Physical Frailty In Older Adults Research Articles

The predictive capacity of adductor pollicis muscle thickness for physical frailty in older adults.

There is a need for an easily measurable and reliable surrogate marker for physical frailty. This study aims to investigate the predictive capacity of adductor pollicis muscle thickness (AMPT), which can be easily measured externally and minimally influenced by subcutaneous adipose tissue, for physical frailty. A total of 589 patients (16.3% physically frail, 54.7% pre-frail, 29% robust) were included. Comprehensive geriatric assessments and anthropometric measurements of the patients were performed. APMT was assessed with a skinfold caliper. Physical frailty was diagnosed using the fried frailty phenotype. The predictive ability of APMT for the diagnosis of frailty was examined. Of all the participants, 64.3% were women, and the average age was 74 ± 5.9years. There was no significant difference in waist and hip circumference, or body mass index between the frail and non-frail groups. APMT, handgrip strength, gait speed, and calf circumference were significantly lower in frail patients than in non-frail ones (p < 0.01). The area under the curve (AUC) of APMT for physical frailty was determined to be 0.627 (95% confidence interval [CI] 0.58-0.66; p < 0.001). The best cut-off value for APMT was ≤ 18.5mm for all individuals. Adductor pollicis muscle thickness can be a useful anthropometric marker for evaluating the risk of physical frailty.

PLASMA NEUROFILAMENT LIGHT CHAIN IS ASSOCIATED WITH PHYSICAL FRAILTY IN OLDER ADULTS WITHOUT DEMENTIA

Abstract Evidence suggests a link between brain biomarkers of neurodegeneration and physical function and frailty. However, the association of neurodegenerative biomarkers in the plasma with physical frailty in older adults remains unelucidated, as current evidence is limited and inconsistent. We tested the association between plasma neurofilament light chain (NFL), a plasma neurodegeneration biomarker, and physical frailty in a sample of community-dwelling older adults. We used baseline demographics, frailty, and plasma NFL data collected from 97 participants in a randomized controlled trial in community-dwelling, sedentary older adults without dementia [Montreal Cognitive Assessment (MoCA)&amp;gt;17]. Physical frailty was assessed using a composite measure of weakness, slow walking speed, unintentional weight loss, exhaustion, and low physical activity. Participants’ frailty levels were categorized into robustness, pre-intermediate frailty, and frailty. Multiple linear regression and ordinal logistic regression models adjusting for age, sex, race, education, and comorbidities were conducted to test the associations of NFL with frailty and levels of frailty. The sample was 70.0 ± 6.0 years old, with 80% being females, 72% having intact cognition, and 28% having mild cognitive impairment (MCI). In the adjusted models, higher plasma NFL was associated with higher frailty scores (β=0.16, 95%CI [Confidence Interval] = [0.06,0.26]) and a higher likelihood of being in a higher level of frailty group (odds ratio=1.28, 95% CI =1.02, 1.61). In summary, plasma NFL was associated with greater frailty in our sample of non-demented older adults. Plasma NFL may be a sensitive and promising neurodegenerative biomarker for physical frailty in older adults without dementia.

Association between Circulating Levels of CXCL9 and CXCL10 and Physical Frailty in Older Adults

Introduction: Dysregulation of pro-inflammatory chemokines is considered a potential mechanism for the development of age-related medical conditions such as frailty. However, evidence linking circulating chemokines with frailty remains lacking. Materials and Methods: We performed a case-control study including 48 cases and 48 controls aged 65–90 years, using the National Center for Geriatrics and Gerontology outpatient registry data. Cases were outpatients with physical frailty and low habitual daily activity. Controls were robust outpatients who performed habitual daily activities. The Japanese version of the Cardiovascular Health Study criteria was used to diagnose physical frailty, and the modified Baecke questionnaire was used to evaluate habitual daily activities. Serum CXCL9 and CXCL10 levels were measured using enzyme-linked immunosorbent assay. Results: The median age (interquartile range) in cases and controls was 78 (73–83) and 76 (72–80) years, with the proportions of men were 47.9% and 43.8%, respectively. In the logistic regression model with adjustment for age, sex, and other confounding factors, the multivariable odds ratios (95% confidence intervals) for the highest versus lowest tertile of CXCL9 and CXCL10 levels were 7.90 (1.61–49.80) and 1.61 (0.42–6.30), respectively. However, we did not observe a linear association between CXCL9 levels and physical frailty components. Discussion/Conclusion: Our preliminary data exhibit that circulating CXCL9 levels were positively associated with the odds of physical frailty. However, these findings lack evidence of a dose-response relationship between CXCL9 levels and physical frailty components. Further research with a larger sample size is required to confirm these findings.

