geriatric syndrome
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2022 ◽  
Author(s):  
Thi Lien To ◽  
Ching-Pyng Kuo ◽  
Chih-Jung Yeh ◽  
Wen-Chun Liao ◽  
Meng-Chih Lee

Abstract Background: Frailty in older adults is a common geriatric syndrome that can be reversed, thus coping strategies for the aging population are essential. Self-management behaviours may represent cost-effective strategies to reverse physical frailty in community-dwelling older adults. This study aimed to describe the changes in frailty status among community-dwelling older adults in Taiwan and investigate the association of self-management behaviours with changes in frailty status over a four-year follow-up period (2007 to 2011).Methods: This data was retrieved from the Taiwan Longitudinal Study of Aging (TLSA), which is a prospective cohort study of 1,283 community-dwelling older adults aged 65 years and older without cognitive impairment. Frailty was assessed based on Fried's frailty phenotype, in which ≥ three criteria indicate frail. Self-management behaviours (maintaining body weight, quitting smoking, drinking less, exercising, diet control, and maintaining a regular lifestyle) were assessed using a questionnaire. Multivariate logistic regression analyses were used to investigate the associations between self-management behaviours and changes in frailty status.Results: The prevalence of frailty was 8.7% at baseline and 8.1% after four years of follow-up, with 196 (15.3%) deaths. Overall, 74.6% of participants remained in the same state (non-frail or frail), 23.5% worsened (non-frail to frail, including missing data, and frail to death), and only 1.95% improved (frail to non-frail). Being aged ≥ 75-years-old, chronic diseases, and an absence of self-management behaviours were associated with higher risks of frailty at baseline and after follow-up. Exercise was significantly associated with a reversal of frailty in community-dwelling older adults (RR, 3.11; 95% CI, 1.95, 4.95) after adjusting for personal and disease covariates, regardless of whether death was coded as frail or not.Conclusions: Self-management behaviours beneficially reverse frailty status; maintaining regular exercise was especially associated with a reversal of frailty in community-dwelling older adults, even among individuals over 75-years-old and with chronic diseases. Older adults should be encouraged to perform adequate physical exercise to prevent the progression of frailty and ameliorate frailty status.


2022 ◽  
Vol 8 ◽  
Author(s):  
Yingying Ke ◽  
Jun Xu ◽  
Xiaoyan Zhang ◽  
Qihao Guo ◽  
Yunxia Zhu

Background: Sarcopenia is a geriatric syndrome characterized by progressive loss of muscle mass, function and quality and associated with a range of adverse health outcomes including disability. Despite a negative correlation between muscle mass and follicle-stimulating hormone (FSH) levels in postmenopausal women, it is unclear if FSH is associated with sarcopenia and its poor outcomes, especially in older men.Methods: We used cross-sectional data from 360 men aged over 80 who participated in health check-ups to investigate correlations between serum FSH and sarcopenia, individual sarcopenia components, low physical performance (gait speed ≤ 0.8 m/s) and instrumental activities of daily living (IADL) disability. Sarcopenia and severe sarcopenia were diagnosed according to the revised definition of the European Working Group on Sarcopenia in Old People (EWGSOP2).Results: The prevalence of sarcopenia was 17.8% in this population. In binary logistic regression analysis, compared with higher FSH group, lower FSH group showed a significant reduction in the risk of low calf circumference (a surrogate for muscle mass; OR 0.308, 95% CI 0.109–0.868, P = 0.026) after adjusting potential confounders including age, waist circumference, education, exercise, associated biochemical parameters, other sex hormones and high-sensitivity C-reactive protein. The correlation between FSH and low handgrip strength was marginally significant (OR 0.390, 95% CI 0.151–1.005, P = 0.051). No associations were observed between FSH and sarcopenia, severe sarcopenia, and disability in adjusted models.Conclusion: In older men, circulating FSH was not associated with sarcopenia, sarcopenia severity, the majority of its components and adverse health outcome (IADL disability), with the exception of low calf circumference. Further work is needed to better elucidate the association of FSH and low muscle quantity by adopting more accurate measurement method of appendicular skeletal muscle mass such as DXA, CT or MRI.


