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frailty and comorbidity

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https://www.readbyqxmd.com/read/28431912/osteosarcopenic-obesity-prevalence-and-relation-with-frailty-and-physical-performance-in-middle-aged-and-older-women
#1
Claudia Szlejf, Lorena Parra-Rodríguez, Oscar Rosas-Carrasco
OBJECTIVES: The aims of this study were to determine the prevalence of osteosarcopenic obesity (OSO) and to investigate its association with frailty and physical performance in Mexican community-dwelling middle-aged and older women. DESIGN: Cross-sectional analysis of a prospective cohort. SETTING: The FraDySMex study, a 2-round evaluation of community-dwelling adults from 2 municipalities in Mexico City. PARTICIPANTS: Participants were 434 women aged 50 years or older, living in the designated area in Mexico City...
April 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28412164/diagnosis-and-management-of-oropharyngeal-dysphagia-among-older-persons-state-of-the-art
#2
REVIEW
Omar Ortega, Alberto Martín, Pere Clavé
Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization and defined as the difficulty or inability to move a bolus safely and effectively from the oral cavity to the esophagus, and can include aspirations, choking, and residue. OD is pandemic among different phenotypes of older people, affecting between 27% and 91% of the population 70 years or older. Although OD can be diagnosed by well-defined clinical methods and complementary explorations, in the clinical setting OD is seldom systematically screened and treated, and awareness among the medical/geriatric community is scarce...
April 12, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28406852/survivorship-after-high-energy-geriatric-trauma
#3
Ida Leah Gitajn, Renan Castillo, Stephen Breazeale, Carrie Schoonover, Peter Berger, Yanjie Huang, Nathan O'Hara, Robert V O'Toole, Marcus F Sciadini
OBJECTIVES: To evaluate in-hospital, 1-year, and 5-year survivorship of geriatric patients after high-energy trauma, to compare survivorship of geriatric patients who sustained high-energy trauma with that of those who sustained low-energy trauma, and to identify predictors for mortality. DESIGN: Retrospective. SETTING: Urban Level I trauma center. PATIENTS: Study group of 1849 patients with high-energy trauma and comparison group of 761 patients with low-energy trauma...
April 18, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28402474/the-nursing-home-physical-performance-test-a-secondary-data-analysis-of-women-in-long-term-care-using-item-response-theory
#4
Subashan Perera, David A Nace, Neil M Resnick, Susan L Greenspan
Background and Objectives: The Nursing Home Physical Performance Test (NHPPT) was developed to measure function among nursing home residents using sit-to-stand, scooping applesauce, face washing, dialing phone, putting on sweater, and ambulating tasks. Using item response theory, we explore its measurement characteristics at item level and opportunities for improvements. Research Design and Methods: We used data from long-term care women. We fitted a graded response model, estimated parameters, and constructed probability and information curves...
April 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28398076/refining-low-physical-activity-measurement-improves-frailty-assessment-in-advanced-lung-disease-and-survivors-of-critical-illness
#5
Matthew R Baldwin, Jonathan P Singer, Debbie Huang, Jessica Sell, Wendy C Gonzalez, Lauren Pollack, Mathew S Maurer, Frank F D'Ovidio, Matthew Bacchetta, Joshua R Sonett, Selim M Arcasoy, Lori Shah, Hilary Robbins, Steven R Hays, Jasleen Kukreja, John R Greenland, Rupal J Shah, Lorriana Leard, Matthew Morrell, Cynthia Gries, Patricia P Katz, Jason D Christie, Joshua M Diamond, David J Lederer
RATIONALE: The frail phenotype has gained popularity as a clinically relevant measure in adults with advanced lung disease and critical illness survivors. Since respiratory disease and chronic illness can greatly limit physical activity, the measurement of participation in traditional leisure-time activities as a frailty component may lead to substantial misclassification of frailty in pulmonary and critical care patients. OBJECTIVES: To test and validate replacing the Duke Activities Scale Index (DASI), a simple 12-item questionnaire, for the Minnesota Leisure Time Activities (MLTA), a detailed questionnaire covering 18 leisure time activities, as the measure of low activity in the Fried frailty phenotype instrument (FFP)...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28389067/prognostic-value-of-geriatric-conditions-beyond-age-after-acute-coronary-syndrome
#6
Juan Sanchis, Vicente Ruiz, Clara Bonanad, Ernesto Valero, Maria Arantzazu Ruescas-Nicolau, Yasmin Ezzatvar, Clara Sastre, Sergio García-Blas, Anna Mollar, Vicente Bertomeu-González, Gema Miñana, Julio Núñez
The aim of the present study was to investigate the prognostic value of geriatric conditions beyond age after acute coronary syndrome. This was a prospective cohort design including 342 patients (from October 1, 2010, to February 1, 2012) hospitalized for acute coronary syndrome, older than 65 years, in whom 5 geriatric conditions were evaluated at discharge: frailty (Fried and Green scales), comorbidity (Charlson and simple comorbidity indexes), cognitive impairment (Pfeiffer test), physical disability (Barthel index), and instrumental disability (Lawton-Brody scale)...
