Journal of Frailty & Aging最新文献

{"title":"Fecal Microbiota Transplantation Modulates Gut Microbiome Composition and Glial Signaling in Brain and Colon of Rats with Neuropathic Pain: Evidence for Microbiota-Gut-Brain Axis.","authors":"C-L Shen, H Deshmukh, J M Santos, M M Elmassry, P Presto, Z Driver, V Bhakta, V Yakhnitsa, T Kiritoshi, G Ji, J Lovett, A Hamood, V Neugebauer","doi":"10.14283/jfa.2024.65","DOIUrl":"10.14283/jfa.2024.65","url":null,"abstract":"<p><p>Despite evidence linking the gut microbiome to neuropathic pain (NP), it is not known if altering gut microbiota can alleviate NP via the microbiome-gut-brain axis. This study examined if healthy gut microbiota of sham male rats (Sham+V) and dysbiotic gut microbiota of NP rats (spinal nerve ligation: NP, SNL+V) can be disrupted and restored, respectively, via fecal microbiota transplant (FMT) from the opposite group [Sham+(SNL-FMT) and SNL+(Sham-FMT), respectively]. All groups received FMT daily for two weeks, followed by three weeks without FMT. SNL rats showed higher mechanical hypersensitivity [SNL+V vs. Sham+V] throughout the study. After two weeks, the FMT of healthy gut microbiota decreased mechanical hypersensitivity in SNL rats [SNL+(Sham-FMT) vs. SNL+V]. A temporal shift in microbiome profiles after 2-week FMT treatment was observed in Sham+(SNL-FMT) and SNL+(Sham-FMT) groups, while the microbiome profile shifted back a certain extent after FMT ceased. At the end of study, the Sham+(SNL-FMT) group acquired low abundance of UCG-001, Odoribacter, and Peptococcaceae, and high abundance of UBA1819 and Victivallis. The SNL+(Sham-FMT) group maintained high abundance of Butyricimonas and Escherichia-Shigella. The SNL+(Sham-FMT) group had altered glial and macrophage activation/inflammation markers in the brain/colon than the SNL+V group. Relative to the SNL+V group, the SNL+(Sham-FMT) group had significantly lower gene expressions of GFAP (hypothalamus), IBA-1 (colon), and NF-κB (amygdala/colon), but higher gene expressions of complex I (amygdala/hypothalamus) and claudin-3 (amygdala/hypothalamus/colon). In conclusion, FMT containing healthy microbiota given to SNL rats attenuates mechanical hypersensitivity, modulates microbiota composition, and mitigates downstream glial activation/inflammation markers in a NP model.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"319-330"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689606","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":"Application of a Social Vulnerability Index and Its Associations with Physical Frailty and Disability in a Cross-sectional Study of Older Kenyan Women Living with and without HIV.","authors":"S Prabhu, B Oyaro, G Wanje, F M Aunon, N Gomez Juarez, B P Flaherty, W McCormick, M K Andrew, W Jaoko, R S McClelland, S M Graham","doi":"10.14283/jfa.2024.71","DOIUrl":"10.14283/jfa.2024.71","url":null,"abstract":"<p><strong>Background: </strong>Social vulnerability reflects deficits in social resources that may disproportionally impact older women with HIV (WWH) in Africa.</p><p><strong>Objective: </strong>To examine the relationship between scores on an adapted Social Vulnerability Index (SVI) and measures of physical frailty and disability.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Participants: </strong>293 women (156 HIV-positive, 137 HIV-negative) aged >40 years in Mombasa, Kenya who were recruited from the Mombasa Cohort of women with a history of transactional sex and the general community.</p><p><strong>Measurements: </strong>Assessments including an SVI adapted for the Kenyan context (SVI-Kenya), the Clinical Frailty Scale (CFS) and the World Health Organization Disability Assessment (WHODAS) were compared by HIV status. Linear regression was used to determine the relationship between SVI-Kenya score and both CFS and WHODAS, after adjustment for potential confounders. An exploratory analysis identified factors associated with SVI-Kenya score. An age-by-HIV-status interaction term was tested and retained if significant in unadjusted analyses.</p><p><strong>Results: </strong>Mean SVI-Kenya score was 34.1 (SD, 12.9) and did not differ by HIV status (p=0.49). In adjusted analyses, each increment in SVI-Kenya score was associated with a 1.10-point higher WHODAS score (95%CI:0. 21, 1.99), but not with CFS. In exploratory analysis, factors associated with higher SVI-Kenya score included WHODAS score (adjusted beta=0.20; 95%CI: 0.05,0.35) and Mombasa Cohort recruitment (adjusted beta=5.91; 95%CI: 2.07,9.75). Being married, separated/divorced, or widowed predicted lower SVI-Kenya scores (by 5.52-9.09 points) compared to being single. Age did not predict SVI-Kenya score.