Author(s):  
Mehdi Kushkestani ◽  
Mohsen Parvani ◽  
Mahmood Ghafari ◽  
Zahra Avazpoor

Aging is a complex process of physiological and social changes that leads to various diseases. The number of elderly people in the world is increasing dramatically and it should be noted that rapid population aging represents a major public health burden. On the other hand, providing an appropriate and low-cost approach to control and prevent complications such as chronic diseases, physical dysfunction, and the geriatric syndrome is necessary. Also, numerous studies have shown that participation in physical activity and exercise training reduces the incidence of dysfunctional capacity, cardiovascular and metabolic disease, as well as the premature death rate in older adults. After plenty of precise observations about the role of exercise on aging-related diseases and geriatric syndromes articles, the benefits of exercise and physical activity in older adults will be more tangible. Therefore, the first purpose of the present review was to investigate the mechanisms of PA and exercises that are involved in the prevention of aging-related diseases and GS using current evidence (from 2015 onwards). Also, the purpose of this study was to provide an exercise guideline (aerobic and resistance training) based on recent evidence (from 2015 onwards). El envejecimiento es un proceso complejo de cambios fisiológicos y sociales que conduce a diversas enfermedades. El número de personas de edad avanzada en el mundo está aumentando drásticamente y cabe señalar que el rápido envejecimiento de la población representa una importante carga para la salud pública. Por otro lado, es necesario brindar un enfoque adecuado y de bajo costo para controlar y prevenir complicaciones como enfermedades crónicas, disfunción física y síndrome geriátrico. Además, numerosos estudios han demostrado que la participación en la actividad física y el entrenamiento físico reduce la incidencia de disfunciones, enfermedades cardiovasculares y metabólicas, así como la tasa de muerte prematura en los adultos mayores. Después de muchas observaciones precisas sobre el papel del ejercicio en los artículos sobre enfermedades relacionadas con el envejecimiento y síndromes geriátricos, los beneficios del ejercicio y la actividad física en los adultos mayores serán más tangibles. Por lo tanto, el primer propósito de la presente revisión fue investigar los mecanismos de actividad física y ejercicios que están involucrados en la prevención de enfermedades relacionadas con el envejecimiento y síndrome geriátrico utilizando la evidencia actual (de 2015 en adelante). Además, el propósito de este estudio fue proporcionar una guía de ejercicio (entrenamiento aeróbico y de resistencia) basada en evidencia reciente (de 2015 en adelante).


Author(s):  
N. Mourtzi ◽  
A. Hatzimanolis ◽  
G. Xiromerisiou ◽  
E. Ntanasi ◽  
M.K. Georgakis ◽  
...  

Background: Frailty is a complex geriatric syndrome arising from a combination of genetic and environmental factors and is associated with adverse health outcomes and mortality. A recent study reported an association between variants of the 9p21-23 locus, associated with a number of age-related disorders, including Alzheimer’s disease (AD), and frailty. Frailty has been associated with increased risk of developing AD and it has been proposed that frailty burden may modify AD clinical presentation. In view of the overlapping genetic architecture between the two disorders, it is noteworthy to conduct studies to uncover risk variants that contribute to both AD and frailty. The purpose of this study is to test the reproducibility of the association of 9p21-23 locus with frailty in a population that is ethnically different from previous work and in the context of multidimensional definitions of frailty that will allow us to examine the potential impact to domains pertaining to AD pathology. Methods: We operationalized frailty according two definitions and the corresponding instruments, the Frailty Index (FI) and the Tilburg Frailty Indicator (TFI) and we determined genotypes of eight alleles previously identified as risk increasing for frailty in 1172 community-dwelling older participants (57% females) from the HELIAD study with a mean age of 74 years old. We cross-sectionally investigated the association between risk alleles and frailty, as well as with specific components of each definition using linear regression analyses adjusted for age, sex and years of education. Results: Compared to non-carriers, carriers of rs7038172 C risk allele, were associated with a higher FI Score (β=0.089, p=0.002). Similarly, we found a positive association between the presence of at least one rs7038172 C variant and TFI score (β=0.053, p=0.04). Moreover, the rs7038172 variant was associated, irrespectively of dementia status, with the memory and psychological domain of FI and TFI, respectively. Conclusion: Our study confirms the association of the rs7038172 C allele with the frailty syndrome in a Greek population and in the context of multidimensional definitions of frailty. Furthermore, we report novel associations between this allele and the memory domain of FI and the psychological domain of TFI, that includes memory problems on its components. Given that frailty burden has been shown to modify the AD clinical presentation, it is likely that rs7038172 C allele may accelerate the transition of AD or frailty to dementia Overall, our study corroborates the role of the 9p21-23 region in frailty development and draw potential links with AD pathology.


Author(s):  
Krzysztof Pachołek ◽  
Małgorzata Sobieszczańska

Comprehensive geriatric assessment (CGA) is a multidimensional diagnostic process enabling evaluation of elderly patients’ physical and mental health status that implies implementation of the management targeted on the preservation of functional independence. Sarcopenia is a common but often underdiagnosed geriatric syndrome associated with increased likelihood of functional dependence and mortality risk. The main objectives of the study were the evaluation of sarcopenia prevalence in the patient group subjected to CGA with the upgraded EWGSOP2 algorithm considering muscle strength as the key criterion and usage of bioimpedance (BIA) muscle mass assessment. The study group consisted of 101 patients (76 women and 25 men) admitted for planned CGA to the Geriatrics Department of Wroclaw University Hospital. A diagnosis of sarcopenia was made according to the EWGSOP2 protocol. Body composition was determined with the bioimpedance technique. Functional status was assessed with ADLs from the VES-13 scale and additional questions. Sarcopenia was diagnosed in 16.8% of the study participants. Sarcopenic individuals presented worse functional status and impaired social activity. Muscle strength, gait speed and muscle mass below cut-off values were associated with dependence found in ADLs. Results showed that sarcopenia is a common impairment correlated with worse functional status and vulnerability to adverse outcomes. BIA can be treated as an accessible and accurate technique for muscle mass measurement in screening for sarcopenia, and the EWGSOP2 algorithm should be an essential part of the routine CGA procedure.


