Cachexia and advanced dementia

Minaglia, C.; Giannotti, Chiara; Boccardi, Virginia; Mecocci, Patrizia; Serafini, Gianluca; Odetti, Patrizio; Monacelli, Fiammetta

doi:10.1002/jcsm.12380

Cited by 33 publications

(18 citation statements)

References 120 publications

(217 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Physical frailty and cognitive impairment often coexist and may progressively worsen with advancing age. [35][36][37][38][39] In longitudinal studies, impaired executive function and working memory were the first signs of cognitive decline presaging Alzheimer's disease, appearing earlier than short-term memory deficits. 40,41 The predementia syndrome, motoric cognitive risk syndrome, which is characterized by slow gait and cognitive impairments, 42 might be a specific phenotype of the mobility frailty subtype that manifests later on.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Subtypes of physical frailty and their long‐term outcomes: a longitudinal cohort study

Huang

Tange

Otsuka

et al. 2020

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

Background Components of physical frailty cluster into subtypes, but it remains unknown how these might be associated with age-related functional declines and multimorbidities. This study aims to investigated associations of physical frailty subtypes with functional declines and multimorbidity in a 10 year longitudinal cohort survey. Methods Complementary longitudinal cohort study used group-based multitrajectory modelling to verify whether frailty subtypes discovered in Taiwan are presented in another aging cohort, then investigated associations of these subtypes with cognitive decline and multimorbidity. Participants aged ≥50 years were recruited from the third to sixth waves (May 2002 to July 2010) of the National Institute for Longevity Sciences-Longitudinal Study of Aging, in Japan. People with incomplete data, pre-frail/frail status before their index wave, and those with incomplete data or who died during follow-up, were excluded. Group-based trajectory analysis denoted five established physical frailty criteria as time-varying binary variables in each wave during follow-up. Incident frailty was classified as mobility subtype (weakness/slowness), non-mobility subtype (weight loss/exhaustion), or low physical activity subtype. General linear modelling investigated associations of these frailty subtypes with activities of daily living, digit symbol substitution test (DSST) and Charlson Comorbidity Index (CCI) at 2 year follow-up. Results We identified four longitudinal trajectories of physical frailty, which corroborated the distinct subtypes we discovered previously. Among 940 eligible participants, 38.0% were robust, 18.4% had mobility subtype frailty, 20.7% non-mobility subtype, and 20.1% low physical activity subtype. People with mobility subtype frailty were older than those with other frailty subtypes or robust status and had higher prevalence of hypertension, diabetes, and heart failure. In the multivariableadjusted general linear models, mobility-subtype frailty was associated with a significantly lower DSST score (point estimate À2.28, P = 0.03) and higher CCI (point estimate 0.82, P < 0.01) than the other groups. Conclusions Mobility-subtype frailty was associated with functional declines and progression of multimorbidity; the longterm effects of physical frailty subtypes deserve further investigation.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Physical frailty and cognitive impairment often coexist and may progressively worsen with advancing age 35–39 . In longitudinal studies, impaired executive function and working memory were the first signs of cognitive decline presaging Alzheimer's disease, appearing earlier than short‐term memory deficits 40,41 .…”

Section: Discussionmentioning

confidence: 99%

Subtypes of physical frailty and their long‐term outcomes: a longitudinal cohort study

Huang

Tange

Otsuka

et al. 2020

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

show abstract

“…The already outdated report from the Swedish population (1990–2007) also demonstrated a substantial 77% increase in HF hospitalization rate in patients aged 85–99 years, which was consistent with demographic changes 28 . Aging and its consequences are becoming currently the challenges of contemporary societies and public health systems 31–33 . Secular trends in the age distribution in Poland are most likely responsible for the increase of HF hospitalizations in the recent decade.…”

Section: Discussionmentioning

confidence: 55%

“…28 Aging and its consequences are becoming currently the challenges of contemporary societies and public health systems. [31][32][33] Secular trends in the age distribution in Poland are most likely responsible for the increase of HF hospitalizations in the recent decade. In the pathophysiological context, frailty and multimorbidity accompanying aging clearly predispose to circulatory decompensations.…”

