Journal of Frailty & Aging最新文献

{"title":"Myokines and Biomarkers of Frailty in Older Inpatients with Undernutrition: A Prospective Study.","authors":"H Liu, W Li, M Zhu, X Wen, J Jin, H Wang, D Lv, S Zhao, X Wu, J Jiao","doi":"10.14283/jfa.2024.9","DOIUrl":"https://doi.org/10.14283/jfa.2024.9","url":null,"abstract":"<p><strong>Background: </strong>Population aging might increase the prevalence of undernutrition in older people, which increases the risk of frailty. Numerous studies have indicated that myokines are released by skeletal myocytes in response to muscular contractions and might be associated with frailty. This study aimed to evaluate whether myokines are biomarkers of frailty in older inpatients with undernutrition.</p><p><strong>Methods: </strong>The frailty biomarkers were extracted from the Gene Expression Omnibus and Genecards datasets. Relevant myokines and health-related variables were assessed in 55 inpatients aged ≥ 65 years from the Peking Union Medical College Hospital prospective longitudinal frailty study. Serum was prepared for enzyme-linked immunosorbent assay using the appropriate kits. Correlations between biomarkers and frailty status were calculated by Spearman's correlation analysis. Multiple linear regression was performed to investigate the association between factors and frailty scores.</p><p><strong>Results: </strong>The prevalence of frailty was 13.21%. The bioinformatics analysis indicated that leptin, adenosine 5'-monophosphate-activated protein kinase (AMPK), irisin, decorin, and myostatin were potential biomarkers of frailty. The frailty group had significantly higher concentrations of leptin, AMPK, and MSTN than the robust group (p < 0.05). AMPK was significantly positively correlated with frailty (p < 0.05). The pre-frailty and frailty groups had significantly lower concentrations of irisin than the robust group (p < 0.05), whereas the DCN concentration did not differ among the groups. Multiple linear regression suggested that the 15 factors influencing the coefficients of association, the top 50% were the ADL score, MNA-SF score, serum albumin concentration, urination function, hearing function, leptin concentration, GDS-15 score, and MSTN concentration.</p><p><strong>Conclusions: </strong>Proinflammatory myokines, particularly leptin, myostatin, and AMPK, negatively affect muscle mass and strength in older adults. ADL and nutritional status play major roles in the development of frailty. Our results confirm that identification of frailty relies upon clinical variables, myokine concentrations, and functional parameters, which might enable the identification and monitoring of frailty.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"82-90"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854424","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":"Combined Social Frailty and Life-Space Activities Associated with Risk of Disability: A Prospective Cohort Study.","authors":"T Doi, K Tsutsumimoto, K Makino, S Nakakubo, F Sakimoto, S Matsuda, H Shimada","doi":"10.14283/jfa.2024.17","DOIUrl":"https://doi.org/10.14283/jfa.2024.17","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the association between social frailty and life-space activities, and determine whether a combined status of life-space activities and social frailty is associated with risk of disability among older adults.</p><p><strong>Design: </strong>A prospective cohort study.</p><p><strong>Setting and participants: </strong>The participants were 8,301 older adults (mean age 72.9 ± 5.6 years, women [53.3%]) from a community setting.</p><p><strong>Methods: </strong>Life-space activities were evaluated using the Active Mobility Index (AMI) to assess activities in each life-space (distance from the respondent's home: up to 1 km, 1-10 km, or greater than 10 km) during the past 1 month. Activities were also assessed according to physical or social activity. Social frailty and characteristics were measured at the baseline. Incident disability was assessed according to long term care insurance.</p><p><strong>Results: </strong>The lowest scoring group was based on the quartile in each of the AMI scores (Q1), with reference to the highest scoring group, which had a higher odds ratios for social frailty (AMI total score Q1: OR 4.32, 95% CI 3.43-5.45, AMI physical score Q1: 2.19, 95% CI 1.79-2.69, AMI social score Q1: 5.04, 95% CI 3.94-6.44). During the follow-up (mean 23.5 months), 330 participants had incident disability. Incident disability was associated with social frailty. Combined status of social frailty and low AMI increased the risk of disability (HR 2.15, 95% CI 1.52-3.03), with reference to non-frailty and higher AMI scores.</p><p><strong>Conclusions and implications: </strong>Social frailty or reduced activity in life-space assessment were identified as risk factors for incident disability. To decrease the risk of disability, the development of an intervention program to enhance activities and cope with social frailty is required.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"184-188"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860270","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}

