Effects of High-Intensity Progressive Resistance Training and Targeted Multidisciplinary Treatment of Frailty on Mortality and Nursing Home Admissions after Hip Fracture: A Randomized Controlled Trial

Singh, Nalin; Quine, Susan; Clemson, Lindy; Williams, Elodie J.; Williamson, Dominique A.; Stavrinos, Theodora M.; Grady, Jodie N.; Perry, Tania J.; Lloyd, Bradley D.; Smith, Emma; Singh, Maria A. Fiatarone

doi:10.1016/j.jamda.2011.08.005

Cited by 248 publications

(147 citation statements)

References 44 publications

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“…Based on these findings, SARC‐F would be an adequate tool to identify persons with muscle weakness that may be amenable to treatment. At present, the major treatment would be resistance exercise and possibly other forms of exercise coupled with increased protein intake 22, 23, 24, 25. This study suggests that SARC‐F is a rapid, question‐based clinical tool that may be a useful sarcopenia screen for primary care physicians.…”

Section: Discussionmentioning

confidence: 99%

SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes

Malmstrom

Miller

Simonsick

et al. 2015

Journal of Cachexia, Sarcopenia and Muscle

826

520

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BackgroundA brief, inexpensive screening test for sarcopenia would be helpful for clinicians and their patients. To screen for persons with sarcopenia, we developed a simple five‐item questionnaire (SARC‐F) based on cardinal features or consequences of sarcopenia.MethodsWe investigated the utility of SARC‐F in the African American Health (AAH) study, Baltimore Longitudinal Study of Aging (BLSA), and National Health and Nutrition Examination Survey (NHANES). Internal consistency reliability for SARC‐F was determined using Cronbach's alpha. We evaluated SARC‐F factorial validity using principal components analysis and criterion validity by examining its association with exam‐based indicators of sarcopenia. Construct validity was examined using cross‐sectional and longitudinal differences among those with high (≥4) vs. low (<4) SARC‐F scores for mortality and health outcomes.ResultsSARC‐F exhibited good internal consistency reliability and factorial, criterion, and construct validity. AAH participants with SARC‐F scores ≥ 4 had more Instrumental Activity of Daily Living (IADL) deficits, slower chair stand times, lower grip strength, lower short physical performance battery scores, and a higher likelihood of recent hospitalization and of having a gait speed of <0.8 m/s. SARC‐F scores ≥ 4 in AAH also were associated with 6 year IADL deficits, slower chair stand times, lower short physical performance battery scores, having a gait speed of <0.8 m/s, being hospitalized recently, and mortality. SARC‐F scores ≥ 4 in the BLSA cohort were associated with having more IADL deficits and lower grip strength (both hands) in cross‐sectional comparisons and with IADL deficits, lower grip strength (both hands), and mortality at follow‐up. NHANES participants with SARC‐F scores ≥ 4 had slower 20 ft walk times, had lower peak force knee extensor strength, and were more likely to have been hospitalized recently in cross‐sectional analyses.ConclusionsThe SARC‐F proved internally consistent and valid for detecting persons at risk for adverse outcomes from sarcopenia in AAH, BLSA, and NHANES.

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Section: Discussionmentioning

confidence: 99%

SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes

Malmstrom

Miller

Simonsick

et al. 2015

Journal of Cachexia, Sarcopenia and Muscle

826

520

View full text Add to dashboard Cite

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“…Resistance training in particular is beneficial in combination with protein supplementation [105]. Overall, the benefits of exercise for older adults outweigh the risks for older adults of falling or suffering an injury during exercise [27,104].…”

Section: Treatment Strategiesmentioning

confidence: 99%

Musculoskeletal health, frailty and functional decline

Milte

Crotty

2014

Best Practice & Research Clinical Rheumatology

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Frailty in older people is associated with a vulnerability to adverse events. While ageing is associated with a loss of physiological reserves identifying those with the syndrome of frailty has the potential to assist clinicians tailor treatments to those at risk of future decline into disability with increased risk of complications, morbidity and mortality. Sarcopenia is a key component of the frailty syndrome and on its own puts older people at risk of fragility fractures however the clinical syndrome of frailty affects musculoskeletal and non musculoskeletal systems. Hip fractures are becoming a prototype condition in the study of frailty. Following a hip fracture many of the interventions are focused on limiting mobility disability and restoring independence with activities of daily living but there are multiple factors to be addressed including osteoporosis, sarcopenia, delirium, weight loss. Established techniques of geriatric evaluation and management allow systematic assessment and intervention on multiple components by multidisciplinary teams and deliver the best outcomes. Using the concept of frailty to identify older people with musculoskeletal problems as at risk of a poor outcome assists in treatment planning and is likely to become more important as effective pharmacological treatments for sarcopenia emerge. This review will focus on the concept of frailty and its relationship with functional decline, as well as describing its causes, prevalence, risk factors and potential clinical applications and treatment strategies. Key wordsFragility fracture, frailty, functional decline, screening, older adult, exercise therapy, dietary therapy Word count 9,401 words (word limit=9,400)

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“…Studies have suggested that exercise and nutrition interventions can improve outcomes in frail older persons (72)(73)(74)(75). A rapid screen -the FRAIL -can be utilized both in hospitals (76,77) and in the outpatient setting (78)(79)(80)(81).…”

Section: Modern Geriatric Giantsmentioning

confidence: 99%