Search

Aim: The aim of this study was to assess the internal consistency, hypothesis testing and criterion‐related validity of the Spanish versions of the Kihon Checklist (KCL) – the original 25‐item and reduced 15‐item versions – for screening frailty in community‐dwelling older adults. Methods: A cross‐sectional study was carried out between March and September 2018 in Valencia province (Spain). A sample of 251 participants was recruited. Construct validity was assessed using four different frailty instruments, and alternative measures corresponding to the KCL domains (handgrip strength, gait speed, the Short Physical Performance Battery, skeletal muscle mass index, physical activity level, functional status, cognitive function, depressive mood, health‐related quality of life and nutritional status). Fried's Frailty Phenotype was used to evaluate criterion validity. Results: Internal consistency assessed with Kuder–Richardson Formula had a value of 0.69 for the 25‐item version, slightly lower than the usual 0.7 for considering good reliability, and 0.71 for the 15‐item version. There were significant correlations between KCL versions and Fried's Frailty Phenotype, Edmonton Scale, Tilburg Indicator and FRAIL Scale. Consistent significant correlations were also obtained with all frailty measurements and instrumental activities of daily living, physical strength, eating, socialization, and mood domains of the KCL. The KCL closely correlated with other standardized measurements of physical function, cognitive function, depressive mood, and health‐related quality of life. The KCL also showed satisfactory diagnostic accuracy for frailty (area under the curve 0.891 for KCL‐25; area under the curve 0.857 for KCL‐15). The optimal cut‐off points were 5/6 and 3/4, respectively. Conclusions: The findings suggest that both versions of the KCL, especially KCL‐15, showed adequate evidence of validity and internal consistency as a preliminary screening of frailty among community‐dwelling older adults in Spain. Geriatr Gerontol Int 2021; 21: 262–267. [ABSTRACT FROM AUTHOR]

Background the potential benefits of dual-task interventions on older adults living in long-term nursing homes (LTNHs) from a multidimensional perspective are unknown. We sought to determine whether the addition of simultaneous cognitive training to a multicomponent exercise program offers further benefits to dual-task, physical and cognitive performance, psycho-affective status, quality of life and frailty in LTNH residents. Design: a single-blind randomized controlled trial. Setting nine LTNHs in Gipuzkoa, Spain. Subjects 85 men and women (ACTRN12618000536268). Methods participants were randomly assigned to a multicomponent or dual-task training group. The multicomponent group performed two sessions per week of individualized and progressive strength and balance exercises for 3 months. The dual-task group performed simultaneous cognitive tasks to the same tasks as in the multicomponent group. Gait speed under single- and dual-task conditions, physical and cognitive performance, psycho-affective status, quality of life and frailty were measured at baseline and after 3 months of intervention. Results both groups showed clinically significant improvements on gait performance under single- and dual-task conditions and on the short physical performance battery (P  < 0.05). Both interventions were effective in maintaining cognitive function (P  > 0.05). Only the multicomponent group significantly improved quality of life, and reduced anxiety and Fried frailty score (P  < 0.05). No group-by-time interactions were found except for the chair-stand test in favour of the multicomponent group (P  < 0.05). Conclusions the addition of simultaneous cognitive training does not seem to offer significantly greater benefits to the evaluated multicomponent exercise program in older adults living in LTNHs. [ABSTRACT FROM AUTHOR]

Background: As a person ages, total body water (TBW), intracellular water (ICW), muscle mass and muscle strength tend to decline. The decline in ICW may reflect losses in the number of muscle cells but may also be responsible for less hydrated muscle cells.Aim: To assess whether TBW and ICW are associated with muscle strength, functional performance and frailty in an aged population, independently of muscle mass.Methodology: Design: An observational cross-sectional study of community-dwelling individuals aged 75 years and older. TBW, ICW, fat mass, lean mass and muscle mass were assessed by bioelectrical impedance analysis, frailty status was measured according to Fried criteria, handgrip strength was measured using the hand-held JAMAR dynamometer, and functional performance was measured according to the Barthel index and gait speed.Results: A total of 324 subjects were recruited (mean age 80.1 years, 47.5% women). TBW and ICW were closely correlated with muscle mass in both sexes. ICW was also associated with Barthel score, gait speed and frailty in both sexes and with handgrip in men. Considerable variability in ICW was observed for the same muscle mass. Multivariate analysis showed a positive effect of ICW on handgrip, functional performance and gait speed and a protective effect of ICW on frailty, independently of age, sex, body mass index and number of comorbidities.Conclusions: In elderly individuals with similar muscle mass, those with higher ICW had a better functional performance and a lower frailty risk, suggesting a protective effect of cell hydration, independently of muscle mass. [ABSTRACT FROM AUTHOR]

Background the association between vitamin intake and frailty has hardly been studied. The objective was to assess the association of dietary vitamin intake with incident frailty in older adults from Spain. Methods data came from a cohort of 1,643 community-dwelling individuals aged ≥65, recruited in 2008–10 and followed up prospectively throughout 2012. At baseline, 10 vitamins were assessed (vitamin A, thiamine, riboflavin, niacin, vitamins B6, B12, C, D, E and folates) using a validated face-to-face diet history. Incident frailty was identified using Fried's definition as having ≥3 of the following five criteria: unintentional weight loss of ≥4.5 kg, exhaustion, weakness, slow walking speed and low physical activity. Nonadherence to the recommended dietary allowances (RDA) was considered when the intake of a vitamin was below the recommendation. Analyses were performed with logistic regression and adjusted for main confounders. Results during a 3.5-year follow-up, 89 (5.4%) participants developed frailty. The odds ratios (95% confidence interval) of frailty for those in the lowest versus the highest tertile of vitamin intake were 2.80 (1.38–5.67), P -trend: 0.004, for vitamin B6; 1.65 (0.93–2.95), P -trend: 0.007, for vitamin C; 1.93 (0.99–3.83), P -trend: 0.06, for vitamin E and 2.34 (1.21–4.52), P -trend: 0.01, for folates. Nonadherence to the RDAs of vitamins was related to frailty for thiamine odds ratio (OR): 2.09 (1.03–4.23); niacin OR: 2.80 (1.46–5.38) and vitamin B6; 2.23 (1.30–3.83). When considering tertiles of RDAs for the 10 vitamins those who met <5 RDAs had a higher risk of frailty, OR: 2.84 (1.34–6.03); P -trend: <0.001, compared to those who met >7. Conclusion a lower intake of vitamins B6, C, E and folates was associated with a higher risk of frailty. Not meeting RDAs for vitamins was also strongly associated. [ABSTRACT FROM AUTHOR]