Journal of Frailty & Aging最新文献

{"title":"The conceptualisation and measurement of social frailty in older people: an umbrella review.","authors":"Martin Webber, Beth Casey, Laura Tucker, Kirsty Shires, Mark Wilberforce, Barbara Hanratty, Louise Tomkow, David Sinclair, Jennifer Liddle, Dawn Sissons, Lynette Joubert","doi":"10.1016/j.tjfa.2025.100078","DOIUrl":"https://doi.org/10.1016/j.tjfa.2025.100078","url":null,"abstract":"<p><strong>Background: </strong>The social domain of frailty is often poorly defined or missing from measures of frailty. The literature is still inconclusive on the nature and scope of social frailty, although studies indicate that it has a substantial impact on disability and mortality outcomes.</p><p><strong>Aims: </strong>This Umbrella Review aimed to synthesise concepts and measures of social frailty.</p><p><strong>Methods: </strong>A search for reviews was performed in Web of Science, CINAHL, SOCINDEX, Medline, PsychoINFO and COSMIN databases. This Umbrella Review was conducted and reported with reference to the Joanna Briggs Institute (JBI) Reviewer's Manual. The JBI Critical Appraisal Checklist for Systematic Review was used to assess the quality of studies.</p><p><strong>Results: </strong>Sixteen reviews were included. The concept of social frailty was summarised as weakness in a person's social infrastructure compounded by a declining ability to change their circumstances. Forty-two measures of social frailty were identified which included a total of 228 items relating to social frailty. These were grouped into nine domains, of which participation in social activities was most commonly included within measures.</p><p><strong>Conclusion: </strong>The use of diverse indicators creates a challenge for the measurement of social frailty. Their limited use in health and social care practice undermines the practical utility of the concept. This review helps to provide conceptual clarity and a platform for the development and validation of a robust social frailty measure which will facilitate the identification of people at risk and target interventions to prevent or alleviate the impact of social frailty on older people.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 5","pages":"100078"},"PeriodicalIF":3.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769302","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":"Associations between intrinsic capacity, plasma p-tau181 and cognitive function over a 5-year follow-up among community-dwelling older adults: a secondary analysis of the MAPT Study.","authors":"Kelly Virecoulon Giudici, Philipe de Souto Barreto, Christelle Cantet, Henrik Zetterberg, Kaj Blennow, Bruno Vellas","doi":"10.1016/j.tjfa.2025.100064","DOIUrl":"10.1016/j.tjfa.2025.100064","url":null,"abstract":"<p><strong>Background: </strong>Intrinsic capacity (IC) is a recent key concept proposed by the World Health Organization (WHO) based on aspects of functional ability (both physical and mental) rather than the presence or absence of diseases, with a potential to predict several health outcomes.</p><p><strong>Objective: </strong>To explore associations between IC and cognitive function (prospectively), and between IC and plasma p-tau181 (cross-sectionally and prospectively) among community-dwelling older adults.</p><p><strong>Methods: </strong>Observational study with 491 subjects ≥70 years (67.4 % female, mean 75.3 years, SD=4.4), participants from the Multidomain Alzheimer Preventive Trial (MAPT). IC domains (locomotion, cognition, psychological, vitality) were combined into a 0-100 score. Alternative classification was based on the number of domains' abnormalities. Plasma p-tau181 was measured at baseline and 36 months of follow-up. A composite cognitive score (CCS) based on four tests was determined at baseline, 6, 12, 24, 36, 48 and 60 months.</p><p><strong>Results: </strong>Inverse cross-sectional associations were observed between baseline IC score and p-tau181 (unadjusted model: β=-0.08, 95 %CI -0.13 to -0.03; p = 0.0025). A significant mean difference in p-tau181 3-year changes was observed between participants with low and normal IC (based on IC score) (adjusted model: 1.71, 95 %CI 0.01 to 3.40; p = 0.0483). Prospective 5-year associations between IC and CCS were only observed in unadjusted analysis according to the alternative IC classification (-0.21, 95 %CI -0.38 to -0.04; p = 0.0156).</p><p><strong>Conclusion: </strong>IC was associated with plasma p-tau181 and cognitive function, but findings varied according to the method of IC classification. Further research may help settle the role of IC as a predictor of neurodegenerative diseases such as AD. In this regard, multidomain interventions have potential to protect IC over the aging process and prevent cognitive impairment, and should also be encouraged.