Journal of Frailty & Aging最新文献

{"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":"https://doi.org/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":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854418","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":"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":"https://doi.org/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":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873532","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":"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":"https://doi.org/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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689430","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":"Impact of Frailty on Gait Speed Improvements in Home Health after Hospital Discharge: Secondary Analysis of Two Randomized Controlled Trials.","authors":"M Tran, A Garbin, R E Burke, E Cumbler, J E Forster, J Stevens-Lapsley, K K Mangione","doi":"10.14283/jfa.2024.52","DOIUrl":"10.14283/jfa.2024.52","url":null,"abstract":"<p><p>More than half of older adults are frail or prefrail in the United States, and hospital-associated deconditioning likely increases this risk. However, the impact of frailty on potential functional improvements after hospital discharge is poorly understood. We sought to identify the influence of baseline frailty on gait speed change in older adults receiving home health physical therapy (PT) after hospital discharge. The severity of frailty was assessed using Cardiovascular Health Study frailty criteria (weakness, slowness, weight loss, physical inactivity, and exhaustion). Gait speed was measured at baseline and 60-days post-hospital discharge. Upon admission to home health rehabilitation services, half of older adults (total N=250) were considered frail, with slowness (90%) and weakness (75%) being the most common characteristics. Older adults, whether pre-frail or frail, demonstrated similar and clinically meaningful improvements in gait speed after receiving home health rehabilitation for 60 days following hospital discharge. These results suggest that clinicians caring for older adults in the hospital can counsel both pre-frail and frail patients that, with home health rehabilitation, clinically significant improvements in function can be expected over the 2 months following discharge. Furthermore, we observed encouraging gait speed improvement with physical therapy following hospitalization in older adults. Results can inform anticipatory guidance on hospital discharge.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 3","pages":"254-258"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857072","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-Related Factors among Women Living with and without HIV Aged 40 Years and Older. The Women's Interagency HIV Study.","authors":"D R Gustafson, Q Shi, M Thurn, S Holman, M H Kuniholm, M Fischl, M Floris-Moore, S Gange, D Konkle-Parker, M Plankey, J C Price, R D Ross, A Rubtsova, A Sharma, D R Hoover","doi":"10.14283/jfa.2023.41","DOIUrl":"10.14283/jfa.2023.41","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a clinical, geriatric syndrome linked to disability and mortality; and may be associated with a variety of factors among underrepresented and underserved women living with HIV (WLWH) and without HIV (WLWOH) transitioning through the adult life course.</p><p><strong>Objectives: </strong>Determine whether a published set of factors associated cross-sectionally with frailty in WLWH and similar WLWOH at average age 39 years in 2005/2006 were associated with frailty in 2018/2019 among women who initiated frailty assessments at age ≥40 years, or whether a new set of factors were associated with frailty.</p><p><strong>Design: </strong>Cross-sectional analyses within a longitudinal cohort study.</p><p><strong>Setting: </strong>The multi-center Women's Interagency HIV Study (WIHS).</p><p><strong>Participants: </strong>1285 participants (951 WLWH, 334 WLWOH), median age 53 years (interquartile range 47-58 years).</p><p><strong>Measurements: </strong>The Fried Frailty Phenotype (FFP) in association with 23 factors representing HIV serostatus, other infections, sociodemographic factors, health behaviors, and chronic diseases.</p><p><strong>Results: </strong>Frailty prevalence was 11.1% in 2018/2019 (12.6% among WLWOH, 9.6% among WLWH, p=0.121). The published 2005/2006 final multivariable stepwise regression model contained 9 predictors of frailty. When refit to women in 2018/2019, only age ≥50 years and annual income ≤$12,000 were independently positively associated with frailty; other significant 2005/2006 factors, HIV serostatus, CD4+ count <500 cells/mL among WLWH, smoking, drinking, FIB-4 and eGFR, were not. A newly-derived stepwise model considering all 23 predictors measured in 2018/2019, showed independent positive associations between frailty and age ≥50 years, annual income ≤$12,000, obesity (body mass index (BMI) ≥30kg/m2), and history of tuberculosis and cancer.</p><p><strong>Conclusion: </strong>Different chronic and infectious disease factors were associated with frailty among WLWH and WLWOH over the adult life course. Understanding factors associated with frailty by adult life stage, allows identification and implementation of novel, temporal interventions to alleviate frailty-associated outcomes and enhance quality of life among WLWH and WLWOH.