Predictors Of Frailty Research Articles

Long-Term Effects of Hospitalization for COVID-19 on Frailty and Quality of Life in Older Adults ≥80 Years.

Objectives: This study aimed to assess the effects of frailty and the perceived quality of life (QOL) on the long-term survival (at least 1 year) of patients ≥ 80 years hospitalized for COVID-19 and the predictors of frailty and QOL deterioration in survivors. Design: This is a single-center, prospective observational cohort study. Setting and Participants: The study was conducted in a teaching hospital and enrolled all COVID-19 patients ≥80 years old consecutively hospitalized between April 2020 and March 2021. Methods: Clinical variables assessed in the Emergency Department (ED), and during hospitalization, were evaluated for association with all-cause death at a follow-up. Frailty was assessed by the clinical frailty scale (CFS), and the QOL was assessed by the five-level EuroQol EQ-5d tool. Multivariate Cox regression analyses and logistic regression analyses were used to identify independent factors for poor outcomes. Results: A total of 368 patients aged ≥80 years survived the index hospitalization (age 85 years [interquartile range 82–89]; males 163 (44.3%)). Compared to non-frail patients (CFS 1–3), patients with CFS 4–6 and patients with CFS 7–9 had an increased risk of death (hazard ratio 6.75 [1.51, 30.2] and HR 3.55 [2.20, 5.78], respectively). In patients alive at the 1-year follow-up, the baseline QOL was an independent predictor of an increase in frailty (OR 1.12 [1.01, 1.24]). Male sex was associated with lower odds of QOL worsening (OR 0.61 [0.35, 1.07]). Conclusions and Implications: In older adults ≥80 years hospitalized for COVID-19, the frailty assessment by the CFS could effectively stratify the risk of long-term death after discharge. In survivors, the hospitalization could produce a long-term worsening in frailty, particularly in patients with a pre-existing reduced baseline QOL. A long-term reduction in the perceived QOL is frequent in ≥80 survivors, and the effect appears more pronounced in female patients.

The Role of Traditional Obesity Parameters in Predicting Frailty among Coronary Artery Disease Patients Undergoing Cardiac Catheterization.

Background Obesity has been reported to be associated with frailty and coronary artery disease (CAD). Objective The present study aimed to investigate the role of the seven traditional obesity parameters body mass index (BMI), waist-height ratio (WHtR), waist-hip ratio (WHR), body adiposity index (BAI), body shape index (BSI), waist circumference (WC), and hip circumference (HC) in the prediction of frailty among CAD patients undergoing cardiac catheterization. Design A secondary data analysis was conducted. Setting. Three main hospitals were located at the northern and middle regions of Jordan. Participants. 220 hospitalized patients undergoing cardiac catheterization were recruited. Measurements. The traditional obesity parameters were measured using an anthropometric tape and weight scale and frailty was measured using the Tilburg Frailty Indicator (TFI). Data were analyzed using bivariate Pearson's correlation and forward linear regression analysis. Results Total cholesterol, HC, triglycerides, age, random blood sugar, and WC had significant positive associations with and were predictors of frailty (p < 0.05). The model of the seven predictors explained 32.4% of the variance in frailty (p = 0.02). Conclusion The incidence of frailty can be predicted by the increase in total cholesterol, HC, triglycerides, age, random blood sugar, and WC. The results of this study may help healthcare providers, including nurses, to identify the factors that could lead to frailty among CAD patients undergoing cardiac catheterization.