</p><p><strong>Conclusion: </strong>Social vulnerability as measured by the SVI-Kenya score was associated with greater disability but not physical frailty. Social vulnerability was also associated with prior sex work and never having married. Our findings suggest that social vulnerability is a distinct construct from physical frailty among older Kenyan women and not related to HIV status.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"552-560"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the Clinical pHysical rEsilience assEssment Scale (CHEES) in Chinese Older Adults.","authors":"J Li, P Liu, Y Zhang, G Wang, Y Zhou, Y Xing, L Zhang, Y Li, L Ma","doi":"10.14283/jfa.2024.24","DOIUrl":"10.14283/jfa.2024.24","url":null,"abstract":"<p><strong>Background: </strong>Physical resilience is an emerging concept that describes an individual's capacity to recover from stressors. However, few instruments are currently available for assessing physical resilience.</p><p><strong>Objective: </strong>To develop a scale to assess physical resilience in older adults.</p><p><strong>Design: </strong>Development of a clinical scale.</p><p><strong>Setting and participants: </strong>A total of 172 hospitalized older adults were recruited.</p><p><strong>Measurements: </strong>This study comprised two stages. First, a pool of physical resilience scale items was created through a literature review, and the Delphi method was used to establish an initial scale. Second, the initial physical resilience scale was tested on hospitalized older adults.</p><p><strong>Results: </strong>Five primary and 19 secondary items were identified after reviewing the literature. After two rounds of expert consultations, three primary and 16 secondary items were determined. The overall Cronbach's alpha for the scale was 0.760. Except for items N2, N4, N5, N8, and N14, Pearson's correlation between the scores of the remaining items and the total score ranged from 0.407 to 0.672. Except for items N2, N4, and N5, the corrected item-total correlation results ranged from 0.301 to 0.580, indicating good consistency between each item and the overall scale. Factor analysis showed that except for N7, the factor loadings of the remaining items were between 0.584 and 0.844. After expert discussions, items N2, N4, N7, and N14 were included in the scale, and items N5 and N8 were removed.</p><p><strong>Conclusion: </strong>A 14-item physical resilience scale, CHEES, was developed to assess physical resilience levels in older adults.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"125-130"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yubi-Wakka Test for Sarcopenia Screening in the Community: Comparative Agreement, Diagnostic Performance and Validity with Calf Circumference Measurements.","authors":"M R B Piodena-Aportadera, S Lau, C N Tan, J Chew, J P Lim, N H Ismail, Y Y Ding, W S Lim","doi":"10.14283/jfa.2024.25","DOIUrl":"10.14283/jfa.2024.25","url":null,"abstract":"<p><strong>Background: </strong>Screening tools such as calf circumference (CC) and Yubi-wakka (finger-ring) test have been recognized as effective tools by Asian Working Group for Sarcopenia 2019 (AWGS'19) for sarcopenia screening but their comparative agreement, diagnostic performance and validity are unclear.</p><p><strong>Objectives: </strong>This study aims to determine: (i)agreement between calf and finger-ring circumference, (ii)diagnostic performance for low muscle mass and AWGS'19 sarcopenia diagnosis, (iii)correlation with muscle mass, strength, and physical performance, and (iv)association with frailty, life space mobility and physical activity.</p><p><strong>Methods: </strong>We studied 187 healthy community-dwelling older adults (mean age=66.8+7.0years) from the GERILABS-2 study. CC was measured via (i) both calves in sitting and standing positions, and (ii) Yubi-wakka test by encircling the thickest part of the non-dominant calf with index fingers and thumbs of both hands. We performed Cohen's kappa to check for agreement, area under receiver operating characteristic curve (AUC) to compare diagnostic performance, partial correlations adjusted for age and gender to compare convergent validity, and logistic regression to determine predictive validity for outcome measures.