Journal of Frailty & Aging最新文献

{"title":"New Perspectives in the Association between Anthropometry and Mortality: The Role of Calf Circumference.","authors":"C Ceolin, V Acunto, C Simonato, S Cazzavillan, M Vergadoro, M V Papa, G S Trapella, R Sermasi, M Noale, M De Rui, B M Zanforlini, C Curreri, A Bertocco, M Devita, A Coin, G Sergi","doi":"10.14283/jfa.2024.4","DOIUrl":"https://doi.org/10.14283/jfa.2024.4","url":null,"abstract":"<p><strong>Aims: </strong>Considering the impact of sarcopenia on mortality, and the difficulty to assessment of body composition, the hypothesis of the study is that calf circumference (CC) is closely related to mortality in older patients. The aim of the study was to analyze the potential role of CC to predict mortality in old individuals at 3, 6 and 12 months after discharge from hospital.</p><p><strong>Methods: </strong>Patients aged >65 years were recruited for this retrospective study from September 2021 to March 2022. Their physical and body composition characteristics (including Body Mass Index-BMI and Mini Nutritional Assessment-MNA) were measured; data on mortality at 3 (T3), 6 (T6) and 12 (T12) months after discharge were recorded. Sarcopenia was diagnosed according to the 2019 European Consensus criteria.</p><p><strong>Results: </strong>Participants were 192 older adults (92 women), with a mean age of 82.8±7.0 years. Sarcopenic people were 41. The mortality rate was higher in sarcopenic people only at T3 and T6. CC had comparable validity in predicting mortality to that of MNA and ASMMI (Appendicular Skeletal Muscle Mass), and was better than BMI and serum albumin at each time point. Youden's index showed that the best cut-off for CC for predicting mortality was 30.6 cm both at T3 (sensitivity: 74%; specificity: 75%) and T6 (sensitivity: 75%; specificity: 67%). At the Cox regression model for mortality, high values of CC (HR 0.73, CI95% 0.60-0.89/p<0.001) and ADL scores (HR 0.72, CI95% 0.54-0.96/p=0.04) were protective factors at T6 and T12 respectively; at T12 high comorbidity rate was a risk factor (HR 1.28, IC95% 1.02-1.62/p=0.04).</p><p><strong>Conclusions: </strong>CC has a validity comparable to MNA and ASMMI in predicting mortality at 3, 6 and 12 months after hospital discharge. Moreover, it can be considered an independent predictor of medium-term mortality in the hospitalized older population. CC can be an effective method for the prognostic stratification of these patients, due to its simplicity and immediacy.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"108-115"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861383","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":"Dose-Responsive Impacts of Social Frailty on Intrinsic Capacity and Healthy Aging among Community-Dwelling Middle-aged and Older Adults: Stronger Roles of Social Determinants over Biomarkers.","authors":"S-T Huang, W-H Lu, W-J Lee, L-N Peng, L-K Chen, F-Y Hsiao","doi":"10.14283/jfa.2024.8","DOIUrl":"https://doi.org/10.14283/jfa.2024.8","url":null,"abstract":"<p><strong>Objective: </strong>The intricate relationship between social determinants, e.g., social frailty, biomarkers and healthy aging remains largely unexplored, despite the potential for social frailty to impact both intrinsic capacity (IC) and functional ability in the aging process.</p><p><strong>Design: </strong>Retrospective longitudinal cohort study.</p><p><strong>Setting and participants: </strong>Participants aged 50+ years from the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan, stratified into three age groups: 50-64, 65-74 and 75+.</p><p><strong>Measurements: </strong>Social frailty was defined based on a score derived from four domains: exclusion from general resources, social resources, social activity, and fulfillment of basic social needs. The scores were categorized as score=0 (no social frailty), 1 (social pre-frailty), and 2+ (social frailty). Multivariable logistic regression and Cox proportional hazard models were employed to examine the dose-responsive relationship between social frailty, low IC, functional and psychological health, and mortality.</p><p><strong>Results: </strong>Of 1015 study participants, 24.9% and 7.9% were classified as social pre-frailty and social frailty, respectively. No significant differences were observed in most biomarkers between those with social frailty and those without. A dose-responsive relationship was found between social frailty and increased risk of low IC (social pre-frailty: aOR 2.20 [95% CI 1.59-3.04]; social frailty: 5.73 [3.39-9.69]). Similar results were found for functional and psychological health. However, no significant association between social frailty and all-cause mortality was found at the 4-year follow-up (social pre-frailty: aHR 1.52 [95% CI 0.94-2.43]; social frailty: 1.59 [0.81-3.09]).</p><p><strong>Conclusions: </strong>The significant association between social frailty and low IC, functional limitations, cognitive declines, and depressive symptoms underscores the pressing need for research on intervention strategies to enhance healthy aging in the lifespan course.