2021 ◽  
Vol 17 (S6) ◽  
Author(s):  
Sara AJ Van de Schraaf ◽  
Hanneke FM Rhodius‐ Meester ◽  
Laurien Aben ◽  
Eefje M Sizoo ◽  
Mike JL Peters ◽  
...  

2021 ◽  
Vol 36 (12) ◽  
pp. 645-651
Author(s):  
Mark Branum

This case study reviews the pharmacotherapy of a resident in a long-term care facility being treated for poststroke seizure, hallucinations, and dementia, a geriatric syndrome that is both common in regard to its prevalence and severe in regard to its impact on the individual, families, caregivers, and health care system. This case describes the past medical history of an older resident in a skilled nursing facility that was receiving pharmacological therapy for auditory hallucinations and for poststroke seizure prophylaxis, was noted to be having side effects from drug therapy, and how the nursing staff communicated with the consultant pharmacist to resolve these issues.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 672-672
Author(s):  
Kevin Ramdas ◽  
Ben Hitchinson ◽  
Lisa McClain-Moss ◽  
Keyvan Yousefi ◽  
Liliana Diaz ◽  
...  

Abstract Frailty is a common and important geriatric syndrome characterized by age-associated declines in physiology and function across multiple organ systems, which lead to increased vulnerability to adverse health outcomes. A biological mechanism that underlies the decline in physical function associated with aging frailty is chronic inflammation. The MSCs in Lomecel-B have immuno-modulatory capacity and control inflammation and the cytokine production of lymphocytes. An individual’s endogenous stem cell production decreases with age, this decrease likely contributes to reduced ability to regenerate and repair organs and tissues. Aging Frailty represents an exciting potential indication for cellular based therapies like Lomecel-B. This study is intended to evaluate the effects of Lomecel-B infusion compared to placebo on mobility and exercise tolerance, patient-reported physical function assessments and biomarkers for inflammation in individuals with Aging Frailty. This is a randomized, double-blind placebo-controlled, parallel multi-arm multicenter study enrolling adults aged 70-85 years identified as mildly or moderately frail per the CSHA Clinical Frailty Scale (CFS), with reduced six minute walk test (6MWT) and elevated Tumor Necrosis Factor-α (TNF-α), at screening. 150 subjects (30 per group) were randomized to receive a single peripheral intravenous infusion of 25, 50, 100, or 200 million doses, or placebo. Safety and efficacy assessments were conducted at 30, 90, 180, and 270 days after infusion. A follow up telephone call to subjects was placed at 365 days. We describe the design and rationale in detail of this 2b study assessing the effects of Lomecel-B on older adults with Aging Frailty.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 822-822
Author(s):  
Carolina Freiria ◽  
Graziele Silva ◽  
Larissa Hara ◽  
Tábatta Brito ◽  
Flávia Arbex Silva Borim ◽  
...  

Abstract The adequate nutrition has an important role in the prevent and treatment of frailty, however, there are only few studies showing the relationship between macronutrients intake and this geriatric syndrome, especially in Latin countries. The aim of this study was to analyze the association between macronutrients intake and frailty among older adults in Brazil. This study included 521 community-dwelling individuals aged 60 years old or older. Frailty was assessed using a self-reported instrument and individuals were categorized in two groups: frail and non-frail (robust + pre frail). Food consumption was evaluated using the 24-hour recall and the software NDSR®. Differences between groups was assessed using the Mann Whitney test. The prevalence of frailty was 42.0%. Older adults considered frails presented lower intake of calories (1510.9 kcal vs 1639.3 kcal; p = 0.016), carbohydrates (196.8 g vs 213.3 g; p = 0.011), proteins (60.7 g vs 68.5 g; p = 0.016) and fiber (15.1 g vs 17.5 g; p= 0.002). They also had lower intake of protein per kilograms of weight (0.88 g/kg vs 0.99 g/kg; p= 0.010). The findings demonstrate high prevalence of frail in our sample, and that intake of most macronutrients was significantly lower among older adults with frail, indicating the importance of the screening of frail as well the evaluation of macronutrients intake among community-based older adults, to prevent malnutrition, sarcopenia and frailty in this population.


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