#Frailty and Outcomes After Cardiac #Surgical Procedures
http://annals.org/mobile/article.aspx?articleid=2545887
Conclusion: Frailty status, assessed by mobility, disability, and nutritional status, may predict mortality at 6 months or later after major cardiac surgical procedures and functional decline after minimally invasive cardiac surgery.
http://annals.org/mobile/article.aspx?articleid=2545887
Conclusion: Frailty status, assessed by mobility, disability, and nutritional status, may predict mortality at 6 months or later after major cardiac surgical procedures and functional decline after minimally invasive cardiac surgery.
#Frailty is associated with #delirium and mortality after transcatheter aortic valve implantation
http://openheartbeta.bmj.com/content/3/2/e000478.short?rss=1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%25253A+openheart%25252Fcurrent+%252528Open+Heart+current+issue%252529&g=w_openheart_current_tab
Delirium frequently occurs after TAVI. Variables from frailty assessment are associated with delirium and mortality, independent of cardiological assessment. Thus, frailty assessment may have additional value in the prediction of delirium and mortality after TAVI.
http://openheartbeta.bmj.com/content/3/2/e000478.short?rss=1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%25253A+openheart%25252Fcurrent+%252528Open+Heart+current+issue%252529&g=w_openheart_current_tab
Delirium frequently occurs after TAVI. Variables from frailty assessment are associated with delirium and mortality, independent of cardiological assessment. Thus, frailty assessment may have additional value in the prediction of delirium and mortality after TAVI.
Open Heart
Frailty is associated with delirium and mortality after transcatheter aortic valve implantation
Objective We hypothesised that frailty assessment is of additional value to predict delirium and mortality after transcatheter aortic valve implantation (TAVI).
Methods Observational study in 89 consecutive patients who underwent TAVI. Inclusion from November…
Methods Observational study in 89 consecutive patients who underwent TAVI. Inclusion from November…
Does current #smoking predict future #frailty? The English longitudinal study of ageing
https://academic.oup.com/ageing/article/doi/10.1093/ageing/afx136/4062212/Does-current-smoking-predict-future-frailty-The
smoking is the single most preventable cause of morbidity and mortality. The evidence on independent associations between smoking in later life and incident frailty is scarce of 2,542 participants, 261 and 2,281 were current smokers and non-smokers, respectively. The current smokers were significantly frailer, younger, with lower BMI, less educated, less wealthy and lonelier compared with non-smokers at baseline. In multivariable logistic regression models adjusting for age and gender, current smokers were twice as likely to develop frailty compared with non-smokers (odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.39–3.39, P = 0.001). The association is attenuated largely by controlling for socioeconomic status. Smoking remains significantly associated with incident frailty in fully adjusted models including age, gender, socioeconomic status, alcohol use, cognitive function and loneliness (OR = 1.60, 95% CI = 1.02–2.51, P = 0.04). The relationship is however attenuated when taking account of non-response bias through multiple imputation.
Conclusions
current smokers compared with non-smokers were significantly more likely to develop frailty over 4 years among community-dwelling older people. Given that smoking is a modifiable lifestyle factor, smoking cessation may potentially prevent or delay developing frailty, even in old age
https://academic.oup.com/ageing/article/doi/10.1093/ageing/afx136/4062212/Does-current-smoking-predict-future-frailty-The
smoking is the single most preventable cause of morbidity and mortality. The evidence on independent associations between smoking in later life and incident frailty is scarce of 2,542 participants, 261 and 2,281 were current smokers and non-smokers, respectively. The current smokers were significantly frailer, younger, with lower BMI, less educated, less wealthy and lonelier compared with non-smokers at baseline. In multivariable logistic regression models adjusting for age and gender, current smokers were twice as likely to develop frailty compared with non-smokers (odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.39–3.39, P = 0.001). The association is attenuated largely by controlling for socioeconomic status. Smoking remains significantly associated with incident frailty in fully adjusted models including age, gender, socioeconomic status, alcohol use, cognitive function and loneliness (OR = 1.60, 95% CI = 1.02–2.51, P = 0.04). The relationship is however attenuated when taking account of non-response bias through multiple imputation.
