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Krivoshapova KE, Vegner EA, Barbarash OL. [Frailty syndrome as an independent predictor of adverse prognosis in patients with chronic heart failure]. KARDIOLOGIIA 2022; 62:89-96. [PMID: 35414366 DOI: 10.18087/cardio.2022.3.n1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 07/29/2020] [Indexed: 06/14/2023]
Abstract
This review presents results of clinical studies of senile asthenia ("fragility") syndrome and chronic heart failure (CHF). Recent reports of the "fragility" prevalence in patients with CHF are described. The review presents specific features of pathophysiological pathways underlying the development of both senile asthenia syndrome and CHF; the role of "fragility" in the progression and complications of CHF is addressed. Senile asthenia syndrome associated with CHF is regarded as an independent predictor of unfavorable prognosis and high mortality in this patient category. The authors concluded that methods for "fragility" evaluation in CHF patients followed by risk stratification and selection of individual management tactics should be implemented in clinical practice.
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Affiliation(s)
- K E Krivoshapova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | | | - Olga L Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases; Kemerovo State Medical
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Abete P, Basile C, Bulli G, Curcio F, Liguori I, Della-Morte D, Gargiulo G, Langellotto A, Testa G, Galizia G, Bonaduce D, Cacciatore F. The Italian version of the "frailty index" based on deficits in health: a validation study. Aging Clin Exp Res 2017; 29:913-926. [PMID: 28688080 DOI: 10.1007/s40520-017-0793-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/29/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIM Several measurements were taken for frailty classification in geriatric population. "Frailty index" is based on "deficits in health," but it is still not available in Italian version. Thus, the aim of the present work was to validate a version of "frailty index" for the Italian geriatric community. METHODS The validation of Italian frailty index (IFi) is based on a cohort study that enrolled 1077 non-disabled outpatients aged 65 years or older (81.3 ± 6.5 years) in Naples (Italy). IFi has been expressed as a ratio of deficits present/deficits considered after a comprehensive geriatric assessment. IFi was stratified in light, moderate and severe frailty. Mortality, disability (considering an increase in ADL lost ≥1 from the baseline) and hospitalization were considered at 3, 6, 12, 18 and 24 months of follow-up. Area under curve (AUC) was evaluated for both Fried's and IFi frailty index. RESULT At the end of follow-up, mortality increased from 1.0 to 30.3%, disability from 40.9 to 92.3% and hospitalization from 0.0 to 59.0% (p < 0.001 for trend). Multivariate analysis shows that the relative risk for unit increase in IFi is 1.09 (95% CI = 1.01-1.17, p = 0.013) for mortality, 1.04 (95% CI = 1.01-1.06, p = 0.024) for disability and 1.03 (95% CI = 1.01-1.07, p = 0.041) for hospitalization. AUC is higher in IFi with respect to Fried's frailty index when considering mortality (0.809 vs. 0.658, respectively), disability (0.800 vs. 0.729, respectively) and hospitalization (0.707 vs. 0.646, respectively). CONCLUSIONS IFi is a valid measure of frailty after the comprehensive geriatric assessment in an Italian cohort of non-institutionalized patients.
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Curcio F, Basile C, Liguori I, Della-Morte D, Gargiulo G, Galizia G, Testa G, Langellotto A, Cacciatore F, Bonaduce D, Abete P. Tinetti mobility test is related to muscle mass and strength in non-institutionalized elderly people. AGE (DORDRECHT, NETHERLANDS) 2016; 38:525-533. [PMID: 27566307 PMCID: PMC5266213 DOI: 10.1007/s11357-016-9935-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 07/13/2016] [Indexed: 05/06/2023]
Abstract
Elderly people are characterized by a high prevalence of falls and sarcopenia. However, the relationship among Tinetti mobility test (TMT) score, a powerful tool to detect elderly people at risk of falls, and sarcopenia is still not thoroughly investigated. Thus, to determine the relationship between TMT score and muscle mass and strength, 337 elderly participants (mean age 77.1 ± 6.9 years) admitted to comprehensive geriatric assessment were enrolled. TMT score, muscle mass by bioimpedentiometer, and muscle strength by grip strength were evaluated. Muscle mass progressively decreased as TMT score decreased (from 15.3 ± 3.7 to 8.8 ± 1.8 kg/m2; p for trend <0.001). Similarly, muscle strength decreased progressively as Tinetti score decreased (from 34.7 ± 8.0 to 23.7 ± 8.7 kg; p for trend 0.001). Linear regression analysis demonstrated that TMT score is linearly related with muscle mass (y = 4.5x + 0.4, r = 0.61; p < 0.01) and strength (y = 14.0x + 0.8, r = 0.53; p < 0.01). Multivariate analysis confirms the strong relationship between the TMT score and muscle mass (r = 0.48, p = 0.024) and strength (r = 0.39, p = 0.046). The present study indicates that TMT score is significantly related to muscle mass and strength in non-institutionalized elderly participants. This evidence suggests that TMT score, together with evaluation of muscle mass and strength, may identify sarcopenic elderly participants at high risk of falls.
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Affiliation(s)
- Francesco Curcio
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy
| | - Claudia Basile
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy
| | - Ilaria Liguori
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy
| | - David Della-Morte
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- IRCCS San Raffaele Pisana, Rome, Italy
| | - Gaetano Gargiulo
- Division of Internal Medicine, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy
| | - Gianluigi Galizia
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy
- Scientific Institute of Veruno, IRCCS Salvatore Maugeri Foundation, Novara, Italy
| | - Gianluca Testa
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Assunta Langellotto
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy
- Division of Geriatrics, Ospedale "S. Maria di Ca' Foncello", Treviso, Italy
| | - Francesco Cacciatore
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy.
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Cacciatore F, Della-Morte D, Basile C, Curcio F, Liguori I, Roselli M, Gargiulo G, Galizia G, Bonaduce D, Abete P. Butyryl-cholinesterase is related to muscle mass and strength. A new biomarker to identify elderly subjects at risk of sarcopenia. Biomark Med 2016; 9:669-78. [PMID: 26174841 DOI: 10.2217/bmm.15.28] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
AIMS To determine the relationship between Butyryl-cholinesterase (α-glycoprotein synthesized in the liver, b-CHE) and muscle mass and strength. METHODS Muscle mass by bioimpedentiometer and muscle strength by grip strength were evaluated in 337 elderly subjects (mean age: 76.2 ± 6.7 years) admitted to comprehensive geriatric assessment. RESULTS b-CHE levels were lower in sarcopenic than in nonsarcopenic elderly subjects (p < 0.01). Linear regression analysis demonstrated that b-CHE is linearly related with grip strength and muscular mass both in men and women (r = 0.45 and r = 0.33, p < 0.01; r = 0.55 and r = 0.39, p < 0.01; respectively). Multivariate analysis confirms this analysis. CONCLUSIONS b-CHE is related to muscle mass and strength in elderly subjects. Thus, b-CHE may be considered to be a fair biomarker for identifying elderly subjects at risk of sarcopenia.
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Affiliation(s)
- Francesco Cacciatore
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy.,IRCCS Salvatore Maugeri Foundation, Scientific Institute of Telese, Benevento, Italy
| | - David Della-Morte
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,IRCCS San Raffaele Pisana, Rome, Italy
| | - Claudia Basile
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Francesco Curcio
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Ilaria Liguori
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Mario Roselli
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gaetano Gargiulo
- Division of Geriatrics, AON SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Gianluigi Galizia
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy.,IRCCS Salvatore Maugeri Foundation, Scientific Institute of Veruno, Novara, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
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