MEASURING FRAILTY AMONG OLDER PEOPLE: FURTHER EVALUATION OF THE BRODY FRAILTY INDEX

2017 ◽  
pp. 1-4
Author(s):  
U. Jakobsson
Keyword(s):  
Older People ◽  
Predictive Validity ◽  
Demographic Data ◽  
Frailty Index ◽  
High Specificity ◽  
Total Sample ◽  
Postal Questionnaire ◽  
Self Report ◽  
The Mean ◽  
Low Sensitivity

Background & Objective: The study aimed to evaluate the predictive validity of the Brody self-report frailty index among older people. Design, setting & measurements: A longitudinal cohort study (2-years) conducted in Sweden, which included 1141 respondents, aged 65–103 years. Data were collected during 2011-2013 through a postal questionnaire with questions about demographic data, living conditions, self-reported health, ADL dependency (ADL-staircase) and frailty (the Brody frailty index). Results: The total sample was comprised of 53 percent women and the mean age was 74.5 years (SD 7.0). The mean frailty index score at baseline was 0.12 and increased with higher age (rs= 0.819) as well as with increased ADL dependency (rs = 0.740). The analyses showed high percentage of correctly classified cases (97.1-98.2), high specificity (98.1-98.4) but low sensitivity (22.2-66.7). Conclusion: The self-report frailty index seems to be a valid measure of current frailty, but its predictive validity was found to be non-acceptable especially regarding the instrument’s sensitivity. Such instrument can be useful to predict frailty and allocate resources in the care of older people.

Validity of hearTest Smartphone-Based Audiometry for Hearing Screening in Workers Exposed to Noise

2020 ◽  
Author(s):  
Luma Cordeiro Rodrigues ◽  
Silvia Ferrite ◽  
Ana Paula Corona
Keyword(s):  
Hearing Loss ◽  
High Specificity ◽  
Hearing Screening ◽  
Youden Index ◽  
Hearing Level ◽  
Predictive Values ◽  
Auditory Thresholds ◽  
The Mean ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Abstract Purpose This article investigates the validity of a smartphone-based audiometry for hearing screening to identify hearing loss in workers exposed to noise. Research Design This is a validation study comparing hearing screening with the hearTest to conventional audiometry. The study population included all workers who attended the Brazilian Social Service of Industry to undergo periodic examinations. Sensitivity, specificity, the Youden index, and positive (PPV) and negative predictive values (NPV) for hearing screening obtained by the hearTest were estimated according to three definitions of hearing loss: any threshold greater than 25 dB hearing level (HL), the mean auditory thresholds for 0.5, 1, 2, and 4 kHz greater than 25 dB HL, and the mean thresholds for 3, 4, and 6 kHz greater than 25 dB HL. Note that 95% confidence intervals were calculated for all measurements. Results A total of 232 workers participated in the study. Hearing screening with the hearTest presented good sensitivity (93.8%), specificity (83.9%), and Youden index (77.7%) values, a NPV (97.2%), and a low PPV (69.0%) for the identification of hearing loss defined as any auditory threshold greater than 25 dB HL. For the other definitions of hearing loss, we observed high specificity, PPV and NPV, as well as low sensitivity and Youden index. Conclusion The hearTest is an accurate hearing screening tool to identify hearing loss in workers exposed to noise, including those with noise-induced hearing loss, although it does not replace conventional audiometry.

CAN AN INTERVENTION WITH TESTOSTERONE AND NUTRITIONAL SUPPLEMENT IMPROVE THE FRAILTY LEVEL OF UNDER-NOURISHED OLDER PEOPLE?

2016 ◽  
pp. 1-6
Author(s):  
O. THEOU ◽  
L. WIJEYARATNE ◽  
C. PIANTADOSI ◽  
K. LANGE ◽  
V. NAGANATHAN ◽  
...  
Keyword(s):  
Older People ◽  
Controlled Trial ◽  
Frailty Index ◽  
Intervention Group ◽  
Nutritional Supplement ◽  
Community Dwelling ◽  
Self Report ◽  
Control Group ◽  
Testosterone Undecanoate ◽  
High Calorie

Objective: To examine whether a testosterone and a high calorie nutritional supplement intervention can reduce frailty scores in undernourished older people using multiple frailty tools. Design: Randomized controlled trial. Setting/Participants: 53 community-dwelling, undernourished men and women aged >65 years from South Australia, Victoria and New South Wales. Intervention: Intervention group received oral testosterone undecanoate and a high calorie supplement (2108-2416 kJ/day) whereas the control group received placebo testosterone and low calorie supplement (142-191 kJ/day). Measurements: Frailty was operationalized using three frailty indices (FI-lab, FI-self-report, FI-combined) and the frailty phenotype. Results: There were no significant differences in changes in frailty scores at either 6 or 12 months follow up between the two treatment groups for all scales. Participants at the intervention group were 4.8 times more likely to improve their FI-combined score at both time points compared to the placebo group. Conclusion: A testosterone and a high calorie nutritional supplement intervention did not improve the frailty levels of under-nourished older people. Even so, when frailty was measured using a frailty index combining self-reported and lab data we found that participants who received the intervention were more likely to show persistent improvement in their frailty scores.

