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Physical frailty

Anna Lloyd, Marilyn Kendall, John M Starr, Scott A Murray
BACKGROUND: The experiences of people with cancer and organ disease have been described across different dimensions of need as they approach death. Such information is lacking for frail older people approaching death, but could highlight how a palliative approach might be relevant for this population. METHODS: Cognitively intact, community dwelling adults considered to be moderately or severely frail were recruited from a medical day hospital. Those recruited nominated an informal carer and case-linked professional...
October 20, 2016: BMC Geriatrics
Shosuke Satake, Hidenori Arai
PURPOSE OF REVIEW: Many frailty screening instruments have been proposed due to the lack of consensus on a unified operational definition of frailty. This review reports on recent frailty screening tools in addition to revisiting the frailty concept. RECENT FINDINGS: Although there are two representative frailty models, both have issues that prevent them from being implemented in clinical settings despite their remarkable advantages. Due to their different characteristics, these models are thought to be complementary rather than substitutive...
October 18, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Agathe D Jadczak, Naresh Makwana, Natalie D Luscombe-Marsh, Renuka Visvanathan, Timothy J Schultz
The objectives of this umbrella review are to determine the effectiveness of exercise interventions, alone or in combination with other interventions, for improving physical function in community-dwelling older people who are identified as frail or at risk of frailty, and to identify if any particular intervention type or characteristic is the most effective.Specifically, the review question is: What is the effectiveness of exercise interventions, alone or in combination with other interventions, for improving physical function in community-dwelling older people identified as frail or at risk of frailty?...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
M Iki, Y Fujita, J Tamaki, K Kouda, A Yura, Y Sato, J S Moon, A Harano, K Hazaki, E Kajita, M Hamada, K Arai, K Tomioka, N Okamoto, N Kurumatani
: Frail elderly individuals have elevated risks of both fracture and mortality. We found that incident fractures were associated with an increased risk of death even after adjusting for pre-fracture frailty status as represented by physical performance tests and laboratory tests for common geriatric diseases in community-dwelling elderly Japanese men. INTRODUCTION: While fractures reportedly increase the risk of mortality, frailty may complicate this association, generating a false-positive result...
October 18, 2016: Osteoporosis International
Ligia J Dominguez, Mario Barbagallo
PURPOSE OF REVIEW: Physical and cognitive frailty are interrelated and synergistic syndromes more frequently seen in old age, which represent intermediate stages between aging successfully and disability. Poor nutrition is a fundamental determinant for both conditions, while various dietary components are proposed to prevent and/or improve them. This updated review discusses the possible influence of nutritional factors on cognitive frailty and its potential mediators. RECENT FINDINGS: Oxidative stress, low-grade systemic inflammation, neuroinflammation, and altered autophagy, all associated with obesity, metabolic syndrome and insulin resistance, are proposed mechanisms to explain the influence of nutrition on cognitive health...
September 28, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Olivier Bruyère, Etienne Cavalier, Fanny Buckinx, Jean-Yves Reginster
PURPOSE OF REVIEW: This article reviews recently published evidence regarding the role of vitamin D in the physiopathology of physical frailty in elderly populations and its role in the management of this geriatric condition. RECENT FINDINGS: Some recent studies have found a low level of 25-hydroxyvitamin D, considered the best marker of vitamin D status, in frail individuals. All prospective studies consistently report that low vitamin D status is associated with an increased risk of becoming frail...
October 1, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Martine Extermann, Christiaan Leeuwenburgh, Laila Samiian, Marina Sehovic, Jinze Xu, Christopher Cubitt, Paul B Jacobsen, Marco Pahor, Stephen R Grobmyer, Todd M Manini
OBJECTIVE: Chemotherapy is less often prescribed in older individuals due to concerns about post-treatment morbidity and quality of life. We evaluated the physical performance of breast cancer survivors treated with and without adjuvant chemotherapy. MATERIALS AND METHODS: We conducted a case-control study in 56 estrogen receptor positive breast cancer survivors (BCS) on adjuvant aromatase inhibitors 1-2years after definitive surgery. Cases had received adjuvant chemotherapy (n=27; age 70...
