The Association between Frailty and Abdominal Symptoms: A Hospital-based Cross-sectional Study

Abstract

Objective The association between frailty and abdominal symptoms has not been evaluated. Methods We conducted a hospital-based, retrospective cross-sectional study of consecutive outpatients ≥65 years old at the Department of Gastroenterology, Juntendo Tokyo Koto Geriatric Medical Center from 2017 to 2019. Patients were included in the study if all of the following information was available from their medical records: patient's profile, the evaluation of osteoporosis, sarcopenia, frailty, nutritional status, findings of upper gastrointestinal endoscopy, and questionnaire results for abdominal symptoms [Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG) and Constipation Scoring System (CSS)]. We divided the subjects into frailty and non-frailty groups and investigated the risk factors for frailty. Results Of the 313 eligible study subjects [134 men (42.8%) and 179 women (57.2%); mean age, 75.7±6.0 years; mean body mass index, 22.8±3.6 kg/m 2 ], frailty was noted in 71 cases (22.7%). In a univariate analysis, an older age (p<0.001), female gender (p=0.010), successful eradication of Helicobacter pylori (p=0.049), proton pump inhibitor (PPI) use (p<0.001), laxative/prokinetics use (p=0.008), sarcopenia (p<0.001), osteoporosis (p<0.001), hypozincemia (p=0.002), hypoalbuminemia (p<0.001), low lymphocytes (p=0.004), a high CONUT score (p<0.001), a high FSSG score (p=0.001), and a high CSS score (p<0.001) were significantly associated with frailty. A multivariate logistic regression analysis showed that an older age [odds ratio (OR) 1.16; 95% confidence interval (CI) 1.08-1.24, p<0.001], PPI use (OR 2.42; 95% CI 1.18-4.98, p=0.016), sarcopenia (OR 7.35; 95% CI 3.30-16.40, p<0.001), hypozincemia (OR 0.96; 95% CI 0.92-0.99, p=0.027), a high FSSG score (OR 1.08; 95% CI 1.01-1.16, p=0.021), and a high CSS score (OR 1.13; 95% CI 1.03-1.23, p=0.007) were significantly associated with frailty. Conclusion Advanced age, PPI user, sarcopenia, hypozincemia, a high FSSG score, and high CSS score are associated with frailty.

Associations of osteoporosis and sarcopenia with frailty and multimorbidity among participants of the Hertfordshire Cohort Study

“…OP, risk of falls, and SP were reported in the I‐Lan Longitudinal Aging Study to be associated with frailty independently 37 . In a hospital‐based study, SP was strongly associated with frailty ( P < 0.001) while relationships with OP were weaker ( P = 0.055) 38 . Finally, in a retrospective study among postmenopausal patients with known OP attending a hospital bone clinic, those with a diagnosis of osteosarcopenia were more likely to be frail than those with OP alone 25 …”

“…37 In a hospital-based study, SP was strongly associated with frailty (P < 0.001) while relationships with OP were weaker (P = 0.055). 38 Finally, in a retrospective study among postmenopausal patients with known OP attending a hospital bone clinic, those with a diag-nosis of osteosarcopenia were more likely to be frail than those with OP alone. 25 As expected, frailty and pre-frailty were more prevalent in individuals over the age of 80 in both sexes.…”

The role of zinc on nutritional status, sarcopenia, and frailty in older adults: a scoping review

“…After excluding 203 articles, a total of 49 articles (including the 2 articles identified by the manual search) were included in the scoping review ( Figure 1 ). Those articles were then categorized as those in which Zn intake was assessed (n = 30), 16–29 , 31–46 serum or tissue Zn levels (n = 18), 47–64 or both (n = 1). 30 Two articles included different findings from the same study sample 54 , 64 ; these findings were reported in combination in this review ( Table 3 ).…”

“… 50 The studies were conducted primarily in Europe (n = 18), 17 , 18 , 22 , 26 , 28 , 29 , 32 , 33 , 41–43 , 46 , 48 , 51 , 56 , 58–60 15 were conducted in Asia. 23 , 24 , 27 , 30 , 35 , 36 , 38 , 39 , 45 , 47 , 49 , 57 , 61 , 63 , 64 Seven studies each were from North America 19 , 25 , 31 , 44 , 52 , 53 , 62 and Australasia, 20 , 21 , 37 , 40 , 50 , 54 , 55 and the remaining 2 studies were from Jordan 16 and Turkey. 34 …”

A Mendelian randomization analysis identifies causal association between sarcopenia and gastroesophageal reflux disease

“…We thought that the lack of collagen and the effect of inflammatory factors might play important roles in it [18][19][20]. Furthermore, the appearance of GERD symptoms limits the patient's physical activity ability [21], and abdominal symptoms affect the patient's nutritional intake to some extent [22]. Muscle wasting and insufficient nutrition could lead to a loss of skeletal muscle mass.…”