154 The Feasibility of Assessing Sarcopenia Among Older People with Arm Fracture Using Different Criteria

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
K Ibrahim ◽  
M A Mullee ◽  
G Lily Yao ◽  
S Zhu ◽  
M Baxter ◽  
...  
Keyword(s):  
Older People ◽  
Grip Strength ◽  
Sensitivity And Specificity ◽  
Gait Speed ◽  
Speed Test ◽  
Increased Risk ◽  
European Working ◽  
Hand Dynamometer ◽  
Risk Of Falls ◽  
And Gender

Abstract Introduction Osteoporosis and sarcopenia often co-exist (osteo-sarcopenia) and both are associated with increased risk of falls and fractures. Early identification and treatment of sarcopenia among older people with fragility arm fractures could prevent further fractures. This study evaluated the feasibility of assessing sarcopenia in a fracture clinic. Methods People aged 65+ years with arm fracture attending fracture clinics in one acute trust were recruited. Sarcopenia was assessed using gait speed, grip strength with unfractured arm (hand dynamometer using appropriate cut off adjusted for age and gender), skeletal muscle mass index SMI (Bioimpedance BIA), SARC-F questionnaire, the European Working Group on Sarcopenia in Older People (EWGSOP) I and II criteria. The sensitivity and specificity of each measure was calculated against the EWGSOP II criteria as the standard reference. Results 100 patients (Mean age 75 years±7.2; 80 female) were recruited. Sarcopenia was identified among 4% (EWGSOP I), 5% (SMI), 13% (EWGSOP II), 16% (gait speed test), 18% (SARC-F) and 39% (grip strength) and was more prevalent among men. SARC-F had the best sensitivity and specificity (100% and 96% respectively) when compared to the EWGSOP II criteria. Sensitivity and specificity for the remaining measures were respectively (100%, 71%) for grip strength, (75%, 94%) for gait speed, (25%, 97%) with SMI and (25%, 99%) for EWGSOP I. Time needed to complete the assessments was 1–2 minutes for gait speed, grip strength and SARC-F; five minutes for BIA test, and nine minutes when EWGSOP I and II criteria were applied. Data were complete for grip strength and SARC-F. Missing data was reported among 2% for gait speed, 8% for BIA test, 8% for EWGSOP II and 10% for EWGSOP I. Conclusion It was feasible to assess sarcopenia in fracture clinics and SARC-F was a quick, simple and sensitive tool suitable for routine use.

scholarly journals MULTIDIMENSIONAL FRAILTY SCORE IS SUPERIOR TO PREDICT COMPLICATIONS AFTER SURGERY THAN CONVENTIONAL RISK FACTORS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S686-S686
Author(s):  
Jung-Yeon Choi ◽  
Kwang-il Kim ◽  
Hee-won Jung ◽  
Cheol-Ho Kim ◽  
Sung-Bum Kang ◽  
...  
Keyword(s):  
Postoperative Complication ◽  
Grip Strength ◽  
Gait Speed ◽  
Surgical Patients ◽  
Secondary Outcome ◽  
P Value ◽  
Asa Classification ◽  
Increased Risk ◽  
Prognostic Utility ◽  
Frailty Score

Abstract Frail older adults are at increased risk for postoperative morbidity compared with their robust counterparts. We compared predictive utility of multidimensional frailty score (MFS) with physical performance parameters or conventional risk stratification indicators to identify postoperative complication in older surgical patients. From January 2016 to June 2017, 648 older surgical patients (age≥ 65) were included for analysis. The MFS was calculated through comprehensive geriatric assessment (CGA). Grip strength and gait speed were measured preoperatively. The primary outcome was postoperative complication (eg, pneumonia, urinary tract infection, delirium, acute pulmonary thromboembolism, and unplanned ICU admission). Secondary outcome was 6-months all-cause mortality. Sixty-six (10.2%) patients experienced postoperative complications and 6-months mortality was 3.9% (n=25). Grip strength, gait speed, MFS and ASA classification could predict postoperative complication but only MFS (Hazard Ratio = 1.564, 95% CI, 1.283-1.905, p < 0.001) could predict 6-months mortality after full adjustment. MFS (C index = 0.747) had superior prognostic utility than age (0.638, p value = 0.008), grip strength (0.566, p value < 0.001) and ASA classification (0.649, p value = 0.004). MFS only had additive predictive value on both age (C-index of 0.638 (age) vs 0.754 (age +MFS), p = 0.001) and ASA classification (C index of 0.649 (ASA) to 0.762 (ASA + MFS), p < 0.001) for postoperative complication, but gait speed or grip strength had no statistical additive prognostic value on both age and ASA classification.

