Volume 10, Issue 1, March 2025

Objectives

The use of forearm circumference (FC) in the estimation equation to predict appendicular lean mass (ALM) in older adults who require care remains unclear.

Methods

This cross-sectional study targeted 132 participants aged ≥65 years requiring care. The ALM was measured with bioelectrical impedance analysis (BIA). Handgrip strength (HS) was measured with a digital hand dynamometer. FC was measured at the site of maximum swelling using a tape measure. Multiple regression analysis was conducted to develop an equation for estimating BIA-measured ALM using FC. Moreover, we investigated a systematic error by Bland–Altman analysis between BIA-measured ALM and ALM calculated by the estimation equation.

Results

We developed the four estimation equations. The values of r, adjusted R², and SEE in the representative model (FC + HS + age) were 0.86, 0.73, and 2.01 (kg), respectively (p<0.05). In contrast, a systematic error was identified between the BIA-measured ALM and ALM calculated by the estimation equations by the Bland–Altman analysis.

Conclusions

This study developed the formula using FC, which can predict ALM with less influence of edema, but it may over- or underestimate ALM in older adults requiring care

Objectives

Acutely ill hospitalized geriatric patients with sarcopenia have a poor clinical outcome. The European Working Group on Sarcopenia in Older People-2 (EWGSOP-2) recommends measuring handgrip strength (HGS) or the 5-times-repeated-Chair-Stand-Test (5t-CST) to assess muscle strength. The modified-thirty-seconds-Chair-Stand-Test (m-30s-CST) is expected to be more feasible than the 5t-CST and probably a better proxy for physical function compared to HGS. The aim of the study is to test the feasibility and reliability of the m-30s-CST in these patients.

Methods

92 patients (aged 84±6 y, mean GFI score of 6.1± 2.9, 53.5% female) participated. The m-30s-CST was performed at 3 different occasions. Feasibility was measured at admission and test-retest reliability at the day before and of discharge. Additionally Short Physical Performance Battery (SPPB), ADL-Barthel-Index (ADL-BI) and HGS were assessed.

Results

The m-30s-CST is a significant more feasible test compared to the 5t-CST (n=92; 76.1% versus 20.1%; P<0.001), with a intraclass correlation coefficient (ICC) of 0.954 (n=59; CI-95%:0.921-0.973; P<0.001). The m-30s-CST has compared to HGS a significant better correlation with the ADL-BI and with the SPPB.

Conclusion

The m-30s-CST is a feasible and reliable method to assess muscle strength and is compared to HGS a better proxy for physical performance in geriatric patients.

Objectives

This study examines relationships between frailty, concerns about falling (CaF), and fall risk in community-dwelling older adults (≥60 years old).

Methods

Frailty, CaF, and fall risk were cross-sectionally assessed using the FRAIL, short FES-I, and STEADI questionnaires in 178 participants. Spearman correlations, logistical regression, and ordinal regression analysis were performed.

Results

38.2% of participants were robust, 48.9% pre-frail, and 12.9% frail. Logistic regressions revealed that frail individuals were 91.4% more likely to have CaF compared to non-frail individuals, and individuals with lower fall risk were 5.7 times less likely to have CaF than those with no fall risk. Pre-frail individuals were more likely to have fall risk than non-frail individuals. Individuals with low CaF were 6 times less likely to have fall risk than those with high CaF. Ordinal logistic regressions revealed that for individuals with no CaF and no fall risk, the odds of being frail were 69.5% and 86.7% lower, respectively, than those with high CaF and high fall risk.

Conclusions

Frailty relationships with fall risk and CaF indicate the importance of addressing frailty to aid in fall prevention in older adults. Further, addressing the CaF mentality is important in fall prevention in older adults.

ClinicalTrials.gov ID:

NCT05778604.

Objectives

While chronological aging does not necessarily impair oncological outcomes after radical prostatectomy, the role of frailty remains less clear. This study aimed to evaluate whether frailty significantly affects early continence rates following radical prostatectomy and to explore the potential association between frailty and postoperative complications.

Methods

A retrospective cohort study of 212 patients undergoing radical prostatectomy was conducted. Preoperative frailty assessment employed a multimodal evaluation encompassing cardiovascular, respiratory, neurological, and urinary systems, supplemented by conventional risk measures such as physical performance status and biochemical markers. The primary endpoint was early continence recovery, while secondary outcomes included 30-day postoperative complications.

Results

Comparative analysis revealed no statistically significant differences in baseline characteristics, oncological outcomes, or complication rates between the open and robotic-assisted surgical cohorts. However, frailty was strongly associated with reduced early continence recovery, irrespective of surgical technique (p<0.001). No significant association was detected between frailty and 30-day postoperative complications (p=0.36).

Conclusions

This study highlights frailty as a pivotal predictor of early continence outcomes. The lack of association between frailty and postoperative complications suggests that comprehensive frailty assessment may be more relevant for anticipating functional recovery than predicting immediate surgical risks. These findings support integrating frailty evaluation into preoperative decision-making frameworks

Objectives

The primary objective was to test the influence of age on lean body mass (LBM), muscle strength, and isokinetic performance adaptation following a 6-week blood-flow restriction training (BFRT) intervention.

Methods

A total of 38 young adults (23.5±3.1) and 34 older adults (72.7±5.5) completed a 6-week BFRT program. Exercises were performed three times per week at 30% of 1-repetition maximums (1-RMs) and 60% of each limb’s arterial occlusion pressure. Body composition was assessed using dual-energy X-ray absorptiometry, muscle strength was measured using 1-RMs, and muscular performance was measured using an isokinetic dynamometer.

Results

A significant increase in LBM was observed in young adults (0.9±1.5kg; p<0.001) but not in older adults (0.3±1.3kg; p>0.05) following the intervention. Both age groups significantly improved 1-RMs for knee extension, knee flexion, and chest press, with the young group displaying greater improvements (all ps<0.001). A significant increase in knee flexion torque and power was observed in young adults (all ps<0.001) but not in older adults, while a significant difference between groups was observed (p<0.05).

Conclusions

The results from our study suggest that young adults improve LBM and muscle performance following 6-weeks of BFRT, while older adults enhance performance, despite a lack of improvement in LBM.

Clinicaltrials.gov ID:

NCT05615831.

Falls efficacy is an important psychological construct in falls prevention and management. It refers to an individual’s perceived physical ability to prevent and manage falls. Despite its significance, falls efficacy remains under-researched. This article highlights three findings to encourage clinical practitioners to integrate falls efficacy assessments into practice for hospitalised and community-dwelling seniors. Hospitalised seniors face reduced mobility and deconditioning, significantly lowering falls efficacy. Conversely, community-dwelling seniors exhibit higher falls efficacy due to greater functioning levels and independence, though some may lack the physical capacity to mitigate falls. Differentiating between domains of falls efficacy is crucial, as confidence expressed by individuals in their specific physical abilities may vary. Seniors displaying discordance between their confidence and actual falls risk may be more vulnerable to falls. Our analysis reveals that 45% of hospitalised seniors and 19% of community-dwelling seniors exhibited such discordance. Incorporating falls efficacy assessments into clinical practice can help identify at-risk individuals, enable personalised interventions, and facilitate safer transitions post-discharge. Understanding the interplay between psychological and physical dimensions of falls risk is essential for improving older adults’ quality of life and independence.