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 4","pages":"100064"},"PeriodicalIF":3.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555674","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":"The relationship between glaucoma and an electronic frailty index with the cumulative incidence of healthcare encounters for falls and fractures in older adults.","authors":"Walter D Duy, Nicholas M Pajewski, Jeff D Williamson, Atalie C Thompson","doi":"10.1016/j.tjfa.2025.100051","DOIUrl":"10.1016/j.tjfa.2025.100051","url":null,"abstract":"<p><strong>Objective: </strong>To compare the association of glaucoma and glaucoma suspect diagnoses with frailty, quantified via an electronic frailty index (eFI), and to evaluate whether a glaucoma diagnosis moderates the association between frailty and the cumulative risk of acute healthcare encounters for incident falls or fractures.</p><p><strong>Design: </strong>Retrospective study of electronic health record (EHR) data.</p><p><strong>Subjects, participants, and/or controls: </strong>Adults ≥65 years old with an ICD-10 diagnosis code for glaucoma or glaucoma suspect who had a calculable eFI score as of 10/1/2017.</p><p><strong>Methods: </strong>Ordinal logistic regression was used to examine the cross-sectional association between glaucoma (predictor) and frailty status (outcome) based on the eFI. The relationship of glaucoma and frailty with the cumulative incidence of hospital or emergency room visits for injurious falls or fractures over time was modeled using cause-specific recurrent event survival models that account for censoring and the competing risk of death.</p><p><strong>Main outcome measures: </strong>Frailty status based on the eFI and cumulative incidence of falls or fractures.</p><p><strong>Results: </strong>Glaucoma patients were significantly more likely to be frail compared to glaucoma suspects (adjusted odds ratio=1.36, 95 % CI(1.16, 1.60)). Both pre-frailty and frailty were associated with an increased risk of incident falls/fractures in older adults: prefrail (hazard ratio=2.07, 95 % CI (1.40, 3.06)), frail (hazard ratio=3.35, 95 % CI (2.24, 5.03)), but there was no interaction of frailty with glaucoma status on falls/fractures risk. Also, the risk of incident falls/fractures did not significantly differ between glaucoma versus glaucoma suspects.</p><p><strong>Conclusions: </strong>Glaucoma patients were more likely to be frail or pre-frail based on an EHR-derived index than glaucoma suspects. Both pre-frailty and frailty were associated with increased cumulative risk of injurious falls or fractures but there was no interaction of frailty with glaucoma. Frailty based on the eFI was better at discriminating who is at risk of acute healthcare utilization for falls/fractures than a glaucoma diagnosis.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 4","pages":"100051"},"PeriodicalIF":3.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095784","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":"Framework for a short muscle function battery using electronic handgrip dynamometry and accelerometry in older adults.","authors":"Ryan McGrath, Grant R Tomkinson, Sarah Andrew, Joshua Batesole, Chloe Carling, Bryan K Christensen, Samantha FitzSimmons, Halli Heimbuch, Tyler Hoang, Donald Jurivich, Jacob Kieser, Kelly Knoll, Peyton Lahr, Matthew Langford, Michaela Mastrud, Megan Orr, Yeong Rhee, Kyle J Hackney","doi":"10.1016/j.tjfa.2025.100045","DOIUrl":"10.1016/j.tjfa.2025.100045","url":null,"abstract":"<p><strong>Background: </strong>Electronic handgrip dynamometry and accelerometry enables novel opportunities to collect additional attributes of muscle function beyond just maximal strength, but some muscle function attributes may already be related, which may warrant discerning these attributes into a short muscle function battery (SMFB).</p><p><strong>Objectives: </strong>We sought to determine the multivariate relationships between maximal strength, asymmetry, submaximal control, rate of force development, bimanual coordination, fatigability, and contractile steadiness in older adults.</p><p><strong>Design: </strong>A cross-sectional design was used for this investigation.</p><p><strong>Setting: </strong>Laboratory.</p><p><strong>Participants: </strong>The analytic sample included 121 generally healthy older adults aged 70.7 ± 4.7 years.</p><p><strong>Measurements: </strong>Electronic handgrip dynamometry and accelerometry measured strength, asymmetry, submaximal control, rate of force development, bimanual coordination, fatigability, and contractile steadiness. The handgrip variables were standardized before they were included in a factor analysis. Factors with eigenvalues >1.0 were kept. Items within a factor with a loading |>0.30| were similarly retained.