</p><p><strong>Results: </strong>Sarcopenia prevalence was 24.0% (AWGS'19). Yubi-wakka identified 16.6% of participants as screen-positive (\"smaller\"), showing moderate agreement only with non-dominant sitting CC measurements (k=0.421,p<0.001) and having lower diagnostic performance in determining low muscle mass (AUC=0.591 vs 0.855-0.870,p<0.001; sensitivity=57.1% vs 75.5-90.8%; specificity=58.4% vs 70.8-80.9%) and sarcopenia diagnosis (AUC=0.581 vs 0.788-0.818,p<0.001; sensitivity=55.6% vs 57.5-71.8%; specificity=74.4% vs 75.6-88.9%) compared to CC measurements. Yubi-wakka correlated significantly with muscle mass, grip strength and knee extension but not physical performance. When adjusted for age, gender and hypertension, Yubi-wakka was significantly associated with frailty (OR=3.96,95%CI:1.09-14.38), life space mobility (OR=2.38,95%CI:1.08-5.24) and physical activity (OR=2.50,95%CI:1.07-5.86).</p><p><strong>Discussion and conclusions: </strong>Yubi-wakka provides a self-administered, low-cost and practicable community screening tool for sarcopenia. Our study affirmed the convergent and predictive validity of Yubi-wakka, albeit with lower sensitivity and specificity in diagnostic performance compared to CC measurements.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"98-107"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable Technologies for Healthy Ageing: Prospects, Challenges, and Ethical Considerations.","authors":"S Canali, A Ferretti, V Schiaffonati, A Blasimme","doi":"10.14283/jfa.2024.19","DOIUrl":"10.14283/jfa.2024.19","url":null,"abstract":"<p><p>Digital technologies hold promise to modernize healthcare. Such opportunity should be leveraged also to address the needs of rapidly ageing populations. Against this backdrop, this paper examines the use of wearable devices for promoting healthy ageing. Previous work has assessed the prospects of digital technologies for health promotion and disease prevention in older adults. However, to our knowledge, ours is one of the first attempts to specifically address the use of wearables for healthy ageing, and to offer ethical insights for assessing the prospects of leveraging wearable devices in this context. We provide an analysis of the considerable opportunities associated with the use of wearables for healthy ageing, with a focus on the five domains of intrinsic capacity: locomotion, sensory functions, psychological aspects, cognition, and vitality. We then highlight current limitations and ethical challenges of such approach to healthy ageing, including issues related to access, inclusion, privacy, surveillance, autonomy, and regulation. We conclude by discussing the implications of our analysis in light of current debates on the ethics of digital health, and suggest measures to address the identified challenges.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"149-156"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food Insecurity, Vision Impairment, and Longitudinal Risk of Frailty and Falls in The National Health and Aging Trends Study.","authors":"A M Wennberg, S Ek, M Na","doi":"10.14283/jfa.2024.21","DOIUrl":"https://doi.org/10.14283/jfa.2024.21","url":null,"abstract":"<p><strong>Background: </strong>Both food insecurity (FI) and vision impairment (VI), which are linked, have been independently associated with frailty and falls.</p><p><strong>Objectives: </strong>Understand how FI and VI may together contribute to frailty and fall risk could improve insight into these growing public health challenges.</p><p><strong>Design, setting, participants, measurements: </strong>This study included 5,963 participants aged 65 and older enrolled in the National Health and Aging Trends Study. Participants were divided into four exposure groups (\"No FI or VI,\" \"FI, no VI,\" \"VI, no FI,\" and \"Both\") based on self-report. The Fried Frailty Index and self-reported falls were assessed annually. We used adjusted logistic and Poisson regression models to examine cross-sectional associations and generalized estimating equations to examine longitudinal associations between FI/VI status and falls and frailty outcomes.</p><p><strong>Results: </strong>Most study participants reported neither FI nor VI (n=5169, 86.7%); however, having both FI and VI (n=57, 1%) was cross-sectionally associated with higher frailty score and higher odds of falling multiple times in the last year. FI and/or VI were longitudinally associated with higher frailty score and increased frailty risk, with the strongest association for Both (RRR=1.29, 95% CI 1.23, 1.58; OR=3.18, 95% CI 1.78, 5.69), and with falling, again highest among those with Both, for one (OR=2.47, 95% CI 1.41, 3.96) and multiple (OR=2.46, 95% CI 1.50, 4.06) falls in the last year.</p><p><strong>Conclusion: </strong>Clinical and public health interventions could address the intersection of FI and VI with the aim of ameliorating the impact of these risk factors and health outcomes.