Recent developments in frailty identification, management, risk factors and prevention: A narrative review of leading journals in geriatrics and gerontology

Dent, Elsa; Hanlon, Peter; Sim, Marc; Jylhävä, Juulia; Liu, Zuyun; Vetrano, Davide L.; Stolz, Erwin; Pérez-Zepeda, Mario Ulises; Crabtree, Daniel R.; Nicholson, Caroline; Job, Jenny; Ambagtsheer, Rachel C.; Ward, Paul R.; Shi, Sandra M.; Huynh, Quan; Hoogendijk, Emiel O.

doi:10.1016/j.arr.2023.102082

Cited by 22 publications

(2 citation statements)

References 191 publications

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“…Frail patients demonstrate decreased physiologic reserve and impaired responses to physiologic stresses, including illness and surgery [53,54]. Poor functional status is a known predictor of postoperative mortality and postoperative length of stay, and frail patients show significantly increased risk of complications even following ambulatory and minor surgical procedures [55].…”

Section: Frailty and Decreased Functional Statusmentioning

confidence: 99%

Lingering effects of COVID-19 in the care of perioperative patients

Jia,

Navare,

Hoyler

2024

Current Opinion in Anaesthesiology

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Purpose of review Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can lead to organ dysfunction and clinical symptoms beyond the acute infection phase. These effects may have significant implications for the management of perioperative patients. The purpose of this article is to provide a systems-based approach to the subacute and chronic effects of SARS-CoV-2 that are most relevant to anesthesiology practice. Recent findings In 2024, COVID-19 remains a concern for anesthesiologists due ongoing new infections, evolving viral strains, and relatively low rates of booster vaccination in the general population. A growing body of literature describes the post-COVID-19 syndrome in which patients experience symptoms more than 12 weeks after acute infection. Recent literature describes the lingering effects of SARS-CoV-2 infection on all major organ systems, including neurologic, pulmonary, cardiovascular, renal, hematologic, and musculoskeletal, and suggests an increased perioperative mortality risk in some populations. Summary This review offers anesthesiologists an organ system-based approach to patients with a history of COVID-19. Recognizing the long-term sequelae of SARS-CoV-2 infection can help anesthesiologists to better evaluate perioperative risk, anticipate clinical challenges, and thereby optimize patient care.

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Section: Frailty and Decreased Functional Statusmentioning

confidence: 99%

Lingering effects of COVID-19 in the care of perioperative patients

Jia,

Navare,

Hoyler

2024

Current Opinion in Anaesthesiology

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“…It is postulated that bacteria present in the oral cavity may serve as potential pathogens implicated in the etiology of respiratory infections (Gomes‐Filho et al, 2010; Scannapieco, 1999). A narrative review has revealed that there is an emerging need for early identification and management of oral frailty in older adults to prevent frailty (Dent et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

The relationship between oral frailty and oral dysbiosis among hospitalized patients aged older than 50 years

Chen,

Ku,

Tsai

et al. 2024

Clinical & Exp Dental Res

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ObjectiveThis study aimed to clarify the relationship between oral frailty and oral dysbiosis among hospitalized patients aged ≥ 50 years.MethodsA prospective observational study was conducted. Number of teeth, masticatory ability, articulatory oral motor skill, tongue pressure, swallowing pressure, and choking were used to assess oral frailty. Saliva samples were collected from the oral cavity for bacterial culture.ResultsA total 103 in patients enrolled and 53.4% suffered from oral frailty. Oral frailty was found to have a 3.07‐fold correlation with the presence of Enterobacterales in the oral cavity (p = 0.037), especially in poor articulatory oral motor skill, which showed at greater risk of Enterobacterales isolated from the oral cavity by 5.58‐fold (p = 0.01).ConclusionHalf of hospitalized patients was found to have oral frailty that was related to more Enterobacterales in the oral cavity. This evidence suggests that the enhancement of articulatory oral motor skills may serve as a potential strategy for mitigating the presence of Enterobacterales within the oral cavity.

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An auxiliary diagnostic approach based on traditional Chinese medicine constitutions for older patients with frailty

Gu,

Wang,

Yang

et al. 2024

Clinical and Translational Dis

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IntroductionAs global population ages, frailty has surfaced as a major public health challenge. Given the heterogeneity of frailty in the clinical presentation, it is imperative to develop personalised diagnostic and treatment strategies. The traditional Chinese medicine (TCM) constitution offers notable advantages in discerning individual differences. This study aims to elucidate the association between TCM constitutions and frailty, providing insights into the application of TCM for the frailty management.MethodsAn observational study was conducted at Huadong hospital from July 2022 to November 2023. A total of 241 older patients were recruited. Each patient underwent assessments for the TCM constitution and frailty status. Comprehensive data collection encompassed medical history, biochemical indicators, bone mineral density (BMD), body composition and physical performance metrics. Plasma samples were also collected to detect levels of inflammatory factors and lymphogenesis‐related factors, including IL‐1β, TNF‐α, VEGF‐C, ANGPTL4 and ACV‐A. Multi‐level statistical analysis was used to establish the relationship of TCM constitutions with frailty.ResultsAmongst all participants, 54 individuals were classified as non‐frail, 90 individuals as pre‐frail and 97 individuals as frail. Regression analysis indicated that frailty was closely associated with four imbalanced TCM constitutions: Qi deficiency, phlegm dampness, blood stasis and Qi depression. Subsequent analysis demonstrated that Qi deficiency was associated with decreased BMD, phlegm dampness with elevated high‐density lipoprotein levels, Blood stasis with elevated blood glucose levels, and Qi depression with both decreased BMD and elevated low‐density lipoprotein levels. Furthermore, individuals characterised by imbalanced TCM constitutions exhibited inferior handgrip strength, walking pace, lower limb strength and higher levels of inflammatory factors and lymphogenesis‐related factors compared to those with balanced TCM constitution.ConclusionFrailty is independently associated with Qi deficiency, phlegm dampness, blood stasis and Qi depression. Personalised diagnostic approaches based on the TCM constitution may offer valuable insights for directing treatment for older patients with frailty.

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Recent developments in frailty identification, management, risk factors and prevention: A narrative review of leading journals in geriatrics and gerontology

Cited by 22 publications

References 191 publications

Lingering effects of COVID-19 in the care of perioperative patients

Lingering effects of COVID-19 in the care of perioperative patients

The relationship between oral frailty and oral dysbiosis among hospitalized patients aged older than 50 years

An auxiliary diagnostic approach based on traditional Chinese medicine constitutions for older patients with frailty

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