Relationship between oral frailty and locomotive syndrome in working-age individuals: a cross-sectional survey of workers in Japan

BackgroundAlthough the relationship between oral and physical frailty in older adults has been investigated, few studies have focused on the working-age population. This study examined the relationships of the number of remaining teeth and masticatory ability, i.e., signs of oral frailty, with locomotive syndrome (LS) in the working-age population.MethodsThe number of remaining teeth, masticatory ability, and presence of LS in 501 participants from four companies were examined. The relationships between the number of remaining teeth groups (≥ 20 teeth or ≤ 19 teeth) and LS and between the masticatory ability groups (high or low) and LS were examined. A binomial logistic regression analysis was conducted using LS from the stand-up test as the objective variable and the two subgroups based on the number of remaining teeth and potential crossover factors as covariates.ResultsThe analysis included 495 participants (354 males and 141 females; median age, 43 years). The median number of remaining teeth among the participants was 28, and 10 participants (2.0%) had ≤ 19 teeth. The mean masticatory ability values were 39.9 for males and 37.7 for females, and 31 participants (6.3%) had low masticatory ability. In the stand-up test, those with ≤ 19 teeth had a higher LS rate than those with ≥ 20 teeth. The odds ratio for LS in the group with ≤ 19 remaining teeth was 5.99, and the confidence interval was 1.44–24.95.ConclusionsThe results confirmed signs of oral frailty in the working-age population. Further, the number of remaining teeth possibly affects standing movement. Thus, oral frailty is associated with LS in the working-age population.

Association between subjective social status and physical frailty in older adults in India: perceived discrimination and III-treatment as mediators and moderators.

While extensive research exists on physical frailty, including in low- and middle-income countries like India, studies have yet to appraise whether perceived social standing is associated with physical frailty. As such, this study examines (1) the association between subjective social status (SSS) and physical frailty among older adults in India; and (2) whether this association is mediated and moderated by perceived discrimination and experiences of III-treatment. Data came from the Longitudinal Aging Study in India with a sample of 31,464 older adults aged 60 and above. Physical frailty was assessed using an adapted version of the frailty phenotype developed by Fried and colleagues. SSS was assessed using the Macarthur scale. Multivariable logistic regression models along with Karlson-Holm-Breen (KHB) methodology were employed to examine the direct association, mediational pathways, and the interactions. The prevalence of frailty was 30.65% and those with lowest SSS reported higher prevalence of frailty (42.06%). After adjusting for several confounders, odds of frailty were lower among persons with high SSS relative to those with low SSS, and the variance explained by the SSS was higher than that explained by household consumption quintiles. Moreover, the association between SSS and frailty was mediated and moderated by perceived discrimination and III-treatment. Our findings underscore that when examining the association between socioeconomic status (SES) and physical frailty, it is important to consider SSS given that perceived social status likely reflects the less apparent psychosocial components associated with SES, and that perceived discrimination and III-treatment both mediate and moderate the association between SSS and physical frailty is critical to identifying those older Indians most susceptible to the functional health implications of lower SSS.

The Effect of High-Speed Power Training on Physical Frailty in Older Adults: Effect of a Visual-Guided Exercise Program in South Korean Rural Areas.