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 1","pages":"40-49"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673629","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 Prevalence of Frailty and Associated Factors, Including Food Security in Community Dwelling Older Adults with Multimorbidity: A Cross-Sectional Analysis from the Longitudinal Aging Study in India.","authors":"V Maheshwari, P Samanta, S Basu","doi":"10.14283/jfa.2024.36","DOIUrl":"https://doi.org/10.14283/jfa.2024.36","url":null,"abstract":"<p><strong>Background: </strong>The global increase in multimorbidity among older adults is a result of ongoing epidemiological and demographic transitions. This study focuses on the prevalence and determinants of frailty in this demographic in India, accounting for the potential mediating role of food insecurity.</p><p><strong>Objectives: </strong>To determine the prevalence and determinants of frailty among older Indian adults with multimorbidity, and to ascertain the mediating effect of food insecurity on frailty.</p><p><strong>Design: </strong>Cross-sectional analysis of cohort study data.</p><p><strong>Setting: </strong>Analysis of data from the Longitudinal Aging Study in India (LASI) Wave 1 (2017-2018).</p><p><strong>Participants: </strong>31,902 individuals aged 60 and above of whom 7900 were categorized as having multimorbidity.</p><p><strong>Measurements: </strong>Frailty was assessed using a modified Fried scale. Details on sociodemographic factors, lifestyle choices, and health-related variables were collected through face-to-face participant interviews. Multimorbidity was defined as the presence of two or more chronic conditions such as hypertension, diabetes, cancer, chronic lung disease, chronic heart disease, stroke, bone disease, neurological or psychiatric problems, and high cholesterol. Statistical analysis was conducted using Stata 15.1.</p><p><strong>Results: </strong>The weighted prevalence of frailty in individuals with multimorbidity was 30.31% (95% CI: 28.17, 32.54), significantly higher than those without multimorbidity (23.81%, 95% CI: 22.90, 24.74) (P<0.001). Frailty prevalence was higher in women (33.27%) than in men (26.56%) among those with multimorbidity. In the group with multimorbidity, age ≥75 (years), middle MPCE quintile, lower educational attainment, unemployment, and low body mass index was associated with higher odds of frailty. Mediation analysis showed that 3.47% of the association between multimorbidity and frailty was mediated by food insecurity.</p><p><strong>Conclusion: </strong>Frailty is prevalent among older adults with multimorbidity in India, with significant disparities based on gender, age, socioeconomic status, and body mass index. Food insecurity partially mediates the relationship between multimorbidity and frailty, highlighting the need for targeted interventions addressing both health and nutritional insecurities in this population.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 3","pages":"276-284"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857119","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":"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":"Teaching Frailty to Medical Residents: A Needs Assessment Among Geriatrics Faculty.","authors":"M Cheslock, A Nahas, A R Orkaby, A W Schwartz","doi":"10.14283/jfa.2024.26","DOIUrl":"https://doi.org/10.14283/jfa.2024.26","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of frailty is essential for meeting the Accreditation Council for Graduate Medical Education core competencies for US trainees. The UK General Medical Council requires that frailty be included in undergraduate and graduate medical education curricula. Trainees are expected to appropriately modify care plans and help make patient-centered decisions, while incorporating diagnostic uncertainty, such as frailty, in older adults. Little is known about current needs for frailty instruction in graduate medical education in the US and beyond.</p><p><strong>Objective: </strong>We sought to capture faculty perceptions on how frailty should be defined and identified, and what aspects and level of detail should be taught to residents.</p><p><strong>Design: </strong>The authors developed a 4-item short response questionnaire, and faculty had the option to respond via electronic survey or via semi-structured interviews.</p><p><strong>Setting and subjects: </strong>Respondents included 24 fellowship-trained geriatricians based at 6 different academic medical centers in a single urban metropolitan area.</p><p><strong>Methods: </strong>An invitation to participate in either an electronic survey or semi-structured virtual interview was e-mailed to 30 geriatricians affiliated with an academic multi-campus Geriatric Medicine fellowship. Responses were transcribed and coded independently by two authors.</p><p><strong>Results: </strong>Responses were received from 24 geriatricians via a combination of digital questionnaires (n=18) and semi-structured online interviews (n=6), for a response rate of 80%. Responses revealed significant diversity of opinion on how to define and identify frailty and how these concepts should be taught.</p><p><strong>Conclusions: </strong>As frailty is increasingly incorporated into clinical practice, consensus is needed on how to define and teach frailty to residents.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"13 2","pages":"189-192"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853518","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}