Instruments to assess sarcopenia and physical frailty in older people living in a community (care) setting: similarities and discrepancies.
Both sarcopenia and physical frailty are geriatric syndromes causing loss of functionality and independence. This study explored the association between sarcopenia and physical frailty and the overlap of their criteria in older people living in different community (care) settings. Moreover, it investigated the concurrent validity of the FRAIL scale to assess physical frailty, by comparison with the widely used Fried criteria.
Data were retrieved from the cross-sectional Maastricht Sarcopenia Study (MaSS).
The study was undertaken in different community care settings in an urban area (Maastricht) in the south of the Netherlands.
Participants were 65 years or older, gave written informed consent, were able to understand Dutch language, and were not wheelchair bound or bedridden.
Not applicable.
Sarcopenia was identified using the algorithm of the European Working Group on Sarcopenia in Older People. Physical frailty was assessed by the Fried criteria and by the FRAIL scale. Logistic regression was performed to assess the association between sarcopenia and physical frailty measured by the Fried criteria. Spearman correlation was performed to assess the concurrent validity of the FRAIL scale compared with the Fried criteria.
Data from 227 participants, mean age 74.9 years, were analyzed. Sarcopenia was identified in 23.3% of the participants, when using the cutoff levels for moderate sarcopenia. Physical frailty was identified in 8.4% (≥3 Fried criteria) and 9.3% (≥3 FRAIL scale criteria) of the study population. Sarcopenia and physical frailty were significantly associated (P = .022). Frail older people were more likely to be sarcopenic than those who were not frail. In older people who were not frail, the risk of having sarcopenia increased with age. Next to poor grip strength (78.9%) and slow gait speed (89.5%), poor performance in other functional tests was common in frail older people. The 2 physical frailty scales were significantly correlated (r = 0.617, P < .001).
Sarcopenia and physical frailty were associated and partly overlap, especially on parameters of impaired physical function. Some evidence for concurrent validity between the FRAIL scale and Fried criteria was found. Future research should elicit the value of combining sarcopenia and frailty measures in preventing disability and other negative health outcomes.
Mijnarends DM
，Schols JM
，Meijers JM
，Tan FE
，Verlaan S
，Luiking YC
，Morley JE
，Halfens RJ
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Global cognitive performance and frailty in non-demented community-dwelling older adults: Findings from the Sasaguri Genkimon Study.
To investigate the associations of global cognitive performance with frailty and pre-frailty in non-demented community-dwelling older adults.
A cross-sectional study was carried out using data from the baseline survey of the Sasaguri Genkimon Study in 2011. The study sample consisted of 1565 older adults with complete data and no evidence of dementia. Global cognitive performance was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Frailty state was defined using the Cardiovascular Health Study criteria, based on five components: unintentional weight loss, low grip strength, exhaustion, low gait speed and low physical activity.
Total MoCA and MMSE scores, and their domain-specific scores decreased across the non-frail, pre-frail and frail groups. Poorer total MoCA and MMSE scores, as well as their domain-specific scores, were associated with the greater likelihood of being frail, but not with pre-frailty after full adjustment. The strength of the association with frailty was greater for total MoCA score than for total MMSE score. Domain-specific scores for visuospatial abilities and attention domains in both of the MoCA and MMSE were consistently associated with the likelihood of pre-frailty and frailty, even after being mutually adjusted for all domains.
The MoCA performance is more strongly associated with the odds of frailty than the MMSE performance in the relatively functional and non-demented older adult population. The present findings could contribute to further exploration of possible common pathways that can be targeted in the prevention and management for both of these two conditions. Geriatr Gerontol Int 2015; ●●: ●●-●●.
Chen S
，Honda T
，Narazaki K
，Chen T
，Nofuji Y
，Kumagai S
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Frailty Screening in the Community Using the FRAIL Scale.
To explore the feasibility of using the FRAIL scale in community screening of older Chinese people aged 65 years and older, followed by clinical validation by comprehensive geriatric assessment of those classified as pre-frail or frail.
