Self-reported Exhaustion, Physical Activity, and Grip Strength Predict Frailty Transitions in Older Outpatients with Chronic Diseases

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Jun 8

PMID 29879035

Citations 7

Authors

Yu-Ching Pao

Chin-Ying Chen

Ching-I Chang

Ching-Yu Chen

Jaw-Shiun Tsai

Affiliations

Soon will be listed here.

Abstract

Effective screening instruments are necessary for evaluating the outcomes of early interventions for the prevention or delay of disability in older persons. This study examined how transitions in frailty items over 1 year and the baseline components of a comprehensive geriatric assessment were associated with improvements in frailty at a 2-year follow-up in a sample of older patients.This was a single-center prospective observational study of older patients aged 65 years and over with chronic diseases (n = 103), who were followed through a hospital-based program over 2 years. Frailty was evaluated via the modified Fried Frailty Index and a comprehensive geriatric assessment.We noted significant improvements in weight loss (P = .016) and self-reported exhaustion (P = .006), and a less decrease in grip strength (P = .009) at the 1-year follow-up. Furthermore, baseline cerebral vascular accident diagnosis (P = .022), high polypharmacy (P = .037), a higher Geriatric Depression Scale score (P = .033), and a lower Mini Nutritional Assessment score (P = .039) were significantly associated with improved frailty at the 2-year follow-up. Furthermore, improvement in self-reported exhaustion (odds ratio [OR]: 4.7, 1.4-16.1, P = .014) and physical activity (OR: 3.8, 1.0-13.7, P = .046), and a less decrease in grip strength (OR: 4.0, 1.3-12.5, P = .017) at the 1-year follow-up were significantly associated with improved frailty at the 2-year follow-up.Self-reported exhaustion, physical activity, and grip strength are easy, quick, and feasible screening tests for improvements in frailty in clinical practice.

Citing Articles

Effects of oral oligopeptide preparation and exercise intervention in older people with sarcopenia: a randomized controlled trial.

Liao X, Cheng D, Li J, Zhu L, Zhang S, Jing X BMC Geriatr. 2024; 24(1):260.

PMID: 38500043 PMC: 10946144. DOI: 10.1186/s12877-024-04860-2.

Malnutrition as a major related factor of frailty among older adults residing in long-term care facilities in Korea.

Moon S, Oh E, Chung D, Choi R, Hong G PLoS One. 2023; 18(4):e0283596.

PMID: 37027397 PMC: 10081797. DOI: 10.1371/journal.pone.0283596.

Dietary Problems Are Associated with Frailty Status in Older People with Fewer Teeth in Japan.

Miyano T, Kaneko R, Kimura T, Maruoka M, Kishimura A, Kato K Int J Environ Res Public Health. 2022; 19(23).

PMID: 36498332 PMC: 9738370. DOI: 10.3390/ijerph192316260.

The Influence of Interpersonal Behaviors and Population Density on Grip Strength of Elderly People: An Analysis of the Direct vs. Indirect Effects via Social Participation.

Lin H, Ren H Front Public Health. 2021; 9:755695.

PMID: 34957015 PMC: 8702431. DOI: 10.3389/fpubh.2021.755695.

Effects of Exergames and Protein Supplementation on Body Composition and Musculoskeletal Function of Prefrail Community-Dwelling Older Women: A Randomized, Controlled Clinical Trial.

Biesek S, Vojciechowski A, Filho J, Menezes Ferreira A, Borba V, Rabito E Int J Environ Res Public Health. 2021; 18(17).

PMID: 34501915 PMC: 8430494. DOI: 10.3390/ijerph18179324.

