Social participation and attitude towards gerontechnology: The moderating role of frailty status

The purpose of this study was to examine whether frailty status moderates the association between social participation and attitude towards using gerontechnology. The sample was Korean older adults without cognitive impairment (N = 310, aged 66-90, 51% women) who completed an online survey. The attitude towards using gerontechnology was measured with two questions from the Senior Technology Acceptance Model (Chen & Chan, 2014), asking whether using technology is a good idea and whether they like the idea of using technology. Social participation was assessed by asking whether the participants engage in social or community activities on a scale of 1–10. Frailty status was determined based on the Korean Groningen Frailty Indicator (K-GFI). Covariates were age, gender, marital status, employment status, education level, and household income. Results from regression analyses showed significant interaction between frailty status and social participation on attitude towards using gerontechnology. Specifically, social participation was associated with positive attitude towards using gerontechnology among non-frail older adults. This association was not significant among frail older adults. Our findings suggest that the relationship between social participation and attitude towards using gerontechnology might differ by physical health status. Among older adults who are physically healthy and actively participate in social activities, the attitude towards using gerontechnology might be more positive due to greater exposure to new technology-related information. Future studies need to address alternative ways to enhance technology-friendliness among older adults with poor physical health.

Prevalence and Risk Factors of Preoperative Frailty in Chinese Elderly Inpatients with Gastrointestinal Cancer Undergoing Surgery: A Single-center Cross-sectional Study Using the Groningen Frailty Indicator

BackgroundFrailty is emerging as an important determinant for health. Compared with Western countries, research in the field of frailty started at a later stage in China and mainly focused on older community dwellers. Little is known about frailty in Chinese cancer patients, nor the risk factors of frailty. This study aimed to investigate the prevalence of frailty and its risk factors in elderly inpatients with gastrointestinal cancer. MethodsThis cross-sectional study was performed at a tertiary hospital in China from Mar. 2020 to Nov. 2020. The study enrolled 265 inpatients aged 60 and older with gastrointestinal cancer who underwent surgery. The demographic and clinical characteristics, biochemical laboratory parameters, and anthropometric data were collected from all patients. The Groningen Frailty Indicator was applied to assess the frailty status of patients. Multivariate logistic regression model analysis was carried out to identify risk factors of frailty and estimate their 95% confidence intervals. ResultsThe prevalence of frailty in elderly inpatients with gastrointestinal cancer was 43.8%. A multivariate logistic regression analysis showed that older age (OR=1.065, 95% CI: 1.001-1.132, P=0.045), low handgrip strength (OR=4.346, 95% CI: 1.739-10.863, P=0.002), no regular exercise habit (OR=3.228, 95% CI: 1.230-8.469, P=0.017), and low MNA-SF score (OR=11.090, 95% CI: 5.119-24.024, P<0.001) were risk factors of frailty. ConclusionsThis study suggested that the prevalence of frailty was high among elderly inpatients with gastrointestinal cancer. Older age, low handgrip strength, no regular exercise habit, and low MNA-SF score were identified as risk factors of frailty.

The prevalence of frailty, measured with different diagnostic tools, and autonomy decline: Results of the Crystal study

INTRODUCTION: Frailty prevalence differs across different population depending on the models used to assess, age, economic situation, social status, and the proportion of men and women in the study. The diagnostic value of different models of frailty varies from population to population. OBJECTIVES: To assess the prevalence of frailty using 4 different diagnostic models and their sensitivity for identifying persons with autonomy decline. MATERIAL AND METHODS: A random sample of 611 people aged 65 and over. Models used: the Age is not a blocking factor model, the SOF Frailty Index, the Groningen Frailty Indicator, L. Fried model. Covariates: nutritional status, anemia, functional status, depression, dementia, chronic diseases, grip strength, physical function. RESULTS: The prevalence of the Frailty Phenotype ranged from 16.6 to 20.4% and the Frailty Index was 32.6%. Frailty, regardless of the used models was associated with an increase in the prevalence of the geriatric syndromes: urinary incontinence, hearing and vision loss, physical decline, malnutrition and the risk of malnutrition, low cognitive functions and autonomy decline (p 0.05). The negative predictive value (NPV) of the Age is not a blocking factor model, the SOF Frailty Index, the Groningen Frailty Indicator for identifying individuals with autonomy decline was 8690%. CONCLUSION: The prevalence of frailty depended on the operational definition and varied from 16.6 to 32.6%. The Age is not a blocking factor model, the SOF Frailty Index, the Groningen Frailty Indicator, L. Fried model can be used as screening tools to identify older patient with autonomy decline. Regardless of the model used, frailty is closely associated with an increase in the prevalence of major geriatric syndromes.