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 3","pages":"285-292"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857070","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":"Integrated Service Delivery Model in Primary Care to Improve Frailty in Older Malaysians: GeKo Integrated Service Delivery.","authors":"S S Ahip, C Y Ting, M A B Abdillah, Y J Tan, S A B Sabri, O Theou, S Shariff-Ghazali, R Visvanathan","doi":"10.14283/jfa.2024.42","DOIUrl":"https://doi.org/10.14283/jfa.2024.42","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the implementation stage of Malaysia's GeKo-Integrated Service Delivery (ISD) model for frailty management in primary care and explore its effectiveness in improving frailty scores.</p><p><strong>Methods: </strong>The implementation stage of Malaysia's first three GeKo- ISD clinics was assessed using the WHO-ICOPE (Integrated Care of the Older Persons) scorecard. This involved evaluating documents related to the GeKo services and conducting in-depth interviews with key informants identified from those documents. The efficacy of GeKo-ISD was assessed by documenting the change in mean frailty scores between baseline and 3 months post intervention, measured by the Pictorial Fit Frail Scale Malay Version (PFFS-M), in patients who received GeKo-ISD care from October 2022 to April 2023.</p><p><strong>Results: </strong>All three GeKo clinics achieved the sustaining implementation level, scoring a total of 50 out of 52. The paired t-test reported a significant reduction (p= 0.001) in the PFFS-M scores from baseline to 3 months after the GeKo-ISD intervention. The mean (SD) scores were 8.6 (4.6) at baseline and 7.0 (4.1) at 3 months post-intervention.</p><p><strong>Conclusion: </strong>GeKo-ISD is a comprehensive approach of integrated care for older people, leveraging existing public funded primary care infrastructure. It shows promise, was impacted by the pandemic but now, with support from the government, exists in 32 centers across one state in Malaysia.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 3","pages":"313-318"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857075","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":"Social Vulnerability, Frailty and Self-Perceived Health: Findings from The Irish Longitudinal Study on Ageing (TILDA).","authors":"L Orlandini, E Patrizio, A M O'Halloran, C A McGarrigle, R Romero-Ortuno, R A Kenny, M Proietti, M Cesari","doi":"10.14283/jfa.2024.1","DOIUrl":"10.14283/jfa.2024.1","url":null,"abstract":"<p><strong>Background: </strong>Social vulnerability interacts with frailty and influences individuals' health status. Although frailty and social vulnerability are highly predictive of adverse outcomes, their relationship with self-perceived health(SPH) has been less investigated.</p><p><strong>Methods: </strong>Data are from the Irish Longitudinal Study on Ageing(TILDA), a population-based longitudinal study of ageing. We included 4,222 participants aged ≥50 years (age 61.4±8.5 years;women 56%) from Wave 1 (2009-2011) followed over three longitudinal waves (2012,2014-2015,2016). Participants responded to single questions with five response options to rate their 1)physical health, 2)mental health, and 3)health compared to peers. 30-item Frailty (FI) and Social Vulnerability (SVI) indices were calculated using standardised methods. Multivariable regression analyses were performed to establish the association between FI and SVI cross-sectionally and longitudinally over 6 years.</p><p><strong>Results: </strong>Cross-sectionally, SVI (mean:0.40±0.08; range:0.14-0.81) and FI (mean: 0.13±0.08; range:0.10-0.58) were modestly correlated (r=0.256), and independently associated with poor physical health (SVI: OR 1.43, 95%CI 1.15-1.78; FI: OR 3.16, 95%CI 2.54-3.93), poor mental health (SVI: OR 1.65, 95%CI 1.17-2.35; FI: OR 3.64, 95%CI 2.53-5.24), and poor health compared to peers (SVI: OR 1.41,95%CI 1.06-1.89; FI: OR 3.86, 95%CI 2.9-5.14). Longitudinally, FI and SVI were independently and positively associated with poor physical health (SVI: β 1.08, 95%CI 0.76-1.39; FI: β 1.97, 95%CI 1.58-2.36), poor mental health (SVI: β 1.18, 95%CI 0.86-1.5; FI: β 1.58, 95%CI 1.2-1.97), and poor overall health compared to peers (SVI: β 0.78, 95%CI 0.89-1.33; FI: β 1.74, 95%CI 0.47-1.1).</p><p><strong>Conclusions: </strong>In a large cohort of community-dwelling older adults, frailty and social vulnerability were associated with poor SPH and with risk of SPH decline over six years.