April 4, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28388276/a-formative-evaluation-of-a-nurse-practitioner-led-interprofessional-geriatric-outpatient-clinic
#7
Kevin T Hansen, Cheryl McDonald, Sue O'Hara, Leslie Post, Susan Silcox, Iris A Gutmanis
The number of older adults with multiple complex comorbidities and frailty is expected to increase dramatically in the coming decades, which will necessitate a concomitant increase in the need for skilled clinicians who are able to manage complex geriatric needs. Many physicians, however, lack the required formal training, often leading to long wait-lists for specialist clinics. Yet, clinics led by non-physician professionals specialising in geriatric care could decrease these delays. This article describes the development and evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic (Inter-D Clinic)...
April 7, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28382607/frailty-and-primary-sarcopenia-a-review
#8
Eli Carmeli
Increasing longevity, coupled with rising frailty and sarcopenia of aging, significantly affects function and quality of life of older adults. This review discusses the definition, assessment, and management of frailty and sarcopenia, and examines the relationship between them. Medline, Scopus and Psychoinfo databases were searched using the keywords frailty, sarcopenia, aging, and functional disability. The findings are that frailty and sarcopenia are often assessed clinically with such methods such as DeXA, CT scan, MRI, bioelectrical impedance, or anthropometry...
April 6, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28359689/frailty-measure-is-more-predictive-of-outcomes-after-curative-therapy-for-endometrial-cancer-than-traditional-risk-factors-in-women-60-and-older
#9
Jane A Driver, Akila N Viswanathan
OBJECTIVES: To determine if readily obtainable markers of frailty predict disease-free survival (DFS) in elderly women with endometrial cancer treated with curative intent. METHODS: 88 consecutive women≥age 60 treated with surgery, chemotherapy and radiation for stage I-IV endometrial cancer were included. We considered the following health deficits as markers of "frailty": albumin <3.5mg/dL, hemoglobin <10mg/dL, BMI<20kg/m,(2) unintentional weight loss, ECOG performance status ≥2, history of osteopenia or osteoporosis and Charlson comorbidity score...
March 27, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28351218/association-among-serum-igf-1-frailty-muscle-mass-bone-mineral-density-and-physical-performance-among-community-dwelling-middle-aged-and-older-adults-in-taiwan
#10
Liang-Yu Chen, Yi-Hui Wu, Li-Kuo Liu, Wei-Ju Lee, An-Chun Hwang, Li-Ning Peng, Ming-Hsien Lin, Liang-Kung Chen
BACKGROUND: Aging is featured by the complex interrelationship between among body composition, frailty status and physical performance. The main aim of this study was to evaluate the association between among serum insulin-like growth factor-1 (IGF-1), body composition, and physical function among community-dwelling middle-aged and elderly population in Taiwan. METHODS: We conducted a cross-sectional study by using the data of I-Lan Longitudinal Aging Study (ILAS), which recruited a total of 1,833 community-dwelling people aged 50 years and older...
March 29, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28329858/cystatin-c-and-the-risk-of-frailty-and-mortality-in-older-men
#11
Allyson Hart, Terri L Blackwell, Misti L Paudel, Brent C Taylor, Eric S Orwoll, Peggy M Cawthon, Kristine E Ensrud
Background: This study examines the association between cystatin C (cysC) levels and risks of progression of frailty status or death in older men. Methods: Prospective study of 2,613 men without overt frailty aged 67 years and older enrolled in the MrOS ancillary sleep study. Baseline measurements included serum cysC, serum creatinine, and frailty status. Repeat frailty status, performed an average of 3.4 years later, was assessed as an ordinal outcome of robust, intermediate stage (prefrail), frail or dead...
November 9, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28327565/impaired-nutritional-status-in-geriatric-trauma-patients
#12
F S Müller, O W Meyer, P Chocano-Bedoya, S Schietzel, M L Gagesch, G Freystaetter, V Neuhaus, H-P Simmen, W Langhans, H A Bischoff-Ferrari
BACKGROUND/OBJECTIVES: Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients. SUBJECTS/METHODS: We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score<17=malnourished (M), ⩽23.5=at risk of malnutrition (ARM), >23...
March 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28325586/-prognostic-indices-for-older-adults-during-the-year-following-hospitalization-in-an-acute-medical-ward-an-update
#13
Josephine Thomazeau, Samantha Huo Yung Kai, Yves Rolland, Sandrine Sourdet, Nicolas Saffon, Fati Nourhashemi
CONTEXT: As population grow older, chronic diseases are more prevalent. It leads to an increase of hospitalization for acute decompensation, sometimes iterative. Management of these patients is not always clear, and care provided is not always proportional to life expectancy. Making decisions in acute situations is not easy. OBJECTIVE: This review aims to list and describe mortality scores within a year following hospitalization of patients of 65 years or older...