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"139-148"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866082","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":"Analysis of the Correspondence of the Degree of Fragility with the Way to Exercise the Force of the Hand.","authors":"E P Guindal, X Parra, M Musté, C Pérez, O Macho, A Català","doi":"10.14283/jfa.2024.46","DOIUrl":"https://doi.org/10.14283/jfa.2024.46","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a geriatric syndrome characterized by increased individual vulnerability with an increase in both dependence and mortality when exposed to external stressors. The use of Frailty Indices in routine clinical practice is limited by several factors, such as the cognitive status of the patient, times of consultation, or lack of prior information from the patient.</p><p><strong>Objectives: </strong>In this study, we propose the generation of an objective measure of frailty, based on the signal from hand grip strength (HGS).</p><p><strong>Design and measurements: </strong>This signal was recorded with a modified Deyard dynamometer and processed using machine learning strategies based on supervised learning methods to train classifiers. A database was generated from a cohort of 138 older adults in a transverse pilot study that combined classical geriatric questionnaires with physiological data.</p><p><strong>Participants: </strong>Participants were patients selected by geriatricians of medical services provided by collaborating entities.</p><p><strong>Setting and results: </strong>To process the generated information 20 selected significant features of the HGS dataset were filtered, cleaned, and extracted. A technique based on a combination of the Synthetic Minority Oversampling Technique (SMOTE) to generate new samples from the smallest group and ENN (technique based on K-nearest neighbors) to remove noisy samples provided the best results as a well-balanced distribution of data.</p><p><strong>Conclusion: </strong>A Random Forest Classifier was trained to predict the frailty label with 92.9% of accuracy, achieving sensitivities higher than 90%.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 3","pages":"248-253"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857112","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":"Temporal Muscle Thickness Predicts Mortality and Disability in Older Adults Diagnosed with Mild Dementia.","authors":"M G Borda, J Patricio Baldera, D Patino-Hernandez, E Westman, M U Pérez-Zepeda, F J Tarazona-Santabalbina, H Wakabayashi, H Arai, M Kivipelto, D Aarsland","doi":"10.14283/jfa.2024.39","DOIUrl":"https://doi.org/10.14283/jfa.2024.39","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia contributes to increased hospitalizations, cognitive impairment, falls, and all-cause mortality. Current diagnostic methods, like body Magnetic Resonance Imaging and dual-energy X-ray absorptiometry, are costly and impractical. Notably, there is no standardized approach for assessing sarcopenia in dementia clinics. We studied the association of temporal muscle thickness (TMT) with key prognostic factors in people with Alzheimer's disease (AD) and Lewy body dementia (DLB).</p><p><strong>Methods: </strong>We utilized data from the DemVest, a longitudinal cohort study, and included participants clinically diagnosed with mild AD or DLB. TMT was measured using baseline MRI scans. The main outcome measures were cognition, functional performance, malnutrition, and mortality. Various demographic and clinical factors were considered as potential confounders.</p><p><strong>Results: </strong>The AD sample was mainly composed by females(76.9%), age 75.5(SD 6.95). The DLB sample was mostly composed by men(63.6%), age 75.8(SD 6.85). At baseline TMT showed significant association with cognitive performance in the DLB group (Est.=0.593, p-value=0.049). The longitudinal analysis revealed significant associations between TMT and functional decline in DLB (Est.=-0.123, p-value 0.007) and increased mortality in the whole sample(HR=0.815, p-value 0.002), the AD group (HR=0.834 p-value=0.031), and the DLB group (HR=0.767 p-value=0.019) respectively. These associations remained significant after adjusting for confounders.</p><p><strong>Conclusions: </strong>The TMT measurement was associated with mortality in both dementia groups as well as with cognition and function in DLB. TMT emerges as a cost-efficient measure of muscle mass indicating clinical relevance and utility in healthcare settings. Implementing TMT assessment could improve patient care and aid in identifying individuals at risk of adverse outcomes in mild dementia.