Conclusions
current smokers compared with non-smokers were significantly more likely to develop frailty over 4 years among community-dwelling older people. Given that smoking is a modifiable lifestyle factor, smoking cessation may potentially prevent or delay developing frailty, even in old age
OUP Academic
Does current smoking predict future frailty? The English longitudinal study of ageing | Age and Ageing | Oxford Academic
Backgroundsmoking is the single most preventable cause of morbidity and mortality. The evidence on independent associations between smoking in later life and incident frailty is scarce.Objectivesto examine the effect of current smoking in older people on…
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Low 25-hydroxyvitamin #D levels and the risk of #frailty syndrome: a systematic review and dose-response meta-analysis
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-0904-2
The pooled risk estimate of frailty syndrome per 25 nmol/L increment in serum 25OHD concentration was 0.88 (95% CI = 0.82–0.95, I2 = 86.8%) in the 6 cross-sectional studies and 0.89 (95% CI = 0.85–0.94, I2 = 0.0%) in the 4 prospective cohort studies. Based on the Akaike information criteria (AIC), a linear model was selected (AIC for the nonlinear model: − 5.4, AIC for the linear model: − 6.8 in the prospective cohort studies; AIC for the linear model: − 13.6, AIC for the nonlinear model: − 1.77 in the cross-sectional studies).
Conclusions
This dose-response meta-analysis indicates that serum 25OHD levels are significantly and directly associated with the risk of frailty. Further studies should address the underlying mechanisms to explain this relationship and to determine whether vitamin D supplementation is effective for preventing frailty syndrome
Low 25-hydroxyvitamin #D levels and the risk of #frailty syndrome: a systematic review and dose-response meta-analysis
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-0904-2
The pooled risk estimate of frailty syndrome per 25 nmol/L increment in serum 25OHD concentration was 0.88 (95% CI = 0.82–0.95, I2 = 86.8%) in the 6 cross-sectional studies and 0.89 (95% CI = 0.85–0.94, I2 = 0.0%) in the 4 prospective cohort studies. Based on the Akaike information criteria (AIC), a linear model was selected (AIC for the nonlinear model: − 5.4, AIC for the linear model: − 6.8 in the prospective cohort studies; AIC for the linear model: − 13.6, AIC for the nonlinear model: − 1.77 in the cross-sectional studies).
Conclusions
This dose-response meta-analysis indicates that serum 25OHD levels are significantly and directly associated with the risk of frailty. Further studies should address the underlying mechanisms to explain this relationship and to determine whether vitamin D supplementation is effective for preventing frailty syndrome
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Multicomponent #Frailty Assessment Tools for Older People with #Psychiatric Disorders: A Systematic Review
https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15710
Of the 48 multicomponent frailty assessment tools identified, no tool had been developed for, or validated in, older adult populations with a psychiatric disorder. Overall, 20 of 48 frailty assessment tools contained a psychological assessment domain, with 17 of 48 tools citing the presence of depressed mood and/or anxiety as a frailty indicator. Common areas of construct overlap in frailty assessment tools and DSM‐5 diagnostic criteria included weight loss (29 of 48) and fatigue (21 of 48).
Conclusions
Significant construct overlap exists between the indicators of frailty as conceptualized in existing frailty assessment tools and DSM‐5 diagnostic criteria for common psychiatric disorders including major depressive episode and generalized anxiety disorder that has the potential to confound frailty assessment results. Further research is necessary to establish a reliable and valid tool to assess frailty in this population.
Multicomponent #Frailty Assessment Tools for Older People with #Psychiatric Disorders: A Systematic Review
https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15710
Of the 48 multicomponent frailty assessment tools identified, no tool had been developed for, or validated in, older adult populations with a psychiatric disorder. Overall, 20 of 48 frailty assessment tools contained a psychological assessment domain, with 17 of 48 tools citing the presence of depressed mood and/or anxiety as a frailty indicator. Common areas of construct overlap in frailty assessment tools and DSM‐5 diagnostic criteria included weight loss (29 of 48) and fatigue (21 of 48).
Conclusions
Significant construct overlap exists between the indicators of frailty as conceptualized in existing frailty assessment tools and DSM‐5 diagnostic criteria for common psychiatric disorders including major depressive episode and generalized anxiety disorder that has the potential to confound frailty assessment results. Further research is necessary to establish a reliable and valid tool to assess frailty in this population.