{"title":"Does a Poor Preoperative Nutritional Status Impact outcomes of Heart Valve Surgery?","authors":"N Pavone, F Cammertoni, P Bruno, G Cutrone, G A Chiariello, M Calabrese, M Grandinetti, M Nesta, E Marzetti, R Calvani, R Gambardella, A D Conserva, E Romagnoli, F Burzotta, M Massetti","doi":"10.14283/jfa.2024.54","DOIUrl":"https://doi.org/10.14283/jfa.2024.54","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition has been variously associated with poor postoperative outcomes. Of note, 10-25 % of cardiac surgery patients are reported to be malnourished.</p><p><strong>Objectives: </strong>To assess the impact of nutritional status (evaluated with the Geriatric Nutritional Risk Index - GNRI) on outcomes of older patients undergoing heart valve surgery.</p><p><strong>Design: </strong>Retrospective, single-center.</p><p><strong>Setting: </strong>Cardiac Surgery Unit, Fondazione Policlinico Universitario \"A. Gemelli\" IRCCS, Rome, Italy.</p><p><strong>Participants: </strong>448 patients older than 75 years who had undergone isolated, elective heart valve surgery. Patients were divided into low (GNRI≥92; 346 patients) and moderate-to-high (GNRI<92; 102 patients) risk groups of nutrition-related complications.</p><p><strong>Measurements: </strong>Demographic, clinical, and biological variables were retrieved from the institutional Heart Valve Database. GNRI was calculated as follows: [1.489 × serum albumin (g/dL)] + [41.7 × actual body weight (kg) / ideal body weight (kg)]. Operative and postoperative outcomes were compared between GNRI groups. Survival at 3 years follow-up was analyzed using the Kaplan-Meier method and log-rank test. Cox regression was used to identify variables associated with survival.</p><p><strong>Results: </strong>Mortality at 30 days did not differ between groups (0.98% vs 0.58% for GNRI < 92 and GNRI ≥ 92, respectively; p=0.54). Those with a GNRI < 92 required more frequently dialysis (2.9% vs 0.3%, p=0.04), inotropes (33.3% vs 22.8%, p=0.04), red blood cells transfusions (63.7% vs 19.9%, p<0.01), and longer mechanical ventilation support (12 ± 2 vs 6 ± 1.5 hours, p=0.03). Intensive care unit (4.7 ± 0.9 vs 1.6 ± 0.8 days, p=0.05) and total postoperative hospital (11.1 ± 1.9 vs 5.2 ± 1.5 days, p=0.05) stays were significantly longer in the GNRI < 92 group.</p><p><strong>Conclusion: </strong>A poor nutritional status may increase morbidity and prolong hospitalization after cardiac surgery. GNRI might improve risk assessment and should be integrated into traditional surgical risk models to offer tailored care to older patients.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"501-506"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689584","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":"Intrinsic Capacity Impairments (ICOPE Step 1 and Step 2), Cardiometabolic Risk and Immune Resilience: An Exploratory Analysis from the Gan-Dau Healthy Longevity Plan.","authors":"Z-J Chen, W-H Lu, L-C Meng, W-F Chao, H-H Tung, F-Y Hsiao, L-K Chen","doi":"10.14283/jfa.2024.66","DOIUrl":"https://doi.org/10.14283/jfa.2024.66","url":null,"abstract":"<p><strong>Importance: </strong>Intrinsic capacity (IC), defined by the World Health Organization's Integrated Care for Older People (ICOPE) framework, is crucial for promoting healthy aging. Understanding the associations between IC impairments and age-related biomarkers can provide insights into the underlying pathophysiological mechanisms and potential interventions.</p><p><strong>Objective: </strong>To investigate the associations between IC impairments (ICOPE step 1 and step 2, respectively) and aging-related biomarkers, including inflammatory and cardiometabolic markers, in community-dwelling middle-aged and older adults.</p><p><strong>Design, setting, and participants: </strong>Cross-sectional analysis of data from 755 participants (aged 50-64 years, n=212; 65-74 years, n=357; ≥75 years, n=186) enrolled in the Gan-Dau Healthy Longevity Plan, a community-based survey in Taipei City, Taiwan, from 2022.