Impact of frailty status on the cost of drugs and dietary supplements prescribed to nursing home residents: the SENIOR cohort

Recent developments in frailty identification, management, risk factors and prevention: A narrative review of leading journals in geriatrics and gerontology

Frailty is an age-related clinical condition characterised by an increased susceptibility to stressors and an elevated risk of adverse outcomes such as mortality. In the light of global population ageing, the prevalence of frailty is expected to soar in coming decades. This narrative review provides critical insights into recent developments and emerging practices in frailty research regarding identification, management, risk factors, and prevention. We searched journals in the top two quartiles of geriatrics and gerontology (from Clarivate Journal Citation Reports) for articles published between 01 January 2018 and 20 December 2022. Several recent developments were identified, including new biomarkers and biomarker panels for frailty screening and diagnosis, using artificial intelligence to identify frailty, and investigating the altered response to medications by older adults with frailty. Other areas with novel developments included exercise (including technology-based exercise), multidimensional interventions, person-centred and integrated care, assistive technologies, analysis of frailty transitions, risk-factors, clinical guidelines, COVID-19, and potential future treatments. This review identified a strong need for the implementation and evaluation of cost-effective, community-based interventions to manage and prevent frailty. Our findings highlight the need to better identify and support older adults with frailty and involve those with frailty in shared decision-making regarding their care.

Effects of Citrulline alone or combined with exercise on muscle mass, muscle strength, and physical performance among older adults: a systematic review

PURPOSE OF REVIEW

To Establish the potential of Citrulline supplementation (CIT) combined or not with exercise on muscle function and physical performance via a systematic review of randomized controlled trials (RCTs) in human aged 50 years and older.

RECENT FINDINGS

Based on Preferred Reporting Items for Systematic Reviews and Meta-analysis guideline, 103 references have been identified. Among this number, only six RCTs (250 participants) matched the inclusion criteria and were included in the present systematic review. Among the included studies, five of six reported beneficial effects of CIT on muscle mass. Then, four of six studies reported CIT effects on muscle strength but also that CIT when combined to exercise results in further improvements in upper muscle strength. Finally, three of six studies reported beneficial CIT effect on physical performance and suggested that CIT with exercise displayed greater improvements in walking speed than exercise alone.

SUMMARY

CIT supplementation seems to be able to improve muscular and physical factors in frail elderly people (malnourished, hypertensive, obese, dynapenic-obese) compared to placebo. More importantly, CIT combined to exercise is more efficient than exercise or CIT alone. However, because of the small number (six) and heterogeneity (dose, duration, population) of the studies realized in older adults, further studies are needed to confirm its promising potential.