Exercise has been shown to be an effective intervention; the difficulty still lies in providing exercise programs to the older adults in rural areas. Therefore, this study aimed to examine the effects of a 12-week exercise program provided with visual guidelines (prerecorded video) on frailty among older adults in rural areas. Fifty participants (71.7 ± 4.9 years) from 5 different rural areas were recruited and divided into two groups: the exercise group (EX, n = 24 (male: 8, female: 18)) and the control group (CON, n = 26 (male: 7, female: 17)). With the commencement of the exercise intervention, a prerecorded high-speed power training program for frail older adults was distributed to the EX group. A new prerecorded exercise program was delivered to the EX group every 4 weeks. Frailty status was diagnosed with Fried's criteria before and after the intervention. Muscle strength was measured in the upper and lower limb strength (hand-grip strength and leg extension and flexion), and physical function was measured using a short physical performance battery and gait speed. Fasting blood was collected before and after the intervention and analyzed for blood lipid profile. After 12 weeks of the intervention period, a significant difference in frailty status (P < 0.01) and score (P < 0.01) favoring the EX group was observed. Physical functions (gait speed (P=0.01) and time for sit to stand (P < 0.01)) were significantly improved in the EX group with a significant increase in knee extensor strength (P < 0.01). A significant difference in serum high-density lipoprotein levels favoring the EX group (P=0.03) was also observed. This study confirmed the positive effect of a visual-guided exercise program on older adults' residents in rural areas and provided alternative methods to effectively provide exercise program for the older adults with limited resources.

An effective and practical tool to assess physical frailty in older adults: Turkish validation of the FRAIL Scale

Objective: Practical scales with tested validity and reliability are needed to clinically determine frailty.The aim of this study is to find out whether the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) Scale is an effective screening scale to show frailty. Patients and Methods: The Frail non-Disabled (FIND) scale validated in the Turkish population was applied for FRAIL Scale validation. Comprehensive geriatric assessment and Fried Index were performed on 85 outpatients who were 65 years and older. The patients were examined in terms of comorbidity, number of falls, living environment, number of drugs used, and hospitalization in the last year. Results: The FRAIL Scale had a high correlation with the FIND scale and Fried Index (correlation coefficients are 0.956 and 0.934, respectively). In addition, it was found to be associated with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) scales, the Mini-Mental State Examination (MMSE),Y esavage Geriatric Depression Scale (GDS), Mini Nutritional Assessment short-form (MNA-sf),Clock Drawing Test (CDT), handgrip strength, and timed up and go test (p&amp;lt;0.05). The compliance between independent practitioners and test-retest compliance were found to be 100% (full compliance,Cronbach’s alpha coefficient is 1.00). Conclusion: In the Turkish geriatric population, the FRAIL Scale was found to be a reliable and valid scale in showing frailty.

Exercise program to reduce the risk of cognitive decline and physical frailty in older adults: study protocol for an open label double-arm clinical trial.

It is a big problem that many older adults are physically inactive. Well-known benefits of physical exercise include a decrease in the risk of cognitive decline and physical frailty. Therefore, this study aims to examine whether our proposed exercise program can prevent cognitive decline and improve physical function in the elderly. This study will include nondemented older adults (n = 103) without regular exercise habits. The trial will include a physical exercise training program (once a week) and nutritional lectures (once a month) over 5 months and follow-up for ≥1 year. The primary endpoint is the program's efficacy in preventing cognitive decline, as assessed by changes in the memory performance index of the mild cognitive impairment (MCI) screen; the secondary endpoints are the incidence of MCI and dementia, physical testing, and frailty proportion. In the exploratory phase of the study, we will elucidate the underlying diseases causing MCI in community-dwelling older adults by neuroimaging. This double-arm trial that aims to assess the impact of physical exercise on nondemented older adults' cognitive and physical function. Furthermore, our newly developed exercise program will be easy for older adults to undertake.Clinical Trial Registration: https://clinicaltrials.gov/, identifier [jRCT 1040220140].

The Relationship of Oral Health with Progression of Physical Frailty among Older Adults: A Longitudinal Study Composed of Two Cohorts of Older Adults from the United Kingdom and United States.