Two-phase study: screening of people aged 65 years and older by trained volunteers, followed by comprehensive geriatric assessment by multidisciplinary staff for those classified as pre-frail or frail.
Elderly Centers in the New Territories East Region of Hong Kong SAR China.
A total of 816 members of elderly centers attending by themselves or accompanied by relatives.
For phase 1, questionnaire (including demographic, lifestyle, chronic diseases) and screening tools were administered by trained volunteers. These consist of the FRAIL scale, SARC-F to screen for sarcopenia, and mild cognitive impairment using the abbreviated screening for mild cognitive impairment (Abbreviated Memory Inventory for the Chinese). Blood pressure, body mass index, and grip strength were recorded. For phase 2, comprehensive geriatric assessment include questionnaires assessing lifestyle domain (physical activity, nutritional status using the Mini-Nutritional Assessment-Short Form), the physical domain (number of diseases and number of drugs, activities of daily living and instrumental activities of daily living disabilities, geriatric syndromes, self-rated health, sleep quality), cognitive and psychological domain (Mini-Mental State Examination, Geriatric Depression Scale), and social domain (income, housing, living satisfaction, family support).
The prevalence of pre-frailty and frailty were 52.4% and 12.5%, respectively. The prevalence for frailty increasing with age from 5.1% for those aged 65-69 years to 16.8% for those ≥75, being greater in women compared with men (13.9% vs 4.2%). Of those who were pre-frail or frail (n = 529), 42.5% had sarcopenia and 60.7% had mild cognitive impairment. Among those who were frail (n = 102), sarcopenia and mild cognitive impairment were also frequently present: 12.8% had sarcopenia, 14.7% had mild cognitive impairment, 63.7% had both sarcopenia and mild cognitive impairment, and only 8.8% had neither. In phase 2, participants who were classified as pre-frail or frail (n = 529) were invited for further interviews; 255 participants (48.2%) returned. Compared with the pre-frail group, those in the frail group were less physically active, had higher number of chronic diseases, were taking more medications (more were taking sleeping pills), reported more falls, rated their health as poor, had higher prevalence of depressive symptoms and mild cognitive impairment, had higher prevalence of sarcopenia, and a high number of activities of daily living and instrumental activities of daily living disabilities.
The FRAIL scale may be used as the first step in a step care approach to detecting frailty in the community, allowing targeted intervention to potentially retard decline and future disability.
Woo J
，Yu R
，Wong M
，Yeung F
，Wong M
，Lum C
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Association between comprehensive health literacy and frailty level in community-dwelling older adults: A cross-sectional study in Japan.
The present study explored the association between comprehensive health literacy and frailty level in community-dwelling older adults in Japan.
This was a cross-sectional study. We enrolled 517 community-dwelling older adults (mean age 73.2 ± 6.3 years; 410 women). We divided the cohort into two groups, non-frail and any-frail, based on Fried Frailty Index scores. We assessed comprehensive health literacy using a 14-item health literacy scale, and classified the participants as having high or low health literacy. We carried out multivariate logistic regression analysis in which the dependent variable was the presence of non-frailty and the independent variable was the presence of high health literacy. The analysis was adjusted for age, sex, body mass index, educational history and cognitive function.
There were 132 (25.5%) and 385 (74.5%) participants in the non-frail and any-frail groups, respectively. The analysis showed that high health literacy was independently associated with the non-frail group (odds ratio 1.64, 95% confidence interval 1.03-2.61).
The results showed that high health literacy was associated with non-frailty. This result implies that comprehensive health literacy might play a salient role in maintaining good health status in community-dwelling older adults in Japan. Geriatr Gerontol Int 2017; 17: 804-809.
Shirooka H
，Nishiguchi S
，Fukutani N
，Adachi D
，Tashiro Y
，Hotta T
，Morino S
，Nozaki Y
，Hirata H
，Yamaguchi M
，Aoyama T
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