Frailty syndrome among older adults after hospitalization: A structural equation modeling analysis

AimTo analyze the association of demographic, clinical, health and functional capacity variables as predictors of frailty in older adults after one year of hospital discharge. BackgroundThere is still insufficient research with older persons after hospital discharge that evaluated the predictive variables for an increase in the frailty score. Identifying the characteristics that result in greater risk helps to guide care and interventions. MethodsLongitudinal study involving 129 older adults who completed the follow-up. The Frailty Phenotype was used according to Fried and sociodemographic, clinical, health and functional capacity variables. Analysis was performed using structural equation modeling. ResultsAt admission, the highest percentage (53.4%) of older adults were pre-frail, followed by frail (23.3%) and non-frail (23.3%). After a year of discharge, there was a decrease in the frail condition (22.5%) and pre-frail (52.7%); and an increase in non-frail (24.8%). At baseline, 29.5% showed impairment in only one component, with an increase in the percentage at follow-up (37.2%). The highest number of morbidities and hospital readmissions and lower IADL scores were predictors of an increase in the frailty score during follow-up. ConclusionThe prevalence of frailty was high among hospitalized older adults and after follow-up. Identifying the risk factors allows early and individualized interventions with reduction of negative outcomes. During hospitalization, a multidimensional assessment of older adults should be performed, especially with regard to frailty. The recognition of frailty predictors directs the care of older persons considering their individual needs and allows the improvement and/or stability of the frailty condition.

AB110. SOH22ABS195. Sarcopenia is an important predictor of frailty in patients awaiting liver transplant

AB110. SOH22ABS195. Sarcopenia is an important predictor of frailty in patients awaiting liver transplant

Abstract 65: Composite Biomarkers Could Assess Frailty Status In Stable Older Adults With Cardiovascular Disease

Background: The relationship between frailty status and laboratory measurements in cardiovascular disease (CVD) remains unclear. We investigated which laboratory measurements indicated frailty in stable older CVD patients. Methods: One-hundred thirty-eight stable older CVD patients were evaluated by laboratory measurements and frailty as assessed by the Kihon Checklist (KCL). We compared laboratory measurements between frail and non-frail groups. Results: Mean age was 81.7 years, mean left ventricular ejection fraction was 57.8%, and mean plasma brain natriuretic peptide content was 182 pg/mL. Patients were allocated to non-frail ( n = 43) and frail ( n = 95) groups on the basis of KCL score. Serum iron was significantly lower in the frail group (frail, 61.2 ± 30.3 μg/dL; non-frail, 89.5 ± 26.1 μg/dL; P &lt; 0.001). Blood urea nitrogen (BUN) and C-reactive protein (CRP) were significantly higher in the frail group (frail, 27.3 ± 16.5 mg/dL, non-frail, 19.7 ± 8.2 mg/dL; P = 0.013; frail, 1.05 ± 1.99 mg/dL, non-frail, 0.15 ± 0.21 mg/dL; P = 0.004, respectively). Multivariate analysis revealed that serum iron, CRP and BUN were significant independent frailty predictors (β = –0.069, 0.917, and 0.086, respectively). Conclusions: Frailty status was significantly associated with iron, CRP, and BUN in stable older CVD patients. Composite biomarkers (inflammation, iron deficiency, and renal perfusion) may be useful for assessing frailty in these patients.

The association between frailty and dignity in community-dwelling older people

BackgroundThe population of people aged 60 and older is rapidly increasing in developing countries such as Iran due to declining birth rates and increased life expectancy. Old age is associated with increased risk for frailty and reduced dignity. Frailty is a clinical syndrome characterized by depletion of physical reserves and multiple system disorders, reducing the individual’s ability to cope with stressful events. Dignity is an inherent characteristic of human beings and respecting dignity is an ethical principle. This study investigated the association of frailty with dignity among older people in Tehran, Iran.MethodsThis correlational study was conducted on 200 individuals aged 60 years and older. Data collection relied on the Demographic Questionnaire, Frailty Index for Elders (FIFE) and the Patient Dignity Inventory (PDI). Data were analyzed with SPSS 25.ResultsThe mean age of the participants was 68 ± 5.05 years; 62% of the participants were at risk for frailty, and 69% had few dignity-related problems. The multiple regression results showed that frailty was significantly associated with dignity (ß = 0.571, p < 0.001). The association was significant across all the dimensions of dignity measured by the PDI. The highest predictors of frailty included dependency (ß = 0.584, p < 0.001), followed by existential distress (ß = 0.560, p < 0.001), symptom distress (ß = 0.400, p = 0.400), social support (ß = 0.391, p < 0.001), and peace of mind (ß = 0.338, p < 0.001) in dignity.ConclusionsThe results show that higher levels of frailty in older people are associated with decreases in their dignity, and frailty was the leading predictor of dignity. Providers should develop programs to prevent and reduce frailty in those at risk and to enhance the dignity of the already frail.