To investigate the prospective associations between oral health and progression of physical frailty in older adults. Prospective analysis. Data are from the British Regional Heart Study (BRHS) comprising 2137 men aged 71 to 92years from 24 British towns and the Health, Aging, and Body Composition (HABC) Study of 3075 men and women aged 70 to 79years. Oral health markers included denture use, tooth count, periodontal disease, self-rated oral health, dry mouth, and perceived difficulty eating. Physical frailty progression after ∼8years follow-up was determined based on 2 scoring tools: the Fried frailty phenotype (for physical frailty) and the Gill index (for severe frailty). Logistic regression models were conducted to examine the associations between oral health markers and progression to frailty and severe frailty, adjusted for sociodemographic, behavioral, and health-related factors. After full adjustment, progression to frailty was associated with dentition [per each additional tooth, odds ratio (OR) 0.97; 95% CI: 0.95-1.00], <21 teeth with (OR 1.74; 95% CI: 1.02-2.96) or without denture use (OR 2.45; 95% CI 1.15-5.21), and symptoms of dry mouth (OR ≥1.8; 95% CI ≥ 1.06-3.10) in the BRHS cohort. In the HABC Study, progression to frailty was associated with dry mouth (OR 2.62; 95% CI 1.05-6.55), self-reported difficulty eating (OR 2.12; 95% CI 1.28-3.50) and ≥2 cumulative oral health problems (OR 2.29; 95% CI 1.17-4.50). Progression to severe frailty was associated with edentulism (OR 4.44; 95% CI 1.39-14.15) and <21 teeth without dentures after full adjustment. These findings indicate that oral health problems, particularly tooth loss and dry mouth, in older adults are associated with progression to frailty in later life. Additional research is needed to determine if interventions aimed at maintaining (or improving) oral health can contribute to reducing the risk, and worsening, of physical frailty in older adults.

Can Measurement of Ultrasonic Echo Intensity Predict Physical Frailty in Older Adults?

Echo intensity (EI) of the tongue in ultrasonography is an easy and quantitative assessment of tongue function. Elucidating the relationship between EI and frailty, is expected to aid in the early detection of frailty and oral hypofunction in older adults. We assessed tongue function and frailty in older outpatients visiting a hospital. The subjects were 101 individuals aged 65 or older (35 men and 66 women, mean age 76.4 ± 7.0 years). Tongue pressure and EI were measured as assessments of tongue function and grip strength, and Kihon Checklist (KCL) scores were measured as assessments of frailty. In women, a significant correlation was not found between the mean EI and grip strength, whereas a significant correlation was noted between each score of the KCL and the mean EI; the scores increased as the mean EI increased. A significant positive correlation was found between tongue pressure and grip strength, but no significant correlation was observed between tongue pressure and the KCL scores. In men, no significant correlation was found between tongue assessments and frailty, except for a significant positive correlation between tongue pressure and grip strength. The results of this study suggest that EI of the tongue is positively associated with physical frailty in women and may be useful for early detection of physical frailty status.

Benefits of a 3-month cycle of weekly virtual museum tours in community dwelling older adults: Results of a randomized controlled trial.

BackgroundMuseums can be instrumental in fostering social inclusion and may improve the overall health of the older population. Over the course of the 2019 coronavirus pandemic, many older adults suffered as a result of confinement measures, which may have accelerated the processes that lead to physical frailty and increased mental health risks. This study aims to examine whether a 3-month cycle of weekly virtual tours of the Montreal Museum of Fine Arts (MMFA) may have improved feelings of social inclusion, wellbeing and quality of life, and reduced physical frailty in older adults living within the community of Montreal.Methods and designA total of 106 older adults, who were community-dwellers living in Montreal (Quebec, Canada), were recruited for a randomized controlled trial in two parallel groups (intervention with n = 53 vs control with n = 53) between January and April 2022. The intervention consisted of a 3-month cycle of weekly virtual museum tours of the MMFA. Social isolation, wellbeing, quality of life and frailty were evaluated using validated scales that were assessed on a web platform at baseline (M0) and after 3 months (M3) in the intervention group. The control group completed the same assessment according to the same schedule. The outcomes were the mean scores at M0 and M3, and changes in mean scores between M0 and M3.ResultsThe intervention group showed significant improvements in their social isolation, wellbeing, quality of life and frailty scores when compared to the control group, the highest benefits being observed with frailty.ConclusionThe results suggest that the 3-month cycle of weekly virtual MMFA tours may improve social inclusion, physical and mental health in community-dwelling older adults living in Montreal.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT05046288, identifier NCT05046288.

Associations Between Social Isolation and Physical Frailty in Older Adults: A Systematic Review and Meta-Analysis.