October 13, 2016: Journal of Geriatric Oncology
Efstathios Papachristou, S Goya Wannamethee, Lucy T Lennon, Olia Papacosta, Peter H Whincup, Steve Iliffe, Sheena E Ramsay
BACKGROUND: Frailty is a state of increased vulnerability to disability, falls, and mortality. The Fried frailty phenotype includes assessments of grip strength and gait speed, which are complex or require objective measurements and are challenging in routine primary care practice. In this study, we aimed to develop a simple assessment tool based on self-reported information on the 5 Fried frailty components to identify older people at risk of incident disability, falls, and mortality...
October 11, 2016: Journal of the American Medical Directors Association
Karen L Barker, David Beard, Andrew Price, Francine Toye, Martin Underwood, Avril Drummond, Gary Collins, Susan Dutton, Helen Campbell, Nicola Kenealy, Jon Room, Sarah E Lamb
BACKGROUND: The number of knee arthroplasties performed each year is steadily increasing. Although the outcome is generally favourable, up to 15 % fail to achieve a satisfactory clinical outcome which may indicate that the existing model of rehabilitation after surgery may not be the most efficacious. Given the increasing number of knee arthroplasties, the relative limited physiotherapy resources available and the increasing age and frailty of patients receiving arthroplasty surgery, it is important that we concentrate our rehabilitation resources on those patients who most need help to achieve a good outcome...
October 13, 2016: Trials
Wilson Nadruz, Dalane Kitzman, Beverly Gwen Windham, Anna Kucharska-Newton, Kenneth Butler, Priya Palta, Michael E Griswold, Lynne E Wagenknecht, Gerardo Heiss, Scott D Solomon, Hicham Skali, Amil M Shah
BACKGROUND: The contribution of cardiovascular dysfunction to frailty in older adults is uncertain. This study aimed to define the relationship between frailty and cardiovascular structure and function, and determine whether these associations are independent of coexisting abnormalities in other organ systems. METHODS: We studied 3,991 older adults (mean age 75.6±5.0 years; 59% female) from the Atherosclerosis Risk in Communities (ARIC) Study in whom the following six organ systems were uniformly assessed: cardiac (by echocardiography), vascular (by ankle-brachial-index and pulse-wave-velocity), pulmonary (by spirometry), renal (by estimated glomerular filtration rate), hematologic (by hemoglobin), and adipose (by body mass index and bioimpedance)...
October 12, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Izabella Uchmanowicz, Beata Jankowska-Polanska, Mariusz Chabowski, Bartosz Uchmanowicz, Andrzej M Fal
COPD is one of the most debilitating diseases. Frailty syndrome and advanced age may decrease the acceptance of illness, quality of life, and worsen health conditions in these patients, as well as lead to an increase in health care expenses. The aim of the study was to assess how the level of frailty affects the acceptance of illness in elderly patients with COPD. We also aimed to evaluate the associations between sociodemographic and clinical factors and the level of acceptance of illness, anxiety, and frailty in this group of patients...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Nobutaka Doba, Yasuharu Tokuda, Keiichirou Saiki, Toshio Kushiro, Masumi Hirano, Yoshihiro Matsubara, Shigeaki Hinohara
Objective It has been increasingly recognized in various clinical areas that self-efficacy promotes the level of competence in patients. The validity, applicability and potential usefulness of a new, simple model for assessing self-efficacy in the elderly with special reference to frailty were investigated for improving elderly patients' accomplishments. Methods The subjects of the present study comprised 257 elderly people who were members of the New Elder Citizen Movement in Japan and their mean age was 82...
2016: Internal Medicine
Kalpana J Kallianpur, Marissa Sakoda, Louie Mar A Gangcuangco, Lishomwa C Ndhlovu, Tracie Umaki, Dominic Chow, Suwarat Wongjittraporn, Cecilia M Shikuma
BACKGROUND: Chronic HIV disease is associated with neurocognitive impairment and age-related conditions such as frailty. OBJECTIVE: To determine whether regional brain volumetric changes correlate with frailty parameters in older (≥ 40 years) HIV+ patients on stable combination antiretroviral therapy. METHOD: Thirty-five HIV-infected participants in the Hawaii Aging with HIV Cohort - Cardiovascular Disease study underwent T1-weighted brain magnetic resonance imaging, frailty assessment and neuropsychological testing...