Section: Discussionmentioning

confidence: 99%

10 year trends in hospitalization rates due to heart failure and related in‐hospital mortality in Poland (2010–2019)

et al. 2020

View full text Add to dashboard Cite

Aims Heart failure (HF) remains a major public health challenge worldwide. Contemporary epidemiological data on HF hospitalization rates and related in-hospital mortality are scarce also in Poland. The aim of the study was to determine the trends in hospitalization rates due to HF and related in-hospital mortality in Poland in the recent decade. Methods and results Data on HF hospitalizations and in-hospital mortality in patients aged >17 years in Poland between 2010 and 2019 were obtained from the central database of the Polish National Health Fund. Hospitalizations with either primary or secondary diagnosis of HF were identified using the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes (I50, I42, J81 with extensions, and R57.0). There were 4 259 698 HF hospitalizations and 608 577 in-hospital deaths (14% in-hospital mortality) reported during 2010-2019 in Poland. During this period, there was a steady increase in the number of HF hospitalizations per 1000 inhabitants in subsequent years, being more pronounced in men than in women (in 2019: 16 and 13 HF hospitalizations per 1000 inhabitants in men and women, respectively). The relative risk of HF hospitalization was higher in men than in women, and this gender-related difference steadily increased from 9% in 2010 to 25% in 2019. During 2010-2019, there was an increase in the number of HF hospitalizations per 1000 inhabitants in subsequent age groups, with a trend being more pronounced in men than in women (129 and 99 HF hospitalizations per 1000 inhabitants in men and women aged ≥80 years, respectively). During this period, there was a slight increase in in-hospital mortality during HF hospitalization in subsequent years, being more pronounced in women than in men (in 2019: 16% and 14% of in-hospital mortality in women and men, respectively). The relative risk of in-hospital mortality during HF hospitalization was higher in women than in men, and this gender-related difference steadily increased from 8% in 2010 to 18% in 2019. During this period, in-hospital mortality during HF hospitalization was~12% for women and men aged 18-29 years, whereas the highest values of in-hospital mortality reached~19% for patients aged ≥80 years. Conclusions We have observed steady growing trends in HF hospitalization rates and related in-hospital mortality in Poland over the last decade. Both age and gender have differentiated the reported epidemiological patterns.

show abstract

“…These include: sodium level greater than 145 mmol/L on admission, weight loss greater than 10% in last year, presence of pressure ulcer at admission (from review of nursing notes and wound care team consultation), and baseline ambulatory status (from case management assessments and initial physical therapy evaluation notes). These markers were consistently reported in the EMR and have been associated with advanced dementia 16‐18 . We also recorded data on whether patients had an ICD‐9 or ICD‐10 code at discharge indicating dementia with behavioral disturbance and whether patients were diagnosed with delirium during hospitalization.…”

Section: Methodsmentioning

confidence: 97%

Characteristics and Outcomes of Dementia Patients Who Receive Inpatient Palliative Care Consultation

Sharda

Zietlow

Wong

et al. 2020

J American Geriatrics Society

View full text Add to dashboard Cite

BACKGROUND/OBJECTIVES Acute hospitalization may be an ideal opportunity to introduce palliative care to dementia patients, who may benefit from symptom management and goals of care discussions. We know little about patients who receive inpatient palliative care consultations (IPCCs). DESIGN Retrospective analysis using electronic medical record. SETTING Tertiary academic medical center and affiliated community hospital. PARTICIPANTS Patients with dementia by International Classification of Diseases diagnosis, 65 years or older, hospitalized between July 1, 2015, and December 31, 2015. MEASUREMENTS We used χ2 and t‐test/Mann‐Whitney U test to compare characteristics (living arrangement, advanced dementia markers, diagnoses of delirium and dementia with behavior disturbance, and admitting diagnosis) and outcomes (change in code status, length of stay [LOS], discharge disposition, and discharge medications for symptom management) of patients who did and did not receive IPCC. Patients were matched on sex, age, and race. RESULTS Among 927 hospitalized patients with dementia, 17% received IPCC (N = 157). Patients who received IPCC were more likely to be admitted from a nursing facility (35.7% vs 12.7%; P < .0001), experience delirium (71.3% vs 57.3%; P = .01), have behavior disturbance (23.6% vs 13.4%; P = .02), have a pressure ulcer at admission (26.1% vs 11.5%; P = .001), have hypernatremia (12.7% vs 3.2%; P = .002), and be bedbound (20.4% vs 3.2%; P < .000). Patients who received IPCC had a longer LOS (median = 5.9 vs 4.3 days; P = .004) and were more likely to be discharged to hospice (56% vs 3.1%; P < .0001). Patients with IPCC were more likely to have a discharge code status of do not attempt resuscitation (89% vs 46%). There was no significant difference in comfort medications at discharge between groups. CONCLUSIONS Patients who received IPCC had evidence of more advanced dementia. These patients were more likely to change their code status and enroll in hospice. IPCC may be useful to prioritize patient‐centered care and discuss what matters most to patients and families.

show abstract

Cachexia and advanced dementia

Cited by 33 publications

References 120 publications

Subtypes of physical frailty and their long‐term outcomes: a longitudinal cohort study

Subtypes of physical frailty and their long‐term outcomes: a longitudinal cohort study

10 year trends in hospitalization rates due to heart failure and related in‐hospital mortality in Poland (2010–2019)

Characteristics and Outcomes of Dementia Patients Who Receive Inpatient Palliative Care Consultation

Contact Info

Product

Resources

About