Volume 9, Issue 2, June 2024

Objectives

The objective of this pilot study was to investigate the feasibility of a three month 'Motor control Home ergonomics Elderlies' Prevention of falls' (McHeELP) programme on muscle mass, muscle strength, functionality, balance and fear of falling among older adults with sarcopenia.

Methods

A feasibility study of the McHeELP programme was performed in patients with sarcopenia. Primary outcome measures included number of participants; number of participants that showed engagement with the programme; adherence rates; data loss in questionnaires and secondary outcome measures; any adverse events, related or not to the intervention programme. All participants received a home-based motor control exercise programme combined with an ergonomic home modification for 12 weeks. Secondary outcome measures included Hand Grip Strength, Bioimpendance Analysis, Muscle Mass, Functionality and Fear of Falling.

Results

Twelve participants, (74.9±5 years), completed the pilot study. Significant differences were recorded before and after the programme on participants' functionality (p<0.001), balance (p<0.05) and fear of falling (p<0.001).

Conclusions

The present study revealed that the McHeELP programme is fesasible and that it is possible to implement the programme in clinical practice. The McHeELP programme positively affects functionality, balance and fear of falling. Thus, it seems feasible to conduct a full-scale randomised controlled trial.

Objectives

1) Map FaME delivery across the UK, 2) explore and understand delivery of the FaME programme in practice.

Methods

Sequential exploratory mixed methods. 1) survey of n=247 Postural Stability Instructor (PSIs) across the UK, 2) purposively sampled n=23 PSIs to take part in interviews. Quantitative data was described descriptively due to low sample size, and qualitative data coded using thematic analysis.

Results

Instructors pre-dominantly delivered classes in a community-setting, were mostly White British females with a range of experience. Most respondents were exercise instructors, physiotherapists, or therapist assistants. Only 136 (55.1%) respondents currently delivered the programme. The essential components of the FaME programme that instructors did not implement routinely were backward chaining, floorwork and Tai Chi. Five main themes emerged from qualitative data: individual, delivery and set-up, evidence-based delivery, motivational strategies, and instructor-based factors. Most instructors reported fidelity to most components of FaME and shared barriers and facilitators to delivering classes.

Conclusion

This study gives a UK overview of the implementation of FaME. PSIs present a complex picture of the ways set-up and delivery of evidence-based programmes in practice can influence older adults' attendance, adherence and experience of the programme, and barriers and facilitators to delivery of the programme with fidelity.

Objectives

The objective of the study was to investigate factors associated with subjective aging among older patients visiting a geriatric medicine outpatient department in Northern-India.

Methods

The study is a crosssectional study. Patients were categorized into three groups: whether they felt younger, equal, or older than their peers of same age. Factors such as fall, incontinence, anorexia, hand grip strength, cognition, depression, vision, hearing, cardiopulmonary function and immunization were assessed. Multinominal logistic regression was used to investigate the associated factors of subjective aging.

Results

We assessed 184 older patients with a median age of 66.5 years (IQR 63.0 -78.8). Chronological age and hand grip strength were the significant factors associated with subjective aging. With one year increase in age, odds of feeling older than peers of same age decreased by 8.9% (OR, 0.911; 95% CI, 0.831-0.999, p = 0.047). With one kilogram increase in hand grip strength, odds of feeling younger than peers of same age increased by 7.3% (OR, 1.073; 95% CI, 1.01-1.14, p = 0.032).

Conclusion

Chronological age and hand grip strength are the factors associated with subjective aging in Northern-Indian older adults. Further longitudinal multi-center studies are needed to confirm our findings.

Objectives

We surveyed healthcare staff working with older people to understand current practice in nutrition screening, initial management and referral for older people with sarcopenia and frailty.

Methods

We conducted a UK-wide web-based survey of staff working with older people in both hospital and community settings. Surveys were distributed through professional organisation e-mail lists and social media channels. Descriptive data were generated from categorical responses and inductive thematic analysis was applied to free-text responses.

Results

Data were analysed from 169 respondents (110 hospital, 59 community), representing 99 healthcare organisations. 91 (83%) hospital respondents and 24 (41%) community respondents reported that nutrition screening was performed on all patients with sarcopenia or frailty. The Malnutrition Universal Screening Tool was most commonly used to trigger referral to dietetics teams, but there was considerable variation in management before referral, referral thresholds and referral pathways. Themes derived from free-text responses included the need for training, issues of responsibility and ownership, inadequate resources (time, staff and equipment) and ineffective or inefficient processes for referral and management.

Conclusions

Current UK nutritional care for older people with sarcopenia and frailty is heterogeneous. There are opportunities for better tools, processes, training and resources to improve current practice and pathways.

Objectives

To develop strategies against sarcopenia, physiological and biochemical data in older women were analyzed using propensity score matching.

Methods

Fifty-six women aged ≥75 years with the AWGS calf circumference Results The possible-sarcopenia group with low muscle strength exhibited significantly lower BMD (p=0.014) and skeletal muscle mass index score (p=0.002) compared to the sarcopenia risk group without low muscle strength. The possible-sarcopenia group with low physical performance exhibited significantly lower AST (p=0.034) compared to the sarcopenia risk group without low physical performance.

Conclusion

These results suggest that older women with possible sarcopenia and low muscle strength may have reduced BMD and skeletal muscle mass index.

Age-related changes in body composition have been associated with reduced physical performance. However, the relationship of fat and lean mass indexes with physical performance in the setting of frailty is yet to be clearly established. We investigated the association between fat and lean mass indexes and physical performance in prefrail and frail older women. Fifty-one community-dwelling women 65 years and older (mean age 76 years) were classified as prefrail or frail according to a modified frailty phenotype. Body composition was estimated by dualenergy X-ray absorptiometry, while physical performance was assessed via the following tests: Berg balance scale, timed-stands, timed up-and-go test, 6-minute walk test, and the short performance physical battery. Correlation coefficients were determined to assess the association between body composition and physical performance parameters. Associations between continuous variables with a p-value <0.05 were included in a linear regression analysis. All fat mass indexes predicted a reduced performance in at least one functional test. Among the lean mass indexes, only leg lean mass adjusted by body fat mass was directly associated with better physical performance. Our findings indicate that fat mass indexes may have a greater impact on physical performance than lean mass in frail and prefrail older women.

Malnutrition, inflammation, comorbid diseases, and inactivity are known causes of sarcopenia. It results in clinical consequences like fractures, falls, low quality of life, cognitive dysfunction, and mortality. Especially in the treatment of patients with prolonged immobilization syndrome, management should not only focus on functional limitations but patients should also be evaluated and followed up for sarcopenia. In this case report, we present the management of probable secondary sarcopenia in the intensive care unit as a result of urosepsis and discuss it in the light of the literature.