Association of Frailty Status and Dietary Patterns in a Nationally Representative Sample of United States Adults with Olfactory Dysfunction.

Background: Olfactory dysfunction (OD) is a strong, independent predictor of frailty and mortality risk. This study evaluated the association of dietary patterns and frailty status in older adults with OD. Methods: This cross-sectional study utilized the 2013–2014 National Health and Nutrition Examination Survey. Dietary patterns (DPs) characteristic of OD were derived using exploratory factor analysis (EFA). Multiple logistic regressions adjusted for demographics and frailty risk factors assessed the association of DPs with two frailty metrics: the frailty index (FI) and physical frailty (PF). Results: EFA yielded six distinct DPs in persons with OD. The protein/selenium (OR 0.82 [95% CI 0.74–0.92], p = 0.041) and β-carotene/vitamin A DPs (OR 0.76 [95% CI 0.66–0.88], p = 0.028) were independently associated with frailty by FI. Only the protein/selenium DP (OR 0.82 [95% CI 0.74–0.92], p = 0.036) was associated with frailty by PF. No DPs were associated with either frailty measure in normosmic persons. Conclusions: Dietary patterns high in protein/selenium and β-carotene/vitamin A are associated with lower frailty prevalence in adults with OD. While the relationship between OD and frailty is likely multifaceted, these findings suggest that dietary patterns are uniquely associated with frailty in older adults with OD.

384 - Prevalence and Predictors of Frailty in Patients with Chronic Graft-Versus-Host Disease

384 - Prevalence and Predictors of Frailty in Patients with Chronic Graft-Versus-Host Disease

DNA methylation is associated with muscle loss in community-dwelling older men -the Yakumo study- : a preliminary experimental study.

ABSTRACTFrailty is a state of reduced muscle strength and activity in older people. DNA methylation is associated with osteoporosis and muscle loss in murine and other animal studies, but there are no epidemiological studies in humans. This study aimed to assess the association of osteoporosis and muscle loss with DNA methylation in community-dwelling older people. This cross-sectional study was performed in a rural part of Japan. We analyzed 204 subjects (98 men and 106 women). In univariate analysis, the two groups were compared according to the presence or absence of osteoporosis and of muscle loss. Logistic regression analysis was performed to determine predictors of frailty in the muscle loss group. We used age, sex, body mass index, smoking history, drinking history, serum albumin and C-reactive protein levels, diabetes, hypertension, hyperlipidemia, heart disease history, and LINE-1 DNA methylation as the factors. Probability values < 0.05 were considered to be statistically significant. The levels of LINE-1 DNA methylation in leukocytes were associated with muscle loss in men over the age of 60. LINE-1 DNA methylation levels were not associated with bone mineral density in either the men or women over the age of 60. LINE-1 DNA methylation levels in leukocytes correlated significantly with the risk of frailty in men over the age of 60. Promoting an understanding of DNA methylation may lead to a better understanding of the pathophysiology of muscle loss.

Use of Single-Item Self-Rated Health Measure to Identify Frailty and Geriatric Assessment-Identified Impairments Among Older Adults with Cancer.

