Estimation of the risk of the frailty syndrome in the independent-living population of older people

The prevalence of frailty and its associated factors in an Italian institutionalized older population: findings from the cross-sectional Alvise Cornaro Center Study

BACKGROUND

While it is well established that frail older people have a higher risk of negative health outcomes, the prevalence of frailty and its associated factors in Italian older institutionalized population has never been investigated.

AIMS

The aims of this study were to assess the prevalence of frailty and to identify its associated factors in an Italian residential care home population.

METHODS

An observational cross-sectional study was designed to evaluate older people aged 70 or over of an Italian residential care home. A multidimensional assessment examining functional, geriatric, ophthalmic, and audiological domains was carried out to identify factors associated with frailty. Physical frailty was evaluated using Fried's criteria.

RESULTS

Data analysis uncovered a 51.1% prevalence of pre-frailty and a 40.4% prevalence of frailty in the 94 eligible participants (64 females) whose data were complete. The multivariable analysis showed that a low education level (OR = 5.12, 95% CI 1.22-21.49), a low physical quality of life score (OR = 13.25, 95% CI 3.51-50.08), a low mental quality of life score (OR = 9.22, 95% CI 2.38-35.69), visual impairment (OR = 7.65, 95% CI 1.77-33.14), and hearing impairment (OR = 4.62, 95% CI 1.03-20.66) were independently associated with frailty.

CONCLUSIONS

Frailty was found to be highly prevalent in the residential care home studied. Since frailty is a reversible condition, identifying the modifiable factors associated to it should be viewed as an important step in planning and implementing targeted, early prevention strategies.

Aerobic Dance on an Air Dissipation Platform Improves Cardiorespiratory, Muscular and Cellular Fitness in the Overweight and Obese Elderly

Background: Obesity is a global health problem associated with a high number of comorbidities that decrease functional capacity, especially in elderly people. Aerobic dance is considered a viable strategy to prevent the effects of aging, mainly in obese and overweight elderly people. This study aimed to evaluate the effects of aerobic dance on an air dissipation platform (ADP) on body composition, oxidative stress and muscular and cardiorespiratory fitness in elderly people. Methods: In total, 32 elderly adults (67.1 ± 3.6) were divided into 3 groups based on body mass index: healthy (HG), overweight (OWG) and obese (OG). Training program of aerobic dance on an ADP was carried out twice a week for 12 weeks. Results: OWG (p = 0.016) and OG decreased their weight (p < 0.001). There was a significant decrease in malondialdehyde concentrations in all experimental groups (p < 0.05). OWG and OG significantly improved their peak oxygen uptake (p < 0.01). HG increased the vertical jump height (p < 0.05), and HG and OG improved the power output of the lower extremities (p < 0.05). Conclusions: The aerobic dance on an ADP may be an effective alternative to lose weight, prevent oxidative stress and improve cardiorespiratory fitness in obese and overweight elderly people.

Functional capacity and risk of frailty syndrome in 85-year-old and older women living in nursing homes in Poland

Maintaining sufficient physical fitness to prevent any limitations in performing activities of daily living and to be functionally independent is of great importance for both longevity and quality of life in older adults. Aim of the study was to evaluate functional physical fitness of women aged 85 years and older, residents of nursing homes, in the Polish population and to assess the risk of frailty syndrome. The study involved 17 women aged 85 years or older, residents of nursing homes in the Lower Silesian voivodeship. The Senior Fitness Test was used to assess functional fitness. The results of functional fitness tests were related to the standards for the elderly population in Poland and to the reference standards for maintaining independence. In addition, hand grip strength level was measured using a hand dynamometer, height and weight were measured, and BMI was calculated. 15-item version of the Geriatric Depression Scale was used to assess the level of depression. We used 3 of the 5 proposed criteria from the Cardiovascular Health Study Frailty Index to assess the presence of frailty syndrome: gait speed, level of hand grip strength, and the presence of depression. The results of the Senior Fitness Test demonstrate the low level of functional fitness of female nursing home residents. A large percentage of the women surveyed are below the standard values developed for Polish seniors. The weakest results were in the timed up and go test, with more than 94% of the women tested falling outside the standard ranges. The mean results of all samples do not meet the developed reference standards for maintaining independence. No non-frail person was found among the study participants and the vast majority were at risk for frailty syndrome. Most of the studied women do not meet functional fitness standards developed for the Polish population, as well as reference standards for maintaining independence. Nursing home residents over the age of 85 are at risk for frailty syndrome.