The emergence of COVID-19 has drastically changed our daily lives.1 Lockdowns were imposed across many countries for extended periods of time during the pandemic to reduce the risk of infection.1 However, the side effects of lockdowns included loss of opportunities to socialize and interact with other people. Social isolation and its impacts on health have since been highlighted, especially among high-risk populations of older people.1 Social isolation has been well documented as a significant risk factor of mortality, and has also been shown to be associated with poorer physical and mental health.

Association of food insecurity with physical frailty among older adults: study based on LASI, 2017-18

BackgroundFood security can be directly linked to nutritional status and either directly or indirectly, it has an impact on health status and well-being of the population. Physical frailty is one of the most important phenotypes used to understand the vulnerable nature of older adults. This paper examined the association between food security and physical frailty in older adults. MethodsWe used data from the Longitudinal Ageing Study in India (LASI, 2017-18), wave-1. The sample size was 31,464 older adults aged 60 years and above. Physical frailty was assessed using the modified version of frailty phenotype proposed by Fried and colleagues. Multivariable logistic regression was used to establish the association between food insecurity with physical frailty. ResultsA proportion of 30.65% of older adults were frail in this study. Older adults with food insecurity had higher prevalence of exhaustion (12.1% vs 6.5%), unintentional weight loss (65.5% vs 5.1%), and weak grip strength (8.6% vs 7.9%) in comparison to their food secure counterparts. After adjusting for a large number of confounders, older adults who reported food insecurity had significantly higher odds of being frail [AOR: 2.68; CI: 2.26-3.19] in comparison to older adults with no food insecurity. ConclusionThe study showed that food insecurity is associated with physical frailty among older adults in India. It is suggested that food security programs in the country may be considered as an effective strategy to prevent physical frailty among older adults.

Lipidomic signatures from physically frail and robust older adults at hospital admission

Identifying serum biomarkers that can predict physical frailty in older adults would have tremendous clinical value for primary care, as this condition is inherently related to poor quality of life and premature mortality. We compared the serum lipid profile of physically frail and robust older adults to identify specific lipid biomarkers that could be used to assess physical frailty in older patients at hospital admission. Forty-three older adults (58.1% male), mean (range) age 86.4 (78–100 years) years, were classified as physically frail (n = 18) or robust (n = 25) based on scores from the Short Physical Performance Battery (≤ 6 points). Non-targeted metabolomic study by ultra-high performance liquid chromatography coupled to mass spectrometry (UHPLC-MS) analysis with later bioinformatics data analysis. Once the significantly different metabolites were identified, the KEGG database was used on them to establish which were the metabolic pathways mainly involved. Area under receiver-operating curve (AUROC) analysis was used to test the discriminatory ability of lipid biomarkers for frailty based on the Short Physical Performance Battery. We identified a panel of five metabolites including ceramides Cer (40:2), Cer (d18:1/20:0), Cer (d18:1/23:0), cholesterol, and phosphatidylcholine (PC) (14:0/20:4) that were significantly increased in physically frail older adults compared with robust older adults at hospital admission. The most interesting in the physically frail metabolome study found with the KEGG database were the metabolic pathways, vitamin digestion and absorption, AGE-RAGE signaling pathway in diabetic complications, and insulin resistance. In addition, Cer (40:2) (AUROC 0.747), Cer (d18:1/23:0) (AUROC 0.720), and cholesterol (AUROC 0.784) were identified as higher values of physically frail at hospital admission. The non-targeted metabolomic study can open a wide view of the physically frail features changes at the plasma level, which would be linked to the physical frailty phenotype at hospital admission. Also, we propose that metabolome analysis will have a suitable niche in personalized medicine for physically frail older adults.

Association between dry mouth and physical frailty among community-dwelling older adults in Japan: The Otassha Study.