Sickle cell crisis as evaluated from measurements of hydroxybutyrate dehydrogenase and myoglobin in plasma.

1981 ◽  
Vol 27 (2) ◽  
pp. 314-316 ◽  
Author(s):  
E F Roth ◽  
P A Bardfeld ◽  
S J Goldsmith ◽  
E Radel ◽  
J C Williams
Keyword(s):  
Steady State ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
High Specificity ◽  
Mean Value ◽  
Cell Disease ◽  
Sickle Cell Crisis ◽  
The Mean ◽  
Low Sensitivity ◽  
Sickle Cell Crises

Abstract Data on plasma hydroxybutyrate dehydrogenase activity (I) and myoglobin concentration were used to evaluate painful sickle cell crises. I was increased during non-crisis steady state in patients with sickle cell disease as compared to normal values (232, SD 79.7 vs 85, SD 33 Sigma units/mL). During crisis, the mean value for I increased further to 379 (SD 139) Sigma units/mL. For 12 patients evaluated both during steady state and crisis, there was a mean increase in plasma I of 131% (SD 76%). Repeated determinations of I in sickle cell disease patients during several months while they were in steady state showed that baseline I varied by no more than 20% from the mean. Plasma myoglobin in patients with sickle cell disease was not above normal, but during crisis 21 of 39 patients tested had increased plasma myoglobin concentrations. Our data suggest that I may be a useful indicator of sickle cell crisis when the patient's own baseline value is available for comparison. Plasma myoglobin measurements give evidence of muscle damage during crisis with high specificity but low sensitivity.

83 A Deficit Accumulation Frailty Index Predicts Mortality in Older South Africans: Findings from the HAALSI Study

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i27-i27
Author(s):  
F J Barker ◽  
J I Davies ◽  
F X Gomez-Olive ◽  
K Kahn ◽  
F E Matthews ◽  
...  
Keyword(s):  
South Africa ◽  
Older People ◽  
Frailty Index ◽  
Cox Proportional Hazards ◽  
Sub Saharan Africa ◽  
Deficit Accumulation ◽  
South Africans ◽  
Risk Of Death ◽  
The Mean ◽  
Cumulative Deficit

Abstract Introduction Few studies have investigated frailty in older people in sub-Saharan Africa, yet such information is vital to prepare responses to rapid population ageing. We aimed to derive and test a cumulative deficit frailty index in a population of older people from rural South Africa. Methods We analysed data from the Health and Ageing in Africa: Longitudinal Studies of an INDEPTH Community (HAALSI) study, which enrolled participants aged 40 years and older nested within the Agincourt Health and Demographic Survey Site, South Africa. We created a 32-variable cumulative deficit frailty index using questionnaire (illnesses, symptoms and activities of daily living), physical performance and physiological indices, and blood test results. Each variable was dichotomised to 1 (deficit) or 0 (no deficit). The frailty index for each individual was calculated as the mean of all frailty variables. Frailty categories were defined using cut-offs from the UK electronic frailty index: 0-0.12 (non-frail), >0.12-0.24 (mild frailty), >0.24-0.36 (moderate frailty) and >0.36 (severe frailty). Cox proportional hazards models, both unadjusted and adjusted for age and sex, were fitted to test the association between frailty status and all-cause mortality. Results We analysed data from 3989 participants, mean age 61 years (SD 13); 2175 (54.5%) were female. The mean follow-up period was 17 months; 1464 (36.7%) were non-frail, 2059 (51.6%) had mild frailty, 402 (10.1%) had moderate frailty and 64 (1.6%) had severe frailty. A total of 135 (3.4%) died. Adjusted Cox models showed worse frailty category was associated with higher risk of death compared with non-frail individuals: hazard ratios 1.94 (95% CI 1.23, 3.07) for mild frailty, 3.25 (95% CI 1.86, 5.68) for moderate frailty, and 5.50 (95% CI 2.44, 12.40) for severe frailty. Conclusions Frailty measured by a cumulative deficits index is common and predicts mortality in a rural population of older South Africans.

scholarly journals Perception of Breastfeeding among Female Medical Students, Taibah University, Medina, Saudi Arabia 2012

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Ghaida Aziz, Ghaida jabri, Ghaida Al-Ahmadi, Mona Ehab, Marw
Keyword(s):  
Medical Students ◽  
Statistical Tests ◽  
Demographic Data ◽  
Knowledge Score ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Hormonal Contraceptives ◽  
Cross Sectional ◽  
The Mean ◽  
Knowledge And Attitude