443 - Measuring frailty in older psychiatric patients

IntroductionFrailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes. Early identification of frailty may help optimizing quality of care. Fried's frailty criteria are often used as the gold standard of frailty. However, it takes too much time and the availability of a hand grip strength meter to measure these criteria in daily practice. Screening instruments for frailty such as the Groningen Frailty Indicator (GFI) and the Tilburg Frailty Indicator (TFI), are available. However, it is not yet certain whether the usual cut-off values are applicable to older psychiatric patients.AimTo determine internal consistency, sensitivity, specificity and area under the curve (AUC) of the receiver operating characteristic-curve (ROC- curve) of the GFI and TFI using validated cut-off values, and to determine the optimal cut-off value in older psychiatric patients.MethodsBaseline data of an ongoing prospective cohort study were used. In this study GFI, TFI and Fried-criteria were determined in hospitalized and non-hospitalized psychiatric patients over 65 years old.ResultsA total of 145 participants were enrolled, 90 of which were hospitalized and 55 were non-hospitalized. Median age of participants was 75.2 (SD =7) years, 108 were female. Prevalence of frailty according to Fried-criteria was 29.7%. Internal consistency (Cronbach's alpha) of the GFI was 0.76 and TFI = 0.75. Using the validated cut-off value and the Fried- criteria as reference, sensitivity of the GFI (≥4) was 0.95 (95% CI 0.83 - 0.99) and specificity 0.27 (95%CI 0.19 - 0.37). Sensitivity of the TFI (≥5) was 0.98 (95% CI 0.86 - 1.00) and specificity 0.31 (95% CI 0.23 - 0.41). The optimum cut-off value for both the GFI and TFI was ≥8. The AUC of the ROC-curve of GFI and TFI were 0.82 (95% CI 0.75 - 0.90) and 0.79 (95% CI 0.72 - 0.87), respectively.ConclusionWe found an acceptable internal consistency and AUC of both the GFI and the TFI in older psychiatric patients. Increasing the cut-off values of both GFI and TFI seems necessary to lower the amount of false positives in this population.

Transition in Frailty State Among Elderly Patients After Vascular Surgery

Background Frailty in the vascular surgical ward is common and predicts poor surgical outcomes. The aim of this study was to analyze transitions in frailty state in elderly patients after vascular surgery and to evaluate influence of patient characteristics on this transition. Methods Between 2014 and 2018, 310 patients, ≥65 years and scheduled for elective vascular surgery, were included in this cohort study. Transition in frailty state between preoperative and follow-up measurement was determined using the Groningen Frailty Indicator (GFI), a validated tool to measure frailty in vascular surgery patients. Frailty is defined as a GFI score ≥4. Patient characteristics leading to a transition in frailty state were analyzed using multivariable Cox regression analysis. Results Mean age was 72.7 ± 5.2 years, and 74.5% were male. Mean follow-up time was 22.7 ± 9.5 months. At baseline measurement, 79 patients (25.5%) were considered frail. In total, 64 non-frail patients (20.6%) shifted to frail and 29 frail patients (9.4%) to non-frail. Frail patients with a high Charlson Comorbidity Index (HR = 0.329 (CI: 0.133–0.812), p = 0.016) and that underwent a major vascular intervention (HR = 0.365 (CI: 0.154–0.865), p = 0.022) had a significantly higher risk to remain frail after the intervention. Conclusions The results of this study, showing that after vascular surgery almost 21% of the non-frail patients become frail, may lead to a more effective shared decision-making process when considering treatment options, by providing more insight in the postoperative frailty course of patients.