March 18, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28323342/inflammatory-markers-and-frailty-in-long-term-care-residents
#14
Gabrielle A Langmann, Subashan Perera, Mary A Ferchak, David A Nace, Neil M Resnick, Susan L Greenspan
OBJECTIVES: To determine whether proinflammatory biomarkers are associated with frailty assessed according to functional status, mobility, mental health, and falls over 24 months. DESIGN: Secondary analysis of a 2-year double-blind clinical trial for osteoporosis. SETTING: Nursing homes and assisted living facilities. PARTICIPANTS: Women aged 65 and older with osteoporosis in long-term care (LTC) (N = 178). MEASUREMENTS: Baseline serum concentrations of proinflammatory cytokines and soluble receptors (high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNFα) and its two receptors (TNFα-R1 and TNFα-R2), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), IL-10), functional status assessed according to activities of daily living, the Nursing Home Physical Performance Test, gait speed, cognitive status, mental health, and falls...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28293557/sepsis-and-immunosenescence-in-the-elderly-patient-a-review
#15
REVIEW
Silvia Martín, Alba Pérez, Cesar Aldecoa
Sepsis is a prevalent, serious medical condition with substantial mortality and a significant consumption of health-care resources. Its incidence has increased around 9% annually in general population over the last years and specially in aged patients group. Several risk factors such as comorbidities, preadmission status, malnutrition, frailty, and an impared function in the immune system called immunosenescence are involved in the higher predisposition to sepsis in the elderly patients. Immunosenescence status consists in a functional impairment in both cell-mediated immunity and humoral immune responses and increases not only the risk for develop sepsis but also lead to more severe presentation of infection and may be is also related with a higher mortality...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28285121/a-novel-rehabilitation-intervention-for%C3%A2-older-patients-with-acute-decompensated%C3%A2-heart-failure-the-rehab-hf-pilot-study
#16
Gordon R Reeves, David J Whellan, Christopher M O'Connor, Pamela Duncan, Joel D Eggebeen, Timothy M Morgan, Leigh Ann Hewston, Amy Pastva, Mahesh J Patel, Dalane W Kitzman
OBJECTIVES: This study sought to assess a novel physical rehabilitation intervention in older patients hospitalized for acute decompensated heart failure (ADHF). BACKGROUND: After ADHF, older patients, who are frequently frail with multiple comorbidities, have prolonged and incomplete recovery of physical function and remain at high risk for poor outcomes. METHODS: The REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) pilot study was a 3-site, randomized, attention-controlled pilot study of a tailored, progressive, multidomain physical rehabilitation intervention beginning in the hospital and continuing for 12 weeks post-discharge in patients ≥60 years hospitalized with ADHF...
March 5, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28268476/heart-rate-independent-qt-variability-component-can-detect-subclinical-cardiac-autonomic-neuropathy-in-diabetes
#17
Mohammad H Imam, Chandan K Karmakar, Ahsan H Khandoker, Herbert F Jelinek, M Palaniswami
Cardiac autonomic neuropathy (CAN) may lead to life threatening arrhythmia due to denervation of both the parasympathetic and sympathetic branches of autonomic nervous system innervating the heart. CAN is a frequently under diagnosed complication of diabetes, because a patient can have asymptomatic CAN for several years before it is clinically apparent. However, detection of CAN at the early or subclinical stage leads to more effective treatment outcomes. Cardiac autonomic reflex tests (CART) (i.e. Ewing test battery) are normally used for the detection and staging of CAN...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267466/rehabilitation-therapy-in-older-acute-heart-failure-patients-rehab-hf-trial-design-and-rationale
#18
Gordon R Reeves, David J Whellan, Pamela Duncan, Christopher M O'Connor, Amy M Pastva, Joel D Eggebeen, Leigh Ann Hewston, Timothy M Morgan, Shelby D Reed, W Jack Rejeski, Robert J Mentz, Paul B Rosenberg, Dalane W Kitzman
BACKGROUND: Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF. HYPOTHESIS: Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28265844/frailty-as-a-risk-predictor-of-morbidity-and-mortality-following-liver-surgery
#19
Faiz Gani, Marcelo Cerullo, Neda Amini, Stefan Buettner, Georgios A Margonis, Kazunari Sasaki, Yuhree Kim, Timothy M Pawlik
BACKGROUND: Given the increasing number of elderly and comorbid patients undergoing surgery, there is increased interest in preoperatively identifying patients at high risk of morbidity and mortality following liver resection. We sought to develop and validate the use of a frailty index (FI) to predict poor postoperative outcomes following liver surgery. METHODS: Patients undergoing a liver resection were identified using the National Surgical Quality Improvement Program Hepatectomy-targeted database for 2014 and randomized into a training or validation cohort...
March 6, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28265210/transcatheter-aortic-valve-replacement-comprehensive-review-and-present-status
#20
REVIEW
Sameer Arora, Jacob A Misenheimer, Radhakrishnan Ramaraj
Aortic stenosis is the most common valvular heart disease in the developed world. About 7% of the population over age 65 years suffers from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is dismal without valve replacement. Even though the American College of Cardiology recommends aortic valve replacement to treat this condition as a class I recommendation, approximately one third of these patients over the age of 75 years are not referred for surgery. Typically, this is from concern about prohibitive surgical risk associated with patient frailty, comorbidities, age, and severe left ventricular dysfunction...
February 2017: Texas Heart Institute Journal
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