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Featured Application: The main finding shows that characteristics assessed using the G-STRIDE device can effectively stratify participants according to their state of frailty and occurrence of falls. Background: The World Health Organization recommends health initiatives focused on the early detection of frailty and falls. Objectives: 1—To compare clinical characteristics, functional performance and gait parameters (estimated with the G-STRIDE inertial sensor) between different frailty groups in older adults with and without falls. 2—To identify variables that stratify participants according to frailty status and falls. 3—To verify the sensitivity, specificity and accuracy of the model that stratifies participants according to frailty status and falls. Methods: Observational, multicenter case-control study. Participants, adults over 70 years with and without falls were recruited from two outpatient clinics and three nursing homes from September 2021 to March 2022. Clinical variables and gait parameters were gathered using the G-STRIDE inertial sensor. Random Forest regression was applied to stratify participants. Results: 163 participants with a mean age of 82.6 ± 6.2 years, of which 118 (72%) were women, were included. Significant differences were found in all gait parameters (both conventional assessment and G-STRIDE evaluation). A hierarchy of factors contributed to the risk of frailty and falls. The confusion matrix and the performance metrics demonstrated high accuracy in classifying participants. Conclusions: Gait parameters, particularly those assessed by G-STRIDE, are effective in stratifying individuals by frailty status and falls. These findings underscore the importance of gait analysis in early intervention strategies. [ABSTRACT FROM AUTHOR]

Background: Vitamin D may have immunomodulatory functions, and might therefore play a role in the pathogenesis of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, no conclusive evidence exists regarding its impact on the prevalence of this infection, the associated course of disease, or prognosis. Objective: To study the association between SARS-CoV-2 infection and vitamin D deficiency in patients attending a tertiary university hospital, and to examine the clinical course of infection and prognosis for these patients. Methods: This non-interventional, retrospective study, which involved big-data analysis and employed artificial intelligence to capture data from free text in the electronic health records of patients diagnosed with SARS-CoV-2, was undertaken at a tertiary university hospital in Madrid, Spain, between March 2020 and March 2021. The variables recorded were vitamin D deficiency, sociodemographic and clinical characteristics, course of disease, and prognosis. Results: Of the 143,157 patients analysed, 36,261 had SARS-CoV-2 infection (25.33%) during the study period, among whom 2,588 (7.14%) had a vitamin D deficiency. Among these latter patients, women (OR 1.45 [95%CI 1.33–1.57]), adults over 80 years of age (OR 2.63 [95%CI 2.38–2.91]), people living in nursing homes (OR 2.88 [95%CI 2.95–3.45]), and patients with walking dependence (OR 3.45 [95%CI 2.85–4.26]) appeared in higher proportion. After adjusting for confounding factors, a higher proportion of subjects with SARS-CoV-2 plus vitamin D deficiency required hospitalisation (OR 1.38 [95%CI 1.26–1.51]), and had a longer mean hospital stay (3.94 compared to 2.19 days in those with normal levels; P = 0.02). Conclusion: A low serum 25(OH) vitamin D concentration in patients with SARS-CoV-2 infection is significantly associated with a greater risk of hospitalisation and a longer hospital stay. Among such patients, higher proportions of institutionalised and dependent people over 80 years of age were detected. [ABSTRACT FROM AUTHOR]