BackgroundPoor self-rated health (SRH) is a known predictor of frailty and mortality in the general population; however, its role among older adults with cancer is unknown. We evaluated the role of SRH as a potential screening tool to identify frailty and geriatric assessment (GA)-identified impairments.Materials and MethodsAdults ≥60 years diagnosed with cancer in the UAB Cancer & Aging Resilience Evaluation (CARE) registry underwent a GA at the time of initial consultation. We measured SRH using a single-item from the Patient-Reported Outcomes Measurement Information System global health scale and dichotomized responses as poor (poor, fair) and good (good, very good, and excellent). We evaluated the diagnostic performance of SRH in measuring frailty, and GA impairment (≥2 deficits among a set of seven GA domains). We examined the impact of SRH with survival using a Cox model adjusting for confounders, exploring the mediating role of frailty.ResultsSix hundred and three older adults with cancer were included, with a median age of 69 years. Overall, 45% (n = 274) reported poor SRH. Poor SRH demonstrated high sensitivity and specificity for identifying frailty (85% and 78%, respectively) and GA impairment (75% and 78%, respectively). In a Cox regression model, poor SRH was associated with inferior survival (HR = 2.26; 95% CI 1.60-3.18) after adjusting for confounders; frailty mediated 69% of this observed relationship.ConclusionSelf-rated health may be used as a screening tool to identify older adults with cancer with frailty and GA impairments. Poor SRH is associated with inferior survival, which is mediated by frailty.

Oral Factors as Predictors of Frailty in Community-Dwelling Older People: A Prospective Cohort Study.

The purpose of this prospective cohort study was to identify predictors for frailty among possible oral factors in community-dwelling older people. Ninety-seven participants (≥60 years old) without frailty at baseline were included and assigned to either the robust or the frailty group after 2-year follow-up. The frailty was defined using the Japan Cardiovascular Health Study index. The numbers of present and functional teeth and periodontal disease severity were recorded. Bacterial counts on the dorsum of the tongue, oral moisture, tongue pressure, occlusal force, masticatory ability, and the oral diadochokinesis (ODK) rate were measured. Swallowing function, along with psychosocial status, relationships with communities and people, nutritional status, medical history, and comorbidities were evaluated using a questionnaire. The newly identified frailty group at follow-up showed significantly lower values in the number of teeth present, ODK/ta/sound and ODK/ka/sound rates, and clinical attachment level at baseline compared to the robust group. A logistic regression model showed a significantly negative association between the ODK/ta/sound rate at baseline and the incidence of frailty. Articulatory oral motor skill was found to be a predictor of frailty after two years.

Predictors of frailty in older people users of Primary Health Care.

to identify the prevalence and predictors of frailty in older people in Primary Health Care. this is a descriptive and correlational study, carried out in a convenience sample of 136 older people in the community. Data were collected through a sociodemographic and clinical questionnaire and frailty phenotype. Student's t test or U-Mann-Whitney test, chi-square and binary logistic regression were used for data analysis. the prevalence of frailty was 26.5% (n=36). Frail individuals had older age (p=0.011), worse self-rated health (p=0.001) and lower physical capacity (p<0.001). In the multivariable regression, it was observed that frail individuals had older age (Odds Ratio=1.111; 95% confidence interval=1.026-1.203) and worse physical capacity (Odds Ratio=0.673; 95% confidence interval=0.508-0.893). the prevalence of frailty in older people in Primary Health Care was considerable. Advanced age and worse physical capacity were the most relevant predictors of frailty in the elderly.

Frequency and risk factors of frailty in nondialyzable chronic kidney disease geriatric patients

Background Frailty is an additional clinical and economic burden in the setting of chronic kidney disease (CKD). In this study, we aimed to determine the frequency and the risk factors for the occurrence of frailty in nondialyzable CKD geriatric patients' (stages 3–4). Patients and methods We conducted a cross-sectional, analytical study, which included consecutive patients with CKD, who attended the Nephrology Unit of Assiut University Hospital from April 2017 to April 2020. The total number of cases is 77 (21 of the control group and 56 of the patient group). Geriatric patients with aged more than or equal to 60 years and CKD stages 3–4 nondialysis dependent patients were included. The patients will be followed-up for 1 year. Results In terms of the frequency of frailty in geriatric CKD patients, the present study showed that 14.3% of the nondialyzable geriatric CKD patients had frailty. Regarding the predictors of frailty, the present study showed that nondialysis patients with frailty had significantly lower hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, platelet count, lymphocyte count, monocyte count, higher blood urea, higher serum creatinine, and higher basophil count. Notably, a lower serum magnesium level was noticed in the frail group. Conclusion In conclusion, frailty is not common in geriatric nondialysis dependent CKD patients. Independent risk factors for frailty in CKD include low serum magnesium and high serum creatinine.