Evaluating the psychometric properties of the Arabic version of the Groningen Frailty Indicator among Lebanese elderly people

Background The levels of frailty are anticipated to increase as a result of population aging. A valid instrument is required to detect individuals at high risk of frailty. The present research aimed to assess feasibility, reliability, and construct validity of the Arabic version of Groningen Frailty Indicator (GFI) in urban and rural populations in South Lebanon. Methods During 2015, a cross-sectional study, which enrolled 390 community-dwelling individuals aged 65 years and above, was conducted in urban and rural areas in Nabatieh in South Lebanon. The survey included questions on sociodemographic and health-related characteristics, GFI, and Vulnerable Elders Survey-13 (VES-13). The translation and cultural adaptation of the GFI followed a standardized protocol. After that, the psychometric properties of the scale (i.e., feasibility, reliability, and validity) were evaluated. Results A total of 390 elderly filled out the questionnaire, of whom 51% were women and 70% lived in rural areas. 81.3% of elderly were identified as frail. The internal consistency of the GFI scale was high for all subscales (Cronbach’s alpha > 0.70), except the social scale (0.56). The GFI yielded statistically significant scores for subgroup analysis (known-groups validity) as higher levels of frailty were seen in older people, women, those with morbidities, and those reported poor financial status. The construct validity of the scale was supported by the significant correlation with the VES-13 (r = 0.73; p = 0.001), quality of life (r = − 0.22; p = 0.001), and self-reported health status (r = − 0.66; p = 0.001). Conclusion This study supports the feasibility, reliability, and validity of the GFI Arabic version as a screening tool for frailty among community-dwelling elderly in South Lebanon.

Effect of frailty on quality of life in elderly patients after hip fracture: a longitudinal study

ObjectivesThe aims of this study were to examine the pattern of changes over time in health status (HS) and quality of life (QoL) in the first year after hip fracture and to quantify the association between frailty at the onset of hip fracture and the change in HS and QoL 1 year later. The major hypothesis was that frailty, a clinical state of increased vulnerability, is a good predictor of QoL in patients recovering from hip fracture.DesignProspective, observational, follow-up cohort study.SettingSecondary care. Ten participating centres in Brabant, the Netherlands.Participants1091 patients entered the study and 696 patients completed the study. Patients with a hip fracture aged 65 years and older or proxy respondents for patients with cognitive impairment were included in this study.Main outcome measuresThe primary outcomes were HS (EuroQol-5 Dimensions questionnaire) and capability well-being (ICEpop CAPability measure for Older people). Prefracture frailty was defined with the Groningen Frailty Indicator (GFI), with GFI ≥4 indicating frailty. Participants were followed up at 1 month, 3 months, 6 months and 1 year after hospital admission.ResultsIn total, 371 patients (53.3%) were considered frail. Frailty was negatively associated with HS (β −0.333; 95% CI −0.366 to −0.299), self-rated health (β −21.9; 95% CI −24.2 to −19.6) and capability well-being (β −0.296; 95% CI −0.322 to −0.270) in elderly patients 1 year after hip fracture. After adjusting for confounders, including death, prefracture HS, age, prefracture residential status, prefracture mobility, American Society of Anesthesiologists grading and dementia, associations were weakened but remained significant.ConclusionsWe revealed that frailty is negatively associated with QoL 1 year after hip fracture, even after adjusting for confounders. This finding suggests that early identification of prefracture frailty in patients with a hip fracture is important for prognostic counselling, care planning and the tailoring of treatment.Trial registration numberNCT02508675

Tradução e adaptação transcultural do Groningen Frailty Indicator para idosos brasileiros

Objetivo: realizar a tradução, a adaptação transcultural e a validação de conteúdo do Groningen Frailty Indicator para aplicação em idosos brasileiros. Método: os procedimentos seguiram de tradução, obtenção da versão consensual da tradução, retrotradução, validação de conteúdo e pré-teste. A versão final em português foi aplicada a 30 idosos. Resultados: a versão brasileira do Groningen Frailty Indicator conservou a equivalência semântica. A população-alvo avaliou todos os itens como de fácil compreensão. Entretanto, faz-se necessário avaliar a equivalência de mensuração, validade externa e reprodutibilidade. Conclusão: os resultados sugerem que o Groningen Frailty Indicator traduzido e adaptado para a cultura brasileira é um instrumento de fácil aplicação, tornando-o viável para a prática clínica com idosos.