Objectives: The main objective was to analyze the evolution of muscle of the Quadriceps Rectus Femoris (QRF) between admission and discharge, in older adults hospitalized with an acute medical disease in Acute Geriatric Units (AGUs)., Design: Prospective multicentric observational cohort study., Setting: Seven AGUs from University Hospitals in Spain., Participants: Hospitalized adults ≥ 70 years old, able to ambulate and without severe dementia., Measurements: Ultrasound measurements of QRF were acquired at 2/3 distal between anterior-superior iliac spine and patella in both legs by trained Geriatricians. Ultrasound Chison model ECO2 was used. QRF area, thickness, edema, echogenicity, and fasciculations were measured., Results: From the complete sample (n = 143), in 45 (31.5%) participants, ultrasound images were classified as non-valid by an expert radiologist. Mean age was 87.8 (SD 5.4). Mean hospital stay 7.6 days (SD 4.3). From those with valid images, 36 (49.3%), 2 (2.7%), and 35 (47.9%) presented a decrease, equal values, or an increase in QRF area from baseline to discharge, respectively, and 37 (50.0%), 2 (2.7%), and 35 (47.3%) presented a decrease, equal values, or an increase in QRF thickness, respectively. 26 (35.6%) presented a decrease in more than 0.2 cm 2 of QRF area, and 23 (31.1%) a decrease in more than 0.1 cm of QRF thickness. Only 4 (5.4%) patients presented new edema, while 13 (17.6%) worsened echogenicity., Conclusion: One third of older adults develop significant muscle loss during a hospitalization for acute medical diseases., Trial Registration Number: NCT05113758., (Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Falls are one of the classic giant geriatric syndromes with a multifactorial etiopathogenesis and closely related to frailty, being this relationship bidirectional. The Consensus Document on the Prevention of Frailty and Falls approved by the Interterritorial Council of the National Health System in 2014 provides recommendations for the screening of frailty and falls in all older adults in order to develop a management plan in high risk older adults so to prevent disability. This review describes the intrinsic relationship between frailty and falls, falls assessment and screening instruments to use and detect frailty and finally gives evidence-based recommendations to reduce falls impact.

Introduction: There are no previous studies evaluating the effect of intravenous iron therapy on functional and cognitive status of patients with hip fracture (HF)., Material and Methods: A single-centre randomised, placebo-controlled, double-blind and parallel treatment, clinical trial has been designed to assess the efficacy of intravenous iron therapy during the peri-operative period in elderly patients suffering from a HF. Blinding will be ensured by the packaging of the drug infusion system. On days 1, 3, and 5 from admission, the intervention group will receive 200mg Venofer® (iron sucrose) diluted in 100ml saline, and the control group 100ml saline, also on days 1, 3 and 5. Patients will received conventional treatment in ortho-geriatric unit of the Hospital Infanta Sofia. Functional variables (activities of daily living and walking), cognitive (cognitive status and delirium), surgical, demographic and clinical characteristics will be collected during admission in order to assess the impact of treatment. A safety analysis of the treatment will also performed. Patients will be followed-up at 3, 6, and 12 months., Results: The study will attempt to provide evidence on the impact of the intravenous iron administration on functional recovery. It will be determined whether iron therapy negatively affects the incidence of post-operative delirium. Finally, report will be presented on the safety data of intravenous iron in elderly HF patients, as well as the impact on allogenic blood transfusion savings., Conclusions: The inclusion of elderly HF patients admitted to an ortho-geriatric unit, in a clinical trial, will help to improve the knowledge of the treatment impact on a usual scenario, and provide useful data for use in other units., (Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The use of proton pump inhibitors (PPI) has increased exponentially since they were introduced. However concerns have been raised regarding the appropriateness of these prescriptions, and the potential side effects, particularly in frail elderly people, as well as the cost of this treatment. The aim of this study was to assess the extent and appropriateness of PPI prescribing in a group of patients over 65 years old admitted to the functional recovery unit of a medium-stay hospital., Materials and Methods: A retrospective review of inpatient prescribing of PPI was carried out in a functional recovery unit in Hospital de la Fuenfría, selecting those older than 65 years, who were admitted during 2011. Data obtained from medical records included, prescription of a PPI before admission and at the time of discharge from hospital (both acute care hospital and Hospital de la Fuenfría), type of PPI, and indications for their prescription., Results: Inclusion criteria were met by 296 patients (mean age 78.8 years, 70.6% females). A total of 45.3, 79.1 and 75.5% of patients were on PPIs before admission, and at the time of being discharge from acute care hospital, and Hospital de la Fuenfría, respectively. A valid indication for therapy was not apparent in 62.7, 30.8 and 54.2% of them. Omeprazole was the most widely prescribed PPI., Conclusions: There appears to be a widespread and inappropriate use of PPIs in hospital practice. Interventions are needed to curtail this inappropriate prescribing practice, avoiding side effects and drug interactions., (Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.)