Effects of mental practice strategies associated to physiotherapy on gait and risk of falls in Parkinson’s disease: a pilot study of a randomized clinical trial

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
T Silva ◽  
L Silva ◽  
K Silva ◽  
S Silva ◽  
D Silva ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Gait Speed ◽  
Mental Practice ◽  
Control Group ◽  
Timed Up And Go ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Degenerative Disorder

Abstract Introduction Parkinson’s Disease (PD) is a degenerative disorder that interferes with the voluntary movements due to dysfunction of the basal ganglia and presenting with motor signals, such as the reduction of gait speed. This contributes to an increased risk of falls. In rehabilitation, mental practice (MP) has been shown to promote plastic modulation of neural circuits and improve motor learning, but the results of research with MP in PD are still ambiguous due to the diversity of intervention strategies. Objectives To compare the effects of MP strategies associated to physiotherapy in gait and risk of falls in PD patients. Methodology We performed a pilot study of a clinical randomized, single blind, trial, conducted in accordance with the consort checklist. Patients with idiopathic PD were included and allocated to four groups: Control group (CG); Group with mental practice guided by images (MPI); Group with mental practice guided by audio (MPA); group with mental practice without a guide (MPWG). The subjects of the experimental groups were submitted to 15 sessions of physiotherapy and mental practice, while the CG received only physiotherapy. The sessions were held 2 times per week, 40 minutes for physiotherapy and approximately 5-10 minutes for the corresponding mental practice protocol. Spatial-temporal parameters of gait were assessed with the 10 meters Walking Test (TC10m), and the risk of falls was evaluated with the Timed Up and Go (TUG) test. Results The MPI group showed significant results for the parameters time (p = 0.027) and speed (p = 0.025) when compared with the results of the CG. No main effects for the group were observed concerning cadence and risk of falls had. Groups MPWG and MPA showed no significant results for the TC10m and TUG when compared with the CG. Conclusion The results of this pilot study suggest that MP guided by images associated to physical therapy was more effective to increase the gait speed than the alternative strategies.

THE USE OF POSTUROGRAPHY IN INVESTIGATING THE RISK OF FALLING IN FRAIL OR PREFRAIL OLDER PEOPLE WITH DIABETES

2019 ◽  
pp. 1-7
Author(s):  
H. Domergue ◽  
L. Rodríguez-Mañas ◽  
O. Laosa Zafra ◽  
K. Hood ◽  
D. Gasq ◽  
...  
Keyword(s):  
Older People ◽  
Walking Speed ◽  
Analysis Data ◽  
Diabetic Patients ◽  
Clinical Test ◽  
Risk Of Falling ◽  
Timed Up And Go ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Risk Patients

Background: In older people, diabetes is associated with an increased risk of falls and frailty. The value of using posturography for evaluating the risk of falling is unclear. In theory, a time-scale analysis should increase the metrological properties of the posturography assessment. Objectives: This study aimed to determine which posturographic parameters can be used to identify fall-risk patients in a frail diabetic older population and to assess their interest in comparison to usual clinical trials for gait and balance. Design: This is a prospective observational cohort. Settings: frail or pre-frail diabetic patients, in Bordeaux, France. Participants: 84 patients were included in the study (mean age 80.09 years, 64.5% of men).Criteria for inclusion were: age over 70 years, diabetes mellitus for over 2 years, and at least one of the Fried’s frailty criteria. Measurements: Gait and balance assessments were undertaken at baseline: Static posturography, the timed up and go test, short physical performance battery, and (gait) walking speed. Raw data from posturography were used for wavelet analysis. Data on self reported new falls were collected prospectively during 6 months. Results: The posturography parameter most useful was area of 90% confidence ellipse of statokinesigram (COP90area): area under the ROC curve AUC = 0.617 (95% CI, 0.445-0.789) and OR=1.003 (95%CI 1.000-1.005) p =0.05. The optimum clinical test was the time to walk over 4m AUC=0.735 (95%CI, 0.587-0.882) and OR=1.42 (95%CI 1.08-1.87) p= 0.013. Conclusion: Posturography has limited utility for assessment of falls risk in frail older people with diabetes. Gait and balance clinical assessments such as walking speed continue to retain their value.

scholarly journals Anticholinergic burden measures and older people’s falls risk: a systematic prognostic review

2021 ◽  
Vol 12 ◽  
pp. 204209862110166
Author(s):  
Carrie Stewart ◽  
Martin Taylor-Rowan ◽  
Roy L. Soiza ◽  
Terence J. Quinn ◽  
Yoon K. Loke ◽  
...  
Keyword(s):  
High Risk ◽  
Older People ◽  
Well Being ◽  
Risk Of Bias ◽  
Plain Language ◽  
Risk Of Falling ◽  
Increased Risk ◽  
Burden Scale ◽  
Risk Of Falls ◽  
Anticholinergic Burden