To elucidate the relationship between physical frailty and dry mouth among community-dwelling older adults in Japan. Oral hypofunction is associated with physical frailty in older adults. Dry mouth, subjectively evaluated as xerostomia and objectively measured as hyposalivation, is highly prevalent in older adults. However, few reports have used both measures of dry mouth and investigated their association with physical frailty. This cross-sectional study included 643 individuals (mean age, 73.9years) from the Otassha Study in 2019. Xerostomia was assessed using the 5-item Summated Xerostomia Inventory (SXI). Hyposalivation was assessed by measuring the amount of resting saliva using the modified cotton roll method. Frailty phenotypes were defined by weakness, slowness, weight loss, low physical activity level and exhaustion components, and served as the outcome variable. Participants with three or more components were considered physically frail, and those with one or two components were considered pre-frail. Ordinal logistic regression analyses were performed to evaluate the associations between physical frailty and xerostomia and hyposalivation. Among the participants, 4.5% and 49.8% had physical frailty and pre-frailty, respectively. In ordinal logistic regression analysis adjusted for demographic and health characteristics, the SXI score was associated with physical frailty status (adjusted odds ratio for a one-point increase in SXI, 1.12; 95% confidence interval, 1.06-1.19). However, no difference was observed between the amount of resting saliva and severity of physical frailty. Xerostomia is associated with physical frailty among community-dwelling older adults in Japan. Not applicable.

Driving cessation and physical frailty in community-dwelling older adults: A longitudinal study.

Physical frailty is a critical health problem that can increase the risk of adverse health outcomes in older adults. Driving cessation has been associated with negative outcomes such as disability. However, the relationship between physical frailty and driving cessation remains unclear. Thus, this study aimed to examine whether driving cessation is associated with physical frailty transition in community-dwelling older adults. This prospective cohort study was performed in a community setting in Japan. Participants were 2934 older Japanese adults, classified into two groups according to their driving status: a driving group (drivers at baseline who continued driving at a 4-year follow-up) and a driving cessation group (drivers at baseline who ceased driving by 4-year follow-up). We examined the association between physical frailty transition and driving cessation over a 4-year period, using logistic regression analysis before and after imputation. In total, 3.9% of community-dwelling older adults had ceased driving by the 4-year follow-up. Rates for physical frailty transition in the driving and driving cessation groups were 4.6% and 17.1%, respectively (P < 0.001). In fully adjusted logistic regression analysis, when compared with driving, driving cessation independently affected physical frailty transition. The results were similar after multiple imputations. Our findings indicated driving cessation was an independent risk factor associated with physical frailty transition in older adults. As physical frailty in older adults can contribute to negative health outcomes, including increased disability and mortality, preventing frailty has important public health implications. Geriatr Gerontol Int 2021; 21: 1047-1052.

Cognitive impairment and physical frailty in older adults in secondary health care.

To analyze the association between cognitive impairment and physical frailty in older adults in secondary health care. This is a cross-sectional study carried out with people aged ≥ 60 years, assisted at a geriatric and gerontology outpatient clinic. For cognitive screening, the Mini Mental State Examination, the semantic verbal fluency test, and frailty assessment using the physical frailty phenotype were used. The likelihood ratio test was applied to the predictive model. 407 older adults participated in the study. Cognitive impairment was observed in 58.5% (n=238) of the sample, being higher in frail (n=66; 75%). A change in the semantic verbal fluency test was identified in 22% (n=90), with a higher prevalence in pre-frail patients (55.5%; n=226). It was identified 2.5 times more chance of a frail older person, when compared to a non-frail one, to have cognitive impairment (95% CI, +0.947 - 0.322). The chance for alteration in the semantic verbal fluency test was 5.4 times higher in frail compared to non-frail ones (95% CI, 1.68 - 0.38). A relationship was observed between cognitive impairment and physical frailty. Screening for frailty in geriatric nursing practice and the implementation of specific care is recommended.

Effectiveness of a 6-Month Multicomponent Training on Physical Frailty in Older Adults With Cognitive Impairment