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"441-447"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689655","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":"Inflammation, Frailty, and Aspirin Use in the Physicians' Health Study: A Pilot Study.","authors":"D Gewurz, G Zhou, Y Endo, I Sinha, J M Gaziano, H D Sesso, A R Orkaby","doi":"10.14283/jfa.2024.37","DOIUrl":"10.14283/jfa.2024.37","url":null,"abstract":"<p><p>Whether anti-inflammatory medications such as aspirin can lower the risk of frailty is an active area of investigation. In previous studies, we reported that regular aspirin use started in midlife was associated with a lower risk of frailty at older age. We therefore sought to further examine the relationship between inflammatory biomarkers, frailty and aspirin use in a pilot nested case-control study of 300 participants aged ≥60 years with available data to calculate a frailty index from the Physicians' Health Study, a completed randomized trial of aspirin that began in 1982. We selected 150 individuals who were frail (frailty index >0.2) and 150 who were not frail (frailty index <0.1). We then matched 29 low users of aspirin (≤60 days/year) 3:1 to 87 regular users of aspirin (>60 days/year). After matching on age, smoking status, history of diabetes and CVD, there was no significant association between aspirin use and level of frailty among those with elevated inflammatory biomarkers (all p>0.05). In this pilot study we did not find evidence of a mediation effect of CRP, TNFR-2 or IL-6 on the association between aspirin and frailty. Additional work is needed to elucidate the potential mechanistic pathways through which medications such as aspirin may be linked with frailty.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"582-585"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689629","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":"Correlation between Muscle Mass and Physical Activity Level in Older Adults at Risk of Falling: The FITNESS Study.","authors":"J-B Gauvain, S Mandigout, M Pambet, M Monseu, P Gillain, J Gautier, C Annweiler, F Puisieux","doi":"10.14283/jfa.2024.53","DOIUrl":"10.14283/jfa.2024.53","url":null,"abstract":"<p><strong>Background: </strong>The study investigates the correlation between muscle mass and physical activity level measured objectively and subjectively in older adults who fall or are at high risk of falling.</p><p><strong>Methods: </strong>FITNESS (Fall Interest to Target Newly Sarcopenic Society) is a multi-center (French university hospitals of Angers, Lille, Limoges and Orléans), cross-sectional, observational study of routine care within a French multidisciplinary hospital consultation. Inclusion criteria were ≥ 75 years old, living at home and consulting for fall or gait disorder. A standardized geriatric assessment, muscle mass evaluation by impedancemetry, physical activity by continuous actimetry (5 days) and Incidental and Planned Exercise Questionnaire (IPEQ) were performed at patient inclusion.</p><p><strong>Results: </strong>170 people aged 75 and over were included in the FITNESS study (mean age 82.9 ±4.7 years, women 72.9%). Muscle mass (whole body and lower limbs) correlated with active energy expenditure (AEE, ρ whole body = 0.32, p-value < 0.001; ρ lower limbs = 0.25, p-value = 0.003), but not with number of daily steps, nor with IPEQ score. Multivariate analysis of whole-body muscle mass showed a positive and significant association with AEE and albumin levels and for lower limb muscle mass, a positive association with AEE and Charlson.</p><p><strong>Conclusion: </strong>This study suggests that in the particular population of older adults who fall and/or are at high risk of falling, loss of muscle mass correlates with reduced physical activity. So subjects who fall or at high risk of falling constitute a special group for whom the fight against sedentary lifestyles and the maintenance of physical activity should be a dual priority.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 3","pages":"240-247"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857117","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":"Most Hospital-Acquired Complications among Older Adults Are Associated with Frailty: The South-Western Sydney Frailty and Hospital-Acquired Complications Study.","authors":"S A Frost, D Ni Chroinin, L Mc Evoy, N Francis, V Deane, M Bonser, C Wilson, M Perkins, B Shepherd, V Vueti, R Shekhar, M Mayahi-Neysi, K M Hillman","doi":"10.14283/jfa.2024.60","DOIUrl":"https://doi.org/10.14283/jfa.2024.60","url":null,"abstract":"<p><strong>Background: </strong>People live longer, and frailty has become an important problem in the acute hospital setting. Increasingly the association between frailty and hospital-acquired complications has been reported. However, the overall burden of frailty in this setting has not been described. Therefore, we undertook this study to describe the association between frailty and the risk of hospital-acquired complications among older adults across our five acute hospitals and to estimate the overall burden of frailty attributable to these complications.