly, the use of the chair stand test as a measure of muscle function can lead to erroneously diagnose muscle dysfunction in some – not infrequent – cases. For example, a lower count in the chair stand test might be the result of the individual presenting obesity, while he/she might present a normal lower limb muscle function (simply the excess of body mass impeded them to perform better in this functional task). So in this case the conclusion should be that physical performance is low, muscle function is normal, but there is an excessive body mass. This may lead to prescribe a different treatment (e.g. achieve a negative energy balance by diet and exercise) compared to the one that should be prescribed to a patient with low lower limb muscle function (e.g. power-oriented resistance training). However, there exists an alternative to use the chair stand test to assess lower limb muscle function in older","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"11 1","pages":"245-246"},"PeriodicalIF":3.9,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46112122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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