Introduction: Several adverse outcomes have been associated with anticholinergic burden (ACB), and these risks increase with age. Several approaches to measuring this burden are available but, to date, no comparison of their prognostic abilities has been conducted. This PROSPERO-registered systematic review (CRD42019115918) compared the evidence behind ACB measures in relation to their ability to predict risk of falling in older people. Methods: Medline (OVID), EMBASE (OVID), CINAHL (EMBSCO) and PsycINFO (OVID) were searched using comprehensive search terms and a validated search filter for prognostic studies. Inclusion criteria included: participants aged 65 years and older, use of one or more ACB measure(s) as a prognostic factor, cohort or case-control in design, and reporting falls as an outcome. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. Results: Eight studies reporting temporal associations between ACB and falls were included. All studies were rated high risk of bias in ⩾1 QUIPS tool categories, with five rated high risk ⩾3 categories. All studies (274,647 participants) showed some degree of association between anticholinergic score and increased risk of falls. Findings were most significant with moderate to high levels of ACB. Most studies (6/8) utilised the anticholinergic cognitive burden scale. No studies directly compared two or more ACB measures and there was variation in how falls were measured for analysis. Conclusion: The evidence supports an association between moderate to high ACB and risk of falling in older people, but no conclusion can be made regarding which ACB scale offers best prognostic value in older people. Plain language summary A review of published studies to explore which anticholinergic burden scale is best at predicting the risk of falls in older people Introduction: One third of older people will experience a fall. Falls have many consequences including fractures, a loss of independence and being unable to enjoy life. Many things can increase the chances of having a fall. This includes some medications. One type of medication, known as anticholinergic medication, may increase the risk of falls. These medications are used to treat common health issues including depression and bladder problems. Anticholinergic burden is the term used to describe the total effects from taking these medications. Some people may use more than one of these medications. This would increase their anticholinergic burden. It is possible that reducing the use of these medications could reduce the risk of falls. We need to carry out studies to see if this is possible. To do this, we need to be able to measure anticholinergic burden. There are several scales available, but we do not know which is best. Methods: We wanted to answer: ‘Which anticholinergic scale is best at predicting the risk of falling in older people?’. We reviewed studies that could answer this. We did this in a systematic way to capture all published studies. We restricted the search in several ways. We only included studies relevant to our question. Results: We found eight studies. We learned that people who are moderate to high users of these medications (often people who will use more than one of these medications) had a higher risk of falling. It was less clear if people who have a lower burden (often people who only use one of these medications) had an increased risk of falling. The low number of studies prevented us from determining if one scale was better than another. Conclusion: These findings suggest that we should reduce use of these medications. This could reduce the number falls and improve the well-being of older people.

scholarly journals Associations of poor oral health with frailty and physical functioning in the oldest old: results from two studies in England and Japan

2021 ◽  
Author(s):  
Viviana Albani ◽  
Kennsuke Nishio ◽  
Tomoka Ito ◽  
Eftychia Kotronia ◽  
Paula Moynihan ◽  
...  
Keyword(s):  
Oral Health ◽  
Grip Strength ◽  
Physical Functioning ◽  
Gait Speed ◽  
Tooth Loss ◽  
Oldest Old ◽  
Mobility Limitations ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Increased Risk

Abstract Background: Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old (>85 years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan.Methods: The Newcastle 85+ Study in England (n=853) and the Tokyo Oldest Old Survey on Total Health (TOOTH; n=542) comprise random samples of people aged >85 years. Oral health markers included tooth loss, dryness of mouth, difficulty swallowing and self-reported difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed; disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression.Results: In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for gender, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26-2.46); 2.52 (1.56-4.08); 2.89 (1.52-5.50); 2.59 (1.44-4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed; and complete tooth loss was associated with increased risk of frailty.Conclusion: Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed.

scholarly journals Associations of poor oral health with frailty and physical functioning in the oldest old: results from two studies in England and Japan

2020 ◽  
Author(s):  
Viviana Albani ◽  
Kennsuke Nishio ◽  
Tomoka Ito ◽  
Eftychia Kotronia ◽  
Paula Moynihan ◽  
...  
Keyword(s):  
Oral Health ◽  
Grip Strength ◽  
Physical Functioning ◽  
Gait Speed ◽  
Tooth Loss ◽  
Oldest Old ◽  
Mobility Limitations ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Increased Risk