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Association of #Frailty and Postoperative Complications With Unplanned Readmissions After Elective Outpatient #Surgery
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2734068
length of stay (LOS)
.. In multivariate analysis, frailty doubled the risk of unplanned readmission (LOS = 0: adjusted relative risk RR, 2.1; 95% CI, 2.0-2.3; LOS ≥ 1: adjusted RR, 1.8; 95% CI, 1.6-2.1). Complications occurred in 3.1% of the entire cohort, and frailty was associated with increased risk of complications (unadjusted RR, 2.6; 95% CI, 2.4-2.8). Mediation analysis confirmed that complications are a significant mediator in the association between frailty and readmissions; however, it also indicated that the association of frailty with readmission was only partially mediated by complications (LOS = 0, 22.8%; LOS ≥ 1, 29.3%).
Conclusions and Relevance These findings suggest that frailty is a significant risk factor for unplanned readmission after elective outpatient surgery both independently and when partially mediated through increased complications. Screening for frailty might inform the development of interventions to decrease unplanned readmissions, including those for outpatient procedures.
Association of #Frailty and Postoperative Complications With Unplanned Readmissions After Elective Outpatient #Surgery
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2734068
length of stay (LOS)
.. In multivariate analysis, frailty doubled the risk of unplanned readmission (LOS = 0: adjusted relative risk RR, 2.1; 95% CI, 2.0-2.3; LOS ≥ 1: adjusted RR, 1.8; 95% CI, 1.6-2.1). Complications occurred in 3.1% of the entire cohort, and frailty was associated with increased risk of complications (unadjusted RR, 2.6; 95% CI, 2.4-2.8). Mediation analysis confirmed that complications are a significant mediator in the association between frailty and readmissions; however, it also indicated that the association of frailty with readmission was only partially mediated by complications (LOS = 0, 22.8%; LOS ≥ 1, 29.3%).
Conclusions and Relevance These findings suggest that frailty is a significant risk factor for unplanned readmission after elective outpatient surgery both independently and when partially mediated through increased complications. Screening for frailty might inform the development of interventions to decrease unplanned readmissions, including those for outpatient procedures.
Jamanetwork
Frailty, Postoperative Complications, and Unplanned Readmissions After Elective Outpatient Surgery
This cohort study uses National Surgical Quality Improvement Program (NSQIP) data to examine the association between frailty and 30-day unplanned readmissions after elective outpatient surgical procedures.
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Complementing chronic #frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results
..we created a frailty index from routine admission laboratory investigations (FI-Laboratory) linked to data comprising hospital outcomes.
..We found that the FI-Laboratory correlated weakly with the Clinical Frailty Scale (CFS; r2 = 0.09). An increase in the CFS and the equivalent of 3 additional abnormal laboratory test results in the FI-Laboratory, respectively, were associated with an increased proportion of inpatient days (rate ratios [RRs] 1.43, 95% confidence interval [CI] 1.35–1.52; and 1.47, 95% CI 1.41–1.54), discharge to a higher level of care (odd ratios [ORs] 1.39, 95% CI 1.27–1.52; and 1.30, 95% CI 1.16–1.47) and increased readmission rate (hazard ratios [HRs] 1.26, 95% CI 1.17–1.37; and 1.18, 95% CI 1.11–1.26). Increases in the CFS and FI-Laboratory were associated with increased mortality HRs of 1.39 (95% CI 1.28–1.51) and 1.45 (95% CI 1.37–1.54), respectively.
INTERPRETATION: We determined that FI-Laboratory, distinct from baseline frailty, could be used to predict risk of many adverse outcomes. The score is therefore a useful way to quantify the degree of acute illness in frail older adults.
https://bit.ly/2Fr7irC
Complementing chronic #frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results
..we created a frailty index from routine admission laboratory investigations (FI-Laboratory) linked to data comprising hospital outcomes.
..We found that the FI-Laboratory correlated weakly with the Clinical Frailty Scale (CFS; r2 = 0.09). An increase in the CFS and the equivalent of 3 additional abnormal laboratory test results in the FI-Laboratory, respectively, were associated with an increased proportion of inpatient days (rate ratios [RRs] 1.43, 95% confidence interval [CI] 1.35–1.52; and 1.47, 95% CI 1.41–1.54), discharge to a higher level of care (odd ratios [ORs] 1.39, 95% CI 1.27–1.52; and 1.30, 95% CI 1.16–1.47) and increased readmission rate (hazard ratios [HRs] 1.26, 95% CI 1.17–1.37; and 1.18, 95% CI 1.11–1.26). Increases in the CFS and FI-Laboratory were associated with increased mortality HRs of 1.39 (95% CI 1.28–1.51) and 1.45 (95% CI 1.37–1.54), respectively.