The Role of Obesity in Frailty Incidence: The San Antonio Longitudinal Study of Aging

Background: Although initially conceptualized as a wasting syndrome, obesity has been associated with frailty in prior studies. The goal of this study was to examine the associations of obesity and waist circumference with frailty and determine whether they predict incident frailty in an ethnically diverse population of older Mexican Americans (MAs) and European Americans (EAs). Methods: 749 MA and EA community-dwelling older adults (65+) participated in the baseline examination of the San Antonio Longitudinal Study of Aging (SALSA), and 474 participants completed the first follow up approximately 6 years later. Frailty was classified using Fried criteria. Baseline characteristics, including body mass index (BMI) and waist circumference (WC) were summarized by frailty category (non-frail, pre-frail, frail) using ANOVA. The odds of becoming frail at follow-up by baseline BMI and WC were estimated using separate logistic regression models, adjusting for age, sex, ethnicity, diabetes, comorbidity (presence of ≥2 chronic diseases not including diabetes), baseline frailty score, and follow-up time. Results: At baseline, participants were 69 ±3 years old, 61% female, and 50% MA. BMI and WC increased with increasing frailty category (p <0.01 for both). BMI was a significant predictor of incident frailty (OR=1.08, 95% confidence interval [CI]: 1.02-1.14, p=0.011). WC also predicted frailty (OR=1.03, 95% CI: 1.01-1.05, p =0.017). Conclusion: These results demonstrate that BMI and WC are significant predictors of frailty. Interventions which target obesity may reduce the incidence of frailty; however, more research in this area is needed.

Accuracy and Diversity of Wearable Device-Based Gait Speed Measurement Among Older Men: Observational Study.

BackgroundGait speed measurements are widely used in clinical practice, as slow gait is a major predictor of frailty and a diagnostic criterion for sarcopenia. With the development of wearable devices, it is possible to estimate the gait speed in daily life by simply wearing the device.ObjectiveThis study aims to accurately determine the characteristics of daily life gait speed and analyze their association with sarcopenia.MethodsWe invited community-dwelling men aged >50 years who had visited the outpatient clinic at a tertiary university hospital to participate in the study. Daily life gait speed was assessed using a wearable smart belt (WELT) for a period of 4 weeks. Data from participants who wore the smart belt for at least 10 days during this period were included. After 4 weeks, data from a survey about medical and social history, usual gait speed measurements, handgrip strength measurements, and dual-energy x-ray absorptiometry were analyzed.ResultsA total of 217,578 daily life gait speed measurements from 106 participants (mean age 71.1, SD 7.6 years) were analyzed. The mean daily life gait speed was 1.23 (SD 0.26) m/s. The daily life gait speed of the participants varied according to the time of the day and day of the week. Daily life gait speed significantly slowed down with age (P<.001). Participants with sarcopenia had significantly lower mean daily life gait speed (mean 1.12, SD 0.11 m/s) than participants without sarcopenia (mean 1.23, SD 0.08 m/s; P<.001). Analysis of factors related to mean daily life gait speed showed that age and skeletal muscle mass of the lower limbs were significantly associated characteristics.ConclusionsMore diverse and accurate information about gait speed can be obtained by measuring daily life gait speed using a wearable device over an appropriate period, compared with one-time measurements performed in a laboratory setting. Importantly, in addition to age, daily life gait speed is significantly associated with skeletal muscle mass of the lower limbs.