</p><p><strong>Results: </strong>There were 3 factors retained with eigenvalues of 1.88, 1.56, and 1.10. The first factor (functional strength), which explained 39.9 % of the variance, included strength, submaximal control, and rate of force development. Factor 2 (lateral function), which explained 35.8 % of the variance, included asymmetry and bimanual coordination. The third factor (muscle endurance), which explained 24.3 % of the variance, included fatigability and contractile steadiness.</p><p><strong>Conclusions: </strong>Our findings suggest the surfacing of themes in the additional muscle function measures, thereby providing framework for a SMFB. More research is needed for electronic handgrip dynamometry and accelerometry derived muscle function on health before consideration of implementation in clinical practice.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 3","pages":"100045"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039135","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":"Psoas muscle density predicts elective colorectal surgical outcomes more accurately than psoas muscle area or indexed area.","authors":"Louis Scarrold, Douglas Stupart, David Watters","doi":"10.1016/j.tjfa.2025.100037","DOIUrl":"10.1016/j.tjfa.2025.100037","url":null,"abstract":"<p><strong>Background: </strong>CT measurements of psoas muscle density (PMD) and area (PMA) (with or without indexing to height-squared or body-surface-area) are used interchangeably as sarcopenia measures - it is unknown which best correlates with surgical risk.</p><p><strong>Objectives: </strong>1.Determine the correlation between psoas muscle density, area, and indexed area; 2.Identify which psoas measures most strongly associated with surgical outcomes DESIGN: The University Hospital Geelong Colorectal database included all patients who underwent elective colorectal surgery from 2007 to 2014 (minimum five-years follow-up). Pre-operative CT scans were reviewed, psoas measures correlated with each other and with outcomes.</p><p><strong>Setting: </strong>University Hospital Geelong is a regional referral hospital in Victoria, Australia.</p><p><strong>Participants: </strong>This database listed 552 patients, 120 were excluded as pre-operative CT-films were not accessible, leaving 432 patients included.</p><p><strong>Exposure: </strong>Psoas muscle density, area, and area indexed by height-squared and body-surface-area.</p><p><strong>Measurements: </strong>Pearson correlations investigated correlations between psoas muscle measures. Logistic regression and ROC-analysis investigated each psoas measures association with peri‑operative morbidity. Kaplan-Meier survival-analysis investigated the association of each psoas measure with long-term survival.</p><p><strong>Results: </strong>Mean age was 70.4 years, 41 % were female. Psoas muscle density correlated poorly with area (R²=0.15). Unindexed psoas muscle area correlated well with area indexed by height-squared (R²=0.950) and body-surface-area (R²=0.938). Long-term survival was associated with psoas muscle density (HR1.515(95 %CI 1.062-2.161)) and area (HR1.886(95 %CI 1.322-2.692)). Increasing psoas muscle density (reduced sarcopenia) was associated with decreased major-complications (OR0.963(95 %CI 0.938-0.989)) and peri‑operative mortality (OR0.903(95 %CI 0.847-0.962)), with ROC-curve AUC=0.829 indicating an accurate test. There was no association between psoas muscle area and major-complications (OR1.000(95 %CI 1.000-1.000)), nor peri‑operative mortality (OR1.000(95 %CI 0.999-1.001)), with ROC-curves AUC=0.507-0.521. Indexed area measures were not associated with outcomes.</p><p><strong>Conclusions: </strong>Psoas muscle density and area did not correlate. Both were associated with long-term survival, but only density was associated major-complications and mortality. Indexing removed the correlation of area with long-term survival.