</p><p><strong>Methods: </strong>Consecutive admissions among women and men aged ≥ 65 years across our local health district's five acute hospitals, between January 2010 and December 2020, were included to investigate the association between the number of cumulative frailty deficit items and hospital-acquired complications and infections. The numbers of cumulative frailty deficits are presented in four groups (0-1 item, 2 items, 3 items, and 4-13 items). Individual events such as falls, delirium, pressure injuries, thromboembolism, malnutrition, and multiple types of infections are also presented. The overall burden of frailty was estimated using a population-attributable-risk approach.</p><p><strong>Results: </strong>During the study period there were 4,428 hospital-acquired complications, among 120,567 older adults (52% women). The risk of any hospital-acquired complication (HAC) or any hospital-acquired infection (HAI) increased as the cumulative number of frailty deficits increased. For the 0-1 deficit item group versus the 4-13 items group, the risk of any HAC increased from 5.5/1000 admissions to 80.0/1000 admissions, and for any HAI these rates were 6.2/1000 versus 58.2/1000, respectively (both p-values < 0.001). The 22% (27,144/120,567) of patients with 3 or more frailty deficit items accounted for 63% (2,774/4,428) of the combined hospital-acquired complications and infections. We estimated that the population-attributable risks of any hospital-acquired complication or infection were 0.54 and 0.47, respectively.</p><p><strong>Conclusion: </strong>We found that an increasing number of cumulative frailty deficit items among older patients are associated with a higher risk of hospital-acquired complications or infections. Importantly, frail older adults account for most of these adverse events.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"522-528"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689642","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":"Frailty Index, Not Age, Predicts Treatment Outcomes and Adverse Events for Older Adults with Cancer.","authors":"J Fletcher, N Reid, R E Hubbard, R Berry, M Weston, E Walpole, R Kimberley, D A Thaker, R Ladwa","doi":"10.14283/jfa.2024.22","DOIUrl":"https://doi.org/10.14283/jfa.2024.22","url":null,"abstract":"<p><strong>Background: </strong>Frailty is an indicator of individual vulnerability and differentiates health status among people of the same chronological age.</p><p><strong>Objectives: </strong>This study aimed to determine whether baseline frailty index (FI) was associated with systemic anticancer therapy treatment outcomes in older adults with solid cancers.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Major metropolitan outpatient oncology service.</p><p><strong>Participants: </strong>Adults aged over 65 years with a solid malignancy who had been referred for consideration of systemic therapy, and had completed a baseline frailty assessment between January 2019 and July 2021.</p><p><strong>Measurements: </strong>Frailty had been prospectively assessed with a 58-item FI derived from a geriatric oncology nurse assessment prior to initial oncologist appointments. Primary outcome was treatment completion, and secondary outcomes included incidence of high-grade treatment-related toxicity or unplanned hospital admissions, and survival outcomes. Univariate and multivariable regression analyses were conducted to test the association between treatment outcomes and baseline FI. Co-variates included age, sex, performance status, treatment intent, and stage. Kaplan-Meier and cox proportional hazard analysis were conducted for survival analysis.</p><p><strong>Results: </strong>The median FI (IQR) was 0.24 (0.15-0.31) and 43% were frail (FI>0.25). FI was positively correlated with ECOG, however 28% of ECOG 0-1 were frail. In multivariable regression analyses, each 0.10 increase in FI was associated with an increased likelihood of not completing or not receiving treatment (OR 1.37, 95% CI 1.02-1.84; p=.04), treatment-related toxicity (OR 1.60, 95% CI 1.14-2.23; p<.01) and unplanned hospital admissions (OR 1.61; 95% CI 1.16-2.25; p<.01). Frail patients had increased mortality (adjusted HR 2.81, 95% CI 1.42-5.56; p<.01). Age did not predict treatment completion, toxicities, or survival.</p><p><strong>Conclusion: </strong>Baseline FI is a granular measure that can help to identify frailer older patients who are more likely to require tailored therapy and support, and less frail older patients who are more likely to tolerate treatment.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"487-494"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689610","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":"Comparative Analysis of Gait Speed Measurement Protocols: Static Start Versus Dynamic Start in a Cross-Sectional Study Using Light Detection and Ranging.","authors":"S Ji, H-W Jung, S Yoon, H Roh, M Kim, H Jung, R Jang, H Ha, J Y Baek, I-Y Jang, E Lee","doi":"10.14283/jfa.2024.48","DOIUrl":"https://doi.org/10.14283/jfa.2024.48","url":null,"abstract":"<p><strong>Background: </strong>There is currently no standardized protocol for the measurement of gait speed in older adults, particularly regarding the choice between static versus dynamic start.