Chapter 1 Frailty: Definition, diagnosis, epidemiology

Satake, Shosuke; Arai, Hidenori

doi:10.1111/ggi.13830

Cited by 50 publications

(48 citation statements)

References 60 publications

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“…Frailty was defined as a clinical syndrome in which three or more of the following criteria were met (frailty score 3, 4, or 5): unintentional BW loss (2, 3 kg or more BW loss within the past 6 months), self-reported exhaustion, muscle weakness (grip strength (GS): <26 kg in men and <18 kg in women), slow WS (<1.0 m/s), and low PA (doing light exercise or not), whereas prefrail was defined as patients with one or two aforementioned phenotypes (frailty score 1 or 2). Patients with none of the five phenotypes were regarded as having robust status (frailty score 0) [4,5]. GS was measured according to the current guidelines [31].…”

Section: Patientsmentioning

confidence: 99%

“…Originally it was proposed to identify elderly people at elevated risk of poor health outcomes, dependencies, falls, disabilities, and mortality [1][2][3]. The Japan Geriatric Society defines frailty as an intermediate between health and need of care [4]. Frailty encompasses not only physical aspects but also social and mental aspects, capturing patients' health in a broader category when compared to sarcopenia characterized by a progressive and generalized decline of skeletal muscle mass, muscle strength, and/or physical activity (PA) [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Frailty is defined as the presence of three or more of the following phenotypes: body weight (BW) loss, self-reported exhaustion, skeletal muscle functional decline, slow walking speed (WS), and decreased PA [4,5]. Recently, the concept of frailty has been enlarged to chronic liver diseases (CLDs) as clinical symptoms of impaired global physical function [6][7][8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Serum Zinc Level Is Associated with Frailty in Chronic Liver Diseases

Nishikawa

Enomoto

Iwata

et al. 2020

JCM

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We sought to examine the serum zinc (Zn) level and frailty in patients with chronic liver diseases (CLDs, n = 285, 107 liver cirrhosis cases, median age = 66 years). Frailty was defined as a clinical syndrome in which three or more of the following criteria were met (frailty score 3, 4, or 5): unintentional body weight loss, self-reported exhaustion, muscle weakness (grip strength: <26 kg in men and <18 kg in women), slow walking speed (<1.0 m/s), and low physical activity. Robust (frailty score 0), prefrail (frailty score 1 or 2), and frailty were found in 90 (31.6%), 157 (55.1%), and 38 (13.3%), respectively. The median serum Zn levels in patients with frailty, prefrailty, and robust were 59.7 μg/dL, 72.8 μg/dL, and 76.9 μg/dL, respectively (p-values: frailty vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0063; frailty vs. robust, p < 0.0001; overall p < 0.0001). For all cases, variables with absolute values of correlation coefficient with frailty score (0–5) ≥ 0.3 were age (rs = 0.3570, p < 0.0001), serum albumin (rs = −0.3212, p < 0.0001), extracellular water to total body water ratio using bioimpedance analysis (rs = 0.4386, p < 0.0001), and serum Zn level (rs = −0.3406, p < 0.0001). In conclusion, decreased serum Zn level in patients with CLDs can be closely associated with the presence of frailty.

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Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum Zinc Level Is Associated with Frailty in Chronic Liver Diseases

Nishikawa

Enomoto

Iwata

et al. 2020

JCM

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“…These alterations could be related to fatigue, among other manifestations. The literature has also referred to a lack of activity as a precursor of frailty and how sedentary lifestyle can be decisive in this process [ 47 , 49 ]. On the other hand, Fried et al [ 5 ] presented a construct based on energy imbalance and sarcopenia to activate the cycle of frailty, whose first manifestation could be weakness [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Frailty Status Typologies in Spanish Older Population: Associations with Successful Aging

Tomás

Sentandreu‐Mañó

Fernández

2020

IJERPH

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Background: Defining frailty typologies would contribute to guiding specific care interventions. These typologies could additionally be related to different health outcomes. This study aims at identifying subgroups of frail older adults based on the physical frailty phenotype and examining the relationships of these frailty profiles with quality of life and perceived health. Methods: This study relies on data from the SHARE project, namely a representative sample of 1765 Spanish-dwelling older adults identified as frail or pre-frail. Analysis included general descriptive statistics, exploratory latent class analysis (LCA) to determine the number of frailty subgroups, and LCA with covariates to examine differential relationships with markers of successful aging. Results: Statistical criteria and interpretability of the classes suggested that the LCA model with four classes should be retained. Class 1 was identified as the “frail people” group, Class 2 “activity problems” group, Class 3 “fatigued” group, and those belonging to Class 4 “lack of strength” group. Final LCA with covariates showed lower levels of quality of life and perceived health of the “frail” as compared to other frailty subgroups. Conclusion: This study revealed four different patterns of frailty attributes and further offered evidence on individuals’ differential status of health regarding distinct frailty conditions.