Breast feeding (BF) is known to have many advantages but our Arab region has a pattern similar to western countries; where exclusive breastfeeding less than 35%. Knowledge given to women during her antenatal visits plays an important influential role in her attitude and practice of BF later on.  Objective: To explore knowledge and attitude of female medical students at Taibah University about breastfeeding.  Methods: A Cross sectional study was carried out from October to November 2012. It included female medical students. Stratified sampling allocation technique was used; with a total sample of 149 students. A specialty designed self-administrated questionnaire in Arabic form was used. It included socio-demographic data, obstetric history, data about the knowledge and attitude of female medical students towards breastfeeding value and guidelines. Mean percent knowledge score for value of BF, mean percent score for BF guidelines and mean percent score for attitude were calculated. Appropriate statistical tests for qualitative and quantitative data were used accordingly. Results: Majority (91.9%) (of the studied sample) was never married and 37.6% got their knowledge about BF via books. Regarding ever married women, 58.3% only were gravid (mean =2.2±1.94). Only 25.0% were family planning users; 66.7% of them used hormonal contraceptives. Only 20% breast fed their infants with a mean duration for exclusive BF of 3.8 ± 2.87 months and mean age of weaning of 2.3 ±0.63 months. The mean knowledge percent score for guidelines of BF was 64.7±8.45. The mean attitude percent score for concepts related to BF was 76.9±7.91. Conclusion: Media and internet have minor roles in getting knowledge about BF. The mean knowledge score about advantages of BF, guidelines of BF and attitude towards BF of all female medical students; especially academic years were unsatisfactory.

scholarly journals Frailty of Māori, Pasifika, and Non-Māori/Non-Pasifika Older People in New Zealand: A National Population Study of Older People Referred for Home Care Services

2020 ◽  
Author(s):  
Rebecca Abey-Nesbit ◽  
Nancye M Peel ◽  
Hector Matthews ◽  
Ruth E Hubbard ◽  
Prasad S Nishtala ◽  
...  
Keyword(s):  
New Zealand ◽  
Home Care ◽  
Older People ◽  
Frailty Index ◽  
Indigenous Populations ◽  
Potential Range ◽  
Linear Regression Models ◽  
Care Assessment ◽  
The Mean ◽  
Age And Sex

Abstract Background Little is known about the prevalence of frailty in indigenous populations. We developed a frailty index (FI) for older New Zealand Māori and Pasifika who require publicly funded support services. Methods An FI was developed for New Zealand adults aged 65 and older who had an interRAI Home Care assessment between June 1, 2012 and October 30, 2015. A frailty score for each participant was calculated by summing the number of deficits recorded and dividing by the total number of possible deficits. This created a FI with a potential range from 0 to 1. Linear regression models for FIs with ethnicity were adjusted for age and sex. Cox proportional hazards models were used to assess the association between the FI and mortality for Māori, Pasifika, and non-Māori/non-Pasifika. Results Of 54 345 participants, 3096 (5.7%) identified as Māori, 1846 (3.4%) were Pasifika, and 49 415 (86.7%) identified as neither Māori nor Pasifika. New Zealand Europeans (48 178, 97.5%) constituted most of the latter group. Within each sex, the mean FIs for Māori and Pasifika were greater than the mean FIs for non-Māori and non-Pasifika, with the difference being more pronounced in women. The FI was associated with mortality (Māori subhazard ratio [SHR] 2.53, 95% CI 1.63–3.95; Pasifika SHR 6.03, 95% CI 3.06–11.90; non-Māori and non-Pasifika SHR 2.86, 95% CI 2.53–3.25). Conclusions This study demonstrated differences in FI between the ethnicities in this select cohort. After adjustment for age and sex, increases in FI were associated with increased mortality. This suggests that FI is predictive of poor outcomes in these ethnic groups.

Usefulness of a DSM Criteria-Based Inventory for Screening for Post-Traumatic Stress Disorder

2007 ◽  
Vol 22 (5) ◽  
pp. 454-456
Author(s):  
Benedetto Farina ◽  
Piero Venturi ◽  
Antonio Onofri ◽  
Michele Raja ◽  
Massimo Di Giannantonio
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
High Specificity ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Post Traumatic ◽  
Low Sensitivity

AbstractThe aim of the study is to evaluate the self-administered Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria-based inventory for the screening of post-traumatic stress disorder. Due to its low sensitivity (57%) and high specificity (88%), it could be useful as a second step of a screening procedure in combination with other validated, self-report instruments. The clinical implications of the findings and the limitations of the study are discussed.

scholarly journals Barriers to Optimal Acute Management of Stroke: Perspective of a Stroke Center in Mexico City