</p><p><strong>Exposures: </strong>IC impairments assessed by ICOPE Step 1 (screening) and Step 2 (in-depth assessment) across six domains: locomotion, vitality, vision, hearing, cognition, and psychological well-being.</p><p><strong>Main outcomes and measures: </strong>Levels of inflammatory biomarkers (albumin, white blood cell count, neutrophils, lymphocytes, monocytes, neutrophil-to-lymphocyte ratio [NLR], lymphocyte-to-monocyte ratio [LMR], platelet-to-lymphocyte ratio [PLR]) and cardiometabolic biomarkers (low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], total cholesterol, fasting glucose, triglycerides, triglyceride-glucose [TyG] index).</p><p><strong>Results: </strong>Of the 755 participants, the mean age was 68.5 years, and 68.2% were women. The proportion of participants with any IC impairment increased with age: 63.2% for those aged 50-64, 65.8% for those aged 65-74, and 74.7% for those aged ≥75 years based on ICOPE Step 1. For ICOPE Step 2, the proportions were 59.9%, 56.9%, and 64.0%, respectively. Impairments in locomotion and cognition were significantly higher in the oldest age group (≥75 years). Adjusted for covariates, IC impairment (ICOPE Step 2) was associated with higher levels of neutrophil count (β = 3.17, p = 0.015) and NLR (β = 0.34, p = 0.021) in those aged 50-64 years, and higher levels of monocyte count in those aged 65-74 years (β = 0.65, p = 0.001) and ≥75 years (β = 0.68, p = 0.037).</p><p><strong>Conclusions and relevance: </strong>In conclusion, IC impairments were associated with alterations in specific inflammatory biomarkers, suggesting potential interactions between IC, age, and inflammatory processes. Longitudinal studies are warranted to establish causal relationships and elucidate the underlying mechanisms linking IC impairments, immune dysregulation, and the aging process.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"541-551"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689633","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":"The Efficacy of 12-Week Progressive Home-Based Strength and Tai-Chi Exercise Snacking in Older Adults: A Mixed-Method Exploratory Randomised Control Trial.","authors":"I J Liang, O J Perkin, S Williams, P M McGuigan, D Thompson, M J Western","doi":"10.14283/jfa.2024.32","DOIUrl":"10.14283/jfa.2024.32","url":null,"abstract":"<p><strong>Background: </strong>Maintaining physical function is important for independence and frailty prevention in later life, but very few older adults meet exercise recommendations. Previous studies found that 4-week 'exercise and Tai-chi snacking' as a viable alternative to traditional exercise is acceptable to healthy older adults.</p><p><strong>Objectives: </strong>This study aimed to investigate the effectiveness of a 12-week progressive exercise and Tai-chi snacking programme on physical function and psychological outcomes in pre-frail older adults.</p><p><strong>Design: </strong>Randomised controlled trial.</p><p><strong>Setting: </strong>Community-dwelling older adults.</p><p><strong>Participants: </strong>90 older adults with impaired strength and balance were recruited. Participants were randomly allocated to an intervention or waitlist control group.</p><p><strong>Intervention: </strong>A 12-week progressive exercise and Tai-chi snacking programme.</p><p><strong>Measurements: </strong>Physical function (the short physical performance battery (SPPB), single-leg balance test and sit-to-stand test) was remotely measured at participants' homes via video calls at baseline, 4-, 8-, and 12-weeks. The self-reported psychological outcomes were also assessed every 4 weeks using online questionnaires. A subset of 40 participants also completed in-person functional assessments, and 26 intervention participants underwent semi-structured interviews to feedback on their experiences.</p><p><strong>Results: </strong>The 12-week progressive home-based exercise and Tai-chi snacking improved SPPB strength (estimated mean difference in week 4: 1.05; week 8: 0.79; and week 12: 0.79) and balance (estimated mean difference in week 4: 0.71; week 8: 0.57; and week 12: 0.65) at each timepoint compared to control group. Timed-up-and-go (estimated mean difference in week 4: 1.94; week 8: 1.58; and week 12: 1.1) and total SPPB scores (estimated mean difference in week 4: 2.24; week 8: 1.79; and week 12: 1.76) were also better in the intervention group compared to the control group in lab subset participants. Based on the qualitative findings, Participants found the programme accessible and beneficial, making it suitable for older adults and increasing self-efficacy in physical activities.