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“…Frailty was defined as a clinical syndrome in which 3 or more of the following criteria were met: i) unintentional BW loss (2 or 3 kg or more within the past 6 months), ii) self-reported exhaustion, iii) muscle weakness (GS<26 kg in men and <18 kg in women), iv) slow WS (<1.0 m/s), and v) low physical activity (doing light exercise or not), while pre-frailty was defined as patients with one or two of the aforementioned phenotypes. Patients with none of the 5 phenotypes were regarded as having a robust status (23,24).…”

Section: Methodsmentioning

confidence: 99%

Sarcopenia and Frailty in Chronic Liver Damage: Common and Different Points

Nishikawa

Enomoto

Iwata

et al. 2020

In Vivo

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Aim: To elucidate the common and different points between sarcopenia and frailty in chronic liver damage (CLD). Patients and Methods: Patients with both grip strength decline and skeletal muscle index decline were regarded as sarcopenia. Frailty was defined as a syndrome in which 3 or more of the following criteria were met: i) exhaustion, ii) body weight loss, iii) slow walking speed, iv) muscle weakness, and v) low physical activity. Results: Sarcopenia and frailty were identified in 52 patients (15.2%) and 46 (13.5%), respectively. The prevalence of sarcopenia and frailty was well stratified according to age and the liver cirrhosis (LC) status. In the multivariate analysis, we identified significant factors for sarcopenia: i) age, ii) LC, iii) body mass index and iv) extracellular water (ECW) to total body water (TBW) ratio, while only the ECW to TBW ratio was significant for frailty. Conclusion: Sarcopenia and frailty in CLD should be separately evaluated. In individuals with chronic liver damage (CLD), metabolic functions are frequently damaged leading to several nutritional disorders, including protein-energy-malnutrition, or muscle abnormalities (1). Since sarcopenia, as assessed by muscle mass decrease and muscle strength impairment in patients with CLD, can be related to falls, poor quality of life or poor prognosis, it has become a very interesting topic to examine for physicians (2-8). Sarcopenia is one of the most common consequences found in patients with liver cirrhosis (LC), affecting 30% to 70% of LC patients, and it can be a main determinant for the incidence of hepatic encephalopathy in LC patients (1, 9, 10-13). Japanese CLD patients can now be found in aging populations, and this fact is also a crucial public health issue since aging itself can cause sarcopenia (14-16). To avoid unfavorable consequences related to sarcopenia one needs to assess this disease as a condition with a systemic involvement (17-19). Improving physical activity or nutrition and adequately managing any underlying diseases are essential steps for avoiding sarcopenia (6). Frailty is a concept globally used in geriatrics that precedes disability, and is defined as a condition of increased vulnerability associated with physiological decline (20-22). Originally, it was proposed to identify elderly people at an elevated risk of adverse health outcomes, dependencies, falls, disabilities, and mortality (20-22). Frailty is determined based on the evaluation of physical, functional and cognitive abilities. The frailty phenotype is defined as the presence of 3 or more of the following criteria: i) body weight (BW) loss, ii) self-reported exhaustion, iii) skeletal muscle function decline, iv) slow walking speed (WS) and v) low physical activity (23, 24). Sarcopenia is an important component of frailty (22). Aging is indeed closely linked to changes in body composition, especially skeletal muscle mass decline, resulting in disability and mortality (14, 16, 24). While any chronic organ dysfunction can also lead to physiological vulne...

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Chapter 1 Frailty: Definition, diagnosis, epidemiology

Cited by 50 publications

References 60 publications

Serum Zinc Level Is Associated with Frailty in Chronic Liver Diseases

Serum Zinc Level Is Associated with Frailty in Chronic Liver Diseases

Frailty Status Typologies in Spanish Older Population: Associations with Successful Aging

Sarcopenia and Frailty in Chronic Liver Damage: Common and Different Points

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