References

MAHONEY F, BARTHEL D . FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Md State Med J. 1965; 14:61-5. View

Gill T, Baker D, Gottschalk M, Peduzzi P, Allore H, Byers A . A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med. 2002; 347(14):1068-74. DOI: 10.1056/NEJMoa020423. View

Vellas B, Villars H, Abellan G, Soto M, Rolland Y, Guigoz Y . Overview of the MNA--Its history and challenges. J Nutr Health Aging. 2006; 10(6):456-63. View

Guigoz Y, Lauque S, Vellas B . Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med. 2003; 18(4):737-57. DOI: 10.1016/s0749-0690(02)00059-9. View

Lawton M, Brody E . Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3):179-86. View

Gillespie L, Robertson M, Gillespie W, Sherrington C, Gates S, Clemson L . Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012; (9):CD007146. PMC: 8095069. DOI: 10.1002/14651858.CD007146.pub3. View

Norman K, Stobaus N, Gonzalez M, Schulzke J, Pirlich M . Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr. 2010; 30(2):135-42. DOI: 10.1016/j.clnu.2010.09.010. View

Leong D, Teo K, Rangarajan S, Lopez-Jaramillo P, Avezum Jr A, Orlandini A . Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015; 386(9990):266-73. DOI: 10.1016/S0140-6736(14)62000-6. View

de Craen A, Heeren T, Gussekloo J . Accuracy of the 15-item geriatric depression scale (GDS-15) in a community sample of the oldest old. Int J Geriatr Psychiatry. 2002; 18(1):63-6. DOI: 10.1002/gps.773. View

10.

Salamero M, Marcos T . Factor study of the Geriatric Depression Scale. Acta Psychiatr Scand. 1992; 86(4):283-6. DOI: 10.1111/j.1600-0447.1992.tb03267.x. View

11.

Vellas B, Lauque S, Andrieu S, Nourhashemi F, Rolland Y, Baumgartner R . Nutrition assessment in the elderly. Curr Opin Clin Nutr Metab Care. 2000; 4(1):5-8. DOI: 10.1097/00075197-200101000-00002. View

12.

Hamasaki H, Kawashima Y, Katsuyama H, Sako A, Goto A, Yanai H . Association of handgrip strength with hospitalization, cardiovascular events, and mortality in Japanese patients with type 2 diabetes. Sci Rep. 2017; 7(1):7041. PMC: 5539205. DOI: 10.1038/s41598-017-07438-8. View

13.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

14.

Ensrud K, Ewing S, Taylor B, Fink H, Cawthon P, Stone K . Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Arch Intern Med. 2008; 168(4):382-9. DOI: 10.1001/archinternmed.2007.113. View

15.

Giampaoli S, Ferrucci L, Cecchi F, Lo Noce C, Poce A, Dima F . Hand-grip strength predicts incident disability in non-disabled older men. Age Ageing. 1999; 28(3):283-8. DOI: 10.1093/ageing/28.3.283. View

16.

Hardy S, Perera S, Roumani Y, Chandler J, Studenski S . Improvement in usual gait speed predicts better survival in older adults. J Am Geriatr Soc. 2007; 55(11):1727-34. DOI: 10.1111/j.1532-5415.2007.01413.x. View

17.

Gill T, Gahbauer E, Han L, Allore H . The relationship between intervening hospitalizations and transitions between frailty states. J Gerontol A Biol Sci Med Sci. 2011; 66(11):1238-43. PMC: 3193526. DOI: 10.1093/gerona/glr142. View

18.

Dennis M, Kadri A, Coffey J . Depression in older people in the general hospital: a systematic review of screening instruments. Age Ageing. 2012; 41(2):148-54. DOI: 10.1093/ageing/afr169. View

19.

Fried L, Ferrucci L, Darer J, Williamson J, Anderson G . Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004; 59(3):255-63. DOI: 10.1093/gerona/59.3.m255. View

20.

Walpole S, Prieto-Merino D, Edwards P, Cleland J, Stevens G, Roberts I . The weight of nations: an estimation of adult human biomass. BMC Public Health. 2012; 12:439. PMC: 3408371. DOI: 10.1186/1471-2458-12-439. View