</p><p><strong>Conclusion: </strong>The home-based exercise and Tai-chi snacking programme significantly improved lower extremity strength, balance, and mobility in pre-frail older adults. This programme is considered to be a beneficial, acceptable and easy implemented physical function intervention.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"572-581"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689658","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":"Utilisation and Outcome of Cranial CT Imaging in Older Adults Attending ED Following a Fall.","authors":"K Warren, T Akinola, K Bailey, J Gwinnett, C Wharton","doi":"10.14283/jfa.2024.55","DOIUrl":"https://doi.org/10.14283/jfa.2024.55","url":null,"abstract":"<p><p>Healthcare demand from falls in older adults is increasing, but guidance from the literature is lacking on the value of neuroimaging, particularly for those who have fallen but have no head injury or an unclear history. We carried out retrospective analysis of data from Emergency Department attendances at a large English hospital to assess compliance with guidelines and explore utility of CT scans for those not covered by existing guidance. Following a fall, 49% (577) of older adults received a cranial CT scan, 4.9% (28) of whom had an intracranial haemorrhage and only 2 received neurosurgical intervention. Only 59% who had a CT had a clear history of head injury, unwitnessed falls were common (71%) and there was a high prevalence of dementia (23%); those scanned without a clear history of head injury were significantly more frail, but not older. There was some indication that seizure, reduced GCS and neurological signs are predictive of intracranial haemorrhage regardless of head injury history, but further research is recommended to provide clarity on which groups stand to benefit most and how clinicians can be supported in decision making that balances diagnostic yield, patient benefit and imaging demand.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"456-460"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688753","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":"Five-Time Sit-To-Stand Lower Limb Muscle Power in Older Women: An Explorative, Descriptive and Comparative Analysis.","authors":"H J Coelho-Júnior, A Álvarez-Bustos, L Rodríguez-Mañas, I de Oliveira Gonçalves, R Calvani, A Picca, M C Uchida, S da Silva Aguiar, E Marzetti","doi":"10.14283/jfa.2024.50","DOIUrl":"https://doi.org/10.14283/jfa.2024.50","url":null,"abstract":"<p><strong>Background: </strong>Muscle power assessment entails the use of complex equipment which impacts its clinical applicability. Recently, equations to estimate lower-limb muscle power measures based on 5-repetition sit-to-stand (5STS) performance and anthropometric parameters were validated. However, their ability to discriminate physical performance status in older adults is still unknown. Moreover, the analysis of the biomechanical aspects of 5STS might represent a valid instrument to identify people with different physical statuses.</p><p><strong>Objectives: </strong>Explore and examine the biomechanical aspects of 5STS performance, and compare the capacity of this measure and 5STS muscle power equations to discriminate older women with different physical function levels.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>Older women.</p><p><strong>Measurements: </strong>5STS using a linear encoder, Timed \"Up-andGo\" (TUG), isometric handgrip strength (IHG) and walking speed (WS).</p><p><strong>Results: </strong>Results from ANOVA analysis indicated that peak concentric muscle power was reached in the first 5STS repetition and then declined significantly (P= 0.006). When participants were divided in high and low physical performance groups according to median results of TUG, IHG and WS tests, significant differences in 5STS biomechanical aspects were observed, according to independent t-test results (P< 0.05). However, no differences were found for 5STS muscle power equations. Pearson's correlation analysis indicated that 5STS biomechanical aspects (P< 0.05), but not 5STS muscle power equations, were significantly associated with physical performance.</p><p><strong>Conclusion: </strong>Findings of the present study suggest that 5STS biomechanical aspects might contribute to discriminating older women with high and low physical performance.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"397-404"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689608","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}