Appendicular skeletal muscle mass and quality estimated by bioelectrical impedance analysis in the assessment of frailty syndrome risk in older individuals

BACKGROUND AND AIM

The rising aging index of many populations necessitates the continuous evolution of geriatric assessment methods, especially the ones used to identify frailty and the risk of frailty. An appropriately early diagnosis of adverse changes in skeletal muscles can reduce the risk of functional limitations in elderly persons. The aim of this study was to assess the correlation between the appendicular skeletal muscle mass and quality, estimated by the bioelectrical impedance analysis method, and the risk of prevalence of the pre-frailty state in elderly persons.

METHODS

One-thousand-and-fifteen subjectively healthy persons aged 60-87 years were tested. Anthropometric measurements and physical fitness and activity measurements were carried out and the frailty phenotype was evaluated. Appendicular skeletal muscle mass was estimated using the bioelectrical impedance analysis method. Muscle quality was assessed through an index correcting strength relative to muscle mass and through the impedance phase angle. The correlation between the muscle mass and quality estimating parameters and the probability of identifying pre-frailty was checked using multiple logistic regression.

RESULTS

The prevalence of pre-frailty was 38%. The pre-frail persons were found to have a significantly lower muscle mass and quality than the non-frail persons, with the difference in the case of the muscle quality index nearly twice larger than for the muscle mass index. A significant logit model was obtained for pre-frailty prevalence, which was strongly dependent on the appendicular skeletal muscle mass (adjusted odds ratio (OR): 0.43, 95% CI 0.36-0.52, p < 0.001) and functional quality (adjusted OR: 0.26, 95% CI 0.18-0.38, p < 0.001) and less on age (adjusted OR: 1.10, 95% CI 1.07-1.13, p < 0.001).

CONCLUSION

The strong correlation between the frailty phenotype and appendicular skeletal muscle mass and functional quality suggests that the two variables should be included in routine geriatric assessment with regard to frailty.

Improved Joint Mobility Associated with Reduced Inflammation Related to Consumption of Nopal Cactus Fruit Juice: Results from a Placebo-Controlled Trial Using Digital Inclinometry to Objectively Document Mobility of All Major Joints

Objective

To evaluate the effects of daily consumption of Nopal cactus fruit juice (NFJ) on joint mobility in a population experiencing chronic pain but otherwise in good health.

Study Design

A double-blind, placebo-controlled study design was used to enroll 40 people after written informed consent, randomized to consume 3 oz/day of NFJ versus placebo. At baseline and 8 weeks, joint range of motion (ROM) was examined by digital inclinometry along the vertical weight-bearing axis of the body from neck to knees and the shoulders. Blood samples were tested for cytokines and C-reactive protein (CRP). Questionnaires addressed wellness, pain, and reliance on pain medications.

Results

After 8 weeks of consuming NFJ, participants showed improved ROM beyond that of participants consuming placebo. Cervical and thoracic/lumbar ROM for the NFJ group was significantly improved when compared to placebo (cervical: P<0.03, thoracic/lumbar: P<0.04). People consuming NFJ relied less on pain medication to complete daily activities (P<0.1) and experienced reduced interference from pain and breathing issues (not significant). Serum levels of Eotaxin, involved in airway inflammation, showed significant differences between placebo and NFJ groups after 8 weeks (P<0.048). Changes in CRP levels showed a larger reduction in the NFJ group (-13%) than in the placebo group (-4%) (not significant). In the subgroup with CRP levels between 1 and 9.9 mg/L at baseline, CRP levels decreased in the NFJ group (-30%) but increased in the placebo group (31%) (P<0.015).

Conclusion

Consumption of NFJ for 8 weeks was associated with statistically significant improvements in joint mobility and physical functioning compared to the placebo group, allowing participants in the NFJ group to be more physically active; daily activities were easier, including walking, sitting, and lying. This was associated with reduced use of pain medication, possibly associated with anti-inflammatory properties of NFJ, as suggested by reduced Eotaxin and CRP levels.