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 1","pages":"50-56"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673633","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":"Loneliness Predicts Progression of Frailty in Married and Widowed, but Not Unmarried Community Dwelling Older Adults.","authors":"C Pollak, J Verghese, A S Buchman, Y Jin, H M Blumen","doi":"10.14283/jfa.2024.27","DOIUrl":"10.14283/jfa.2024.27","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is highly prevalent among older adults and is associated with frailty. Most studies consider loneliness in isolation without consideration for structural and functional measures of social relationships - and longitudinal studies are scarce.</p><p><strong>Objectives: </strong>This study examined longitudinal associations between loneliness and frailty and analyzed how structural and functional social measures influence these associations.</p><p><strong>Design: </strong>Linear mixed effects models examined longitudinal associations between loneliness and frailty assessed with the frailty index (scale 0-100). Models were adjusted for baseline age, gender, education, depressive symptoms, global cognition, and structural (e.g., social network, marital status), and functional social measures (e.g., social, cognitive, and physical activity, and social support).</p><p><strong>Participants: </strong>Loneliness and frailty data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project were examined (mean age 79.6 ± 7.7 years, 74.9% female).</p><p><strong>Measurements: </strong>Baseline loneliness assessed by the de Jong Gierveld Loneliness Scale was the predictor of interest.</p><p><strong>Results: </strong>Frailty increased significantly over a mean follow-up period of 4.6 years. Effects of loneliness on frailty were modified by marital status. Loneliness predicted an additional accumulation of 0.37 and 0.34 deficits on the frailty index per year in married and widowed individuals respectively, compared to those who were not lonely (married: p=0.009, CI 0.09, 0.64; widowed: p=0.005, CI 0.1, 0.58). Loneliness did not predict frailty progression in unmarried individuals.</p><p><strong>Conclusions: </strong>Loneliness predicts frailty progression, highlighting the importance of social determinants on physical health in aging.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"163-171"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission of Older Patients to Geriatric Inpatient Care from the Emergency Department Compared with Admission through Acute Medical Unit: Cost and Length of Stay Outcomes.","authors":"R A Merchant, Y H Chan, N M W Ling, M Z X Chen, V W T Ho, B L L Wong, Z Lim, S E Ng, V Anantharaman","doi":"10.14283/jfa.2024.58","DOIUrl":"https://doi.org/10.14283/jfa.2024.58","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether direct admission to geriatric inpatient care from the emergency department (EMD) was associated with lower length of stay (LOS) and cost compared to patients admitted through an acute medical unit (AMU).</p><p><strong>Methods: </strong>Retrospective single-centre cohort study conducted using hospital database on older patients ≥ 75 years discharged from geriatric inpatient service in a tertiary academic centre from March 2021 to September 2021 who were admitted through AMU or direct from EMD.</p><p><strong>Intervention: </strong>Traditional AMU run by internists followed by geriatrician led-care compared with geriatrician led-care.</p><p><strong>Measure: </strong>We evaluated the difference in median length of stay (LOS), and cost using quantile regression adjusted for primary discharge diagnoses, hospital frailty risk score (HFRS) and Age-adjusted Charlson Comorbidity Index (ACCI).</p><p><strong>Results: </strong>Among 574 older patients, 140 (24.4%) were admitted from AMU. Mean age was 84.0 ± 6.3 years and 83.8% were categorized as high or intermediate frailty risk based on HFRS. 46% of patients admitted through EMD were discharged within three days. After adjusting for primary diagnoses, HFRS, and ACCI, patients admitted through AMU had a longer median LOS of 1.6 days (95% confidence interval (CI): 0.86-2.4, p<0.001), higher total cost $1386.0 (95% CI 733-2038, p<0.001), laboratory cost $226.0 (95% CI 131-322, p<0.001), medication cost $65.0 (95% CI 15-115, p<0.010), physiotherapy cost $45.0 (95% CI 16-75, p=0.002) and occupational therapy cost $35.0 (95% CI 12-58, p=0.003).</p><p><strong>Conclusion: </strong>Older adults admitted through AMU had significantly longer median LOS, higher total cost, physiotherapy and occupational therapy costs, medication, and laboratory costs.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"507-513"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689421","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}