Frailty and comorbidity are meaningful and complementary associated with increased hospital healthcare resources use, and related costs.

Objectives:To determine the association between functional assessment instruments and frailty.Design:Concurrent cohort study. Setting:Albacete Health Area (Spain). Participants:993 subjects aged ≥ 70years, participating in the FRADEA Study. Measurements:The following functional instruments were applied:Barthel index, Lawton index and Short Form-Late Life Function and Disability Instrument (SF-LLFDI) asdisability questionnaires; Holden ́s Functional Ambulation Classification (FAC) as ambulation scale, and sevenperformance tests: gait speed (m/s), Timed up and go (TUG) (sec), unipodal balance time (sec), 5-chair-sit-to-stand test (sec), Short Physical Performance Battery (SPPB), hand grip strength (kg) and elbow flexion strength(kg). Frailty was assessed by Fried ́s criteria. The association between functional instruments and frailty wasassessed, ROC curves were constructed and the area under the curves (AUC) calculated. The best cut-point wasidentified for each instrument and their sensitivity (S) and specificity (SP) are described. Results:16.9%participants were frail. The AUC, best cut-point, S and SP for each instrument were respectively: Barthel (0.916;≤ 85; 0.90, 0.82), Lawton (0.917; ≤ 3; 0.86, 0.93), SF-LLFDI (0.948; ≤ 90; 0.87, 0.91), FAC (0.885; ≤ 4; 0.81,0.83), gait speed (0.938; ≤ 0.62; 0.90, 0.90), TUG (0.984; ≥ 17.8; 0.93, 0.98), unipodal balance time (0.753; ≤ 5;0.73, 0.71), 5-chair-sit-to-stand test (0.880; ≥ 15; 0.78, 0.76), SPPB (0.956; ≤ 6; 0.88, 0.88), hand grip strength(0.807; ≤ 26; 0.75, 0.75) and elbow flexion strength (0.924; ≤ 15; 0.89, 0.87). Conclusion:The best performancetests to identify frail subjects are the Timed Up and Go test, gait speed and the SPPB, and the best questionnaireis the SF-LLFDI.

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Objetivo Analizar si la presencia de anemia incrementa el riesgo de mortalidad a largo plazo asociado al estado de fragilidad y discapacidad en adultos mayores. Diseño Subestudio de la cohorte concurrente de base poblacional FRADEA (Fragilidad y Dependencia en Albacete), con 10 años de seguimiento (2007-2017), en mayores de 69 años. Emplazamiento Albacete capital, España. Participantes De los 993 participantes incluidos en la primera oleada se seleccionaron 790 sujetos con datos válidos de función (fragilidad y discapacidad), anemia y estado vital a los 10 años. Mediciones principales La anemia se definió según los criterios de la Organización Mundial de la Salud (hemoglobina < 13 g/dl en hombres y < 12 g/dl en mujeres). Se creó la variable «clasificación funcional» incluyendo fragilidad y discapacidad, e identificando cuatro niveles progresivos: robusto, prefrágil, frágil y con discapacidad en actividades básicas de la vida diaria, empleando el fenotipo de fragilidad e índice de Barthel, respectivamente. Se construyó una nueva variable de ocho categorías combinando las cuatro funcionales con la presencia o ausencia de anemia. La asociación con mortalidad se determinó mediante Kaplan-Meier y análisis de riesgos proporcionales de Cox ajustado por edad, sexo, comorbilidad, polifarmacia, institucionalización y creatinina. Resultados Edad media 79 años, siendo el 59,6% mujeres. Un total de 393 participantes (49,7%) fallecieron durante el periodo de seguimiento. La mediana de supervivencia fue de 98,4 meses (rango intercuartil 61). El riesgo de mortalidad aumentó desde los niveles con mejor clasificación funcional hasta aquellos con peor, y para cada subgrupo fue mayor en los participantes con anemia. Prefrágiles sin anemia hazard ratio (HR): 1,59, IC 95%: 1,07-2,36, y con anemia HR: 2,37, IC 95%: 1,38-4,05. Frágiles sin anemia HR: 3,18, IC 95%: 1,68-6,02, y con anemia HR: 4,42, IC 95%: 1,99-9,84. Discapacitados sin anemia HR: 3,81, IC 95%: 2,45-5,84, y con anemia HR: 5,48, IC 95%: 3,43-8,76. Conclusión La anemia incrementa el riesgo de mortalidad asociado a la fragilidad y discapacidad en adultos mayores.

Background: there is no consensus on how to optimally use diagnostic tests in each stage of COVID-19 pandemic. The objective of this research is to determine the efficiency of sorting positive antibody test quarterly. Methods: this research uses a retrospective, observational study. COVID-19 diagnostic tests performed and avoided refer to a Spanish nursing home. Population: 261 employees and 107 residents. A quarterly antibody test was performed on subjects who had tested positive during the first wave of coronavirus, and a antibody rapid test on the remaining subjects. Results: during the first wave, 24.0% of the employees and 51.4% of the residents had a positive antibody test. Seronegativization was observed in 7.6% of employees and 1.6% of residents. An employee was infected with COVID-19 in September 2020, followed by a nursing home outbreak in October: 118 Polymerase Chain Reactions tests were avoided in residents and 18 in employees, which in turn prevented 15 workers from going on sick leave and the quarantine of 59 residents. This represents savings of about $15,000. Conclusions: our study supports the need to know and apply the strategies for early detection, surveillance and control of COVID-19 for future outbreaks. We conclude that surveillance for positive COVID-19 serology among long-term care staff and residents may be a cost-effective strategy during a pandemic.