INTERPRETATION: We determined that FI-Laboratory, distinct from baseline frailty, could be used to predict risk of many adverse outcomes. The score is therefore a useful way to quantify the degree of acute illness in frail older adults.
https://bit.ly/2Fr7irC
CMAJ
Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine…
BACKGROUND: Acutely ill and frail older adults have complex social and health care needs. It is important to understand how this complexity affects acute outcomes for admission to hospital. We validated a frailty index using routine admission laboratory tests…
#Mediterranean diet intervention alters the gut microbiome in older people reducing #frailty and improving health status: the NU-AGE 1-year dietary intervention across five European countries
..Adherence to the diet was associated with specific microbiome alterations. Taxa enriched by adherence to the diet were positively associated with several markers of lower frailty and improved cognitive function, and negatively associated with inflammatory markers including C-reactive protein and interleukin-17.
Analysis of the inferred microbial metabolite profiles indicated that the diet-modulated microbiome change was associated with an increase in short/branch chained fatty acid production and lower production of secondary bile acids, p-cresols, ethanol and carbon dioxide. Microbiome ecosystem network analysis showed that the bacterial taxa that responded positively to the MedDiet intervention occupy keystone interaction positions, whereas frailty-associated taxa are peripheral in the networks.
Conclusion Collectively, our findings support the feasibility of improving the habitual diet to modulate the gut microbiota which in turn has the potential to promote healthier ageing.
https://bit.ly/3bLC8ug
..Adherence to the diet was associated with specific microbiome alterations. Taxa enriched by adherence to the diet were positively associated with several markers of lower frailty and improved cognitive function, and negatively associated with inflammatory markers including C-reactive protein and interleukin-17.
Analysis of the inferred microbial metabolite profiles indicated that the diet-modulated microbiome change was associated with an increase in short/branch chained fatty acid production and lower production of secondary bile acids, p-cresols, ethanol and carbon dioxide. Microbiome ecosystem network analysis showed that the bacterial taxa that responded positively to the MedDiet intervention occupy keystone interaction positions, whereas frailty-associated taxa are peripheral in the networks.
Conclusion Collectively, our findings support the feasibility of improving the habitual diet to modulate the gut microbiota which in turn has the potential to promote healthier ageing.
https://bit.ly/3bLC8ug
Gut
Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU…
Objective Ageing is accompanied by deterioration of multiple bodily functions and inflammation, which collectively contribute to frailty. We and others have shown that frailty co-varies with alterations in the gut microbiota in a manner accelerated by consumption…
Association Between Arterial #Stiffness, #Frailty and Fall-Related Injuries in Older Adults
https://2medical.news/2020/07/27/association-between-arterial-stiffness-frailty-and-fall-related-injuries-in-older-adults/
..A cross-sectional study of a random sample of older adults aged 60 years and older was conducted. Main study parameters: arterial stiffness was measured by the determining the cardio-ankle vascular index (CAVI); Frailty status was defined using a 7-item frailty screening scale, developed in Russia. This questionnaire included question about falls and fall-related injuries. Orthostatic test and anthropometric tests were done. Medical history (comorbidity, medications), …
https://2medical.news/2020/07/27/association-between-arterial-stiffness-frailty-and-fall-related-injuries-in-older-adults/
..A cross-sectional study of a random sample of older adults aged 60 years and older was conducted. Main study parameters: arterial stiffness was measured by the determining the cardio-ankle vascular index (CAVI); Frailty status was defined using a 7-item frailty screening scale, developed in Russia. This questionnaire included question about falls and fall-related injuries. Orthostatic test and anthropometric tests were done. Medical history (comorbidity, medications), …
#Circadian disturbances and #frailty risk in #older adults
https://2medical.news/2023/11/20/circadian-disturbances-and-frailty-risk-in-older-adults/
https://2medical.news/2023/11/20/circadian-disturbances-and-frailty-risk-in-older-adults/
2Medical.News
#Circadian disturbances and #frailty risk in #older adults
Frailty is characterized by diminished resilience to stressor events. It is associated with adverse future health outcomes and impedes healthy aging. The circadian system orchestrates ~24-h rhythms…