Abstract Background: Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old (>85 years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan.Methods: The Newcastle 85+ Study in England (n=853) and the Tokyo Oldest Old Survey on Total Health (TOOTH; n=542) comprise random samples of people aged >85 years. Oral health markers included tooth loss, dryness of mouth, and self-reported difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed; disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression.Results: In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for gender, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26-2.46); 2.52 (1.56-4.08); 2.89 (1.52-5.50); 2.59 (1.44-4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed; and complete tooth loss was associated with increased risk of frailty.Conclusion: Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed.

scholarly journals Gait Speed and Grip Strength Are Predictors of Cognitive Decline and Dementia in Older Individuals

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 652-653
Author(s):  
Suzanne Orchard ◽  
Joanne Ryan ◽  
Robyn Woods ◽  
Galina Polekhina ◽  
Elsdon Storey ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Grip Strength ◽  
Gait Speed ◽  
Specific Interaction ◽  
Cognitive Outcomes ◽  
Older Individuals ◽  
Incident Dementia ◽  
Increased Risk ◽  
Longitudinal Association

Abstract Lower gait speed and grip strength are common in older adults. However, the results of lower motor function on cognitive outcomes have been mixed. We examined the longitudinal association between baseline slow gait speed and weak grip strength, alone and in combination, with risk of incident dementia or cognitive decline in a cohort of older adults. Participants (n=19,114) aged 70 and over (65 if U.S. minority) without documented evidence of dementia, significant cognitive impairment, physical disability or previous cardiovascular disease at baseline, were recruited from community settings. Incident dementia was adjudicated by an expert panel using DSM-IV criteria. Incident cognitive decline was defined as a persistent intra-individual decline in score of >1.5 SD from baseline on any of the cognitive tests. Using cox proportional hazard models, slow gait speed at baseline was associated with an increased risk of dementia (63%) and cognitive decline (43%), over a median 4.7 years. Weak grip strength was not as strong a predictor, but was also associated with risk (43% and 11%, respectively). Both outcomes showed higher risk for dementia than cognitive decline. There was no gender-specific interaction. When considered together (adjusted for one another), gait speed and grip strength were both independently associated with cognitive decline and dementia. The synergistic association of these physical measures, each of which is readily administered in the clinic or home, serve as effective early markers of increasing risk of cognitive decline and incident dementia and thus, should be considered for routine health assessments for older adults.

Associations between nutrient intakes and dietary patterns with different sarcopenia definitions in older Australian men: the concord health and ageing in men project

2020 ◽  
pp. 1-16 ◽  
Author(s):  
Arpita Das ◽  
Robert G Cumming ◽  
Vasi Naganathan ◽  
Fiona Blyth ◽  
David G Le Couteur ◽  
...  
Keyword(s):  
Older People ◽  
Dietary Patterns ◽  
Working Group ◽  
Nutrient Intake ◽  
Older Men ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
European Working Group ◽  
Increased Risk ◽  
European Working

Abstract Objective: To assess the associations between nutrient intake and dietary patterns with different sarcopenia definitions in older men. Design: Cross-sectional study. Setting: Sarcopenia was defined using the Foundation for the National Institutes of Health (FNIH), the European Working Group on Sarcopenia in Older People (EWGSOP) and the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Dietary adequacy of fourteen nutrients was assessed by comparing participants’ intakes with the Nutrient Reference Values (NRV). Attainment of NRV for nutrients was incorporated into a variable ‘poor’ (meeting ≤ 9) v. ‘good’ (meeting ≥ 10) using the cut-point method. Also, two different dietary patterns, monounsaturated:saturated fat and n-6:n-3 fatty acids ratio and individual nutrients were used as predictor variables. Participants: A total of 794 men aged ≥75 years participated in this study. Results: The prevalence of sarcopenia by the FNIH, EWGSOP and EWGSOP2 definitions was 12·9 %, 12·9 % and 19·6 %, respectively. With the adjustment, poor nutrient intake was significantly associated with FNIH-defined sarcopenia (OR: 2·07 (95 % CI 1·16, 3·67)), but not with EWGSOP and EWGSPOP2 definitions. The lowest and second-lowest quartiles of protein, Mg and Ca and the lowest quartiles of n-6 PUFA and n-3 PUFA intakes were significantly associated with FNIH-defined sarcopenia. Each unit decrease in n-6:n-3 ratio was significantly associated with a 9 % increased risk of FNIH-defined sarcopenia (OR: 1·09 (95 % CI 1·04, 1·16)). Conclusions: Inadequate intakes of nutrients are associated with FNIH-defined sarcopenia in older men, but not with the other two sarcopenia definitions. Further studies are required to understand these relationships.

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