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 3","pages":"100037"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744430","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":"Maximising inclusivity in care home research: Lessons learned from the AFRI-c randomised controlled trial.","authors":"Laurel Campbell-Smith, Sophie Rees, Jane Sprackman, Karen Sargent, Alastair D Hay, Rachel Cm Brierley","doi":"10.1016/j.tjfa.2025.100038","DOIUrl":"10.1016/j.tjfa.2025.100038","url":null,"abstract":"<p><p>Ethical and procedural requirements make research in care homes challenging. With people living longer globally, it is essential that older people are included in research, including within the care home setting. We conducted a randomised controlled trial (AFRI-c) in 91 care homes across England, aiming to make the study available to every eligible resident. Facilitators included flexible models for receiving consent; commitment from care home staff, residents and families; tailored and specific training for care home staff; and support from national research infrastructure to engage care homes in research. To facilitate inclusive care home research, we recommend consulting with care homes about their research priorities; continuing investment in national research infrastructure for care homes; using advance directives for research planning for care home residents; embedding research nurses in care home environments; and more guidance for researchers and ethics committees on applying legal frameworks regarding capacity to research settings.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 3","pages":"100038"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797038","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":"Frailty indices based on routinely collected data: a scoping review.","authors":"Schenelle Dayna Dlima, Danielle Harris, Abodunrin Quadri Aminu, Alex Hall, Chris Todd, Emma Rlc Vardy","doi":"10.1016/j.tjfa.2025.100047","DOIUrl":"10.1016/j.tjfa.2025.100047","url":null,"abstract":"<p><p>A frailty index (FI) is a frailty assessment tool calculated as the proportion of the number of health-related deficits an individual has to the total number of variables in the index. Routinely collected clinical and administrative data can be used as sources of deficits to automatically calculate FIs. This scoping review aimed to evaluate the current research landscape on routine data-based FIs. We searched seven databases to find literature published in 2013-2023. Main inclusion criteria were original research articles on FIs constructed from routine data, with deficits in at least two of the following categories: \"symptoms/signs\", \"laboratory values\", \"diseases\", \"disabilities\", and \"others\". From 7526 publications screened, 218 were included. Studies were primarily from North America (47.7 %), conducted in the community (35.3 %), and used routine data-based FIs for risk stratification (51.4 %). FIs were calculated using various routine data sources; however, most were initially developed and validated using hospital records. We noted geographical differences in study settings and routine data sources. We identified 611 unique deficits comprising these FIs. Most were either \"diseases\" (34.4 %) or \"symptoms/signs\" (32.1 %). Routine data-based FIs are feasible and valid risk stratification tools, but research is confined to high-income countries, their routine adoption is slow, and deficits comprising these FIs emphasise a reactive and overtly medical approach in addressing frailty. Future directions include exploring the feasibility and applicability of using routine databases for frailty assessment in lower- and middle-income countries, and leveraging non-clinical routine data through data linkages to proactively identify and manage frailty.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 3","pages":"100047"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028107","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":"Sarcopenia is associated with lower quality of life scores among community-dwelling older Filipinos: Findings from a cross-sectional study.","authors":"Robby Carlo Tan, Kyler Kenn Castilla, Michael Serafico, Marco Mensink, Lisette de Groot","doi":"10.1016/j.tjfa.2025.100044","DOIUrl":"10.1016/j.tjfa.2025.100044","url":null,"abstract":"<p><strong>Background and objectives: </strong>Sarcopenia, characterized by a progressive decline in muscle mass and strength, is a significant concern among older individuals, impacting their functionality and overall quality of life (QOL). The relationship between sarcopenia and QOL among Filipino older adults remains underexplored. Thus, the study aims to determine the prevalence of sarcopenia and its association with the QOL of community-dwelling older adults in selected Philippine cities.</p><p><strong>Design: </strong>This cross-sectional study used convenience sampling in the selection of the cities. Participants were randomly selected from the list provided by each local city government.</p><p><strong>Setting and participants: </strong>536 apparently healthy community-dwelling Filipino older adults from three major islands in the Philippines.