Clinical Frailty Scale and Biomarkers for Assessing Frailty in Elder Inpatients in China

Xu, Liyu; Zhang, J.; Shen, Shanshan; Liu, Z.; Zeng, Xingkun; Yang, Yinghong; Hong, Xiufang; Chen, Xujiao

doi:10.1007/s12603-020-1455-8

“…Several previous studies have reported that the elevation of plasma D-dimer level was associated with the clinical frailty scale in older patients [27] and with the development of functional disability through the subclinical activation of coagulation and inflammatory cascades [28]. Our study may also indicate the association between vascular endothelial damage due to excessive inflammation in COVID-19 patients and functional decline.…”

Section: Discussionsupporting

confidence: 62%

Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study

Hosoda

¹

,

Hamada

²

2021

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Background This study aimed to determine the frequency of functional decline and to identify the factors related to a greater risk of functional decline among hospitalized older patients with coronavirus disease 2019 (COVID-19). Methods We reviewed the medical records of patients aged over 65 years who were admitted to a tertiary care hospital for COVID-19 over 1 year from February 2020. We evaluated the proportion of functional decline, which was defined as a decrease in the Barthel Index score from before the onset of COVID-19 to discharge. Multivariable logistic regression analyses were performed to evaluate the associations between the demographic and clinical characteristics of patients at admission and a greater risk of functional decline. Two sensitivity analyses with different inclusion criteria were performed: one in patients without very severe functional decline before the onset of COVID-19 (i.e., limited to those with Barthel Index score ≥ 25), and the other with a composite outcome of functional decline and death at discharge. Results The study included 132 patients with COVID-19; of these, 72 (54.5%) developed functional decline. The severity of COVID-19 did not differ between patients with functional decline and those without (P = 0.698). Factors associated with a greater risk of functional decline included female sex (adjusted odds ratio [aOR], 3.14; 95% confidence interval [CI], 1.25 to 7.94), Barthel Index score < 100 before the onset of COVID-19 (aOR, 13.73; 95% CI, 3.29 to 57.25), and elevation of plasma D-dimer level on admission (aOR, 3.19; 95% CI, 1.12 to 9.07). The sensitivity analyses yielded similar results to those of the main analysis. Conclusions Over half of the older patients who recovered from COVID-19 developed functional decline at discharge from a tertiary care hospital in Japan. Baseline activities of daily living impairment, female sex, and elevated plasma D-dimer levels at admission were associated with a greater risk of functional decline.

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“…Although previous studies have noted that people with diabetes were more prone to frailty than those without diabetes, the reported prevalence in the diabetic population varied widely (ranging from 5% to 48%) [ 36 , 37 ]. In line with previous studies [ 38 , 39 , 40 ], our study showed that the prevalence of frailty significantly increased with age ( p < 0.001). The mean age of our sample population was 69.1 ± 9.0 years.…”

Section: Discussionsupporting

confidence: 93%

Frailty in Community-Dwelling Adults Aged 40 Years and over with Type 2 Diabetes: Association with Self-Management Behaviors

Tang

¹

,

Shen

²

,

Tong

³

et al. 2022

IJERPH

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Background: Evidence is lacking on risk factors for frailty and prefrailty and their relationship with self-management behaviors in patients ≥40 years of age with type 2 diabetes. Methods: Participants were selected as a cross-sectional cohort at five communities in Shanghai, China during January–March 2021. The modified FRAIL scale and the Summary of Diabetes Self-Care Activities (SDSCA) measure were used. Results: Of the 558 participants, 10.2% were classified as frailty and 34.1% as prefrailty. The prevalence of frailty was higher in males than in females (p = 0.009), whereas females were associated with higher odds of prefrailty (aOR 1.67, 95% CI [1.08–2.60]). Multimorbidity, ≥3 chronic diseases, and hospitalization in the past year were considered risk factors for both frailty and prefrailty. Each point earned on SDSCA and physical activity were associated with lower odds of frailty (aOR 0.95, 95% CI [0.92–0.98]) and prefrailty (aOR 0.52, 95% CI [0.31–0.85]), respectively. Frail participants performed significantly worse self-care practice than prefrail and non-frail ones, especially on diet, physical activity, and medication adherence (p < 0.001). Conclusions: Frail patients ≥40 years of age with type 2 diabetes reported poorer self-care performance. Further interventional studies are warranted to clarify their causal relationship.

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“…It includes, among others, factors like living ability, cognitive function, and disease and disability status [ 3 ]. The literature supports the fact that frail individuals have many complicating factors, some closely associated with age and inflammatory or nourishment markers [ 4 ]. How to find a way to easily predict frailty in old adults is the aim of our study.…”

Section: Introductionmentioning

confidence: 84%

Calf circumference predicts frailty in older adults: the Chinese longitudinal healthy longevity survey

Xu

¹

,

Wang

²

,

Chen

³

et al. 2022

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Background Although frailty is a common geriatric syndrome in old adults, a simple method to assess the degree of frailty in a person has not yet been established. In this study we have tried to establish the association between calf circumference (CC) and frailty among older Chinese people. Methods We used the data obtained from the 2014 edition of the Chinese Longitudinal Healthy Longevity Survey; 1216 participants aged ≥60 years were included for the study. Body mass index, CC and waist circumference measurement data, and laboratory test results were collected. Frailty status was measured using the frailty index (FI). Participants were then classified into non-frail (FI < 0.25) and frail (FI ≥ 0.25) groups. Results There were 874 participants (71.9%) in the non-frail group and 342 (28.1%) in the frail group. The CC was significantly different between the two groups (31.54 ± 4.16 versus 28.04 ± 4.53, P < 0.001). Logistic regression analysis revealed that CC (odds ratio = 0.947, 95% confidence interval: 0.904–0.993, P = 0.023) was an independent impact factor associated with frailty. The CC value of 28.5 cm was considered the best cut-off value in women with area under the curve (AUC) was 0.732 (P < 0.001) and 29.5 cm in men with AUC was 0.592 (P = 0.004);We created a simple prediction model for frailty that included age,sex and CC:$$\textrm{Logit}(P)=-9.756+0.123\ast \textrm{Age}-0.512\ast \textrm{Sex}\left(\textrm{man}=1,\textrm{woman}=0\right)-0.053\ast \textrm{CC},$$ Logit ( P ) = - 9.756 + 0.123 * Age - 0.512 * Sex man = 1 , woman = 0 - 0.053 * CC , P = elogit(P) /1 + elogit(P), and AUC is 0.849 (P < 0.001). Conclusions CC is a convenient and predictable marker of frailty in older adults.

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Clinical Frailty Scale and Biomarkers for Assessing Frailty in Elder Inpatients in China

Cited by 19 publications

References 50 publications

Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study

Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study

Frailty in Community-Dwelling Adults Aged 40 Years and over with Type 2 Diabetes: Association with Self-Management Behaviors

Calf circumference predicts frailty in older adults: the Chinese longitudinal healthy longevity survey

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