</p><p><strong>Objectives: </strong>This study aimed to assess the impact of removing the initial phase on gait speed measurement and compare the correlation of different measurement methods with other physical performance metrics.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Setting: </strong>A geriatric clinic in a tertiary hospital in Seoul, Korea.</p><p><strong>Participants: </strong>Adults aged 65 years or older who underwent physical performance examinations during comprehensive geriatric assessments (n = 511).</p><p><strong>Measurements: </strong>A one-dimensional light detection and ranging device was used to obtain real-time gait signal data and measure the participants' gait speed. Descriptive statistics were obtained for the acceleration phase. Various lengths of the initial phase were removed to determine the point at which gait speed plateaued. Correlations between four-meter gait speeds, with different initial phase lengths, and chair stand and balance test results were examined.</p><p><strong>Results: </strong>The mean ± standard deviation of the acceleration phase (m) was 0.92 ± 0.51. The removal of various initial phase lengths showed that 2 m gait speed based on dynamic start (0.5 m) significantly differed from static start (0.7 m/s versus 1.05 m/s, p<0.001). Gait speed showed an increase with the removal of longer initial phases but plateaued after removing 1 meter. This change lacked clinical significance after removing 0.5 meters. Dynamic start gait speed exhibited superior discriminative ability in chair stand and balance tests compared to static start gait speed.</p><p><strong>Conclusion: </strong>Static start underestimates gait speed, while dynamic start aligns better with other physical performance results. An acceleration phase of 0.5 to 1 meter appears sufficient, but further studies are needed to optimize gait measurement methods.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"391-396"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689535","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 Feasibility of Implementing the WHO Integrated Care for Older People (ICOPE) Framework in Singapore.","authors":"C H K Ma, D Q L Chua, L Tay, E W C Teo, W C Ng, A Y M Leung","doi":"10.14283/jfa.2024.59","DOIUrl":"https://doi.org/10.14283/jfa.2024.59","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) introduced the Integrated Care for Older People (ICOPE) approach to assist communities in evaluating the intrinsic capacities of older adults and proposing strategies to prevent, mitigate, or reverse declines. This study represents the inaugural attempt to assess intrinsic capacities among older adults in Singapore, aligning with the nation's Healthier Singapore (Healthier SG) initiative aimed at enhancing quality of life.</p><p><strong>Objectives: </strong>This study aims to investigate the feasibility of implementing Step 1 screening of the ICOPE framework, which assesses cognition, locomotion, vitality, psychological state, visual and auditory functions, within the Singapore context.</p><p><strong>Design, setting, and participants: </strong>Using a mixed-method approach, this cross-sectional study established a baseline understanding of the levels of intrinsic capacity in 367 community-dwelling older adults in Singapore (mean age 71.8 years), elucidated the experiences of administering the ICOPE Step 1 screening tool and the formulation of personalized care plans from the perspective of 25 assessors.</p><p><strong>Measurements: </strong>Participants completed ICOPE Step 1 screening, providing basic demographic and health profiles, while assessors engaged in focus group discussions.</p><p><strong>Results: </strong>Among older participants, 284 exhibited signs of decline in intrinsic capacity. The primary areas of decline were visual impairment (42.0%), hearing loss (33.5%), and cognitive deterioration (31.3%), followed by limited mobility (24.3%), malnutrition (16.1%), and depressive symptoms (16.1%). Assessors found the ICOPE screening tool user-friendly and appreciated its person-centred approach, noting its integration with care plans, which many other tools lacked. They were confident in Singapore's capacity to adopt the ICOPE approach, citing existing practices in assessing intrinsic capacity domains and integrated care models.</p><p><strong>Conclusion: </strong>Critical steps for successful implementation of the ICOPE framework include follow-up interventions like self-management strategies for declining intrinsic capacity, diagnostic assessments, and routine monitoring. Coordination between healthcare clusters and community care networks is essential for its success.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 4","pages":"514-521"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689661","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}