2021 ◽  
Vol 12 ◽  
Author(s):  
Vanessa Cano-Nigenda ◽  
Enrique Castellanos-Pedroza ◽  
Diana Manrique-Otero ◽  
Beatriz Méndez ◽  
María Fernanda Menéndez-Manjarrez ◽  
...  
Keyword(s):  
Demographic Data ◽  
Total Sample ◽  
Acute Management ◽  
Middle Income ◽  
Middle Income Countries ◽  
Telephone Interviews ◽  
Single Center Study ◽  
Private Car ◽  
The Mean ◽  
Stroke Center

Background: Stroke is a leading cause of death and disability worldwide, particularly in low- and middle-income countries. We aimed to identify the main barriers to optimal acute management of stroke in a referral center.Methods: Demographic data was collected from patients assessed with acute stroke in the emergency department of the Instituto Nacional de Neurología y Neurocirugía (INNN) from January to June 2019. Additionally, a telephone interview was conducted with patients/primary caregiver to know which they considered the main reason for the delay in arrival at INNN since the onset of stroke.Results: 116 patients were assessed [age 65 ± 15 years, 67 (57.8%) men]. Patients consulted other facilities prior to arrival at INNN in 59 (50.9%) cases (range of hospitals visited 1–4), 83 (71.6%) arrived in a private car, with prenotification in only 4 (3.4%) of the total sample. The mean onset-to-door time was 17 h (45 min−10 days). Telephone interviews were done in 61 patients/primary caregivers, stating that they consider the multiple evaluations in other facilities [n = 26/61 (42.6%)] as the main reason for delay in arrival at the ED, followed by ignorance of stroke symptoms and treatment urgency [n = 21/61 (34.4%)].Conclusion: In this small, retrospective, single center study, the main prehospital barrier to optimal acute management of stroke in a developing country is multiple medical evaluations prior to the patient's transport to a specialized stroke hospital, who mostly arrived in a private car and without prenotification. These barriers can be overcome by strengthening public education and improving patient transfer networks and telemedicine.

scholarly journals The predictive validity of three self-report screening instruments for identifying frail older people in the community

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Ramon Daniels ◽  
Erik van Rossum ◽  
Anna Beurskens ◽  
Wim van den Heuvel ◽  
Luc de Witte
Keyword(s):  
Older People ◽  
Predictive Validity ◽  
Self Report ◽  
Screening Instruments ◽  
Frail Older People

scholarly journals Compare the severity of psychological distress among four groups of Iranian society in COVID-19 pandemic

2020 ◽  
Author(s):  
Amir Vahedian-Azimi ◽  
Malihe Sadat Moayed ◽  
Farshid Rahimibashar ◽  
Sajad Shojaei ◽  
Sara Ashtari ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Medical Students ◽  
Medical Staff ◽  
Demographic Data ◽  
Iranian Population ◽  
Self Report ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Community Population ◽  
The Mean

Abstract Background: Coronavirus Disease 2019 (COVID-19) pandemic has caused serious psychological problems, such as panic attack, anxiety, stress and depression. The main objective of this study was to measure the prevalence and compare the severity of this psychological distress among four groups of Iranian population.Method: In cross-sectional survey, the mental health status of four groups of Iranian society such as community population, patients with COVID-19, medical staff and medical students were investigated by self-report questionnaire Depression, Anxiety and Stress Scale (DASS). DASS-21 questionnaire and the demographic data sheet were filled in by all participants. All statistical analyses were done using SPSS version 21.0. P-values less than 0.05 were considered statistically significant.Results: Of the 886 participants in this survey, 554 (62.5%) were male and 332 (37.5%) were female, and the mean ± standard division (SD) age of subjects was 40.91±10.7 years. Among these participants, 241 (27.2%) were selected from community population, 221 (24.9%) were patients with COVID-19, 217 (24.5%) were medical staff and 207 (23.4%) were medical students. The mean score of stress, anxiety and depression in medical students and patients with COVID-19 was significantly higher than medical staff and community population (P<0.05). In overall, the score of anxiety level in male was higher than that in female (27.4±4.6 vs. 26.48±4.8, P=0.006), and the score of depression in unmarried participants was significantly higher than that in married group (27.5±4.8 vs. 26.7±4.6, P=0.023). In addition, the score of depression in female medical staff (27.08±4.6 vs. 25.33±4.3, P=0.011) and community population (26.6±4.3 vs. 25.3±4.3, P=0.02) was higher than that in male.Conclusion: In COVID-19 pandemic, the severity of anxiety, stress and depression was high among Iranian population. Patients with COVID-19 and medical students who spent time with patients with COVID-19, with low experience than professional medical staff and community population were at high risk for mental illness. Continuous surveillance and monitoring of psychological distress for outbreaks should become routine as part of preparedness efforts worldwide.

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