Vision Impairment and Frailty among Older Mexican Americans: Findings from the Hispanic Established Population Epidemiologic Study of the Elderly

<h3>Research Objectives</h3> To examine distant vision impairment (DVI) as predictor of frailty among non-frail Mexican American older adults overtime. <h3>Design</h3> Longitudinal survey of 14 years follow-up. <h3>Setting</h3> Community setting. <h3>Participants</h3> 1,100 non-institutionalized Mexican Americans aged 70 years and older from the Hispanic Established Population Epidemiologic Study of the Elderly (1998-2013) residing in Arizona, California, Colorado, New Mexico, and Texas. At the end of follow-up, 292 participants were re-interviewed in person, 119 were lost to follow-up, and 689 were confirmed dead through the National Death Index and report from relatives. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Frailty was defined as meeting three or more of the following: unintentional weight loss of >10 pounds, weakness, self-reported exhaustion, low physical activity, and slow walking speed. Covariates included socio-demographics, comorbidities, body mass index, and depressive symptoms. Self-reported DVI was defined as difficulty in recognizing a friend across the street or across the room. General estimating equation models were performed to estimate the odds ratios of the frailty over time as a function of self-reported DVI. <h3>Results</h3> Non-frail participants with DVI at baseline were more likely to be older (mean 78.63 ± SD 5.85), have decreased MMSE score (mean 20.80 ± SD 4.97), and reported more comorbidities than those without DVI. Over time participants with DVI had increased odds ratio of frailty (OR=2.05, CI=1.36-3.09) than those without DVI after controlling for all covariates. <h3>Conclusions</h3> This study fills a research gap that currently exists with DVI and frailty among Older Mexican Americans. Knowledge gained from this study will increase awareness among policy makers and health care providers related to vision health disparities. <h3>Author(s) Disclosures</h3> None.

Symptoms Based on Deficiency Syndrome in Traditional Chinese Medicine Might Be Predictor of Frailty in Elderly Community Dwellers.

Background The most widely used frailty phenotype and frailty indexes are either time-consuming or complicated, thus restricting their generalization in clinical practice; and therefore, an easier and faster screening tool is needed to be developed. Objective To select sensitive symptoms in traditional Chinese medicine (TCM) and study whether they can improve the risk prediction of frailty. Methods This is a cross-sectional study enrolling 2249 Chinese elderly community dwellers. Data were collected via face-to-face inquiries, anthropometric measurements, laboratory tests, and community health files. Frailty was the main outcome measure, and it was evaluated by Fried's frailty phenotype (FP). The ordinal logistic regression model was used to identify the factors associated with frailty. The risk assessment plot was used to compare the discriminative ability for frailty among models with and without TCM symptoms. Results The identified sensitive influential factors for frailty included age, education level, dietary habits, chronic obstructive pulmonary disease, diabetes, cerebral infarction, osteoporosis, cold limbs, lethargy and laziness in speaking and moving, weakness of lower limbs, slow movement, dry mouth and throat, and glazed expression. The risk prediction for “frailty cumulative components ≥1” was not significantly increased, while for “frailty cumulative components ≥2”, a new model developed with the above selected TCM symptoms had a higher AUC than the baseline model without it (0.79 VS 0.81, P=0.002). And the NRI and IDI for the new model were 41.4% (P=0.016) and 0.024% (P=0.041), respectively. Conclusion This research might provide an easier and faster way for early identification and risk prediction of frailty in elderly community dwellers.

Multimorbidity networks associated with frailty among middle-aged and older people with HIV.

People with HIV (PWH) have increased prevalence of multimorbidity and frailty at younger ages compared with the general population. This study investigated individual and combinatorial effects of neuropsychiatric and medical comorbidities as predictors of frailty in PWH. Analysis of data from the National NeuroAIDS Tissue Consortium, a longitudinal observational cohort. Five hundred and twenty-four PWH over age 40 years were classified using Fried's Frailty criteria. Twelve comorbidities were documented from longitudinal data and associations between individual and co-occurring comorbidities with frailty were assessed using weighted network and logistic regression analyses. At frailty assessment between 2015 and 2020, median age was 61 years, 76% were men, 94% were on antiretroviral therapy (ART), 73% had two or more comorbidities, 24% were frail, and 52% were prefrail. Among individual comorbidities, highest odds of frailty were in participants with depressive symptoms [adjusted odds ratio (aOR), 95% confidence interval (CI) 3.48 (2.22-5.46)], followed by bone disease and chronic obstructive pulmonary disease (COPD) [2.47 (1.28-4.72) and 2.13 (1.36-3.34), respectively]. Among co-occurring comorbidities, highest odds of frailty were in participants having depressive symptoms with diabetes, hypertension, or obesity [aORs (95% CIs) 5.29 (2.32-12.08), 5.21 (2.65-10.40), 4.85 (2.39-9.95), respectively], cognitive impairment with diabetes or renal disease [2.81 (1.38-5.68) and 2.53 (1.26-5.03), respectively], renal disease with cardiovascular disease [2.81 (1.32-6.01)], and diabetes with obesity [2.76 (1.39-5.45)]. Co-occurrence of depressive symptoms, cognitive impairment, diabetes, or renal disease with other medical conditions substantially increases odds of frailty in older PWH. Identifying and treating these comorbidities may help to reduce functional decline with aging in PWH.