2016: Open Medicine Journal
Diana Castaneda-Gameros, Sabi Redwood, Janice L Thompson
OBJECTIVE: To examine associations between energy/nutrient intakes and frailty in older migrant women, and to explore perceptions of body weight, dietary intake, and physical function. DESIGN: Cross-sectional, mixed-methods study. SETTING: Birmingham, United Kingdom. PARTICIPANTS: Seventy-six first-generation migrant women ≥ 60 years of age. MAIN OUTCOME MEASURES: Energy/nutrient intakes (assessed by 24-hour dietary recall), frailty (using the frailty phenotype), and links between perceptions of body weight, dietary intake, and physical function (via semi-structured interviews)...
October 6, 2016: Journal of Nutrition Education and Behavior
Angela K Beckert, Megan Huisingh-Scheetz, Katherine Thompson, Amy D Celauro, Jordan Williams, Paul Pachwicewicz, Mark K Ferguson
BACKGROUND: The presence of frailty or prefrailty in older adults is a risk factor for postsurgical complications. The frailty phenotype can be improved through long-term resistance and aerobic training. It is unknown whether short-term preoperative interventions targeting frailty will help to mitigate surgical risk. The purpose of this study was to determine the proportion of frail and prefrail patients presenting to a thoracic surgical clinic who could benefit from a frailty reduction intervention...
October 4, 2016: Annals of Thoracic Surgery
Aideen C M Young, Karen Glaser, Timothy D Spector, Claire J Steves
Our study examines the contribution of genetic and environmental factors (both shared and unique) to frailty, measured using the Rockwood Frailty Index (FI) in a sample of twins from the St Thomas' UK Adult Twin Registry. The FI was based on 39 items of potential health deficit. Study participants were 3,375 volunteer adult twins (840 monozygotic and 802 dizygotic twin-pairs) 40.0-84.5 years old. First, we used structural equation modeling to estimate the relative contribution of genetics and of the shared and unique environment to variance in FI adjusted for age...
October 10, 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Charlotte Beaudart, Eugène McCloskey, Olivier Bruyère, Matteo Cesari, Yves Rolland, René Rizzoli, Islène Araujo de Carvalho, Jotheeswaran Amuthavalli Thiyagarajan, Ivan Bautmans, Marie-Claude Bertière, Maria Luisa Brandi, Nasser M Al-Daghri, Nansa Burlet, Etienne Cavalier, Francesca Cerreta, Antonio Cherubini, Roger Fielding, Evelien Gielen, Francesco Landi, Jean Petermans, Jean-Yves Reginster, Marjolein Visser, John Kanis, Cyrus Cooper
BACKGROUND: Sarcopenia is increasingly recognized as a correlate of ageing and is associated with increased likelihood of adverse outcomes including falls, fractures, frailty and mortality. Several tools have been recommended to assess muscle mass, muscle strength and physical performance in clinical trials. Whilst these tools have proven to be accurate and reliable in investigational settings, many are not easily applied to daily practice. METHODS: This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia...
October 5, 2016: BMC Geriatrics
Meredith Greene, Amy C Justice, Kenneth E Covinsky
: As the number of older adults living with HIV continues to increase, understanding how to incorporate geriatric assessments within HIV care will be critical. Assessment of geriatric syndromes and physical function can be useful tools for HIV clinicians and researchers to help identify the most vulnerable older adults and to better understand the aging process in PLWH. This review focuses on the assessment of falls, frailty and physical function, first in the general population of older adults and includes a specific focus on use of these assessments in older adults living with HIV...
October 7, 2016: Virulence
V Soler, S Sourdet, L Balardy, G Abellan van Kan, D Brechemier, M E Rougé-Bugat, N Tavassoli, M Cassagne, F Malecaze, F Nourhashémi, B Vellas
OBJECTIVES: To evaluate visual performance and factors associated with abnormal vision in patients screened for frailty at the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability at Toulouse University Hospital. DESIGN: Retrospective, observational cross-sectional, single-centre study. SETTING: Institutional practice. PARTICIPANTS: Patients were screened for frailty during a single-day hospital stay between October 2011 and October 2014 (n = 1648)...
2016: Journal of Nutrition, Health & Aging
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