Multicomponent training (MT) that combines aerobic, strength, postural, and balance exercises seems to be safe and effective to prevent and even reverse early stages of frailty, as well as counteract the physical consequences of cognitive impairment. This study analyzes the effectiveness of MT on physical frailty in older adults diagnosed with cognitive impairment. Forty-nine subjects (34 women) diagnosed with mild cognitive impairment (MCI) or dementia were allocated into exercise group (EG; 75.80±6.60 years; age range: 61-90) or a control group (CG; 82.56±5.45 years; age range: 73-90). EG was submitted to a 6-month MT intervention (2x/week, 50min). CG had a monthly recreational session. Sample mean of MMSE at baseline was 21.02 (±4.98). Participants were categorized as frail, pre-frail and robust according to a validated physical performance battery - Short Performance Physical Battery (SPPB). Overall, in baseline there were 12.5% frail and 37.5% pre-frail individuals in the EG group; in the CG there were 36% and 32%, respectively. Data from SPPB total score revealed that EG group increased the performance over time [t(23)=3,94; Δ=1.21 (±1.50); p<0.001], as opposite to CG individuals [t(24)=-2.26; Δ=-0.92 (±2.04); p=0.034]; also, there were 8.3% frail and 29.2% pre-frail in EG, and 40% and 32% in CG after intervention. By improving lower extremity functionality of patients diagnosed with cognitive impairment, MT intervention may be an important non-pharmacological strategy to improve physical frailty status and modify subjects’ condition from frail to pre-frail or even robust. Supported by IPDJ & FCT: CIAFEL (FCT/UIDB/00617/2020), “Body and Brain” (POCI-01-0145-FEDER-031808), PhD Grant (SFRH/BD/136635/2018).

Low calf circumference is associated with frailty in diabetic adults aged over 80 years

BackgroundFrailty is now seen as a significant factor in older people with diabetes, whose mortality and disability increased. This study aims to investigate the association between calf circumference (CC) with frailty in diabetic adults aged over 80 years.MethodsA cross-sectional analysis was performed on the data of 426 diabetic adults aged over 80 years. On admission, demographic data and laboratory parameters were recorded. CC was measured on the lower right leg at the point of the maximal circumference. All participants accepted frailty assessments. Frailty was mainly defined using the Fried frailty phenotype criteria.ResultsThe CC levels were significantly lower in the frail than the non-frail (26.7 ± 4.0 vs. 31.2 ± 4.0, P < 0.001). CC was negatively correlated with the Fried frailty phenotype index (P < 0.001). Logistic regression analysis of frailty revealed that age (Odds Ratio (OR), 1.368; 95% Confidential Interval (CI) 1.002–1.869; P = 0.049), CC (OR, 0.756; 95%CI 0.598–0.956; P = 0.019) were independent impact factors of frailty after adjusting all the potential confounders. Participants with low CC tertile had a significantly higher Fried frailty phenotype index than those with high CC tertiles. The best CC cut-off value for predicting frailty was 29.3 cm, its sensitivity was 75.0%, and the specificity was 78.6%, and areas under the curve (AUC) was 0.786 (P < 0.001).ConclusionsCC was strongly related to frailty in diabetic adults aged over 80 years, suggesting that CC may be helpful for monitoring physical frailty in older adults in clinical and research settings.

ADAMO INDOOR MOBILITY, PHYSICAL FRAILTY, AND AUTONOMY IN OLDER ADULTS: A MEDIATION MODEL

Physical frailty represents a clinical condition among older adults leading to adverse health outcomes, such as autonomy loss. To evaluate physical frailty in older adults, adopting information and communication technologies (ICT) may be useful. ADAMO (Caretek S.r.l.) is a care-watch accelerometer that allows to measure mobility in a non-intrusive way (Magistro et al., 2018) providing wider information on individual general health (Mulasso et al., in press). The aim of this study was to evaluate the relationship between indoor mobility, physical frailty and autonomy in a sample of Italian older adults. Methods: Thirty-two volunteers (age 65–84 years; women 56.2%) participated in the study. All wore ADAMO care-watch continuously over a 7-day period. The number of steps indoor was the main endpoint. Fragmented daily mobility was estimated. Physical frailty and autonomy were measured using the Tilburg Frailty Indicator (physical components) and the Groningen Activity Restriction Scale, respectively. Results: Significant inverse correlations were observed between number of steps and autonomy, and number of steps and physical frailty. Conversely, a significant direct correlation was observed between physical frailty and autonomy. Additionally, mediation analysis demonstrated full mediation effect of physical frailty between the number of steps and autonomy. Our results imply that high indoor mobility per se can reduce physical frailty and consequently helps to maintain autonomy. Conclusions: Indoor mobility captured by ADAMO accelerometer may be an important indicator of physical frailty and autonomy. ADAMO may be used as a non-intrusive telemonitoring solution to capture relevant information on individual general health in aged people.