Non-use of information and communication technology as a predictor of frailty in postmenopausal midlife and older women

BackgroundFrailty is a clinically discernible state in which decreased physiological reserve and function result in a reduced ability to cope with stressors. Information and communication technology (ICT) has been proposed as an aid to help with frailty, yet the use of ICT by older people, particularly women, is an understudied area. AimTo analyze the association between use of ICT (specifically internet functions and social media) and frailty status in postmenopausal midlife and elderly women. MethodsA cross-sectional study was designed to investigate whether frailty status is related to ICT use in postmenopausal midlife and older women. Community-dwelling women attending primary health care centers for health checks were invited to participate in the study. Postmenopausal status was the only inclusion criterion, whereas limitations that could interfere with use of ICT were exclusion criteria. The Fried phenotype was used to assess frailty. Four types of ICT use were examined: the internet for e-mail, the internet for other functions, and social media (WhatsApp or Facebook). Chi-square test and multivariate multinomial regression analysis were used to examine the association between frailty status and ICT use. ResultsWe included 409 women (age = 67.45 ± 7.81 years, mean ± SD), who were frail (n = 135, 33.01%), pre-frail (n = 159, 38.87%), or robust (n = 115, 28.11%). Frailty status was significantly and inversely associated with any ICT use, showing a strong association with use of WhatsApp (P < 0.001) and internet searches (P < 0.001). ICT non-use was a predictor of frailty, while ICT users were more likely to be robust (OR 10.62; 95% [CI], 5.34–21.10) or pre-frail (OR 9.03; [CI], 95% 5.18–15.74). ConclusionPostmenopausal midlife and older women not using ICT were more likely to be frail.

Nutritional risk assessed by the Malnutrition Universal Screening Tool as a predictor of frailty in acutely hospitalised older patients: An observational study.

Frailty and malnutrition are overlapping geriatric syndromes and leads to poor clinical outcomes in older patients. This study determined whether Malnutrition Universal Screening Tool (MUST) can predict frailty in older hospitalised patients. This prospective study recruited 243 patients ≥65 years in a tertiary-teaching hospital in Australia. Frailty assessment was performed by use of the Edmonton-Frail-Scale (EFS), while malnutrition-risk was determined by use of the MUST. Patients with an EFS score >8 were classified as frail, while patients with a MUST score of 1 as at moderate malnutritionrisk and ≥2 as at high malnutrition-risk. Multivariable logistic regression determined whether malnutrition-risk predicts frailty after adjustment for various co-variates. The mean (SD) age was 83.9 (6.5) years) and 126 (51.9%) were females. One-hundred and forty-nine (61.3%) patients were classified as frail, while 66 (27.2%) were found to be at high malnutrition-risk according to the MUST. Frail patients were more likely to be older with a higher Charlson-index and on polypharmacy than non-frail patients. Patients who were at high malnutrition- risk were more likely to be living alone and on vitamin D supplementation than those at low malnutritionrisk. Patients who were at a high malnutrition-risk but not those who were at moderate malnutrition-risk, were more likely to be deemed frail (aOR 2.6, 95% CI 1.2-5.5, p=0.015) when compared to those who were at low malnutrition-risk. Only patients who were classified as at high malnutrition-risk according to the MUST are more likely to be deemed frail.