</p><p><strong>Methods: </strong>Sarcopenia was determined using the 2019 Asian Working Group for Sarcopenia criteria which is the presence of low muscle mass, plus low muscle strength, and/or low physical performance. Quality of life was assessed using the culturally-validated WHO-QOL short form questionnaire. Mixed Model logistic regression adjusted for covariates was performed to study the association of sarcopenia indicators to quality of life.</p><p><strong>Results: </strong>24.3 % of older Filipinos were found to have sarcopenia. Sarcopenic community-dwelling older adults had significantly decreased odds of attaining higher score in the physical domain (OR 0.63; 0.40-0.98), psychological domain (OR 0.55; CI 0.35-0.84), and overall quality of life (OR 0.57; CI 0.37-0.89) than the non-sarcopenic group.</p><p><strong>Conclusion: </strong>One in four community-dwelling Filipino older adults met the sarcopenia criteria. Sarcopenia is associated with decreased QOL scores, particularly in the physical health and psychological health domains. Sarcopenia needs to be considered in the context of public health to come up with targeted nutrition and health interventions for improved QOL.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 3","pages":"100044"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005320","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":"Immediate admission to the surgery hospital significantly optimises quality indicators in older patients with hip fractures: A before-and-after study.","authors":"José Luis Dinamarca-Montecinos, Alejandra Vásquez Leiva, Carmelinda Ruggiero, Yasna Fernández Barrera, Rayén Gac Delgado, Ada Carrillo, Gedeón Améstica Lazcano, Daniel Vásquez Ulloa, Fernando Aranda, Andrés Pizarro Canales, Graciela Mardones, Constanza Gherardelli Morales, Victoria Novik Assael, Osvaldo Sepúlveda, Jossie Acuña, Carola Aravena Arancibia, Julio Ibarra, Jack Bell, Emma Sutton","doi":"10.1016/j.tjfa.2025.100014","DOIUrl":"10.1016/j.tjfa.2025.100014","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures generate high biomedical, social, functional, organisational, and economic costs. There are various quality indicators to guide its management. One of them is surgery within 48-72 h. In Chilean public health system, this indicator has out-of-standard results. This situation could have organizational causes: after hip fracture diagnosis, many older patients are first referred to general hospitals, whilst waiting an orthopedic surgical bed.</p><p><strong>Objective: </strong>To evaluate the effects of a protocol of immediate-admission to the surgery hospital on organisational and economic indicators of hip-fractured older patients.</p><p><strong>Design: </strong>Before-and-after study, between 01/01/2017-09/30/2019; 12 months before and 21 months after implementation.</p><p><strong>Setting: </strong>Regional surgical hospital responsible for 87 % of the older population in its assigned territory, in the more aged region of Chile.</p><p><strong>Participants: </strong>Anonymised data of 902 hip-fractured older adults (≥ 60 years).</p><p><strong>Intervention: </strong>Implementation of a protocol that requires immediate admission to the surgical hospital of all older hip-fractured patients at the time of diagnosis.</p><p><strong>Measurements: </strong>Number of hip-fractured patients with no immediate admission, time to surgery, total in-hospital time, and economic costs. Normality tests (Kolmogorov-Smirnov), non-parametric tests (Chi-squared), Mann-Whitney and Kruskal-Wallis tests were performed. Measures of central tendency (medians and percentiles) were used.</p><p><strong>Results: </strong>After protocol there was a significant reduction in the proportion of patients referred to general hospitals in both, first and second year (pre=37,8 %; post 1 = 27,3 %; post 2 = 23,3 %, p = 0,000). Time to surgery was also significantly reduced (medians bed days pre=15, post 1 = 11, post 2 = 10, p = 0,000). Total in-hospital time decreased 21 % (3395 bed days), and there was also a significant decrease in costs from USD130,000 to USD35,000 (p = 0,000).</p><p><strong>Conclusion: </strong>Immediate admission to orthopedic surgical hospital of older adults with hip fractures significantly decreases inter-hospital transfers, time to surgery, total in-hospital time, and direct hospital costs.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 3","pages":"100014"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755832","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":"Reflection points on how frailty concepts have changed clinical practice.","authors":"Cornel Christian Sieber","doi":"10.1016/j.tjfa.2025.100046","DOIUrl":"10.1016/j.tjfa.2025.100046","url":null,"abstract":"","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 3","pages":"100046"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008010","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}