Explore the breadth of frailty research, from evaluating multimodal interventions in co-morbid conditions like Type 2 Diabetes Mellitus to understanding the role of nutrition and exercise in mitigating frailty. Gain insights into the complex interplay between frailty, sarcopenia, and chronic diseases, and discover innovative strategies to improve outcomes for the elderly.
Despite earlier research indicating a potential link between the development of sarcopenia and an elevated risk of frailty, the lack of comprehensive prospective data on the correlation between sarcopenia and frailty incidence leaves open the question of whether depression and...
Bilirubin is a by-product of haemoglobin breakdown and has been reported to be a potent antioxidant recently. While elevated levels of bilirubin have been linked to a reduced risk of various diseases, their role remains unknown in frailty. This study...
๐๏ธ 2024-11-25
๐ฐ Publication: Journal Of Cachexia Sarcopenia And Muscle
Hospital-associated deconditioning is a broad term, which refers non-specifically to declines in any function of the body secondary to hospitalisation. Older people, particularly those living with frailty, are known to be at greatest risk. It has historically been most commonly...
Frailty is a severe, common co-morbidity associated with heart failure (HF) with preserved ejection fraction (HFpEF). The impact of frailty on HFpEF outcomes may affect treatment choices in HFpEF. The impact of frailty on HFpEF patients and any impact on...
๐๏ธ 2023-12-29
๐ฐ Publication: Journal Of Cachexia Sarcopenia And Muscle
This study investigates multimodal interventions for older adults with frailty and Type 2 Diabetes Mellitus (T2DM), focusing on the effects of physical, nutritional, and educational strategies on improving functional performance. Involving 843 individuals aged 70+, findings highlight improved mobility, especially gait speed, linked to adherence and baseline health. Published in 'Age and Ageing', the research by Alvarez-Bustos A, Laosa O, Marzetti E, et al., emphasizes tailored interventions' importance for T2DM and frailty in the elderly.
It is known that one in five adults with pre-frailty progresses to frailty over a 3-year period. Low protein and energy intake, increased prevalence of multimorbidity, and a sedentary lifestyle are well-characterised drivers of sarcopenia. Consequently, they act as catalysts of older adultsโ transition to frailty. In this vein, stimulating increased muscle protein synthesis through regular physical exercise and protein-enriched diet consumption is pivotal for pre-frail older adults. Current U.S. Food and Nutrition Board guidelines recommend a dietary allowance of 0.8 g/kg of protein per day for older adults. However, this amount may be insufficient for those with pre-frailty due to their low-grade inflammation, multimorbidity, and increased susceptibility to anabolic resistance.
This study aimed to examine the impact of leucine-enriched protein supplementation with or without exercise on 1) physical function, 2) body composition, and 3) systemic inflammation in pre-frail older adults with a daily protein consumption of โค1 g/kg.
The development of frailty has been attributed to a number of biological mechanisms, including immunosenescence and mitochondrial dysfunction. Impairments in immune cell mitochondria have been proposed to both cause and interact with immunosenescence, hypothetically leading to ageing-related increases in sterile inflammation, commonly known as โinflammagingโ. However, despite the convincing evidence supporting these suggestions, claims regarding the effects of immunosenescence on clinical outcomes such as frailty have recently been challenged.
The aim of this article was to examine the association between immunosenescence, mitochondrial dysfunction, and frailty syndrome in community-dwelling frail and non-frail older adults.
Walking speed (WS) is clinically recognized as a crucial vital sign. Associations between daily walking speed (DWS) and health outcomes have been underscored by a number of studies, which have further recognized it as an accurate predictor of dependency and mortality in elderly individuals. Despite this knowledge, very few studies have examined the link between DWS and frailty.
The aim of this study was to investigate a smartphone applicationโs ability to assess the association between DWS and frailty. This application measured DW parameters such as speed and step length and further conducted an in-app frailty assessment using the Kihon checklist.
Frailty is a known risk factor for negative surgical outcomes, and the Liver Frailty Index (LFI) has been shown to predict mortality in patients awaiting liver transplants. Despite this, neither a diagnosis of frailty nor a patientโs LFI holds any weight when determining their position on liver transplant waitlists.
The aim of this article was to assess frailty and the LFIโs ability to predict pre- and post-transplant outcomes.
Pancreatic ductal adenocarcinoma, PDAC, is one of the most fatal types of solid tumours. It is also linked to a high prevalence of cachexia, with around 80% of PDAC patients exhibiting cachexia. There is one hypothesis, the endocrine organโlike tumour hypothesis, which aims to explain the reasons behind cancer cachexia occurring during pancreatic ductal adenocarcinoma. Some of the reasons include metabolites, epigenetic changes, hormonal disturbance and genetic instability may be behind the development of cancer cachexia. Generally, the belief is held that metabolic disruption is the process behind cachexia development, but it is also believed there is not one single factor that triggers it.
This review by Yu Y et al aimed to synthesise an understanding of cancer cachexia development and the response of cachexia to current available treatments.
For patients with head and neck cancer, malnutrition and frailty are linked with adverse treatment outcomes, higher mortality rates, complications post-surgery and generally lower quality of life. However, the relationship between malnutrition and frailty is not fully known. It is, however, clear that these two conditions often coexist, suggesting they may share similar risk factors. In this study on 197 patients, it was found that the risk of malnutrition is strongly positively associated with frailty. However, some other interesting factors were discovered. Alcohol consumption was shown to present a greater risk of developing malnutrition, but on the other hand, alcohol consumption seems protective for being frail. Overall, these conditions often coexist but do not always fully overlap: screening for both conditions is therefore recommended.
This review by Dewansingh P et al aimed to understand the relationship between the risk of malnutrition and frailty in patients with head and neck cancer.
Dynapenia is characterised by an age-related loss of muscle strength. When coupled with low muscle mass, it is instead diagnosed as sarcopenia according to the European Working Group on Sarcopenia in Older People revised guidelines (EWGSOP2).
The SARS-CoV-2 infection is accompanied by severe inflammation and increased catabolism, which may significantly impact infected patientsโ skeletal muscle structure and function. These impacts may be detrimental to elderly patients, who are disproportionately affected and already highly burdened by the disease. Recent studies have suggested that sarcopenia at the time of hospital admission may shape older patientsโ length of stay and increase mortality in those with moderate to severe COVID-19.
The aim of this study was to examine the association between simple clinical biomarkers, including those for the assessment of muscle function and frailty, and the risk of poor survival as well as increased length of hospital stay in older patients with COVID-19. Sarcopenia was screened using SARC-F, while frailty was assessed in accordance with the Rockwood Clinical Frailty Scale.
Patients with chronic kidney disease (CKD) possess an increased risk of developing physical or phenotypic frailty. The skeletal muscle dysfunction underpinning physical frailty has been associated with increased mortality. CKD-related phenotypic frailty shares features with ageing-related frailty, and CKD has thus been touted as a clinically relevant model of premature ageing.
The aim of this review was to examine the metabolic basis and pathogenesis of the skeletal muscle dysfunction responsible for phenotypic frailty in patients with CKD.
๐ฐ Publication: American Journal of Nephrology 2022
It is known that advanced liver disease and frailty are heavily interlinked, and frailtyโs association with an increased risk of progression to cirrhosis and death has been widely documented. Patients with advanced liver disease who are on waiting lists for liver transplants are urged to increase their physical activity prior to surgery. However, this patient population only represents a minority of liver disease patients.
This article aims to examine the prevalence of frailty in patients with non-cirrhotic non-alcoholic fatty liver disease (NAFLD), and exposes the faults of current models of care for this patient population.
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