Association of Multimorbidity With Frailty in Older Adults for Elective Non-Cardiac Surgery

Au-Yong, Phui-Sze Angie; Sim, Eileen Yilin; Ho, Collin Yih Xian; He, Yingke; Kwa, Charlene Xian Wen; Teo, L.W.; Abdullah, Hairil Rizal

doi:10.7759/cureus.15033

Cited by 5 publications

(5 citation statements)

References 30 publications

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“…The association between frailty and the number of diseases suggests that the increased use of medication could reflect the manifestation of comorbid conditions. Various chronic diseases may be comorbid with frailty owing to the accumulation of biological defects, which are associated with functional decline, polypharmacy and increased utilization of healthcare (Au Yong et al., 2021). Frailty may predispose an individual to chronic disease; conversely, frailty may stem from chronic diseases.…”

Section: Discussionmentioning

confidence: 99%

“…If the initial model did not fit the data, it was modified and retested until an acceptable fit was achieved. The model fit was assessed using the following criteria: (1) χ 2 statistics, where p > .05 indicates a good fit; (2) χ 2 to degrees of freedom ratio ( χ 2 /df), where <3 indicates a good fit; (3) comparative fit index (CFI), Tucker–Lewis index (TLI) and normed fit index (NFI), where ≥.9 indicates a good fit; and (4) root mean square error of approximation (RMSEA), which is acceptable if ≤.06 (Au Yong et al., 2021; Fan et al., 2021). The significance of the direct, indirect and total effects was assessed using bootstrap resampling (2000 resamples) and bias‐corrected 95% confidence intervals around the standardized estimates.…”

Section: Methodsmentioning

confidence: 99%

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Frailty and social isolation before and during the coronavirus disease 2019 pandemic among older adults: A path analysis

Su,

Hamatani,

Yuki

et al. 2023

Journal of Advanced Nursing

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AimTo explore the prevalence of social isolation among Japanese community‐dwelling older adults before and during the COVID‐19 pandemic as well as determine how family and friend connections before and during the pandemic affected frail older adults during the pandemic.DesignA cross‐sectional study.MethodsA total of 852 community‐dwelling older adults in Hokkaido and Tokyo, Japan were surveyed conducted between April and November 2021 using convenience sampling. The Lubben social network scale‐6, frailty screening index, and geriatric depression scale were used to assess social isolation, frailty and depression, respectively. A path analysis was conducted to evaluate the effect of social isolation on frailty.ResultsParticipants had a mean age of 76.8 ± 6.6 years. Overall, 46% and 59% of participants were socially isolated before and during the COVID‐19 pandemic, respectively. Frailty was found in 19% of participants during the pandemic. Friends and family connectedness before the pandemic had no direct relationship with frailty; only friend connectedness affected frailty indirectly via depression. Family connectedness during the pandemic had a significant, negative and direct relationship with frailty.ConclusionThe findings show that connectedness with family and friends is critical for older people's physical and mental health.ImpactNurses in the community should consider these findings to reduce mental health problems and physical decline among older adults. It is important to identify older adults who are socially isolated from their families or friends and provide resources to help them build relationships within their communities.Patient or Public ContributionCommunity centre staff and community volunteers assisted in data collection. The public was not involved in data analysis, interpretation or manuscript preparation.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Frailty and social isolation before and during the coronavirus disease 2019 pandemic among older adults: A path analysis

Su,

Hamatani,

Yuki

et al. 2023

Journal of Advanced Nursing

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“…Furthermore, the joint interaction between CMDs and frailty may also lead to disability and subsequent institutionalization, all of which may influence QoL (M. Bloch, 2018;Yamada et al, 2022). Although, previous aging studies have found that CMDs are unique risk factors for frailty onset, noteworthy is the notion that frailty may also be examined as a predictor of future CMD burden in PLWH and future studies assessing these longitudinal relations are needed (Au Yong et al, 2021;Lorenz et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Cardiometabolic Diseases and Quality-of-Life Outcomes in Adults With HIV in the Deep South: A Cross-sectional Study

Enogela¹,

Buford²,

Vance³

et al. 2022

J Assoc Nurses AIDS Care

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The role of cardiometabolic diseases (CMDs) on physical health-related quality of life (P-HRQoL) and quality of sleep was examined among 261 PLWH $40 years, recruited from a university-affiliated HIV clinic in the Deep U.S. South. Using a cross-sectional study design, participants completed the Medical Outcomes Study HIV Health Survey (MOS-HIV; P-HRQoL) and Pittsburgh Sleep Quality Index. The overall prevalence of self-reporting $1 CMD was 64.4%. P-HRQoL scores were lower in PLWH with $1 CMD compared with those with no CMDs (45.53 6 11.54 vs. 49.67 6 10.77, p ,.01). Poor sleep quality was higher among participants with $1 CMD compared with those with no CMDs (9.28 6 4.42 vs. 7.26 6 4.17, p,.01). Each additional CMD resulted in a 1.83-point decrease in P-HRQoL and 0.74-point increase in poor sleep quality scores. Interventions that focus on targeting these quality-of-life domains in PLWH with CMDs are needed.

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“…33 Moreover, a positive correlation exists between multimorbidity and frailty. In particular, diabetes mellitus (DM), chronic kidney disease, previous cerebrovascular accidents or transient ischaemic attack, dementia, depression, peptic ulcer disease and moderate anaemia are some independent factors associated with frailty 34 that should be reviewed before surgery.…”

Section: Risk Mitigation (Medical Health and Functional Risks)mentioning

confidence: 99%

Transforming the perioperative medicine care model: The Singapore experience

Sim

Kwa

et al. 2023

Anaesth Intensive Care

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More than 300 million surgeries are performed worldwide annually. Established perioperative centres in the UK, USA and Australia have demonstrated the impact of improving perioperative care in reducing costs, increasing patient satisfaction and improving population health. Likewise, the surgical burden of care in Asia is increasing, but with sociocultural, economic and epigenetic differences compared to the west. As Singapore’s largest hospital, the Singapore General Hospital pre-admission perioperative clinic sees about 20,000 patients annually. We aim to illustrate Singapore General Hospital’s perioperative model of care to contribute to the paucity of literature describing perioperative programme implementation within Asia, and to encourage the cross-sharing of perioperative practices internationally. Our perioperative framework navigates risk assessment, risk counselling, and mitigation of health, medical and functional risks to better patients’ perioperative outcomes and population health. We have implemented evidence-based pathways for common conditions such as anaemia and malnutrition, including a multidisciplinary programme for the elderly to tackle frailty and reduce length of stay. We describe how we have enhanced local risk profiling with the Combined Assessment of Risk Encountered in Surgery surgical risk calculator derived locally using a gradient boosting machine learning model. Finally, we report clinical outcomes of these interventions and discuss further challenges and new initiatives at each tier of our perioperative model. Our perioperative care model provides a framework that other centres can adopt to promote value-driven care, while catering for differences in the Asian population, thereby promoting evidence-based improvements in the area of perioperative medicine.

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Association of Multimorbidity With Frailty in Older Adults for Elective Non-Cardiac Surgery

Cited by 5 publications

References 30 publications

Frailty and social isolation before and during the coronavirus disease 2019 pandemic among older adults: A path analysis

Frailty and social isolation before and during the coronavirus disease 2019 pandemic among older adults: A path analysis

Cardiometabolic Diseases and Quality-of-Life Outcomes in Adults With HIV in the Deep South: A Cross-sectional Study

Transforming the perioperative medicine care model: The Singapore experience

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